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Frontiers in Immunology 2024Peri-implant diseases (peri-implant mucositis and peri-implantitis) are pathologies of an infectious-inflammatory nature of the mucosa around dental implants. Probiotics... (Meta-Analysis)
Meta-Analysis
The role of probiotic therapy on clinical parameters and human immune response in peri-implant diseases: a systematic review and meta-analysis of randomized clinical studies.
BACKGROUND
Peri-implant diseases (peri-implant mucositis and peri-implantitis) are pathologies of an infectious-inflammatory nature of the mucosa around dental implants. Probiotics are microorganisms that regulate host immunomodulation and have shown positive results in the treatment of peri-implant diseases. The objective of the systematic review and meta-analysis was to evaluate the efficacy of probiotics in the treatment of peri-implant oral diseases.
METHODS
According to the PRISMA guidelines, the research question was established: Are probiotics able to favorably modify clinical and immunological biomarkers determinants of peri-implant pathologies? and an electronic search of the databases MEDLINE/PubMed, Embase, Cochrane Central, Web of Science, (until December 2023) was performed. Inclusion criteria were established for intervention studies (RCTs), according to the PICOs strategy in subjects with peri-implant pathology (participants), treated with probiotics (intervention) compared to patients with conventional treatment or placebo (control) and evaluating the response to treatment (outcomes). Results- 1723 studies were obtained and 10 were selected. Risk of bias was assessed using the Cochrane Risk of Bias Tool and methodological quality using the Joanna Briggs Institute for RCTs. Two meta-analyses were performed, one to evaluate probiotics in mucositis and one for peri-implantitis. All subgroups were homogeneous (I0%), except in the analysis of IL-6 in mucositis (I65%). The overall effect was favorable to the experimental group in both pathologies. The analysis of the studies grouped in peri-implantitis showed a tendency to significance (p=0.09).
CONCLUSION
The use of probiotics, as basic or complementary treatment of peri-implant diseases, showed a statistically significant trend, but well-designed studies are warranted to validate the efficacy of these products in peri-implant pathologies.
Topics: Humans; Probiotics; Peri-Implantitis; Randomized Controlled Trials as Topic; Dental Implants; Treatment Outcome; Stomatitis
PubMed: 38686378
DOI: 10.3389/fimmu.2024.1371072 -
Journal of Dentistry Jul 2024To analyze the role of oxidative stress (OS) biomarkers in peri‑implant diseases using a systematic review and meta-analysis approach. DATE: The review incorporated... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To analyze the role of oxidative stress (OS) biomarkers in peri‑implant diseases using a systematic review and meta-analysis approach. DATE: The review incorporated cross-sectional studies, randomized controlled trials, and case-control trials to evaluate the differences in OS biomarkers of peri‑implant disease.
SOURCES
A comprehensive literature search was conducted in electronic databases such as PubMed, Scopus, Embase, Web of Science, and CNKI, and no restrictions were applied during the search process.
STUDY SELECTION
A total of 452 studies were identified, of which 18 were eligible for inclusion. Risk of bias and sensitivity analysis were assessed using Egger's test and funnel plots.
RESULTS
We found that the levels of glutathione peroxidase (GSH-Px) in the peri‑implant sulcus fluid (PISF) of patients with peri‑implant diseases were significantly reduced (SMD = -1.40; 95 % CI = 1.70, -1.11; p < 0.001), while the levels of total myeloperoxidase (MPO) and malondialdehyde (MDA) were significantly increased (SMD = 0.46; 95 % CI = 0.12, 0.80; p = 0.008; SMD = 0.28; 95 % CI = 0.01, 0.56; p = 0.043). However, there were no significant differences of MPO concentration (SMD = 0.38; 95 % CI = -0.39, 1.15; p = 0.331) and superoxide dismutase (SOD)(SMD = -0.43; 95 % CI = -1.94, 1.07; p = 0.572) in PISF between peri‑implant disease group and control group. Similarly, salivary MPO did not show significant differences (SMD = 1.62; 95 % CI = -1.01, 4.24; p = 0.227).
CONCLUSIONS
Our results supported that the level of local OS biomarkers was closely related to peri‑implant diseases. GSH-Px, total MPO and MDA may be PISF biomarkers with good capability to monitor the development of peri‑implant disease.
CLINICAL SIGNIFICANCE
This study found significant differences in the levels of local OS biomarkers (GSH-Px, total MPO, and MDA) between patients with peri‑implant diseases and healthy subjects, which may be ideal candidate biomarkers for predicting and diagnosing peri‑implant diseases.
Topics: Humans; Oxidative Stress; Biomarkers; Peroxidase; Malondialdehyde; Peri-Implantitis; Glutathione Peroxidase; Dental Implants; Gingival Crevicular Fluid
PubMed: 38679134
DOI: 10.1016/j.jdent.2024.105026 -
Diagnostics (Basel, Switzerland) Apr 2024: The availability of multiple dental implant systems makes it difficult for the treating dentist to identify and classify the implant in case of inaccessibility or loss... (Review)
Review
: The availability of multiple dental implant systems makes it difficult for the treating dentist to identify and classify the implant in case of inaccessibility or loss of previous records. Artificial intelligence (AI) is reported to have a high success rate in medical image classification and is effectively used in this area. Studies have reported improved implant classification and identification accuracy when AI is used with trained dental professionals. This systematic review aims to analyze various studies discussing the accuracy of AI tools in implant identification and classification. : The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the study was registered with the International Prospective Register of Systematic Reviews (PROSPERO). The focused PICO question for the current study was "What is the accuracy (outcome) of artificial intelligence tools (Intervention) in detecting and/or classifying the type of dental implant (Participant/population) using X-ray images?" Web of Science, Scopus, MEDLINE-PubMed, and Cochrane were searched systematically to collect the relevant published literature. The search strings were based on the formulated PICO question. The article search was conducted in January 2024 using the Boolean operators and truncation. The search was limited to articles published in English in the last 15 years (January 2008 to December 2023). The quality of all the selected articles was critically analyzed using the Quality Assessment and Diagnostic Accuracy Tool (QUADAS-2). : Twenty-one articles were selected for qualitative analysis based on predetermined selection criteria. Study characteristics were tabulated in a self-designed table. Out of the 21 studies evaluated, 14 were found to be at risk of bias, with high or unclear risk in one or more domains. The remaining seven studies, however, had a low risk of bias. The overall accuracy of AI models in implant detection and identification ranged from a low of 67% to as high as 98.5%. Most included studies reported mean accuracy levels above 90%. : The articles in the present review provide considerable evidence to validate that AI tools have high accuracy in identifying and classifying dental implant systems using 2-dimensional X-ray images. These outcomes are vital for clinical diagnosis and treatment planning by trained dental professionals to enhance patient treatment outcomes.
PubMed: 38667452
DOI: 10.3390/diagnostics14080806 -
The Journal of Craniofacial Surgery Jun 2024Head and neck cancer (HNC) patients benefit from craniofacial reconstruction, but no clear guidance exists for rehabilitation timing. This meta-analysis aims to clarify... (Meta-Analysis)
Meta-Analysis Review
Head and neck cancer (HNC) patients benefit from craniofacial reconstruction, but no clear guidance exists for rehabilitation timing. This meta-analysis aims to clarify the impact of oncologic treatment order on implant survival. An algorithm to guide placement sequence is also proposed in this paper. PubMed, Embase, and Web of Science were searched for studies on HNC patients with ablative and fibula-free flap (FFF) reconstruction surgeries and radiotherapy (RTX). Primary outcomes included treatment sequence, implant survival rates, and RTX dose. Of 661 studies, 20 studies (617 implants, 199 patients) were included. Pooled survival rates for implants receiving >60 Gy RTX were significantly lower than implants receiving < 60 Gy (82.8% versus 90.1%, P =0.035). Placement >1 year after RTX completion improved implant survival rates (96.8% versus 82.5%, P =0.001). Implants receiving pre-placement RTX had increased survival with RTX postablation versus before (91.2% versus 74.8%, P <0.001). One hundred seventy-seven implants were placed only in FFF with higher survival than implants placed in FFF or native bone (90.4% versus 83.5%, P =0.035). Radiotherapy is detrimental to implant survival rates when administered too soon, in high doses, and before tumor resection. A novel evidence-based clinical decision-making algorithm was presented for utilization when determining the optimal treatment order for HNC patients. The overall survival of dental prostheses is acceptable, reaffirming their role as a key component in rehabilitating HNC patients. Considerations must be made regarding RTX dosage, timing, and implant location to optimize survival rates and patient outcomes for improved functionality, aesthetics, and comfort.
Topics: Humans; Dental Implants; Fibula; Free Tissue Flaps; Head and Neck Neoplasms; Plastic Surgery Procedures; Algorithms
PubMed: 38666786
DOI: 10.1097/SCS.0000000000010127 -
Journal of Prosthodontics : Official... Apr 2024This systematic review aims to compare clinical outcomes of digital dentures with conventional dentures. (Review)
Review
PURPOSE
This systematic review aims to compare clinical outcomes of digital dentures with conventional dentures.
MATERIALS AND METHODS
This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in Prospero. The formulated population, intervention, comparison, outcome (PICO) question was "What is the clinical outcome of digital versus conventional complete dentures (CDs) in edentulous patients?". The search strategy used three main electronic databases and an additional manual search was completed in August 2023 by following an established search strategy. Initial inclusion was based on titles and abstracts, followed by a detailed review of selected studies, and clinical studies that evaluated the clinical outcome of digital (milled or 3D-printed) versus conventional CDs were included. A qualitative analysis for clinical studies was used to assess the risk of bias. The certainty of the evidence was assessed according to the grading of recommendations, assessment, development, and evaluations (GRADE) system. In addition, a single-arm meta-analysis was performed to evaluate the retention between digital versus conventional CDs.
RESULTS
The initial search yielded a total of 947 articles, out of which 19 were selected for a comprehensive review, and six met the eligibility criteria to be included in this systematic review. The computer-aided design and computer-aided manufacturing (CAD-CAM) CDs showed increased retention, no relevant differences in oral health-related quality of life (OHRQoL), and shorter working time compared to conventional dentures. Two studies were eligible for meta-analysis; retention was significantly better among CAD-CAM fabricated dentures (standardized mean difference [SMD] 0.501) than conventional dentures. The heterogeneity between studies was high (95% CI: 0.049-0.952).
CONCLUSIONS
Clinically, both the milled and the 3D-printed CD fared better than conventional dentures in terms of retention, reduction in the number of appointments, improved patient comfort, and improved predictable maintenance of the denture. Patients' perceptions and satisfaction were independent of the digital and conventional fabricated dentures.
PubMed: 38666691
DOI: 10.1111/jopr.13859 -
Photobiomodulation, Photomedicine, and... Apr 2024Studies have shown positive effects of erbium lasers in removal of biofilms. A review article was required with quantitative data for confirmation of their effects, but... (Meta-Analysis)
Meta-Analysis
Studies have shown positive effects of erbium lasers in removal of biofilms. A review article was required with quantitative data for confirmation of their effects, but there is still no a comprehensive study reviewing their effects based on the root canal and implant surface. This systematic review and meta-analysis was conducted to evaluate the efficiency of erbium lasers in removal of the root canal system and surface biofilms. Studies were searched with keywords in databases of PubMed, Scopus, Europe PMC, Cochrane Central, Embase, and Web of Science and screened by referees. Data were included based on mean ± standard deviation and size of control and laser groups. Effect sizes were assessed as standardized mean differences and calculated for each study and for the root and dental surface. Laser characteristics and bacteria were considered as moderators. Nineteen articles in the current study comprised 565 samples (283 control samples and 282 laser samples). The analyses showed the significant effects of erbium lasers on bacterial biofilms on the implant surface [-0.496, 95% confidence interval, CI (-0.720 to -0.273); = 26.94; = 0.029; = 13.28] and root canal [-0.551, 95% CI (-0.656 to -0.445); = 23.89; = 0.031; = 10.46]. Results showed that highest efficiency lasers were obtained at higher wavelengths of 2940 nm, 75-100 mJ energy, and 100-150 μsec and <50-Hz pulses. Erbium lasers can be used to remove biofilms on dental implant surfaces and root canal systems and are safe options for untouchable sites in the root canal.
Topics: Biofilms; Lasers, Solid-State; Humans; Dental Pulp Cavity; Low-Level Light Therapy
PubMed: 38662505
DOI: 10.1089/photob.2023.0190 -
The Journal of Oral Implantology Jun 2024A systematic review was designed to investigate the effect of treatment with oral bisphosphonate (BP) on osseointegration of dental implants and the incidence of... (Meta-Analysis)
Meta-Analysis Review
A systematic review was designed to investigate the effect of treatment with oral bisphosphonate (BP) on osseointegration of dental implants and the incidence of BP-related osteonecrosis of the jaw (BRONJ) in postmenopausal women. Multiple electronic databases, including MEDLINE (PubMed), EMBASE, and SCOPUS, were searched to find all eligible articles published since 1990. All titles and abstracts retrieved by searching information sources were evaluated independently by 2 authors against the eligibility criteria. The number of cases ranged from 11 to 235, and the number of controls ranged from 14 to 343. Alendronate was used in all other studies. Risedronate was used in 6 studies, while ibandronate was used in 4 studies. The number of implants in cases ranged from 25 to 1267, while in controls, the number of implants ranged from 28 to 1450. The time between the placement of implant and the follow-up visit ranged from 4-6 months to 8 years. The results show that out of 2582 placed implants, 50 (1.94%) failed in BP-treated patients. This is while out of 4050 placed implants, 188 (4.6%) failed in the non-BP group. The results from the meta-analysis demonstrated that BP therapy is significantly associated with increased implant failure rates (RR = 1.73 [95% CI, 1.03-2.83], P = .04). Overall, the qualitative assessment of this review suggests that oral treatment with BPs in postmenopausal women does not increase the rate of dental implant failure. Thus, further studies with larger sample sizes should compare BP and non-BP groups in regard to dental implants.
Topics: Humans; Female; Diphosphonates; Dental Implants; Bone Density Conservation Agents; Dental Restoration Failure; Postmenopause; Bisphosphonate-Associated Osteonecrosis of the Jaw; Osseointegration; Administration, Oral
PubMed: 38660740
DOI: 10.1563/aaid-joi-D-23-00069 -
The International Journal of Oral &... Apr 2024To analyze the effectiveness of coating of abutments with antimicrobial agents and their influence on the physicochemical and biologic properties of the coated materials.
PURPOSE
To analyze the effectiveness of coating of abutments with antimicrobial agents and their influence on the physicochemical and biologic properties of the coated materials.
MATERIALS AND METHODS
This work was registered in Open Science Framework (osf.io/6tkcp) and followed the PRISMA protocols. A search of two independent reviewers of articles published up to October 29, 2021, was performed in the Embase, PubMed, Science Direct, and Scopus databases.
RESULTS
The databases found a total of 1,474 references. After excluding the duplicates, 1,050 remained. After reading the titles and abstracts and applying the inclusion criteria, 13 articles remained and were read in full. A total of 8 articles were included in this systematic review. Different antimicrobial agents have been used to coat abutments, including graphene oxide, polydopamine, titanium and zirconium nitride, lactoferrin, tetracycline, silver, and doxycycline with varied release times. Titanium-coated silver showed a better antimicrobial agent release time of up to 28 days. Chemical analysis confirmed the presence of antimicrobials on the surface after coating. Different pathogenic microorganisms, such as Streptococcus sanguinis, Streptococcus oralis, and Staphylococcus aureus, were inhibited when in contact with the coated surface.
CONCLUSIONS
This review showed that there is still no consensus on which is the better antimicrobial agent and which coated materials have the better performance. However, the association of surface coating of abutments with antimicrobials is feasible and can benefit many patients, which can support their clinical use to favor the healing process and prevent infections that can lead to treatment failure with dental implants.
Topics: Humans; Anti-Infective Agents; Coated Materials, Biocompatible; Dental Abutments; Surface Properties; Titanium
PubMed: 38657216
DOI: 10.11607/jomi.9992 -
The Journal of Prosthetic Dentistry Apr 2024Data on the role of artificial intelligence (AI) in dental implant planning is insufficient. (Review)
Review
STATEMENT OF PROBLEM
Data on the role of artificial intelligence (AI) in dental implant planning is insufficient.
PURPOSE
The purpose of this systematic review with meta-analysis was to analyze and evaluate articles that assess the effectiveness of AI algorithms in dental implant planning, specifically in detecting edentulous areas and evaluating bone dimensions.
MATERIAL AND METHODS
A systematic review was conducted across the MEDLINE/PubMed, Web of Science, Cochrane, and Scopus databases. In addition, a manual search was performed. The inclusion criteria consisted of peer-reviewed studies that examined the accuracy of AI-based diagnostic tools on dental radiographs for dental implant planning. The most recent search was conducted in January 2024. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the quality of the included articles.
RESULTS
Twelve articles met the inclusion criteria for this review and focused on the application of AI in dental implant planning using cone beam computed tomography (CBCT) images. The pooled data indicated an overall accuracy of 96% (95% CI=94% to 98%) for the mandible and 83% (95% CI=82% to 84%) for the maxilla in identifying edentulous areas for implant planning. Eight studies had a low risk of bias, 2 studies had some concern of bias, and 2 studies had a high risk of bias.
CONCLUSIONS
AI models have the potential to identify edentulous areas and provide measurements of bone as part of dental implant planning using CBCT images. However, additional well-conducted research is needed to enhance the accuracy, generalizability, and applicability of AI-based approaches.
PubMed: 38653687
DOI: 10.1016/j.prosdent.2024.03.032 -
BMJ Open Apr 2024The objective of this study is to determine the relationship between serum vitamin D level and the risk of developing benign paroxysmal positional vertigo (BPPV)... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The objective of this study is to determine the relationship between serum vitamin D level and the risk of developing benign paroxysmal positional vertigo (BPPV) incidence and recurrence in countries in the Northern Hemisphere.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
PubMed, Scopus and Web of Science databases were searched for studies published between January 2000 and February 2023.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
Participants located in the Northern Hemisphere aged 18 or over with at least one episode of BPPV, serum 25-hydroxyvitamin D levels measured and reported, no comorbidities or history of vitamin D supplementation.
DATA EXTRACTION AND SYNTHESIS
Data extraction and synthesis were performed by a single reviewer and checked by a second reviewer. Inclusion and exclusion criteria and risk of bias were assessed by two independent reviewers using the Newcastle Ottawa Tool for Cohort studies and Risk of Bias Assessment Tool for Nonrandomised Studies checklist for case-control studies. Meta-analysis was conducted using random effects models. Standard mean difference with a 95% CI was used to measure the relationship between vitamin D level and BPPV.
RESULTS
The 35 articles identified by the literature search reported data of 9843 individuals. 19 studies (7387 individuals) were included in the BPPV incidence meta-analysis while 7 studies (622 individuals) were included in the BPPV recurrence meta-analysis. Lower serum vitamin D levels were found in BPPV incidence compared with controls, but the relationship between vitamin D levels in recurrent BPPV compared with non-recurrent disease remained uncertain.
CONCLUSION
Results of this systematic review and meta-analysis demonstrated a negative correlation between serum vitamin D and BPPV incidence, while any relationship between serum vitamin D and BPPV recurrence remained uncertain. Risk of bias analysis revealed evidence of variable quality. There were insufficient data available to evaluate seasonal relationships between serum vitamin D and BPPV. Given the potential for this as a confounding factor, future research should aim to investigate this further.
PROSPERO REGISTRATION NUMBER
CRD42021271840.
Topics: Humans; Benign Paroxysmal Positional Vertigo; Vitamin D Deficiency; Recurrence; Incidence; Vitamin D
PubMed: 38653514
DOI: 10.1136/bmjopen-2023-077986