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The Journal of Prosthetic Dentistry Dec 2019Immediate loading of dental implants has gained widespread popularity because of its advantages in shortening treatment duration and improving esthetics and patient... (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Immediate loading of dental implants has gained widespread popularity because of its advantages in shortening treatment duration and improving esthetics and patient acceptance. However, whether immediate loading can achieve clinical outcomes comparable with those of early or conventional delayed loading is still unclear.
PURPOSE
The purpose of this systematic review and meta-analysis was to compare the efficacy of immediate loading versus early or conventional loading implants in patients rehabilitated with fixed prostheses.
MATERIAL AND METHODS
Electronic searches of CENTRAL, EMBASE, and MEDLINE were supplemented by manual searches up to October 2018. Only human randomized controlled trials (RCTs) comparing immediate with early or conventional loading dental implants were included. Quality assessment was performed by using the Cochrane Collaboration tool. For the meta-analysis, the dichotomous and continuous variables were pooled and analyzed by using risk ratios (RRs) and weighted mean differences (WMDs), with 95% confidence intervals (95% CIs). The outcomes assessed included survival rate, marginal bone level changes, peri-implant gingival level, probing depth, and implant stability. The subgroup analyses included healing methods, implant time, occlusal contact, number of missing teeth, and tooth position.
RESULTS
Thirty-nine trials (49 articles) were included from the initial 763 references evaluated. When compared with conventional loading, with implants regarded as a statistical unit, a statistically significant lower survival rate was observed in the immediate loading dental implant (RR=0.974; 95% CI, 0.954, 0.994; P=.012). Regarding other outcomes, including marginal bone level changes, peri-implant gingival level, probing depth, and implant stability, no statistically significant differences were observed when comparing immediate versus early or conventional loading (P>.05).
CONCLUSIONS
Compared with early loading, immediate loading could achieve comparable implant survival rates and marginal bone level changes. Compared with conventional loading, immediate loading was associated with a higher incidence of implant failure.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Restoration Failure; Esthetics, Dental; Humans; Immediate Dental Implant Loading; Randomized Controlled Trials as Topic; Time Factors; Tooth Loss
PubMed: 31421892
DOI: 10.1016/j.prosdent.2019.05.013 -
The Cochrane Database of Systematic... Dec 2017Fixed prosthodontic treatment (crowns, fixed dental prostheses (FDPs), complete arch prostheses) involves the use of several different materials to replace missing tooth... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Fixed prosthodontic treatment (crowns, fixed dental prostheses (FDPs), complete arch prostheses) involves the use of several different materials to replace missing tooth structure. Traditionally full metal or metal frameworks veneered with ceramic (metal-ceramic (MC)) have been used. In recent years several different metal-free systems have become available to clinicians and patients. In general, metal-free restorations should allow practitioners to better reproduce natural tooth colour, avoiding shortcomings of MC restorations. The comparative in service clinical performance of fixed prosthodontic treatments of different materials is unclear.
OBJECTIVES
To assess the effects of metal-free materials for prosthodontic restorations compared to metal-ceramic or other conventional all-metal materials.
SEARCH METHODS
Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (searched 3 May 2017), Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 4) in the Cochrane Library (searched 3 May 2017), MEDLINE Ovid (1946 to 3 May 2017), and Embase Ovid (1980 to 3 May 2017). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials (searched 3 May 2017). No restrictions were placed on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
Randomised controlled trials (RCTs) in which the clinical performance of metal-free fixed prosthodontic restorations was compared with metal-ceramic (MC) or other conventional restorations in adult patients requiring prosthodontic treatment. RCTs in which the clinical performance of different kinds of metal-free systems were compared among themselves were also considered.
DATA COLLECTION AND ANALYSIS
We used standard methodological procedures expected by Cochrane. Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted independently and in duplicate. Trial authors were contacted for missing information. Available results for the outcomes of interest of the systematic review of the studies included were tabulated as they could not be included in a formal meta-analysis.
MAIN RESULTS
Nine trials involving a total of 448 participants were included. We judged two trials to be at unclear risk of bias and seven to be at high risk of bias. The majority of items of risk of bias were evaluated to be at unclear or high risk level in more than 50% of the included trials. Each trial except two was addressing a different type of intervention. All evidence was rated as being of very low quality due to problems with risk of bias and imprecision of results, the latter being due to very small sample sizes, low event rates, 95% confidence intervals including the possibility of benefit for both the test and control groups, or combinations of these problems. This means that we are very uncertain about all of the results presented in this review.One trial compared metal-free single crowns (full contour zirconia) to cast gold single crowns in 224 participants and found insufficient evidence of a difference in failure rate after one year, but after five years there was some evidence of a benefit for the gold crowns. There was insufficient evidence of a difference for crown complications at either time of assessment.One trial compared three-unit metal-free FDPs (lithium disilicate) to three-unit metal-ceramic FDPs in 37 participants. There was insufficient evidence of a difference in bridge failure at one and six years, but some evidence of a benefit for the lithium disilicate group in terms of bridge complications at six years. One trial compared zirconia-ceramic FDPs to metal-ceramic FDPs in 34 participants but found insufficient evidence of a difference in bridge failures (i.e. no failures in either treatment group), bridge complications or patients' aesthetic evaluation at any time of assessment up to three years.One trial compared metal-free cantilevered FDPs to metal-ceramic cantilevered FDPs in 21 participants. There was insufficient evidence of a difference for any primary outcome: bridge failures (i.e. no failures in either treatment group), bridge complications, or patients' aesthetic evaluation at any time of assessment up to three years.One trial compared metal-free implant-supported screw retained single crowns (zirconia veneered with feldspathic ceramic) to metal-ceramic implant-supported screw-retained single crowns in 20 participants. There was insufficient evidence of a difference for any primary outcome: crown failures (i.e. no failures in either treatment group), crown complications, or satisfaction/aesthetic evaluation at any time of assessment up to two years.Two trials compared metal-free implant abutments (zirconia) to metal implant abutments both supporting single crowns in 50 participants. There was insufficient evidence of a difference in abutment failure at one year.One trial compared metal-free implant-supported FDPs made of two different types of zirconia ceramic in 18 participants. There was insufficient evidence of a difference in failures at any time of assessment up to 10 years (i.e. no failures in either treatment group). There was some evidence of a benefit for the zirconia-toughened alumina group in terms of complications (chipping).One trial compared metal-free tooth-supported FDPs made with two different veneering techniques (pressed versus layered) in 40 participants. There was insufficient evidence of a difference for failures (i.e. no failures in either treatment group) or complications at any time of assessment up to three years.
AUTHORS' CONCLUSIONS
There is insufficient evidence to support or refute the effectiveness of metal-free materials for fixed prosthodontic treatment over metal-ceramic or other type of standard restorations. The overall quality of existing evidence was very low, therefore great caution should be exercised when generalising the results of the included trials. Until more evidence becomes available clinicians should continue to base decisions on which material to use for fixed prosthodontic treatment on their own clinical experience, whilst taking into consideration the individual circumstances and preferences of their patients. There is urgent need of properly designed RCTs.
Topics: Crowns; Dental Alloys; Dental Materials; Dental Restoration, Permanent; Humans; Randomized Controlled Trials as Topic; Zirconium
PubMed: 29261853
DOI: 10.1002/14651858.CD009606.pub2 -
Clinical Oral Implants Research Oct 2021To assess the survival, failure, and complication rates of veneered and monolithic all-ceramic implant-supported single crowns (SCs). (Meta-Analysis)
Meta-Analysis Review
A systematic review and meta-analysis evaluating the survival, the failure, and the complication rates of veneered and monolithic all-ceramic implant-supported single crowns.
OBJECTIVE
To assess the survival, failure, and complication rates of veneered and monolithic all-ceramic implant-supported single crowns (SCs).
METHODS
Literature search was conducted in Medline (PubMed), Embase, and Cochrane Central Register of Controlled Trials until September 2020 for randomized, prospective, and retrospective clinical trials with follow-up time of at least 1 year, evaluating the outcome of veneered and/or monolithic all-ceramic SCs supported by titanium dental implants. Survival and complication rates were analyzed using robust Poisson's regression models.
RESULTS
Forty-nine RCTs and prospective studies reporting on 57 material cohorts were included. Meta-analysis of the included studies indicated an estimated 3-year survival rate of veneered-reinforced glass-ceramic implant-supported SCs of 97.6% (95% CI: 87.0%-99.6%). The estimated 3-year survival rates were 97.0% (95% CI: 94.0%-98.5%) for monolithic-reinforced glass-ceramic implant SCs, 96.9% (95% CI: 93.4%-98.6%) for veneered densely sintered alumina SCs, 96.3% (95% CI: 93.9%-97.7%) for veneered zirconia SCs, 96.1% (95% CI: 93.4%-97.8%) for monolithic zirconia SCs and only 36.3% (95% CI: 0.04%-87.7%) for resin-matrix-ceramic (RMC) SCs. With the exception of RMC SCs (p < 0.0001), the differences in survival rates between the materials did not reach statistical significance. Veneered SCs showed significantly (p = 0.017) higher annual ceramic chipping rates (1.65%) compared with monolithic SCs (0.39%). The location of the SCs, anterior vs. posterior, did not influence survival and chipping rates.
CONCLUSIONS
With the exception of RMC SCs, veneered and monolithic implant-supported ceramic SCs showed favorable short-term survival and complication rates. Significantly higher rates for ceramic chipping, however, were reported for veneered compared with monolithic ceramic SCs.
Topics: Ceramics; Crowns; Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Prospective Studies; Retrospective Studies
PubMed: 34642991
DOI: 10.1111/clr.13863 -
Clinical and Experimental Dental... Feb 2022The purpose of this systematic review and meta-analysis was to compare implant-supported removable partial dentures (ISRPDs) with distal extension removable partial... (Meta-Analysis)
Meta-Analysis Review
Implant-supported removable partial dentures compared to conventional dentures: A systematic review and meta-analysis of quality of life, patient satisfaction, and biomechanical complications.
OBJECTIVES
The purpose of this systematic review and meta-analysis was to compare implant-supported removable partial dentures (ISRPDs) with distal extension removable partial dentures (DERPDs) in terms of patient-reported outcome measures (PROMs: patients' quality of life and satisfaction) and to determine mechanical and biological complications associated with ISRPDs.
MATERIAL AND METHODS
An electronic search was performed on four databases to identify studies treating Kennedy class I or II edentulous patients and which compared ISRPDs with DERPDs in terms of PROMS and studies, which evaluated mechanical and biological complications associated ISRPDs. Two authors independently extracted data on quality of life, patient satisfaction, and biomechanical complications from these studies. The risk of bias was assessed for each study, and for PROMs, the authors performed a meta-analysis by using a random-effects model.
RESULTS
Thirteen articles were included based on the selection criteria. The difference in mean scores for quality of life (30.5 ± 1.8; 95% confidence interval [CI], 24.9-36.1) and patient satisfaction (-20.8 ± 0.2; 95% CI, -23.7 to -17.8) between treatments with conventional and implant-supported removable dentures was statistically significant (p < .05). Implant-supported removable dentures improved patients' overall quality of life and satisfaction. Some mechanical and biological complications, such as clasp adjustment, abutment or implant loosening, marginal bone resorption, and peri-implant mucositis, were noted in ISRPDs during patient follow-up. Studies assessing PROMs were very heterogeneous (I = 65%, p = .85; I = 75%, p = .88).
CONCLUSIONS
ISRPDs significantly improved quality of life and patient satisfaction. Some mechanical and biological complications have been associated with ISRPDs treatment, requiring regular monitoring of patients to avoid the occurrence of these complications.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Partial, Removable; Humans; Patient Satisfaction; Quality of Life
PubMed: 35014207
DOI: 10.1002/cre2.521 -
Clinical Oral Implants Research Jan 2022To analyze the clinical outcomes of all-ceramic single crowns (SCs) and fixed dental prostheses (FDPs) supported by ceramic implants. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To analyze the clinical outcomes of all-ceramic single crowns (SCs) and fixed dental prostheses (FDPs) supported by ceramic implants.
MATERIALS AND METHODS
Based on a focused question and customized PICO framework, electronic (Medline/EMBASE/Cochrane) and manual searches for studies reporting the clinical outcomes of all-ceramic SCs and FDPs supported by ceramic implants ≥12 months were performed. The primary outcomes were reconstruction survival and the chipping proportion. The secondary outcomes were implant survival, technical complications, and patient-related outcome measurements. Meta-analyses were performed after 1, 2, and 5 years using random-effect meta-analyses.
RESULTS
Eight of the 1,403 initially screened titles and 55 full texts were included. Five reported on monolithic lithium disilicate (LS2) SCs, one on veneered zirconia SCs, and two on veneered zirconia SCs and FDPs, which reported all on cement-retained reconstructions (mean observation: 12.0-61.0 months). Meta-analyses estimated a 5-year survival rate of 94% (95% confidence interval [CI]: 82%-100%) for overall implant survival. Reconstruction survival proportions after 5 years were: monolithic LS2, 100% (95%CI: 95%-100%); veneered zirconia SCs, 89% (95%CI: 62%-100%); and veneered zirconia FDPs 94% (95%CI: 81%-100%). The chipping proportion after 5 years was: monolithic LS2, 2% (95%CI: 0%-11%); veneered zirconia SCs, 38% (95%CI: 24%-54%); and veneered zirconia FDPs, 57% (95%CI: 38%-76%). Further outcomes were summarized descriptively.
CONCLUSIONS
Due to the limited data available, only tendencies could be identified. All-ceramic reconstructions supported by ceramic implants demonstrated promising survival rates after mid-term observation. However, high chipping proportions of veneered zirconia SCs and, particularly, FDPs diminished the overall outcome. Monolithic LS2 demonstrated fewer clinical complications. Monolithic reconstructions could be a valid treatment option for ceramic implants.
Topics: Ceramics; Crowns; Dental Implants; Dental Porcelain; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Humans; Metal Ceramic Alloys; Zirconium
PubMed: 34665900
DOI: 10.1111/clr.13871 -
The Cochrane Database of Systematic... Sep 2015Endodontic treatment involves removal of the dental pulp and its replacement by a root canal filling. Restoration of root filled teeth can be challenging due to... (Review)
Review
BACKGROUND
Endodontic treatment involves removal of the dental pulp and its replacement by a root canal filling. Restoration of root filled teeth can be challenging due to structural differences between vital and non-vital root-filled teeth. Direct restoration involves placement of a restorative material e.g. amalgam or composite, directly into the tooth. Indirect restorations consist of cast metal or ceramic (porcelain) crowns. The choice of restoration depends on the amount of remaining tooth, and may influence durability and cost. The decision to use a post and core in addition to the crown is clinician driven. The comparative clinical performance of crowns or conventional fillings used to restore root-filled teeth is unknown. This review updates the original, which was published in 2012.
OBJECTIVES
To assess the effects of restoration of endodontically treated teeth (with or without post and core) by crowns versus conventional filling materials.
SEARCH METHODS
We searched the following databases: the Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE via OVID, EMBASE via OVID, CINAHL via EBSCO, LILACS via BIREME. We also searched the reference lists of articles and ongoing trials registries.There were no restrictions regarding language or date of publication. The search is up-to-date as of 26 March 2015.
SELECTION CRITERIA
Randomised controlled trials (RCTs) or quasi-randomised controlled trials in participants with permanent teeth that have undergone endodontic treatment. Single full coverage crowns compared with any type of filling materials for direct restoration or indirect partial restorations (e.g. inlays and onlays). Comparisons considered the type of post and core used (cast or prefabricated post), if any.
DATA COLLECTION AND ANALYSIS
Two review authors independently extracted data from the included trial and assessed its risk of bias. We carried out data analysis using the 'treatment as allocated' patient population, expressing estimates of intervention effect for dichotomous data as risk ratios, with 95% confidence intervals (CI).
MAIN RESULTS
We included one trial, which was judged to be at high risk of performance, detection and attrition bias. The 117 participants with a root-filled, premolar tooth restored with a carbon fibre post, were randomised to either a full coverage metal-ceramic crown or direct adhesive composite restoration. None experienced a catastrophic failure (i.e. when the restoration cannot be repaired), although only 104 teeth were included in the final, three-year assessment. There was no clear difference between the crown and composite group and the composite only group for non-catastrophic failures of the restoration (1/54 versus 3/53; RR 0.33; 95% CI 0.04 to 3.05) or failures of the post (2/54 versus 1/53; RR 1.96; 95% CI 0.18 to 21.01) at three years. The quality of the evidence for these outcomes is very low. There was no evidence available for any of our secondary outcomes: patient satisfaction and quality of life, incidence or recurrence of caries, periodontal health status, and costs.
AUTHORS' CONCLUSIONS
There is insufficient evidence to assess the effects of crowns compared to conventional fillings for the restoration of root-filled teeth. Until more evidence becomes available, clinicians should continue to base decisions about how to restore root-filled teeth on their own clinical experience, whilst taking into consideration the individual circumstances and preferences of their patients.
Topics: Adult; Crowns; Dental Restoration, Permanent; Female; Humans; Male; Middle Aged; Post and Core Technique; Randomized Controlled Trials as Topic; Tooth Root; Tooth, Nonvital
PubMed: 26403154
DOI: 10.1002/14651858.CD009109.pub3 -
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 -
Brazilian Oral Research 2018This study compared the survival rate of dental implants, amount of marginal bone loss, and rates of complications (biological and prosthetic) between short implants and... (Meta-Analysis)
Meta-Analysis Review
This study compared the survival rate of dental implants, amount of marginal bone loss, and rates of complications (biological and prosthetic) between short implants and long implants placed after maxillary sinus augmentation. This systematic review has been registered at PROSPERO under the number (CRD42017073929). Two reviewers searched the PubMed/MEDLINE, Embase, LILACS, and Cochrane Library databases. Eligibility criteria included randomized controlled trials, comparisons between short implants and long implants placed after maxillary sinus augmentation in the same study, and follow-up for >6 months. The Cochrane Collaboration's tool for assessing the risk of bias in randomized trials was used to assess the quality and risk of bias of the included studies. The search identified 1366 references. After applying the inclusion criteria, 11 trials including 420 patients who received 911 dental implants were considered eligible. No significant difference was observed in the survival rate [p = 0.86; risk ratio (RR): 1.08; 95% confidence interval (CI): 0.46-2.52] or in the amount of marginal bone loss (p = 0.08; RR: -0.05; 95%CI: -0.10 to 0.01). However, higher rates of biological complications for long implants associated with maxillary sinus augmentation were observed (p < 0.00001; RR: 0.21; 95%CI: 0.10-0.41), whereas a higher prosthetic complication rate for short implants was noted (p = 0.010; RR: 3.15; 95%CI: 1.32-7.51). Short implant placement is an effective alternative because of fewer biological complications and similar survival and marginal bone loss than long implant placement with maxillary sinus augmentation. However, the risk of mechanical complications associated with the prostheses fitted on short implants should be considered.
Topics: Alveolar Bone Loss; Bias; Dental Implantation; Dental Implants; Dental Prosthesis Design; Dental Restoration Failure; Humans; Maxillary Sinus; Postoperative Complications; Risk Factors; Sinus Floor Augmentation; Treatment Outcome
PubMed: 30231176
DOI: 10.1590/1807-3107bor-2018.vol32.0086 -
International Journal of Implant... Nov 2021Implant-assisted removable partial dentures (IARPDs) have recently become popular, but little information is available on the treatment outcomes based on the Kennedy... (Review)
Review
BACKGROUND
Implant-assisted removable partial dentures (IARPDs) have recently become popular, but little information is available on the treatment outcomes based on the Kennedy classification and attachment types.
OBJECTIVE
The objective of this review was to evaluate the treatment outcomes of IARPD delivered for distal extension edentulous areas based on the differences in the Kennedy classification and attachment type.
MATERIALS AND METHODS
English-language clinical studies on IARPD published between January 1980 and February 2020 were collected from MEDLINE (via PubMed), the Cochrane Library (via the Cochrane Central Register of Controlled Trials), Scopus online database, and manual searching. Two reviewers selected the articles based on pre-determined inclusion and exclusion criteria, followed by data extraction and analysis.
RESULTS
Eighty-one studies were selected after evaluating the titles and abstracts of 2410 papers. Nineteen studies were finally included after the perusal of the full text. Fourteen studies focused on Class I, 4 studies investigated both Class I and II, and only 1 study was conducted on Kennedy's class II. Eight types of attachments were reported. The ball attachment was the most frequently used attachment, which was employed in 8 of the included studies. The implant survival rate ranged from 91 to 100%. The reported marginal bone loss ranged from 0.3 mm to 2.30 mm. The patient satisfaction was higher with IARPD than with conventional RPDs or that before treatment. The results of prosthetic complications were heterogeneous and inconclusive.
CONCLUSION
IARPD exhibited favorable clinical outcomes when used as a replacement for distal extension edentulous areas. The comparison between the clinical outcomes of Kennedy's class I and II was inconclusive owing to the lack of studies focusing on Kennedy Class II alone. The stud attachment was the most commonly used type in IARPDs. Overall, the different attachment systems did not influence the implant survival rate and patient satisfaction. Further high-quality studies are needed to investigate the attachment systems used in IARPD.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Partial, Removable; Humans; Patient Satisfaction; Treatment Outcome
PubMed: 34773513
DOI: 10.1186/s40729-021-00394-z -
Dental Materials : Official Publication... Aug 2022The loss of the dental coronal portion following carious lesions or fractures leads to endodontic treatment with subsequent restoration to ensure correct anatomy and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The loss of the dental coronal portion following carious lesions or fractures leads to endodontic treatment with subsequent restoration to ensure correct anatomy and function. Recently, partial adhesive restorations have been widely proposed to increase the survival rate of endodontically treated teeth. The primary purpose of this review is to assess the failure rate of indirect partial adhesive restorations on endodontically treated teeth (ETT), considering the follow-up period.
METHODS
The indications reported in the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) were used to draft the present review. The study was constructed on PICO questions: population (patients who need indirect adhesive restorative treatment on endodontically treated teeth with onlay and overlay), intervention (onlay and overlay), control (patients with onlay and overlay on endodontically treated teeth) and outcome (failure rate and types of failure for onlay and overlay). The asked scientific question was: what are the failure rate and types of failure for adhesive indirect partial restorations on ETT?
RESULTS
The overall failure rate that emerges is 0.087 with a ratio of 121/1254, I 80 % p-value< 0.001. Moreover, by meta-regression with covariates the follow-up period reports a coefficient of 0.013 with a P-value< 0.001. In conclusion, the indirect partial restorations on endodontically treated teeth displayed overall acceptable outcomes in terms of success from 2 to 4 years after their placement with only 4.32 % of failure. Failures increase after 7 years up to 12-30 years with failure rates of approximatively 10.65 % and 20.94 %. The analysis of the included articles reporting the causes of restorations failures showed that 15.51 % of cases were related to the loss of dental element.
SIGNIFICANCE
Besides the survival rates of indirect adhesive restorations on endodontically treated posterior teeth, it was highlighted that the majority of failures appeared restorable. Thus, partial restorations seemed able to prevent the ETT tooth loss.
Topics: Composite Resins; Dental Restoration Failure; Dental Restoration, Permanent; Humans; Inlays; Prognosis; Tooth, Nonvital
PubMed: 35835608
DOI: 10.1016/j.dental.2022.06.018