RESUMEN
STATEMENT OF PROBLEM: Quad zygomatic implants have been used as a treatment option for patients with a severely resorbed maxilla. However, data on the average rate of success of the prosthesis, survival of the zygomatic implants, and associated complications are sparse. PURPOSE: The purpose of this systematic review and meta-analysis was to assess prosthetic and zygomatic implant success of treating severe maxillary resorption with prostheses supported by 4 zygomatic implants, with an additional review on potential complications. MATERIAL AND METHODS: A comprehensive search of studies published in English between January 2001 and December 2020 was performed in the PubMed, OVID, EBSCO, and EMBASE databases according to the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO ID: CRD42021219468). The population, intervention, comparison, and outcome (PICO) question was "What is the effectiveness of oral rehabilitations using only 4 zygomatic implants placed in severely resorbed maxillae?" The search results were subjected to a systematic review for articles reporting prosthetic success and zygomatic implant survival. Prosthetic success was analyzed by using a fixed-effects inverse-variance model. The random-effects model was adopted for meta-analysis as moderate heterogeneity was identified among studies that reported implant survival in quad zygoma treatments. The quality of publications was appraised by using the Critical Appraisal Skills Program (CASP) checklists. RESULTS: Of the 82 titles, 7 studies that met the inclusion criteria without an overlap of patient cohorts were quantitatively analyzed for the average rate of prosthetic success and implant survival. All prostheses in the aggregated studies were immediately loaded with acrylic resin interim prostheses replaced by a definitive prosthesis, which consisted of overdentures retained by bar splinting (n=2), metal bar-reinforced prostheses (n=2), fixed screw-retained acrylic resin prostheses (n=34), and screw-retained titanium prostheses with ceramic or acrylic resin teeth (n=75). Technical complications of zygomatic implants included mobility associated with a machined surface and fracture of the abutment screw. The most common prosthetic complications reported were fracture of the definitive prosthesis and loss of the interim prosthesis subsequent to the failure of at least 1 zygomatic implant. The results showed that prostheses supported by quad zygoma implants displayed an overall success of 100% (CI=95%, I2=0.00%, P=.850), whereas zygomatic implants showed a survival rate of 98% (CI=95%, I2=60.48%, P=.040) with minimal implant failures and few complications. CONCLUSIONS: Although the data analysis showed favorable results for rehabilitating severely resorbed maxillae by using quad zygoma with high prosthetic success and high implant survival rate, further long-term clinical studies are required to strengthen the evidence. However, potential implant and prosthetic complications should be considered while planning this treatment approach.
RESUMEN
PURPOSE/OBJECTIVES: Social media platforms (SMPs) have become a popular portal for the acquisition and dissemination of dentistry-related information. The study aims to identify the pattern and influence SMPs for education and practice among dental trainees and professionals. METHOD AND MATERIALS: A cross-sectional study involving dental trainees and clinical professionals was conducted based on a structured 20-item survey instrument among dental trainees and professionals. The validated questionnaire was circulated among six dental training institutions in India through the internet-based application Google form and achieved a response rate of 60%. The questionnaire focused on identifying the usage of social media in disseminating dentistry-related content. The data from responders were extracted, sorted, and analyzed for descriptive analysis of various factors. RESULT: The survey revealed the most common SMP used for dentistry-related content as YouTube. The second most commonly used SMP was Facebook for professionals whereas it was Instagram for younger trainees. There was a highly significant difference between professionals and trainees concerning their sources of new information and the most commonly used SMP for dental education (p < 0.001). CONCLUSIONS: There is a growing consensus among young dental trainees and professionals on SMPs being an effective open access knowledge center. The survey results call for the need for a scientific journal and dental schools to have verified pages in social media to act as flagbearers of evidence-based dental practices. The potentials of SMPs in providing open access information collection to wider viewership across the globe and being a digital archive in attractive audio-visual forms can be used to strengthen the conventional educational model and improvise clinical practice.
