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Clinical Oral Implants Research May 2019To evaluate whether zirconia implants demonstrate differences in hard and soft tissue integration compared to titanium implants in preclinical studies. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To evaluate whether zirconia implants demonstrate differences in hard and soft tissue integration compared to titanium implants in preclinical studies.
MATERIAL AND METHODS
In March 2017, electronic (MEDLINE, EMBASE) and hand search was performed to identify preclinical studies comparing zirconia and titanium implants. Primary outcomes were bone-to-implant contact (BIC) and removal torque out (RTQ), respectively, push-in (PI) measurements. Secondary outcomes included biologic width (BW) dimensions.
RESULTS
A total of 37 studies were included for data extraction after screening of 91 from 1,231 selected titles. Thirty-seven experimental studies using six different species were identified. The follow-up periods ranged between 0.4 and 56 weeks. For titanium, mean values of 59.1% (95% CI: 53.3 - 64.8), 102.6 Ncm (95% CI: 81.5 - 123.6), and 25.1 N (95% CI: 20.2 - 30.0) for BIC, RTQ, and PI were estimated, respectively. The mean values for zirconia were 55.9% (95% CI: 51.6 - 60.1), 71.5 Ncm (95% CI: 51.1 - 91.9), and 22.0 N (95% CI: 13.2 - 30.7) for corresponding parameters. Confounding factors such as animal species, implant material, loading protocol, and study or loading duration significantly influenced the outcomes. Similar qualitative soft tissue integration was reported for zirconia and titanium implants. However, faster maturation processes of epithelial and connective tissues around zirconia implants were assumed. Quantitatively, similar BW dimensions were evaluated for titanium (3.5 mm; 95% CI: 2.9 - 4.2) and zirconia (3.2 mm; 95% CI: 2.7 - 3.7), whereas the loading protocol significantly influenced the outcomes.
CONCLUSIONS
Zirconia and titanium implants demonstrate a similar soft and hard tissue integration capacity. However, titanium tended to show a faster initial osseointegration process compared to zirconia. Importantly, not only material characteristics but predominantly animal species and study protocols can significantly influence the outcomes.
Topics: Animals; Dental Implants; Dental Prosthesis Design; Osseointegration; Surface Properties; Titanium; Zirconium
PubMed: 30916812
DOI: 10.1111/clr.13425 -
Journal of Esthetic and Restorative... Sep 2023Direct resin composite bonding offers a highly esthetic, minimally invasive option for the treatment of anterior teeth however the challenge to improve their longevity... (Review)
Review
STATEMENT OF PROBLEM
Direct resin composite bonding offers a highly esthetic, minimally invasive option for the treatment of anterior teeth however the challenge to improve their longevity remains. Direct resin composite restorations are limited by the risk of staining which may be influenced by the final surface roughness (Ra) of composite achieved.
PURPOSE
The purpose of this review is to investigate, using a systematic approach, whether the final surface roughness of anterior composite restorations is affected by the interaction between resin composite and polishing systems.
MATERIALS AND METHODS
The review was conducted by 3 independent reviewers and included articles published up to January 21, 2021. Three electronic databases were searched: Medline, Embase, and Web of Science. Studies assessing a quantitative effect of polishing methods on the Ra of direct composite resin materials published after the year 2000 and restricted to the English language were included.
RESULTS
The database search for the effect of polishing systems on composite materials retrieved 125 eligible studies. Twelve duplicate records were removed. The resulting records were screened using title and abstract leading to 38 reports which were sought for retrieval. Application of eligibility criteria led to 11 studies included in the review. Hand searching of these studies yielded no additional papers.
CONCLUSIONS
There is insufficient evidence to determine whether combination of composite and polisher influences final Ra. More research is required to determine if there is an optimum combination of polisher and composite.
CLINICAL IMPLICATIONS
Polishing should be completed following planned finishing procedures. The approximation to the final surface and which finishing burs to use, if any, should be considered when planning a restoration. Durafill VS predictably achieves an acceptable Ra by different polishers.
Topics: Dental Restoration, Permanent; Dental Polishing; Surface Properties; Diamond; Materials Testing; Dental Materials; Composite Resins
PubMed: 37458370
DOI: 10.1111/jerd.13102 -
Medicina (Kaunas, Lithuania) Dec 2021: Preliminary studies emphasize the similar performance of autogenous bone blocks (AUBBs) and allogeneic bone blocks (ALBBs) in pre-implant surgery; however, most of... (Review)
Review
: Preliminary studies emphasize the similar performance of autogenous bone blocks (AUBBs) and allogeneic bone blocks (ALBBs) in pre-implant surgery; however, most of these studies include limited subjects or hold a low level of evidence. The purpose of this review is to test the hypothesis of indifferent implant survival rates (ISRs) in AUBB and ALBB and determine the impact of various material-, surgery- and patient-related confounders and predictors. : The national library of medicine (MEDLINE), Excerpta Medica database (EMBASE) and Cochrane Central Register of Controlled Trials (CENTRAL) were screened for studies reporting the ISRs of implants placed in AUBB and ALBB with ≥10 participants followed for ≥12 months from January 1995 to November 2021. The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The risk of bias was assessed via several scoring tools, dependent on the study design. Means of sub-entities were presented as violin plots. : An electronic data search resulted in the identification of 9233 articles, of which 100 were included in the quantitative analysis. No significant difference ( 0.54) was found between the ISR of AUBB (96.23 ± 5.27%; range: 75% to 100%; 2195 subjects, 6861 implants) and that of ALBB (97.66 ± 2.68%; range: 90.1% to 100%; 1202 subjects, 3434 implants). The ISR in AUBB was increased in blocks from intraoral as compared to extraoral donor sites ( 0.0003), partially edentulous as compared to totally edentulous ( 0.0002), as well as in patients younger than 45 as compared to those older ( 0.044), cortical as compared to cortico-cancellous blocks ( 0.005) and in delayed implantations within three months as compared to immediate implantations ( 0.018). The ISR of ALBB was significantly increased in processed as compared to fresh-frozen ALBB ( 0.004), but also in horizontal as compared to vertical augmentations ( 0.009). : The present findings widely emphasize the feasibility of achieving similar ISRs with AUBB and ALBB applied for pre-implant bone grafting. ISRs were negatively affected in sub-entities linked to more extensive augmentation procedures such as bone donor site and dentition status. The inclusion and pooling of literature with a low level of evidence, the absence of randomized controlled clinical trials (RCTs) comparing AUBB and ALBB and the limited count of comparative studies with short follow-ups increases the risk of bias and complicates data interpretation. Consequently, further long-term comparative studies are needed.
Topics: Bone Transplantation; Dental Implants; Hematopoietic Stem Cell Transplantation; Humans; Mouth, Edentulous; Survival Rate; United States
PubMed: 34946333
DOI: 10.3390/medicina57121388 -
Clinical Oral Investigations Jan 2017The aim was to compile the current knowledge about the efficacy of different soft tissue correction methods around osseointegrated, already uncovered and/or loaded... (Review)
Review
OBJECTIVES
The aim was to compile the current knowledge about the efficacy of different soft tissue correction methods around osseointegrated, already uncovered and/or loaded (OU/L) implants with insufficient soft tissue conditions. Procedures to increase peri-implant keratinized mucosa (KM) width and/or soft tissue volume were considered.
MATERIALS AND METHODS
Screening of two databases: MEDLINE (PubMed) and EMBASE (OVID), and manual search of articles were performed. Human studies reporting on soft tissue augmentation/correction methods around OU/L implants up to June 30, 2016, were considered. Quality assessment of selected full-text articles to weight risk of bias was performed using the Cochrane collaboration's tool.
RESULTS
Overall, four randomized controlled trials (risk of bias = high/low) and five prospective studies (risk of bias = high) were included. Depending on the surgical techniques and graft materials, the enlargement of keratinized tissue (KT) ranged between 1.15 ± 0.81 and 2.57 ± 0.50 mm. The apically positioned partial thickness flap (APPTF), in combination with a free gingival graft (FGG), a subepithelial connective tissue graft (SCTG), or a xenogeneic graft material (XCM) were most effective. A coronally advanced flap (CAF) combined with SCTG in three, combined with allogenic graft materials (AMDA) in one, and a split thickness flap (STF) combined with SCTG in another study showed mean soft tissue recession coverage rates from 28 to 96.3 %. STF combined with XCM failed to improve peri-implant soft tissue coverage.
CONCLUSIONS
The three APPTF-techniques combined with FGG, SCTG, or XCM achieved comparable enlargements of peri-implant KT. Further, both STF and CAF, both in combination with SCTG, are equivalent regarding recession coverage rates. STF + XCM and CAF + AMDA did not reach significant coverage.
CLINICAL RELEVANCE
In case of soft tissue deficiency around OU/L dental implants, the selection of both an appropriate surgical technique and a suitable soft tissue graft material is of utmost clinical relevance.
Topics: Connective Tissue; Dental Implants; Gingivoplasty; Humans; Jaw, Edentulous, Partially; Periodontium; Surgical Flaps; Vestibuloplasty
PubMed: 27873018
DOI: 10.1007/s00784-016-2007-9 -
The International Journal of... 2010The aim of this review was to systematically evaluate and compare the frequency of veneer chipping and core fracture of zirconia fixed dental prostheses (FDPs) and... (Comparative Study)
Comparative Study Review
PURPOSE
The aim of this review was to systematically evaluate and compare the frequency of veneer chipping and core fracture of zirconia fixed dental prostheses (FDPs) and porcelain-fused-to-metal (PFM) FDPs and determine possible influencing factors.
MATERIALS AND METHODS
The SCOPUS database and International Association of Dental Research abstracts were searched for clinical studies involving zirconia and PFM FDPs. Furthermore, studies that were integrated into systematic reviews on PFM FDPs were also evaluated. The principle investigators of any clinical studies on zirconia FDPs were contacted to provide additional information. Based on the available information for each FDP, a data file was constructed. Veneer chipping was divided into three grades (grade 1 = polishing, grade 2 = repair, grade 3 = replacement). To assess the frequency of veneer chipping and possible influencing factors, a piecewise exponential model was used to adjust for a study effect.
RESULTS
None of the studies on PFM FDPs (reviews and additional searching) sufficiently satisfied the criteria of this review to be included. Thirteen clinical studies on zirconia FDPs and two studies that investigated both zirconia and PFM FDPs were identified. These studies involved 664 zirconia and 134 PFM FDPs at baseline. Follow-up data were available for 595 zirconia and 127 PFM FDPs. The mean observation period was approximately 3 years for both groups. The frequency of core fracture was less than 1% in the zirconia group and 0% in the PFM group. When all studies were included, 142 veneer chippings were recorded for zirconia FDPs (24%) and 43 for PFM FDPs (34%). However, the studies differed extensively with regard to veneer chipping of zirconia: 85% of all chippings occurred in 4 studies, and 43% of all chippings included zirconia FDPs. If only studies that evaluated both types of core materials were included, the frequency of chipping was 54% for the zirconia-supported FDPs and 34% for PFM FDPs. When adjusting the survival rate for the study effect, the difference between zirconia and PFM FDPs was statistically significant for all grades of chippings (P = .001), as well as for chipping grade 3 (P = .02). If all grades of veneer chippings were taken into account, the survival of PFM FDPs was 97%, while the survival rate of the zirconia FDPs was 90% after 3 years for a typical study. For both PFM and zirconia FDPs, the frequency of grades 1 and 2 veneer chippings was considerably higher than grade 3. Veneer chipping was significantly less frequent in pressed materials than in hand-layered materials, both for zirconia and PFM FDPs (P = .04).
CONCLUSIONS
Since the frequency of veneer chipping was significantly higher in the zirconia FDPs than PFM FDPs, and as refined processing procedures have started to yield better results in the laboratory, new clinical studies with these new procedures must confirm whether the frequency of veneer chipping can be reduced to the level of PFM.
Topics: Dental Polishing; Dental Porcelain; Dental Restoration Failure; Dental Veneers; Denture Design; Denture Repair; Denture, Partial, Fixed; Humans; Metal Ceramic Alloys; Survival Analysis; Zirconium
PubMed: 21209982
DOI: No ID Found -
The Journal of Prosthetic Dentistry Jul 2023Screwmentable prostheses were developed to combine the benefits of screw retention and cement retention. However, data are limited on the clinical performance of this... (Review)
Review
STATEMENT OF PROBLEM
Screwmentable prostheses were developed to combine the benefits of screw retention and cement retention. However, data are limited on the clinical performance of this type of prosthesis.
PURPOSE
The purpose of this systematic review was to collect scientific evidence on screwmentable prostheses and evaluate their long-term clinical behavior.
MATERIAL AND METHODS
An electronic search was conducted by 2 independent reviewers for articles published in scientific dental journals in English from 2004 to April 2020. The search strategy followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria were scientific studies concerning the screwmentable type of prosthesis.
RESULTS
The search provided 494 records. Of these, 24 studies fulfilled the inclusion criteria and were included in the review. The included articles presented significant heterogeneity concerning the manufacturing process and the materials used. One randomized clinical trial, 2 prospective clinical studies, 14 in vitro studies, 3 protocol descriptions, 1 case series, and 3 case reports were included.
CONCLUSIONS
Based on the systematic search of the literature, it is concluded that the screwmentable prosthesis combines advantages of both cement-retained and screw-retained restorations, including passive fit, retrievability, excess cement control, tissue-friendly emergence profile, and improved esthetics. Nevertheless, data from well-designed clinical trials are limited, and further research is required to provide evidence on their long-term clinical behavior.
Topics: Dental Implants; Dental Prosthesis Retention; Prospective Studies; Dental Prosthesis, Implant-Supported; Esthetics, Dental; Dental Cements; Glass Ionomer Cements; Randomized Controlled Trials as Topic
PubMed: 34740460
DOI: 10.1016/j.prosdent.2021.08.027 -
Dental Materials : Official Publication... Jan 2023Since peri-implantitis differs clinically and histopathologically from periodontitis, implant wear debris is considered to play a role in the destructive processes. This...
OBJECTIVE
Since peri-implantitis differs clinically and histopathologically from periodontitis, implant wear debris is considered to play a role in the destructive processes. This work aims to systematically review if titanium particles affect oral-related cells through changes in molecular signatures (e.g., transcriptome, proteome, epigenome), thereby promoting peri-implantitis.
METHODS
Leveraging three literature databases (Medline, Embase, Cochrane) a systematic search based on a priori defined PICOs was conducted: '-omics' studies examining titanium exposure in oral-related cells. After risk of bias assessments, lists of differentially expressed genes, proteins, and results of functional enrichment analyses were compiled. The significance of overlapping genes across multiple studies was assessed via Monte Carlo simulation and their ranking was verified using rank aggregation.
RESULTS
Out of 2104 screened articles we found 12 eligible publications. A significant overlap of gene expression in oral-related cells exposed to titanium particles was found in four studies. Furthermore, changes in biological processes like immune/inflammatory or stress response as well as toll-like receptor (TLR) and mitogen-activated protein kinase (MAPK) signaling pathways were linked to titanium in transcriptome and proteome studies. Epigenetic changes caused by titanium were detected but inconsistent.
CONCLUSION
An influence of titanium implant wear debris on the development and progression of peri-implantitis is plausible but needs to be proven in further studies. Limitations arise from small sample sizes of included studies and insufficient publication of re-analyzable data.
Topics: Humans; Peri-Implantitis; Dental Implants; Titanium; Proteome; Dental Materials
PubMed: 36526446
DOI: 10.1016/j.dental.2022.11.022 -
The Journal of Prosthetic Dentistry Oct 2022Although recent studies have reported the success of implant-supported monolithic restorations, consensus on the use of monolithic ceramic restorations is lacking. (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Although recent studies have reported the success of implant-supported monolithic restorations, consensus on the use of monolithic ceramic restorations is lacking.
PURPOSE
The purpose of this systematic review and meta-analysis was to evaluate the survival and biological and technical complication rates of monolithic single crowns and fixed partial dentures (FPDs).
MATERIAL AND METHODS
An electronic search was conducted by 2 independent authors on the PubMed/MEDLINE, Scopus, and Cochrane Library databases. The Newcastle-Ottawa scale and Cochrane risk of bias tool were used to assess the quality and risk of bias of the included studies. Meta-analysis was performed by using the R software program.
RESULTS
The search identified 763 articles, 18 of which met the eligibility criteria. A total of 15 studies evaluated monolithic ceramic single crowns, and 4 studies evaluated FPDs. The studies included 1061 monolithic single crowns (524 lithium disilicate, 461 zirconia, and 76 polymer-infiltrated ceramic network [PICN]) and 104 FPDs (36 lithium disilicate and 68 zirconia). Meta-analysis of single-arm studies indicated the proportion of survival, biological, and technical complication rates of 1% (95% confidence interval [CI]: 0% to 3%), 1% (CI: 0% to 4%), and 2% (CI: 1% to 4%), respectively, for single crowns, independent of ceramic material, and 3% (CI: 0% to 34%), 5% (CI: 1% to 21%), and 5% (CI: 1% to 21%) for FPDs, respectively. Only 5 studies performed a direct comparison between monolithic and veneered ceramic restorations, and no significant difference was observed in terms of survival (risk ratio [RR]: 0.68; CI: 0.25-1.91; P=.96), biological (RR: 0.69; CI: 0.31-1.53; P=.35), and technical complication rates (RR: 0.87; CI: 0.40-1.88; P=.29).
CONCLUSIONS
The use of monolithic ceramic can be considered a favorable treatment for tooth-supported single crowns and FPDs, with high survival and low complication rates. However, further randomized controlled trials are needed to reassess these clinical performances, mainly by comparing them with the performance of veneered restorations.
Topics: Dental Restoration Failure; Dental Prosthesis Design; Zirconium; Dental Porcelain; Ceramics; Crowns; Dental Prosthesis, Implant-Supported
PubMed: 33745685
DOI: 10.1016/j.prosdent.2021.01.020 -
Journal of Prosthodontics : Official... Dec 2023To evaluate the influence of implant scan body (ISB) design (height, diameter, geometry, material, and retention system) on the accuracy of digital implant scans.
PURPOSE
To evaluate the influence of implant scan body (ISB) design (height, diameter, geometry, material, and retention system) on the accuracy of digital implant scans.
MATERIAL AND METHODS
A literature search was completed in five databases: PubMed/Medline, Scopus, Embase, World of Science, and Cochrane. A manual search was also conducted. Studies reporting the evaluation of ISB design on the accuracy of digital scans obtained by using IOSs were included. Two investigators evaluated the studies independently by applying the Joanna Briggs Institute critical appraisal. A third examiner was consulted to resolve any lack of consensus. Articles were classified based on the ISB features of height, geometry, material, and retention system.
RESULTS
Twenty articles were included. Among the reviewed studies, 11 investigations analyzed the influence of different ISB geometries, 1 study assessed the impact of ISB diameter, 4 studies investigated the effect of ISB splinting, 2 articles evaluated ISB height, and 2 studies focused on the effect of ISB material on scan accuracy. In addition, 8 studies involved ISBs fabricated with different materials (1- and 2-piece polyetheretherketone and 1-piece titanium ISBs), and all of the reviewed articles tested screw-retained ISBs, except for 3 in vitro studies.
CONCLUSIONS
The findings did not enable concrete conclusions regarding the optimal ISB design, whether there is a relationship between IOS technology and a specific ISB design, or the clinical condition that maximizes intraoral scanning accuracy. Research efforts are needed to identify the optimal ISB design and its possible relationship with the IOS selected for acquiring intraoral digital implant scans.
Topics: Dental Implants; Imaging, Three-Dimensional; Dental Impression Technique; Computer-Aided Design; Models, Dental
PubMed: 37771200
DOI: 10.1111/jopr.13774 -
The Journal of Contemporary Dental... Aug 2023The present systematic review aimed to report the studies concerning the primers in improving bond strength and identifying pertinent primers for a particular dental... (Meta-Analysis)
Meta-Analysis
AIM
The present systematic review aimed to report the studies concerning the primers in improving bond strength and identifying pertinent primers for a particular dental alloy by adhering to PRISMA precepts.
MATERIALS AND METHODS
PubMed and Semantic Scholar databases were scoured for articles using 10 search terms. studies satisfying the inclusion criteria were probed which were meticulously screened and scrutinized for eligibility adhering to the 11 exclusion criteria. The quality assessment tool for studies (QUIN Tool) containing 12 criteria was employed to assess the risk of bias (RoB).
RESULTS
A total of 48 studies assessing shear bond strength (SBS) and 15 studies evaluating tensile bond strength (TBS) were included in the qualitative synthesis. Concerning SBS, 33.4% moderate and 66.6% high RoB was observed. Concerning TBS, 26.8% moderate and 73.2% high RoB was discerned. Seventeen and two studies assessing SBS and TBS, respectively, were included in meta-analyses.
CONCLUSIONS
Shear bond strength and TBS increased for the primed alloys. Cyclic disulfide primer is best-suited for noble alloys when compared with thiol/thione primers. Phosphoric acid- and phosphonic acid ester-based primers are opportune for base alloys.
CLINICAL SIGNIFICANCE
The alloy-resin interface (ARI) would fail if an inappropriate primer was selected. Therefore, the selection of an appropriate alloy adhesive primer for an alloy plays a crucial role in prosthetic success. This systematic review would help in the identification and selection of a congruous primer for a selected alloy.
Topics: Databases, Factual; Dental Alloys; Disulfides; Thiones; Dental Cements
PubMed: 38193174
DOI: 10.5005/jp-journals-10024-3514