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Materials (Basel, Switzerland) Jun 2021The purpose of this systematic review was to investigate the clinical outcomes of frameworks made of different materials in patients with implant-supported full-arch... (Review)
Review
The purpose of this systematic review was to investigate the clinical outcomes of frameworks made of different materials in patients with implant-supported full-arch prostheses. A literature search was conducted on MEDLINE, Scopus and Cochrane Library, until the 1st of March 2021, with the following search terms: framework or substructure combined with "dental implants". The outcomes evaluated were: implant and prosthesis survival, bone resorption, biological and technical complications. The Cochrane Handbook for Systematic Reviews of Interventions was employed to assess the risk of bias in randomized clinical trials. The Newcastle-Ottawa quality assessment scale was used for non-randomized studies. In total, 924 records were evaluated for title and abstract, and 11 studies were included in the review: 4 clinical randomized trials and 7 cohort studies. The framework materials investigated were: gold alloy, titanium, silver-palladium alloy, zirconia and polymers including acrylic resin and carbon-fiber-reinforced composites. High implant and prosthetic cumulative survival rates were recorded by all included studies. Various materials and different fabrication techniques are now available as alternatives to traditional cast metal frameworks, for full-arch implant-supported rehabilitations. Further long-term studies are needed to validate the use of these materials and clarify their specific clinical indications and manufacturing protocols to optimize their clinical outcomes.
PubMed: 34204681
DOI: 10.3390/ma14123251 -
Clinical and Experimental Dental... Dec 2021Grade V titanium alloy (Ti-6Al-4 V) is a well-recognized metallic biomaterial for medical implants. There has been some controversy regarding the use of this alloy in... (Review)
Review
OBJECTIVES
Grade V titanium alloy (Ti-6Al-4 V) is a well-recognized metallic biomaterial for medical implants. There has been some controversy regarding the use of this alloy in medical devices in relation to the toxicity of vanadium. In Dentistry, Ti-6Al-4 V remains prevalent. This systematic review aims to evaluate the effects of Ti-6Al-4 V on cells relevant to oral environments such as gingival fibroblasts.
MATERIALS AND METHODS
A literature search was undertaken for relevant English language publications in the following databases: Dental and Oral Science, Medline and Web of Science. The electronic search was supplemented with a search of references.
RESULTS
After application of inclusion and exclusion criteria. A total of eight papers are included in this review. These papers were all in vitro studies and were categorized into whole implant, discs, or implant particles based on the type of test materials used in the studies.
CONCLUSION
Based on the analyses of the eight included studies in this review, if Ti-6Al-4 V as a material is unchallenged, i.e., as a whole implant in pH neutral environments, there appears to be little effect on fibroblasts. If Ti-6Al-4 V is challenged through corrosion or wear (particle release), the subsequent release of vanadium and aluminium particles has an increased cytotoxic effect in vitro in comparison to commercially pure titanium, hence concerns should be raised in the clinical setting.
Topics: Alloys; Dental Implants; Fibroblasts; Materials Testing; Titanium
PubMed: 34018703
DOI: 10.1002/cre2.444 -
Frontiers in Bioengineering and... 2021Systematic review assessing the association between oral microorganisms and corrosion of intra-oral metallic alloy-based dental appliances. PubMed, Scopus, and Web of...
Systematic review assessing the association between oral microorganisms and corrosion of intra-oral metallic alloy-based dental appliances. PubMed, Scopus, and Web of Science were searched using keyword combinations such as microbes and oral and corrosion; microbes and dental and corrosion; microorganisms and oral and corrosion; microorganisms and dental and corrosion. Out of 141 articles, only 25 satisfied the selection criteria. s, sulfate-reducing bacteria, sulfate oxidizing bacteria, Veilonella, Actinomyces, were found to have a potential association with corrosion of intraoral metallic alloys such as stainless steel, titanium, nickel, cobalt-chromium, neodymium-iron-boron magnets, zirconia, amalgam, copper aluminum, and precious metal alloys. The included studies inferred an association between oral microorganisms and intra-oral metallic alloys-based dental appliances, although, it is vital to acknowledge that most studies in the review employed an simulation of the intra-oral condition.
PubMed: 33791285
DOI: 10.3389/fbioe.2021.631103 -
Journal of Prosthodontic Research Jan 2022This study comprehensively reviewed the current status of the digital workflow of removable partial dentures (RPDs) and summarized information about the fabrication...
PURPOSE
This study comprehensively reviewed the current status of the digital workflow of removable partial dentures (RPDs) and summarized information about the fabrication methods and material properties of the dental framework, artificial teeth, and denture base.
STUDY SELECTION
We performed a systematic review of the literature published in online databases from January 1980 to April 2020 regarding RPD fabrication and materials used in the related digital technology. We selected eligible articles, retrieved information regarding digital RPDs, and conducted qualitative/quantitative analyses. In this paper, the computer-aided design/computer-aided manufacturing (CAD/CAM) framework, artificial teeth, and denture base materials are reported.
RESULTS
A variety of materials, such as cobalt-chromium alloy, titanium, zirconia, and polyether ether ketone, are used for dental CAD/CAM frameworks. The mechanical strength of the metal materials used for the CAD/CAM framework was superior to that of the cast framework. However, the fitness and surface roughness of the framework and clasp fabricated using a selective laser melting (SLM) method were not superior to those obtained via cast fabrication. Most material properties and the surface roughness of poly methyl methacrylate (PMMA) discs used for digital RPDs were superior to those of heat-cured PMMA.
CONCLUSION
The use of a CAD/CAM framework and PMMA disc for digital RPDs offers numerous advantages over conventional RPDs. However, technical challenges regarding the accuracy and durability of adhesion between the framework and denture base remain to be solved. In digital fabrication, human technical factors influence the quality of the framework.
Topics: Computer-Aided Design; Denture Bases; Denture, Partial, Removable; Humans; Tooth, Artificial; Workflow
PubMed: 33504722
DOI: 10.2186/jpr.JPR_D_20_00117 -
Journal of International Society of... 2020Dental implants are considered the best treatment option for replacement of missing teeth due to high survival rates and diverse applications. However, not all dental... (Review)
Review
BACKGROUND
Dental implants are considered the best treatment option for replacement of missing teeth due to high survival rates and diverse applications. However, not all dental implant therapies are successful and some fail due to various biological and or/mechanical factors. The objective of this study was to systematically review primary studies that focus on the biomechanical properties of dental implants in order to determine which biomechanical properties are most important for success of dental implant therapy.
MATERIALS AND METHODS
An electronic database search was performed using MEDLINE (PubMed), EMBASE, Google Scholar, and CAB Abstracts. Six principal biomechanical properties were considered to prepare the search strategy for each database using key words and Boolean operators. Human and animal studies (observational studies, trials, and studies) were included in this review. Human studies that were considered eligible needed to have subjects above 18 years who received permanent restorations after implant surgery and followed up for at least 6 months after receiving permanent restorations. Studies with subjects who had absolute contraindications at the time of dental implant surgery were excluded.
RESULTS
In total, 28 studies were included in the review after application of the eligibility criteria; 18 studies, 5 cohort clinical studies, 3 animal studies, and 2 nonrandomized trials. Six studies assessed loss of preload, five studies assessed fatigue strength, four assessed implant abutment connection design, and one assessed implant diameter. Two nonrandomized trials assessed torque and six observational studies assessed the effect of cantilevers. Gold alloy coating of abutment screws resulted in higher preload values followed by titanium alloy coating and gold coating; there was a difference in preload values between coated and uncoated screws when tightened repeatedly. Preload values decreased as a function of time with majority of preload loss occurred within 10s of tightening. The 8-degree internal conical implant performed better than the internal hex design. Higher rate of complications (porcelain chipping, de-cementation) was observed in the cantilever groups in studies.
CONCLUSION
Biomechanical properties of implants like preload, torque, cantilever design, implant abutment design have profound effects on the survival rates of dental implants. With limiations, this review provides some important parameters to consider for successful implant therapy.
PubMed: 33437702
DOI: 10.4103/jispcd.JISPCD_138_20 -
Iranian Journal of Pharmaceutical... 2019An important field of bone tissue engineering (BTE) concerns the design and fabrication of smart scaffolds capable of inducing cellular interactions and differentiation... (Review)
Review
An important field of bone tissue engineering (BTE) concerns the design and fabrication of smart scaffolds capable of inducing cellular interactions and differentiation of osteo-progenitor cells. One of these additives that has gained growing attention is metallic ions as therapeutic agents (MITAs). The specific biological advantage that these ions bring to scaffolds as well as other potential mechanical, and antimicrobial enhancements may vary depending on the ion entity, fabrication method, and biomaterials used. Therefore, this article provides an overview on current status of application of MITAs in BTE and the remaining challenges in the field. Electronic databases, including PubMed, Scopus, Science direct and Cochrane library were searched for studies on MITAs treatments for BTE. We searched for articles in English from January-2000 to October-2019. Abstracts, letters, conference papers and reviews, studies, studies on alloys and studies investigating effects other than enhancement of new bone formation (NBF) were excluded. A detailed summary of relevant metallic ions with specific scaffold material and design, cell type, animal model and defect type, the implantation period, measured parameters and obtained qualitative and quantitative results is presented. No ideal material or fabrication method suited to deliver MITAs can yet be agreed upon, but an investigation into various systems and their drawbacks or potential advantages can lead the future research. A tendency to enhance NBF with MITAs can be observed in the studies. However, this needs to be validated with further studies comparing various ions with each other in the same animal model using critical-sized defects.
PubMed: 32802092
DOI: 10.22037/ijpr.2020.112641.13894 -
Materials (Basel, Switzerland) Aug 2020Complex dental components which are individually tailored to the patient can be obtained due to new additive manufacturing technology. This paper reviews the metallic... (Review)
Review
Complex dental components which are individually tailored to the patient can be obtained due to new additive manufacturing technology. This paper reviews the metallic powders used in dental applications, the fabrication process (build orientation, process parameters) and post-processing processes (stress relieving, surface finishing). A review of the literature was performed using PubMed, ScienceDirect, Mendeley and Google Scholar. Over eighty articles were selected based on relevance to this review. This paper attempts to include the latest research from 2010 until 2020, however, older manuscripts (10 articles) were also selected. Over 1200 records were identified through the search; these were screened for title and/or summary. Over eighty articles were selected based on relevance to this review. In order to obtain a product which can be used in clinical applications, the appropriate manufacturing parameters should be selected. A discussion was made on optimal selective laser melting (SLM) parameters in dentistry. In addition, this paper includes a critical review of applied thermal treatment methods for Co-Cr alloys used in dentistry.
PubMed: 32785055
DOI: 10.3390/ma13163524 -
Brazilian Oral Research 2019The objective of this systematic review and meta-analysis was to evaluate the effect of welding techniques on implant-supported prostheses and determine whether they... (Meta-Analysis)
Meta-Analysis
The objective of this systematic review and meta-analysis was to evaluate the effect of welding techniques on implant-supported prostheses and determine whether they contribute to a better adaptation compared with a one-piece cast. A search was conducted using the PubMed/MEDLINE, Embase, and Cochrane Library databases, and articles published until November 2017 were obtained from these databases. This review followed the PRISMA criteria and is registered on the PROSPERO platform (CRD42017081865). The PICO question was "Do welding procedures in one-piece cast implant-supported frameworks influence implant/abutment-framework marginal misfits?" Eleven studies were selected for a qualitative analysis, and seven studies were selected for a quantitative analysis. A total of 189 specimens were fabricated using different materials (cp-Ti, Ni-Cr, Cr-Co, and noble alloys), and welding techniques such as laser welding, conventional welding, tungsten inert gas, and brazing were applied. A vertical marginal misfit was measured using an optical microscope, a stereomicroscope, and/or a scanning electron microscopy. The qualitative analysis in the studies demonstrated a positive effect of the welding techniques on the adaptation of the infrastructures. The meta-analysis confirmed the results (p < 0.00001; MD: -36.14; 95%CI: -48.69 to -23.59). Within the limitations of this study and regarding the heterogeneity of the samples, we conclude that the soldering point technique is effective for obtaining relatively low values of marginal misfit, with laser welding as the most effective technique. However, additional studies were recommended due to the heterogeneity of different variables (alloys, connection, and misfit evaluation) in the included studies.
Topics: Dental Casting Technique; Dental Marginal Adaptation; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Soldering; Humans; Prosthesis Fitting; Welding
PubMed: 31778474
DOI: 10.1590/1807-3107bor-2019.vol33.0110 -
The Cochrane Database of Systematic... Oct 2019Dental implants are available in different materials, shapes and with different surface characteristics. In particular, numerous implant designs and surface... (Review)
Review
BACKGROUND
Dental implants are available in different materials, shapes and with different surface characteristics. In particular, numerous implant designs and surface modifications have been developed for improving clinical outcome. This is an update of a Cochrane review first published in 2002, and previously updated in 2003, 2005 and 2007.
OBJECTIVES
Primary: to compare the clinical effects of different root-formed osseointegrated dental implant types for replacing missing teeth for the following specific comparisons: implants with different surface preparations, but having similar shape and material; implants with different shapes, but having similar surface preparation and material; implants made of different materials, but having similar surface preparation and shape; different implant types differing in surface preparation, shape, material or a combination of these.Secondary: to compare turned and roughened dental implants for occurrence of early implant failure (before prosthetic loading) and occurrence of peri-implantitis.
SEARCH METHODS
We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 17 January 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 12), MEDLINE via OVID (1946 to 17 January 2014) and EMBASE via OVID (1980 to 17 January 2014). We placed no restrictions on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
We included any randomised controlled trial (RCT) comparing osseointegrated dental implants of different materials, shapes and surface properties having a follow-up in function of at least one year. Outcome measures were success of the implants, radiographic peri-implant marginal bone levels changes and incidence of peri-implantitis.
DATA COLLECTION AND ANALYSIS
At least two review authors independently conducted screening, risk of bias assessment and data extraction of eligible trials in duplicate. We expressed results using fixed-effect models (if up to three studies were present in a meta-analysis) or random-effects models (when there were more than three studies) using mean differences (MD) for continuous outcomes and risk ratios (RR) for dichotomous outcomes with 95% confidence intervals (CI). We reported the following endpoints: one, three, five and 10 years after functional loading.
MAIN RESULTS
We identified 81 different RCTs. We included 27 of these RCTs, reporting results from 1512 participants and 3230 implants in the review. We compared 38 different implant types with a follow-up ranging from one to 10 years. All implants were made of commercially pure titanium or its alloys, and had different shapes and surface preparations. We judged two trials to be at low risk of bias, 10 to be at unclear risk of bias and 15 to be at high risk of bias. On a 'per participant' rather than 'per implant' basis, we found no significant differences between various implant types for implant failures. The only observed statistically significant difference for the primary objective regarded more peri-implant bone loss at Nobel Speedy Groovy implants when compared with NobelActive implants (MD -0.59 mm; 95% CI -0.74 to -0.44, different implant shapes). The only observed statistically significant difference for the secondary objective was that implants with turned (smoother) surfaces had a 20% reduction in risk to be affected by peri-implantitis than implants with rough surfaces three years after loading (RR 0.80; 95% CI 0.67 to 0.96). There was a tendency for implants with turned surfaces to fail early more often than implants with roughened surfaces.
AUTHORS' CONCLUSIONS
Based on the results of the included RCTs, we found no evidence showing that any particular type of dental implant had superior long-term success. There was limited evidence showing that implants with relatively smooth (turned) surfaces were less prone to lose bone due to chronic infection (peri-implantitis) than implants with much rougher surfaces (titanium-plasma-sprayed). These findings were based on several RCTs, often at high risk of bias, with few participants and relatively short follow-up periods.
PubMed: 31600407
DOI: 10.1002/14651858.CD003815.pub5 -
The Cochrane Database of Systematic... Jul 2019Management of individuals presenting with partial loss of teeth is a common task for dentists. Outcomes important to the management of missing teeth in the partially... (Review)
Review
BACKGROUND
Management of individuals presenting with partial loss of teeth is a common task for dentists. Outcomes important to the management of missing teeth in the partially absent dentition should be systematically summarized. This review recognizes both the challenges associated with such a summarization and the critical nature of the information for patients.
OBJECTIVES
To assess the effects of different prostheses for the treatment of partially absent dentition in terms of the following outcomes: long-term success, function, morbidity and patient satisfaction.
SEARCH METHODS
We searched the Cochrane Oral Health Group's Trials Register (to 21 March 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 1), MEDLINE via OVID (1950 to March 2011) and EMBASE via OVID (1980 to March 2011). There were no restrictions regarding language or date of publication. We contacted several authors to identify non-published trials.
SELECTION CRITERIA
Randomized controlled trials (RCTs) comparing different methods (including the design and materials used) of treating partial edentulism, with clinically relevant outcomes, were included in this review. Trials reporting only surrogate outcomes, such as plaque accumulation or gingival volume, were excluded from this review.
DATA COLLECTION AND ANALYSIS
Two review authors independently carried out the screening of eligible studies, assessment of dimensions of quality of trials, and data extraction. Results were expressed as mean differences for continuous data, risk ratios for dichotomous outcomes, and hazard ratios with 95% confidence intervals for time-to-event data.
MAIN RESULTS
Twenty-one trials met the inclusion criteria for this review. Twenty-four per cent of these were assessed as being at high risk of bias and the remainder were at unclear risk of bias. The clinical heterogeneity among the included studies precluded any attempt at meta-analysis. There was insufficient evidence to determine whether one type of removable dental prosthesis (RDP) was better or worse than another. With fixed dental prostheses (FDPs), there was no evidence that high gold alloys are better or worse than other alloys, nor that gold alloys or frameworks are better or worse than titanium. There is insufficient evidence to determine whether zirconia is better or worse that other FDP materials, that ceramic abutments are better or worse than titanium, or that one cement was better or worse than another in retaining FDPs. There is insufficient evidence to determine the relative effectiveness of FDPs and RDPs in patients with shortened dental arch or to determine the relative advantages of implant supported FDPs versus tooth/implant supported FDPs.
AUTHORS' CONCLUSIONS
Based on trials meeting the inclusion criteria for this review, there is insufficient evidence to recommend a particular method of tooth replacement for partially edentulous patients.
PubMed: 31425605
DOI: 10.1002/14651858.CD003814.pub3