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Medicina (Kaunas, Lithuania) Apr 2023: This project was developed from anecdotal evidence of varied practices around antibiotic prescribing in dental procedures. The aim of the study was to ascertain if... (Meta-Analysis)
Meta-Analysis Review
: This project was developed from anecdotal evidence of varied practices around antibiotic prescribing in dental procedures. The aim of the study was to ascertain if there is evidence to support whether antibiotic (AB) use can effectively reduce postoperative infections after dental implant placements (DIPs). : Following PRISMA-P© methodology, a systematic review of randomised controlled clinical trials was designed and registered on the PROSPERO© database. Searches were performed using PubMed, Science Direct and the Cochrane© Database, plus the bibliographies of studies identified. The efficacy of prophylactic antibiotics, independent of the regimen used, versus a placebo, control or no therapy based on implant failure due to infection was the primary measured outcome. Secondary outcomes were other post-surgical complications due to infection and AB adverse events. : Twelve RCTs were identified and analysed. Antibiotic use was reported to be statistically significant in preventing infection ( < 001). The prevention of complications was not statistically significant ( = 0.96), and the NNT was >5 (14 and 2523 respectively), which indicates that the intervention was not sufficiently effective to justify its use. The occurrence of side effects was not statistically significant ( = 0.63). NNH was 528 indicating that possible harm caused by the use of ABs is very small and does not negate the AB use when indicated. : The routine use of prophylactic antibiotics to prevent infection in dental implant placement was found to be not sufficiently effective to justify routine use. Clear clinical assessment pathways, such as those used for medical conditions, based on the patients' age, dental risk factors, such as oral health and bone health, physical risk factors, such as chronic or long-term conditions and modifiable health determinants, such as smoking, are required to prevent the unnecessary use of antibiotics.
Topics: Humans; Anti-Bacterial Agents; Antibiotic Prophylaxis; Dental Implants
PubMed: 37109671
DOI: 10.3390/medicina59040713 -
The International Journal of Oral &... 2014The aim of the paper is to identify, review, analyze, and summarize available evidence in three areas on the use of cross-sectional imaging, specifically maxillofacial... (Review)
Review
PURPOSE
The aim of the paper is to identify, review, analyze, and summarize available evidence in three areas on the use of cross-sectional imaging, specifically maxillofacial cone beam computed tomography (CBCT) in pre- and postoperative dental implant therapy: (1) Available clinical use guidelines, (2) indications and contraindications for use, and (3) assessment of associated radiation dose risk.
MATERIALS AND METHODS
Three focused questions were developed to address the aims. A systematic literature review was performed using a PICO-based search strategy based on MeSH key words specific to each focused question of English-language publications indexed in the MEDLINE database retrospectively from October 31, 2012. These results were supplemented by a hand search and gray literature search.
RESULTS
Twelve publications were identified providing guidelines for the use of cross-sectional radiography, particularly CBCT imaging, for the pre- and/or postoperative assessment of potential dental implant sites. The publications discovered by the PICO strategy (43 articles), hand (12), and gray literature searches (1) for the second focus question regarding indications and contraindications for CBCT use in implant dentistry were either cohort or case-controlled studies. For the third question on the assessment of associated radiation dose risk, a total of 22 articles were included. Publication characteristics and themes were summarized in tabular format.
CONCLUSIONS
The reported indications for CBCT use in implant dentistry vary from preoperative analysis regarding specific anatomic considerations, site development using grafts, and computer-assisted treatment planning to postoperative evaluation focusing on complications due to damage of neurovascular structures. Effective doses for different CBCT devices exhibit a wide range with the lowest dose being almost 100 times less than the highest dose. Significant dose reduction can be achieved by adjusting operating parameters, including exposure factors and reducing the field of view (FOV) to the actual region of interest.
Topics: Cone-Beam Computed Tomography; Contraindications; Dental Implants; Humans; Practice Guidelines as Topic; Radiation Dosage; Therapy, Computer-Assisted
PubMed: 24660190
DOI: 10.11607/jomi.2014suppl.g1.4 -
Annals of African Medicine 2019The overall success of dental implants depends on the crestal bone support around the implants. During the initial years of dental implant placement, the bone loss...
BACKGROUND
The overall success of dental implants depends on the crestal bone support around the implants. During the initial years of dental implant placement, the bone loss around the implants determines the success rate of treatment. Platform switching (PLS) concept preserves the crestal bone loss, and this approach should be applied clinically for the overall success of dental implants.
PURPOSE
The purpose of this study is to discuss the literature dealing with the concept of PLS concept and preservation of marginal bone, the mechanism by which it contributes to maintenance of marginal bone, its clinical applications, advantages, and disadvantages, to assess its survival rates.
MATERIALS AND METHODS
PubMed and Google Scholar search was done to find out the studies involving PLS concept from 2005 to 2017. Data were analyzed using SPSS statistical software.
RESULTS
Literature search revealed studies involving concepts of PLS, comparison of platform-switched and nonplatform-switched implants, case reports on PLS, and studies with histological and finite element analyses regarding PLS.
CONCLUSION
PLS helps preserve crestal bone around the implants, and this concept should be followed when clinical situations in implant placement permit.
Topics: Adult; Alveolar Bone Loss; Alveolar Process; Bone Density; Dental Abutments; Dental Implant-Abutment Design; Dental Implantation; Dental Implants; Dental Prosthesis Design; Humans; Prosthesis Fitting
PubMed: 30729925
DOI: 10.4103/aam.aam_15_18 -
Journal of Periodontology Dec 2013Whether a minimal width of keratinized mucosa (KM) is required to maintain peri-implant tissue health has been a topic of interest. This systematic review and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Whether a minimal width of keratinized mucosa (KM) is required to maintain peri-implant tissue health has been a topic of interest. This systematic review and meta-analysis aims to investigate the effect of KM on various peri-implant health-related parameters.
METHODS
An electronic search of five databases (from 1965 to October 2012) and a hand search of peer-reviewed journals for relevant articles were performed. Human cross-sectional or longitudinal studies with data on the relationship between the amount of KM around dental implants and various peri-implant parameters, with a follow-up period of at least 6 months, were included.
RESULTS
Eleven studies, seven cross-sectional and four longitudinal, were included. Weighted mean difference (WMD) and confidence interval (CI) were calculated with meta-analyses for each clinical parameter. The results showed statistically significant differences in plaque index (PI) and modified PI (WMD = -0.27, 95% CI = -0.43 to -0.11), modified gingival index (mGI) (WMD = -0.48, 95% CI = -0.70 to -0.27), mucosal recession (MR) (WMD = -0.60 mm, 95% CI = -0.85 to -0.36 mm), and attachment loss (AL) (WMD = -0.35 mm, 95% CI = -0.65 mm to -0.06 mm), all favoring implants with wide KM. However, comparisons of other parameters (bleeding on probing, modified bleeding index, GI, probing depth, and radiographic bone loss) did not reach statistically significant differences. The result of heterogeneity test showed only one parameter (AL, P value for the χ(2) test = 0.30 and I(2) test = 18%) had a low degree of heterogeneity among analyzed studies; meta-analyses of other parameters presented moderate-to-high degree of heterogeneity. Limitations of the present review include limited number of selected studies (n = 11), existence of heterogeneity and publication bias, and only English-written articles searched.
CONCLUSION
Based on current available evidence, a lack of adequate KM around endosseous dental implants is associated with more plaque accumulation, tissue inflammation, MR, and AL.
Topics: Alveolar Bone Loss; Dental Implants; Dental Plaque Index; Gingiva; Gingival Recession; Humans; Keratins; Periodontal Attachment Loss; Periodontal Index; Stomatitis
PubMed: 23451989
DOI: 10.1902/jop.2013.120688 -
BMC Oral Health Oct 2022Peri-implantitis is a usual finding but estimates of its prevalence fluctuate very much. This may be due to the wide variety of disease definitions. This systematic... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Peri-implantitis is a usual finding but estimates of its prevalence fluctuate very much. This may be due to the wide variety of disease definitions. This systematic review aims to estimate the overall prevalence of peri-implantitis and the effect of different study designs, function times and use of probing depth on prevalence rate.
METHODS
Following electronic and manual searches of the literature published from January 2005 to December 2021, data were extracted from the studies fitting the study criteria. Fifty-seven articles were included in this study.
RESULTS
Prevalence of peri-implantitis was 19.53% (95% CI 12.87-26.19) at the patient-level, and 12.53% (95% CI 11.67-13.39) at the implant-level and it remains highly variable even following restriction to the clinical case definition. The use of probing depth like diagnostic criteria affected the prevalence data.
CONCLUSION
The results indicate that it remains essential the identification of the diagnostic markers for more accurate disease classification.
Topics: Humans; Peri-Implantitis; Prevalence; Dental Implants; Research Design
PubMed: 36261829
DOI: 10.1186/s12903-022-02493-8 -
Journal of Prosthodontic Research Jan 2022To review the current clinical studies regarding the accuracy of implant computer-guided surgery in partially edentulous patients and investigate potential influencing... (Meta-Analysis)
Meta-Analysis
PURPOSE
To review the current clinical studies regarding the accuracy of implant computer-guided surgery in partially edentulous patients and investigate potential influencing factors.
STUDY SELECTION
Electronic searches on the PubMed and Cochrane Central Register of Controlled Trials databases, and subsequent manual searches were performed. Two reviewers selected the studies following our inclusion and exclusion criteria. Qualitative review and meta-analysis of the implant placement accuracy were performed to analyze potential influencing factors. Angular deviation, coronal deviation, apical deviation, and depth deviation were evaluated as the accuracy outcomes.
RESULTS
Eighteen studies were included in this systematic review, including six randomized controlled trials, nine prospective studies, and three retrospective clinical studies. A total of 1317 implants placed in 642 partially edentulous patients were reviewed. Eight studies were evaluated using meta-analysis. Fully guided surgery showed statistically higher accuracy in angular (P <0.001), coronal (P <0.001), and apical deviation (P <0.05) compared with pilot-drill guided surgery. A statistically significant difference (P <0.001) was also observed in coronal deviation between the bounded edentulous (BES) and distal extension spaces (DES). A significantly lower angular deviation (P <0.001) was found in implants placed using computer-aided design/computer-aided manufacturing (CAD/CAM) compared to the conventional surgical guides.
CONCLUSION
The edentulous space type, surgical guide manufacturing procedure, and guided surgery protocol can influence the accuracy of computer-guided surgery in partially edentulous patients. Higher accuracy was found when the implants were placed in BES, with CAD/CAM manufactured surgical guides, using a fully guided surgery protocol.
Topics: Computer-Aided Design; Computers; Cone-Beam Computed Tomography; Dental Implantation, Endosseous; Dental Implants; Humans; Prospective Studies; Retrospective Studies; Surgery, Computer-Assisted
PubMed: 33504723
DOI: 10.2186/jpr.JPR_D_20_00184 -
Clinical Oral Implants Research Mar 2018The goal of Working Group 1 at the 2nd Consensus Meeting of the Osteology Foundation was to comprehensively assess the effects of soft tissue augmentation procedures on... (Review)
Review
Evidence-based knowledge on the aesthetics and maintenance of peri-implant soft tissues: Osteology Foundation Consensus Report Part 1-Effects of soft tissue augmentation procedures on the maintenance of peri-implant soft tissue health.
OBJECTIVES
The goal of Working Group 1 at the 2nd Consensus Meeting of the Osteology Foundation was to comprehensively assess the effects of soft tissue augmentation procedures on peri-implant health or disease.
MATERIALS AND METHODS
A systematic review and meta-analysis on the effects of soft tissue augmentation procedures included a total of 10 studies (mucosal thickness: n = 6; keratinized tissue: n = 4). Consensus statements, clinical recommendations, and implications for future research were based on structured group discussions and a plenary session approval.
RESULTS
Soft tissue grafting to increase the width of keratinized tissue around implants was associated with greater reductions in gingival and plaque indices when compared to non-augmented sites. Statistically significant differences were noted for final marginal bone levels in favor of an apically positioned flap plus autogenous graft vs. all standard-of-care control treatments investigated. Soft tissue grafting (i.e., autogenous connective tissue) to increase the mucosal thickness around implants in the aesthetic zone was associated with significantly less marginal bone loss over time, but no significant changes in bleeding on probing, probing depths, or plaque scores when compared to sites without grafting.
CONCLUSIONS
The limited evidence available supports the use of soft tissue augmentation procedures to promote peri-implant health.
Topics: Alveolar Ridge Augmentation; Connective Tissue; Consensus; Dental Implantation; Dental Implantation, Endosseous; Dental Implants; Gingiva; Humans; Jaw, Edentulous, Partially; Meta-Analysis as Topic; Mucous Membrane; Osteology; Surgical Flaps
PubMed: 29498127
DOI: 10.1111/clr.13110 -
International Journal of Implant... Apr 2022The aim of this study was to systematically review the available evidence to evaluate the efficacy of vitamin D supplementation or vitamin D depletion on the... (Review)
Review
PURPOSE
The aim of this study was to systematically review the available evidence to evaluate the efficacy of vitamin D supplementation or vitamin D depletion on the osseointegration of implants in animals and humans.
METHODS
The focus questions addressed were "Do vitamin D deficient subjects treated with (dental) implants have an inferior osseointegration than subjects with adequate serum vitamin D level?" and "Do vitamin D supplemented subjects treated with (dental) implants have a superior osseointegration than subjects with adequate serum vitamin D level?" Humans and animals were considered as subjects in this study. Databases were searched from 1969 up to and including March 2021 using different combination of the following terms: "implant", "bone to implant contact", "vitamin D" and "osseointegration". Letters to the editor, historic reviews, commentaries and articles published in languages other than English and German were excluded. The pattern of the present systematic review was customize to primarily summarize the pertinent data.
RESULTS
Thirteen experimental studies with animals as subject, two clinical studies and three case reports, with humans as subjects, were included. The amount of inserted titanium implants ranged between 24 and 1740. Results from three animal studies showed that vitamin D deficiency has a negative effect on new bone formation and/or bone to implant contact (BIC). Eight animal studies showed that vitamin D supplementation has a enhancing effect on BIC and/or new bone formation around implants. Furthermore, enhancing the impact of vitamin D supplementation on the osseointegration of implants in subjects with diabetes mellitus, osteoporosis and chronic kidney disease (CKD) were assessed. Studies and case reports involving human subjects showed that patients with a low serum vitamin D level have a higher tendency to exhibit an early dental implant failure. When supplemented with vitamin D the osseointegration was successful in the case reports and a beneficial impact on the changes in the bone level during the osseointegration were determined.
CONCLUSIONS
Vitamin D deficiency seems to have a negative effect on the osseointegration of implants in animals. The supplementation of vitamin D appears to improve the osseointegration in animals with systemic diseases, such as vitamin D deficiency, diabetes mellitus, osteoporosis, and CKD. Slight evidence supports the hypothesis that humans similarly benefit from vitamin D supplementation in terms of osseointegration. Further investigation is required to maintain these assumptions.
Topics: Animals; Dental Implantation, Endosseous; Dental Implants; Diabetes Mellitus; Humans; Osseointegration; Osteoporosis; Renal Insufficiency, Chronic; Vitamin D; Vitamin D Deficiency; Vitamins
PubMed: 35403929
DOI: 10.1186/s40729-022-00414-6 -
Journal of Education and Health... 2021The importance of dental implant quality register has been well-documented. However, no systematic review conducted on dental implant quality register can be found in...
BACKGROUND
The importance of dental implant quality register has been well-documented. However, no systematic review conducted on dental implant quality register can be found in the literature. Therefore, the purpose of this study was to study the existed dental implant quality registries to explain the goals, data elements, and reports of dental implant quality registries.
MATERIALS AND METHODS
This systematic study was conducted in PubMed, Scopus, Web of Science, and Embase databases. For evaluating dental implant quality registers, all studies in the English language were examined with no time limitation. Case reports, conference abstracts, and letters to the editor were excluded. The analysis of the quality of the studies was done by the STrengthening the Reporting of OBservational studies in Epidemiology checklist.
RESULTS
The primary search identified 5565 articles. After eliminating duplicate articles and articles that did not meet the inclusion criteria and reviewing 40 full texts, 11 studies were included in this study. In this review, seven countries as Sweden, the USA, Canada, Germany, Finland, Australia, and South Korea had dental implant quality registers. Furthermore, the goals of dental implant quality registers were classified into the categories of research, epidemiology, administrative, clinical, and surveillance.
CONCLUSION
The results of this study provide dentists and other stakeholders useful information on the existed dental implant quality registers and databases worldwide. It also provides a framework of the goals, data elements, and reports of dental implant quality registry. The establishment of dental implant quality register will be beneficial for societies and also allows them to control the complications of dental implants in future.
PubMed: 34395651
DOI: 10.4103/jehp.jehp_1302_20 -
Journal of Periodontology Dec 2022The use of biologics may be indicated for alveolar ridge preservation (ARP) and reconstruction (ARR), and implant site development (ISD). The present systematic review...
BACKGROUND
The use of biologics may be indicated for alveolar ridge preservation (ARP) and reconstruction (ARR), and implant site development (ISD). The present systematic review aimed to analyze the effect of autologous blood-derived products (ABPs), enamel matrix derivative (EMD), recombinant human platelet-derived growth factor-BB (rhPDGF-BB), and recombinant human bone morphogenetic protein-2 (rhBMP-2), on the outcomes of ARP/ARR and ISD therapy (i.e., alveolar ridge augmentation [ARA] and maxillary sinus floor augmentation [MSFA]).
METHODS
An electronic search for eligible articles published from January 2000 to October 2021 was conducted. Randomized clinical trials evaluating the efficacy of ABPs, EMD, rhBMP-2, and rhPDGF-BB for ARP/ARR and ISD were included according to pre-established eligibility criteria. Data on linear and volumetric dimensional changes, histomorphometric findings, and a variety of secondary outcomes (i.e., clinical, implant-related, digital imaging, safety, and patient-reported outcome measures [PROMs]) were extracted and critically analyzed. Risk of bias assessment of the selected investigations was also conducted.
RESULTS
A total of 39 articles were included and analyzed qualitatively. Due to the high level of heterogeneity across studies, quantitative analyses were not feasible. Most studies in the topic of ARP/ARR revealed that the use of biologics rendered similar results compared with conventional protocols. However, when juxtaposed to unassisted healing or socket filling using collagen sponges, the application of biologics did contribute to attenuate post-extraction alveolar ridge atrophy in most investigations. Additionally, histomorphometric outcomes were positively influenced by the application of biologics. The use of biologics in ARA interventions did not yield superior clinical or radiographic outcomes compared with control therapies. Nevertheless, ABPs enhanced new bone formation and reduced the likelihood of early wound dehiscence. The use of biologics in MSFA interventions did not translate into superior clinical or radiographic outcomes. It was observed, though, that the use of some biologics may promote bone formation during earlier stages of healing. Only four clinical investigations evaluated PROMs and reported a modest beneficial impact of the use of biologics on pain and swelling. No severe adverse events in association with the use of the biologics evaluated in this systematic review were noted.
CONCLUSIONS
Outcomes of therapy after post-extraction ARP/ARR and ARA in edentulous ridges were comparable among different therapeutic modalities evaluated in this systematic review. Nevertheless, the use of biologics (i.e., PRF, EMD, rhPDGF-BB, and rhBMP-2) in combination with a bone graft material generally results into superior histomorphometric outcomes and faster wound healing compared with control groups.
Topics: Humans; Tooth Socket; Sinus Floor Augmentation; Biological Products; Becaplermin; Alveolar Ridge Augmentation; Alveolar Process; Tooth Extraction
PubMed: 35841608
DOI: 10.1002/JPER.22-0069