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The International Journal of Oral &... Oct 2023To evaluate the peri-implant outcomes of customized healing abutments (CstHA) placed on dental implants inserted in fresh tooth extraction sockets.
PURPOSE
To evaluate the peri-implant outcomes of customized healing abutments (CstHA) placed on dental implants inserted in fresh tooth extraction sockets.
MATERIALS AND METHODS
The study was registered on PROSPERO: CRD42022304320. A systematic search in PubMed, Scopus, and Web of Science was conducted between April 2022 and October 2022 to identify clinical studies involving immediate implant surgery associated with CstHA placement. The Joanna Briggs Institute Critical Appraisal and RoB2 tool were performed for the risk of bias analysis.
RESULTS
A total of 12 studies were included, most of them with low risk of bias. Four studies compared CstHA vs conventional healing abutments (CnvtHA), two compared CstHA vs cover screw and collagen matrix (CMa), and six were clinical case series. For the CstHA vs CnvtHA comparison, favorable results were observed for CstHA considering papilla maintenance and probing depth, yet the mean marginal bone level was statistically similar between CstHA and CnvtHA. CstHA showed advantages when compared to CMa for total bone volume, papilla height, and midfacial mucosa maintenance. Significantly less horizonal bone loss was reported when using CstHA compared with CMa. Horizontal and vertical bone loss was observed in a few (or no) sites in the case series using CstHA.
CONCLUSIONS
CstHA provides favorable peri-implant response because in general it does not result in a significant loss of soft and hard tissues.
Topics: Humans; Dental Implants; Immediate Dental Implant Loading; Dental Implants, Single-Tooth; Dental Implantation, Endosseous; Tooth Socket; Tooth Extraction; Dental Abutments
PubMed: 37847840
DOI: 10.11607/jomi.10311 -
Journal of Pharmacy & Bioallied Sciences Aug 2020Diabetes mellitus is an endocrinal disorder affecting worldwide and the disease incidence is rising alarmingly high. The effects of diabetes on tooth development are... (Review)
Review
Diabetes mellitus is an endocrinal disorder affecting worldwide and the disease incidence is rising alarmingly high. The effects of diabetes on tooth development are explored by limited studies and their molecular insights are very rarely studied. This systematic review is aimed to provide the best scientific literature source on the molecular insights into odontogenesis in hyperglycemic environment caused by diabetes mellitus or by maternal diabetes on the offspring. The literature search was conducted on the databases, namely PubMed, PubMed Central, Cochrane, and Scopus. The original studies exploring the alterations in the molecular pathways of odontogenesis in diabetes mellitus were selected. Data were extracted, chosen, and evaluated by two independent researchers. At the end of thorough data search, four articles were eligible for the review. Three articles brought out the molecular pathways involved in the offspring of gestational diabetes through animal models. Fourth article was an study, which treated the stem cells in hyperglycemic environment and drafted the molecular pathway. The altered molecular pathways in dental epithelial stem cells (DESCs), dental papilla cells (DPCs), and stem cells from apical papilla were studied and empowered with statistical analysis. Thus with this systematic review, we conclude that apurinic/apyrimidinic endonuclease1 downregulation causing deoxyribonucleic acid hypermethylation and gene silencing, activation of toll-like receptor-4/nuclear factor kappa B (TLR4/NF-κB) pathway are involved in suppressing cell proliferation and accelerated apoptosis in DESCs in high glucose environment. DPCs are suppressed from odonto differentiation by activation of TLR4 signaling and resulting inhibition of SMAD1/5/9 phosphorylation in diabetic condition. NF-κB pathway activation causes decreased cell proliferation and enhanced differentiation in apical papilla stem cells in hyperglycemia. Further studies targeting various stages of odontogenesis can reveal more molecular insight.
PubMed: 33149430
DOI: 10.4103/jpbs.JPBS_159_20 -
Clinical Oral Implants Research Oct 2021To address the following question: "Is the timing of implant placement and/or loading influencing the esthetic outcomes of implant-supported single crowns?" (Review)
Review
OBJECTIVES
To address the following question: "Is the timing of implant placement and/or loading influencing the esthetic outcomes of implant-supported single crowns?"
MATERIAL AND METHODS
A literature screening was performed in four electronic databases until June 2020. Randomized controlled clinical trials with a minimum of 10 patients and 1 year of follow-up and reporting on dimensional changes of the peri-implant mucosa (midfacial recession, papilla level) and esthetic indexes were included. Cochrane Risk of Bias Tool was used, and comparable trials were subjected to meta-analyses.
RESULTS
Out of 8549 articles, 72 full-text articles were assessed for eligibility and 18 were included. Nine trials evaluated the timing of implant placement, and nine trials evaluated the timing of loading. The included trials comparing immediate implant placement to delayed implant placement evaluating the midfacial recession reported heterogeneous findings. No differences were found at 1 and 2-years, when comparing midfacial recession and papilla level between immediate and early implant placement. In immediate and delayed implant placement, when comparing conventional and immediate loading, the midfacial mucosal margin change was not statistically significant at the 1-year follow-up. When evaluating the timing of implant placement and/or loading the included trials found no differences in the Pink Esthetic score, White Esthetic score, and Papilla Index between groups.
CONCLUSIONS
Both immediate and early implant placement protocols presented stable treatment results in terms of esthetic outcomes at the 1-, 2-, and 10-years follow-up. Loading protocols did not seem to influence esthetic outcomes in short- and medium-term follow-ups.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Esthetics; Esthetics, Dental; Humans
PubMed: 34642985
DOI: 10.1111/clr.13811 -
Acta Odontologica Scandinavica Jun 2024Non-surgical therapeutics to reconstruct lost interdental papilla are evolving; these include hyaluronic acid injection. The aim of this systematic review is to evaluate...
OBJECTIVE
Non-surgical therapeutics to reconstruct lost interdental papilla are evolving; these include hyaluronic acid injection. The aim of this systematic review is to evaluate the efficacy, safety, and long-term outcomes of hyaluronic acid injection in the treatment of black triangles and reconstruction of lost interdental papilla in anterior teeth.
MATERIALS AND METHODS
The protocol was registered in PROSPERO (CRD42023446875) and in accordance with the Cochrane Handbook of Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 'PRISMA'. The search involved four databases, PubMed/MEDLINE, The Cochrane Library, Google Scholar, and ProQuest for ''grey literature' with additional manual search for studies published up to May 2024. Human clinical studies of a prospective nature (randomised clinical trials and prospective cohort studies) were included. Exclusion criteria were case reports, case series, review articles, letter to editor, personal opinion, and animal studies. Furthermore, studies which utilised hyaluronic acid injection in conjunction with other therapeutic material, tissue graft, or any surgical procedure were also excluded. The data were extracted independently by the two authors and incorporated after consensus. The risk of bias was assessed using the RoB2: the revised Cochrane risk of bias tool for randomised clinical trials and the Newcastle Ottawa scale for prospective cohort studies.
RESULTS
24 studies, 15 prospective clinical studies and nine randomised clinical trials, were included with a total of 898 interdental papillae injected with hyaluronic acid. The studies showed promising outcomes in the reconstruction of lost interdental papilla with minimal adverse reactions. Risk of bias assessment among prospective clinical studies revealed 13 good quality studies with only two poor studies while the randomised clinical trials consisted of three with low, one with some concern, and five studies with high risk of bias. However, due to the high heterogeneity, a meta-analysis was not feasible. Conclusion: Hyaluronic acid injection is an effective minimally invasive approach in treating black triangles and reconstructing lost interdental papilla in the anterior teeth. Further long-term well-designed randomised clinical trials employing standardised procedures are essential to validate this treatment and provide better quality of evidence.
Topics: Hyaluronic Acid; Humans; Dental Papilla
PubMed: 38864684
DOI: 10.2340/aos.v83.40864 -
European Endodontic Journal Oct 2022This systematic review aimed to evaluate the cytotoxicity of intracanal medicaments used for root canal disinfection and assess their effect on the proliferation and...
This systematic review aimed to evaluate the cytotoxicity of intracanal medicaments used for root canal disinfection and assess their effect on the proliferation and differentiation potential of stem cells from apical papilla (SCAP). The PubMed/Medline, Cochrane, Scopus, EMBASE, CINAHL and Web of Science databases were searched. Studies evaluating the effect of intracanal medicament on human SCAP (in-vitro primary cell culture experiment) were included in this systematic review. The risk of bias analysis of included studies was carried out using the Toxicological data Reliability Assessment tool. The data was analysed for qualitative characteristics. A meta-analysis was not carried out considering the heterogeneity of selected studies in terms of cell culture experiments, methods of analysis and the interpretation of results. Four studies fulfilled the desired inclusion criteria. The different antibiotic pastes and their intracanal concentrations lead to reduction in the SCAP survival compared to calcium hydroxide medicament. The findings were insufficient to make a clear distinction between different antibiotic pastes regarding their cytotoxicity. Within the limitations of the present systematic review, it can be concluded that calcium hydroxide is a relatively better intracanal medicament than antibiotic paste mixtures in terms of their cytotoxicity and effect on proliferation of SCAP.
Topics: Anti-Bacterial Agents; Calcium Hydroxide; Cell Proliferation; Humans; Reproducibility of Results; Stem Cells
PubMed: 36217639
DOI: 10.14744/eej.2022.63835 -
Clinical Oral Investigations Aug 2021The aim of this systematic review was to evaluate the efficacy of immediate implant placement (IIP) compared to implants placed after alveolar ridge preservation (ARP)... (Meta-Analysis)
Meta-Analysis Review
AIM
The aim of this systematic review was to evaluate the efficacy of immediate implant placement (IIP) compared to implants placed after alveolar ridge preservation (ARP) in terms of clinical, esthetic, and patient-reported outcomes.
METHODS
A manual and electronic search (National Library of Medicine) was performed for controlled clinical trials, with at least 12 months of follow-up. Primary outcome variable was implant survival and secondary outcomes were marginal bone level (MBL) (change), pink esthetic score (PES), mid-facial mucosal level (change), papilla index score, complications, and patient-reported outcomes.
RESULTS
A total of 10 publications were included (7 randomized clinical trials and 3 controlled clinical trials). The results from the meta-analyses showed that survival rate was significantly lower in the IIP group compared to ARP group [RR = 0.33; 95% CI (0.14; 0.78); p = 0.01]. No significant differences between the two groups were observed regarding radiographic MBL, PES scores, or mid-facial mucosal level (p > 0.05).
CONCLUSION
The results from this systematic review and meta-analysis showed that IIP had lower survival rates and similar esthetic results when compared to ARP.
CLINICAL RELEVANCE
Clinicians should weigh the benefits and disadvantages of each intervention to select the optimal timing of implant placement.
Topics: Alveolar Process; Alveolar Ridge Augmentation; Dental Implantation, Endosseous; Dental Implants; Esthetics, Dental; Humans; Tooth Extraction; Tooth Socket; Treatment Outcome
PubMed: 34100157
DOI: 10.1007/s00784-021-03986-6 -
Journal of Clinical and Experimental... May 2021This systematic review evaluates the available scientific literature to demonstrate the aesthetic and clinical benefits and to determine the survival and the success of... (Review)
Review
BACKGROUND
This systematic review evaluates the available scientific literature to demonstrate the aesthetic and clinical benefits and to determine the survival and the success of zirconium dioxide implants concerning titanium implants.
MATERIAL AND METHODS
The electronic databases were searched until January 2020. Outcome measures were pink aesthetic score (PAS), white aesthetic score (WAS), bleeding on probing (BOP) and probing depth (PD). The addressed PICO question was: In partially edentulous patients in the upper-anterior sector, do zirconium dioxide implants provide aesthetic benefits over conventional titanium implants?
RESULTS
In the 15 articles included after the screening were evaluated respectively, the pink aesthetic score, white aesthetics score, the peri-implant, and crown index, bleeding on probing, plaque index, probing pocket depth, radiographic bone loss, papilla height, and survival and success rate. The results show how the aesthetic and clinical benefits and the survival and success rate of zirconium dioxide implants are, in general, better than titanium implants.
CONCLUSIONS
Despite the optimal aesthetics, clinical and survival results obtained in the review, more studies are needed to confirm these data. Ceramic dental implants, zirconia implants, esthetics, zirconium dioxide and zirconia.
PubMed: 33981400
DOI: 10.4317/jced.58063 -
The Journal of Evidence-based Dental... Jun 2022To systematically evaluate the application of stem cells in tissue engineering for regeneration of periodontal defects and to provide a basis for clinical application. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To systematically evaluate the application of stem cells in tissue engineering for regeneration of periodontal defects and to provide a basis for clinical application.
METHODS
PubMed, The Cochrane Library, EMbase, SinoMed, CNKI and Wanfang database were searched for randomized controlled trial (RCT) studies on periodontal defect regeneration using bone marrow mesenchymal stem cells, adipose tissue-derived stem cells, periodontal ligament stem cells (PDLSCs), dental pulp stem cells (DPSCs), gingival mesenchymal stem cells, stem cells from apical papilla and other odontogenic stem cells. Chinese and English literature as of May 9, 2021 (without limitation on retrieve starting date) were searched, and included RCT studies were followed for at least 3 months. Two reviewers independently screened the literature, extracted basic research information, the situation of the research object and outcome measures including probing depth (PD), clinical attachment level (CAL), bone defect depth (BDD) and gingival recession (GR). Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0) was used to evaluate bias risk in included studies and Meta-analysis was performed using RevMan 5.4 software.
RESULTS
A total of 182 teeth were included in 7 RCT studies. The experimental group was treated with stem cell tissue engineering technology (87 cases), and the control group was treated with conventional periodontal regeneration therapy without stem cell (95 cases). In the meta-analysis, a significant difference between experimental and control groups was found for PD [mean difference (MD) = -0.66, 95% CI (-1.11, -0.22), P = .004], CAL [MD = -1.11, 95% CI (-1.45, -0.77), P < .00001], BDD [MD = -0.99, 95% CI (-1.42, -0.57), P < .00001] and GR [MD = -0.35, 95% CI (-0.62, -0.07), P = .01]. By observing the 4 outcome indicators of periodontal tissue regeneration, the improvement of CAL was the best, while the improvement of GR was poor. In the subgroup analysis of follow-up time, PD improved best at 6 months compared with other follow-up times [MD = -1.07, 95% CI (-1.58, -0.55), P < .0001]. However, in the subgroup analysis of CAL, BDD and GR, there was no statistical significance among follow-up time.
CONCLUSIONS
Compared with conventional periodontal regeneration therapy, the application of stem cells in tissue engineering exhibits a significant advantage in promoting periodontal defect regeneration and allows for complete periodontal regeneration possibly. Due to limitations related to the number and quality of the included studies, additional large-sample and high-quality clinical studies are needed to support future meta-analyses.
Topics: Alveolar Bone Loss; Gingival Recession; Guided Tissue Regeneration, Periodontal; Humans; Periodontal Attachment Loss; Randomized Controlled Trials as Topic; Stem Cells; Tissue Engineering; Treatment Outcome
PubMed: 35718427
DOI: 10.1016/j.jebdp.2022.101713 -
Journal of Periodontology Dec 2018The efficacy of Coronally Advance Flap (CAF) has been extensively evaluated and several parameters influencing the results, such as interproximal attachment loss,... (Review)
Review
BACKGROUND
The efficacy of Coronally Advance Flap (CAF) has been extensively evaluated and several parameters influencing the results, such as interproximal attachment loss, recession defect size, papilla dimension, flap thickness, have also been identified. However, the influence of tooth location has not been systematically investigated yet. Therefore, the aim of this systematic review was to evaluate the influence of tooth location on the outcomes of CAF.
METHODS
A literature search on PubMed, EMBASE, Cochrane libraries and hand-searched journal until September 2017 was performed to identify clinical studies reporting the outcome of CAF for localized gingival recessions (GRs) for each single tooth.
RESULTS
Eighteen articles reporting 399 localized GRs treated with CAF were included in the present systematic review. Canines and incisors were related to a higher mRC and CRC than premolars and molars (odds ratio 1.63) (p < 0.05), while the right side showed a higher CRC than the left side (odds ratio 1.60) (p < 0.05). No differences were found between maxillary and mandibular dentition (p > 0.05). The addition of a graft such as Connective Tissue Graft (CTG) with or without Enamel Matrix Derivative (EMD) was shown to enhance the outcomes compared to CAF alone (p < 0.05). CRC was negatively affected by initial clinical attachment level (p < 0.05), but not from the initial recession depth (p > 0.05).
CONCLUSIONS
Tooth location plays an important role on mRC and CRC following CAF. The addition of CTG or substitutes, especially with biological agents (EMD), enhance the clinical outcomes compared to CAF alone.
Topics: Connective Tissue; Dental Enamel Proteins; Gingiva; Gingival Recession; Humans; Surgical Flaps; Tooth Root; Treatment Outcome
PubMed: 29963707
DOI: 10.1002/JPER.18-0201 -
European Journal of Dentistry Nov 2023Recent evidence suggests the immense potential of human mesenchymal stem cell (hMSC) secretome conditioned medium-mediated augmentation of angiogenesis. However,...
Recent evidence suggests the immense potential of human mesenchymal stem cell (hMSC) secretome conditioned medium-mediated augmentation of angiogenesis. However, angiogenesis potential varies from source and origin. The hMSCs derived from the oral cavity share an exceptional quality due to their origin from a hypoxic environment. Our systematic review aimed to compare the mesenchymal stem cells (MSCs) derived from various oral cavity sources and cell-derived secretomes, and evaluate their angiogenic potential. A literature search was conducted using PubMed and Scopus from January 2000 to September 2020. Source-wise outcomes were systematically analyzed using , , and studies, emphasizing endothelial cell migration, tube formation, and blood vessel formation. Ninety-four studies were included in the systematic review, out of which 4 studies were subsequently included in the meta-analysis. Prominent growth factors and other bioactive components implicated in improving angiogenesis were included in the respective studies. The findings suggest that oral tissues are a rich source of hMSCs. The meta-analysis revealed a positive correlation between dental pulp-derived MSCs (DPMSCs) and stem cells derived from apical papilla (SCAP) compared to human umbilical cord-derived endothelial cell lines as a control. It shows a statistically significant positive correlation between the co-culture of human umbilical vein endothelial cells (HUVECs) and DPMSCs with tubule length formation and total branching points. Our meta-analysis revealed that oral-derived MSCs (dental pulp stem cells and SCAP) carry a better angiogenic potential than endothelial cell lines alone. The reviewed literature illustrates that oral cavity-derived MSCs (OC-MSCs) increased angiogenesis. The present literature reveals a dearth of investigations involving sources other than dental pulp. Even though OC-MSCs have revealed more significant potential than other MSCs, more comprehensive, target-oriented interinstitutional prospective studies are warranted to determine whether oral cavity-derived stem cells are the most excellent sources of significant angiogenic potential.
PubMed: 37995732
DOI: 10.1055/s-0043-1776315