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Burns : Journal of the International... Jun 2023Hypertrophic scarring is a deviate occurrence after wound closure and is a common burn sequela. The mainstay of scar treatment consists of a trifold approach: hydration,... (Review)
Review
BACKGROUND
Hypertrophic scarring is a deviate occurrence after wound closure and is a common burn sequela. The mainstay of scar treatment consists of a trifold approach: hydration, UV-protection and the use of pressure garments with or without extra paddings or inlays to provide additional pressure. Pressure therapy has been reported to induce a state of hypoxia and to reduce the expression pattern of transforming growth factor-β1 (TGF-β1), therefore limiting the activity of fibroblasts. However, pressure therapy is said to be largely based on empirical evidence and a lot of controversy concerning the effectiveness still prevails. Many variables influencing its effectivity, such as adherence to treatment, wear time, wash frequency, number of available pressure garment sets and amount of pressure remain only partially understood. This systematic review aims to give a complete and comprehensive overview of the currently available clinical evidence of pressure therapy.
METHODS
A systematic search for articles concerning the use of pressure therapy in the treatment and prevention of scars was performed in 3 different databases (Pubmed, Embase, and Cochrane library) according to the PRISMA statement. Only case series, case-control studies, cohort studies, and RCTs were included. The qualitative assessment was done by 2 separate reviewers with the appropriate quality assessment tools.
RESULTS
The search yielded 1458 articles. After deduplication and removal of ineligible records, 1280 records were screened on title and abstract. Full text screening was done for 23 articles and ultimately 17 articles were included. Comparisons between pressure or no pressure, low vs high pressure, short vs long duration and early vs late start of treatment were investigated.
CONCLUSION
There is sufficient evidence that indicates the value of prophylactic and curative use of pressure therapy for scar management. The evidence suggests that pressure therapy is capable of improving scar color, thickness, pain, and scar quality in general. Evidence also recommends commencing pressure therapy prior to 2 months after injury, and using a minimal pressure of 20-25 mmHg. To be effective, treatment duration should be at least 12 months and even preferably up to 18-24 months. These findings were in line with the best evidence statement by Sharp et al. (2016).
Topics: Humans; Burns; Cicatrix, Hypertrophic; Treatment Outcome; Cohort Studies; Time Factors
PubMed: 36941176
DOI: 10.1016/j.burns.2023.03.007 -
Journal of Dentistry Feb 2023This systematic review aimed to collect and interpret the randomized clinical trials (RCTs) that investigated the outcome of the self-adhesive luting resins (SA)... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
This systematic review aimed to collect and interpret the randomized clinical trials (RCTs) that investigated the outcome of the self-adhesive luting resins (SA) compared to total-etch (TE), selective etch with dentin adhesives (Sle), selective etch without dentin adhesives (SleSA) or self-etch adhesives (SE).
DATA SOURCES
A thorough search of Internet databases was conducted without language restrictions, and the search ran up to and including April 2022. The illegible records citations were checked for more relevant clinical studies.
STUDY SELECTION/RESULTS
The inclusion criteria were randomized controlled trials (RCTs) that compared self-adhesive luting resins with total-etch, selective-etch, or self-etch adhesives regarding postoperative sensitivity, incidences of debonding, and survival rates of indirect restorations. From 1732 records, 9 RCTs met the eligibility criteria. Three RCTs compared total-etch adhesive to self-adhesive luting resin for intracoronal restorations, one RCT compared selective etch to self-adhesive luting resin for inlays, and 5 RCTs compared self-adhesive to other protocols for partial ceramic crowns. Postoperative sensitivity showed a non-statistically significant difference between SA and other adhesive protocols, SA revealed a non-statistically significant difference in debonding and survival to TE, but a lower statistically significant difference to Sle, SleSA, and SE.
CONCLUSIONS
Postoperative sensitivity might not be affected by the adhesive protocol. In relatively short observation, TE revealed comparable survival to SA for intracoronal restorations. SE and Sle exhibited the best clinical outcomes, followed by SleSA. Selective etch, and self-etch adhesives are preferable to self-adhesive resins.
CLINICAL SIGNIFICANCE
The significance of enamel etching and the superiority of self-etching adhesives over self-adhesive luting resins for reliable and durable bonding and improved clinical outcomes. However, long-term RCTs, particularly for total-etch comparison to self-adhesive luting resins, might be recommended to derive further evidence.
Topics: Humans; Acid Etching, Dental; Composite Resins; Dental Bonding; Dental Cements; Dentin-Bonding Agents; Materials Testing; Reproducibility of Results; Resin Cements; Randomized Controlled Trials as Topic
PubMed: 36566829
DOI: 10.1016/j.jdent.2022.104394 -
Journal of Conservative Dentistry : JCD 2022Advances in adhesive technologies and escalation in esthetic demands have increased indications for tooth-colored, partial coverage restorations. Recently, material... (Review)
Review
BACKGROUND
Advances in adhesive technologies and escalation in esthetic demands have increased indications for tooth-colored, partial coverage restorations. Recently, material knowledge has evolved, new materials have been developed, and no systematic review has answered the question posed by practitioners: Is the clinical efficacy of resin or ceramic better, for inlay, onlay, and overlay in the long run?
AIM
The aim of this systematic review and meta-analysis was to evaluate the clinical performance of ceramic and resin inlays, onlays, and overlays and to identify the complication types associated with the main clinical outcomes.
MATERIALS AND METHODS
Two reviewers (VN and AJ) searched PubMed, Embase, and Cochrane Central registry of controlled trials for published articles between 1983 and 2020 conforming to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines for systematic reviews. Only clinical studies which met the following criteria were included (1) studies regarding ceramic and resin inlays, onlays, and overlays were included; (2) randomized controlled trials, retrospective or prospective studies conducted in humans; (3) studies with a dropout rate <50% 4) studies with a follow-up higher than 5 years.
RESULTS
Of 1718 articles, 21 articles were selected. At 5 years, the estimated survival rates for resin ( = 129) was 86%, feldspathic porcelain ( = 1048) was 90%, and glass ceramic ( = 2218) was 92%; at 10 years, the survival of resin was 75% ( = 115), feldspathic porcelain was 91% ( = 1829), and glass ceramic was 89% ( = 1075).
CONCLUSION
The meta-regression indicated that ceramic partial coverage restorations (feldspathic porcelain and glass-ceramic) outperformed resin partial coverage restorations both at 5-year and 10-year follow-up. When compared between ceramic types, glass ceramics outperformed feldspathic porcelain at 5 years' follow-up and feldspathic porcelain outperformed glass ceramics at 10 years' follow-up. The failures were mostly due to fractures (6.2%), endodontic problems (3%), secondary caries (1.7%), and debonding which was 0.9%.
PubMed: 36187858
DOI: 10.4103/jcd.jcd_184_22 -
Dental Materials : Official Publication... Aug 2022The loss of the dental coronal portion following carious lesions or fractures leads to endodontic treatment with subsequent restoration to ensure correct anatomy and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The loss of the dental coronal portion following carious lesions or fractures leads to endodontic treatment with subsequent restoration to ensure correct anatomy and function. Recently, partial adhesive restorations have been widely proposed to increase the survival rate of endodontically treated teeth. The primary purpose of this review is to assess the failure rate of indirect partial adhesive restorations on endodontically treated teeth (ETT), considering the follow-up period.
METHODS
The indications reported in the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) were used to draft the present review. The study was constructed on PICO questions: population (patients who need indirect adhesive restorative treatment on endodontically treated teeth with onlay and overlay), intervention (onlay and overlay), control (patients with onlay and overlay on endodontically treated teeth) and outcome (failure rate and types of failure for onlay and overlay). The asked scientific question was: what are the failure rate and types of failure for adhesive indirect partial restorations on ETT?
RESULTS
The overall failure rate that emerges is 0.087 with a ratio of 121/1254, I 80 % p-value< 0.001. Moreover, by meta-regression with covariates the follow-up period reports a coefficient of 0.013 with a P-value< 0.001. In conclusion, the indirect partial restorations on endodontically treated teeth displayed overall acceptable outcomes in terms of success from 2 to 4 years after their placement with only 4.32 % of failure. Failures increase after 7 years up to 12-30 years with failure rates of approximatively 10.65 % and 20.94 %. The analysis of the included articles reporting the causes of restorations failures showed that 15.51 % of cases were related to the loss of dental element.
SIGNIFICANCE
Besides the survival rates of indirect adhesive restorations on endodontically treated posterior teeth, it was highlighted that the majority of failures appeared restorable. Thus, partial restorations seemed able to prevent the ETT tooth loss.
Topics: Composite Resins; Dental Restoration Failure; Dental Restoration, Permanent; Humans; Inlays; Prognosis; Tooth, Nonvital
PubMed: 35835608
DOI: 10.1016/j.dental.2022.06.018 -
Eye (London, England) Sep 2022Small-aperture corneal inlays, commonly known as KAMRA, are tiny optical devices inserted in the corneal stroma aiming to gain near vision in patients with presbyopia.... (Review)
Review
Small-aperture corneal inlays, commonly known as KAMRA, are tiny optical devices inserted in the corneal stroma aiming to gain near vision in patients with presbyopia. The purpose of this study was to systematically review case series of small-aperture corneal inlays performed in presbyopic emmetropic patients and to evaluate the visual outcomes of this procedure. This systematic review included 18 articles published between 2011 and 2018, overall studying 2724 eyes from 2691 participants. The mean longest follow-up was 19 months. Results showed that 78.5% of eyes reported an uncorrected near visual acuity of 20/32 or better and 90.50% of eyes achieved an uncorrected distance visual acuity of 20/25 or better. All patients experienced an improvement in uncorrected near visual acuity with a patient satisfaction ranging between 60% and 90%. The highlighted complications were keratocyte activation leading to corneal stromal haze, epithelial growth, iron deposits and poor distance visual acuity. Explantation was carried out in 101 eyes (3.7%) due to distance vision blurriness, development of epithelial microcysts, incorrect implant placement or hyperopic shift changes. KAMRA demonstrated high efficacy. However, safety and satisfaction rates remain unclear. Despite the low explantation rates reported in the literature, some complications were permanent. The results and conclusions should be taken with caution due to the conflict of interest stated in the reviewed articles.
Topics: Corneal Stroma; Humans; Presbyopia; Prospective Studies; Prostheses and Implants; Prosthesis Implantation; Refraction, Ocular; Treatment Outcome; Vision Disorders
PubMed: 35347289
DOI: 10.1038/s41433-022-02032-3 -
Clinical Oral Investigations May 2022To evaluate clinical performance of the new CAD/CAM resin-matrix ceramics and compare it with ceramic partial coverage restorations. (Review)
Review
OBJECTIVE
To evaluate clinical performance of the new CAD/CAM resin-matrix ceramics and compare it with ceramic partial coverage restorations.
MATERIALS AND METHODS
An electronic search of 3 databases (The National Library of Medicine (MEDLINE/PubMed), Scopus, and the Cochrane Central Register of Controlled Trials) was conducted. English clinical studies published between 2005 and September 2020 that evaluated the clinical performance of CAD/CAM resin-matrix ceramics inlays, onlays, or overlays were selected. The primary clinical question was applied according to PICOS strategy (Population, Intervention, Comparison, Outcome, Study design). The included studies were individually evaluated for risk of bias according to the modified Cochrane Collaboration tool criteria.
RESULTS
A total of 7 studies were included according to the established inclusion and exclusion criteria. From the included studies, 6 were randomized clinical trials while one study was longitudinal observational study without control group. According to the results of the included studies, the success rate of CAD/CAM resin-based composite ranged from 85.7 to 100% whereas the success rate reported for ceramic partial coverage restorations ranged from 93.3 to 100%. Fractures and debondings are found to be the most common cause of restorations failure.
CONCLUSION
CAD/CAM resin-based composite can be considered a reliable material for partial coverage restorations with clinical performance similar to glass ceramic restorations. However, this result needs to be confirmed in long-term evaluations.
CLINICAL RELEVANCE
CAD/CAM resin-based composites provide a potential alternative to ceramic indirect restorations. However, clinicians must be aware of the lake of knowledge regarding long-term outcome.
Topics: Ceramics; Composite Resins; Computer-Aided Design; Dental Materials; Dental Porcelain; Inlays; Longitudinal Studies; Observational Studies as Topic
PubMed: 35320383
DOI: 10.1007/s00784-022-04449-2 -
Clinical Oral Investigations Dec 2021The survival rate of indirect partial adhesive restorations on vital versus endodontically treated teeth is still controversial. The hypothesis is that there may be a... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The survival rate of indirect partial adhesive restorations on vital versus endodontically treated teeth is still controversial. The hypothesis is that there may be a difference in the survival rate of partial adhesive restorations performed on non-vital teeth compared to vital teeth.
MATERIALS AND METHODS
This systematic review was conducted following the PRISMA guidelines. The considered clinical studies investigated the outcomes of adhesive inlays, onlays, and overlays conducted over the past 40 years, focusing on Kaplan-Meier survival curves to calculate the hazard ratio (primary objective) and the survival rate (secondary objective) between vital and non-vital teeth. The risk of bias was assessed using the Newcastle-Ottawa Scale. Studies included in the review were identified through bibliographic research on electronic databases ("PubMed," "Scopus," "Cochrane Central Register of Controlled Trial," and "Embase"). The K agreement between the two screening reviewers was evaluated.
RESULTS
A total of 55,793 records were identified on PubMed, Scopus, and other bibliographic sources, and after the application of the eligibility and inclusion criteria, eight articles were included for qualitative analysis and six for quantitative analysis. The meta-analysis of the primary and secondary outcomes demonstrated that hazard ratios (HR = 8.41, 95% CI: [4.50, 15.72]) and survival rates (OR = 3.24, 95% CI: [1.76, 5.82]) seemed more favorable for indirect partial adhesive restorations on vital teeth than for those on endodontically treated teeth.
CONCLUSIONS
Within the limits of this study, these findings suggest that the risk of failure of indirect partial adhesive restorations on endodontically treated teeth is higher than on vital teeth.
CLINICAL RELEVANCE
The use of partial adhesive restorations on vital and endodontically treated teeth showed different long-term clinical outcomes.
Topics: Composite Resins; Dental Restoration Failure; Dental Restoration, Permanent; Humans; Inlays; Kaplan-Meier Estimate; Mass Screening; Tooth, Nonvital
PubMed: 34628547
DOI: 10.1007/s00784-021-04187-x -
Operative Dentistry Jan 2021Composite resin or ceramic inlays, onlays, and overlays can achieve high long-term survival and success rates. (Meta-Analysis)
Meta-Analysis
CLINICAL RELEVANCE
Composite resin or ceramic inlays, onlays, and overlays can achieve high long-term survival and success rates.
Topics: Ceramics; Composite Resins; Dental Porcelain; Inlays
PubMed: 33882133
DOI: 10.2341/19-107-LIT -
Journal of Indian Prosthodontic Society 2020The aim of this meta analysis was to evaluate the influence of the processing method on the marginal and internal gaps of lithium disilicate inlays/onlays. (Review)
Review
AIM
The aim of this meta analysis was to evaluate the influence of the processing method on the marginal and internal gaps of lithium disilicate inlays/onlays.
SETTINGS AND DESIGN
A systematic literature review was conducted using the PubMed/Medline, Embase, Scopus, and Cochrane Library databases. This review was registered on the PROSPERO platform.
MATERIALS AND METHODS
The studies were selected according to the marginal and internal gaps of two different fabrication methods for lithium disilicate (milled and pressed).
STATISTICAL ANALYSIS USED
The meta analysis was performed based on the Mantel-Haenszel and inverse variance methods, using the random effects model and a 95% confidence interval.
RESULTS
From all databases, 127 studies were identified. Four in vitro studies were included in the qualitative analysis and three in the meta analysis. Moreover, 197 restorations were evaluated (103 pressed and 94 milled). During the evaluation of only the internal gap, there was a statistically significant difference favoring the pressed technique ( = 0.002). There was no statistically significant difference in the analyses of the marginal gap ( = 0.530) and the total gap ( = 0.450).
CONCLUSION
Both the techniques provided acceptable marginal and total gaps, although the pressed technique revealed a more favorable internal adaptation than the milled onlays/inlays.
PubMed: 33487960
DOI: 10.4103/jips.jips_112_20 -
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