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The International Journal of Oral &... 2016Multiple bone augmentation techniques are available to allow implant placement in the atrophic maxilla. However, questions remain, regarding which methods are most... (Review)
Review
PURPOSE
Multiple bone augmentation techniques are available to allow implant placement in the atrophic maxilla. However, questions remain, regarding which methods are most predictable and have the best dental implant survival rate (SR) in grafted bone. The aim of this systematic review was to evaluate literature from the last 30 years to determine predictability of bone grafting of the edentulous maxilla for implant placement as well as for implant SR.
MATERIALS AND METHODS
A systematic review was performed of studies conducted during the period 1980 to 2014, specifically focusing on the edentulous maxilla and bone grafting. Surgical techniques discussed in the publications included were guided bone regeneration (GBR), sinus augmentation, onlay bone grafting, nasal floor grafting, and Le Fort I interpositional grafting. All identified articles were evaluated and screened to meet strict inclusion criteria of at least 10 patients, complete maxillary edentulism, 1-year follow-up, and information regarding implant SR. A total of 974 articles were identified with electronic and manual searches. On further evaluation of the titles and abstracts, 44 articles were excluded. Full texts of the articles that met the inclusion criteria were reviewed, of which 40 articles were included in the systematic review.
RESULTS
For onlay bone grafting, 16 studies were included and analyzed, and the weighted mean implant SR was 85.2%. For the GBR technique, two studies were included, with a reported SR ranging from 96.1% to 100%. For Le Fort I interpositional grafting, 11 studies were included, with a weighted mean SR of 89.6%. For the sinus augmentation technique, 12 studies were investigated and the weighted mean SR was 91.5%. For the combination technique, six studies were analyzed and the weighted mean SR was 93.6%.
CONCLUSIONS
All five treatment modalities discussed-onlay bone grafting, GBR, Le Fort I interpositional grafting, maxillary sinus augmentation, and/or nasal floor inlay grafting or the combination approach-can be successfully used to augment edentulous maxillary ridge with high implant SRs.
Topics: Alveolar Ridge Augmentation; Bone Transplantation; Dental Implantation, Endosseous; Dental Implants; Humans; Jaw, Edentulous; Maxilla; Maxillary Sinus
PubMed: 27228250
DOI: 10.11607/jomi.16suppl.g1 -
The European Journal of Prosthodontics... Sep 2014The purpose of this study is to review the available literature related to composite inlays. Electronic databases published up to November 2013 were searched. Studies... (Comparative Study)
Comparative Study Review
The purpose of this study is to review the available literature related to composite inlays. Electronic databases published up to November 2013 were searched. Studies that evaluate composite resin inlays for the restoration of posterior teeth were selected. The studies should compare composite inlays against gold inlays, ceramic inlays and direct composite fillings regarding longevity, aesthetic quality and postoperative sensitivity or comparing the clinical effectiveness of them on premolars versus molars or on 1-2 surface preparations versus multi-surface preparations. Despite the heterogeneity of the available clinical trials composite inlays seem to be an effective method for the restoration of posterior teeth.
Topics: Ceramics; Composite Resins; Dental Materials; Dental Restoration, Permanent; Esthetics, Dental; Gold Alloys; Humans; Inlays
PubMed: 25831713
DOI: No ID Found -
Clinical Implant Dentistry and Related... Feb 2024The primary aim of this systematic review was to investigate and compare the outcomes of different vertical ridge augmentation (VRA) techniques in relation to... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
The primary aim of this systematic review was to investigate and compare the outcomes of different vertical ridge augmentation (VRA) techniques in relation to peri-implant bone loss (PBL), after at least 12 months of functional loading.
MATERIAL AND METHODS
The search was conducted to find all the studies about VRA and measurements of PBL with at least 12 months follow-up. Three pairwise meta-analysis (MA) was performed to completely evaluate the outcomes.
RESULTS
A total of 42 studies were included, of which 11 were randomized clinical trials (RCTs). RCTs were available only for guided bone regeneration (GBR), onlay, and inlay techniques. The weighted mean estimate (WME) of PBL value was found to be 1.38 mm (95% confidence interval [95% CI]: 1.10-1.66) after a mean follow-up of 41.0 ± 27.8 months. GBR, Inlay, Onlay, osteodistraction, and SBB represented in weight 32.9%, 30.6%, 25.0%, 7.6%, and 3.9%, respectively; and their WME (95% CI) were 1.06 (0.87-1.26) mm, 1.72 (1.00-2.43) mm, 1.31 (0.87-1.75) mm, 1.81 (0.87-1.75) mm, and 0.66 (0.55-0.77) mm, respectively. Among the secondary outcomes, the analysis was conducted for vertical bone gain, healing complication rate, surgical complication rate, implant survival, and success rate.
CONCLUSIONS
The primary findings of the meta-analysis, based on the changes between final and baseline values, showed that the peri-implant bone loss could be influenced by the type of intervention but there is a need to evaluate in RCTs the behavior of the peri-implant bone levels after long-term follow-up for all techniques.
Topics: Dental Implantation, Endosseous; Dental Implants; Alveolar Ridge Augmentation; Bone Transplantation; Bone Regeneration
PubMed: 38114425
DOI: 10.1111/cid.13282 -
Clinical Oral Investigations Mar 2003The purpose of the present study was to conduct a systematic review of ceramic inlays, assess the quality of published clinical studies, and determine the clinical... (Review)
Review
The purpose of the present study was to conduct a systematic review of ceramic inlays, assess the quality of published clinical studies, and determine the clinical effectiveness of ceramic inlays compared to other forms of posterior restorations. Prospective clinical trials of ceramic inlays published from 1990 to 2001 were retrieved by electronic and hand searching. The methodological quality of each study was assessed by two calibrated reviewers using a standardised checklist. The clinical effectiveness of ceramic inlays was evaluated in terms of failure rate, postoperative pain, and aesthetics. The results were compared to those of other forms of posterior restorations by means of an odds ratio. Among 46 articles selected for quality assessment, only five (10.6%) reported randomised controlled trials and 15 (32.6%) presented controlled clinical trials. The remaining 26 papers (56.5%) were longitudinal clinical trials lacking control groups. Only three papers fulfilled the requirement for statistical analysis to evaluate the clinical effectiveness of ceramic inlays. The results indicate no significant differences in longevity or postoperative sensitivity between ceramic and other posterior restorations over assessment periods of up to 1 year. It is concluded that no strong evidence is available to confirm the clinical effectiveness of ceramic inlays in comparison to other posterior restorations. Greater attention is required to the design and reporting of studies to improve the quality of clinical trials of ceramic inlays.
Topics: Clinical Trials as Topic; Data Interpretation, Statistical; Dental Porcelain; Dental Restoration Failure; Humans; Inlays; Journalism, Dental; Logistic Models; Observer Variation; Odds Ratio; Reproducibility of Results; Research Design
PubMed: 12673432
DOI: 10.1007/s00784-002-0186-z -
The International Journal of Oral &... 2007A variety of techniques and materials have been used to establish the structural base of osseous tissue for supporting dental implants. The aim of this systematic review... (Review)
Review
PURPOSE
A variety of techniques and materials have been used to establish the structural base of osseous tissue for supporting dental implants. The aim of this systematic review was to identify the most successful technique(s) to provide the necessary alveolar bone to place a dental implant and support long-term survival.
METHODS
A systematic online review of a main database and manual search of relevant articles from refereed journals were performed between 1980 and 2005. Updates and additions were made from September 2004 to May 2005. The hard tissue augmentation techniques were separated into 2 anatomic sites, the maxillary sinus and alveolar ridge. Within the alveolar ridge augmentation technique, different surgical approaches were identified and categorized, including guided bone regeneration (GBR), onlay/veneer grafting (OVG), combinations of onlay, veneer, interpositional inlay grafting (COG), distraction osteogenesis (DO), ridge splitting (RS), free and vascularized autografts for discontinuity defects (DD), mandibular interpositional grafting (MI), and socket preservation (SP). All identified articles were evaluated and screened by 2 independent reviewers to meet strict inclusion criteria. Articles meeting the inclusion criteria were further evaluated for data extraction. The initial search identified a total of 526 articles from the electronic database and manual search. Of these, 335 articles met the inclusion criteria after a review of the titles and abstracts. From the 335 articles, further review of the full text of the articles produced 90 articles that provided sufficient data for extraction and analysis.
RESULTS
For the maxillary sinus grafting (SG) technique, the results showed a total of 5,128 implants placed, with follow-up times ranging from 12 to 102 months. Implant survival was 92% for implants placed into autogenous and autogenous/composite grafts, 93.3% for implants placed into allogeneic/nonautogenous composite grafts, 81% for implants placed into alloplast and alloplast/xenograft materials, and 95.6% for implants placed into xenograft materials alone. For alveolar ridge augmentation, a total of 2,620 implants were placed, with follow-up ranging from 5 to 74 months. The implant survival rate was 95.5% for GBR, 90.4% for OVG, 94.7% for DO, and 83.8% for COG. Other techniques, such as DD, RS, SP, and MI, were difficult to analyze because of the small sample size and data heterogeneity within and across studies.
CONCLUSIONS
The maxillary sinus augmentation procedure has been well documented, and the long-term clinical success/survival (> 5 years) of implants placed, regardless of graft material(s) used, compares favorably to implants placed conventionally, with no grafting procedure, as reported in other systematic reviews. Alveolar ridge augmentation techniques do not have detailed documentation or long-term follow-up studies, with the exception of GBR. However, studies that met the inclusion criteria seemed to be comparable and yielded favorable results in supporting dental implants. The alveolar ridge augmentation procedures may be more technique- and operator-experience-sensitive, and implant survival may be a function of residual bone supporting the dental implant rather than grafted bone. More in-depth, long-term, multicenter studies are required to provide further insight into augmentation procedures to support dental implant survival.
Topics: Alveolar Ridge Augmentation; Bone Substitutes; Bone Transplantation; Dental Implantation, Endosseous; Dental Implants; Follow-Up Studies; Guided Tissue Regeneration, Periodontal; Humans; Osteogenesis, Distraction
PubMed: 18437791
DOI: No ID Found -
Journal of Prosthodontics : Official... Aug 2014The purpose of this systematic review was to review clinical studies of fixed tooth-supported prostheses, and to assess the quality of evidence with an emphasis on the... (Comparative Study)
Comparative Study Review
PURPOSE
The purpose of this systematic review was to review clinical studies of fixed tooth-supported prostheses, and to assess the quality of evidence with an emphasis on the assessment of the reporting of outcome measurements. Multiple hypotheses were generated to compare the effect of study type on different outcome modifiers and to compare the quality of publications before and after January 2005.
MATERIALS AND METHODS
An electronic search was conducted using specific databases (MEDLINE via Ovid, EMBASE via Ovid, Cochrane Library) through July 2012. This was complemented by hand searching the past 10 years of issues of the Journal of Oral Rehabilitation, Journal of Prosthetic Dentistry, Journal of Prosthodontics, and the International Journal of Prosthodontics. All experimental and observational clinical studies evaluating survival, success, failure, and complications of tooth-supported extracoronal fixed partial dentures, crowns, and onlays were included. No restrictions on age or follow-up time were placed.
RESULTS
The electronic search generated 14,869 papers, of which 206 papers were included for full-text review. Hand-searching added 23 papers. Inclusion criteria were met by 182 papers and were included for the review. The majority were retrospective studies. Only 8 (4.4%) were randomized controlled trials. The majority of the studies measured survival and failure, and few studies recorded data on success; however, more than 60% of the studies failed to define survival, success, and failure. Many studies did not use any standardized criteria for assessment of the quality of the restorations and, when standardized criteria were used, they were modified, thereby not allowing for comparisons with other studies. There was an increase of 21.8% in the number of studies evaluating outcome measurements of all-ceramic restorations in past 8 years.
CONCLUSIONS
Prosthodontic literature presents with a reduced percentage of RCTs compared to other disciplines in dentistry. The overall quality of recording prosthodontic outcome measurements has not improved greatly in the past 8 years.
Topics: Crowns; Dental Abutments; Dental Restoration Failure; Denture, Partial, Fixed; Humans; Inlays; Outcome Assessment, Health Care; Survival Analysis; Treatment Outcome
PubMed: 24947268
DOI: 10.1111/jopr.12160 -
Journal of Oral Rehabilitation Nov 2018The aim of this study was to identify if different types of indirect restorations used for single teeth had different biological and technical complications, as well as...
OBJECTIVE
The aim of this study was to identify if different types of indirect restorations used for single teeth had different biological and technical complications, as well as survival rates.
METHOD
An electronic search was performed in various electronic databases to identify articles, published between 1980 and 2017. The search terms were categorised into 4 groups: inlay, onlay, inlay/onlay and crown. Manual searches of published full-text articles and related reviews were also performed.
RESULTS
A total number of 2849 papers were retrieved initially. After a detailed assessment for eligibility, 9 studies were selected for inclusion. The heterogeneity of the studies did allow neither a meta-analysis nor any meaningful comparison between types of restorations or materials. Only some pooling was performed for representative reasons. The mean survival rate of inlays was 90.89%, while for onlays and crowns it was 93.50% and 95.38%, respectively. For the fourth study group, consisting of both inlays and onlays, the survival rate was found to be 99.43%. Statistical analysis demonstrated caries to be the main biological complication for all types of restorations, followed by a root and/or tooth fracture incidence (11.34%) and endodontic incidence. Ceramic fractures represented the most common technical complication, followed by loss of retention and porcelain chipping.
CONCLUSION
The 5-year survival rate for crowns and inlays/onlays is very high, exceeding 90%. An association between the kind of complications and different types of restorations could not be established. Nevertheless, a relatively high failure rate due to caries and ceramic fractures was noted.
Topics: Ceramics; Composite Resins; Dental Porcelain; Dental Restoration Failure; Dental Restoration, Permanent; Dental Stress Analysis; Denture, Overlay; Humans
PubMed: 30019391
DOI: 10.1111/joor.12695 -
The Cochrane Database of Systematic... May 2012Endodontic treatment, involves removal of the dental pulp and its replacement by a root canal filling. Restoration of root filled teeth can be challenging due to... (Review)
Review
BACKGROUND
Endodontic treatment, involves removal of the dental pulp and its replacement by a root canal filling. Restoration of root filled teeth can be challenging due to structural differences between vital and non-vital root filled teeth. Direct restoration involves placement of a restorative material e.g. amalgam or composite directly into the tooth. Indirect restorations consist of cast metal or ceramic (porcelain) crowns. The choice of restoration depends on the amount of remaining tooth which may influence long term survival and cost. The comparative in service clinical performance of crowns or conventional fillings used to restore root filled teeth is unclear.
OBJECTIVES
To assess the effects of restoration of endodontically treated teeth (with or without post and core) by crowns versus conventional filling materials.
SEARCH METHODS
We searched the following databases: the Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE via OVID, EMBASE via OVID, CINAHL via EBSCO, LILACS via BIREME and the reference lists of articles as well as ongoing trials registries.There were no restrictions regarding language or date of publication. Date of last search was 13 February 2012.
SELECTION CRITERIA
Randomised controlled trials (RCTs) or quasi-randomised controlled trials in participants with permanent teeth which have undergone endodontic treatment. Single full coverage crowns compared with any type of filling materials for direct restoration, as well as indirect partial restorations (e.g. inlays and onlays). Comparisons considered the type of post and core used (cast or prefabricated post), if any.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed trial quality and extracted data.
MAIN RESULTS
One trial judged to be at high risk of bias due to missing outcome data, was included. 117 participants with a root filled premolar tooth restored with a carbon fibre post, were randomised to either a full coverage metal-ceramic crown or direct adhesive composite restoration. At 3 years there was no reported difference between the non-catastrophic failure rates in both groups. Decementation of the post and marginal gap formation occurred in a small number of teeth.
AUTHORS' CONCLUSIONS
There is insufficient evidence to support or refute the effectiveness of conventional fillings over crowns for the restoration of root filled teeth. Until more evidence becomes available clinicians should continue to base decisions on how to restore root filled teeth on their own clinical experience, whilst taking into consideration the individual circumstances and preferences of their patients.
Topics: Adult; Crowns; Dental Restoration, Permanent; Female; Humans; Male; Middle Aged; Post and Core Technique; Randomized Controlled Trials as Topic; Tooth Root; Tooth, Nonvital
PubMed: 22592736
DOI: 10.1002/14651858.CD009109.pub2 -
The Cochrane Database of Systematic... 2003In recent decades ceramic inlays have been used with the increasing requirements from patients for tooth-coloured restorations in posterior teeth. Ceramic inlays can... (Review)
Review
BACKGROUND
In recent decades ceramic inlays have been used with the increasing requirements from patients for tooth-coloured restorations in posterior teeth. Ceramic inlays can offer an excellent appearance, however, their long-term prognosis is uncertain, as only a few studies have reported the long-term clinical performance of these restorations.
OBJECTIVES
To compare the effectiveness of ceramic inlays in posterior teeth with other posterior restorations.
SEARCH STRATEGY
We conducted an electronic search of the Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials ( The Cochrane Library Issue 1, 2002), MEDLINE, and EMBASE from 1990 to 2001. Handsearching included relevant journals and bibliographies of all relevant papers and review articles from 1990 up to 2001. In addition, we contacted experts and companies conducting clinical research on ceramic restorations to find other trials or unpublished materials or to clarify ambiguous or missing data.
SELECTION CRITERIA
Randomized controlled trials, in which the longevity of ceramic inlays is compared with those of other posterior restorations.
DATA COLLECTION AND ANALYSIS
Screening of possible studies and data extraction were independently conducted by two reviewers (MH and AY) using a specially designed chart. Authors of studies were contacted for additional information. The methodological quality of studies was assessed in duplicate using individual components. The Cochrane Oral Health Group statistical guidelines were followed and the results expressed as Odds Ratio (OR) and 95% confidence interval for dichotomous outcomes.
MAIN RESULTS
Two studies fulfilled the criteria to be included in the review. However, one of them was later excluded from the review, as the study design was not clearly described. The remaining, included study, evaluated the clinical performance of 60 ceramic inlays and 20 gold inlays for five years. Seven of the 60 ceramic inlays and two of the 20 gold inlays failed at five-year review. No ceramic inlays resulted in postoperative pain/discomfort after the treatment, however, one gold inlay did. The power of the included study was not great enough to detect an important difference in longevity and postoperative pain/discomfort between ceramic and gold inlays.
REVIEWER'S CONCLUSIONS
There is no strong evidence available to support any differences in the clinical performance of ceramic inlays and other posterior restorations. There is a limited number of well-designed clinical trials within this research area. Greater attention to the design and reporting of studies should be given to improve the study quality of ceramic restoration trials.
Topics: Ceramics; Gold; Humans; Inlays; Molar; Randomized Controlled Trials as Topic; Time Factors
PubMed: 12535474
DOI: 10.1002/14651858.CD003450 -
Journal of Esthetic and Restorative... Mar 2024To assess the feasibility of producing 3D-printed intracoronal restorations, thin and ultrathin veneers, and to compare their mechanical behavior, accuracy, biological,... (Review)
Review
3D-printed intracoronal restorations, occlusal and laminate veneers: Clinical relevance, properties, and behavior compared to milled restorations; a systematic review and meta-analysis.
OBJECTIVES
To assess the feasibility of producing 3D-printed intracoronal restorations, thin and ultrathin veneers, and to compare their mechanical behavior, accuracy, biological, and stain susceptibility to the currently applied milled restorations.
MATERIALS AND METHODS
The databases were comprehensively searched for relevant records up to January 2024 without language restrictions. All studies that assessed 3D-printed partial coverage restorations including inlays, onlays, laminate, and occlusal veneers were retrieved.
RESULTS
The web search yielded a total of 1142 records, with 8 additional records added from websites at a later stage. Only 17 records were ultimately included in the review. The included records compared 3D-printed; alumina-based- and zirconia ceramics, lithium disilicate ceramics, polymer infiltrated ceramics, polyetheretherketone (PEEK), resin composites, and acrylic resins to their CNC milled analogs. The pooled data indicated that it is possible to produce ultrathin restorations with a thickness of less than 0.2 mm. 3D-printed laminate veneers and intracoronal restorations exhibited superior trueness, as well as better marginal and internal fit compared to milled restorations (p < 0.05). However, it should be noted that the choice of materials and preparation design may influence these outcomes. In terms of cost, the initial investment and production expenses associated with 3D printing were significantly lower than those of CNC milling technology. Additionally, 3D printing was also shown to be more time-efficient.
CONCLUSIONS
Using additive manufacturing technology to produce restorations with a thickness ranging from 0.1 to 0.2 mm is indeed feasible. The high accuracy of these restorations, contributes to their ability to resist caries progression, surpassing the minimum clinical threshold load of failure by a significant margin and reliable adhesion. However, before 3D-printed resin restorations can be widely adopted for clinical applications, further improvements are needed, particularly in terms of reducing their susceptibility to stains.
CLINICAL SIGNIFICANCE
3D-printed intracoronal restorations and veneers are more time and cost-efficient, more accurate, and could provide a considerable alternative to the currently applied CNC milling. Some limitations still accompany the resin materials, but this could be overcome by further development of the materials and printing technology.
PubMed: 38551205
DOI: 10.1111/jerd.13228