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Dentistry Journal Apr 2024The integration of wireless sensors with artificial intelligence could represent a transformative approach in restorative dentistry, offering a sophisticated means to... (Review)
Review
The integration of wireless sensors with artificial intelligence could represent a transformative approach in restorative dentistry, offering a sophisticated means to enhance diagnostic precision, treatment planning, and patient outcomes. This systematic review was conducted to pinpoint and assess the efficacy of wireless sensors in restorative dentistry. The search methodology followed the guidelines outlined by PRISMA and involved the utilization of prominent scientific databases. Following the final phase of evaluating eligibility, the systematic review included six papers. Five experiments were conducted in vitro, while one was a randomized clinical trial. The investigations focused on wireless sensors for cavity diagnosis, toothbrush forces, facial mask applications, and physiological parameter detection from dental implants. All wireless sensors demonstrated efficacy in achieving the objectives established by each study and showed the validity, accuracy, and reproducibility of this device. The investigations examined in this systematic review illustrate the potential of wireless sensors in restorative dentistry, especially in the areas of caries detection, dental implant systems, face masks, and power brushes. These technologies hold promise for enhancing patient outcomes and alleviating the workload of dental practitioners.
PubMed: 38786518
DOI: 10.3390/dj12050120 -
Dental and Medical Problems May 2024Alveolar reconstructive surgery employs a variety of surgical techniques and biomaterials, with a particular focus on bone blocks as a crucial methodology for restoring... (Review)
Review
Alveolar reconstructive surgery employs a variety of surgical techniques and biomaterials, with a particular focus on bone blocks as a crucial methodology for restoring and augmenting deficient bone structures. Bone blocks are often employed to support periodontal health or as a foundation for future prosthetic rehabilitation with dental implants. This systematic review investigated recent advances in bone blocks for alveolar bone reconstruction, comparing autologous, allogeneic and xenogeneic types. A search of PubMed identified 56 records, of which 21 were included in the qualitative analysis. The studies involved 685 patients in total. Bone blocks are pivotal for three-dimensional bone regeneration, providing a stable scaffold for achieving the desired bone volume during healing. Autologous bone, harvested from the patient, boasts high biocompatibility, excellent osteogenic properties and minimal immunologic risks. However, its drawbacks include the need for an additional surgical site and extended procedural times. Allogeneic bone blocks involve transferring bone between individuals, offering increased graft availability and customization options without requiring a second surgical site. However, they exhibit moderate resorption rates and carry a heightened risk of immunologic reactions and disease transmission. Innovative techniques, such as tunneling, laser osteotomy, graft customization, and platelet-rich fibrin (PRF) application on wound during surgical treatment show promise in enhancing alveolar bone reconstruction efficacy. In conclusion, despite the traditional preference for autologous bone, the review suggests that alternative materials, particularly individualized allogeneic bone blocks, coupled with modern techniques, could emerge as a standard procedure for regenerating alveolar bone defects due to their satisfactory results and potential advantages.
PubMed: 38780363
DOI: 10.17219/dmp/181532 -
Craniomaxillofacial Trauma &... Jun 2024Systematic Review and Meta-Analysis. (Review)
Review
STUDY DESIGN
Systematic Review and Meta-Analysis.
OBJECTIVE
There has been an increasing trend in maxillofacial injuries associated with combat trauma. Within the maxillofacial complex, the mandible is the most likely structure to be damaged during combat. The structural deficits as a result can be reconstructed with many options. These include vascularised bone grafts (VBGs), non-vascularised bone grafts (NVBGs), alloplastic implants, reconstruction bars and distraction osteogenesis. This study aimed to determine the common modality and efficacy of mandibular reconstruction in combat trauma-related defects.
METHODS
A literature search was conducted on Pubmed, Prospero, Dynamed, DARE, EMBASE, COCHRANE and BMJ databases.
RESULTS
A total of six articles met the inclusion criteria identifying 165 patients requiring mandibular reconstruction. Non-vascularised iliac bone graft (n = 137) was the most common method followed by ileac crest bone chips harvest using Dacron urethran osteomesh tray (n = 24) and frontoparietal grafts (n = 4). Meta-analysis of five out of six trials demonstrated an overall success rate of 85% (95% CI 79-90; I = 59%). A total of 13% (n = 22) of reconstructions failed either completely or partially and 21% (n = 34) of patients suffered postoperative complications.
CONCLUSIONS
NVBGs are a practical, cost-effective and favourable method of war zone management of mandibular defects with success rates comparable to those reported in the civilian literature. However, general trauma principles take precedence to rule out life-threatening injuries. Due consideration of patient factors, surgical factors, and available resources are required in the first-line management of combat-related mandibular defects.
PubMed: 38779399
DOI: 10.1177/19433875231198947 -
Journal of Prosthodontic Research May 2024This study aimed to provide the latest updates on the therapeutic effectiveness of keratinized mucosa (KM) augmentation using autogenous soft tissue grafts for dental...
PURPOSE
This study aimed to provide the latest updates on the therapeutic effectiveness of keratinized mucosa (KM) augmentation using autogenous soft tissue grafts for dental implants retaining prostheses.
STUDY SELECTION
A systematic search of electronic databases was conducted on autogenous soft tissue grafts to create and/or augment KM for functioning dental implants. Two investigators independently extracted data from the selected 11 clinical studies, including 290 participants, from the initially retrieved 573 publications.
RESULTS
A lack of KM surrounding dental implants was associated with greater mucosal inflammation. A free gingival graft (FGG) was used to increase the KM width, and a connective tissue graft (CTG) was used to manage peri-implant mucosal recession (MR). The weighted mean gain in KM was 2.6 mm from the selected FGG studies, with a significant reduction in mucosal inflammation and no changes in crestal bone levels for up to 4 years. The weighted mean reduction in MR was 2 mm in selected CTG studies.
CONCLUSIONS
A lack of KM negatively affects soft tissue health around dental implants. FGG was effective in increasing KM and reducing mucosal inflammation, whereas CTG was effective in decreasing MR.
PubMed: 38777752
DOI: 10.2186/jpr.JPR_D_24_00002 -
Journal of Experimental Orthopaedics Jul 2024Patellofemoral joint instability (PFJI) can surgically be treated with a multitude of approaches, depending on the underlying pathology. In the presence of increased... (Review)
Review
Promising results following derotational femoral osteotomy in patellofemoral instability with increased femoral anteversion: A systematic review on current indications, outcomes and complication rate.
PURPOSE
Patellofemoral joint instability (PFJI) can surgically be treated with a multitude of approaches, depending on the underlying pathology. In the presence of increased femoral anteversion, some authors have reported good results with a derotational distal femoral osteotomy (DeDFO). The purpose of the study was to investigate the indications, outcomes and complication rate of DeDFO for PFJI.
METHODS
A systematic review was performed according to the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses) by searching Medline, Embase, Web of Science and Cochrane Library databases through 1 December 2023. Included were levels 1-4 clinical studies of skeletally mature patients undergoing a DeDFO for PFJI irrespective of concomitant procedures. Study characteristics, indications, radiological and clinical outcomes, surgical technique and concomitant procedures, re-dislocation and complication rate were all analysed, as was methodological quality.
RESULTS
A total of 12 studies including 310 patients (325 knees) were included. Three studies were cohort studies, all others were case series. The mean patient age across the studies was 22 years, and the mean follow-up was 29.4 months. Femoral anteversion cut-off was between 20° and 30°. Every study included at least one concurrent soft tissue, bony or combined procedure. Across all studies, one case of re-dislocation was reported (0.3%) and four implant or osteotomy-related complications (1.2%) were reported. All studies reported a statistically significant increase in clinical scores.
CONCLUSION
This systematic review of DeDFO for patellofemoral instability in the presence of increased femoral anteversion demonstrates promising clinical results and an extremely low dislocation and complication rate. The heterogeneity of the cut-off in anteversion and concomitant procedures, especially tibial tubercle osteotomy with seemingly identical results, indicates the need for high-quality evidence for treating patellofemoral instability. Based upon this systematic review, we strongly recommend that DeDFO be added to the 'menu à la carte' of PFJI.
LEVEL OF EVIDENCE
Level III Systematic Review.
PubMed: 38774579
DOI: 10.1002/jeo2.12032 -
Heliyon May 2024The objective of the systematic review is to find an answer to a question: "What is the influence of the building direction of titanium implants produced by additive... (Review)
Review
The objective of the systematic review is to find an answer to a question: "What is the influence of the building direction of titanium implants produced by additive manufacturing on their physical and mechanical properties?" This review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA 2020) and was registered in the Open Science Framework (OSF) (osf.io/rdc84). Searches were performed in PubMed, Scopus, Science Direct, Embase, and Google Scholar databases on February 17th, 2024. Articles were chosen in 2 steps by 2 blinded reviewers based on previously selected inclusion criteria: In vitro studies that evaluated the influence of the impression direction of titanium implants produced by additive manufacturing on their physical and mechanical properties were selected. Articles were excluded that (1) did not use additive technology to obtain the implants, 2) used surfaces other than titanium, 3) did not evaluate the direction of impression, 4) Studies with only in vivo analyses, clinical studies, systematic reviews, book chapters, short communications, conference abstracts, case reports, and personal opinions.). In the initial search, 581 results were found. Of this total, 108 were excluded for duplication and, after applying the eligibility criteria, 16 articles were included in the present review. The risk of bias was analyzed using the RoBDEMAT. The risk of bias was analyzed using the RoBDEMAT. In addition, the coefficient of interagreement of the reviewers (Cohen's Kappa) and the certainty of evidence by GRADE were analyzed. In general, different impression angles showed variations in the physical and mechanical characteristics of the groups evaluated, including roughness, tensile strength, hardness, and modulus of elasticity. While some impression orientations resulted in greater strength or hardness, others showed greater elasticity or lower surface roughness. These findings suggest that print orientation plays a significant role in determining material properties. It can be concluded that printing directions influence the physical and mechanical properties of titanium implants and the studies included showed that the 0°, 45°, and 90° directions are the most evaluated as they present lower probabilities of structural anisotropies and provide better results in their roughness, hardness, tensile and compressive strength.
PubMed: 38774089
DOI: 10.1016/j.heliyon.2024.e30108 -
Journal of Dentistry May 2024The purpose of this systematic review and meta-analysis was to evaluate the accuracy (trueness and precision), marginal and internal adaptation, and margin quality of...
Accuracy, adaptation and margin quality of monolithic zirconia crowns fabricated by 3D printing versus subtractive manufacturing technique: A systematic review and meta-analysis of in vitro studies.
OBJECTIVE
The purpose of this systematic review and meta-analysis was to evaluate the accuracy (trueness and precision), marginal and internal adaptation, and margin quality of zirconia crowns made by additive manufacturing compared to subtractive manufacturing technology.
METHODS
The investigation adhered to the PRISMA-ScR guidelines for systematic reviews and was registered at the Prospero database (n°CRD42023452927). Four electronic databases, including PubMed, Scopus, Embase, and Web of Science and manual search was conducted to find relevant studies published until September 2023. In vitro studies that assessed the trueness and precision, marginal and internal adaptation, and margin quality of printed crowns compared to milled ones were included. Studies on crowns over implants, pontics, temporary restorations, laminates, or exclusively experimental materials were excluded.
RESULTS
A total of 9 studies were included in the descriptive reporting and 7 for meta-analysis. The global meta-analysis of the trueness (P<0.74,I=90 %) and the margin quality (P<0.61,I=0 %) indicated no significant difference between the root mean square of printed and milled zirconia crowns. The subgroup analysis for the printing system showed a significant effect (P<0.01). The meta-analysis of the crown areas indicated no significant difference in most of the areas, except for the marginal (favoring milled crowns) and axial (favoring printed crowns) areas. For precision and adaptation, both methods showed a clinically acceptable level.
CONCLUSIONS
Additive manufacturing technology produces crowns with trueness and margin quality comparable to subtractive manufacturing. Both techniques have demonstrated the ability to produce crowns with precision levels, internal discrepancy, and marginal fit within clinically acceptable limits.
CLINICAL SIGNIFICANCE
3D printing emerges as a promising and potentially applicable alternative method for manufacturing zirconia crowns, as it shows trueness and margin quality comparable to restorations produced by the subtractive method.
PubMed: 38772449
DOI: 10.1016/j.jdent.2024.105089 -
Journal of Dentistry Jul 2024This systematic review and meta-analysis aimed to assess the current performance of artificial intelligence (AI)-based methods for tooth segmentation in... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
This systematic review and meta-analysis aimed to assess the current performance of artificial intelligence (AI)-based methods for tooth segmentation in three-dimensional cone-beam computed tomography (CBCT) images, with a focus on their accuracy and efficiency compared to those of manual segmentation techniques.
DATA
The data analyzed in this review consisted of a wide range of research studies utilizing AI algorithms for tooth segmentation in CBCT images. Meta-analysis was performed, focusing on the evaluation of the segmentation results using the dice similarity coefficient (DSC).
SOURCES
PubMed, Embase, Scopus, Web of Science, and IEEE Explore were comprehensively searched to identify relevant studies. The initial search yielded 5642 entries, and subsequent screening and selection processes led to the inclusion of 35 studies in the systematic review. Among the various segmentation methods employed, convolutional neural networks, particularly the U-net model, are the most commonly utilized. The pooled effect of the DSC score for tooth segmentation was 0.95 (95 %CI 0.94 to 0.96). Furthermore, seven papers provided insights into the time required for segmentation, which ranged from 1.5 s to 3.4 min when utilizing AI techniques.
CONCLUSIONS
AI models demonstrated favorable accuracy in automatically segmenting teeth from CBCT images while reducing the time required for the process. Nevertheless, correction methods for metal artifacts and tooth structure segmentation using different imaging modalities should be addressed in future studies.
CLINICAL SIGNIFICANCE
AI algorithms have great potential for precise tooth measurements, orthodontic treatment planning, dental implant placement, and other dental procedures that require accurate tooth delineation. These advances have contributed to improved clinical outcomes and patient care in dental practice.
Topics: Humans; Cone-Beam Computed Tomography; Artificial Intelligence; Tooth; Imaging, Three-Dimensional; Algorithms; Neural Networks, Computer; Image Processing, Computer-Assisted
PubMed: 38768854
DOI: 10.1016/j.jdent.2024.105064 -
Journal of Clinical Periodontology Jul 2024To systematically identify, synthesize and critically summarize the available scientific evidence from randomized controlled trials (RCTs) regarding whether short... (Meta-Analysis)
Meta-Analysis Comparative Study Review
Short (≤6 mm) compared with ≥10-mm dental implants in different clinical scenarios: A systematic review of randomized clinical trials with meta-analysis, trial sequential analysis and quality of evidence grading.
AIM
To systematically identify, synthesize and critically summarize the available scientific evidence from randomized controlled trials (RCTs) regarding whether short (≤6 mm) perform as well as long (≥10 mm) implants regarding implant survival, marginal bone loss, and biologic and prosthetic complications in different clinical scenarios.
MATERIALS AND METHODS
Cochrane Collaboration's risk of bias tool and the GRADE approach were applied. Results were synthesized using random-effects meta-analyses assessed by trial sequential analyses.
RESULTS
Forty reports on 19 RCTs comprising 2214 (1097 short; 1117 long) implants were included. Moderate/high certainty/quality evidence demonstrated similar 5-year survival rates for ≤6-mm and ≥10-mm implants in non-augmented bone and full-mouth rehabilitation in either jaw, and for 6-mm implants in the maxilla instead of sinus lift. Nevertheless, the evidence for 5-year survival rates remains inconclusive or insufficient for the remaining combinations of implant lengths and clinical scenarios. They include 4-mm and 5-mm implants as alternatives to sinus lift as well as placing all implant lengths ≤6 mm instead of vertical ridge augmentation with long implants. Marginal bone level and short- and long-term biologic or prosthetic complications were similar.
CONCLUSIONS
Based on moderate/high certainty/quality evidence from 5-year RCTs, implants ≤6 mm may be viable alternatives to ≥10-mm implants in either jaw in native bone and full-arch rehabilitation, and 6-mm implants may be used as an alternative to sinus lift.
TRIAL REGISTRATION
PROSPERO ID: CRD42021254365.
Topics: Humans; Dental Implants; Randomized Controlled Trials as Topic; Dental Prosthesis Design; Dental Restoration Failure; Dental Implantation, Endosseous; Alveolar Bone Loss
PubMed: 38764386
DOI: 10.1111/jcpe.13981 -
Journal of Clinical Periodontology May 2024To determine the accuracy of salivary active matrix metalloproteinase (aMMP)-8 point-of-care test (POCT) for detecting periodontitis in adults, through meta-analysis. (Review)
Review
OBJECTIVE
To determine the accuracy of salivary active matrix metalloproteinase (aMMP)-8 point-of-care test (POCT) for detecting periodontitis in adults, through meta-analysis.
MATERIALS AND METHODS
Diagnostic studies evaluating the accuracy of salivary/oral rinse aMMP-8 POCT for detecting periodontitis in adults, when compared with clinical examination, were considered eligible. A comprehensive search was performed up to 31 August 2023 through five databases. Quality Assessment of Diagnostic Accuracy Studies 2 was utilized to evaluate the methodological quality of the included articles. Meta-analysis was performed using Bayesian bivariate hierarchical model and subgroup analysis.
RESULTS
From 368 screened studies, 6 studies (4 cross-sectional and 2 longitudinal studies) were included in the meta-analysis. Overall, the pooled sensitivity and specificity of salivary aMMP-8-POCT for detecting periodontitis were 0.63 (95% CI: 0.41-0.82) and 0.84 (95% CI: 0.65-0.95), respectively. Subgroup analyses revealed that the 95% CI for oral fluid types, predefined diagnostic thresholds and the POCT systems largely overlapped, indicating that the differences between them may not be significant.
CONCLUSION
Salivary aMMP-8 POCT shows fair accuracy for detecting periodontitis. The diagnostic accuracy cannot be significantly influenced by the types of oral fluids, predefined diagnostic thresholds or the specific POCT systems used. More research is needed to confirm the clinical utility and implementation of aMMP-8 POCT in the diagnosis of periodontitis.
PubMed: 38763168
DOI: 10.1111/jcpe.14000