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Materials (Basel, Switzerland) Aug 2022The toxicological risk of Co-Cr dental alloys is actually a sensitive subject with the European regulatory changes, namely regulation (EU) 2017/745 and annex VI to the... (Review)
Review
The toxicological risk of Co-Cr dental alloys is actually a sensitive subject with the European regulatory changes, namely regulation (EU) 2017/745 and annex VI to the CLP regulation (EC) 1972/2008. : The objective of this review is to conduct a rigorous analysis of the cytocompatibility of cobalt-chromium (Co-Cr) dental alloys. Considering various parameters such as cytotoxicity, type IV hypersensitivity reaction, sensitization, and irritation, we investigated evidence of toxicity of Co-Cr in human dental applications. : Specific search strategies were performed in three electronic databases, namely , , and , using a main restriction in the search regarding the publication date (1995-2022). : Out of a total of 836 articles, only 21 studies were selected and analyzed according to PRISMA methodology. : Among them, 10 in vitro studies using human samples and 11 in vivo studies on human patients were distinguished. Most of the in vitro studies confirmed that Co-Cr alloys have a good cytocompatibility compared to Ni alloys. Regarding the in vivo studies, it appeared that Co-Cr could rarely cause sensitization, irritation, and allergic reactions. Reactions were mainly observed for people allergic to Co or Cr. Nevertheless, titanium-based materials showed better results. : This study proposes a new state of the art on Co-Cr dental alloys and will thus be very useful for carrying out additional studies. : This review will help practitioners in their daily clinical choice.
PubMed: 36079183
DOI: 10.3390/ma15175801 -
Clinical Oral Investigations Jul 2021Microsurgical principles, techniques, and armamentarium have made significant contributions to the periodontal plastic surgery. The present meta-analysis aimed to... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Microsurgical principles, techniques, and armamentarium have made significant contributions to the periodontal plastic surgery. The present meta-analysis aimed to investigate the overall efficacy of microsurgery on root coverage, and its clinical outcomes when compared to traditional macrosurgery.
MATERIAL AND METHODS
Electronic searches on PubMed, Embase, and CINAHL were used to retrieve prospective clinical trials. Primary outcomes were the mean root coverage (mRC) and probability of achieving complete root coverage (cRC), with secondary outcomes as other periodontal parameters and patient-reported outcome measures (PROMs).
RESULTS
Nineteen studies were included in the quantitative analysis. Microsurgery was estimated to achieve 83.3% mRC and 69.3% cRC. From a subgroup of 9 comparative studies, it was estimated microsurgery increased mRC by 6.6% (p<0.001) and cRC by 27.9% (p<0.01) compared to macrosurgical control treatments. Operating microscope (OM) yielded a significantly 6.7% higher mRC than the control group (p=0.002), while using loupes showed 6.16% increase in mRC with a borderline significance (p=0.09). OM and loupes-only had a 31.05% (p=0.001) and 25.54% (p=0.001) increases in achieving cRC compared to control, respectively. As for PROMs, microsurgery reduced postoperative pain (p<0.001) and enhanced esthetics (p= 0.05).
CONCLUSIONS
Microsurgery significantly improved mean root coverage, probability of achieving complete root coverage, esthetics, and post-surgical recovery. Microsurgery enhances not only subclinical healing but also clinical outcomes, possibly owing to its minimally invasive approach and surgical precision.
CLINICAL RELEVANCE
Periodontal plastic microsurgery is minimally invasive, inducing less surgical trauma and ultimately resulting in improved clinical outcomes, patient's satisfaction, and quality of life.
Topics: Connective Tissue; Esthetics, Dental; Gingiva; Gingival Recession; Humans; Microsurgery; Prospective Studies; Quality of Life; Surgical Flaps; Tooth Root; Treatment Outcome
PubMed: 33928441
DOI: 10.1007/s00784-021-03954-0 -
QJM : Monthly Journal of the... Dec 2011Since its introduction, the cobalt chromium alloy MULTI-LINK VISION stent (MLV) has been extensively investigated thus leading to the largest amount of data so far... (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND
Since its introduction, the cobalt chromium alloy MULTI-LINK VISION stent (MLV) has been extensively investigated thus leading to the largest amount of data so far available for a bare metal stent. Aim and
METHODS
Systematic review and meta-analysis (according to Cochrane collaboration guidelines) aiming at summarizing the real world safety and efficacy of MLV stent. Endpoints of interest were: major adverse events [(MAE) combination of overall death and non-fatal myocardial infarction, MI], and target vessel revascularization (TVR). Rate of stent thrombosis was also assessed.
RESULTS
Eleven studies finally retrieved totalling 5539 patients [7 study registries, 4243 patients and 4 randomized controlled trials (RCTs) comparing MLV vs. first generation of drug-eluting stent (DES) (paclitaxel or sirolimus eluting), (RCTs) 1296 patients]. Across study registries, at a mean follow-up of 11.1 months, MLV was associated with a 5.3% risk of MAE, 3% of death, 2.3% of MI and a 9% of TVR. Risk of ST was 0.5%. Compared to first generation of DES in RCTs, at a mean follow-up of 10.5 months, MLV achieved similar results in terms of MAE, death and MI. On the other hand, MLV was associated with a double risk of TVR [OR 2.01 (1.34-3.01), P < 0.001, number needed to treat 18 (13-40)]. Overall, in stent late loss with MLV was 0.81 mm (±0.51), while the in segment late loss was 0.61 mm (±0.5). Risk of stent thrombosis was equivalent. Of note, performance of MLV in terms of safety, efficacy and risk of repeat revascularization was quite consistent across all the published studies, despite inherent differences in study design, clinical setting, complexity of the lesions and ethnicity.
CONCLUSION
Compared to first-generation DES, MLV showed substantial equivalence with respect to hard clinical endpoints. Data are consistent in study registries and RCTs meaning that the overall performance of MLV is quite predictable and reproducible into the wide spectrum of clinical settings.
Topics: Chromium Alloys; Coronary Stenosis; Drug-Eluting Stents; Female; Humans; Immunosuppressive Agents; Male; Myocardial Infarction; Myocardial Revascularization; Paclitaxel; Randomized Controlled Trials as Topic; Registries; Risk Factors; Sirolimus; Stents; Thrombosis; Treatment Outcome; Tubulin Modulators
PubMed: 21896624
DOI: 10.1093/qjmed/hcr138 -
The Cochrane Database of Systematic... Oct 2009Dental caries (tooth decay) is one of the commonest diseases which afflicts mankind, and has been estimated to affect up to 80% of people in high-income countries.... (Review)
Review
BACKGROUND
Dental caries (tooth decay) is one of the commonest diseases which afflicts mankind, and has been estimated to affect up to 80% of people in high-income countries. Caries adversely affects and progressively destroys the tissues of the tooth, including the dental pulp (nerve), leaving teeth unsightly, weakened and with impaired function. The treatment of lesions of dental caries, which are progressing through dentine and have caused the formation of a cavity, involves the provision of dental restorations (fillings).
OBJECTIVES
To assess the effects of adhesive bonding on the in-service performance and longevity of restorations of dental amalgam.
SEARCH STRATEGY
Databases searched July 2009: the Cochrane Oral Health Group's Trials Register; CENTRAL (The Cochrane Library 2009, Issue 3); MEDLINE (1950 to July 2009); and EMBASE (1980 to July 2009).
SELECTION CRITERIA
Randomised controlled trials comparing adhesively bonded versus traditional non-bonded amalgam restorations in conventional preparations utilising deliberate retention, in adults with permanent molar and premolar teeth suitable for Class I and II amalgam restorations only.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened papers, extracted trial details and assessed the risk of bias in the included study.
MAIN RESULTS
One trial with 31 patients who received 113 restorations was included. At 2 years only 3 out of 53 restorations in the non-bonded group were lost, which was attributed to a lack of retention, and 55 of 60 bonded restorations survived with five unaccounted for at follow-up. Post-insertion sensitivity was not significantly different (P > 0.05) at baseline or 2-year follow-up. No fractures of tooth tissue were reported and there was no significant difference between the groups or matched pairs of restorations in their marginal adaptation (P > 0.05).
AUTHORS' CONCLUSIONS
There is no evidence to either claim or refute a difference in survival between bonded and non-bonded amalgam restorations. This review only found one methodologically sound but somewhat under-reported trial. This trial did not find any significant difference in the in-service performance of moderately sized adhesively bonded amalgam restorations, in terms of their survival rate and marginal integrity, in comparison to non-bonded amalgam restorations over a 2-year period. In view of the lack of evidence on the additional benefit of adhesively bonding amalgam in comparison with non-bonded amalgam, it is important that clinicians are mindful of the additional costs that may be incurred.
Topics: Adult; Dental Amalgam; Dental Bonding; Dental Caries; Dental Restoration Failure; Dental Restoration, Permanent; Humans
PubMed: 19821423
DOI: 10.1002/14651858.CD007517.pub2 -
Journal of the American Dental... Apr 2020The authors aimed to compare the survival and complication rates of zirconia-ceramic (ZC) versus metal-ceramic (MC) restorative material in multiunit tooth-supported... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The authors aimed to compare the survival and complication rates of zirconia-ceramic (ZC) versus metal-ceramic (MC) restorative material in multiunit tooth-supported posterior fixed dental prostheses (FDP).
TYPES OF STUDIES REVIEWED
The authors conducted a systematic search of randomized controlled trials (RCTs), with no time or language restrictions, up to May 2019 using the MEDLINE (PubMed), Scopus, Web of Science, and Cochrane Central Register of Controlled Trials databases, followed by a manual search.
RESULTS
The authors included 7 RCTs in the review and 5 RCTs in the meta-analysis. All studies had a low risk of bias. The authors included 330 participants (177 ZC and 173 MC tooth-supported FDP) in the meta-analysis, which revealed a medium-term survival rate of 95.4% (95% confidence interval [CI], 90.5% to 99.1%) for ZC FDP compared with 96.9% (95% CI, 94.3% to 99.4%) for MC FDP, with no significant differences (P = .364). The biological or technical complications did not show statistically significant differences, except in the global ceramic veneering chipping analysis (P = .023; risk difference [RD], 22.3%; 95% CI, 3.0% to 41.6%) and their subanalysis: minor chipping or chipping that can be solved with polishing (P = .044; RD, 19.5%; 95% CI, 0.5% to 38.4%), and major chipping or chipping that needs repair in the laboratory (P = .023; RD, 6.0%; 95% CI, 0.8% to 11.3%).
CONCLUSIONS AND PRACTICAL IMPLICATIONS
Posterior multiunit ZC restorations are considered a predictable treatment in the medium term, although they are slightly more susceptible to chipping of the veneering ceramic than MC restorations.
Topics: Ceramics; Dental Porcelain; Dental Prosthesis Design; Dental Restoration Failure; Denture, Partial, Fixed; Metal Ceramic Alloys; Randomized Controlled Trials as Topic; Zirconium
PubMed: 32222175
DOI: 10.1016/j.adaj.2019.12.013 -
The Cochrane Database of Systematic... Feb 2014Amalgam is a common filling material for posterior teeth, as with any restoration amalgams have a finite life-span. Traditionally replacement was the ideal approach to... (Review)
Review
BACKGROUND
Amalgam is a common filling material for posterior teeth, as with any restoration amalgams have a finite life-span. Traditionally replacement was the ideal approach to treat defective amalgam restorations, however, repair offers an alternative more conservative approach where restorations are only partially defective. Repairing a restoration has the potential of taking less time and may sometimes be performed without the use of local anaesthesia hence it may be less distressing for a patient when compared with replacement. Repair of amalgam restorations is often more conservative of the tooth structure than replacement.
OBJECTIVES
To evaluate the effects of replacing (with amalgam) versus repair (with amalgam) in the management of defective amalgam dental restorations in permanent molar and premolar teeth.
SEARCH METHODS
For the identification of studies relevant to this review we searched the Cochrane Oral Health Group's Trials Register (to 5 August 2013); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 7); MEDLINE via OVID (1946 to 5 August 2013); EMBASE via OVID (1980 to 5 August 2013); BIOSIS via Web of Knowledge (1969 to 5 August 2013); Web of Science (1945 to 5 August 2013) and OpenGrey (to 5 August 2013). Researchers, experts and organisations known to be involved in this field were contacted in order to trace unpublished or ongoing studies. No restrictions were placed on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
Trials were selected if they met the following criteria: randomised controlled trial (including split-mouth studies), involving replacement and repair of amalgam restorations in adults with a defective restoration in a molar or premolar tooth/teeth.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed titles and abstracts for each article identified by the searches in order to decide whether the article was likely to be relevant. Full papers were obtained for relevant articles and both review authors studied these. The Cochrane Collaboration statistical guidelines were to be followed for data synthesis.
MAIN RESULTS
The search strategy retrieved 201 potentially eligible studies after de-duplication. After examination of the titles and abstracts, full texts of the relevant studies were retrieved but none of these met the inclusion criteria of the review.
AUTHORS' CONCLUSIONS
There are no published randomised controlled trials relevant to this review question. There is therefore a need for methodologically sound randomised controlled trials that are reported according to the Consolidated Standards of Reporting Trials (CONSORT) statement (www.consort-statement.org/). Further research also needs to explore qualitatively the views of patients on repairing versus replacement and investigate themes around pain, distress and anxiety, time and costs.
Topics: Adult; Dental Amalgam; Dental Restoration Failure; Dental Restoration, Permanent; Humans; Retreatment
PubMed: 24510713
DOI: 10.1002/14651858.CD005970.pub3 -
The Journal of Prosthetic Dentistry Dec 2013The increasing demand by patients for esthetic and metal-free restorations has driven the development of ceramic restorations with good esthetic and mechanical... (Comparative Study)
Comparative Study Review
STATEMENT OF PROBLEM
The increasing demand by patients for esthetic and metal-free restorations has driven the development of ceramic restorations with good esthetic and mechanical stability. Recent clinical studies have investigated the use of zirconium dioxide as a core material for complete crowns and computer-aided-design/computer-aided-manufacturing fabricated restorations.
PURPOSE
The aim of this systematic review was to evaluate the clinical survival rates of porcelain-fused-to-zirconia (PFZ) single crowns on anterior and posterior teeth and to compare them with metal ceramic (MC) crowns.
MATERIAL AND METHODS
A systematic search was conducted with PubMed and manual research to identify literature written in English that refers to in vivo studies published from January 1, 1950 through July 1, 2011. Clinical trials that evaluated PFZ and MC single crowns on natural teeth were selected for further analysis. Titles and/or abstracts of articles identified through the electronic searches were reviewed and evaluated for appropriateness. In addition, a hand search of relevant dental journals was peformed, and reference lists of culled articles were screened to identify publications.
RESULTS
The search resulted in a total of 488 initial matches. Nineteen studies with a total of 3621 crowns met the inclusion criteria. The survival rates of PFZ crowns (total 300) ranged from 92.7% to 100% for a follow-up time of 24 to 39 months, whereas those of MC crowns (total 3321) ranged from 70% to 100% for a follow-up time of 12 to 298 months. Studies that reported long-term results were found only for the MC crown group.
CONCLUSIONS
The scientific clinical data available to compare PFZ and MC crowns are limited. The survival rates may well be influenced by the selection and appropriate use of the veneering ceramic, and, therefore, additional prospective long-term clinical trials are necessary to draw reliable conclusions.
Topics: Crowns; Dental Cements; Dental Materials; Dental Porcelain; Dental Prosthesis Design; Dental Restoration Failure; Humans; Metal Ceramic Alloys; Treatment Outcome; Zirconium
PubMed: 24169079
DOI: 10.1016/j.prosdent.2013.09.015 -
The International Journal of... Feb 2024The purpose of this systematic review and meta-analysis was to compare the influence of fabrication method (conventional, subtractive, and additive procedures) and... (Meta-Analysis)
Meta-Analysis
Influence of the Manufacturing Trinomial (Technology, Printer, and Material) on the Marginal and Internal Discrepancies of Printed Metal Frameworks for the Fabrication of Tooth-Supported Prostheses: A Systematic Review and Meta-analysis.
PURPOSE
The purpose of this systematic review and meta-analysis was to compare the influence of fabrication method (conventional, subtractive, and additive procedures) and manufacturing trinomial (technology, printer, and material combination) on the marginal and internal fit of cobaltchromium (Co-Cr) tooth-supported frameworks.
MATERIALS AND METHODS
An electronic systematic review was performed in five data bases: MEDLINE/PubMed, Embase, World of Science, Cochrane, and Scopus. Studies that reported the marginal and internal discrepancies of tooth-supported Co-Cr additive manufacturing (AM) frameworks were included. Two authors independently completed the quality assessment of the studies by applying the Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies. A third examiner was consulted to resolve lack of consensus.
RESULTS
A total of 31 articles were included and classified based on the evaluation method: manufacturing accuracy, the dual- or triple-scan method, stereomicroscope, optical coordinate measurement machine, microCT, profilometer, and silicone replica. Six subgroups were created: 3D Systems, Bego, Concept Laser, EOS, Kulzer, and Sisma. Due to the heterogeneity and limited data available, only the silicone replica group was considered for meta-analysis. The metaanalysis showed a mean marginal discrepancy of 91.09 μm (I2 = 95%, P < .001) in the conventional group, 77.48 μm (I2 = 99%, P < .001) in the milling group, and 82.92 μm (I2 = 98%, P < .001) in the printing group. Additionally, a mean internal discrepancy of 111.29 μm (I2 = 94%, P < .001) was obtained in the conventional casting group, 121.96 μm (I2 = 100%, P < .001) in the milling group, and 121.25 μm (I2 = 99%, P < .001) in the printing group.
CONCLUSIONS
Manufacturing method and selective laser melting (SLM) metal manufacturing trinomial did not impact the marginal and internal discrepancies of Co-Cr frameworks for the fabrication of tooth-supported restorations.
Topics: Humans; Computer-Aided Design; Chromium Alloys; Dental Marginal Adaptation; Printing, Three-Dimensional; Denture Design; Dental Prosthesis Design; Technology, Dental; Dental Materials
PubMed: 38819942
DOI: 10.11607/ijp.8830 -
Clinical Oral Implants Research Sep 2009The objective of this systematic review was to assess the 5-year survival rates and incidences of complications associated with ceramic abutments and to compare them... (Comparative Study)
Comparative Study Review
OBJECTIVES
The objective of this systematic review was to assess the 5-year survival rates and incidences of complications associated with ceramic abutments and to compare them with those of metal abutments.
METHODS
An electronic Medline search complemented by manual searching was conducted to identify randomized-controlled clinical trials, and prospective and retrospective studies providing information on ceramic and metal abutments with a mean follow-up time of at least 3 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data abstraction was performed independently by three reviewers. Failure rates were analyzed using standard and random-effects Poisson regression models to obtain summary estimates of 5-year survival proportions.
RESULTS
Twenty-nine clinical and 22 laboratory studies were selected from an initial yield of 7136 titles and data were extracted. The estimated 5-year survival rate of ceramic abutments was 99.1% [95% confidence interval (CI): 93.8-99.9%] and 97.4% (95% CI: 96-98.3%) for metal abutments. The estimated cumulative incidence of technical complications after 5 years was 6.9% (95% CI: 3.5-13.4%) for ceramic abutments and 15.9% (95% CI: 11.6-21.5%) for metal abutments. Abutment screw loosening was the most frequent technical problem, occurring at an estimated cumulative incidence after 5 years of 5.1% (95% CI: 3.3-7.7%). All-ceramic crowns supported by ceramic abutments exhibited similar annual fracture rates as metal-ceramic crowns supported by metal abutments. The cumulative incidence of biological complications after 5 years was estimated at 5.2% (95% CI: 0.4-52%) for ceramic and 7.7% (95% CI: 4.7-12.5%) for metal abutments. Esthetic complications tended to be more frequent at metal abutments. A meta-analysis of the laboratory data was impossible due to the non-standardized test methods of the studies included.
CONCLUSION
The 5-year survival rates estimated from annual failure rates appeared to be similar for ceramic and metal abutments. The information included in this review did not provide evidence for differences of the technical and biological outcomes of ceramic and metal abutments. However, the information for ceramic abutments was limited in the number of studies and abutments analyzed as well as the accrued follow-up time. Standardized methods for the analysis of abutment strength are needed.
Topics: Alveolar Bone Loss; Animals; Crowns; Dental Abutments; Dental Porcelain; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Dental Stress Analysis; Denture, Partial, Fixed; Gingival Recession; Gold Alloys; Humans; Survival Analysis; Titanium
PubMed: 19663946
DOI: 10.1111/j.1600-0501.2009.01787.x -
The Journal of Prosthetic Dentistry Jun 2023High-power laser irradiation may be a promising treatment for titanium dental implant surfaces. However, systematic reviews of the influence of high-power laser... (Review)
Review
STATEMENT OF PROBLEM
High-power laser irradiation may be a promising treatment for titanium dental implant surfaces. However, systematic reviews of the influence of high-power laser irradiation on the different properties of titanium surfaces are lacking.
PURPOSE
The purpose of this systematic review was to analyze the influence of surface treatment by high-power laser irradiation on the surface properties of titanium and its alloys.
MATERIAL AND METHODS
The PubMed, LILACS, COCHRANE library, and Science Direct databases were searched, and articles published in the last 10 years were included. Of the 725 articles initially identified, 27 were selected after full reading and the application of inclusion and exclusion criteria.
RESULTS
The studies evaluated showed that laser irradiation treatment, depending on the settings and parameters used, promoted changes in the surface properties of titanium. In general, lower speed and a higher number of scans increased roughness. Laser surface treatment promoted the inclusion of more oxygen and improved the wetting capacity of titanium. Additionally, laser treatment improved the adherence of coatings.
CONCLUSIONS
Changes in the surface properties of titanium after laser treatment have been demonstrated. However, determining protocols with specific parameters is necessary to optimize the results.
Topics: Titanium; Dental Implants; Microscopy, Electron, Scanning; Surface Properties; Lasers
PubMed: 34493390
DOI: 10.1016/j.prosdent.2021.07.026