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Imaging Science in Dentistry Jun 2018This study aimed to carry out a systematic review of studies in the literature comparing conventional imaging techniques with cone-beam computed tomography in terms of... (Review)
Review
PURPOSE
This study aimed to carry out a systematic review of studies in the literature comparing conventional imaging techniques with cone-beam computed tomography in terms of the role of these techniques for assessing any of the following periodontal conditions and parameters: infrabony defects, furcation involvement, height of the alveolar bone crest, and the periodontal ligament space.
MATERIALS AND METHODS
Interventional and observational studies comparing conventional imaging techniques with cone-beam computed tomography were considered eligible for inclusion. The MEDLINE and Embase databases were searched for articles published through 2017. The PRISMA statement was followed during data assessment and extraction.
RESULTS
The search strategy yielded 351 publications. An initial screening of the publications was performed using abstracts and key words, and after the application of exclusion criteria, 13 studies were finally identified as eligible for review.
CONCLUSION
These studies revealed cone-beam computed tomography to be the best imaging technique to assess infrabony defects, furcation lesions, the height of the alveolar bone crest, and the periodontal ligament space.
PubMed: 29963478
DOI: 10.5624/isd.2018.48.2.79 -
International Journal of Environmental... Nov 2021(1) Background: To assess orthodontic forced eruption (OFE) as a pre-restorative procedure for non-restorable permanent teeth with subgingival dental hard tissue defects... (Review)
Review
(1) Background: To assess orthodontic forced eruption (OFE) as a pre-restorative procedure for non-restorable permanent teeth with subgingival dental hard tissue defects after dental trauma. (2) Methods: A systematic electronic search of three databases, namely, MEDLINE, Cochrane Library, and EMBASE, revealed a total of 2757 eligible publications. Randomized controlled clinical trials (RCT), retro- and prospective clinical studies, or case series (with a minimum of three patients) were reviewed. (3) Results: Thirteen full-text papers were included: one RCT, one prospective clinical trial, two retrospective cohort studies, and nine case series. Within case series, statistical significance between age and cause of fracture ( < 0.03) was determined. The mean extrusion rate of OFE was 1.5 mm a week within a four to six weeks treatment period followed by retention. Three OFE protocols for maxillary single teeth are available: 1. OFE without migration of gingiva and alveolar bone, 2. OFE with gingival migration and slight alveolar bone migration, and 3. OFE with migration of both gingiva and alveolar bone. (4) Conclusions: The current state of the evidence suggests that OFE is a feasible pre-treatment option for non-restorable permanent teeth. OFE can promote the migration of tooth surrounding hard and soft tissues in the esthetic zone. Root resorption does not seem to be a relevant side effect of OFE.
Topics: Fractures, Bone; Gingiva; Humans; Orthodontic Extrusion; Prospective Studies; Root Resorption
PubMed: 34886307
DOI: 10.3390/ijerph182312580 -
Clinical Oral Investigations Aug 2023To investigate the histomorphometric changes occurring in alveolar ridge preservation (ARP) based on the use of different plasma concentrates (PCs) in randomized... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To investigate the histomorphometric changes occurring in alveolar ridge preservation (ARP) based on the use of different plasma concentrates (PCs) in randomized clinical trials (RCT). There is controversy whether the placement of PCs in ARP is effective in the formation of new bone.
MATERIALS AND METHODS
A systematic review search was conducted in PubMed, Scopus, Web of Science, and Cochrane Database to answer the PICO question: In patients undergoing tooth extraction followed by ARP, do PCs alone in the post-extraction socket in comparison with spontaneous healing improve new vital bone formation percentage in histomorphometric analysis after more than 10 weeks? The risk of bias was assessed and a meta-analysis was conducted.
RESULTS
Of 3809 results, 8 studies were considered suitable for inclusion. A total of 255 teeth were extracted in 250 patients. Regarding the PCs used, ARP was performed with platelet- and leukocyte-rich fibrin (L-PRF) in 120 sockets, and with pure platelet-rich plasma (P-PRP) in 31 sockets and 104 sockets were controlled. PCs improved new bone formation in ARP with respect to the spontaneous healing group (SMD = 1.77, 95%C.I. = 1.47-2.06, p-value < 000.1). There were no differences between the different PCs (L-PRF and P-PRP).
CONCLUSION
The results of this meta-analysis support the efficacy of the use of PCs in new bone formation in ARP. With respect to the different types of PCs studied, no differences were observed.
CLINICAL RELEVANCE
When planning implant surgery after tooth extraction, treatment with PCs should be considered for ARP. Any PC increases new bone formation compared to spontaneous healing.
Topics: Humans; Tooth Socket; Alveolar Process; Osteogenesis; Tooth; Platelet-Rich Plasma; Tooth Extraction; Fibrin; Alveolar Ridge Augmentation
PubMed: 37439800
DOI: 10.1007/s00784-023-05126-8 -
Journal of International Society of... 2021The aim of this study was to systematically review the applications of adipose tissue stem cells (ADSCs) in regenerative dentistry. (Review)
Review
AIM
The aim of this study was to systematically review the applications of adipose tissue stem cells (ADSCs) in regenerative dentistry.
MATERIALS AND METHODS
An electronic search was conducted in Medline (PubMed) and Scopus databases. The original research associated with the role of ADSCs in regeneration of alveolar bone, periodontal ligament (PDL), cementum as well as the dental pulp was evaluated. Among the included studies, three animal studies and one human study had low risk of bias.
RESULTS
A total of 33 relevant studies were included in the review. The animal models, human, and studies revealed that ADSCs had a significant osteogenic differentiation potential. Besides, they had potential to differentiate into PDL, cementum, and dental pulp tissue.
CONCLUSION
The ADSCs may be specifically applied for bone tissue engineering in the management of alveolar bone defects, specifically in dental implants and periodontal disease. However, their role in regeneration of PDL, cementum, and dental pulp requires further investigations. Overall, their applications in regenerative dentistry needs further verification through human clinical trials.
PubMed: 34268188
DOI: 10.4103/jispcd.JISPCD_43_21 -
Brazilian Oral Research 2018Botulinum toxin type A is effective in reducing excessive gingival display caused by hyperfunctional upper lip elevator muscles; however, this effect is transient. This... (Meta-Analysis)
Meta-Analysis Review
Botulinum toxin type A is effective in reducing excessive gingival display caused by hyperfunctional upper lip elevator muscles; however, this effect is transient. This study aimed to determine the duration of the effectiveness of botulinum toxin type A on a gummy smile. A systematic search was conducted using Medline (PubMed), Scopus, and Web of Science electronic databases, from 1970 to March 2017 with no language restriction; the search included studies evaluating adult patients with excessive gingival display who were treated with botulinum toxin and were followed-up for at least 3 months. OpenGrey and Clinical Trial Registry were also consulted. Quality assessment was applied to determine the level of evidence and bias, and a meta-analysis was performed. Of 2181 full texts, 71 were obtained, with 3 prospective studies meeting the selection criteria. The gingival display was significantly reduced to baseline with 2, 4, and 8 weeks of treatment. The gingival display considerably reduced at the baseline-2-week comparison (-4.44 mm using raw data and-4.05 mm using the standard difference) and increased throughout the weeks of follow-up. There is scant evidence to determine the duration of the effectiveness of toxin type A on a gummy smile. The effect tends to be stable until at least 8 weeks of follow-up, and the gingival exposure may not return to baseline within 12 weeks of follow-up. Well-designed randomized clinical trials with a minimum of 6 months of follow-up are necessary to strengthen the evidence.
Topics: Botulinum Toxins, Type A; Esthetics, Dental; Facial Muscles; Gingiva; Humans; Neuromuscular Agents; Reproducibility of Results; Smiling; Time Factors; Treatment Outcome
PubMed: 29742231
DOI: 10.1590/1807-3107bor-2018.vol32.0030 -
Medicina (Kaunas, Lithuania) Mar 2022The periodontium has important proprioceptive receptors that prevent teeth from using excessive occlusal forces during chewing. There are other receptors from adjacent... (Review)
Review
The periodontium has important proprioceptive receptors that prevent teeth from using excessive occlusal forces during chewing. There are other receptors from adjacent tissues that replace periodontal ones when teeth are extracted and rehabilitated with prosthesis, although they seem to be less effective. Psychophysical studies investigate tactile sensibility thresholds, which are useful to measure this masticatory efficiency in different prosthetic rehabilitations. There are two types of sensibility depending on the receptors that are activated during these studies: active and passive tactile sensibility. The purpose of this study is to obtain active and passive tactile sensibility threshold figures in natural dentition and prosthetic rehabilitations so we can compare them and understand how this sensibility works in different situations. We performed a systematic review of the available literature, following PRISMA guidelines and including articles from 2004 to 2021 in the MEDLINE database. Only 10 articles were included in this investigation as they provided concrete threshold figures. The mean values of active tactile sensibility thresholds in complete dentures, implant prosthesis and natural dentition are 64 µ, 23.3 µ and 16.1 µ, respectively. The mean values of passive tactile sensibility thresholds in implant prosthesis and natural dentition are 6.7 N and 0.8 N, respectively. Implant prosthesis have lower thresholds, that are very close to those present in natural dentition, than complete dentures due to an increased tactile sensibility. Active tactile sensibility thresholds present fewer differences between values than passive tactile ones; as these are only influenced by receptors from periodontal or periimplant tissues.
Topics: Dentition; Denture, Complete; Humans; Mouth, Edentulous; Sensory Thresholds; Touch
PubMed: 35454340
DOI: 10.3390/medicina58040501 -
Journal of Periodontology Oct 2006Thick gingival tissue eases manipulation, maintains vascularity, and promotes wound healing during and after surgery. A few recent case reports correlate greater flap... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Thick gingival tissue eases manipulation, maintains vascularity, and promotes wound healing during and after surgery. A few recent case reports correlate greater flap thickness to mean and complete root coverage after mucogingival therapy for recession defects. The aim of this systematic review is to appraise the current literature on this subject and to combine existing data to verify the presence of any association between gingival thickness and root coverage outcomes.
METHODS
Human studies that reported the number and class of recessions, measured flap thickness at a well-defined location, described the method of root coverage used, followed results for at least 3 months, and detailed mean root coverage underwent review and statistical analysis. Investigations were scored from 1 to 5 based on methodological quality. Weighted gingival thickness and weighted mean root coverage was calculated based on standard error. Statistical analysis used the Mann-Whitney test, analysis of variance (ANOVA), and linear regression to determine any correlation between a number of factors (i.e., thickness, treatment type, and follow-up time) and mean and complete root coverage. A significant P value was set at <0.05.
RESULTS
Fifteen investigations met the inclusion criteria. All of these reported at least 0.7 mm of flap thickness, although measurement locations varied. Treatment modalities included coronally advanced flap, connective tissue graft, and guided tissue regeneration with and without adjuncts. A significant moderate correlation occurred between weighted flap thickness and weighted mean root coverage and weighted complete root coverage (r = 0.646 and 0.454, respectively). According to Mann-Whitney analysis, a critical threshold thickness >1.1 mm existed for weighted mean and complete root coverage (P <0.02). The type of treatment rendered also influenced root coverage. Further simple linear regression revealed a high correlation between weighted thickness and weighted mean root coverage in connective tissue grafting and guided tissue regeneration (r = 0.909 and 0.714, respectively) but not coronally advanced flap therapy. Study score and follow-up time did not affect the percentage of root coverage.
CONCLUSION
Within the limits of this review, a positive association exists between weighted flap thickness and mean and complete root coverage.
Topics: Connective Tissue; Gingiva; Gingival Recession; Guided Tissue Regeneration, Periodontal; Humans; Surgical Flaps; Tooth Root; Treatment Outcome
PubMed: 17032103
DOI: 10.1902/jop.2006.060107 -
Clinical Oral Implants Research Mar 2018One task of Working Group 1 at the 2nd Consensus Meeting of the Osteology Foundation was to comprehensively assess the effects of hard tissue augmentation procedures on... (Review)
Review
Evidence-based knowledge on the aesthetics and maintenance of peri-implant soft tissues: Osteology Foundation Consensus Report Part 2-Effects of hard tissue augmentation procedures on the maintenance of peri-implant tissues.
OBJECTIVES
One task of Working Group 1 at the 2nd Consensus Meeting of the Osteology Foundation was to comprehensively assess the effects of hard tissue augmentation procedures on peri-implant health or disease.
MATERIALS AND METHODS
One systematic review and meta-analysis on the effects of hard tissue augmentation procedures included a total of eight studies (n = 12 publications). Consensus statements, clinical recommendations, and implications for future research were based on structured group discussions and plenary session approval.
RESULTS
After 1-10 years of follow- up, lateral bone augmentation procedures were associated with peri-implant tissue stability, as evidenced by minimal and non-significant changes in bleeding on probing, probing depth, and marginal bone levels. Case definitions based on clinical and radiographic parameters to differentiate peri-implant health from disease have been inconsistently employed in the studies investigated.
CONCLUSIONS
Lateral bone augmentation procedures are associated with peri-implant tissue stability on short-term (1-3 years) and midterm follow-ups to long-term (>3 years) follow-ups.
Topics: Alveolar Ridge Augmentation; Bone Transplantation; Consensus; Dental Implantation, Endosseous; Dental Implants; Esthetics, Dental; Gingiva; Humans; Meta-Analysis as Topic; Osteology; Periodontal Index
PubMed: 29498125
DOI: 10.1111/clr.13109 -
BioMed Research International 2016The aim of this study was to evaluate the effectiveness of techniques for soft tissue augmentation in the placement of immediate implants with and without... (Review)
Review
The aim of this study was to evaluate the effectiveness of techniques for soft tissue augmentation in the placement of immediate implants with and without provisionalization and to assess the quality of the reports in the literature. Randomized clinical trials, prospective clinical trials, and case series were included in this review. Clinical questions were formulated and organised according to the PICOS strategy. An electronic search was performed in PubMed, Cochrane Central Register of Controlled Trials, Scopus, and ISI Web up until June 2016. Interexaminer agreement on eligibility (k = 0.842; p = 0.103) and quality (k = 0.933; p < 0.001) was high. Methodological approaches were assessed using criteria based on design related forms designed by the Dutch Cochrane Collaboration. Finally, 14 papers were identified. In two studies, the implant survival was 90%; for the rest of the studies it was 100%. All studies reported favourable aesthetic, biological, and radiographic outcomes. Surgical and biomechanical complications of this technique were not relevant. This technique effectively compensates for the expected loss of volume of the oral soft tissues and maintains high success rates with good aesthetic results over time.
Topics: Clinical Trials as Topic; Dental Implantation; Dental Implants; Gingiva; Humans; Prospective Studies; Randomized Controlled Trials as Topic; Suture Techniques
PubMed: 27517046
DOI: 10.1155/2016/7374129 -
Stem Cells Translational Medicine Jun 2014Periodontitis is a chronic infectious disease of the soft and hard tissues supporting the teeth. Recent advances in regenerative medicine and stem cell biology have... (Review)
Review
Periodontitis is a chronic infectious disease of the soft and hard tissues supporting the teeth. Recent advances in regenerative medicine and stem cell biology have paved the way for periodontal tissue engineering. Mesenchymal stromal cells (MSCs) delivered in situ to periodontal defects may exert their effects at multiple levels, including neovascularization, immunomodulation, and tissue regeneration. This systematic review had two goals: (a) to objectively quantify key elements for efficacy and safety of MSCs used for periodontal regeneration and (b) to identify patterns in the existing literature to explain differences between studies and suggest recommendations for future research. This systematic review provided good evidence of the capacity of MSCs to regenerate periodontal tissues in animals; however, experimentally generated defects used in animal studies do not sufficiently mimic the pathophysiology of periodontitis in humans. Moreover, the safety of such interventions in humans still needs to be studied. There were marked differences between experimental and control groups that may be influenced by characteristics that are crucial to address before translation to human clinical trials. We suggest that the appropriate combination of cell source, carrier type, and biomolecules, as well as the inclusion of critical path issues for a given clinical case, should be further explored and refined before transitioning to clinical trials. Future studies should investigate periodontal regenerative procedures in animal models, including rodents, in which the defects generated are designed to more accurately reflect the inflammatory status of the host and the shift in their pathogenic microflora.
Topics: Animals; Evidence-Based Medicine; Humans; Mesenchymal Stem Cell Transplantation; Periodontitis; Periodontium; Regeneration; Regenerative Medicine; Treatment Outcome
PubMed: 24744392
DOI: 10.5966/sctm.2013-0183