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The International Journal of Oral &... 2021The aim of this systematic review was to evaluate the influence of zirconia and titanium as abutment materials on peri-implant soft tissue color. (Meta-Analysis)
Meta-Analysis
PURPOSE
The aim of this systematic review was to evaluate the influence of zirconia and titanium as abutment materials on peri-implant soft tissue color.
MATERIALS AND METHODS
The searched electronic databases included MEDLINE/PubMed, LILACS, Web of Science, Scopus, and LIVIVO. Two types of studies were included: randomized clinical trials (RCTs) and controlled clinical trials (CCTs) that compared zirconia (Zr) and titanium (Ti) abutments. The outcomes measured were as follows: implant crown esthetic index, visual analog scale, esthetic index, gingiva discoloration index-spectrophotometry, papilla index, recession index, and pink esthetic score. Two reviewers selected the records, assessed quality, and extracted data of included studies independently.
RESULTS
A total of 323 patients enrolled in 13 studies were included in this analysis with 11 RCTs and 2 CCTs. Due to the wide variety of methodologies used, meta-analysis was only possible for RCTs that performed spectrophotometric analysis. The use of zirconia or titanium for implant abutments does not seem to be the principal factor for influencing peri-implant soft tissue color. The meta-analysis showed no difference between zirconia and titanium abutments.
CONCLUSION
This study does not support any better advantage of the use of zirconia in comparison to the use of titanium related to peri-implant tissue color.
Topics: Crowns; Dental Abutments; Esthetics, Dental; Gingiva; Humans; Spectrophotometry; Titanium; Zirconium
PubMed: 34698712
DOI: 10.11607/jomi.8904 -
Clinical Oral Implants Research Oct 2021To address the following question: "Is the timing of implant placement and/or loading influencing the esthetic outcomes of implant-supported single crowns?" (Review)
Review
OBJECTIVES
To address the following question: "Is the timing of implant placement and/or loading influencing the esthetic outcomes of implant-supported single crowns?"
MATERIAL AND METHODS
A literature screening was performed in four electronic databases until June 2020. Randomized controlled clinical trials with a minimum of 10 patients and 1 year of follow-up and reporting on dimensional changes of the peri-implant mucosa (midfacial recession, papilla level) and esthetic indexes were included. Cochrane Risk of Bias Tool was used, and comparable trials were subjected to meta-analyses.
RESULTS
Out of 8549 articles, 72 full-text articles were assessed for eligibility and 18 were included. Nine trials evaluated the timing of implant placement, and nine trials evaluated the timing of loading. The included trials comparing immediate implant placement to delayed implant placement evaluating the midfacial recession reported heterogeneous findings. No differences were found at 1 and 2-years, when comparing midfacial recession and papilla level between immediate and early implant placement. In immediate and delayed implant placement, when comparing conventional and immediate loading, the midfacial mucosal margin change was not statistically significant at the 1-year follow-up. When evaluating the timing of implant placement and/or loading the included trials found no differences in the Pink Esthetic score, White Esthetic score, and Papilla Index between groups.
CONCLUSIONS
Both immediate and early implant placement protocols presented stable treatment results in terms of esthetic outcomes at the 1-, 2-, and 10-years follow-up. Loading protocols did not seem to influence esthetic outcomes in short- and medium-term follow-ups.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Esthetics; Esthetics, Dental; Humans
PubMed: 34642985
DOI: 10.1111/clr.13811 -
Clinical Oral Implants Research Oct 2021To evaluate the peri-implant tissue changes and esthetic outcomes of cemented and screw-retained crowns of single-tooth implants in the esthetic zone using zirconia... (Meta-Analysis)
Meta-Analysis Review
Peri-implant and esthetic outcomes of cemented and screw-retained crowns using zirconia abutments in single implant-supported restorations-A systematic review and meta-analysis.
OBJECTIVES
To evaluate the peri-implant tissue changes and esthetic outcomes of cemented and screw-retained crowns of single-tooth implants in the esthetic zone using zirconia abutments.
MATERIAL AND METHODS
An electronic search was performed on nine databases. The risk-of-bias was assessed by the revised Cochrane risk-of-bias tool for randomized (RoB 2) and non-randomized (ROBINS-I) clinical trials. Marginal bone level change, soft tissue thickness, bleeding on probing, probing depth, survival rates of implants and crowns, complications, plaque and papilla indexes, and pink esthetic score data were extracted and analyzed. The certainty of evidence was accessed through the GRADE approach.
RESULTS
Nine records were included and 7 were used in the meta-analyses. Screw-retained crowns presented greater marginal bone level change (MD -0.04 [-0.08, -0.00] p = 0.04, I = 0%) compared to cemented crowns up to 1-year. At 3 and 4 years no significant differences (p > 0.05) were observed. Soft tissue thickness did not differ between groups (p > 0.05). The bleeding on probing was higher in cemented group than in screw-retained crowns at 1-year (MD 0.17 [0.08, 0.27] p = 0.0005, I = 0%), at medium-term periods (3 and 4 years) no statistically significant differences (p > 0.05) were observed for this outcome. Probing depth, survival rates of implants and crowns, complications, and plaque index, as well as esthetic analysis using the papilla index and pink esthetic score did not differ statistically (p > 0.05) between both retention systems at short and medium-term periods.
CONCLUSION
The connection system considering zirconia abutments presented no influence on peri-implant parameters and esthetics evaluation for medium-term periods (3 and 4 years).
Topics: Bone Screws; Crowns; Dental Abutments; Dental Implants; Dental Implants, Single-Tooth; Dental Prosthesis, Implant-Supported; Esthetics, Dental; Zirconium
PubMed: 34352144
DOI: 10.1111/clr.13824 -
Journal of Clinical Periodontology Jun 2022To assess the beneficial and adverse effects on the dental and periodontal issues of periodontal-orthodontic treatment of teeth with pathological tooth flaring,... (Meta-Analysis)
Meta-Analysis Review
Effect of periodontal-orthodontic treatment of teeth with pathological tooth flaring, drifting, and elongation in patients with severe periodontitis: A systematic review with meta-analysis.
AIM
To assess the beneficial and adverse effects on the dental and periodontal issues of periodontal-orthodontic treatment of teeth with pathological tooth flaring, drifting, and elongation in patients with severe periodontitis.
MATERIALS AND METHODS
Nine databases were searched in April 2020 for randomized/non-randomized clinical studies. After duplicate study selection, data extraction, and risk-of-bias assessment, random-effect meta-analyses of mean differences (MDs) and their 95% confidence intervals (CIs) were performed, followed by subgroup/meta-regression analyses.
RESULTS
A total of 30 randomized and non-randomized clinical studies including 914 patients (29.7% male; mean age 43.4 years) were identified. Orthodontic treatment of pathologically migrated teeth was associated with clinical attachment gain (-0.24 mm; seven studies), pocket probing depth reduction (-0.23 mm; seven studies), marginal bone gain (-0.36 mm; seven studies), and papilla height gain (-1.42 mm; two studies) without considerable adverse effects, while patient sex, gingival phenotype, baseline disease severity, interval between periodontal and orthodontic treatment, and orthodontic treatment duration affected the results. Greater marginal bone level gains were seen by additional circumferential fiberotomy (two studies; MD = -0.98 mm; 95% CI = -1.87 to -0.10 mm; p = .03), but the quality of evidence was low.
CONCLUSIONS
Limited evidence of poor quality indicates that orthodontic treatment might be associated with small improvements of periodontal parameters, which do not seem to affect prognosis, but more research is needed.
Topics: Female; Humans; Male; Periodontitis
PubMed: 34327710
DOI: 10.1111/jcpe.13529 -
Clinical and Experimental Dental... Aug 2021Octenidine dihydrochloride is an antimicrobial cationic surfactant compound. We conducted a systematic review to determine the efficacy of octenidine-based mouthwash on...
OBJECTIVE
Octenidine dihydrochloride is an antimicrobial cationic surfactant compound. We conducted a systematic review to determine the efficacy of octenidine-based mouthwash on plaque formation, gingivitis, and oral microbial growth in subjects with or without periodontal disease.
MATERIALS AND METHODS
PubMed/MEDLINE, ScienceDirect, Google Scholar, and Cochrane Library were searched for relevant studies. The review was conducted per PRISMA guidelines. Only randomized controlled trials and observational studies comparing octenidine with placebo or other mouthwashes in healthy subjects with or without periodontal disease, were considered for this review. The endpoints included percentage reduction in plaque index (PI), gingival index (GI), absolute reduction in the mean number of colony-forming units (CFU/ml [log ]) and adverse effects (AEs; tooth staining/mucosal tolerance).
RESULTS
Ten randomized controlled and six observational studies fulfilled the selection criteria. Twice or thrice daily rinsing with 0.1% octenidine for 30-60 s produced significant reduction in plaque, gingivitis and oral microbial growth. Compared to control mouthwash or baseline, 0.1% octenidine inhibited plaque formation by ~38.7%-92.9%, which was either equal or greater than that of chlorhexidine gluconate. 0.1% octenidine reduced gingivitis by ~36.4%-68.37% versus control mouthwash or baseline and microbial growth by 0.37-5.3 colony-forming units (vs. chlorhexidine: 0.4-4.23 colony-forming units). Additional benefits of 0.1% octenidine were significant reduction in the number of bleeding sites, papilla bleeding index, sulcus bleeding index, and gingival fluid flow.
CONCLUSION
Within the limitations of this study, there exists moderate evidence that 0.1% OCT was found to be an effective antiplaque agent. Octenidine inhibited plaque formation upto 93% and gingivitis upto 68% versus placebo and was either superior or comparable to chlorhexidine. Octenidine was well-tolerated and safe and can be an effective alternative to CHX and other contemporary mouthwashes.
Topics: Chlorhexidine; Dental Plaque; Gingivitis; Humans; Imines; Mouthwashes; Periodontal Diseases; Pyridines
PubMed: 34227746
DOI: 10.1002/cre2.386 -
Journal of Indian Society of... 2021Access to apical root canal system is gained after flap elevation using various incision techniques. Soft-tissue healing after periradicular surgery may include gingival... (Review)
Review
BACKGROUND
Access to apical root canal system is gained after flap elevation using various incision techniques. Soft-tissue healing after periradicular surgery may include gingival recession, papilla recession, changes in probing depth, and clinical attachment loss.
OBJECTIVE
The objective of this study was to compare the effect of full sulcular flap design versus papilla-sparing flap design on the periodontal parameters in periradicular surgeries.
MATERIALS AND METHODS
It was a systematic review and meta-analysis. Electronic and manual searches were conducted in multiple databases including PubMed, Dental and Oral Sciences, Cochrane, and CINAHL Plus until May 2019. Initial search yielded 2575 studies with 5 articles meeting the inclusion criteria. The primary outcomes assessed were gingival recession and change in the papilla height. The secondary outcomes evaluated were probing depth, clinical attachment loss, postoperative pain, bleeding, and discomfort. Random-effects model was employed for computation of effect size, and forest plots were made.
RESULTS
Out of the five articles that satisfied the inclusion criteria, three were randomized control trials and two were nonrandom trials. No significant differences were found in the gingival recession ( = 0.79), papilla height ( = 0.55), gingival bleeding, and plaque indices. Statistically significant differences in probing depth ( = 0.006) and clinical attachment loss ( = 0.0004) were observed for the two flap designs in probing depth ( = 0.006) and clinical attachment loss ( = 0.0004).
CONCLUSIONS
The present systematic review and meta-analysis showed that probing depth and attachment loss are affected by the choice of flap design. On the other hand, gingival recession and papilla height are not influenced by the type of incision. However, finding of the present review may change if more studies on this topic will be included in the future. Therefore, more clinical trials with long-term follow-ups are needed.
PubMed: 34158683
DOI: 10.4103/jisp.jisp_290_20 -
Clinical Oral Investigations Aug 2021The aim of this systematic review was to evaluate the efficacy of immediate implant placement (IIP) compared to implants placed after alveolar ridge preservation (ARP)... (Meta-Analysis)
Meta-Analysis Review
AIM
The aim of this systematic review was to evaluate the efficacy of immediate implant placement (IIP) compared to implants placed after alveolar ridge preservation (ARP) in terms of clinical, esthetic, and patient-reported outcomes.
METHODS
A manual and electronic search (National Library of Medicine) was performed for controlled clinical trials, with at least 12 months of follow-up. Primary outcome variable was implant survival and secondary outcomes were marginal bone level (MBL) (change), pink esthetic score (PES), mid-facial mucosal level (change), papilla index score, complications, and patient-reported outcomes.
RESULTS
A total of 10 publications were included (7 randomized clinical trials and 3 controlled clinical trials). The results from the meta-analyses showed that survival rate was significantly lower in the IIP group compared to ARP group [RR = 0.33; 95% CI (0.14; 0.78); p = 0.01]. No significant differences between the two groups were observed regarding radiographic MBL, PES scores, or mid-facial mucosal level (p > 0.05).
CONCLUSION
The results from this systematic review and meta-analysis showed that IIP had lower survival rates and similar esthetic results when compared to ARP.
CLINICAL RELEVANCE
Clinicians should weigh the benefits and disadvantages of each intervention to select the optimal timing of implant placement.
Topics: Alveolar Process; Alveolar Ridge Augmentation; Dental Implantation, Endosseous; Dental Implants; Esthetics, Dental; Humans; Tooth Extraction; Tooth Socket; Treatment Outcome
PubMed: 34100157
DOI: 10.1007/s00784-021-03986-6 -
Journal of Clinical and Experimental... May 2021This systematic review evaluates the available scientific literature to demonstrate the aesthetic and clinical benefits and to determine the survival and the success of... (Review)
Review
BACKGROUND
This systematic review evaluates the available scientific literature to demonstrate the aesthetic and clinical benefits and to determine the survival and the success of zirconium dioxide implants concerning titanium implants.
MATERIAL AND METHODS
The electronic databases were searched until January 2020. Outcome measures were pink aesthetic score (PAS), white aesthetic score (WAS), bleeding on probing (BOP) and probing depth (PD). The addressed PICO question was: In partially edentulous patients in the upper-anterior sector, do zirconium dioxide implants provide aesthetic benefits over conventional titanium implants?
RESULTS
In the 15 articles included after the screening were evaluated respectively, the pink aesthetic score, white aesthetics score, the peri-implant, and crown index, bleeding on probing, plaque index, probing pocket depth, radiographic bone loss, papilla height, and survival and success rate. The results show how the aesthetic and clinical benefits and the survival and success rate of zirconium dioxide implants are, in general, better than titanium implants.
CONCLUSIONS
Despite the optimal aesthetics, clinical and survival results obtained in the review, more studies are needed to confirm these data. Ceramic dental implants, zirconia implants, esthetics, zirconium dioxide and zirconia.
PubMed: 33981400
DOI: 10.4317/jced.58063 -
The International Journal of... 2021To systematically review the influence of abutment material and configuration on the soft tissue esthetic outcomes of implant-supported single crowns (iSCs) after 3... (Meta-Analysis)
Meta-Analysis
PURPOSE
To systematically review the influence of abutment material and configuration on the soft tissue esthetic outcomes of implant-supported single crowns (iSCs) after 3 years.
MATERIALS AND METHODS
An electronic search on MEDLINE (PubMed) from January 2000 to July 2019 was conducted for clinical trials with no language restrictions. The focus question was: In partially edentulous patients with iSCs, does the abutment material (metal vs ceramic) or the configuration (standardized vs customized) have an effect on the soft tissue esthetic outcomes? Randomized controlled trials, controlled clinical trials, and prospective or retrospective case series with at least 10 patients and a minimum of 3 years of follow-up were included. The esthetic outcomes Pink Esthetic Score (PES), PES/White Esthetic Score (WES; ie, modPES), Papilla Index (PI), soft tissue recession, and papilla height change were extracted. Meta-analysis was performed when applicable.
RESULTS
Of the 6,399 titles identified, 27 studies were included. Combined mean PES/modPES scores, translated into a scale of 0 to 100, were 68.8 for ceramic, 74.2 for metal (P = .392), 71.9 for customized, and 71.3 for standard (P = .981) abutments. Mean soft tissue recession was also similar between the abutment groups, abutment material (P = .850), and configuration (P = .849), ranging from -1.09 mm to +0.59 mm gain. Papilla height changes ranged from -1.22 mm to +1.0 mm gain. The reported mean PI was 2.16 for customized, 2.06 for standard (P = .552), 2.01 for ceramic, and 2.28 for metallic (P = .04) abutments.
CONCLUSION
This systematic review showed that the abutment material and configuration had minimal impact on the evaluated soft tissue esthetic outcomes. Future research focusing on the included parameters in a randomized controlled manner is needed to validate the present findings.
Topics: Crowns; Dental Abutments; Dental Implants; Dental Implants, Single-Tooth; Dental Prosthesis, Implant-Supported; Esthetics, Dental; Humans; Prospective Studies; Retrospective Studies
PubMed: 33882569
DOI: 10.11607/ijp.6314 -
Journal of Clinical Periodontology Jun 2021To systematically assess the clinical performance of different approaches for periodontal regeneration of intrabony defects in terms of pocket resolution compared to... (Meta-Analysis)
Meta-Analysis Review
Pocket resolution in regenerative treatment of intrabony defects with papilla preservation techniques: A systematic review and meta-analysis of randomized clinical trials.
AIM
To systematically assess the clinical performance of different approaches for periodontal regeneration of intrabony defects in terms of pocket resolution compared to access surgery with papilla preservation techniques (PPTs).
MATERIAL AND METHODS
Systematic literature searches were conducted on PubMed, EMBASE, and CENTRAL up to April 2020 to identify RCTs on regenerative treatment [guided tissue regeneration (GTR) or enamel matrix derivative (EMD) with or without biomaterials] of intrabony defects using PPTs. Results were expressed as weighted mean percentages (WMP) or risk ratios of pocket resolution at 12 months (considering both final PD ≤ 3 mm and ≤4 mm).
RESULTS
A total of 12 RCTs were included. Based on a final PD ≤ 3 mm or PD ≤ 4 mm, the WMP of pocket resolution was 61.4% and 92.1%, respectively. EMD and GTR obtained comparable results. Pairwise meta-analysis identified a greater probability of achieving pocket resolution for GTR compared to PPTs. The number needed to treat for GTR to obtain one extra intrabony defect achieving PD ≤ 3 mm or PD ≤ 4 mm over PPTs was 2 and 4, respectively.
CONCLUSION
Regenerative surgery represents a viable approach to obtain final PD ≤ 4 mm in the short-term.
Topics: Alveolar Bone Loss; Bone Transplantation; Dental Enamel Proteins; Guided Tissue Regeneration, Periodontal; Humans; Periodontal Attachment Loss; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 33476402
DOI: 10.1111/jcpe.13428