1
|
Ferrairo BM, de Azevedo-Silva LJ, Minim PR, Monteiro-Sousa RS, Pereira LF, Bitencourt SB, Cesar PF, Sidhu SK, Borges AFS. Biomechanical consideration in tooth-supported glass-ceramic restorations: A systematic review and meta-analysis of survival rates and irreparable failures. J Prosthet Dent 2024:S0022-3913(24)00357-3. [PMID: 38849264 DOI: 10.1016/j.prosdent.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 06/09/2024]
Abstract
STATEMENT OF PROBLEM Knowledge on the biomechanical behavior of glass-ceramics, their survival rate over time, and their potential failures is essential for decision-making in clinical practice. Systematic reviews and meta-analysis of their survival rates and irreparable failures are lacking. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate the survival rates and irreparable failures of various monolithic glass-ceramic dental restorations to help determine biomechanical indications. MATERIAL AND METHODS A comprehensive literature search was conducted across the PubMed, Scopus, Web of Science, and EMBASE databases based on the population, intervention, comparison, and outcome (PICO) question, risk of bias assessment, data extraction, subgroup analysis, and meta-analysis. Both randomized and nonrandomized clinical trials that reported survival rate and irreparable failure were screened. The risk, with a 95% confidence interval, was calculated by using the Mantel-Haenszel method. RESULTS A total of 46 articles met the inclusion criteria: 8 for laminate veneers, 20 for partial coverage restorations, 11 for single crowns, and 6 for fixed partial dentures, encompassing 1715 participants rehabilitated with 4209 restorations. The estimated cumulative survival rate for partial coverage restorations was 90% over an average span of 6.2 years, with an irreparable failure occurrence of n=5.9. Laminate veneers had a survival rate of 90.2% over 6.5 years, with an irreparable failure occurrence of n=8.2. Single crowns had a survival rate of 96% over 4.6 years and an irreparable failure of n=2.7. Conversely, fixed partial dentures had a survival rate of 76.1% over 6.5 years with an irreparable failure of n=5.2. CONCLUSIONS Glass-ceramic materials demonstrate relatively high survival rates, indicating that they provide a safe and reliable option for partial coverage restorations, laminate veneers, and single crowns. However, fixed partial dentures had a higher proportion of irreparable failures and a lower survival rate, and caution is required.
Collapse
Affiliation(s)
- Brunna M Ferrairo
- Postgraduate student, Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo (USP), Bauru, Brazil
| | - Lucas José de Azevedo-Silva
- Postgraduate student, Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo (USP), Bauru, Brazil
| | - Pedro R Minim
- Postgraduate student, Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo (USP), Bauru, Brazil
| | - Raphaelle S Monteiro-Sousa
- Postgraduate student, Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo (USP), Bauru, Brazil
| | - Leticia F Pereira
- Postgraduate student, Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo (USP), Bauru, Brazil
| | - Sandro B Bitencourt
- Professor, Department of Rehabilitative and Reconstructive Dentistry, School of Dentistry, University of Louisville, Louisville, Ky
| | - Paulo Francisco Cesar
- Associate Professor, Department of Biomaterials and Oral Biology, School of Dentistry, School of Dentistry, University of São Paulo (USP), Bauru, Brazil
| | - Sharanbir K Sidhu
- Full Professor, Institute of Dentistry, Queen Mary, University of London, London, England, UK
| | - Ana Flávia S Borges
- Associate Professor, Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo (USP), Bauru, Brazil.
| |
Collapse
|
2
|
Liang L, Wu X, Yan Q, Shi B. Are short implants (≤8.5 mm) reliable in the rehabilitation of completely edentulous patients: A systematic review and meta-analysis. J Prosthet Dent 2024; 131:826-832. [PMID: 35469646 DOI: 10.1016/j.prosdent.2022.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 02/16/2022] [Accepted: 02/16/2022] [Indexed: 11/21/2022]
Abstract
STATEMENT OF PROBLEM Limited data are available regarding the reliability of short implants (≤8.5 mm) in patients with resorbed completely edentulous jaws. PURPOSE The purpose of this systematic review and meta-analysis was to compare the clinical outcomes of short implants (intervention) versus long implants (≥10 mm, comparison) in the rehabilitation of completely edentulous jaws. MATERIAL AND METHODS The PubMed, Embase, and Cochrane CENTRAL databases were searched for randomized controlled trials (RCTs) comparing short and long implants supporting fixed or removable prostheses in completely edentulous jaws. Outcome measures included implant survival, marginal bone loss (MBL), and biological and technical complications. The risks of bias within and across the studies were assessed, and meta-analyses, sensitivity analyses, and subgroup analyses by types of prostheses, jaw locations, and follow-up length were performed. RESULTS A total of 4 RCTs with 158 participants were included. No significant difference was found between short implants and long implants regarding implant survival (RR=1.01, 95% CI: 0.97 to 1.05, P=.710, I2=70%) or MBL (MD=-0.19 mm, 95% CI: -0.39 to 0.02, P=.070, I2=94%). In subgroup analyses, when supporting fixed prostheses, short implants showed significantly less MBL than long implants (P<.001). In the mandible, short implants showed higher implant survival (P=.008) and less MBL (P<.001). Participants receiving long implants combined with bone augmentation procedures reported more postsurgery pain. CONCLUSIONS For completely edentulous jaws, short implants provide a reliable treatment alternative, as survival and MBL were not different when compared with those of long implants. However, additional high-level evidence is still needed to determine the long-term clinical outcomes of short implants in completely edentulous jaws.
Collapse
Affiliation(s)
- Liang Liang
- Graduate student, The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China; Department of Oral Implantology, Jianli Stomatology Hospital, Dongguan, PR China
| | - Xinyu Wu
- Graduate student, The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Qi Yan
- Lecturer, The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Bin Shi
- Professor, The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China.
| |
Collapse
|
3
|
Aliberti SM, Funk RHW, De Stefano M, Hoffmann T, Capunzo M. An epidemiological qualitative/quantitative SWOT-AHP analysis in order to highlight the positive or critical aspects of dental implants: A pilot study. Clin Exp Dent Res 2024; 10:e2836. [PMID: 38450945 PMCID: PMC10918715 DOI: 10.1002/cre2.836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 12/15/2023] [Accepted: 12/22/2023] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVES In recent years, dental implants are increasing in popularity due to their high success rate, demonstrated functionality, and aesthetic treatment results. Scientific research is very active in proposing improvements in the quality and survival of implants, taking into consideration various aspects. The objective of this study was to provide a holistic epidemiologic view of the state of dental implants, using a systematic approach based on a multimethod SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis and AHP (analytical hierarchical process) qualitative-quantitative analysis to identify the characteristics that can determine their success or failure. MATERIALS AND METHODS The study used the hybrid method of SWOT-AHP. RESULTS Analysis of the results showed that among strengths, the skill of the dentist was considered the most important factor, followed by the success of dental implants in the old people; among weaknesses, bruxism and chronic diseases were highlighted; for opportunities, biomechanical behavior, in terms of good mechanical strength and good tribological resistance to chemical and physical agents in the oral cavity, were considered the most important factors; finally, among threats, medical liability and biomechanical problems had equal weight. CONCLUSIONS This study applied a multimethod SWOT-AHP approach to bring out favorable or critical evidence on the topic of dental implants. In accordance with the result of the strategic vector identified in the Twisting zone Adjustment type section, showed that implant surgery is a widespread technique but always needs improvement to increase the likelihood of success and reduce the complications that can lead to implant failure.
Collapse
Affiliation(s)
- Silvana Mirella Aliberti
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”University of SalernoSalernoItaly
| | - Richard H. W. Funk
- Institute of AnatomyTechnische Universität (TU) DresdenDresdenGermany
- Division of Preventive MedicineDresden International University (DIU)DresdenGermany
| | - Marco De Stefano
- Department of Industrial EngineeringUniversity of SalernoSalernoItaly
| | - Thomas Hoffmann
- Division of Preventive MedicineDresden International University (DIU)DresdenGermany
| | - Mario Capunzo
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”University of SalernoSalernoItaly
| |
Collapse
|
4
|
Bonfante EA, Calamita M, Bergamo ETP. Indirect restorative systems-A narrative review. J ESTHET RESTOR DENT 2023; 35:84-104. [PMID: 36688803 DOI: 10.1111/jerd.13016] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The background and clinical understanding of the properties of currently available indirect restorative systems and fabrication methods is, along with manufacturer and evidence-based literature, an important starting point to guide the clinical selection of materials for tooth and/or implant supported reconstructions. Therefore, this review explores most indirect restorative systems available in the market, especially all-ceramic, along with aspects of manufacturing process, clinical survival rates, and esthetic outcomes. OVERVIEW Progressive incorporation of new technologies in the dental field and advancements in materials science have enabled the development/improvement of indirect restorative systems and treatment concepts in oral rehabilitation, resulting in reliable and predictable workflows and successful esthetic and functional outcomes. Indirect restorative systems have evolved from metal ceramics and polymers to glass ceramics, polycrystalline ceramics, and resin-matrix ceramics, aiming to improve not only biological and mechanical properties, but especially the optical properties and esthetic quality of the reconstructions, in attempt to mimic natural teeth. CONCLUSIONS Based on several clinical research, materials, and patient-related parameters, a decision tree for the selection of indirect restorative materials was suggested to guide clinicians in the rehabilitation process. CLINICAL SIGNIFICANCE The pace of materials development is faster than that of clinical research aimed to support their use. Since no single material provides an ideal solution to every case, professionals must continuously seek information from well designed, long-term clinical trials in order to incorporate or not new materials and technological advancements.
Collapse
Affiliation(s)
- Estevam A Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry - University of São Paulo, Bauru, SP, Brazil
| | - Marcelo Calamita
- Department of Restorative Dental Sciences at the University of Florida, Gainesville, Florida, USA
| | - Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry - University of São Paulo, Bauru, SP, Brazil
| |
Collapse
|
5
|
Insertion Torque, Removal Torque, and Resonance Frequency Analysis Values of Ultrashort, Short, and Standard Dental Implants: An In Vitro Study on Polyurethane Foam Sheets. J Funct Biomater 2022; 14:jfb14010010. [PMID: 36662057 PMCID: PMC9866818 DOI: 10.3390/jfb14010010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 12/25/2022] Open
Abstract
Short implants were introduced to reduce morbidity, treatment duration, and complex bone regeneration interventions in atrophic jaws and to improve patient-reported outcomes. This study aimed to determine the insertion torque (IT), removal torque (RT), and resonance frequency analysis (RFA) values of ultrashort (3 mm length), short (7 mm length), and standard implants (10 mm length) inserted in 1-, 2-, 3-, and 4-mm thickness polyurethane sheets with densities of 10, 20, and 30 pounds per cubic foot (PCF). Standard-length implants were the gold standard (control). Overall, short-length implant IT values were higher or similar to the control in most experimental conditions. Those inserted into a 3 mm/30 PCF lamina showed the highest IT values, whereas 5 mm diameter ultrashort-length implants inserted into 2 and 3 mm/20 PCF laminas were higher than other implants. RT values followed the same trend and RFA values were more appreciable in short- and standard-length implants in all the scenarios. However, ultrashort-length implants reached a primary stability comparable to that of standard implants in lower thicknesses. In conclusion, although further studies are needed to corroborate this in vitro model with preclinical and clinical studies, our data shed light on short- and ultrashort-length implants geometries to a potential application in critical atrophy of the posterior jaws.
Collapse
|
6
|
Cheng YC, Bergamo ETP, Murcko L, Hirayama M, Perpetuini P, Speratti D, Bonfante EA. Fiber-reinforced composite partial fixed dental prostheses supported by short or extra-short implants: A 10 year retrospective study. Clin Implant Dent Relat Res 2022; 24:854-861. [PMID: 36205843 DOI: 10.1111/cid.13133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 09/04/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION This study evaluated the 10-year survival and success of partial fixed dental prostheses (P-FDPs) fabricated with a milled fiber-reinforced composite (FRC) framework, supported by short or extra-short implants. METHODS Patients restored with FRC P-FDPs supported by short or extra-short implants were included in this retrospective study. Kaplan-Meier analysis was used to calculate the survival and success rates of the prostheses. Univariate and multivariate Cox regression models, clustered to adjust for multiple implants and prostheses being placed in the same patient, were used to correlate changes in peri-implant bone levels with patient, implant, and prosthesis-related covariates. RESULTS This study followed 121 FRC P-FDPs supported by 261 implants, placed in 96 patients. At 118 months in function, the P-FDP survival rate was 95.9% (95% CI: 87.5%-98.7%), and the success rate was 89.8% (95%CI: 80.4%-94.8%). Differences in prosthesis span length, abutment/pontic ratio, and the presence of distal extensions (cantilevers) did not affect the prosthetic outcomes. Bone levels around implants were stable, with an average rate of change of -0.01 ± 0.05 mm/month. Cox regression revealed that grafted sites were correlated with peri-implant bone loss, while longer prosthetic spans were correlated with bone gain. CONCLUSION P-FDPs comprised of milled fiber-reinforced composite frameworks, supported by short and extra-short implants, had high survival and success rates for up to 10 years.
Collapse
Affiliation(s)
- Yu-Chi Cheng
- Department of Biology, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of Sao Paulo-Bauru School of Dentistry, Bauru, Brazil
| | - Laura Murcko
- Implant Dentistry Centre, Boston, Massachusetts, USA
| | | | | | | | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of Sao Paulo-Bauru School of Dentistry, Bauru, Brazil
| |
Collapse
|
7
|
Kihara H, Hatakeyama W, Kondo H, Yamamori T, Baba K. Current complications and issues of implant superstructure. J Oral Sci 2022; 64:257-262. [PMID: 35989295 DOI: 10.2334/josnusd.21-0534] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The purpose of this review is to search for complications of dental implant superstructures and consider the issues involved. This narrative review was performed by searching through PubMed databases and review articles that were published after 1990. Misfitting of the superstructure can result in loosening of screws, reduced preload, and in some cases, significant stress around the implant. External connection modalities and single implant prostheses have been reported to have more loose or broken abutment screws. In addition, when zirconia abutment was used for platform shifting, the rate of fracture of the abutment was considered to be high. Additionally, it was reported that men were significantly at an increased risk of abutment fracture. As for the retention mechanism of implant overdenture, stud attachment (Locator type) should receive more attention to wear and damage of retention parts than other attachments. The causes of the complications of implant superstructures have not been clarified in some cases, and further verification is required. Verification of complications is considered important to obtain a long-term prognosis for superstructures of implants. It will be necessary to further verify complications of implants in the future.
Collapse
Affiliation(s)
- Hidemichi Kihara
- Department of Prosthodontics and Oral Implantology, Iwate Medical University School of Dentistry
| | - Wataru Hatakeyama
- Department of Prosthodontics and Oral Implantology, Iwate Medical University School of Dentistry
| | - Hisatomo Kondo
- Department of Prosthodontics and Oral Implantology, Iwate Medical University School of Dentistry
| | - Tetsuo Yamamori
- Department of Prosthetic Dentistry, Ohu University School of Dentistry
| | - Kazuyoshi Baba
- Department of Prosthodontics, Showa University School of Dentistry
| |
Collapse
|
8
|
Seelig da Cunha K, De Lima Coltro MP, Drummond LG, Ozkomur A, Villarinho EA, Teixeira ER, Vigo Á, Shinkai RSA. Biomechanical variables affect peri-implant bone loss in implant-supported fixed complete dentures: a methodological and prospective study. J Prosthodont Res 2022; 67:173-179. [PMID: 35613872 DOI: 10.2186/jpr.jpr_d_21_00254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE Implant-supported fixed complete dentures (IFCD) experience failures and complications related to biological and technical risk factors. This study investigated the effect of biomechanical variables of IFCD on 1-year peri-implant bone loss at the buccal, palatal/lingual, mesial, and distal implant sides. A new method was used to measure the geometric biomechanical variables of IFCD using cone beam computed tomography (CBCT). METHODS The study sample consisted of 246 external hexagon implants supporting 48 hybrid IFCD in 44 patients. CBCT images obtained immediately (T0) and 1 year (T1) after prosthesis installation were used to measure the support polygon area, clinical crown/implant (C/I) ratio (vertical lever), anteroposterior power and resistance arms, anterior and posterior cantilevers (horizontal levers), and peri-implant bone remodeling (T1-T0). Data were analyzed using multilevel multivariable models. RESULTS The average total bone loss in the mandible and maxilla were 0.88 mm, with a loss of 0.62 mm in the mandible and 1.08 mm in the maxilla. The C/I ratio had a significant effect on bone loss on the mesial, distal, and palatal/lingual sides (P <.05). The anterior cantilever had a protective effect on the lingual side of the anterior implant. No effect on bone loss was found for the support polygon area, posterior cantilever, resistance arm, or power arm (P >.05). CONCLUSIONS The results suggest that the C/I ratio and anterior cantilever in IFCD affect peri-implant bone loss according to the implant side and position in the arch.
Collapse
Affiliation(s)
- Kael Seelig da Cunha
- Pontifical Catholic University of Rio Grande do Sul, Post-graduate Program in Dentistry, Porto Alegre, Brazil
| | - Maria Paula De Lima Coltro
- Pontifical Catholic University of Rio Grande do Sul, Post-graduate Program in Dentistry, Porto Alegre, Brazil
| | | | - Ahmet Ozkomur
- Lutheran University of Brazil, Post-graduate Program in Dentistry, Canoas, Brazil
| | - Eduardo Aydos Villarinho
- Pontifical Catholic University of Rio Grande do Sul, Post-graduate Program in Dentistry, Porto Alegre, Brazil
| | | | - Álvaro Vigo
- Federal University of Rio Grande do Sul, Post-graduate Program in Epidemiology, Porto Alegre, Brazil
| | - Rosemary S A Shinkai
- Pontifical Catholic University of Rio Grande do Sul, Post-graduate Program in Dentistry, Porto Alegre, Brazil.,University of São Paulo, School of Dentistry, São Paulo, Brazil
| |
Collapse
|
9
|
Afrashtehfar KI, Moawad RA, F.-Eddin AW, Wang HL. Mandibular full-arch fixed prostheses supported by three-dental-implants: A protocol of an overview of reviews. PLoS One 2022; 17:e0265491. [PMID: 35377903 PMCID: PMC8979460 DOI: 10.1371/journal.pone.0265491] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/16/2022] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION To minimize trauma and cost of treatment, oral health practitioners have successfully rehabilitated full arches by supporting the prostheses on four implants. However, there is no consensus whether less than four implants supporting full mandibular arches would provide similar clinical outcomes to other well-established all-on-four alternative. OBJECTIVE To identify, summarize, appraise, and compare the clinical outcomes evidence of three-implant fixed full-arch prostheses in completely edentulous mandibular patients. MATERIALS AND METHODS This overview of systematic reviews (OoSRs) will include secondary synthesis studies (i.e., systematic reviews with or without a meta-analysis). A three-step search strategy will be conducted in MEDLINE (Ovid), EMBASE (Ovid), Cochrane Database of Systematic Reviews, Scopus, Web of Science (WoS Core Collection), and Google Scholar. Grey literature and a manual search in 12 specialized journals will also be conducted. Three independent reviewers will screen all retrieved articles for eligibility, extract data and assess the methodological quality of the included studies. The results will be presented as tables or narrative synthesis. The studies will be evaluated for risk of bias by ROBIS and methodology quality by the AMSTAR-2 tool. If new primary studies are identified, a meta-analysis will be conducted. Certainty of the evidence will be assessed to answer the following focused research question: In edentulous mandibular patients, what are the implant and prostheses clinical outcomes of three-implant fixed full-arch prostheses compared to other all-on-x solutions? DISCUSSION There are some systematic reviews about the use of fixed complete dental prostheses supported by three implants; however, their clinical outcomes related to the other all-on-four plus solutions are conflicting. So, an overview on this topic is required to provide recommendations. REVIEW REGISTRATION NUMBER International prospective register of systematic reviews (PROSPERO) ID#: CRD42021262175. National Institute for Health Research (NIHR) and Centre for Reviews and Dissemination, University of York, York, United Kingdom.
Collapse
Affiliation(s)
- Kelvin I. Afrashtehfar
- Evidence-Based Practice Unit, Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City, Ajman Emirate, UAE
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, Bern, Switzerland
- Centre of Medical and Bio-allied Health Sciences Research (CMBHSR), Ajman University, Dubai, City of Gold, UAE
- * E-mail:
| | - Rosalin A. Moawad
- Evidence-Based Practice Unit, Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City, Ajman Emirate, UAE
| | - Afaf W. F.-Eddin
- Evidence-Based Practice Unit, Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City, Ajman Emirate, UAE
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
| |
Collapse
|
10
|
de Oliveira Fernandes GV, Costa BMGN, Trindade HF, Castilho RM, Fernandes JCH. Comparative analysis between extra‐short implants (≤ 6mm) and 6mm‐longer implants: A
Meta‐Analysis
of Randomized Controlled Trial. Aust Dent J 2022; 67:194-211. [DOI: 10.1111/adj.12900] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2022] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | - Rogerio M. Castilho
- University of Michigan Periodontics and Oral Medicine Department Ann Arbor Michigan U.S.A
| | | |
Collapse
|
11
|
Ala LAB, Nogueira TE, Leles CR. One-year prospective study on single short (7-mm) implant overdentures in patients with severely resorbed mandibles. Clin Oral Implants Res 2021; 33:291-301. [PMID: 34951501 DOI: 10.1111/clr.13887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 12/02/2021] [Accepted: 12/19/2021] [Indexed: 01/15/2023]
Abstract
OBJECTIVE This prospective study aimed to assess the effectiveness of using a single short implant to retain a single-implant mandibular overdenture (SIMO) in participants with severely atrophic edentulous mandibles. MATERIAL AND METHODS The study sample included 18 edentulous participants with severely resorbed mandibular ridges and limited bone height in the symphyseal region sufficient for the insertion of a 7.0-mm-height implant. First, patients received new conventional dentures or had their dentures relined, followed by the insertion of a 3.75 x 7 mm morse-taper implant, and the incorporation of a stud-type attachment and a nylon retentive insert after a 3-month healing period. Implant stability quotient (ISQ) was measured at baseline and after 3 and 12 months. Patient-reported outcomes (satisfaction with the dentures and oral health-related quality of life) were assessed before implant placement and at the 3-, 6-, and 12-month follow-ups. Clinical-radiographic outcomes and the incidence of prosthodontic events were assessed throughout the follow-up period. RESULTS The implant survival rate was 100%. ISQ increased from baseline (72.7 ± 6.6) to the 3-month (82.0 ± 3.3) and 1-year (85.4 ± 2.9) follow-ups (p < .001). After 1 year, satisfaction with the mandibular prosthesis increased significantly, and the overall OHIP-Edent score decreased by 79.2%. No effects were found for the maxillary denture (p = .420). Due to dissatisfaction with treatment, two participants (11.1%) required additional implants after the 1-year follow-up and were considered as prosthodontic failures. CONCLUSION Single-implant mandibular overdenture retained by a short implant showed favorable outcomes after 1 year. Further studies with larger samples and longer follow-up periods are needed to confirm the findings of this single-group prospective study. The present study was registered at the Brazilian Clinical Trials Registry (REBEC), identifier RBR-7p2xmg. The trial registry occurred during the study execution, and its final approval was delayed because of several formatting adequacies required by the platform REBEC.
Collapse
Affiliation(s)
| | - Túlio Eduardo Nogueira
- Department of Oral Rehabilitation, Faculty of Dentistry, Federal University of Goias, Goiânia, Brazil
| | - Cláudio Rodrigues Leles
- Department of Oral Rehabilitation, Faculty of Dentistry, Federal University of Goias, Goiânia, Brazil
| |
Collapse
|
12
|
Yu X, Xu R, Zhang Z, Yang Y, Deng F. A meta-analysis indicating extra-short implants (≤ 6 mm) as an alternative to longer implants (≥ 8 mm) with bone augmentation. Sci Rep 2021; 11:8152. [PMID: 33854095 PMCID: PMC8047002 DOI: 10.1038/s41598-021-87507-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 03/30/2021] [Indexed: 12/28/2022] Open
Abstract
Extra-short implants, of which clinical outcomes remain controversial, are becoming a potential option rather than long implants with bone augmentation in atrophic partially or totally edentulous jaws. The aim of this study was to compare the clinical outcomes and complications between extra-short implants (≤ 6 mm) and longer implants (≥ 8 mm), with and without bone augmentation procedures. Electronic (via PubMed, Web of Science, EMBASE, Cochrane Library) and manual searches were performed for articles published prior to November 2020. Only randomized controlled trials (RCTs) comparing extra-short implants and longer implants in the same study reporting survival rate with an observation period at least 1 year were selected. Data extraction and methodological quality (AMSTAR-2) was assessed by 2 authors independently. A quantitative meta-analysis was performed to compare the survival rate, marginal bone loss (MBL), biological and prosthesis complication rate. Risk of bias was assessed with the Cochrane risk of bias tool 2 and the quality of evidence was determined with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. 21 RCTs were included, among which two were prior registered and 14 adhered to the CONSORT statement. No significant difference was found in the survival rate between extra-short and longer implant at 1- and 3-years follow-up (RR: 1.002, CI 0.981 to 1.024, P = 0.856 at 1 year; RR: 0.996, CI 0.968 to 1.025, P = 0.772 at 3 years, moderate quality), while longer implants had significantly higher survival rate than extra-short implants (RR: 0.970, CI 0.944 to 0.997, P < 0.05) at 5 years. Interestingly, no significant difference was observed when bone augmentations were performed at 5 years (RR: 0.977, CI 0.945 to 1.010, P = 0.171 for reconstructed bone; RR: 0.955, CI 0.912 to 0.999, P < 0.05 for native bone). Both the MBL (from implant placement) (WMD: - 0.22, CI - 0.277 to - 0.164, P < 0.01, low quality) and biological complications rate (RR: 0.321, CI 0.243 to 0.422, P < 0.01, moderate quality) preferred extra-short implants. However, there was no significant difference in terms of MBL (from prosthesis restoration) (WMD: 0.016, CI - 0.036 to 0.068, P = 0.555, moderate quality) or prosthesis complications rate (RR: 1.308, CI 0.893 to 1.915, P = 0.168, moderate quality). The placement of extra-short implants could be an acceptable alternative to longer implants in atrophic posterior arch. Further high-quality RCTs with a long follow-up period are required to corroborate the present outcomes.Registration number The review protocol was registered with PROSPERO (CRD42020155342).
Collapse
Affiliation(s)
- Xiaoran Yu
- Department of Oral Implantology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Ling Yuan Xi Road, Guangzhou, 510006, Guangdong, People's Republic of China.,Guangdong Provincial Key Laboratory of Stomatology, 74 Zhong Shan Er Road, Guangzhou, 510006, Guangdong, People's Republic of China
| | - Ruogu Xu
- Department of Oral Implantology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Ling Yuan Xi Road, Guangzhou, 510006, Guangdong, People's Republic of China.,Guangdong Provincial Key Laboratory of Stomatology, 74 Zhong Shan Er Road, Guangzhou, 510006, Guangdong, People's Republic of China
| | - Zhengchuan Zhang
- Department of Oral Implantology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Ling Yuan Xi Road, Guangzhou, 510006, Guangdong, People's Republic of China.,Guangdong Provincial Key Laboratory of Stomatology, 74 Zhong Shan Er Road, Guangzhou, 510006, Guangdong, People's Republic of China
| | - Yang Yang
- Department of Oral Implantology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Ling Yuan Xi Road, Guangzhou, 510006, Guangdong, People's Republic of China.,Guangdong Provincial Key Laboratory of Stomatology, 74 Zhong Shan Er Road, Guangzhou, 510006, Guangdong, People's Republic of China
| | - Feilong Deng
- Department of Oral Implantology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Ling Yuan Xi Road, Guangzhou, 510006, Guangdong, People's Republic of China. .,Guangdong Provincial Key Laboratory of Stomatology, 74 Zhong Shan Er Road, Guangzhou, 510006, Guangdong, People's Republic of China.
| |
Collapse
|
13
|
Sánchez-Labrador L, Molinero-Mourelle P, Cortés-Bretón Brinkmann J, Prados-Frutos JC, Gómez-Polo M, Martínez-González JM. Clinical Behavior and Complications of Mandibular Full-Arch Fixed Dental Prostheses Supported by Three Dental Implants. A Systematic Review and Meta-Analysis. BIOLOGY 2021; 10:308. [PMID: 33917787 PMCID: PMC8068140 DOI: 10.3390/biology10040308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 11/17/2022]
Abstract
This systematic review and meta-analysis set out to assess the clinical behavior of mandibular implant-supported fixed complete dental prostheses (ISFCDP) on three dental implants by analyzing implant and prosthetic survival rates, marginal bone loss, biological/technical complications, and patient-reported outcomes. The review was conducted according to PRISMA guidelines. Electronic searches were conducted in the Medline (PubMed), Web of Science, and Cochrane databases, complimented by a manual search in specialist journals for relevant articles published up to February 2021. The Newcastle-Ottawa Quality Assessment Scale tool was used to assess the quality of evidence in the studies reviewed. The study included 13 articles with 728 patients treated with 2184 implants. A mean implant survival rate of 95.9% (95% CI: 94.6-97.3%) and a prosthetic survival rate of 97.0% (95% CI: 95.7-98.3%) were obtained over 1-6-year follow-up periods. Mandibular implant-supported fixed complete dental prostheses on three dental implants would appear to be a viable option for restoring the edentulous mandible in comparison with mandibular ISFCDP on more than three implants. Further comparative studies are needed, with adequate protocols, as well as sufficient sample sizes and follow-up periods to confirm these findings.
Collapse
Affiliation(s)
- Luis Sánchez-Labrador
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (L.S.-L.); (J.M.M.-G.)
| | - Pedro Molinero-Mourelle
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (P.M.-M.); (M.G.-P.)
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Jorge Cortés-Bretón Brinkmann
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (L.S.-L.); (J.M.M.-G.)
| | - Juan Carlos Prados-Frutos
- Department of Medical Specialties and Public Health, Rey Juan Carlos University, 28922 Madrid, Spain;
- IDIBO GROUP (Group of High-Performance Research, Development and Innovation in Dental Biomaterials), Department of Medical Specialties and Public Health, Rey Juan Carlos University, 28922 Madrid, Spain
| | - Miguel Gómez-Polo
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (P.M.-M.); (M.G.-P.)
| | - José María Martínez-González
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (L.S.-L.); (J.M.M.-G.)
| |
Collapse
|
14
|
Mazza LC, Lemos CAA, Pesqueira AA, Pellizzer EP. Survival and complications of monolithic ceramic for tooth-supported fixed dental prostheses: A systematic review and meta-analysis. J Prosthet Dent 2021; 128:566-574. [PMID: 33745685 DOI: 10.1016/j.prosdent.2021.01.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 01/11/2023]
Abstract
STATEMENT OF PROBLEM Although recent studies have reported the success of implant-supported monolithic restorations, consensus on the use of monolithic ceramic restorations is lacking. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate the survival and biological and technical complication rates of monolithic single crowns and fixed partial dentures (FPDs). MATERIAL AND METHODS An electronic search was conducted by 2 independent authors on the PubMed/MEDLINE, Scopus, and Cochrane Library databases. The Newcastle-Ottawa scale and Cochrane risk of bias tool were used to assess the quality and risk of bias of the included studies. Meta-analysis was performed by using the R software program. RESULTS The search identified 763 articles, 18 of which met the eligibility criteria. A total of 15 studies evaluated monolithic ceramic single crowns, and 4 studies evaluated FPDs. The studies included 1061 monolithic single crowns (524 lithium disilicate, 461 zirconia, and 76 polymer-infiltrated ceramic network [PICN]) and 104 FPDs (36 lithium disilicate and 68 zirconia). Meta-analysis of single-arm studies indicated the proportion of survival, biological, and technical complication rates of 1% (95% confidence interval [CI]: 0% to 3%), 1% (CI: 0% to 4%), and 2% (CI: 1% to 4%), respectively, for single crowns, independent of ceramic material, and 3% (CI: 0% to 34%), 5% (CI: 1% to 21%), and 5% (CI: 1% to 21%) for FPDs, respectively. Only 5 studies performed a direct comparison between monolithic and veneered ceramic restorations, and no significant difference was observed in terms of survival (risk ratio [RR]: 0.68; CI: 0.25-1.91; P=.96), biological (RR: 0.69; CI: 0.31-1.53; P=.35), and technical complication rates (RR: 0.87; CI: 0.40-1.88; P=.29). CONCLUSIONS The use of monolithic ceramic can be considered a favorable treatment for tooth-supported single crowns and FPDs, with high survival and low complication rates. However, further randomized controlled trials are needed to reassess these clinical performances, mainly by comparing them with the performance of veneered restorations.
Collapse
Affiliation(s)
- Letícia Cerri Mazza
- MSc student, São Paulo State University (UNESP), School of Dentistry, Department of Dental Materials and Prosthodontics, Araçatuba, Sao Paulo, Brazil
| | - Cleidiel Aparecido Araujo Lemos
- Adjunct Professor, Division of Prosthodontics, Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Aldiéris Alves Pesqueira
- Assistant Professor, São Paulo State University (UNESP), School of Dentistry, Department of Dental Materials and Prosthodontics, Araçatuba, Sao Paulo, Brazil.
| | - Eduardo Piza Pellizzer
- Titular Professor, São Paulo State University (UNESP), School of Dentistry, Department of Dental Materials and Prosthodontics, Araçatuba, Sao Paulo, Brazil
| |
Collapse
|
15
|
Comparative Analysis of Peri-Implant Bone Loss in Extra-Short, Short, and Conventional Implants. A 3-Year Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249278. [PMID: 33322472 PMCID: PMC7764541 DOI: 10.3390/ijerph17249278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/02/2020] [Accepted: 12/09/2020] [Indexed: 02/02/2023]
Abstract
Objective: To evaluate the influence of implant length on marginal bone loss, comparing implants of 4 mm, 6 mm, and >8 mm, supporting two splinted crowns after 36-month functional loading. Materials and Methods: this retrospective clinical trial evaluated the peri-implant behavior of splinted crowns (two per case) on pairs of implants of the same length placed in the posterior maxilla (molar area). Implants were divided into three groups according to length (Group 1: extra-short 4 mm; Group 2: short 6 mm; Group 3: conventional length >8 mm). Marginal bone loss was analyzed using standardized periapical radiographs at the time of loading and 36 months later. Results: 24 patients (19 women and 5 men) were divided into three groups, eight rehabilitations per group, in the position of the maxillary first and second molars. The 48 Straumann® Standard Plus (Regular Neck (RN)/Wide Neck (WN)) implants were examined after 36 months of functional loading. Statistical analysis found no significant differences in bone loss between the three groups (p = 0.421). No implant suffered biological complications or implant loss. Long implants were associated with less radiographic bone loss. Conclusions: extra-short (4 mm); short (6 mm); and conventional length (>8 mm) implants in the posterior maxilla present similar peri-implant bone loss and 100% survival rates in rehabilitation, by means of two splinted crowns after 36 months of functional loading. Implants placed in posterior positions present better bone loss results than implants placed in anterior positions, regardless of the interproximal area where bone loss is measured. Conventional length (>8 mm) implants show better behavior in terms of distal bone loss than short (6 mm) and extra-short (4 mm) implants.
Collapse
|
16
|
Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2020; 124:274-349. [PMID: 32811666 DOI: 10.1016/j.prosdent.2020.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 01/20/2023]
Abstract
This comprehensive review of the 2019 restorative dental literature is offered to inform busy dentists regarding remarkable publications and noteworthy progress made in the profession. Developed by the Scientific Investigation Committee of the American Academy of Restorative Dentistry, each author brings discipline-specific expertise to 1 of 8 sections of the report: (1) prosthodontics; (2) periodontics, alveolar bone, and peri-implant tissues; (3) implant dentistry; (4) dental materials and therapeutics; (5) occlusion and temporomandibular disorders; (6) sleep-related breathing disorders; (7) oral medicine and oral and maxillofacial surgery; and (8) dental caries and cariology. The report targets important information likely to influence day-to-day dental treatment decisions. Each review is not intended to stand alone but to update interested readers so that they may visit source material when greater detail is desired. As the profession moves toward evidence-based clinical decision-making, an incredible volume of potentially valuable dental literature continues to increase. It is the intention of this review and its authors to provide assistance in negotiating the extensive dental literature published in 2019. It is our hope that readers find this work useful in the clinical management of dental patients.
Collapse
|