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Clinical Implant Dentistry and Related... Jun 2022To assess the effect of grafting the gap (SG) between the implant surface and alveolar socket on hard and soft tissue changes following single immediate implant... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To assess the effect of grafting the gap (SG) between the implant surface and alveolar socket on hard and soft tissue changes following single immediate implant placement (IIP).
MATERIALS AND METHODS
Two independent reviewers conducted an electronic literature search in Pubmed, Web of Science, Embase and Cochrane databases as well as a manual search to identify eligible clinical studies up to August 2021. Randomized controlled trials (RCTs) comparing IIP with and without SG were included for a qualitative analysis. Meta-analyses were performed when possible.
RESULTS
Out of 3627 records, 15 RCTs were selected and reported on 577 patients who received 604 single immediate implants (IIP + SG: 298 implants in 292 patients; IIP: 306 implants in 285 patients) with a mean follow-up ranging from 4 to 36 months. Two RCTs showed low risk of bias. Meta-analysis revealed 0.59 mm (95% CI [0.41; 0.78], p < 0.001) or 54% less horizontal buccal bone resorption following IIP + SG when compared to IIP alone. In addition, 0.58 mm (95% CI [0.28; 0.88], p < 0.001) less apical migration of the midfacial soft tissue level was found when immediate implants were installed with SG. A trend towards less distal papillary recession was found (MD 0.60 mm, 95% CI [-0.08; 1.28], p = 0.080) when SG was performed, while mesial papillae appeared not significantly affected by SG. Vertical buccal bone changes were also not significantly affected by SG. Insufficient data were available for meta-analyses on horizontal midfacial soft tissue changes, pink esthetic score, marginal bone level changes, probing depth and bleeding on probing. Based on GRADE guidelines, a moderate recommendation for SG following IIP can be made.
CONCLUSION
SG may contribute to horizontal bone preservation and soft tissue stability at the midfacial aspect of immediate implants. Therefore, SG should be considered as an adjunct to IIP in clinical practice.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Esthetics, Dental; Humans; Immediate Dental Implant Loading; Tooth Socket
PubMed: 35313067
DOI: 10.1111/cid.13079 -
American Journal of Orthodontics and... Dec 2021This systematic review aimed to identify, evaluate, and provide a synthesis of the available literature on the proximal enamel thickness (PET) of permanent teeth. (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
This systematic review aimed to identify, evaluate, and provide a synthesis of the available literature on the proximal enamel thickness (PET) of permanent teeth.
METHODS
The eligibility criteria were studies that assessed the PET of the permanent teeth. A search of studies in Medline (via PubMed), the Cochrane Library, Scopus, Web of Science, Embase, and Lilacs databases that measured PET was conducted until August 31, 2020. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias for systematic reviews involving cross-sectional studies. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations approach. PET data generated from the systematic review were summarized by random-effects inverse-generic meta-analysis.
RESULTS
From 1388 potentially eligible studies, 11 were considered for systematic review and meta-analysis. The measurement of PET was done with radiographs, microscopes, microtomographs, or profilometers. In total, 4019 mesial and distal surfaces involving 2118 teeth were assessed. All included studies showed low to moderate risk of bias, whereas GRADE revealed that the level of evidence was low. Greater mesial and distal enamel thickness was observed for the premolars and molars, whereas it was least for the mandibular central incisors. The least difference of 0.02 mm (95% confidence interval [CI], -0.07 to 0.11 and -0.06 to 0.09, respectively) between mesial and distal sides was observed for the maxillary and mandibular second molars, whereas the maximum difference of 0.12 mm (95% CI, 0.07-0.17 and 0.07-0.16, respectively) was observed for the maxillary central incisors and maxillary first premolars. The meta-analysis indicated a moderate level of heterogeneity (I of 45%). The funnel plot revealed minimal publication bias.
CONCLUSIONS
The summary effect of the meta-analysis revealed that the thickness of the enamel on the distal aspect was greater than on the mesial aspect by an average of 0.10 mm (95% CI, 0.09-0.12). This finding would be of relevance to all disciplines of dentistry and especially for the clinician planning interproximal reduction, a procedure that is routinely done for clear aligner therapy.
Topics: Cross-Sectional Studies; Dental Caries; Dental Enamel; Dentition, Permanent; Humans; Molar
PubMed: 34420845
DOI: 10.1016/j.ajodo.2021.05.007 -
The British Journal of Oral &... Jul 2019We conducted a systematic review of epidemiological studies to assess the prevalence of distal surface caries (DSC) in second molars adjacent to third molars. We... (Meta-Analysis)
Meta-Analysis
We conducted a systematic review of epidemiological studies to assess the prevalence of distal surface caries (DSC) in second molars adjacent to third molars. We searched the Cochrane Library, Lilacs, Embase, and Medline through Ovid (Wolters Kluwer) to retrieve English and non-English papers from inception to June 2016, and supplemented this with a search of the references and by tracking citations. Three reviewers contributed: one reviewed all the papers, and the other two divided the rest between them. They extracted data, completed structured quality assessments with a validated risk of bias tool for observational studies, and categorised the summary scores. The search yielded 81 records and 11 studies were analysed. The considerable methodological diversity meant that five were not eligible for inclusion in the quantitative synthesis. A meta-analysis of six studies on the prevalence of DSC and a subgroup analysis of three on various third-molar angulations were indicated. The overall pooled prevalence estimate calculated with a random-effects model was 23% (95% CI 2% to 44%) among patients. Prevalence subtotals were 20% (95% CI 5% to 36%) for prospective, and 15% (95% CI 5% to 36%) for retrospective studies among teeth. A subgroup analysis of three studies with 1296 patients (1666 molars) yielded a prevalence of DSC of 36% (95% CI 5% to 67%) for mesial impactions and 22% (95% CI 1% to 42%) for horizontal impactions. DSC was present in 3% of distally-inclined impactions, (95% CI 1% to 5%) and in 7% (95% CI 1% to 13%) of vertical third molars. The studies varied. The risk of bias was low in one and moderate in two. European studies suggested that DSC may be present in about one in four referrals for the assessment of third molars, and that the risk is considerably higher in those with convergent third molar impactions.
Topics: Dental Caries; Humans; Molar; Molar, Third; Prevalence; Prospective Studies; Referral and Consultation; Retrospective Studies
PubMed: 31128951
DOI: 10.1016/j.bjoms.2019.04.016 -
Journal of Oral Biology and... 2022Photobiomodulation has been gaining traction as a plausible therapy to control orthodontically induced root resorption. (Review)
Review
BACKGROUND
Photobiomodulation has been gaining traction as a plausible therapy to control orthodontically induced root resorption.
AIM
The aim of the present review was to systematically appraise randomized controlled trials conducted to study the influence of photobiomodulation on external root resorption during orthodontic movement in humans.
METHOD
ology - A systematic search was carried out employing keywords in various electronic databases namely MEDLINE (Pubmed), Cochrane Library, Google Scholar, Semantic Scholar, ScienceDirect and Opengrey.eu for studies up to March 2020. Pre-defined inclusion and exclusion criteria were used to select the studies. Data extraction was carried out and the risk of bias was assessed using Cochrane Risk of Bias tool. Meta-analysis was conducted using random effects model for selected studies. Subgroup analysis was conducted for resorption on each axial surface of the tooth root viz. mesial, buccal, distal and palatal as well as for vertical thirds viz. cervical, middle and apical third. Summary of Findings was formulated according to GRADE Profile.
RESULTS
The search retrieved 1509 results out of which six studies were included for the systematic review. Two studies showed low overall risk of bias and the remaining four showed unclear risk of bias. The meta-analysis was conducted for three studies with an overall sample size of 120 teeth which showed a pooled mean difference of 0.08 (95% CI 0.15 - (-0.02) to 1.96, p=<0.0001) in favour of photobiomodulation group with respect to mean total resorption per tooth. I index revealed 88% heterogeneity.
CONCLUSION
It is concluded that there is moderate grade of evidence to suggest beneficial effect of photobiomodulation on root resorption. Further high-quality randomized controlled trials with standardized intervention parameters are recommended.
REGISTRATION
PROSPERO registration number - CRD42020167291.
PubMed: 35692967
DOI: 10.1016/j.jobcr.2022.05.014