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Diagnostics (Basel, Switzerland) Mar 2024A common application for intraoral scanners is the digitization of the morphology of teeth and palatal rugae. Palatal scans are most commonly required to fabricate... (Review)
Review
A common application for intraoral scanners is the digitization of the morphology of teeth and palatal rugae. Palatal scans are most commonly required to fabricate complete dentures and immediate transitional dentures and serve as a reference point for assessing orthodontic results. However, they are also frequently included by accident, even though the main purpose of intraoral scanning is to reconstruct dentition using computer-aided manufacturing (CAM). The literature shows that the identification of disaster victims has frequently involved palatal rugae impressions. As the skull provides sound insulation, the rugae are resistant to heat, chemicals, and stress. Antemortem data might be difficult to find during a forensic inquiry, particularly in disaster victim identification cases. In contrast with DNA and fingerprints, there is a greater likelihood of having a dental record that contains palatal scans. With specialized software, the scans can be exported as open stereolithography (STL) files. Considering that a full case consumes up to about 100 MB of hard drive space, long-term storage should not be an issue compared to a plaster model. Additionally, dentists widely use online databases to exchange data for smile design, implant registration, and orthodontic purposes. This will produce a digital database that grows quickly and is readily usable for forensic investigations. The uniqueness of forensic features is frequently challenged; however, palatal morphology's unique trait could make it possible as it is characteristic of individuals as well as the most distinguishing factor. This review will highlight how rugae, palatal morphology, mirroring, superimposition, and geometrics can serve in forensic identification.
PubMed: 38473003
DOI: 10.3390/diagnostics14050531 -
BMC Oral Health Mar 2024The present systematic review and meta-analysis investigated the available evidence about the adherence of Candida Albicans to the digitally-fabricated acrylic resins... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The present systematic review and meta-analysis investigated the available evidence about the adherence of Candida Albicans to the digitally-fabricated acrylic resins (both milled and 3D-printed) compared to the conventional heat-polymerized acrylic resins.
METHODS
This study followed the guidelines of the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA). A comprehensive search of online databases/search tools (Web of Science, Scopus, PubMed, Ovid, and Google Scholar) was conducted for all relevant studies published up until May 29, 2023. Only in-vitro studies comparing the adherence of Candida albicans to the digital and conventional acrylic resins were included. The quantitative analyses were performed using RevMan v5.3 software.
RESULTS
Fourteen studies were included, 11 of which were meta-analyzed based on Colony Forming Unit (CFU) and Optical Density (OD) outcome measures. The pooled data revealed significantly lower candida colonization on the milled digitally-fabricated compared to the heat-polymerized conventionally-fabricated acrylic resin materials (MD = - 0.36; 95%CI = - 0.69, - 0.03; P = 0.03 and MD = - 0.04; 95%CI = - 0.06, - 0.01; P = 0.0008; as measured by CFU and OD respectively). However, no differences were found in the adhesion of Candida albicans between the 3D-printed digitally-fabricated compared to the heat-polymerized conventionally-fabricated acrylic resin materials (CFU: P = 0.11, and OD: P = 0.20).
CONCLUSION
The available evidence suggests that candida is less likely to adhere to the milled digitally-fabricated acrylic resins compared to the conventional ones.
Topics: Acrylic Resins; Candida albicans; Databases, Factual
PubMed: 38439020
DOI: 10.1186/s12903-024-04083-2 -
Photodiagnosis and Photodynamic Therapy Apr 2024Orthodontic acrylic resins containing antimicrobial photocatalytic nanoparticles aims to reduce oral lesions including denture stomatitis and white spot lesions but they... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND/PURPOSE
Orthodontic acrylic resins containing antimicrobial photocatalytic nanoparticles aims to reduce oral lesions including denture stomatitis and white spot lesions but they should not imperil its mechanical properties. This systematic review was done to evaluate the effect of various photocatalytic nanoparticles on the flexural strength (FS) of acrylic resins.
MATERIALS AND METHODS
We systematically searched the PubMed/Medline, Cochrane Library, and Scopus databases from January 2018 to October 2023. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the quality of the studies was evaluated using the QUIN tool, which is specifically designed to assess the risk of bias in vitro studies.
RESULTS
Following screening of 1016 initial records, 23 studies were deemed eligible for inclusion. The addition of photocatalytic nanoparticles, such as emodin (Emo), curcumin (Cur), Cur nisin (CurNis), zeolite/zinc oxide (Zeo/ZnO), and Ulva lactuca (U. lactuca), to acrylic resins resulted in a reduction in FS, with the extent of reduction dependent on the nanoparticle concentration. Specifically, the addition of Emo (≥0.5 %), Cur (≥0.5 %), CurNis (≥5 %), Zeo/ZnO (≥2), and U. lactuca (≥1 %) to acrylic resins significantly decreased FS. Conversely, the inclusion of ZnO and titanium dioxide (TiO) in acrylic resins improved FS, but higher concentrations (≥5 % for TiO) had a limited positive effect.
CONCLUSION
Our study supports the use of low concentrations of photocatalytic nanoparticles, such as ZnO (≤2 %), TiO (≤3 %), Emo (≤0.5 %), Cur (≤0.5 %), CurNis (≤5 %), and U. lactuca (≤1 %), in orthodontic acrylic resins without compromising FS.
Topics: Acrylic Resins; Nanoparticles; Flexural Strength; Anti-Infective Agents; Photochemotherapy; Humans
PubMed: 38401821
DOI: 10.1016/j.pdpdt.2024.104021 -
Journal of Prosthodontic Research Feb 2024This systematic review examined the effectiveness of soft denture relining (SDR) materials.
PURPOSE
This systematic review examined the effectiveness of soft denture relining (SDR) materials.
STUDY SELECTION
A comprehensive search of MEDLINE, Cochrane Library, and ICHUSHI was conducted up to July 26, 2020. Target outcomes were patient satisfaction, oral health-related quality of life (OHRQOL), masticatory ability (MA), denture functional duration, residual ridge resorption (RRR), and microbial contamination. An organization specializing in literature searches performed the reference searches, and two reviewers independently selected the literature sources, extracted the data, and assessed the risk of bias. The reviewers resolved any disagreements concerning the assortment of literature sources through discussion. SDR included acrylic- and silicone-based materials, which were evaluated separately.
RESULTS
Reviewers selected 7, 5, 11, 1, 4, and 6 studies to assess patient satisfaction, OHRQOL, MA, functional duration, RRR, and microbial contamination, respectively. The results confirmed that SDR improved patient satisfaction, OHRQOL, MA, and RRR. However, the functional duration of SDR material is shorter than that of hard denture relining (HDR) or acrylic resin material. Furthermore, SDR material is more susceptible to microbial contamination in the long term. The risk of bias for the included studies tended to be high because of specific issues (difficulty in blinding SDR versus HDR).
CONCLUSIONS
For patients who wear complete dentures, SDR often provides beneficial outcomes such as pain reduction and recovery from MA. However, caution should be exercised regarding their use owing to insufficient functional duration and the possibility of microbial contamination during long-term use.
PubMed: 38382972
DOI: 10.2186/jpr.JPR_D_23_00067 -
Cureus Jan 2024Removable partial dentures (RPDs) offer a broad range of aesthetics and restorative functions for partially edentulous patients. This systematic review examines... (Review)
Review
Removable partial dentures (RPDs) offer a broad range of aesthetics and restorative functions for partially edentulous patients. This systematic review examines patients' satisfaction rates and the factors that influence RPD satisfaction. This systematic review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and the Cochrane Handbook for Systematic Reviews. A systematic literature search was done on PubMed, Scopus, and Google Scholar using preset inclusion criteria. A total of 923 non-duplicate articles were screened, and 35 were included in this review. Among the included studies, RPDs generally exhibited high satisfaction rates, with reported rates ranging between 50% and 81%. Several factors influenced satisfaction. Age played a major role, with older adults expressing higher satisfaction. Gender differences were also noted, especially in appearance satisfaction where women were more satisfied with RPDs than men. Prior experience with RPDs correlated positively with overall satisfaction. The number and location of missing teeth, as well as the type of RPD (metal vs. flexible), significantly influenced satisfaction levels. Flexible dentures were more satisfactory than metal RPDs. Attachments, such as magnetic attachments and implants, increased satisfaction. Patient complaints, encompassing pain, aesthetics, and cleanliness, were identified as common sources of dissatisfaction. The results underscore the significance of customizing RPD treatment to individual needs, considering factors that influence RPD satisfaction. Recognizing the importance of influential factors such as age, gender RPD experience, etc., for clinicians seeking to optimize patient outcomes in RPD therapy is crucial.
PubMed: 38322077
DOI: 10.7759/cureus.51793 -
Heliyon Feb 2024To investigate whether the clinical and radiographical outcomes are affected when four or six implants support the maxillary fixed complete denture (FCD).
Outcomes that may affect implant and prosthesis survival and complications in maxillary fixed prosthesis supported by four or six implants: A systematic review and meta-analysis.
OBJECTIVE
To investigate whether the clinical and radiographical outcomes are affected when four or six implants support the maxillary fixed complete denture (FCD).
MATERIALS AND METHODS
This study was registered on PROSPERO (CRD42021226432) and followed the PRISMA guidelines. The focused PICO question was, "For an edentulous maxillary patient rehabilitated with an implant-supported fixed prosthesis, do the clinical and radiographical outcomes differ when four or six implants support the prosthesis ". A thorough search of the relevant studies was designed and performed electronically. The survival rate of implant and prosthesis, marginal bone loss, and complications (mechanical and biological) were the primary outcomes, whereas implant distribution and using the surgical guide, follow-up, and framework material were evaluated as secondary outcomes.
RESULTS
Out of 1099 articles initially retrieved, 53 clearly stated the outcomes of interest and were included in this study. There were no significant differences in implant and prosthesis survival, technical/mechanical complications, and biological complications between the 4-implant group (4-IG) and the 6-implant group (6-IG). However, marginal bone loss (MBL) was significantly higher in the 4-IG (p < 0.01). The surgical guide and follow-up period did not significantly affect implant/prosthesis survival. Additionally, using the CAD/CAM milled framework and anteroposterior implant distribution were associated with significantly higher implant survival in the 6-IG (p < 0.01).
CONCLUSION
The findings of this study indicated that having a greater number of implants, as seen in the 6-implant group, can lead to a decrease in technical and biological complications and reduce marginal bone loss. It is worth noting that factors such as using CAD/CAM frameworks and the anteroposterior distribution of implants were recognized as important in improving implant survival rates when more implants are present.
PubMed: 38317918
DOI: 10.1016/j.heliyon.2024.e24365 -
The Journal of Prosthetic Dentistry Jan 2024Time and cost are factors that influence a patient's decision on dental prosthetic treatment. Evidence is needed to demonstrate that restoration using digital systems is... (Review)
Review
STATEMENT OF PROBLEM
Time and cost are factors that influence a patient's decision on dental prosthetic treatment. Evidence is needed to demonstrate that restoration using digital systems is more rapid and less costly than the conventional process.
PURPOSE
The purpose of this systematic review was to analyze and compare the duration and cost of fixed dental prostheses fabricated using digital and conventional methods from scanning or impression making to delivery of the prosthesis.
MATERIAL AND METHODS
A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA-P 2015) guidelines. The analysis methods and inclusion criteria were documented in a protocol registered in the Prospective International Register of Systematic Reviews (PROSPERO) (CRD42023458734). The bibliographic search was carried out using PubMed, Cochrane, and PROSPERO databases. The main keywords used were (Prosthodontic OR restorative dentistry OR denture) AND (CAD CAM OR Digital workflow OR Computer Dentistry OR Digital Design) AND (Economic OR cost OR Financial OR time efficiency). Two investigators undertook the different steps of article selection.
RESULTS
A total of 8 articles published between 2010 and 2023 were found for the qualitative synthesis by using the search criteria. Two studies showed that conventional impressions took more time than digital scans for the fabrication of a single crown, and 1 study showed the opposite. One study found that a digital scan was faster than conventional impression making for the fabrication of a 3-unit fixed partial denture, and another study showed the opposite. The dental laboratory technician spent more time on the conventional workflow than the digital workflow for the 3-unit framework and veneering process. No difference was found between conventional and digital workflows for clinical evaluation and chairside adjustment for the fabrication of a single crown. No articles have compared the cost of fixed prostheses.
CONCLUSIONS
The digital pathway can shorten the laboratory process. However, the duration of the impression or scan may vary depending on the technique used. Studies are needed to analyze the cost-effectiveness of the fabrication of tooth-supported restorations.
PubMed: 38302291
DOI: 10.1016/j.prosdent.2024.01.003 -
BMC Oral Health Jan 2024Different characteristics of bars (cross-sectional shape, diameter, distal extension etc.) lead to different biomechanical behavior (retention and stress) with implants...
Different characteristics of bars (cross-sectional shape, diameter, distal extension etc.) lead to different biomechanical behavior (retention and stress) with implants and peri-implant tissues.Aim: To evaluate the impact of implant-supported removable prostheses bar designs in fully edentulous arch (in the maxilla and/or mandibula), with 4 implants or more, on the peri-implant soft and hard tissues.Two reviewers searched for observational studies, RCT and in vitro studies, published on five main databases and three from the grey literature, without restrictions on November 2023.Of the 3049 selected articles, four met the inclusion criteria. Four RCT evaluated peri-implant health tissues in full edentulous arches with 4 or 6 implants rehabilitated with implant bar overdentures. One prospective study with 5 years follow-up evaluated the success/survival rate of implants and implant bar overdentures. Overall, 261 subjects were enrolled in our systematic review with 1176 implants. Overdentures' survival rate was 100%. There was a trend that plaque indices and gingival indices were low in all of the studies, however no statistical analysis was done due to the lack of information.Due to the lack of information in the included studies, we cannot confirm if bar characteristics affect the peri-implant tissues health.
Topics: Humans; Dental Implants; Prospective Studies; Jaw, Edentulous; Dental Prosthesis, Implant-Supported; Mouth, Edentulous; Mandible; Denture, Overlay; Denture Retention
PubMed: 38281916
DOI: 10.1186/s12903-024-03915-5 -
Journal of Prosthodontics : Official... Jan 2024This systematic review aimed to verify whether anatomic, semi-anatomic, or nonanatomic occlusal morphology of artificial teeth improves the masticatory function of... (Review)
Review
PURPOSE
This systematic review aimed to verify whether anatomic, semi-anatomic, or nonanatomic occlusal morphology of artificial teeth improves the masticatory function of complete or removable partial denture wearers.
MATERIALS AND METHODS
According to the PICO strategy, six databases and the grey literature were searched to identify randomized (RCT) and non-randomized clinical trials (N-RCT) comparing masticatory function, in terms of masticatory performance and efficiency, and muscle activity as primary outcomes; and patient-reported results (O) in individuals using removable dentures (P) with different occlusal morphologies of artificial teeth (I/C). Masticatory ability, satisfaction with the prosthetic treatment, and oral health-related quality of life (OHRQoL) were evaluated as secondary outcomes. Risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials (RoB 2.0) for RCT and Risk of Bias for non-randomized studies with intervention (ROBINS-I) for N-RCT studies. Meta-analyses were performed to compare primary outcomes and masticatory ability between the occlusal morphologies of artificial teeth of complete or removable partial dentures (α = 0.05). Certainty of the evidence was verified using the GRADE approach.
RESULTS
Eleven studies (seven RCTs and four N-RCTs) were included. The risk of bias was considered low for two studies, some concerns for five, and high for the last four studies. Meta-analyses showed that removable partial dentures with anatomic artificial teeth improved masticatory efficiency for carrot chewing (MD 6.31; 95% CI [3.39, 9.22], I = 0%). However, masseter and temporal muscle activities increased when removable partial dentures with nonanatomic teeth were used (MD -756.97; 95% CI [-892.25, -621.68], I = 100%). Masticatory ability was not influenced by occlusal morphology during chewing of all foods in complete denture users: Carrot (MD -0.88, 95% CI [-8.98, 7.23], I = 57%); sausage (MD -8.86, 95% CI [-23.05, 5.33], I = 71%); apple (MD -5.78, 95% CI [-28.82, 17.26], I = 87%); and cheese (MD -4.16, 95% CI [-15.14, 6.82], I = 62%). The certainty of evidence for all evaluated outcomes was very low, mainly due to very serious problems found in the parameters of inconsistency, indirectness, and imprecision.
CONCLUSIONS
Despite the very low certainty of evidence, the occlusal morphology of artificial teeth influences masticatory function. Anatomic teeth improved the masticatory efficiency and muscle activity of removable partial denture wearers. Nonanatomic teeth increased temporal and masseter muscle activity, which negatively affected chewing in removable partial denture users. However, patients using complete dentures with anatomic and semi-anatomic teeth presented similar masticatory ability.
PubMed: 38279686
DOI: 10.1111/jopr.13824 -
Gerodontology Jan 2024To evaluate clinical parameters that affect the performance of root-supported overdentures (ROD) and to identify the possible factors that may affect it. (Review)
Review
OBJECTIVE
To evaluate clinical parameters that affect the performance of root-supported overdentures (ROD) and to identify the possible factors that may affect it.
BACKGROUND
ROD still serve as an alternative and successful treatment plan nowadays for partially edentulous patients. Nonetheless, there is not yet conclusive evidence about their clinical evaluation.
MATERIALS AND METHODS
A search strategy was developed following a PIO (Population, Intervention, Outcome) framework including an electronic search in the following databases: PubMed, Cochrane Library and Scopus. The systematic search included only randomised controlled clinical trials (RCTs), published until January 2023 in English language and was performed by two independent reviewers. Quality assessment of the included studies was conducted according to the Cochrane Risk of Bias tool.
RESULTS
The final selection of studies included 11 RCTs. Clinically relevant variables derived from this search were: Complications, with caries being the most frequently reported, periodontal aspects and bone changes around abutment teeth. Additionally, methods and clinical suggestions for the maintenance of these restorations and patient-related outcomes were assessed. According to the risk of bias assessment, nine studies were considered of high risk, whereas only 2 of low risk. A meta-analysis was not feasible.
CONCLUSION
Within the limitations of this systematic review, ROD remain a viable treatment plan, offering better denture stability and bone preservation around abutment teeth and high patient satisfaction. Thorough oral hygiene and regular follow-ups are of utmost importance. Further well-designed RCTs are necessary for firmer conclusions.
PubMed: 38247020
DOI: 10.1111/ger.12739