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Clinical Oral Implants Research Oct 2018To systematically review the evidence for the clinical outcome of fixed implant prostheses treated with different combinations of implant placement and loading protocols...
OBJECTIVES
To systematically review the evidence for the clinical outcome of fixed implant prostheses treated with different combinations of implant placement and loading protocols in partially edentulous patients.
MATERIALS AND METHODS
An electronic search was performed in Medline, Embase, and Central to identify studies investigating the outcome of implants subjected to immediate placement + immediate restoration/loading (Type 1A), immediate placement + early loading (Type 1B), immediate placement + conventional loading (Type 1C), early placement + immediate restoration/loading (Type 2-3A), early placement + early loading (Type 2-3B), early placement + conventional loading (Type 2-3C), late placement + immediate restoration/loading (Type 4A), late placement + early loading (Type 4B), late placement + conventional loading (Type 4C) with implant-supported fixed dental prostheses (IFDPs) in partially edentulous patients. Only human studies with at least 10 cases and a minimum follow-up time of 12 months, reporting on solid-screw-type implants with rough surfaces and an intra-osseous diameter between 3 and 6 mm, were included. A cumulative survival rate for each type of the implant placement and loading protocols was weighted by the duration of follow-up and number of implants.
RESULTS
The search provided 5,248 titles from which 2,362 abstracts and 449 full-text articles were screened. A total of 69 publications that comprised 23 comparative studies (15 randomized controlled trials, 7 controlled clinical trials) and 47 noncomparative studies (34 prospective cohort studies, 13 retrospective cohort studies) were included for analysis. Considerable heterogeneity in study design was found, and therefore, a meta-analysis of controlled studies was not possible. The weighted cumulative survival rate of each type of placement and loading protocol was 98.4% (Type 1A), 98.2% (Type 1B), 96.0% (Type 1C), 100% (Type 2-3B), 96.3% (Type 2-3C), 97.9% (Type 4A), 98.3% (Type 4B), and 97.7% (Type 4C). Type 1C, Type 2-3C, Type 4B, and Type 4C were scientifically and clinically validated (SCV). Type 1A, Type 1B, and Type 4A were clinically documented (CD), and Type 2-3A and Type 2-3B were clinically insufficiently documented (CID).
CONCLUSIONS
Evaluating outcomes in oral implantology by combining the placement and loading protocols are paramount. The selected loading protocol appears to influence the outcome of immediate implant placement.
Topics: Humans; Databases, Factual; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Partial, Fixed; Immediate Dental Implant Loading; Mouth, Edentulous
PubMed: 30328194
DOI: 10.1111/clr.13276 -
Dental Materials : Official Publication... Oct 2015In this study the literature was systematically reviewed to investigate the clinical longevity of anterior composite restorations. (Review)
Review
OBJECTIVE
In this study the literature was systematically reviewed to investigate the clinical longevity of anterior composite restorations.
DATA
Clinical studies investigating the survival of anterior light-cured composite restorations with at least three years of follow-up were screened and main reasons associated with restoration failure were registered.
SOURCES
PubMed, Scopus, and Cochrane databases were searched without restriction on date or language. Reference lists of eligible studies were hand-searched. The grey literature search was not made systematically.
STUDY SELECTION
Two reviewers screened titles and/or abstracts of 2273 unique studies. In total, 41 studies were selected for full-text reading, from which 17 were included in the qualitative synthesis. The included studies evaluated the clinical performance of Class III and/or IV restorations (10 studies), which were placed due to caries, fracture, or replaced old restorations; veneers and full-coverage restorations placed for aesthetic reasons (five studies); and restorations in worn teeth (two studies). Annual failure rates (AFRs) were calculated for each study.
CONCLUSIONS
In total, 1821 restorations were evaluated and the total failure rate was 24.1%. AFRs varied from 0 to 4.1% and survival rates varied from 53.4% to 100%. Class III restorations generally had lower AFRs than the other restorations. Few studies addressed factors associated with failure, which included adhesive technique, composite resin, retreatment risk, and time required to build-up the restoration. Fracture of tooth/restoration was the most common reason for failure, whereas failures related to aesthetic qualities (color, anatomical form, surface stain) were more frequent when restorations were placed for aesthetic reasons.
Topics: Composite Resins; Dental Materials; Dental Restoration Failure; Dental Restoration, Permanent; Humans
PubMed: 26303655
DOI: 10.1016/j.dental.2015.07.005 -
Clinical Oral Implants Research Sep 2023The aim of this study was to review available evidence for Type 1A (immediate implant placement and immediate loading) of single tooth replacement in the maxillary... (Meta-Analysis)
Meta-Analysis Review
Selection criteria for immediate implant placement and immediate loading for single tooth replacement in the maxillary esthetic zone: A systematic review and meta-analysis.
OBJECTIVES
The aim of this study was to review available evidence for Type 1A (immediate implant placement and immediate loading) of single tooth replacement in the maxillary esthetic zone.
MATERIALS AND METHODS
An electronic search was conducted utilizing the databases of MEDLINE, Embase, and Cochrane to identify publications reporting on the outcomes of Type 1A for single tooth replacement in the maxillary esthetic zone. The success and survival rates of the included articles were reported, which were further categorized according to the clinical criteria reported in Type 1A. Mean survival rates were univariately compared between risk groups and additionally between studies published before and since 2012 using bias-corrected and study size-weighed bootstrap tests. A study time-correcting meta-analysis was then performed to obtain an overall effect for the study pool.
RESULTS
A total of 3118 publications were identified in the search, with a total of 68 articles included. A mean number of implants per study were 37.2 and mean follow-up was 2.8 years. All the included studies utilizing Type 1A report highly selective inclusion and exclusion criteria. Univariate risk group comparison determined that studies before 2012 report a significantly lower mean survival rate (difference of -1.9 percentage points [PP], 95% CI: [-0.3, -4.0], p = .02), facial gap dimension had an impact on survival rates (+3.1 PP [0.2, 5.3] for width >2 mm, p = .04), as well as presence of endodontic infection (+2.6 PP [0.9, 5.1], p = .004).
CONCLUSIONS
Type 1A has a high survival rate in studies reporting strict patient and site selection criteria. Further research is required to assess esthetic and functional success with Type 1A treatments.
Topics: Humans; Patient Selection; Dental Implants; Esthetics, Dental; Databases, Factual
PubMed: 37750515
DOI: 10.1111/clr.14109 -
Journal of Oral Rehabilitation May 2010Orthodontic treatment aims at providing an acceptable functional and aesthetic occlusion with appropriate tooth movements. These movements are strongly related to... (Review)
Review
Orthodontic treatment aims at providing an acceptable functional and aesthetic occlusion with appropriate tooth movements. These movements are strongly related to interactions of teeth with their supportive periodontal tissues. In recent years, because of the increased number of adult patients seeking orthodontic treatment, orthodontists frequently face patients with periodontal problems. Aesthetic considerations, like uneven gingival margins or functional problems resulting from inflammatory periodontal diseases should be considered in orthodontic treatment planning. Furthermore, in cases with severe periodontitis, orthodontics may improve the possibilities of saving and restoring a deteriorated dentition. In modern clinical practice, the contribution of the orthodontist, the periodontist and the general dentist is essential for optimized treatment outcomes. The purpose of this systematic review is to highlight the relationship between orthodontics and periodontics in clinical practice and to improve the level of cooperation between dental practitioners. Potentials and limitations that derive from the interdisciplinary approach of complex orthodontic-periodontal clinical problems are discussed.
Topics: Alveolar Bone Loss; Animals; Dental Plaque; Esthetics, Dental; Humans; Malocclusion; Orthodontic Anchorage Procedures; Orthodontic Extrusion; Orthodontics; Patient Care Team; Periodontics; Periodontitis; Secondary Prevention
PubMed: 20202098
DOI: 10.1111/j.1365-2842.2010.02068.x -
Journal of Prosthodontic Research Jul 2022The purpose of this systematic review was to evaluate the survival rate, biological complications, technical complications, and clinical behavior of single crowns... (Meta-Analysis)
Meta-Analysis
PURPOSE
The purpose of this systematic review was to evaluate the survival rate, biological complications, technical complications, and clinical behavior of single crowns supported by teeth made up in monolithic zirconia with CAD/CAM technology.
STUDY SELECTION
An extensive electronic search was conducted through Medline/PubMed, Embase, and Cochrane Library databases. Additional manual search was performed on the references of included articles to identify relevant publications. Two reviewers independently performed the selection and electronic and manual search.
RESULTS
From nine articles included, there was a total of 594 participants and 1657 single-tooth restorations with a mean exposure time of 1.07 years, and follow-up period between 0.3 and 2.1 years. All studies showed a moderate level of quality, with a consequent moderate possibility of associated bias, using the Newcastle-Ottawa Scale (NOS), with survival rate (SR) ranging between 91% to 100%. Bleeding on probing (BOP) were reported with an average value of 29.12%. Marginal integrity showed high success rate values for the observation periods, except for one that included patients with bruxism which obtained a SR of 31.60%. Failures and/or fractures, mostly total and requiring replacement, were observed in three studies. Linear regression showed that there was no statistical correlation between survival rate and type of cementation and the average years of follow-up (p=0.730 e p=0.454). There was high heterogeneity between studies (I2 = 93.74% and Q = 79.672).
CONCLUSION
Within the limitation of this study, monolithic zirconia might be considered as a possible option for restoring single crowns, especially in the posterior zone.
Topics: Computer-Aided Design; Crowns; Dental Prosthesis Design; Dental Restoration Failure; Humans; Zirconium
PubMed: 34615842
DOI: 10.2186/jpr.JPR_D_21_00081 -
Journal of Prosthodontic Research Jan 2018Several studies reported better outcomes when restoring edentulous mandible with unsplinted IODs compared to CCDs; however, it is not clear if these outcomes remain when... (Comparative Study)
Comparative Study Meta-Analysis
PURPOSE
Several studies reported better outcomes when restoring edentulous mandible with unsplinted IODs compared to CCDs; however, it is not clear if these outcomes remain when the full literature is considered. The aim of this systematic review is to compare conventional complete dentures (CCDs) to unsplinted implant-retained overdentures (IODs) with regard to efficacy, satisfaction and quality of life.
STUDY SELECTION
The main question addressed was: How do CCDs compare to unsplinted IODs with regard to efficacy, satisfaction and quality of life? Three databases were electronically searched to identify articles comparing CCD to unsplinted IOD. Twenty-six articles were selected and reviewed in full. Of these selected articles, twenty-five compared CCDs restoring function in both arches to a maxillary CCD opposing a mandibular IOD retained by two unsplinted implants. Only one articles compared a maxillary CCDs to a maxillary IOD.
RESULTS
Outcome measures varied among the studies, including the Oral Health Impact Profile (OHIP), visual analogue scales (VAS), and masticatory performance tests. Overall, IODs were associated with significantly better patient's masticatory performance and quality of life as indicated by Oral Health as Related to Quality of Life (OHRQoL). Mandibular unsplinted IODs were more likely than CCDs to be associated with improved OHRQoL for edentulous patients and were associated with significantly higher ratings of overall satisfaction, comfort, stability, ability to speak and ability to chew.
CONCLUSIONS
Results of this systematic review indicate the superiority of IODs retained by two unsplinted mandibular implants when compared to CCDs with regards to efficacy, satisfaction and quality of life.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Complete; Denture, Overlay; Humans; Jaw, Edentulous; Mandible; Mastication; Patient Satisfaction; Quality of Life
PubMed: 28666845
DOI: 10.1016/j.jpor.2017.06.004 -
Journal of Endodontics Feb 2018Both the role of an endodontic post and the ferrule effect have been discussed for decades. The clinical impact of endodontic posts compared with post-free restoration... (Review)
Review
INTRODUCTION
Both the role of an endodontic post and the ferrule effect have been discussed for decades. The clinical impact of endodontic posts compared with post-free restoration with or without ferrule support was not systematically reviewed so far. It was assumed that the effect of an endodontic post compared with a post-free restoration can be evaluated only when at the same time a ferrule or no-ferrule situation was clinically compared.
METHODS
The specific PICO question was as follows: Patient: adults with sufficient endodontic treatment needing a core or post; Intervention: post-endodontic treatment using posts with or without ferrule; Comparison: post-endodontic treatment without posts with or without ferrule; Outcomes: failure rates of post/core complexes with or without ferrule support. A Medline search was performed via PubMed in June 2017 using relevant electronic databases. Additionally, hand search was performed. Only prospective clinical studies in humans comparing the success/survival of teeth restored with or without posts over a minimum time of observation of 5 years were included.
RESULTS
In total, 7 randomized controlled trials and 1 prospective clinical trial met inclusion criteria. Cochrane rating showed high risk of bias in 5 studies. Two of 3 studies support the ferrule-effect concept. Seven of 8 show no post effect. Clinical evidence regarding the influence of tooth location on its survival is scarce.
CONCLUSION
Ferrule effect and maintaining cavity walls are the predominant factors with regard to tooth and restoration survival of endodontically treated teeth. Most studies do not confirm a positive effect of post placement.
Topics: Dental Restoration, Permanent; Humans; Post and Core Technique; Root Canal Therapy; Tooth, Nonvital
PubMed: 29229457
DOI: 10.1016/j.joen.2017.09.020 -
Clinical and Experimental Dental... Dec 2022This systematic review aims to investigate the effect of different preparation designs on the marginal fit and fracture strength of ceramic occlusal veneers. (Review)
Review
OBJECTIVES
This systematic review aims to investigate the effect of different preparation designs on the marginal fit and fracture strength of ceramic occlusal veneers.
MATERIALS AND METHODS
Based on the PICO question and the search terms, an electronic search was performed in Google Scholar, PubMed (MEDLINE), Scopus, Cochrane Library, Web of Science, Science Direct, Wiley, Ovid, and SAGE for articles published up to July 2022. After including English in vitro studies that evaluated posterior ceramic occlusal overlays at the posterior with ceramic restorations by following the PRISMA statement, the extracted data was tabulated. The methodological quality of the included studies was evaluated. Risk of bias assessment was done independently by two authors using the modified MINORS scale.
RESULTS
About 3138 search results were screened, of which 22 were selected due to their titles. Twenty-one full-text articles were assessed for eligibility. Seventeen in-vitro studies were finalized for the extraction of quantitative data. All 17 articles had a low risk of bias and were retained. The influencing items for evaluating the research were different in most studies; therefore, qualitative synthesis of the results was feasible. They generally included preparation design, material thickness, depth of preparation in the tooth, internal divergence angle, and finish line. Meta-analysis was not done due to heterogeneity of preparation types and evaluation methods. Results revealed that fracture resistance of occlusal veneers is higher than normal mastication force, and it is sufficient to prepare the occlusal surface, use a self-etching primer for bonding, and an acceptable minimum ceramic thickness. The marginal discrepancy of occlusal veneers is clinically acceptable. However, this systematic review faces some limitations due to the lack of in vivo studies, different preparation designs in included studies, different follow-ups, and lack of comprehensive explanations in articles.
CONCLUSIONS
The preparation design of occlusal veneers influences both marginal adaptation and fracture resistance. Various preparation designs are proven to have clinically acceptable fracture strength and marginal adaptation.
Topics: Dental Porcelain; Dental Veneers; Flexural Strength; Dental Stress Analysis; Materials Testing; Ceramics
PubMed: 36062841
DOI: 10.1002/cre2.653 -
BioMed Research International 2021Analyzing and comparing the fit and accuracy of removable partial denture (RPDs) frameworks fabricated with CAD/CAM and rapid prototyping methods with conventional...
OBJECTIVE
Analyzing and comparing the fit and accuracy of removable partial denture (RPDs) frameworks fabricated with CAD/CAM and rapid prototyping methods with conventional techniques.
MATERIALS AND METHODS
The present systematic review was carried out according to PRISMA guidelines. The search was carried out on PubMed/MEDLINE, Cochrane collaboration, Science direct, and Scopus scientific engines using selected MeSH keywords. The articles fulfilling the predefined selection criteria based on the fit and accuracy of removable partial denture (RPD) frameworks constructed from digital workflow (CAD/CAM; rapid prototyping) and conventional techniques were included.
RESULTS
Nine full-text articles comprising 6 in vitro and 3 in vivo studies were included in this review. The digital RPDs were fabricated in all articles by CAD/CAM selective laser sintering and selective laser melting techniques. The articles that have used CAD/CAM and rapid prototyping technique demonstrated better fit and accuracy as compared to the RPDs fabricated through conventional techniques. The least gaps between the framework and cast (41.677 ± 15.546 m) were found in RPDs constructed through digital CAD/CAM systems.
CONCLUSION
A better accuracy was achieved using CAD/CAM and rapid prototyping techniques. The RPD frameworks fabricated by CAD/CAM and rapid prototyping techniques had clinically acceptable fit, superior precision, and better accuracy than conventionally fabricated RPD frameworks.
Topics: Computer-Aided Design; Denture Design; Denture, Partial; Denture, Partial, Removable; Humans; Lasers; Workflow
PubMed: 34532499
DOI: 10.1155/2021/3194433 -
BMC Oral Health Sep 2017The continuous development in dental processing ensures new opportunities in the field of fixed prosthodontics in a complete virtual environment without any physical... (Review)
Review
BACKGROUND
The continuous development in dental processing ensures new opportunities in the field of fixed prosthodontics in a complete virtual environment without any physical model situations. The aim was to compare fully digitalized workflows to conventional and/or mixed analog-digital workflows for the treatment with tooth-borne or implant-supported fixed reconstructions.
METHODS
A PICO strategy was executed using an electronic (MEDLINE, EMBASE, Google Scholar) plus manual search up to 2016-09-16 focusing on RCTs investigating complete digital workflows in fixed prosthodontics with regard to economics or esthetics or patient-centered outcomes with or without follow-up or survival/success rate analysis as well as complication assessment of at least 1 year under function. The search strategy was assembled from MeSH-Terms and unspecific free-text words: {(("Dental Prosthesis" [MeSH]) OR ("Crowns" [MeSH]) OR ("Dental Prosthesis, Implant-Supported" [MeSH])) OR ((crown) OR (fixed dental prosthesis) OR (fixed reconstruction) OR (dental bridge) OR (implant crown) OR (implant prosthesis) OR (implant restoration) OR (implant reconstruction))} AND {("Computer-Aided Design" [MeSH]) OR ((digital workflow) OR (digital technology) OR (computerized dentistry) OR (intraoral scan) OR (digital impression) OR (scanbody) OR (virtual design) OR (digital design) OR (cad/cam) OR (rapid prototyping) OR (monolithic) OR (full-contour))} AND {("Dental Technology" [MeSH) OR ((conventional workflow) OR (lost-wax-technique) OR (porcelain-fused-to-metal) OR (PFM) OR (implant impression) OR (hand-layering) OR (veneering) OR (framework))} AND {(("Study, Feasibility" [MeSH]) OR ("Survival" [MeSH]) OR ("Success" [MeSH]) OR ("Economics" [MeSH]) OR ("Costs, Cost Analysis" [MeSH]) OR ("Esthetics, Dental" [MeSH]) OR ("Patient Satisfaction" [MeSH])) OR ((feasibility) OR (efficiency) OR (patient-centered outcome))}. Assessment of risk of bias in selected studies was done at a 'trial level' including random sequence generation, allocation concealment, blinding, completeness of outcome data, selective reporting, and other bias using the Cochrane Collaboration tool. A judgment of risk of bias was assigned if one or more key domains had a high or unclear risk of bias. An official registration of the systematic review was not performed.
RESULTS
The systematic search identified 67 titles, 32 abstracts thereof were screened, and subsequently, three full-texts included for data extraction. Analysed RCTs were heterogeneous without follow-up. One study demonstrated that fully digitally produced dental crowns revealed the feasibility of the process itself; however, the marginal precision was lower for lithium disilicate (LS2) restorations (113.8 μm) compared to conventional metal-ceramic (92.4 μm) and zirconium dioxide (ZrO2) crowns (68.5 μm) (p < 0.05). Another study showed that leucite-reinforced glass ceramic crowns were esthetically favoured by the patients (8/2 crowns) and clinicians (7/3 crowns) (p < 0.05). The third study investigated implant crowns. The complete digital workflow was more than twofold faster (75.3 min) in comparison to the mixed analog-digital workflow (156.6 min) (p < 0.05). No RCTs could be found investigating multi-unit fixed dental prostheses (FDP).
CONCLUSIONS
The number of RCTs testing complete digital workflows in fixed prosthodontics is low. Scientifically proven recommendations for clinical routine cannot be given at this time. Research with high-quality trials seems to be slower than the industrial progress of available digital applications. Future research with well-designed RCTs including follow-up observation is compellingly necessary in the field of complete digital processing.
Topics: Computer-Aided Design; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Humans; Workflow
PubMed: 28927393
DOI: 10.1186/s12903-017-0415-0