-
The International Journal of Oral &... 2014To assess the 5-year survival rate and number of technical, biologic, and esthetic complications involving implant abutments. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To assess the 5-year survival rate and number of technical, biologic, and esthetic complications involving implant abutments.
MATERIALS AND METHODS
Electronic (Medline) and hand searches were performed to assess studies on metal and ceramic implant abutments. Relevant data from a previous review were included. Two reviewers independently extracted the data. Failure and complication rates were analyzed, and estimates of 5-year survival proportions were calculated from the relationship between event rate and survival function. Multivariable robust Poisson regression was used to compare abutment characteristics.
RESULTS
The search yielded 1,558 titles and 274 abstracts. Twenty-four studies were selected for data analysis. The survival rate for ceramic abutments was 97.5% (95% confidence interval [CI]): 89.6% to 99.4%) and 97.6% (95% CI: 96.2% to 98.5%) for metal abutments. The overall 5-year rate for technical complications was 11.8% (95% CI: 8.5% to 16.3%), 8.9% (95% CI: 4.3% to 17.7%) for ceramic and 12.0% (95% CI: 8.5% to 16.8%) for metal abutments. Biologic complications occurred with an overall rate of 6.4% (95% CI: 3.3% to 12.0%), 10.4% (95% CI: 1.9% to 46.7%) for ceramic, and 6.1% (95% CI: 3.1% to 12.0%) for metal abutments.
CONCLUSIONS
The present meta-analysis on single-implant prostheses presents high survival rates of single implants, abutments, and prostheses after 5 years of function. No differences were found for the survival and failure rates of ceramic and metal abutments. No significant differences were found for technical, biologic, and esthetic complications of internally and externally connected abutments.
Topics: Ceramics; Confidence Intervals; Dental Abutments; Dental Alloys; Dental Implants, Single-Tooth; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Esthetics, Dental; Humans; Incidence; Time Factors
PubMed: 24660193
DOI: 10.11607/jomi.2014suppl.g2.2 -
The Journal of Thoracic and... Jul 2018
Meta-Analysis
Topics: Bone Wires; Humans; Prosthesis Design; Randomized Controlled Trials as Topic; Steel; Sternotomy; Sternum; Time Factors; Treatment Outcome; Wound Closure Techniques; Wound Healing
PubMed: 29572025
DOI: 10.1016/j.jtcvs.2018.02.033 -
Journal of Neuroengineering and... Jul 2020Understanding how prostheses are used in everyday life is central to the design, provision and evaluation of prosthetic devices and associated services. This paper...
BACKGROUND
Understanding how prostheses are used in everyday life is central to the design, provision and evaluation of prosthetic devices and associated services. This paper reviews the scientific literature on methodologies and technologies that have been used to assess the daily use of both upper- and lower-limb prostheses. It discusses the types of studies that have been undertaken, the technologies used to monitor physical activity, the benefits of monitoring daily living and the barriers to long-term monitoring, with particular focus on low-resource settings.
METHODS
A systematic literature search was conducted in PubMed, Web of Science, Scopus, CINAHL and EMBASE of studies that monitored the activity of prosthesis users during daily-living.
RESULTS
Sixty lower-limb studies and 9 upper-limb studies were identified for inclusion in the review. The first studies in the lower-limb field date from the 1990s and the number has increased steadily since the early 2000s. In contrast, the studies in the upper-limb field have only begun to emerge over the past few years. The early lower-limb studies focused on the development or validation of actimeters, algorithms and/or scores for activity classification. However, most of the recent lower-limb studies used activity monitoring to compare prosthetic components. The lower-limb studies mainly used step-counts as their only measure of activity, focusing on the amount of activity, not the type and quality of movements. In comparison, the small number of upper-limb studies were fairly evenly spread between development of algorithms, comparison of everyday activity to clinical scores, and comparison of different prosthesis user populations. Most upper-limb papers reported the degree of symmetry in activity levels between the arm with the prosthesis and the intact arm.
CONCLUSIONS
Activity monitoring technology used in conjunction with clinical scores and user feedback, offers significant insights into how prostheses are used and whether they meet the user's requirements. However, the cost, limited battery-life and lack of availability in many countries mean that using sensors to understand the daily use of prostheses and the types of activity being performed has not yet become a feasible standard clinical practice. This review provides recommendations for the research and clinical communities to advance this area for the benefit of prosthesis users.
Topics: Artificial Limbs; Humans; Lower Extremity; Monitoring, Physiologic; Prostheses and Implants; Technology; Upper Extremity
PubMed: 32665020
DOI: 10.1186/s12984-020-00711-4 -
AJNR. American Journal of Neuroradiology Mar 2017Flow diversion is now an established technique to treat unruptured intracranial aneurysms not readily amenable to endovascular coil embolization or open microsurgical... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Flow diversion is now an established technique to treat unruptured intracranial aneurysms not readily amenable to endovascular coil embolization or open microsurgical occlusion. The role of flow-diverting devices in treating ruptured aneurysms is less clear.
PURPOSE
To estimate rates of angiographic occlusion and good clinical outcome in patients with ruptured intracranial aneurysms treated with flow-diverting devices.
DATA SOURCES
Systematic review of Ovid MEDLINE, PubMed, Cochrane databases, and EMBASE from inception to December 2015 for articles that included ruptured aneurysms treated with flow diversion.
STUDY SELECTION
One hundred seventy-two records were screened, of which 20 articles contained sufficient patient and outcome data for inclusion.
DATA ANALYSIS
Clinical and radiologic characteristics, procedural details, and outcomes were extracted from these reports. Aggregated occlusion rates and clinical outcomes were analyzed by using the Fisher exact test (statistical significance, α = .05).
DATA SYNTHESIS
Complete occlusion of the aneurysm was achieved in 90% of patients, and favorable clinical outcome was attained in 81%. Aneurysm size greater than 7 mm was associated with less favorable clinical outcomes ( = .027). Aneurysm size greater than 2 cm was associated with a greater risk of rerupture after treatment ( < .001).
LIMITATIONS
Observational studies and case reports may be affected by reporting bias.
CONCLUSIONS
Although not recommended as a first-line treatment, the use of flow diverters to treat ruptured intracranial aneurysms may allow high rates of angiographic occlusion and good clinical outcome in carefully selected patients. Aneurysm size contributes to treatment risk because the rerupture rate following treatment is higher for aneurysms larger than 2 cm.
Topics: Aneurysm, Ruptured; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Humans; Intracranial Aneurysm; Stents; Treatment Outcome
PubMed: 28007770
DOI: 10.3174/ajnr.A5030 -
International Orthopaedics Oct 2004It has been stated in the literature that a bipolar hemiarthroplasty has a lower risk of dislocation compared to a unipolar hemiarthroplasty. As this statement has not... (Comparative Study)
Comparative Study Review
It has been stated in the literature that a bipolar hemiarthroplasty has a lower risk of dislocation compared to a unipolar hemiarthroplasty. As this statement has not been substantiated we undertook a systematic review of the literature of published articles from the last 40 years. In addition we used our own database of hip fractures. One hundred and thirty-three published articles were included in the review to give a total of 23,107 cases. The overall dislocation rate for all types of hemiarthroplasty was 791/23,107 (3.4%). An increased risk of dislocation was associated with a posterior surgical approach and the use of a cemented prosthesis. After adjustment for surgical approach and the use of cement there was no difference in risk of dislocation between unipolar and bipolar hemiarthroplasties. There was an increased risk of open reduction for a bipolar hemiarthroplasty.
Topics: Arthroplasty, Replacement, Hip; Confidence Intervals; Female; Follow-Up Studies; Hip Dislocation; Hip Fractures; Hip Prosthesis; Humans; Male; Odds Ratio; Probability; Prosthesis Design; Range of Motion, Articular; Recovery of Function; Risk Assessment; Treatment Outcome
PubMed: 15316673
DOI: 10.1007/s00264-004-0572-z -
Clinical Oral Implants Research Oct 2021To study the time and costs involved with computer-assisted versus non-computer-assisted implant planning and placement. (Review)
Review
AIM
To study the time and costs involved with computer-assisted versus non-computer-assisted implant planning and placement.
MATERIAL AND METHODS
Based on the PICO question, "In patients receiving dental implants, is computer-assisted implant planning and surgery (CAIPS) compared to non-computer-assisted implant planning and surgery (non-CAIPS) beneficial in terms of treatment related costs and time involved?", a search path was created to perform an electronic search in the databases PubMed, PubMed Central, EMBASE, and Cochrane. The publication period of eligible publications extended from 01.01.2005 to 04.05.2020. Four independent reviewers reviewed the literature to identify studies that met the eligibility inclusion criteria. A further manual search of articles was performed, and gray literature was excluded. Corresponding authors of potentially eligible manuscripts were contacted for further information.
RESULTS
Of the 1354 retrieved titles after the search were screened. Thirty-one articles have been identified to read the full text, resulting in four articles to be analyzed for the present review all of which were RCTs. In total, 182 partially and completely edentulous patients were treated with 416 implants following either non-computer-assisted or computer-assisted implant planning and surgery to determine the duration of the single working steps and the financial aspects of the different procedures.
CONCLUSIONS
When evaluating the time and costs involved with the diagnostic and planning procedures in computer-assisted implant planning and surgery workflow protocols, one can summarize that these are higher than in the non-computer-assisted workflow protocols. The time involved with the procedures appears to be the driving factor when it comes to economic considerations. On the basis of the conclusions, also the time for the prosthetic restoration should be taken into account.
Topics: Computers; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis, Implant-Supported; Humans; Surgery, Computer-Assisted
PubMed: 34642994
DOI: 10.1111/clr.13862 -
Journal of the American Heart... Dec 2022Background In the absence of randomized controlled trials, reports from nonrandomized studies comparing valve-in-valve implantation (ViV) to redo surgical aortic valve... (Meta-Analysis)
Meta-Analysis Review
Valve-in-Valve Transcatheter Aortic Valve Replacement Versus Redo Surgical Aortic Valve Replacement for Failed Surgical Aortic Bioprostheses: A Systematic Review and Meta-Analysis.
Background In the absence of randomized controlled trials, reports from nonrandomized studies comparing valve-in-valve implantation (ViV) to redo surgical aortic valve replacement (rAVR) have shown inconsistent results. Methods and Results PubMed/MEDLINE, Google Scholar, and CENTRAL (Cochrane Central Register of Controlled Trials) were searched through December 2021. Meta-Analysis of Observational Studies in Epidemiology guidelines were followed. The protocol was registered at the International Prospective Register of Systematic Reviews. Random effects models were applied. The primary outcomes of interest were short-term and midterm mortality. Secondary outcomes included stroke, myocardial infarction, acute renal failure, and permanent pacemaker implantation, as well as prosthetic aortic valve regurgitation, mean transvalvular gradient, and severe prosthesis-patient mismatch. Of 8881 patients included in 15 studies, 4458 (50.2%) underwent ViV and 4423 (49.8%) rAVR. Short-term mortality was 2.8% in patients undergoing ViV compared with 5.0% in patients undergoing rAVR (risk ratio [RR] 0.55 [95% CI, 0.34-0.91], =0.02). Midterm mortality did not differ in patients undergoing ViV compared with patients undergoing rAVR (hazard ratio, 1.27 [95% CI, 0.72-2.25]). The rate of acute kidney failure was lower following ViV, (RR, 0.54 [95% CI, 0.33-0.88], =0.02), whereas prosthetic aortic valve regurgitation (RR, 4.18 [95% CI, 1.88-9.3], =0.003) as well as severe patient-prothesis mismatch (RR, 3.12 [95% CI, 2.35-4.1], <0.001) occurred more frequently. The mean transvalvular gradient was higher following ViV (standard mean difference, 0.44 [95% CI, 0.15-0.72], =0.008). There were no significant differences between groups with respect to stroke (=0.26), myocardial infarction (=0.93), or pacemaker implantation (=0.21). Conclusions Results of this meta-analysis demonstrate better short-term mortality after ViV compared with rAVR. Midterm mortality was similar between groups. Given the likely selection bias in these individual reports, an adequately powered multicenter randomized clinical trial with sufficiently long follow-up in patients with low-to-intermediate surgical risk is warranted. Registration URL: crd.york.ac.uk/prospero/. Unique identifier: CRD42021228752.
Topics: Humans; Aortic Valve; Transcatheter Aortic Valve Replacement; Bioprosthesis; Reoperation; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Aortic Valve Stenosis; Aortic Valve Insufficiency; Myocardial Infarction; Stroke; Treatment Outcome; Risk Factors; Randomized Controlled Trials as Topic; Multicenter Studies as Topic
PubMed: 36533610
DOI: 10.1161/JAHA.121.024848 -
BioMed Research International 2021This systematic review is aimed at investigating the biomechanical stress that develops in the maxillofacial prostheses (MFP) and supporting structures and methods to...
AIM
This systematic review is aimed at investigating the biomechanical stress that develops in the maxillofacial prostheses (MFP) and supporting structures and methods to optimize it. . A literature survey was conducted for full-text English articles which used FEA to examine the stress developed in conventional and implant-assisted MFPs from January 2010 to December 2020.
RESULTS
87 articles were screened to get an update on the desired information. 74 were excluded based on a complete screening, and finally, 13 articles were recruited for complete reviewing. . The MFP is subjected to stress, which is reflected in the form of compressive and tensile strengths. The stress is mainly concentrated the resection line and around the apices of roots of teeth next to the defect. Diversity of designs and techniques were introduced to optimize the stress distribution, such as modification of the clasp design, using materials with different mechanical properties for dentures base and retainer, use of dental (DI) and/or zygomatic implants (ZI), and free flap reconstruction before prosthetic rehabilitation.
CONCLUSION
Using ZI in the defective side of the dentulous maxillary defect and defective and nondefective side of the edentulous maxillary defect was found more advantageous, in terms of compression and tensile stress and retention, when compared with DI and free flap reconstruction.
Topics: Animals; Biomechanical Phenomena; Finite Element Analysis; Humans; Imaging, Three-Dimensional; Maxilla; Maxillofacial Prosthesis; Stress, Mechanical
PubMed: 34447852
DOI: 10.1155/2021/6419774 -
Medicine Apr 2023Retrograde type A dissection (RTAD) is a devastating complication of thoracic endovascular repair (TEVAR) with low incidence but high mortality. The objective of this... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Retrograde type A dissection (RTAD) is a devastating complication of thoracic endovascular repair (TEVAR) with low incidence but high mortality. The objective of this study is to report the incidence, mortality, potential risk factors, clinical manifestation and diagnostic modalities, and medical and surgical treatments.
METHODS
A systematic review and single-arm and two-arm meta-analyses evaluated all published reports of RTAD post-TEVAR through January 2021. All study types were included, except study protocols and animal studies, without time restrictions. Outcomes of interest were procedural data (implanted stent-grafts type, and proximal stent-graft oversizing), the incidence of RTAD, associated mortality rate, clinical manifestations, diagnostic workouts and therapeutic management.
RESULTS
RTAD occurred in 285 out of 10,600 patients: an estimated RTAD incidence of 2.3% (95% CI: 1.9-2.8); incidence of early RTAD was approximately 1.8 times higher than late. Wilcoxon signed-rank testing showed that the proportion of RTAD patients with acute type B aortic dissection (TBAD) was significantly higher than those with chronic TBAD (P = .008). Pooled meta-analysis showed that the incidence of RTAD with proximal bare stent TEVAR was 2.1-fold higher than with non-bare stents: risk ratio was 1.55 (95% CI: 0.87-2.75; P = .13). Single arm meta-analysis estimated a mortality rate of 42.2% (95% CI: 32.5-51.8), with an I2 heterogeneity of 70.11% (P < .001).
CONCLUSION
RTAD is rare after TEVAR but with high mortality, especially in the first month post-TEVAR with acute TBAD patients at greater risk as well as those treated with proximal bare stent endografts.
Topics: Humans; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Endovascular Aneurysm Repair; Aortic Aneurysm, Thoracic; Endovascular Procedures; Treatment Outcome; Prosthesis Design; Stents; Aortic Dissection; Risk Factors; Retrospective Studies
PubMed: 37058052
DOI: 10.1097/MD.0000000000032944 -
Clinical Oral Implants Research Dec 2009The purpose of this study was to systematically review the literature on the survival rates of palatal implants, Onplants((R)), miniplates and mini screws. (Review)
Review
AIM
The purpose of this study was to systematically review the literature on the survival rates of palatal implants, Onplants((R)), miniplates and mini screws.
MATERIAL AND METHODS
An electronic MEDLINE search supplemented by manual searching was conducted to identify randomized clinical trials, prospective and retrospective cohort studies on palatal implants, Onplants((R)), miniplates and miniscrews with a mean follow-up time of at least 12 weeks and of at least 10 units per modality having been examined clinically at a follow-up visit. Assessment of studies and data abstraction was performed independently by two reviewers. Reported failures of used devices were analyzed using random-effects Poisson regression models to obtain summary estimates and 95% confidence intervals (CI) of failure and survival proportions.
RESULTS
The search up to January 2009 provided 390 titles and 71 abstracts with full-text analysis of 34 articles, yielding 27 studies that met the inclusion criteria. In meta-analysis, the failure rate for Onplants((R)) was 17.2% (95% CI: 5.9-35.8%), 10.5% for palatal implants (95% CI: 6.1-18.1%), 16.4% for miniscrews (95% CI: 13.4-20.1%) and 7.3% for miniplates (95% CI: 5.4-9.9%). Miniplates and palatal implants, representing torque-resisting temporary anchorage devices (TADs), when grouped together, showed a 1.92-fold (95% CI: 1.06-2.78) lower clinical failure rate than miniscrews.
CONCLUSION
Based on the available evidence in the literature, palatal implants and miniplates showed comparable survival rates of >or=90% over a period of at least 12 weeks, and yielded superior survival than miniscrews. Palatal implants and miniplates for temporary anchorage provide reliable absolute orthodontic anchorage. If the intended orthodontic treatment would require multiple miniscrew placement to provide adequate anchorage, the reliability of such systems is questionable. For patients who are undergoing extensive orthodontic treatment, force vectors may need to be varied or the roots of the teeth to be moved may need to slide past the anchors. In this context, palatal implants or miniplates should be the TADs of choice.
Topics: Confidence Intervals; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Humans; Orthodontic Anchorage Procedures; Poisson Distribution; Survival Rate; Time Factors
PubMed: 19793320
DOI: 10.1111/j.1600-0501.2009.01754.x