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Clinical Oral Investigations Jun 2024To evaluate the potential of laser-microtextured abutments (LMAs) compared to machined abutments (MAs) in peri-implant clinical and radiographic outcomes. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To evaluate the potential of laser-microtextured abutments (LMAs) compared to machined abutments (MAs) in peri-implant clinical and radiographic outcomes.
MATERIALS AND METHODS
Eligible studies consisted of randomized clinical trials (RCTs) retrieved from MEDLINE, Web of Science, Scopus, and Embase databases. The study adhered to the PRISMA statement, and the protocol was registered at the PROSPERO (registration number CRD42023443112). The risk of bias was evaluated according to version 2 of the Cochrane risk of bias tool (RoB 2). Meta-analyses were performed using random effect models. Afterward, the GRADE approach was used to determine the certainty of evidence.
RESULTS
Four RCTs were included from a total of 2,876 studies. LMAs had lower peri-implant sulcus depth at 6-8 weeks (WMD: -0.69 mm; 95% CI: -0.97, -0.40; p = 0.15, I = 53%) and at one year (WMD: -0.75 mm; 95% CI: -1.41, -0.09; p = 0.09, I = 65%), but the certainty of evidence was low. In addition, the marginal bone loss favored the LMAs group (WMD: -0.29 mm; 95% CI: -0.36, -0.21; p = 0.69, I = 0%) with moderate evidence. There were fewer sites with bleeding on probing in the LMAs group (WMD: -1.10; 95% CI: -1.43, -0.77; p = 0.88, i = 0%). There was no statistical difference between groups for the modified gingival index and modified plaque index. Furthermore, all studies were classified as having some concerns risk of bias.
CONCLUSIONS
There was low to moderate certainty evidence that LMAs can favor peri-implant clinical and radiographic parameters compared to MAs.
CLINICAL RELEVANCE
Laser-microtextured abutments may benefit peri-implant clinical and radiographic outcomes.
Topics: Humans; Dental Abutments; Lasers; Dental Implant-Abutment Design; Randomized Controlled Trials as Topic
PubMed: 38898305
DOI: 10.1007/s00784-024-05785-1 -
Acta Odontologica Scandinavica Jun 2024To evaluate the current evidence of digital workflow feasibility based on the data acquisition methods and the software tools used to fabricate intraoral prostheses for...
OBJECTIVES
To evaluate the current evidence of digital workflow feasibility based on the data acquisition methods and the software tools used to fabricate intraoral prostheses for patients with partial or total maxillary and mandibular defects.
MATERIALS AND METHODS
An electronic search was performed in PubMed, SCOPUS, and Web of Science using a combination of relevant keywords: digital workflow, digital designing, computer-assisted design-computer aided manufacturing, 3D printing, maxillectomy, and mandibulectomy. The Joanna Briggs Institute Critical Appraisal Tool was used to assess the quality of evidence in the studies reviewed.
RESULTS
From a total of 542 references, 33 articles were selected, including 25 on maxillary prostheses and 8 on mandibular prostheses. The use of digital workflows was limited to one or two steps of the fabrication of the prostheses, and only four studies described a complete digital workflow. The most preferred method for data acquisition was intraoral scanning with or without a cone beam computed tomography combination.
CONCLUSION
Currently, the fabrication process of maxillofacial prostheses requires combining digital and conventional methods. Simplifying the data acquisition methods and providing user-friendly and affordable software may encourage clinicians to use the digital workflow more frequently for patients requiring maxillofacial prostheses.
Topics: Humans; Workflow; Maxillofacial Prosthesis; Computer-Aided Design; Feasibility Studies; Printing, Three-Dimensional; Software; Prosthesis Design
PubMed: 38895776
DOI: 10.2340/aos.v83.40870 -
Dental and Medical Problems Jun 2024Severe tooth wear is related to substantial loss of tooth structure, with dentin exposure and significant loss (≥1/3) of the clinical crown. The objective of this... (Review)
Review
Severe tooth wear is related to substantial loss of tooth structure, with dentin exposure and significant loss (≥1/3) of the clinical crown. The objective of this systematic review was to summarize and analyze the scientific evidence regarding the mechanical performance of computer-aided design/computer-aided manufacturing (CAD/CAM) composite resin and CAD/CAM lithium disilicate ceramic occlusal veneers, in terms of fatigue and fracture resistance, on severely worn posterior teeth. Currently, occlusal veneers are an alternative for treating worn posterior teeth. Although scientific evidence demonstrates the good performance of lithium disilicate occlusal veneers, there are less brittle materials with a modulus of elasticity more similar to dentin than ceramics, such as resin CAD/CAM blocks. Therefore, it is important to identify which type of material is best for restoring teeth with occlusal wear defects and which material can provide better clinical performance. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search of the PubMed, Embase, Web of Science, Scopus, Cochrane, OpenGrey, Redalyc, DSpace, and Grey Literature Report databases was conducted and supplemented by a manual search, with no time or language limitations, until January 2022. We aimed to identify studies evaluating the fatigue and fracture resistance of CAD/CAM composite resin and ceramic occlusal veneers. The quality of the full-text articles was evaluated according to the modified Consolidated Standards of Reporting Trials (CONSORT) criteria for in vitro studies, and 400 articles were initially identified. After removing duplicates and applying the selection criteria, 6 studies were included in the review. The results demonstrated that the mechanical performance of CAD/CAM composite resin occlusal veneers is comparable to that of CAD/CAM lithium disilicate occlusal veneers in terms of fatigue and fracture resistance.
PubMed: 38888224
DOI: 10.17219/dmp/157347 -
Clinical Cardiology Jun 2024Long-term follow-up results of various trials comparing Zotarolimus eluting stents (ZES) with Everolimus eluting stents (EES) have been published recently. Additionally,... (Comparative Study)
Comparative Study Meta-Analysis
Temporal Trends in the Outcomes of Percutaneous Coronary Intervention With Zotarolimus Eluting Stents Versus Everolimus Eluting Stents: A Meta-Analysis of Randomized Controlled Trials.
INTRODUCTION
Long-term follow-up results of various trials comparing Zotarolimus eluting stents (ZES) with Everolimus eluting stents (EES) have been published recently. Additionally, over the last decade, there have been new trials comparing the ZES with various commercially available EES. We aim to conduct an updated meta-analysis in light of new evidence from randomized controlled trials (RCTs) to provide comprehensive evidence regarding the temporal trends in the clinical outcomes.
METHODS
A comprehensive literature search was conducted across PubMed, Cochrane, and Embase. RCTs comparing ZES with EES for short (<2 years), intermediate (2-3 years), and long-term follow-ups (3-5 years) were included. Relative risk was used to pool the dichotomous outcomes using the random effects model employing the inverse variance method. All statistical analysis was conducted using Revman 5.4.
RESULTS
A total of 18 studies reporting data at different follow-ups for nine trials (n = 14319) were included. At short-term follow-up (<2 years), there were no significant differences between the two types of stents (all-cause death, cardiac death, Major adverse cardiovascular events (MACE), target vessel myocardial infarction, definite or probable stent thrombosis or safety outcomes (target vessel revascularization, target lesion revascularization, target vessel failure, target lesion failure). At intermediate follow-up (2-3 years), EES was superior to ZES for reducing target lesion revascularization (RR = 1.28, 95% CI = 1.05-1.58, p < 0.05). At long-term follow-up (3-5 years), there were no significant differences between the two groups for any of the pooled outcomes (p > 0.05).
CONCLUSION
ZES and EES have similar safety and efficacy at short, intermediate, and long-term follow-ups.
Topics: Humans; Cardiovascular Agents; Coronary Artery Disease; Drug-Eluting Stents; Everolimus; Percutaneous Coronary Intervention; Prosthesis Design; Randomized Controlled Trials as Topic; Risk Factors; Sirolimus; Time Factors; Treatment Outcome
PubMed: 38888152
DOI: 10.1002/clc.24306 -
BMC Pulmonary Medicine Jun 2024Rapamycin has been extensively utilized for coating coronary artery stents to reduce the occurrence of restenosis, yet there has been limited research on the potential...
BACKGROUND
Rapamycin has been extensively utilized for coating coronary artery stents to reduce the occurrence of restenosis, yet there has been limited research on the potential harms of rapamycin-eluting stents. Herein, We report a case of eosinophilia and interstitial pneumonia caused by a cobalt-based alloy stent eluted with rapamycin.
CASE PRESENTATION
The patient was admitted due to fever, cough, and expectoration symptoms. Previously, the patient had undergone a procedure of percutaneous coronary stent implantation in our hospital's cardiology department, which led to a gradual rise in blood eosinophil count. This time, the eosinophil count was higher than the previous admission. A chest CT scan revealed multiple flocculent density increases in both lungs and bronchiectasis. The rapamycin-eluting stents may have caused eosinophilia and interstitial pneumonia, which improved after administering corticosteroids. A systematic review of relevant literature was conducted to summarize the characteristics of interstitial pneumonia caused by drug-eluting stents.
CONCLUSION
Paclitaxel, everolimus, zotarolimus, and rapamycin are the types of drugs that can lead to drug-eluting stents, and because of the rarity of their onset, clinical doctors must be precise and prompt in diagnosing suspected cases to avoid misdiagnosis and delayed treatment.
Topics: Humans; Lung Diseases, Interstitial; Drug-Eluting Stents; Sirolimus; Eosinophilia; Male; Tomography, X-Ray Computed; Percutaneous Coronary Intervention; Aged
PubMed: 38886703
DOI: 10.1186/s12890-024-03101-x -
Frontiers in Cardiovascular Medicine 2024In recent years, the use of artificial intelligence (AI) models to generate individualised risk assessments and predict patient outcomes post-Transcatheter Aortic Valve...
OBJECTIVES
In recent years, the use of artificial intelligence (AI) models to generate individualised risk assessments and predict patient outcomes post-Transcatheter Aortic Valve Implantation (TAVI) has been a topic of increasing relevance in literature. This study aims to evaluate the predictive accuracy of AI algorithms in forecasting post-TAVI mortality as compared to traditional risk scores.
METHODS
Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses for Systematic Reviews (PRISMA) standard, a systematic review was carried out. We searched four databases in total-PubMed, Medline, Embase, and Cochrane-from 19 June 2023-24 June, 2023.
RESULTS
From 2,239 identified records, 1,504 duplicates were removed, 735 manuscripts were screened, and 10 studies were included in our review. Our pooled analysis of 5 studies and 9,398 patients revealed a significantly higher mean area under curve (AUC) associated with AI mortality predictions than traditional score predictions (MD: -0.16, CI: -0.22 to -0.10, < 0.00001). Subgroup analyses of 30-day mortality (MD: -0.08, CI: -0.13 to -0.03, = 0.001) and 1-year mortality (MD: -0.18, CI: -0.27 to -0.10, < 0.0001) also showed significantly higher mean AUC with AI predictions than traditional score predictions. Pooled mean AUC of all 10 studies and 22,933 patients was 0.79 [0.73, 0.85].
CONCLUSION
AI models have a higher predictive accuracy as compared to traditional risk scores in predicting post-TAVI mortality. Overall, this review demonstrates the potential of AI in achieving personalised risk assessment in TAVI patients.
REGISTRATION AND PROTOCOL
This systematic review and meta-analysis was registered under the International Prospective Register of Systematic Reviews (PROSPERO), under the registration name "All-Cause Mortality in Transcatheter Aortic Valve Replacement Assessed by Artificial Intelligence" and registration number CRD42023437705. A review protocol was not prepared. There were no amendments to the information provided at registration.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/, PROSPERO (CRD42023437705).
PubMed: 38883982
DOI: 10.3389/fcvm.2024.1343210 -
BMC Cardiovascular Disorders Jun 2024Stent restenosis is a relatively common phenomenon among patients with coronary heart disease undergoing percutaneous coronary intervention (PCI). It seems that a set of...
BACKGROUND
Stent restenosis is a relatively common phenomenon among patients with coronary heart disease undergoing percutaneous coronary intervention (PCI). It seems that a set of clinical, laboratory, and even genetic factors make people susceptible to such a phenomenon and in fact, this is multi-factorial. We aimed to first determine the underlying clinical and laboratory risk factors for the occurrence of stent re-stenosis after PCI based on a systematic review study, and after that, through a bioinformatics study, to evaluate the related genes and microRNAs with the occurrence of stent re-stenosis.
MAIN TEXT
In the first step, the manuscript databases including Medline, Web of Knowledge, Google Scholar, Scopus, and Cochrane were deeply searched by the two blinded investigators for all eligible studies based on the considered keywords to introduce clinical and laboratory determinants of stent re-stenosis. In the bioinformatic phase, and following a review of the literature to identify genes and microRNAs involved in restenosis, the interaction of each gene with other genes associated with stent re-stenosis was determined by GeneMANIA network analysis and Cytoscape software. Overall, 67 articles (including 40,789 patients) on clinical and biochemical predictors for stent restenosis and 25 articles on genetic determinants of this event were eligible for the final analysis. The predictors for this event were categorized into four subgroups patient-based parameters including traditional cardiovascular risk profiles, stent-based parameters including type and diametric characteristics of the stents used, coronary lesion-based parameters including several two target lesions and coronary involvement severity and laboratory-based parameters particularly related to activation of inflammatory processes. In the bioinformatic phase, we uncovered 42 genes that have been described to be involved in such a phenomenon considering a special position for genes encoding inflammatory cytokines. Also, 12 microRNAs have been pointed to be involved in targeting genes involved in stent re-stenosis.
CONCLUSIONS
The incidence of stent re-stenosis will be the result of a complex interaction of clinical risk factors, laboratory factors mostly related to the activation of inflammatory processes, and a complex network of gene-to-gene interactions.
Topics: Humans; Percutaneous Coronary Intervention; Coronary Restenosis; Stents; Risk Factors; Computational Biology; Coronary Artery Disease; MicroRNAs; Risk Assessment; Genetic Predisposition to Disease; Treatment Outcome; Female; Male; Gene Regulatory Networks; Middle Aged; Aged
PubMed: 38877398
DOI: 10.1186/s12872-024-03955-3 -
Otology & Neurotology : Official... Jul 2024Misplacement of electrode arrays in the internal auditory canal (IAC) presents a unique clinical challenge. Speech recognition is limited for cochlear implant (CI) users...
OBJECTIVE
Misplacement of electrode arrays in the internal auditory canal (IAC) presents a unique clinical challenge. Speech recognition is limited for cochlear implant (CI) users with misplaced arrays, and there are risks with revision surgery including facial and/or cochlear nerve injury.
DATABASES REVIEWED
PubMed, Embase, and Scopus.
METHODS
A literature search was performed from inception to September 2023. The search terms were designed to capture articles on misplaced arrays and the management options. Articles written in English that described cases of array misplacement into the IAC for children and adults were included. The level of evidence was assessed using Oxford Center for Evidence Based Medicine guidelines. Descriptive statistical analyses were performed.
RESULTS
Twenty-eight cases of arrays misplaced in the IAC were identified. Thirteen (46%) were patients with incomplete partition type 3 (IP3), and 7 (25%) were patients with common cavity (CC) malformations. Most misplaced arrays were identified postoperatively (19 cases; 68%). Of these cases, 11 (58%) were managed with array removal. No facial nerve injuries were reported with revision surgery. Eight cases (42%) were left in place. Several underwent mapping procedures in an attempt improve the sound quality with the CI.
CONCLUSION
Electrode array misplacement in the IAC is a rare complication that reportedly occurs predominately in cases with IP3 and CC malformations. Removal of misplaced arrays from the IAC reportedly has not been associated with facial nerve injuries. Cases identified with IAC misplacement postoperatively can potentially be managed with modified mapping techniques before proceeding with revision surgery.
Topics: Humans; Cochlear Implants; Cochlear Implantation; Ear, Inner; Electrodes, Implanted; Reoperation
PubMed: 38865720
DOI: 10.1097/MAO.0000000000004222 -
Otology & Neurotology : Official... Jul 2024To compare the rate of device failure for those cochlear implants (CIs) involved in the 2020 Food and Drug Administration (FDA) voluntary field corrective action (VFCA). (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To compare the rate of device failure for those cochlear implants (CIs) involved in the 2020 Food and Drug Administration (FDA) voluntary field corrective action (VFCA).
DATABASES REVIEWED
Medline, Embase, and Scopus.
METHODS
A systematic review was performed according to the PRISMA guidelines. Publications reporting institutional experiences with implants affected by the VFCA were included. Outcomes assessed included etiology of, rate of, and time to failure and pre-/post-device failure speech perception testing. All outcomes reported in at least two independent studies were included in a meta-analysis.
RESULTS
Six studies met criteria for analysis. The overall pooled failure rate was 23.7% (95% CI, 11.6-38.4%). The pooled device, inconclusive, and medical failure rates were 21.5%, 0.2%, and 0.7%, respectively. Pediatric failure rates were higher than those of adults (46.9% [95% CI, 11.2-84.5%] versus 32.6% [95% CI, 8.2-63.7%]). WRS declined with primary implant failure (55.1% [95% CI, 48.0-62.1%] to 34.1% [95% CI, 30.2-38.0%]) but improved after reimplantation (34.1% [95% CI, 30.2-38.0%] to 50.1% [95% CI, 45.2-55.1%]).
CONCLUSIONS
The rate of pooled reported failure for CIs falling under the 2020 VFCA in the literature thus far is 23.7%. The overwhelming majority of these failures were device related, the rates of which were higher in children. Speech perception improved significantly after reimplantation.
Topics: Humans; Cochlear Implants; United States; United States Food and Drug Administration; Prosthesis Failure; Cochlear Implantation; Speech Perception
PubMed: 38865719
DOI: 10.1097/MAO.0000000000004224 -
Cirugia Y Cirujanos 2024The effect of a pre-operative biliary stent on complications after pancreaticoduodenectomy (PD) remains controversial. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The effect of a pre-operative biliary stent on complications after pancreaticoduodenectomy (PD) remains controversial.
MATERIALS AND METHOD
We conducted a meta-analysis according to the preferred reporting items for systematic reviews and meta-analyses guidelines, and PubMed, Web of Science Knowledge, and Ovid's databases were searched by the end of February 2023. 35 retrospective studies and 2 randomized controlled trials with a total of 12641 patients were included.
RESULTS
The overall complication rate of the pre-operative biliary drainage (PBD) group was significantly higher than the no-PBD group (odds ratio [OR] 1.46, 95% confidence interval [CI] 1.22-1.74; p < 0.0001), the incidence of post-operative delayed gastric emptying was increased in patients with PBD compared those with early surgery (OR 1.21, 95% CI: 1.02-1.43; p = 0.03), and there was a significant increase in post-operative wound infections in patients receiving PBD with an OR of 2.2 (95% CI: 1.76-2.76; p < 0.00001).
CONCLUSIONS
PBD has no beneficial effect on post-operative outcomes. The increase in post-operative overall complications and wound infections urges the exact indications for PBD and against routine pre-operative biliary decompression, especially for patients with total bilirubin < 250 umol/L waiting for PD.
Topics: Humans; Drainage; Pancreaticoduodenectomy; Preoperative Care; Postoperative Complications; Stents; Surgical Wound Infection; Randomized Controlled Trials as Topic; Gastric Emptying; Ampulla of Vater; Pancreatic Neoplasms; Common Bile Duct Neoplasms
PubMed: 38862121
DOI: 10.24875/CIRU.23000318