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Annals of Anatomy = Anatomischer... Feb 2023This review aimed to investigate the clinical outcomes of autogenous particulated dentin (APD) used for alveolar ridge preservation (ARP), evaluating volume gain,...
PURPOSE
This review aimed to investigate the clinical outcomes of autogenous particulated dentin (APD) used for alveolar ridge preservation (ARP), evaluating volume gain, histologic/histomorphometric data, and associated complications.
MATERIAL AND METHODS
The review followed PRISMA guidelines and was registered in the International Prospective Register of Systematic Reviews (PROSPERO). An automated search was made in four databases (Medline/Pubmed, Scopus, Web of Science, and Cochrane Library) supplemented by a manual search for relevant clinical articles published before March 10th, 2022. The review included human studies of at least four patients in which extraction and subsequent ARP were performed in a single surgery. Both comparative studies and studies that assessed ARP with APD exclusively were admitted. The quality of evidence was assessed with the Cochrane bias assessment tool, the Newcastle-Ottawa Quality Assessment Scale, and the Joanna Briggs Institute Critical Appraisal tool.
RESULTS
Eleven studies fulfilled the inclusion criteria and were included for descriptive analysis, with a total of 215 patients, and 337 alveoli preserved by APD, spontaneous healing (blood clot), or other bone substitutes, obtaining comparatively less vertical and horizontal resorption when APD was used.
CONCLUSIONS
After dental extraction, autogenous dentin was effective in terms of volume maintenance, showing promising results in histologic/histomorphometric analysis, and a low complication rate. Nevertheless, few comparative studies with comparable parameters have been published and so more research providing long-term data is needed to confirm these findings.
Topics: Humans; Alveolar Ridge Augmentation; Bone Transplantation; Bone Substitutes; Minerals; Alveolar Process; Dentin; Tooth Socket; Tooth Extraction
PubMed: 36396018
DOI: 10.1016/j.aanat.2022.152024 -
Clinical Implant Dentistry and Related... Feb 2023Immediate implant placement in conjunction with partial extraction therapy has been shown to result in functional osseo- and dento-integration with partial preservation... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Immediate implant placement in conjunction with partial extraction therapy has been shown to result in functional osseo- and dento-integration with partial preservation of the periodontal ligament (PDL) in humans. Strategic buccal root retention for PDL preservation is a biologically driven procedure that maintains alveolar ridge dimensions and esthetics, while allowing for implant placement. The aim of this study was to conduct a systematic review of longitudinal clinical outcomes of PDL-mediated ridge preservation in conjunction with implant placement in adults, compared with conventional immediate implant placement with total extractions. The primary outcome for this study was marginal bone level (MBL) changes after strategic buccal root retention implant placement techniques.
MATERIALS AND METHODS
To address a predefined PICOS question, a systematic search of randomized clinical trials and cohort studies with at least 10 participants per group and a minimum 12-month follow-up was conducted. A two-phase systematic selection strategy, data extraction, and risk of bias assessment, was performed independently and in duplicate. Randomized trials were quantitatively analyzed in a meta-analysis.
RESULTS
Ten human studies fulfilled the predefined criteria and were included; three clinical trials and seven cohort studies, for a total of 506 patients and 587 implants. PDL-mediated implant placement of single-rooted periodontally healthy teeth was found to reduce marginal peri-implant bone loss and buccal plate changes as compared to conventional immediate implants across studies, while implant survival and success rates were comparable between the two procedures. A meta-analysis found that bone changes were significantly less when retention of the buccal root section was performed as compared to total extractions (standardized mean difference: [-4.53, -0.11]); the three clinical trials were, however, largely heterogeneous (I : 93.1%; Q = 28.98, p < 0.001).
CONCLUSION
Strategic retention of the buccal root section has a benefit in terms of dimensional ridge stability over conventional immediate implantation when implemented in carefully selected cases of single-rooted teeth.
Topics: Adult; Humans; Dental Implants; Immediate Dental Implant Loading; Tooth Socket; Dental Implants, Single-Tooth; Esthetics, Dental; Longitudinal Studies; Tooth Extraction; Treatment Outcome
PubMed: 36331494
DOI: 10.1111/cid.13150 -
Journal of Maxillofacial and Oral... Sep 2022Honey has been used for millennia as a treatment for covering wounds that are difficult to repair. Hippocrates already reported the benefits of honey with this type of... (Review)
Review
OBJECTIVES
Honey has been used for millennia as a treatment for covering wounds that are difficult to repair. Hippocrates already reported the benefits of honey with this type of treatment. The objective of this work is to evaluate the literature on the use of honey in cases as preventive as treatment complications after extractions, more specifically alveolar osteitis or alveolitis.
MATERIAL AND METHODS
A systematic literature review was carried out on PubMed, LILACS and Dimensions platforms, following PRISMA guidelines, to gain more knowledge on the topic. Due to the scarcity of articles on the topic, there are no restrictions regarding languages, publication dates or impact factor journal. Animal studies and reviews were excluded. Risk of bias was assessed through Review Manager Software 5.4.
RESULTS
With simple, low-cost, and affordable medications, many of the complications after tooth extractions can be resolved more quickly and less painfully for patients with more significant difficulties, whether financial or access, to other treatments.
CONCLUSION
Honey is an effective prevention and treatment for alveolar osteitis.
PubMed: 36274888
DOI: 10.1007/s12663-021-01611-3 -
Journal of Esthetic and Restorative... Jan 2023Taxonomy and classification of a disease contributes to facilitating the diagnosis and treatment planning process and simplifies communication between clinicians. The... (Review)
Review
Taxonomy and classification of a disease contributes to facilitating the diagnosis and treatment planning process and simplifies communication between clinicians. The aim of this study was to provide a critical appraisal based on a systematic review of the single-rooted extraction socket (ES) classifications and subsequently, introduce a new classification system combining the cornerstones of the previously proposed systems and based on the latest consensus in implant dentistry. Following the systematic search process in PubMed, EMBASE, and SCOPUS databases 13 ES classifications were detected. The most repeated hard and soft tissue factors in the previous classifications were buccal bone dehiscence, interproximal bone, gingival recession, and soft tissue phenotype. However, there was minimal attention to patient-related factors such as systemic conditions and smoking. Therefore, a new classification system based on the combination of patient-related factors, clinical and radiographical parameters was proposed. This divides an ES into three types. Class I and II sockets are candidates for receiving immediate implant placement and conversely, a class III socket includes a compromised condition that requires multiple-stage reconstruction mostly suitable for standard delayed implant placement with alveolar ridge preservation. Within the limitations of this study, the new classification system not only provides comprehensive inclusion of various crucial parameters in implant placement (such as prediction of future implant position and osteotomy difficulty, etc.) but also, in contrast to the previously introduced systems, is able to classify the ES prior to extraction and also, takes into the account the patient-related factors as the class modifiers following the extraction.
Topics: Humans; Tooth Socket; Tooth Extraction; Gingival Recession; Immediate Dental Implant Loading; Dental Implants, Single-Tooth; Dental Implantation, Endosseous
PubMed: 36196906
DOI: 10.1111/jerd.12967 -
The Journal of Evidence-based Dental... Sep 2022This systematic review aimed to compare the clinical data including success rates, tissue preservation, esthetic results, and patient-reported outcomes between delayed... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
This systematic review aimed to compare the clinical data including success rates, tissue preservation, esthetic results, and patient-reported outcomes between delayed implant placement after alveolar ridge preservation (ARP) and immediate implant placement (IIP).
MATERIAL AND METHODS
Both electronic and manual searches were performed for randomized controlled trials and cohort studies consisting of at least 10 cases per group and a follow-up of at least 1-year in duration. The primary outcome was the implant success rate and secondary outcomes were changes in marginal bone level (MBL), pink esthetic score (PES) and patient reported outcomes consisting of complications and satisfaction.
RESULTS
A total of 12 studies were included (8 randomized controlled trials and 4 cohort studies). This review contained 456 implants placed after ARP and 459 implants placed through IIP. The results from this meta-analysis showed that the success rates of implants placed through ARP protocol (98.68%) was significantly higher than that of implants placed through IIP protocol (95.21%) (RR = 1.03; 95% CI [1.01; 1.06]; P = .008; I = 0%).
CONCLUSION
The results from this meta-analysis and systematic review showed that implants placed through ARP protocol may demonstrate higher success rates compared to implants placed through IIP.
Topics: Alveolar Process; Alveolar Ridge Augmentation; Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Esthetics, Dental; Humans; Tooth Extraction; Tooth Socket; Treatment Outcome
PubMed: 36162892
DOI: 10.1016/j.jebdp.2022.101734 -
The Journal of Evidence-based Dental... Sep 2022Al-Maawi, S, Becker, K, Schwarz, F, Sader R, Ghanaati, S. Efficacy of platelet-rich fibrin in promoting the healing of extraction sockets: a systematic review. Int J...
Al-Maawi, S, Becker, K, Schwarz, F, Sader R, Ghanaati, S. Efficacy of platelet-rich fibrin in promoting the healing of extraction sockets: a systematic review. Int J Implant Dent 7, 117 (2021). https://doi.org/10.1186/s40729-021-00393-0 SOURCE OF FUNDING: This study was self-funded by the author TYPE OF STUDY/DESIGN: Systematic review (SR).
Topics: Humans; Platelet-Rich Fibrin; Tooth Extraction; Tooth Socket; Wound Healing
PubMed: 36162878
DOI: 10.1016/j.jebdp.2022.101758 -
The Cochrane Database of Systematic... Sep 2022Alveolar osteitis (dry socket) is a complication of dental extractions more often involving mandibular molar teeth. It is associated with severe pain developing 2 to 3... (Review)
Review
BACKGROUND
Alveolar osteitis (dry socket) is a complication of dental extractions more often involving mandibular molar teeth. It is associated with severe pain developing 2 to 3 days postoperatively with or without halitosis, a socket that may be partially or totally devoid of a blood clot, and increased postoperative visits. This is an update of the Cochrane Review first published in 2012. OBJECTIVES: To assess the effects of local interventions used for the prevention and treatment of alveolar osteitis (dry socket) following tooth extraction.
SEARCH METHODS
An Information Specialist searched four bibliographic databases up to 28 September 2021 and used additional search methods to identify published, unpublished, and ongoing studies.
SELECTION CRITERIA
We included randomised controlled trials of adults over 18 years of age who were having permanent teeth extracted or who had developed dry socket postextraction. We included studies with any type of local intervention used for the prevention or treatment of dry socket, compared to a different local intervention, placebo or no treatment. We excluded studies reporting on systemic use of antibiotics or the use of surgical techniques because these interventions are evaluated in separate Cochrane Reviews.
DATA COLLECTION AND ANALYSIS
We used standard methodological procedures expected by Cochrane. We followed Cochrane statistical guidelines and reported dichotomous outcomes as risk ratios (RR) and calculated 95% confidence intervals (CI) using random-effects models. For some of the split-mouth studies with sparse data, it was not possible to calculate RR so we calculated the exact odds ratio (OR) instead. We used GRADE to assess the certainty of the body of evidence.
MAIN RESULTS
We included 49 trials with 6771 participants; 39 trials (with 6219 participants) investigated prevention of dry socket and 10 studies (with 552 participants) looked at the treatment of dry socket. 16 studies were at high risk of bias, 30 studies at unclear risk of bias, and 3 studies at low risk of bias. Chlorhexidine in the prevention of dry socket When compared to placebo, rinsing with chlorhexidine mouthrinses (0.12% and 0.2% concentrations) both before and 24 hours after extraction(s) substantially reduced the risk of developing dry socket with an OR of 0.38 (95% CI 0.25 to 0.58; P < 0.00001; 6 trials, 1547 participants; moderate-certainty evidence). The prevalence of dry socket varies from 1% to 5% in routine dental extractions to upwards of 30% in surgically extracted third molars. The number of patients needed to be treated (NNT) with chlorhexidine rinse to prevent one patient having dry socket was 162 (95% CI 155 to 240), 33 (95% CI 27 to 49), and 7 (95% CI 5 to 10) for control prevalence of dry socket 0.01, 0.05, and 0.30 respectively. Compared to placebo, placing chlorhexidine gel intrasocket after extractions reduced the odds of developing a dry socket by 58% with an OR of 0.44 (95% CI 0.27 to 0.71; P = 0.0008; 7 trials, 753 participants; moderate-certainty evidence). The NNT with chlorhexidine gel (0.2%) to prevent one patient developing dry socket was 180 (95% CI 137 to 347), 37 (95% CI 28 to 72), and 7 (95% CI 5 to 15) for control prevalence of dry socket of 0.01, 0.05, and 0.30 respectively. Compared to chlorhexidine rinse (0.12%), placing chlorhexidine gel (0.2%) intrasocket after extractions was not superior in reducing the risk of dry socket (RR 0.74, 95% CI 0.46 to 1.20; P = 0.22; 2 trials, 383 participants; low-certainty evidence). The present review found some evidence for the association of minor adverse reactions with use of 0.12%, 0.2% chlorhexidine mouthrinses (alteration in taste, staining of teeth, stomatitis) though most studies were not designed explicitly to detect the presence of hypersensitivity reactions to mouthwash as part of the study protocol. No adverse events were reported in relation to the use of 0.2% chlorhexidine gel placed directly into a socket. Platelet rich plasma in the prevention of dry socket Compared to placebo, placing platelet rich plasma after extractions was not superior in reducing the risk of having a dry socket (RR 0.51, 95% CI 0.19 to 1.33; P = 0.17; 2 studies, 127 participants; very low-certainty evidence). A further 21 intrasocket interventions to prevent dry socket were each evaluated in single studies, and there is insufficient evidence to determine their effects. Zinc oxide eugenol versus Alvogyl in the treatment of dry socket Two studies, with 80 participants, showed that Alvogyl (old formulation) is more effective than zinc oxide eugenol at reducing pain at day 7 (mean difference (MD) -1.40, 95% CI -1.75 to -1.04; P < 0.00001; 2 studies, 80 participants; very low-certainty evidence) A further nine interventions for the treatment of dry socket were evaluated in single studies, providing insufficient evidence to determine their effects.
AUTHORS' CONCLUSIONS
Tooth extractions are generally undertaken by dentists for a variety of reasons, however, all but five studies included in the present review included participants undergoing extraction of third molars, most of which were undertaken by oral surgeons. There is moderate-certainty evidence that rinsing with chlorhexidine (0.12% and 0.2%) or placing chlorhexidine gel (0.2%) in the sockets of extracted teeth, probably results in a reduction in dry socket. There was insufficient evidence to determine the effects of the other 21 preventative interventions each evaluated in single studies. There was limited evidence of very low certainty that Alvogyl (old formulation) may reduce pain at day 7 in patients with dry socket when compared to zinc oxide eugenol.
Topics: Adolescent; Adult; Anti-Bacterial Agents; Chlorhexidine; Dry Socket; Eugenol; Humans; Mouthwashes; Pain; Zinc Oxide
PubMed: 36156769
DOI: 10.1002/14651858.CD006968.pub3 -
British Dental Journal Sep 2022Since its introduction in 1998, alveolar ridge preservation has become a popular technique, currently accounting for approximately 29% of all procedures involving bone...
Since its introduction in 1998, alveolar ridge preservation has become a popular technique, currently accounting for approximately 29% of all procedures involving bone substitute materials. The global cost of bone substitute materials for alveolar ridge preservation is estimated at $190 million annually and is expected to rise by approximately 11.4% per year.Numerous randomised controlled trials have compared alveolar ridge preservation to extraction alone. A recent Cochrane review reported that, in terms of socket dimensional change, the mean difference between alveolar ridge preservation and extraction alone is 1.18 mm horizontally and 1.35 mm vertically. The clinical impact of this is uncertain, for there is no significant difference in the need for graft procedures at implant placement between ridge preservation and extraction alone. There are no randomised controlled trials comparing aesthetic or functional outcomes.A systematic review of the histological outcomes of ridge preservation demonstrates that, compared to extraction alone, many bone substitute materials can significantly delay the bone healing process. No bone substitute material achieves statistically more new bone formation than extraction alone and many commonly used materials achieve significantly less bone formation. Grafted sites can demonstrate high levels of residual graft and granulation tissue.In the absence of good-quality clinical evidence to support alveolar ridge preservation, the technique must be questioned as the treatment of choice at extraction sites. This paper assesses recent systematic reviews and presents two case reports of late graft failure.
Topics: Alveolar Bone Loss; Alveolar Process; Alveolar Ridge Augmentation; Bone Substitutes; Esthetics, Dental; Humans; Tooth Extraction; Tooth Socket
PubMed: 36151171
DOI: 10.1038/s41415-022-4967-2 -
The Cleft Palate-craniofacial Journal :... Feb 2024Cleft lip and/or palate is the most commonly documented orofacial anomaly and may impact the status of health and disease of adjacent teeth along with their associated... (Meta-Analysis)
Meta-Analysis
Cleft lip and/or palate is the most commonly documented orofacial anomaly and may impact the status of health and disease of adjacent teeth along with their associated supporting structures. The authors performed a systematic review and meta-analysis to assess whether the presence of clefts altered the periodontal status of patients. The study was registered in PROSPERO (CRD42020210178). A systematic search of literature was performed utilizing unique search strings for PubMed, Scopus, and GoogleScholar as databases including gray literature from April 28, 2020 to October 3, 2020. Cross-sectional and longitudinal human studies published in the English language, providing information about periodontal disease and its association with cleft lip, alveolus, and palate. Periodontal outcome measures such as gingival index (GI), clinical attachment level (CAL), plaque index (PI), periodontal probing depth (PPD), and bleeding on probing (BOP) were utilized as the main outcome measures. Patients with clefts were predisposed to poorer periodontal outcomes. Subgroup analysis revealed compromised periodontal measures for clefts as compared to control sites without cleft which were statistically significant in terms of GI [ = 2.44, = .01], CAL [ = 2.52, = .01], PI [ = 2.76, = .006] and not statistically significant for PPD [ = 0.27, = .79] and BOP [ = 1.47, = .14]. Within the limitations of the review, the authors conclude that the presence of orofacial clefts may predispose to periodontal compromise when compared to normal controls. The GRADE rating was moderate.
Topics: Humans; Cleft Lip; Cleft Palate; Cross-Sectional Studies; Periodontal Diseases; Tooth
PubMed: 36130097
DOI: 10.1177/10556656221127549 -
International Journal of Environmental... Aug 2022The objective of this systematic review was (a) to explore the current clinical applications of AI/ML (Artificial intelligence and Machine learning) techniques in... (Review)
Review
OBJECTIVE
The objective of this systematic review was (a) to explore the current clinical applications of AI/ML (Artificial intelligence and Machine learning) techniques in diagnosis and treatment prediction in children with CLP (Cleft lip and palate), (b) to create a qualitative summary of results of the studies retrieved.
MATERIALS AND METHODS
An electronic search was carried out using databases such as PubMed, Scopus, and the Web of Science Core Collection. Two reviewers searched the databases separately and concurrently. The initial search was conducted on 6 July 2021. The publishing period was unrestricted; however, the search was limited to articles involving human participants and published in English. Combinations of Medical Subject Headings (MeSH) phrases and free text terms were used as search keywords in each database. The following data was taken from the methods and results sections of the selected papers: The amount of AI training datasets utilized to train the intelligent system, as well as their conditional properties; Unilateral CLP, Bilateral CLP, Unilateral Cleft lip and alveolus, Unilateral cleft lip, Hypernasality, Dental characteristics, and sagittal jaw relationship in children with CLP are among the problems studied.
RESULTS
Based on the predefined search strings with accompanying database keywords, a total of 44 articles were found in Scopus, PubMed, and Web of Science search results. After reading the full articles, 12 papers were included for systematic analysis.
CONCLUSIONS
Artificial intelligence provides an advanced technology that can be employed in AI-enabled computerized programming software for accurate landmark detection, rapid digital cephalometric analysis, clinical decision-making, and treatment prediction. In children with corrected unilateral cleft lip and palate, ML can help detect cephalometric predictors of future need for orthognathic surgery.
Topics: Artificial Intelligence; Child; Cleft Lip; Cleft Palate; Humans; Machine Learning
PubMed: 36078576
DOI: 10.3390/ijerph191710860