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Clinical Oral Investigations Dec 2021The primary aim of this systematic review was to evaluate whether intraoral scanning (IOS) is able to reduce working time and improve patient-reported outcome measures... (Review)
Review
OBJECTIVES
The primary aim of this systematic review was to evaluate whether intraoral scanning (IOS) is able to reduce working time and improve patient-reported outcome measures (PROMs) compared to conventional impression (CI) techniques, taking into account the size of the scanned area. The secondary aim was to verify the effectiveness of IOS procedures based on available prosthodontic outcomes.
MATERIALS AND METHODS
Electronic and manual literature searches were performed to collect evidence concerning the outcomes of IOS and CI performed during the treatment of partially and complete edentulous patients for tooth- or implant-supported restorations. Qualitative analysis was conducted to evaluate the time efficiency and PROMs produced by the two different techniques. Clinical prosthodontic outcomes were analyzed among the included studies when available.
RESULTS
Seventeen studies (9 randomized controlled trials and 8 prospective clinical studies) were selected for qualitative synthesis. The 17 included studies provided data from 430 IOS and 370 CI performed in 437 patients. A total of 7 different IOS systems and their various updated versions were used for digital impressions. The results demonstrated that IOS was overall faster than CI independent of whether quadrant or complete-arch scanning was utilized, regardless of the nature of the restoration (tooth or implant supported). IOS was generally preferred over CI regardless of the size of the scanned area and nature of the restoration (tooth- or implant-supported). Similar prosthodontic outcomes were reported for workflows implementing CI and IOS.
CONCLUSIONS
Within the limitations of this systematic review, IOS is faster than CI, independent of whether a quadrant or complete arch scan is conducted. IOS can improve the patient experience measured by overall preference and comfort and is able to provide reliable prosthodontic outcomes.
CLINICAL RELEVANCE
Reduced procedure working time associated with the use of IOS can improve clinical efficiency and the patient experience during impression procedures. Patient-reported outcome measures (PROMs) are an essential component of evidence-based dental practice as they allow the evaluation of therapeutic modalities from the perspective of the patient. IOS is generally preferred by patients over conventional impressions.
Topics: Computer-Aided Design; Dental Implants; Dental Impression Technique; Humans; Patient Comfort; Prospective Studies; Prosthodontics
PubMed: 34568955
DOI: 10.1007/s00784-021-04157-3 -
Journal of Dental Research Aug 2016This systematic review and meta-analysis aimed to evaluate the survival rate of ceramic and resin inlays, onlays, and overlays and to identify the complication types... (Meta-Analysis)
Meta-Analysis Review
This systematic review and meta-analysis aimed to evaluate the survival rate of ceramic and resin inlays, onlays, and overlays and to identify the complication types associated with the main clinical outcomes. Two reviewers searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials for articles published between 1983 through April 2015, conforming to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews. Clinical studies meeting the following criteria were included: 1) studies related to resin and ceramic inlays, onlays, and overlays; 2) prospective, retrospective, or randomized controlled trials conducted in humans; 3) studies with a dropout rate of less than 30%; and 4) studies with a follow-up longer than 5 y. Of 1,389 articles, 14 met the inclusion criteria. The meta-regression indicated that the type of ceramic material (feldspathic porcelain vs. glass-ceramic), study design (retrospective vs. prospective), follow-up time (5 vs. 10 y), and study setting (university vs. private clinic) did not affect the survival rate. Estimated survival rates for glass-ceramics and feldspathic porcelain were between 92% and 95% at 5 y (n = 5,811 restorations) and were 91% at 10 y (n = 2,154 restorations). Failures were related to fractures/chipping (4%), followed by endodontic complications (3%), secondary caries (1%), debonding (1%), and severe marginal staining (0%). Odds ratios (95% confidence intervals) were 0.19 (0.04 to 0.96) and 0.54 (0.17 to 1.69) for pulp vitality and type of tooth involved (premolars vs. molars), respectively. Ceramic inlays, onlays, and overlays showed high survival rates at 5 y and 10 y, and fractures were the most frequent cause of failure.
Topics: Ceramics; Composite Resins; Dental Materials; Dental Restoration Failure; Denture, Overlay; Humans; Inlays
PubMed: 27287305
DOI: 10.1177/0022034516652848 -
The Journal of Prosthetic Dentistry Apr 2019Different parameters can influence the adaptation of computer-assisted design and computer-assisted manufacturing (CAD-CAM) inlay/onlay restorations. However, systematic... (Review)
Review
STATEMENT OF PROBLEM
Different parameters can influence the adaptation of computer-assisted design and computer-assisted manufacturing (CAD-CAM) inlay/onlay restorations. However, systematic reviews to identify and discuss these parameters are lacking.
PURPOSE
The purpose of this systematic review was to summarize the scientific literature investigating all parameters that can influence both the marginal and internal adaptation of CAD-CAM inlay/onlay restorations.
MATERIAL AND METHODS
An electronic search was conducted by 2 independent reviewers for studies published in English between January 1, 2007 and September 20, 2017 on the PubMed/MEDLINE, Scopus, and Web of Science databases and in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Factors investigated in the selected articles included the type of CAD-CAM system, virtual space parameters, version of the software, type of block, luting procedure, type of restoration, sample size and aging procedure, evaluation method, and number of measurement points per specimen.
RESULTS
A total of 162 articles were identified, of which 23 articles met the inclusion criteria. Nine studies investigated adaptation with different restorative materials, 2 evaluated adaptation according to the type of preparation design, 9 compared adaptation before/after thermomechanical loading, and 2 before/after cementation, 1 study investigated marginal adaptation based on whether the optical scan was made intraorally or extraorally, 1 compared adaptation with 5 and 3 axis CAM systems, and 1 assessed adaptation with 4 different intraoral scanners. The risk of bias was high for 7, medium for 15, and low for 1 of the studies reviewed. The high level of heterogeneity across the studies excluded meta-analysis.
CONCLUSIONS
Most of the studies reported clinically acceptable values for marginal adaptation. The performance of a CAD-CAM system is influenced by the type of restorative material. A nonretentive cavity preparation exhibited better adaptation than a retentive preparation. Most studies showed that thermomechanical loading affected the quality of marginal adaptation. Cementation increased marginal discrepancies. No statistically significant difference was found for marginal fit of onlays between intraoral and extraoral optical scans using a stone die. The number of milling axes, the type of digital camera, and the region measured were statistically significant in relation to marginal/internal adaptation. Values of adaptation recorded failed to reproduce the preestablished spacer parameters in the software. Clarification is needed concerning adaptation according to the type of preparation design, the type of material, the choice of intrinsic parameters for the CAD process, the type and shape of milling instruments, and the behavior of the material during milling. Adaptation of CAD-CAM inlay/onlays should be evaluated under clinical conditions.
Topics: Computer-Aided Design; Crowns; Dental Marginal Adaptation; Dental Materials; Dental Prosthesis Design; Inlays
PubMed: 30509548
DOI: 10.1016/j.prosdent.2018.06.006 -
Journal of Dentistry Sep 2015The aim of the present review was to evaluate by means of a systematic review and meta-analysis the hypothesis of no difference in failure rates between amalgam and... (Comparative Study)
Comparative Study Meta-Analysis Review
OBJECTIVES
The aim of the present review was to evaluate by means of a systematic review and meta-analysis the hypothesis of no difference in failure rates between amalgam and composite resin posterior restorations.
DATA
Randomized controlled trials, controlled clinical trials and prospective and retrospective cohort studies were included in this review. The eligibility criteria included clinical trials in humans with at least 12 months of follow-up comparing the failures rates between occlusal and occlusoproximal amalgam and composite resin restorations. Clinical questions were formulated and organized according to the PICOS strategy.
SOURCE
An electronic search without restriction on the dates or languages was performed in PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, and Web of Science up until March 2015.
STUDY SELECTION
The initial search resulted in 938 articles from PubMed/MEDLINE, 89 titles from the Cochrane Central Register of Controlled Trials, and 172 from the Web of Science. After an initial assessment and careful reading, 8 studies published between 1992 and 2013 were included in this review. According to the risk of bias evaluation, all studies were classified as high quality.
CONCLUSIONS
The results of this review suggest that composite resin restorations in posterior teeth still have less longevity and a higher number of secondary caries when compared to amalgam restorations. In relation to fractures, there was no statistically significant difference between the two restorative materials regarding the time of follow-up.
CLINICAL SIGNIFICANCE
There is currently a worldwide trend towards replacing amalgam restorations with mercury-free materials, which are adhesive and promote aesthetics. It is important to perform an updated periodic review to synthesize the clinical performance of restorations in the long-term.
Topics: Acrylic Resins; Composite Resins; Dental Amalgam; Dental Restoration Failure; Humans; Polyurethanes
PubMed: 26116767
DOI: 10.1016/j.jdent.2015.06.005 -
Journal of Esthetic and Restorative... Feb 2024To assess and compare, through a systematic review of the literature, the biomechanical performance of endocrowns and traditional core-crowns (with and without... (Review)
Review
OBJECTIVE
To assess and compare, through a systematic review of the literature, the biomechanical performance of endocrowns and traditional core-crowns (with and without intracanal post) for the rehabilitation of endodontically treated teeth with severe coronal structure damage.
MATERIALS AND METHODS
A systematic search was performed in MEDLINE/PubMed, Scopus, and Web of Science databases. In-vitro studies comparing endocrowns with (post-)core-crown restorations were selected and screened by two independent reviewers. The included studies were submitted to the risk of bias analysis using the RoBDEMAT tool and the biomechanical outcomes were collected for qualitative analysis. The extracted data were presented based on comparative analyses among the included studies.
RESULTS
Thirty-one studies were included: 9 studies evaluated restorations of molars, 14 for premolars, and 8 studies evaluated anterior restorations. For the majority of the studies, endocrowns showed either similar or greater survival rates under fatigue and monotonic load than (post-)core-crown restorations, irrespectively of the tooth. The endocrowns showed more favorable failure patterns than (post-)core-crowns, irrespectively of the tooth. Endocrowns produced lower stresses in the restorative material for molars and premolars and in the luting material for premolars than (post-)core-crown restorations. The included studies presented adequate information for most items of the RoBDEMAT risk of bias tool.
CONCLUSION
Endocrowns showed similar or greater biomechanical performance than the traditional (post-)core-crown restorations in most of the evaluated studies.
CLINICAL SIGNIFICANCE
This systematic review showed that endocrowns present either similar or greater biomechanical performance than core-crown restorations for anterior and posterior endodontically treated teeth with severe structural damage.
Topics: Humans; Crowns; Dental Materials; Dental Restoration Failure; Dental Stress Analysis; Materials Testing; Tooth, Nonvital; Prosthodontics
PubMed: 37571973
DOI: 10.1111/jerd.13119 -
Journal of Dentistry Jul 2015A systematic review was conducted to determine whether the etch-and-rinse or self-etching mode is the best protocol for dentin and enamel adhesion by universal adhesives. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
A systematic review was conducted to determine whether the etch-and-rinse or self-etching mode is the best protocol for dentin and enamel adhesion by universal adhesives.
DATA
This report followed the PRISMA Statement. A total of 10 articles were included in the meta-analysis.
SOURCES
Two reviewers performed a literature search up to October 2014 in eight databases: PubMed, Web of Science, Scopus, BBO, SciELO, LILACS, IBECS and The Cochrane Library.
STUDY SELECTION
In vitro studies evaluating the bond strength of universal adhesives to dentin and/or enamel by the etch-and-rinse and self-etch strategies were eligible to be selected. Statistical analyses were conducted using RevMan 5.1 (The Cochrane Collaboration, Copenhagen, Denmark). A global comparison was performed with random-effects models at a significance level of p<0.05.
RESULTS
The analysis of dentin micro-tensile bond strength showed no statistically significant difference between the etch-and-rinse and self-etch strategies for mild universal adhesives (p≥0.05). However, for the ultra-mild All-Bond Universal adhesive, the etch-and-rinse strategy was significantly different than the self-etch mode in terms of dentin micro-tensile bond strength, as well as in the global analysis of enamel micro-tensile and micro-shear bond strength (p≤0.05).
CONCLUSIONS
The enamel bond strength of universal adhesives is improved with prior phosphoric acid etching. However, this effect was not evident for dentin with the use of mild universal adhesives with the etch-and-rinse strategy.
CLINICAL SIGNIFICANCE
Selective enamel etching prior to the application of a mild universal adhesive is an advisable strategy for optimizing bonding.
Topics: Composite Resins; Dentin; Dentin-Bonding Agents; Materials Testing; Methacrylates; Resin Cements; Surface Properties
PubMed: 25882585
DOI: 10.1016/j.jdent.2015.04.003 -
International Journal of Environmental... Oct 2020A systematic review and meta-analysis was performed to analyze the survival of onlay restorations in the posterior region, their clinical behavior according to the... (Meta-Analysis)
Meta-Analysis
A systematic review and meta-analysis was performed to analyze the survival of onlay restorations in the posterior region, their clinical behavior according to the material used (ceramic reinforced with lithium disilicate, conventional feldspathic ceramic or reinforced with leucite; hybrid materials and composite), possible complications, and the factors influencing restoration success. The systematic review was based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement, without publication date or language restrictions. An electronic search was made in the PubMed, Scopus, Embase, and Cochrane databases. After discarding duplicate publications and studies that failed to meet the inclusion criteria, the articles were selected based on the population, intervention, comparison, outcome (PICO) question. The following variables were considered in the qualitative and quantitative analyses: restoration survival rate (determined by several clinical parameters), the influence of the material used upon the clinical behavior of the restorations, and the complications recorded over follow-up. A total of 29 articles were selected for the qualitative analysis and 27 for the quantitative analysis. The estimated restoration survival rate was 94.2%. The predictors of survival were the duration of follow-up (beta = -0.001; = 0.001) and the onlay material used (beta = -0.064; = 0.028). Composite onlays were associated with a lower survival rate over time. Onlays are a good, conservative, and predictable option for restoring dental defects in the posterior region, with a survival rate of over 90%. The survival rate decreases over time and with the use of composite as onlay material.
Topics: Ceramics; Composite Resins; Dental Restoration Failure; Humans; Inlays
PubMed: 33086485
DOI: 10.3390/ijerph17207582 -
Journal of Dentistry Nov 2016The aim of this systematic review and meta-analysis was to assess the differences in clinical performance in direct and indirect resin composite restorations in... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The aim of this systematic review and meta-analysis was to assess the differences in clinical performance in direct and indirect resin composite restorations in permanent posterior teeth.
SOURCES
PubMed, the Cochrane Library, Web of Science, Scopus, LILACS, BBO, ClinicalTrials.gov and SiGLE were searched without restrictions.
STUDY SELECTION
We included randomized clinical trials (RCTs) that compared the clinical performance of direct and indirect resin composite restorations in Class I and Class II cavities in permanent teeth, with at least two years of follow-up. The risk of bias tool suggested by Cochrane Collaboration was used for quality assessment.
DATA
After duplicate removal, 912 studies were identified. Twenty fulfilled the inclusion criteria after the abstract screening. Two articles were added after a hand search of the reference list of included studies. After examination, nine RCTs were included in the qualitative analysis and five were considered to have a 'low' risk of bias. The overall risk difference in longevity between direct and indirect resin composite restorations in permanent posterior teeth (p>0.05) at five-year follow-up was 1.494 [0.893-2.500], and regardless of the type of tooth restored, that of molar and premolars was 0.716 [0.177-2.888] at three-year follow-up.
CONCLUSIONS
Based on the findings, there was no difference in longevity of direct and indirect resin composite restorations regardless of the type of material and the restored tooth.
CLINICAL SIGNIFICANCE
Contemporary dentistry is based on minimally invasive restorations. Any indication of a less conservative technique must have unquestionable advantages. In vitro and in vivo studies reveal contradictory evidence of the clinical performance of direct and indirect resin composite restorations in posterior teeth. Thus this study clarified this doubt.
Topics: Composite Resins; Dental Caries; Dental Restoration, Permanent; Dentition, Permanent; Humans; Molar
PubMed: 27523636
DOI: 10.1016/j.jdent.2016.08.003 -
Drug Metabolism Reviews May 2020Nano-hydroxyapatite (nano-HA) is a material with multiple uses due to its biocompatibility and its resemblance to the nonorganic bone structure. It is used in various...
Nano-hydroxyapatite (nano-HA) is a material with multiple uses due to its biocompatibility and its resemblance to the nonorganic bone structure. It is used in various dental domains such as implantology, surgery, periodontology, esthetics and prevention. The aim of this study is to provide a wide understanding of nano-HA and to promote treatments based on nanomaterials in dentistry. A search in two data bases, Scopus, and PubMED, was conducted over a 5 years period. We chose a 5 years period because this revealed the most recent published studies with the key words 'nano-HA' and 'dentistry'. A number of 32 studies were included in this systematic review. In implantology the main use of nano-HA was as a coating material for titanium implants and its effect was assessed in the matter of osteointegration and inflammatory response as well as antibacterial activity. In tissue engineering the use of nano-HA was directed to surgery and periodontology and this material was assessed mainly as a grafting material. In esthetics and prevention its use was mainly focused on dentinal hypersensitivity treatment, remineralizing potential and as bleaching co-agent. Nano-HA is a relatively novel material with outstanding physical, chemical, mechanical and biological properties that makes it suitable for multiple interventions. It outperformed most of the classic materials used in implantology and surgery but it should be further investigated for bone engineering and caries therapy.
Topics: Animals; Dental Materials; Dental Prosthesis; Humans; Hydroxyapatites; Nanoparticles
PubMed: 32393070
DOI: 10.1080/03602532.2020.1758713 -
The Cochrane Database of Systematic... May 2018In children, dental caries (tooth decay) is among the most prevalent chronic diseases worldwide. Pulp interventions are indicated for extensive tooth decay. Depending on... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
In children, dental caries (tooth decay) is among the most prevalent chronic diseases worldwide. Pulp interventions are indicated for extensive tooth decay. Depending on the severity of the disease, three pulp treatment techniques are available: direct pulp capping, pulpotomy and pulpectomy. After treatment, the cavity is filled with a medicament. Materials commonly used include mineral trioxide aggregate (MTA), calcium hydroxide, formocresol or ferric sulphate.This is an update of a Cochrane Review published in 2014 when insufficient evidence was found to clearly identify one superior pulpotomy medicament and technique.
OBJECTIVES
To assess the effects of different pulp treatment techniques and associated medicaments for the treatment of extensive decay in primary teeth.
SEARCH METHODS
Cochrane Oral Health's Information Specialist searched the Cochrane Oral Health Group's Trials Register (to 10 August 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2017, Issue 7), MEDLINE Ovid (1946 to 10 August 2017), Embase Ovid (1980 to 10 August 2017) and the Web of Science (1945 to 10 August 2017). OpenGrey was searched for grey literature. The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) comparing interventions that combined a pulp treatment technique with a medicament or device in children with extensive decay in the dental pulp of their primary teeth.
DATA COLLECTION AND ANALYSIS
Two review authors independently extracted data and assessed 'Risk of bias'. We contacted authors of RCTs for additional information when necessary. The primary outcomes were clinical failure and radiological failure, as defined in trials, at six, 12 and 24 months. We performed data synthesis with pair-wise meta-analyses using fixed-effect models. We assessed statistical heterogeneity by using I² coefficients.
MAIN RESULTS
We included 40 new trials bringing the total to 87 included trials (7140 randomised teeth) for this update. All were small, single-centre trials (median number of randomised teeth = 68). All trials were assessed at unclear or high risk of bias.The 87 trials examined 125 different comparisons: 75 comparisons of different medicaments or techniques for pulpotomy; 25 comparisons of different medicaments for pulpectomy; four comparisons of pulpotomy and pulpectomy; and 21 comparisons of different medicaments for direct pulp capping.The proportion of clinical failures and radiological failures was low in all trials. In many trials, there were either no clinical failures or no radiographic failures in either study arm.For pulpotomy, we assessed three comparisons as providing moderate-quality evidence. Compared with formocresol, MTA reduced both clinical and radiological failures, with a statistically significant difference at 12 months for clinical failure and at six, 12 and 24 months for radiological failure (12 trials, 740 participants). Compared with calcium hydroxide, MTA reduced both clinical and radiological failures, with statistically significant differences for clinical failure at 12 and 24 months. MTA also appeared to reduce radiological failure at six, 12 and 24 months (four trials, 150 participants) (low-quality evidence). When comparing calcium hydroxide with formocresol, there was a statistically significant difference in favour of formocresol for clinical failure at six and 12 months and radiological failure at six, 12 and 24 months (six trials (one with no failures), 332 participants).Regarding pulpectomy, we found moderate-quality evidence for two comparisons. The comparison between Metapex and zinc oxide and eugenol (ZOE) paste was inconclusive, with no clear evidence of a difference between the interventions for failure at 6 or 12 months (two trials, 62 participants). Similarly inconclusive, there was no clear evidence of a difference in failure between Endoflas and ZOE (outcomes measured at 6 months; two trials, 80 participants). There was low-quality evidence of a difference in failure at 12 months that suggested ZOE paste may be better than Vitapex (calcium hydroxide/iodoform) paste (two trials, 161 participants).Regarding direct pulp capping, the small number of studies undertaking the same comparison limits any interpretation. We assessed the quality of the evidence as low or very low for all comparisons. One trial appeared to favour formocresol over calcium hydroxide; however, there are safety concerns about formocresol.
AUTHORS' CONCLUSIONS
Pulp treatment for extensive decay in primary teeth is generally successful. Many included trials had no clinical or radiological failures in either trial arm, and the overall proportion of failures was low. Any future trials in this area would require a very large sample size and follow up of a minimum of one year.The evidence suggests MTA may be the most efficacious medicament to heal the root pulp after pulpotomy of a deciduous tooth. As MTA is relatively expensive, future research could be undertaken to confirm if Biodentine, enamel matrix derivative, laser treatment or Ankaferd Blood Stopper are acceptable second choices, and whether, where none of these treatments can be used, application of sodium hypochlorite is the safest option. Formocresol, though effective, has known concerns about toxicity.Regarding pulpectomy, there is no conclusive evidence that one medicament or technique is superior to another, and so the choice of medicament remains at the clinician's discretion. Research could be undertaken to confirm if ZOE paste is more effective than Vitapex and to evaluate other alternatives.Regarding direct pulp capping, the small number of studies and low quality of the evidence limited interpretation. Formocresol may be more successful than calcium hydroxide; however, given its toxicity, any future research should focus on alternatives.
Topics: Aluminum Compounds; Calcium Compounds; Calcium Hydroxide; Child; Child, Preschool; Controlled Clinical Trials as Topic; Dental Caries; Dental Cements; Dental Materials; Drug Combinations; Electric Stimulation Therapy; Ferric Compounds; Formocresols; Humans; Molar; Oxides; Pulpectomy; Pulpotomy; Randomized Controlled Trials as Topic; Silicates; Tooth, Deciduous; Treatment Failure; Zinc Oxide-Eugenol Cement
PubMed: 29852056
DOI: 10.1002/14651858.CD003220.pub3