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Dental Materials : Official Publication... Dec 2023The objective is to compare the preventive effect on secondary caries of glass ionomer cement (GIC) restorations with amalgam or resin-composite restorations. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The objective is to compare the preventive effect on secondary caries of glass ionomer cement (GIC) restorations with amalgam or resin-composite restorations.
METHODS
Two independent researchers conducted a systematic search of English publications in PubMed, Web of Science, Cochrane and Scopus. They selected randomized clinical trials comparing secondary caries incidences around GIC restorations (conventional GIC or resin-modified GIC) with amalgam or resin-composite restorations. Meta-analysis of the secondary-caries incidences with risk ratio (RR) and 95% confidence interval (95% CI) as the effect measure was performed.
RESULTS
This review included 64 studies. These studies included 8310 GIC restorations and 5857 amalgam or resin-composite restorations with a follow-up period from 1 to 10 years. Twenty-one studies with 4807 restorations on primary teeth and thirty-eight studies with 4885 restorations on permanent teeth were eligible for meta-analysis. The GIC restorations had a lower secondary caries incidence compared with amalgam restorations in both primary dentition [RR= 0.55, 95% CI:0.41-0.72] and permanent dentition [RR= 0.20, 95% CI:0.11-0.38]. GIC restorations showed similar secondary caries incidence compared with resin-composite restorations in primary dentition [RR= 0.92, 95% CI:0.77-1.10] and permanent dentition [RR= 0.77, 95% CI:0.39-1.51]. Conventional GIC restorations showed similar secondary caries incidence compared with resin-modified GIC-restored teeth in both primary dentition [RR= 1.12, 95% CI:0.67-1.87] and permanent dentition [RR= 1.63, 95% CI:0.34-7.84].
CONCLUSIONS
GIC restorations showed a superior preventive effect against secondary caries compared to amalgam restorations, and a similar preventive effect against secondary caries compared to resin-composite restorations in both primary and permanent teeth. [PROSPERO Registration ID: CRD42022380959].
Topics: Humans; Dental Restoration, Permanent; Glass Ionomer Cements; Dental Caries Susceptibility; Dental Caries; Composite Resins; Dental Amalgam
PubMed: 37838608
DOI: 10.1016/j.dental.2023.10.008 -
Clinical Oral Implants Research Sep 2023In patients with dental implants, what is the effect of transmucosal components made of materials other than titanium (alloys) compared to titanium (alloys) on the... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
In patients with dental implants, what is the effect of transmucosal components made of materials other than titanium (alloys) compared to titanium (alloys) on the surrounding peri-implant tissues after at least 1 year?
MATERIALS AND METHODS
This systematic review included eligible randomized controlled trials identified through an electronic search (Medline, Embase and Web of Science) comparing alternative abutment materials versus titanium (alloy) abutments with a minimum follow-up of 1 year and including at least 10 patients/group. Primary outcomes were peri-implant marginal bone level (MBL) and probing depth (PD), these were evaluated based on meta-analyses. Abutment survival, biological and technical complications and aesthetic outcomes were the secondary outcomes. The risk of bias was assessed with the RoB2-tool. This review is registered in PROSPERO with the number (CRD42022376487).
RESULTS
From 5129 titles, 580 abstracts were selected, and 111 full-text articles were screened. Finally, 12 articles could be included. Concerning the primary outcomes (MBL and PD), no differences could be seen between titanium abutment and zirconia or alumina abutments, not after 1 year (MBL: zirconia: MD = -0.24, 95% CI: -0.65 to 0.16, alumina: MD = -0.06, 95% CI: -0.29 to 0.17) (PD: zirconia: MD = -0.06, 95% CI: -0.41 to 0.30, alumina: MD = -0.29, 95% CI: -0.96 to 0.38), nor after 5 years. Additionally, no differences were found concerning the biological complications and aesthetic outcomes. The most important technical finding was abutment fracture in the ceramic group and chipping of the veneering material.
CONCLUSIONS
Biologically, titanium and zirconia abutments seem to function equally up to 5 years after placement.
Topics: Humans; Titanium; Dental Implants; Alloys; Aluminum Oxide
PubMed: 37750527
DOI: 10.1111/clr.14159 -
Clinical Oral Implants Research Sep 2023For the present review, the following focused question was addressed: In patients with root-analog dental implants, what is the effect of implants made of other... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
For the present review, the following focused question was addressed: In patients with root-analog dental implants, what is the effect of implants made of other materials than titanium (alloy) on implant survival, marginal bone loss (MBL), and technical and biological complications after at least 5 years.
MATERIALS AND METHODS
An electronic (Medline, Embase, Web of Science) search was performed to identify observational clinical studies published from January 2000 investigating a minimum of 20 commercially available zirconia implants with a mean follow-up of at least 60 months. Primary outcome was implant survival, secondary outcomes included peri-implant MBL, probing depths (PDs), and technical and biological complications. Meta-analyses were performed to evaluate implant survival, MBL, and PD.
RESULTS
From 5129 titles, 580 abstracts were selected, and 111 full-text articles were screened. Finally, 4 prospective and 2 retrospective observational clinical cohort studies were included for data extraction. Meta-analyses estimated after 5 years of loading mean values of 97.2% (95% CI 94.7-99.1) for survival (277 implants, 221 patients), 1.1 mm (95% CI: 0.9-1.3) for MBL (229 implants, 173 patients), and 3.0 mm (95% CI 2.5-3.4) for PDs (231 implants, 175 patients).
CONCLUSIONS
After 5 years, commercially available zirconia implants showed reliable clinical performance based on survival rates, MBL, and PD values. However, more well-designed prospective clinical studies and randomized clinical trials investigating titanium and zirconia implants are needed to confirm the presently evaluated promising outcomes.
Topics: Humans; Dental Implants; Prospective Studies; Retrospective Studies; Titanium; Bone Diseases, Metabolic
PubMed: 37750521
DOI: 10.1111/clr.14133 -
Acta Biomaterialia Oct 2023Titanium (Ti) and Ti alloys are commonly used in dental implants, which have good biocompatibility, mechanical strength, processability, and corrosion resistance.... (Review)
Review
Titanium (Ti) and Ti alloys are commonly used in dental implants, which have good biocompatibility, mechanical strength, processability, and corrosion resistance. However, the surface inertia of Ti implants leads to delayed integration of Ti and new bone, as well as problems such as aseptic loosening and inadequate osseointegration. Magnesium (Mg) ions can promote bone regeneration, and many studies have used Mg-containing materials to modify the Ti implant surface. This systematic review summarizes the methods, effects, and clinical applications of surface modification of Ti implants with Mg-containing coatings. Database collection was completed on Janury 1, 2023, and a total of 29 relevant studies were ultimately included. Mg can be compounded with different materials and coated to the surface of Ti implants using different methods. In vitro and in vivo experiments have shown that Mg-containing coatings promote cell adhesion and osteogenic differentiation. On the one hand, the surface roughness of implants increases with the addition of Mg-containing coatings, which is thought to have an impact on the osseointegration of the implant. On the other hand, Mg ions promote cell attachment through binding interactions between the integrin family and FAK-related signaling pathways. And Mg ions could induce osseointegration by activating PI3K, Notch, ERK/c-Fos, BMP-4-related signaling pathways and TRPM7 protein channels. Overall, Mg-based coatings show great potential for the surface modification of Ti implants to promote osseointegration. STATEMENT OF SIGNIFICANCE: The inertia surface of titanium (Ti) implants leads to delayed osseointegration. Magnesium (Mg) ions, known for promoting bone regeneration, have been extensively studied to modify the surface of Ti implants. However, no consensus has been reached on the appropriate processing methods, surface roughness and effective concentration of Mg-containing coatings for osseointegration. This systematic review focus on the surface modification of Ti implants with Mg-containing compounds, highlighting the effects of Mg-containing coatings on the surface properties of Ti implants and its associated mechanisms. Besides, we also provide an outlook on future directions to promote the clinical application of Mg-modified implants.
Topics: Coated Materials, Biocompatible; Ions; Magnesium; Osseointegration; Osteogenesis; Surface Properties; Titanium
PubMed: 37517617
DOI: 10.1016/j.actbio.2023.07.048 -
Journal of the Mechanical Behavior of... Sep 2023The purpose of this systematic review and meta-analysis was to compare the results of tribocorrosion in titanium alloys of dental implants submitted to surface treatment... (Meta-Analysis)
Meta-Analysis Review
The purpose of this systematic review and meta-analysis was to compare the results of tribocorrosion in titanium alloys of dental implants submitted to surface treatment with those whose treatment was not performed. An electronic search was carried out on the MEDLINE (PubMed), Web of Science, Virtual Health Library and Scopus databases. The search strategy used was PECO: Participants (P): titanium alloys; Exposure (E): surface treatment; Comparison (C): absence of surface treatment; and Result/Outcome (O): tribocorrosion. The search found a total of 336 articles, where 27 was selected by title or abstract, resulted to 10 after reading in full. The treatments that formed the rutile layer had better tribological results and therefore better protected the material from mechanical and chemical degradation, contrary to the technique with the addition of nanotubes. It was concluded that the surface treatment proves to be efficient to protect metals from mechanical and chemical wear.
Topics: Humans; Alloys; Titanium; Corrosion; Dental Implants; Surface Properties
PubMed: 37423010
DOI: 10.1016/j.jmbbm.2023.106008 -
International Journal of Implant... Jul 2023The purpose of this study was to perform a systematic review with meta-analysis on the long-term survival rates of zygomatic implants (ZI). ZI success, prostheses... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The purpose of this study was to perform a systematic review with meta-analysis on the long-term survival rates of zygomatic implants (ZI). ZI success, prostheses survival and success, sinus pathology and patient reported outcomes were also investigated.
METHODS
Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed. Embase and OvidMedline databases were searched alongside the grey literature. The systematic review was recorded in PROSPERO (CRD42022358024). Studies reporting titanium/titanium alloy ZI survival data, ZI-supported prosthesis data, ZIs directly compared to any other implant therapy including grafted sites, a minimum follow-up time of 3 years and a minimum number of 10 patients were included. All study designs were considered if they met the inclusion criteria. Studies not involving ZIs, ZIs not made from titanium/titanium alloy, a follow-up time of < 3 years or < 10 patients, animal studies and in vitro studies were excluded. Long-term follow-up has not been defined in the literature. A minimum of 3 years follow-up was considered acceptable to capture survival after initial healing, alongside in-function prosthesis data via delayed or immediate load protocols. ZI success, was predominantly defined as ZI survival without biological or neurological complications. Meta-analyses were performed for ZI survival, ZI failure incidence, ZI success, loading protocol, prosthesis survival, and prevalence of sinusitis using random effects models. Descriptive analysis was used for ZI success, prosthesis success and patient reported outcome measures.
RESULTS
Five hundred and seventy-four titles were identified, of which 18 met the inclusion criteria. Eligible studies included 1349 ZIs in 623 patients. Mean follow-up period was 75.4 months (range 36-141.6). The mean survival of ZIs was 96.2% [95% CI: 93.8; 97.7] at 6 years. Mean survival for delayed loading was 95% [95% CI: 91.7; 97.1] and 98.1% [95% CI: 96.2; 99.0] for immediate loading (p = 0.03). Annual incidence rate of ZI failure was 0.7% [95% CI 0.4; 1.0]. Mean ZI success was 95.7% [95% CI 87.8; 98.6]. Mean prosthesis survival was 94% [95% CI 88.6; 96.9]. Sinusitis prevalence was 14.2% [95% CI 8.8; 22.0] at 5 years. Patients' reported increased satisfaction with ZIs.
CONCLUSIONS
ZIs have long-term survival comparable to conventional implants. Immediate loading showed a statistically significant increase in survival over delayed loading. Prosthesis survival was similar to that of prostheses supported by conventional implants, with similar complications. Sinusitis was the most frequently encountered biological complication. Patients reported improved outcome measures with ZI use.
Topics: Humans; Dental Implantation, Endosseous; Dental Implants; Prosthesis Failure; Titanium; Treatment Outcome; Alloys
PubMed: 37405545
DOI: 10.1186/s40729-023-00479-x -
Journal of Esthetic and Restorative... Dec 2023The aim of this systematic review was to evaluate the influence of the characteristics of intraoral scan bodies (ISBs) on the accuracy of intraoral scanning. (Review)
Review
OBJECTIVE
The aim of this systematic review was to evaluate the influence of the characteristics of intraoral scan bodies (ISBs) on the accuracy of intraoral scanning.
MATERIALS AND METHODS
An electronic search was conducted through PubMed (MEDLINE), Scopus and Cochrane Library, up to March 2023. The literature search intended to retrieve all relevant clinical and in vitro studies about the effect that the various properties of ISBs may have on the accuracy (trueness and precision) of intraoral scanning. Only publications in English language were selected with animal studies, case reports, case series, technique presentation articles and expert opinions being excluded.
RESULTS
A total of 28 studies met the inclusion criteria and were included in this systematic review. They were published between 2019 and 2023 and were all in vitro studies. Among the parameters described, the scan body material, position, geometry, height, diameter, and fixation torque were evaluated. The most common materials used for ISBs were polyetheretherketone (PEEK) and titanium alloys. The diameter and position of ISBs seemed to affect the trueness of implant impressions. Subgingival implant position and decreased ISB height affected negatively the trueness of scanning. Geometrical characteristics of ISBs also affect the implant impression accuracy, especially the bevel location and the types of designing modifications.
CONCLUSIONS
The characteristics of the currently used ISBs vary widely and the available scientific evidence is not yet conclusive about the optimal design of ISB. The implant impression accuracy achieved by any of the studied parameters is encouraging. Clinical studies are however necessary for more concrete conclusions.
CLINICAL SIGNIFICANCE
ISBs play a vital role in the digital workflow and influence significantly the accuracy and fit of implant restorations. More clinical trials are needed in order to conclude to the optimal characteristics of ISBs which would further enhance the success of the restorations.
Topics: Dental Implants; Dental Impression Technique; Computer-Aided Design; Research Design; Imaging, Three-Dimensional
PubMed: 37381677
DOI: 10.1111/jerd.13074 -
Journal of Dentistry Aug 2023To systematically assess aspects of teaching of posterior composite restorations (PCRs) in permanent teeth in dental schools. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To systematically assess aspects of teaching of posterior composite restorations (PCRs) in permanent teeth in dental schools.
STUDY SELECTION
Quantitative studies reporting on dental schools' teaching regarding the placement of PCRs in permanent teeth. Random-effects meta-analyses and meta-regressions were performed. Risk of bias was assessed based on the Medical Education Research Study Quality Instrument (MERSQI).
SOURCES
Electronic databases (MEDLINE via PubMed, EMBASE via Ovid, Web of Science, and Scopus) were searched in January 2023.
DATA
Forty sources reporting on 34 studies having surveyed 1,286 dental schools were included. Overall, 92.7% (95%-CI: 88.2-95.5) of dental schools reported to teach PCRs. PCRs in three-surface Class II cavities are taught by 82.0% (95%-CI: 70.4-89.7). The mandatory use of liners in deep cavities is taught by 78.3% (95%-CI: 68.9-85.5), and 44.0% (95%-CI: 34.3-54.2) reported to teach bulk-fill composites. While most posterior restorations placed by students were composites (56.1%; 95%-CI: 46.0-65.8), 94.7% (95%-CI: 86.6-98.0) of dental schools (still) teach posterior amalgam restorations. The proportion of dental schools teaching PCRs in three-surface Class II cavities increased and the mean proportion of PCRs among all posterior restorations increased over time (p≤0.003).
CONCLUSIONS
The teaching of PCRs in dental schools around the world reflects the increased use of resin composite in clinical practice, with students in countries where dental amalgam continues to be used, placing more posterior composites than restorations of dental amalgam. The teaching of PCRs, which is anticipated to increase, will continue to be refined with further developments in adhesive materials, devices, instrumentation, and techniques.
CLINICAL SIGNIFICANCE
Graduating dentists can be expected to be familiar with the use of resin composites for the restoration of posterior teeth.
Topics: Humans; Dental Restoration, Permanent; Dental Amalgam; Dental Cavity Preparation; Composite Resins; Dental Caries; Students; Teaching
PubMed: 37336355
DOI: 10.1016/j.jdent.2023.104589