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Journal of Bone and Mineral Research :... Jan 2015This work provides a systematic review of the literature from January 2003 to April 2014 pertaining to the incidence, pathophysiology, diagnosis, and treatment of... (Review)
Review
This work provides a systematic review of the literature from January 2003 to April 2014 pertaining to the incidence, pathophysiology, diagnosis, and treatment of osteonecrosis of the jaw (ONJ), and offers recommendations for its management based on multidisciplinary international consensus. ONJ is associated with oncology-dose parenteral antiresorptive therapy of bisphosphonates (BP) and denosumab (Dmab). The incidence of ONJ is greatest in the oncology patient population (1% to 15%), where high doses of these medications are used at frequent intervals. In the osteoporosis patient population, the incidence of ONJ is estimated at 0.001% to 0.01%, marginally higher than the incidence in the general population (<0.001%). New insights into the pathophysiology of ONJ include antiresorptive effects of BPs and Dmab, effects of BPs on gamma delta T-cells and on monocyte and macrophage function, as well as the role of local bacterial infection, inflammation, and necrosis. Advances in imaging include the use of cone beam computerized tomography assessing cortical and cancellous architecture with lower radiation exposure, magnetic resonance imaging, bone scanning, and positron emission tomography, although plain films often suffice. Other risk factors for ONJ include glucocorticoid use, maxillary or mandibular bone surgery, poor oral hygiene, chronic inflammation, diabetes mellitus, ill-fitting dentures, as well as other drugs, including antiangiogenic agents. Prevention strategies for ONJ include elimination or stabilization of oral disease prior to initiation of antiresorptive agents, as well as maintenance of good oral hygiene. In those patients at high risk for the development of ONJ, including cancer patients receiving high-dose BP or Dmab therapy, consideration should be given to withholding antiresorptive therapy following extensive oral surgery until the surgical site heals with mature mucosal coverage. Management of ONJ is based on the stage of the disease, size of the lesions, and the presence of contributing drug therapy and comorbidity. Conservative therapy includes topical antibiotic oral rinses and systemic antibiotic therapy. Localized surgical debridement is indicated in advanced nonresponsive disease and has been successful. Early data have suggested enhanced osseous wound healing with teriparatide in those without contraindications for its use. Experimental therapy includes bone marrow stem cell intralesional transplantation, low-level laser therapy, local platelet-derived growth factor application, hyperbaric oxygen, and tissue grafting.
Topics: Antibodies, Monoclonal, Humanized; Bacterial Infections; Bisphosphonate-Associated Osteonecrosis of the Jaw; Cone-Beam Computed Tomography; Consensus; Denosumab; Diphosphonates; Humans; Macrophages; Mandible; Monocytes; Osteoporosis; Receptors, Antigen, T-Cell, gamma-delta; Risk Factors; T-Lymphocytes
PubMed: 25414052
DOI: 10.1002/jbmr.2405 -
Medicina (Kaunas, Lithuania) Dec 2021: Tobacco is today the single most preventable cause of death, being associated with countless diseases, including cancer and neurological, cardiovascular, and... (Meta-Analysis)
Meta-Analysis Review
: Tobacco is today the single most preventable cause of death, being associated with countless diseases, including cancer and neurological, cardiovascular, and respiratory diseases. Smoking also brings negative consequences to oral health, potentially impairing treatment with dental implants. The present review aimed to evaluate the influence of smoking on dental implant failure rates and marginal bone loss (MBL). : Electronic search was undertaken in three databases, plus a manual search of journals. Meta-analyses were performed, in addition to meta-regressions, in order to verify how the odds ratio (OR) and MBL were associated with follow-up time. : The review included 292 publications. Altogether, there were 35,511 and 114,597 implants placed in smokers and in non-smokers, respectively. Pairwise meta-analysis showed that implants in smokers had a higher failure risk in comparison with non-smokers (OR 2.402, < 0.001). The difference in implant failure between the groups was statistically significant in the maxilla (OR 2.910, < 0.001), as well as in the mandible (OR 2.866, < 0.001). The MBL mean difference (MD) between the groups was 0.580 mm ( < 0.001). There was an estimated decrease of 0.001 in OR ( = 0.566) and increase of 0.004 mm ( = 0.279) in the MBL MD between groups for every additional month of follow-up, although without statistical significance. Therefore, there was no clear influence of the follow-up on the effect size (OR) and on MBL MD between groups. : Implants placed in smokers present a 140.2% higher risk of failure than implants placed in non-smokers.
Topics: Dental Implants; Humans; Mandible; Maxilla; Smokers; Smoking
PubMed: 35056347
DOI: 10.3390/medicina58010039 -
Journal of Periodontology May 2019The aim of this systematic review and meta-analysis was to compare the clinical efficacy of the early dental implant placement protocol with immediate and delayed dental... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The aim of this systematic review and meta-analysis was to compare the clinical efficacy of the early dental implant placement protocol with immediate and delayed dental implant placement protocols.
METHODS
An electronic and manual search of literature was made to identify clinical studies comparing early implant placement with immediate or delayed placement. Data from the included studies were pooled and quantitative analyses were performed for the implant outcomes reported as the number of failed implants (primary outcome variable) and for changes in peri-implant marginal bone level, peri-implant probing depth, and peri-implant soft tissue level (secondary outcome variables).
RESULTS
Twelve studies met the inclusion criteria. Significant difference in risk of implant failure was found neither between the early and immediate placement protocols (risk difference = -0.018; 95% confidence interval [CI] = -0.06, 0.025; P = 0.416) nor between early and delayed placement protocols (risk difference = -0.008; 95% CI = -0.044, 0.028; P = 0.670). Pooled data of changes in peri-implant marginal bone level demonstrated significantly less marginal bone loss for implants placed using the early placement protocol compared with those placed in fresh extraction sockets (P = 0.001; weighted mean difference = -0.14 mm; 95% CI = -0.22, -0.05). No significant differences were found between the protocols for the other variables.
CONCLUSIONS
The available evidence supports the clinical efficacy of the early implant placement protocol. Present findings indicate that the early implant placement protocol results in implant outcomes similar to immediate and delayed placement protocols and a superior stability of peri-implant hard tissue compared with immediate implant placement.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Immediate Dental Implant Loading; Tooth Extraction; Tooth Socket; Treatment Outcome
PubMed: 30395355
DOI: 10.1002/JPER.18-0338 -
Journal of Periodontology Nov 2015There is a need for studying bone characteristics systematically for a better understanding of planning (i.e., timing of placement and loading) and outcomes of implant... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
There is a need for studying bone characteristics systematically for a better understanding of planning (i.e., timing of placement and loading) and outcomes of implant therapy. Therefore, the aim of the present review is to evaluate alveolar bone microarchitecture and its modifiers.
METHODS
Two independent reviewers conducted electronic and manual literature searches in several databases, including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Oral Health Group Trials Register, for articles published up to February 2015 reporting alveolar bone microstructure. The random-effect model was applied to calculate the weighted mean (WM) of total bone volume (TBV), which has a range from 0 to 1. TBV was stratified by anatomic locations, atrophic status, and types of specimens. Correlations between TBV and other bone-related parameters were also analyzed.
RESULTS
A total of 800 articles were initially identified. After abstract/full-text review, 24 articles were included in the systematic review, of which 23 were also included in the quantitative analysis. The WM TBV was 0.365 (95% confidence interval = 0.278 to 0.452), higher in the maxillary/mandibular anterior sites than the maxillary/mandibular posterior sites. However, great variations existed within each anatomic location. Additionally, WM TBV was lower in atrophic sites than non-atrophic sites. TBV was correlated negatively with trabecular spacing (R(2) = 0.11).
CONCLUSIONS
The present systematic review suggests that the TBV might not be different between the defined anatomic locations. However, the atrophy status might influence TBV.
Topics: Dental Implantation, Endosseous; Dental Implants; Humans; Mandible; Maxilla; Randomized Controlled Trials as Topic
PubMed: 26177631
DOI: 10.1902/jop.2015.150263 -
Journal of Indian Prosthodontic Society 2021This systematic review aimed to compare different attachment systems used in mandibular implant supported overdentures by assessing outcomes such as prosthodontic... (Meta-Analysis)
Meta-Analysis Review
AIM
This systematic review aimed to compare different attachment systems used in mandibular implant supported overdentures by assessing outcomes such as prosthodontic maintenance and complication, peri implant tissue changes, retention, and patient satisfaction for optimum selection of attachment system.
SETTINGS AND DESIGN
This systematic review conducted following Preferred Reporting Items for the Systematic Review and Meta Analysis (PRISMA) guidelines.
MATERIALS AND METHODS
A systematic electronic literature search was conducted through PubMed, The Cochrane Central Register of Controlled Trials (Central), and Science direct. A hand search was also performed for individual journals and reference lists of selected studies. Randomized controlled clinical trials and crossover clinical trials from 2010 to 2020 with follow up of more than 1 year were included. The Cochrane Collaboration's tool was used for assessing the risk of bias of included studies.
STATISTICAL ANALYSIS USED
The statistical meta analysis was performed using Review Manager (RevMan) [computer program]. Version 5.4. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboation, 2020.
RESULTS
Six studies that met the inclusion criteria possess the low risk of bias with follow up of more than 1 year were included in this systematic review. Out of four outcomes, meta analysis was performed for prosthodontic maintenance and peri implant tissue changes. Due to the limited availability of data, retention and patient satisfaction were reviewed systematically without meta analysis. The result of meta analysis for ball versus magnet attachment showed statistically significant differences in prosthodontic complications and maintenance, and ball attachment reported fewer complications than the locator attachment (risk ratio [RR] =0.55, confidence interval [CI] =95%, P = 0.03). Peri implant tissue changes were analyzed in the included studies as probing depth and marginal bone loss. The result of meta analysis for probing depth showed no statistically significant difference between bar versus telescopic type of attachment (RR = 0.20, CI = 95%, P = 0.74). The meta analysis results for marginal bone loss showed no statistically significant difference between bar versus telescopic type of attachment (mean difference = 0.35, CI = 95%, P = 0.10).
CONCLUSION
It can be concluded from the current review that bar attachment provided the most superior retention. The telescopic attachment system not only showed the most favorable patient's satisfaction but also reported the least peri implant mucosal changes. The ball attachment system is a favorable choice for limited inter arch space and parallel implant placement.
Topics: Cross-Over Studies; Denture, Overlay; Humans; Jaw, Edentulous; Mandible; Patient Satisfaction
PubMed: 34810359
DOI: 10.4103/jips.jips_158_21 -
International Journal of Implant... May 2022Placement of dental implants has evolved to be an advantageous treatment option for rehabilitation of the fully or partially edentulous mandible. In case of extensive... (Review)
Review
PURPOSE
Placement of dental implants has evolved to be an advantageous treatment option for rehabilitation of the fully or partially edentulous mandible. In case of extensive horizontal bone resorption, the bone volume needs to be augmented prior to or during implant placement in order to obtain dental rehabilitation and maximize implant survival and success.
METHODS
Our aim was to systematically review the available data on lateral augmentation techniques in the horizontally compromised mandible considering all grafting protocols using xenogeneic, synthetic, or allogeneic material. A computerized and manual literature search was performed for clinical studies (published January 1995 to March 2021).
RESULTS
Eight studies ultimately met the inclusion criteria comprising a total of 276 procedures of xenogeneic, allogeneic, or autogenous bone graft applications in horizontal ridge defects. Particulate materials as well as bone blocks were used as grafts with a mean follow-up of 26.0 months across all included studies. Outcome measures, approaches and materials varied from study to study. A gain of horizontal bone width of the mandible with a mean of 4.8 mm was observed in seven of eight studies. All but one study, reported low bone graft failure rates of 4.4% in average.
CONCLUSIONS
Only limited data are available on the impact of different horizontal augmentation strategies in the mandible. The results show outcomes for xenogeneic as well as autologous bone materials for horizontal ridge augmentation of the lower jaw. The use of allogeneic bone-block grafts in combination with resorbable barrier membranes must be re-evaluated. Randomized controlled clinical trials are largely missing.
Topics: Alveolar Ridge Augmentation; Bone Resorption; Bone Transplantation; Dental Implantation, Endosseous; Humans; Mandible
PubMed: 35532820
DOI: 10.1186/s40729-022-00421-7 -
Effect of alveolar ridge preservation after tooth extraction: a systematic review and meta-analysis.Journal of Dental Research Oct 2014Alveolar ridge preservation strategies are indicated to minimize the loss of ridge volume that typically follows tooth extraction. The aim of this systematic review was... (Meta-Analysis)
Meta-Analysis Review
Alveolar ridge preservation strategies are indicated to minimize the loss of ridge volume that typically follows tooth extraction. The aim of this systematic review was to determine the effect that socket filling with a bone grafting material has on the prevention of postextraction alveolar ridge volume loss as compared with tooth extraction alone in nonmolar teeth. Five electronic databases were searched to identify randomized clinical trials that fulfilled the eligibility criteria. Literature screening and article selection were conducted by 3 independent reviewers, while data extraction was performed by 2 independent reviewers. Outcome measures were mean horizontal ridge changes (buccolingual) and vertical ridge changes (midbuccal, midlingual, mesial, and distal). The influence of several variables of interest (i.e., flap elevation, membrane usage, and type of bone substitute employed) on the outcomes of ridge preservation therapy was explored via subgroup analyses. We found that alveolar ridge preservation is effective in limiting physiologic ridge reduction as compared with tooth extraction alone. The clinical magnitude of the effect was 1.89 mm (95% confidence interval [CI]: 1.41, 2.36; p < .001) in terms of buccolingual width, 2.07 mm (95% CI: 1.03, 3.12; p < .001) for midbuccal height, 1.18 mm (95% CI: 0.17, 2.19; p = .022) for midlingual height, 0.48 mm (95% CI: 0.18, 0.79; p = .002) for mesial height, and 0.24 mm (95% CI: -0.05, 0.53; p = .102) for distal height changes. Subgroup analyses revealed that flap elevation, the usage of a membrane, and the application of a xenograft or an allograft are associated with superior outcomes, particularly on midbuccal and midlingual height preservation.
Topics: Alveolar Bone Loss; Alveolar Process; Alveolar Ridge Augmentation; Bone Transplantation; Humans; Membranes, Artificial; Randomized Controlled Trials as Topic; Surgical Flaps; Tooth Extraction; Tooth Socket
PubMed: 24966231
DOI: 10.1177/0022034514541127 -
Clinical Oral Investigations Nov 2022This systematic review evaluated the available evidence regarding the skeletal, dentoalveolar, and soft tissue effects of orthodontic camouflage (OC) versus... (Review)
Review
OBJECTIVE
This systematic review evaluated the available evidence regarding the skeletal, dentoalveolar, and soft tissue effects of orthodontic camouflage (OC) versus orthodontic-orthognathic surgical (OOS) treatment in borderline class III malocclusion patients.
METHODS
Eligibility criteria. The included studies were clinical trials and/or follow-up observational studies (retrospective and prospective). Information sources. PubMed, Scopus, Science Direct, Web of Science, Cochrane, and LILACS were searched up to October 2021. Risk of bias. Downs and Black quality assessment checklist was used. Synthesis of results. The outcomes were the skeletal, dentoalveolar, and soft tissue changes obtained from pre- and post-cephalometric measurements.
RESULTS
Included studies. Out of 2089 retrieved articles, 6 were eligible and thus included in the subsequent analyses. Their overall risk of bias was moderate. Outcome results. The results are presented as pre- and post-treatment values or mean changes in both groups. Two studies reported significant retrusion of the maxillary and mandibular bases in OC, in contrast to significant maxillary protrusion and mandibular retrusion with increased ANB angle in OOS. Regarding the vertical jaw relation, one study reported a significant decrease in mandibular plane inclination in OC and a significant increase in OOS. Most of the included studies reported a significant proclination in the maxillary incisors in both groups. Three studies reported a significant proclination of the mandibular incisors in OOS, while four studies reported retroclination in OC.
CONCLUSION
Interpretation. The OSS has a protrusive effect on the maxillary base, retrusive effect on the mandibular base, and thus improvement in the sagittal relationship accompanied with a clockwise rotational effect on the mandibular plane. The OC has more proclination effect on the maxillary incisors and retroclination effect on the mandibular incisors compared to OOS. Limitation. Meta-analysis was not possible due to considerable variations among the included studies. Owing to the fact that some important data in the included studies were missing, conducting further studies with more standardized methodologies is highly urgent. Registration. The protocol for this systematic review was registered at the International Prospective Register of Systematic Reviews (PROSPERO, No.: CRD42020199591).
CLINICAL RELEVANCE
The common features including skeletal, dental, and soft tissue characteristics of borderline class III malocclusion cases make it more difficult to select the most appropriate treatment modality that can be either OC or OOS. The availability of high-level evidence-systematic reviews-makes the clinical decision much more clear and based on scientific basis rather than personal preference.
Topics: Humans; Retrospective Studies; Malocclusion, Angle Class III; Orthognathic Surgical Procedures; Cephalometry; Maxilla; Mandible; Malocclusion, Angle Class II
PubMed: 36098813
DOI: 10.1007/s00784-022-04685-6 -
Journal of Prosthodontic Research Jan 2022Dental implant therapy is a common clinical treatment for missing teeth. However, the esthetic result is not as satisfactory as expected in some cases, especially in the...
PURPOSE
Dental implant therapy is a common clinical treatment for missing teeth. However, the esthetic result is not as satisfactory as expected in some cases, especially in the anterior maxillary area. Poor esthetic results are caused by inadequate preparation of the hard and soft tissues in this area before treatment. The socket shield technique may be an alternative for a desirable esthetic outcome in dental implant treatments.
STUDY SELECTION
In the present systematic review, PubMed-Medline, Google Scholar, and ScienceDirect were searched for clinical studies published from January 2000 to December 2018.
RESULTS
Twenty studies were included, comprising one randomized controlled trial, two cohort studies, 14 clinical human case reports, and three retrospective case series. In total, 288 patients treated with the socket shield technique with immediate implant placement and follow-up between 3-60 months after placement were included. A quality assessment showed that 12 of the 20 included studies were of good quality. Twenty-six of the 274 (9.5%) cases developed complications or adverse effects related to the socket shield technique. Most studies reported implant survival without the complications (90.5%); most of the cases that were followed up for more than 12 months after implant placement achieved a good esthetic appearance. The failure rate was low without the complications, although there were some failures due to failed implant osseointegration, socket shield mobility and infection, socket shield exposure, socket shield migration, and apical root resorption.
CONCLUSIONS
The socket shield technique can be used in dental implant treatment, but it remains difficult to predict the long-term success of this technique until high-quality evidence becomes available.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Esthetics, Dental; Humans; Immediate Dental Implant Loading; Retrospective Studies; Tooth Extraction; Tooth Socket; Treatment Outcome
PubMed: 33692284
DOI: 10.2186/jpr.JPR_D_20_00054 -
Progress in Orthodontics Dec 2016In the view of the widespread acceptance of indefinite retention, it is important to determine the effects of fixed and removable orthodontic retainers on periodontal... (Review)
Review
OBJECTIVE
In the view of the widespread acceptance of indefinite retention, it is important to determine the effects of fixed and removable orthodontic retainers on periodontal health, survival and failure rates of retainers, cost-effectiveness, and impact of orthodontic retainers on patient-reported outcomes.
METHODS
A comprehensive literature search was undertaken based on a defined electronic and gray literature search strategy (
PROSPERO
CRD42015029169). The following databases were searched (up to October 2015); MEDLINE via OVID, PubMed, the Cochrane Central Register of Controlled Trials, LILACS, BBO, ClinicalTrials.gov, the National Research Register, and ProQuest Dissertation and Thesis database. Randomized and non-randomized controlled clinical trials, prospective cohort studies, and case series (minimum sample size of 20) with minimum follow-up periods of 6 months reporting periodontal health, survival and failure rates of retainers, cost-effectiveness, and impact of orthodontic retainers on patient-reported outcomes were identified. The Cochrane Collaboration's Risk of Bias tool and Newcastle-Ottawa Scale were used to assess the quality of included trials.
RESULTS
Twenty-four studies were identified, 18 randomized controlled trials and 6 prospective cohort studies. Of these, only 16 were deemed to be of high quality. Meta-analysis was unfeasible due to considerable clinical heterogeneity and variations in outcome measures. The mean failure risk for mandibular stainless steel fixed retainers bonded from canine to canine was 0.29 (95 % confidence interval [CI] 0.26, 0.33) and for those bonded to canines only was 0.25 (95 % CI: 0.16, 0.33). A meta-regression suggested that failure of fixed stainless steel mandibular retainers was not directly related to the period elapsed since placement (P = 0.938).
CONCLUSION
Further well-designed prospective studies are needed to elucidate the benefits and potential harms associated with orthodontic retainers.
Topics: Cost-Benefit Analysis; Humans; Mandible; Meta-Analysis as Topic; Non-Randomized Controlled Trials as Topic; Orthodontic Retainers; Orthodontics, Corrective; Periodontal Diseases; Randomized Controlled Trials as Topic; Stainless Steel; Treatment Outcome
PubMed: 27459974
DOI: 10.1186/s40510-016-0137-x