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BMC Oral Health Oct 2023The gold standard for a soft tissue augmentation around implants is a subepithelial connective tissue graft (CTG), but the xenogeneic collagen matrices (XCM) started to... (Meta-Analysis)
Meta-Analysis
Comparative analysis of xenogeneic collagen matrix and autogenous subepithelial connective tissue graft to increase soft tissue volume around dental implants: a systematic review and meta-analysis.
OBJECTIVE
The gold standard for a soft tissue augmentation around implants is a subepithelial connective tissue graft (CTG), but the xenogeneic collagen matrices (XCM) started to be used as an alternative. This systematic review aimed to assess the effectiveness XCM in comparison to CTG for the increasing the thickness of the soft tissue around implants.
DATA
All studies included at least two parallel groups comparing the use of CTG and XCM with a minimum follow-up of 3 months. As the primary outcome, the amount of soft tissue thickness gain after soft tissue augmentation with XCM or CTG was assessed. Secondary outcomes were clinical and patient-related outcomes; evaluation of aesthetic outcomes, patient-reported outcomes measures (PROMs) and complications. Eligible studies were selected based on the inclusion criteria. Meta-analysis was applied whenever possible. The quality of the evidence of studies including in meta-analysis was assessed using the GRADE approach.
SOURCE
A systematic literature search up to January 2022 was conducted using the following electronic databases: PubMed (MEDLINE), Scopus, Cochrane Library, LILACS, eLIBRARY.RU. Unpublished researches, the gray literature, nonprofit reports, government studies and other materials were reviewed electronically using an EASY search. An additional manual search was carried out in November 2022.
STUDY SELECTION
Of the 1376 articles from the initial search, 8 randomized controlled trials (RCTs) (306 patients and 325 implants) were included in this systematic review, and 7 studies were part of the meta-analysis. Meta-analysis revealed that XCM is less effective than the CTG in increasing soft tissue thickness around dental implants. However, XCM also provides soft tissue thickness gain and can be recommended for use in various clinical situations.
CLINICAL SIGNIFICANCE
Previous systematic reviews and meta-analyses have shown that autologous grafts are more effective than collagen matrices in increasing soft tissue thickness, however, the latter can be used as an alternative. Studies included in previous systematic reviews varied in design, which could lead to limitations. The present systematic review and meta-analysis includes for the first time only randomized controlled clinical trials with collagen matrix of xenogeneic origin in the test group. Tight eligibility criteria were established, and the main parameter studied was soft tissue thickness. It was found that xenogeneic collagen matrix is effective for increasing soft tissue thickness around dental implants, however, the results obtained using an autogenous connective tissue graft are superior.
Topics: Humans; Dental Implants; Gingiva; Collagen; Connective Tissue
PubMed: 37817128
DOI: 10.1186/s12903-023-03475-0 -
International Journal of Implant... Dec 2022To assess the dimensional establishment of a bony envelope after alveolar ridge preservation (ARP) with deproteinized bovine bone mineral (DBBM) in order to estimate the... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To assess the dimensional establishment of a bony envelope after alveolar ridge preservation (ARP) with deproteinized bovine bone mineral (DBBM) in order to estimate the surgical feasibility of standard diameter implants placement without any additional augmentation methods.
METHODS
PubMed, Embase and CENTRAL databases were searched for suitable titles and abstracts using PICO elements. Inclusion criteria were as follows: randomized controlled trials (RCTs) comprising at least ten systemically healthy patients; test groups comprised placement of (collagenated) DBBM w/o membrane and control groups of no grafting, respectively. Selected abstracts were checked regarding their suitability, followed by full-text screening and subsequent statistical data analysis. Probabilities and number needed to treat (NNT) for implant placement without any further need of bone graft were calculated.
RESULTS
The initial database search identified 2583 studies. Finally, nine studies with a total of 177 implants placed after ARP with DBBM and 130 implants after SH were included for the quantitative and qualitative evaluation. A mean difference of 1.13 mm in ridge width in favour of ARP with DBBM could be calculated throughout all included studies (95% CI 0.28-1.98, t2 = 1-1063, I2 = 68.0%, p < 0.01). Probabilities for implant placement with 2 mm surrounding bone requiring theoretically no further bone augmentation ranged from 6 to 19% depending on implant diameter (3.25: 19%, RD = 0.19, C = 0.06-0.32, p < 0.01/4.0: 14%, RD = 0.14, C = 0.05-0.23, p < 0.01/5.0: 6%, RD = 0.06, C = 0.00-0.12, p = 0.06).
CONCLUSION
ARP employing DBBM reduces ridge shrinkage on average by 1.13 mm and improves the possibility to place standard diameter implants with up to 2 mm circumferential bone housing; however, no ARP would have been necessary or additional augmentative bone interventions are still required in 4 out of 5 cases.
Topics: Animals; Cattle; Humans; Alveolar Process; Health Status; Dental Implants; Bone Resorption; Alveolar Ridge Augmentation
PubMed: 36477662
DOI: 10.1186/s40729-022-00453-z -
The Pan African Medical Journal 2016Periodontal disease is a neglected bacterial infection that causes destruction of the periodontium in pregnant women. Yet its impact on the occurrence of adverse... (Review)
Review
INTRODUCTION
Periodontal disease is a neglected bacterial infection that causes destruction of the periodontium in pregnant women. Yet its impact on the occurrence of adverse pregnancy outcomes has not systematically evaluated and there is no clear statement on the relationship between periodontal disease and preterm low birth weight. The objective of this study was to summarize the evidence on the impact of periodontal disease on preterm low birth weight.
METHODS
We searched the following data bases from January 2005 to December 2015: CINAHL (cumulative index to nursing and allied health literature), MEDLINE, AMED, EMBASE (excerpta medica database), Cochrane library and Google scholar. Only case-control studies with full text in English were eligible. Critical appraisal of the identified articles was done by two authors independently to provide the possible relevance of the papers for inclusion in the review process. The selected Case control studies were critically appraised with 12 items structured checklist adapted from national institute of health (NIH). Odds ratio (OR) or risk ratios (RR) were extracted from the selected studies. The two reviewers who selected the appropriate studies also extracted the data and evaluated the risk of bias.
RESULTS
Of 229 articles, ten studies with a total of 2423 participants with a mean age ranged from 13 to 49 years were met the inclusion criteria. The studies focused on preterm birth, low birth weight and /or preterm low birth weight and periodontitis. Of the selected studies, 9 implied an association between periodontal disease and increased risk of preterm birth, low birth weight and /or preterm low birth weight outcome (ORs ranging from 2.04 to 4.19) and only one study found no evidence of association.
CONCLUSION
Periodontal disease may be one of the possible risk factor for preterm low birth weight infant. However, more precise studies with randomized clinical trial with sufficient follow-up period must be done to confirm the association.
Topics: Adolescent; Adult; Female; Humans; Infant, Low Birth Weight; Infant, Newborn; Middle Aged; Periodontal Diseases; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Premature Birth; Risk Factors; Young Adult
PubMed: 27800070
DOI: 10.11604/pamj.2016.24.215.8727 -
Clinical Oral Investigations Mar 2017The present systematic review compared the effectiveness of soft tissue substitutes (STSs) and autogenous free gingival grafts (FGGs) in non-root-coverage procedures to... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The present systematic review compared the effectiveness of soft tissue substitutes (STSs) and autogenous free gingival grafts (FGGs) in non-root-coverage procedures to increase keratinized tissue (KT) width around teeth.
MATERIALS AND METHODS
Included studies fulfilled the following main eligibility criteria: (a) preclinical in vivo or human controlled trials using FGG as control, (b) non-root-coverage procedures, and (c) assessment of KT width. Meta-analysis was performed on the gain in KT width (primary outcome variable) and several secondary variables.
RESULTS
Eight human trials with short observation time evaluating five different STSs were identified. FGG yielded consistently significantly (p < 0.001) larger increase in KT width irrespective whether the comparison regarded an acellular matrix or a tissue-engineered STS. Further, FGG yielded consistently ≥2 mm KT width postoperatively, while use of STS did not, in the few studies reporting on this outcome. On the other hand, STSs resulted in significantly better aesthetic outcomes and received greater patient preference (p < 0.001).
CONCLUSIONS
Based on relatively limited evidence, in non-root-coverage procedures, FGG (1) resulted consistently in significantly larger increase in KT width compared to STS and (2) yielded consistently ≥2 mm KT width postoperatively, while STSs did not. STSs yielded significantly better aesthetic outcomes, received greater patient preference, and appeared safe.
CLINICAL RELEVANCE
Larger and more predictable increase in KT width is achieved with FGG, but STSs may be considered when aesthetics is important. Clinical studies reporting relevant posttreatment outcomes, e.g., postop KT width ≥2 mm, on the long-term (>6 months) are warranted.
Topics: Connective Tissue; Esthetics, Dental; Gingiva; Gingival Recession; Gingivoplasty; Humans; Surgical Flaps
PubMed: 28108833
DOI: 10.1007/s00784-016-2044-4 -
The Cochrane Database of Systematic... Jun 2015A range of surgical and non-surgical techniques have received increasing attention in recent years in an effort to reduce the duration of a course of orthodontic... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
A range of surgical and non-surgical techniques have received increasing attention in recent years in an effort to reduce the duration of a course of orthodontic treatment. Various surgical techniques have been used; however, uncertainty exists in relation to the effectiveness of these procedures and the possible adverse effects related to them.
OBJECTIVES
To assess the effects of surgically assisted orthodontics on the duration and outcome of orthodontic treatment.
SEARCH METHODS
We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 10 September 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 8), MEDLINE via OVID (1946 to 10 September 2014), EMBASE via OVID (1980 to 10 September 2014), LILACS via BIREME (1980 to 10 September 2014), metaRegister of Controlled Trials (to 10 September 2014), ClinicalTrials.gov (to 10 September 2014), and the World Health Organization (WHO) International Clinical Trials Registry Platform (to 10 September 2014). We checked the reference lists of all trials identified for further studies. There were no restrictions regarding language or date of publication in the electronic searches.
SELECTION CRITERIA
Randomised controlled trials (RCTs) evaluating the effect of surgical adjunctive procedures for accelerating tooth movement compared with conventional treatment (no surgical adjunctive procedure).
DATA COLLECTION AND ANALYSIS
At least two review authors independently assessed the risk of bias in the trials and extracted data. We used the fixed-effect model and expressed results as mean differences (MD) with 95% confidence intervals (CI). We investigated heterogeneity with reference to both clinical and methodological factors.
MAIN RESULTS
We included four RCTs involving a total of 57 participants ranging in age from 11 to 33 years. The interventions evaluated were corticotomies to facilitate orthodontic space closure or alignment of an ectopic maxillary canine, with the effect of repeated surgical procedures assessed in one of these studies. The studies did not report directly on the primary outcome as prespecified in our protocol: duration of orthodontic treatment, number of visits during active treatment (scheduled and unscheduled) and duration of visits. The main outcome assessed within the trials was the rate of tooth movement, with periodontal effects assessed in one trial and pain assessed in one trial. A maximum of just three trials with small sample sizes were available for each comparison and outcome. We assessed all of the studies as being at unclear risk of bias.Tooth movement was found to be slightly quicker with surgically assisted orthodontics in comparison with conventional treatment over periods of one month (MD 0.61 mm; 95% CI 0.49 to 0.72; P value < 0.001) and three months (MD 2.03 mm, 95% CI 1.52 to 2.54; P value < 0.001). Our results and conclusions should be interpreted with caution given the small number of included studies. Information on adverse events was sought; however, no data were reported in the included studies.
AUTHORS' CONCLUSIONS
This review found that there is limited research concerning the effectiveness of surgical interventions to accelerate orthodontic treatment, with no studies directly assessing our prespecified primary outcome. The available evidence is of low quality, which indicates that further research is likely to change the estimate of the effect. Based on measured outcomes in the short-term, these procedures do appear to show promise as a means of accelerating tooth movement. It is therefore possible that these procedures may prove useful; however, further prospective research comprising assessment of the entirety of treatment with longer follow-up is required to confirm any possible benefit.
Topics: Adolescent; Adult; Alveolar Process; Child; Cuspid; Humans; Malocclusion; Orthodontics, Corrective; Osteogenesis, Distraction; Randomized Controlled Trials as Topic; Reoperation; Time Factors; Tooth Movement Techniques
PubMed: 26123284
DOI: 10.1002/14651858.CD010572.pub2 -
Journal of Dental Research Sep 2014There is substantial evidence supporting the role of certain oral bacteria species in the onset and progression of periodontitis. Nevertheless, results of... (Review)
Review
There is substantial evidence supporting the role of certain oral bacteria species in the onset and progression of periodontitis. Nevertheless, results of independent-culture diagnostic methods introduced about a decade ago have pointed to the existence of new periodontal pathogens. However, the data of these studies have not been evaluated together, which may generate some misunderstanding on the actual role of these microorganisms in the etiology of periodontitis. The aim of this systematic review was to determine the current weight of evidence for newly identified periodontal pathogens based on the results of "association" studies. This review was conducted and reported in accordance with the PRISMA statement. The MEDLINE, EMBASE, and Cochrane databases were searched up to September 2013 for studies (1) comparing microbial data of subgingival plaque samples collected from subjects with periodontitis and periodontal health and (2) evaluating at least 1 microorganism other than the already-known periodontal pathogens. From 1,450 papers identified, 41 studies were eligible. The data were extracted and registered in predefined piloted forms. The results suggested that there is moderate evidence in the literature to support the association of 17 species or phylotypes from the phyla Bacteroidetes, Candidatus Saccharibacteria, Firmicutes, Proteobacteria, Spirochaetes, and Synergistetes. The phylum Candidatus Saccharibacteria and the Archaea domain also seem to have an association with disease. These data point out the importance of previously unidentified species in the etiology of periodontitis and might guide future investigations on the actual role of these suspected new pathogens in the onset and progression of this infection.
Topics: Archaea; Bacteria; Bacteroidetes; Dental Plaque; Gram-Negative Anaerobic Bacteria; Gram-Negative Bacteria; Humans; Periodontitis; Periodontium; Phylogeny; Proteobacteria; Spirochaetales
PubMed: 25074492
DOI: 10.1177/0022034514542468 -
Stomatologija 2008The concept of biologic width forms a basis for successful peri-implant soft tissue integration around titanium implants. Therefore, the objectives of this review are to... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The concept of biologic width forms a basis for successful peri-implant soft tissue integration around titanium implants. Therefore, the objectives of this review are to determine and critically evaluate the present knowledge about biologic width around implants and to establish future research trends.
MATERIALS AND METHODS
The literature was selected through several electronic databases, as well as a manual search in the major dental implant, prosthetic and periodontal journals. The reviewed data was published in English from 1980 to December 2007. Questions for systematic review were formulated. Abstracts, chapters from books, and unpublished materials were excluded, as they do not meet criteria for evidence-based studies. Articles were prioritized according to the value of different study types on the same issue. In vitro studies and literature reviews were excluded. The included publications were clinical, human histology and animal studies.
RESULTS
In total, 75 articles were obtained. After two rounds of evaluation and criteria application 54 papers remained for final appraisal, namely 2 clinical papers, 8 human histology and 44 animal studies were analysed. Twenty-one full-text articles were excluded.
CONCLUSIONS
Evidence analysis shows that the present knowledge about biologic width around implants is mainly derived from animal studies and that clinical controlled human studies are insufficient.
Topics: Animals; Dental Implants; Dental Materials; Dental Prosthesis Design; Evidence-Based Medicine; Humans; Periodontium; Titanium
PubMed: 18493163
DOI: No ID Found -
Journal of Clinical and Experimental... Dec 2020The aim of this systematic review was to analyze the types of human chewing simulator described in scientific literature. (Review)
Review
BACKGROUND
The aim of this systematic review was to analyze the types of human chewing simulator described in scientific literature.
MATERIAL AND METHODS
An electronic search was conducted in the databases PubMed, Embase and Scopus. The search strategy included 10 search terms: ""; "dental materials"; "shear strength"; "fatigue fracture"; "bite force"; "prosthetic materials"; "chewing simulator"; "chewing machine"; "simulated mastication"; and "dental wear simulator." Two researchers worked independently to assess the titles and abstracts of the articles. The quality of the trials selected was evaluated by means of the Consolidated Standards of Reporting Trials scale.
RESULTS
The electronic search identified 80 articles related to the topic of interest. After reading the full texts, ten works were selected. The articles focused mainly on the design of chewing simulators. Most of them were considered of moderate quality. Regarding the characteristics that an ideal chewing simulator should encompass, the devices described in articles varied greatly in terms of movement, periodontal ligament simulation, force sensors, and the materials tested.
CONCLUSIONS
No chewing simulator offers all the characteristics necessary to reproduce human masticatory movements and forces under the humidity and pH conditions of the oral cavity. A simulator that encompasses all these characteristics would make it possible to standardize trials involving simulated mastication. In vitro, dental materials, dental wear simulator.
PubMed: 33282141
DOI: 10.4317/jced.57279 -
Scientific Reports Mar 2017The prognosis for successful treatment of periodontal diseases is generally poor. Current therapeutic strategies often fail to regenerate infected periodontium. Recently... (Meta-Analysis)
Meta-Analysis Review
The prognosis for successful treatment of periodontal diseases is generally poor. Current therapeutic strategies often fail to regenerate infected periodontium. Recently an alternative strategy has been developed that combines conventional treatment with the application of recombinant human growth factors (rhGFs). But ambiguities in existed studies on the clinical efficacy of rhGFs do not permit either the identification of the specific growth factors effective for therapeutic interventions or the optimal concentration of them. Neither is it known whether the same rhGF can stimulate regeneration of both soft tissue and bone, or whether different patient populations call for differential use of the growth factors. In order to explore these issues, a meta-analysis was carried out. Particular attention was given to the therapeutic impact of fibroblast growth factor 2(FGF-2) and platelet derived growth factor BB (PDGF-BB). Our findings indicate that 0.3% rhFGF-2 and 0.3 mg/ml rhPDGF-BB show a greater capacity for periodontal regeneration than other concentrations and superiority to control groups with statistical significance. In the case of patients suffering only from gingival recession, however, the application of rhPDGF-BB produces no significant regenerative advantage. The findings of this study can potentially endow clinicians with guidelines for the appropriate application of these two rhGFs.
Topics: Becaplermin; Dose-Response Relationship, Drug; Drug Therapy, Combination; Fibroblast Growth Factor 2; Humans; Periodontal Diseases; Periodontium; Proto-Oncogene Proteins c-sis; Randomized Controlled Trials as Topic; Recombinant Proteins; Regeneration; Treatment Outcome
PubMed: 28246406
DOI: 10.1038/s41598-017-00113-y -
Nutrients Jan 2021Flavan-3-ols and their oligomeric forms called proanthocyanidins are polyphenolic compounds occurring in several foodstuffs and in many medicinal herbs. Their...
Flavan-3-ols and their oligomeric forms called proanthocyanidins are polyphenolic compounds occurring in several foodstuffs and in many medicinal herbs. Their consumption is associated with numerous health benefits. They exhibit antioxidant, anti-inflammatory, cytoprotective, as well as antimicrobial activity. The latter property is important in the prevention and treatment of periodontal diseases. Periodontitis is a multifactorial polymicrobial infection characterized by a destructive inflammatory process affecting the periodontium. Using non-toxic and efficient natural products such as flavanol derivatives can significantly contribute to alleviating periodontitis symptoms and preventing the disease's progress. Therefore, a comprehensive systematic review of proanthocyanidins and flavan-3-ols in the prevention and treatment of periodontitis was performed. The present paper reviews the direct antibacterial effects of these compounds against periodontic pathogens. The immunomodulatory effects, including animal and clinical studies, are included in a separate, parallel article. There is significant evidence supporting the importance of the antibacterial action exerted by proanthocyanidins from edible fruits, tea, and medicinal herbs in the inhibition of periodontitis-causing pathogens.
Topics: Animals; Anti-Bacterial Agents; Anti-Inflammatory Agents; Antioxidants; Flavonoids; Fruit; Gingivitis; Humans; Periodontitis; Plant Extracts; Plants, Medicinal; Polyphenols; Proanthocyanidins; Tannins; Tea
PubMed: 33430257
DOI: 10.3390/nu13010165