Analgesic potential of transdermal nicotine patch in surgery: a systematic review and meta-analysis of randomised placebo-controlled trials.

OBJECTIVES: We aimed (1) to systematically review the efficacy of transdermal nicotine patches (NP) for postoperative analgesia, (2) to establish the current quality of evidence and assist clinical decision-making on the subject, and (3) to identify methodological limitations and the need for more well-designed studies. MATERIALS AND METHODS: We searched six electronic databases, protocol records, and other sources without date or language restriction until March 2022. To develop the search strategy, we formulated a clinical question by using the PICOD method. Eligibility criteria included randomised placebo-controlled trials on the analgesic potential of NP for surgical procedures. This systematic review followed the PRISMA 2020 statement, and we registered the protocol in PROSPERO (#CRD42020205956). RESULTS: We included 10 randomised placebo-controlled trials (535 patients). The NP administered before induction of anaesthesia and at beginning of surgery reduced the pain immediately after surgery (-0.38; 95% confidence interval [CI]: -0.73 to -0.02), and 6 h (-0.34; 95% CI: -0.68 to -0.01), 12 h (-0.43; 95% CI: -0.71 to -0.15) and 24 h (-0.35; 95%CI: -0.59 to -0.10) after surgery, compared with the placebo patch (PP) group. Sensitivity testing suggests that opioid use could underestimate NP analgesia. Late demand for the first analgesic and consumption of rescue analgesics tended to be lower in the NP group. CONCLUSIONS: The current findings suggest, with low certainty of evidence, the analgesic potential of NP for surgical procedures. CLINICAL RELEVANCE: Perioperative use of NP significantly improved postoperative pain, even when opioids were administered or prescribed. Nevertheless, the clinical relevance should be interpreted with caution, owing to the effect sizes of the summary measures and methodological issues. The analgesic potential of NP as an adjuvant therapy to regulate pain and acute inflammation may offer certain clinical advantages, thus warranting further investigation.

Workflow for complete dentures fabrication in three appointments: A dental technique.

This technical report describes a novel workflow for complete denture fabrication designed to abbreviate the necessary steps for dental prostheses delivery by using a 3-appointment protocol in which preliminary impressions are made in the first session together with the registration of maxillary lip support, occlusal plane, and reference lines for tooth arrangement. A trial denture is fabricated with conventional or computer-aided design and computer-aided manufacturing procedures and is evaluated in the second appointment for esthetics, the definitive impression, and the maxillomandibular relationship record to provide precise references for definitive denture fabrication.

Evaluation of masticatory function, satisfaction, and quality of life among users of complete dentures relined with resilient materials - A systematic review.

PURPOSE: To evaluate whether complete dentures (CDs) relined with long-term resilient liners (LTRLs) favor better masticatory function, satisfaction, and quality of life among completely edentulous patients when compared to conventional CDs. MATERIALS AND METHODS: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and was registered in PROSPERO (the International Prospective Register of Systematic Reviews; CRD42021258700). The population, intervention, comparison, and outcome (PICO) question was: Do complete dentures relined with LTRLs favor better masticatory function, satisfaction, and quality of life among completely edentulous patients when compared to CDs? Searches were performed in the PubMed/MEDLINE, Embase, Scopus, Lilacs, BBO, and OpenGrey databases. Manual searches were also performed to identify additional primary studies. RESULTS: Overall, 3,953 articles were found; after removing duplicates, reading the articles, and applying the inclusion and exclusion criteria, 15 articles were selected for qualitative analysis, totaling 422 patients with follow-up periods ranging from 1 week to 3 years. Among these, 8 studies assessed masticatory function using different methods, 2 assessed satisfaction, 1 assessed quality of life, and 4 assessed more than one outcome. Through qualitative analysis, LTRLs showed satisfactory results in most studies when compared to CDs in relation to masticatory function, satisfaction, and quality of life. CONCLUSION: LTRLs favor better masticatory function, satisfaction, and quality of life among completely edentulous patients when compared to CDs.

Mechanical behavior of titanium and zirconia abutments at the implant-abutment interface: A systematic review.

STATEMENT OF PROBLEM: Zirconia has become popular for dental implant abutments in the esthetic zone but can damage the implant connection interface. Studies have been conducted to compare zirconia abutments with conventional titanium abutments; however, a consensus or systematic review is lacking. PURPOSE: The purpose of this systematic review was to evaluate the performance of abutments made of zirconia and titanium in relation to wear and misfit at the implant-abutment interface. MATERIAL AND METHODS: Electronic databases (PubMed/MEDLINE, Embase, Web of Science) were independently searched by 2 researchers for relevant studies published up to June 2021. The population, intervention, comparison, outcome (PICO) question was "Do zirconia abutments cause greater wear at the implant-abutment interface than titanium abutments under occlusal forces?" Eligible studies included in vitro studies that evaluated changes in the surface of external and/or internal connections and single and/or multiple, screwed and/or cemented prostheses rehabilitated with titanium and zirconia abutments submitted to mechanical cycling. RESULTS: Nine studies were included for qualitative analysis. A total of 172 specimens were analyzed, 86 zirconia and 86 titanium abutments. In terms of wear on the implant connection surface, zirconia abutments caused more severe wear, more scratches, and more rounding of the hexagonal angles at the implant connection interface than titanium abutments. In terms of misfit at the connection interface, zirconia abutments showed greater misfit than titanium abutments. CONCLUSIONS: Zirconia abutments produce more wear at the titanium implant connection interface, titanium abutments showed better fit to the implant connection interface, and the fit can be influenced by the abutment manufacturing method.

Masticatory performance of denture wearers with the use of denture adhesives: A systematic review.

STATEMENT OF PROBLEM: Denture adhesives are products used by wearers of removable dental prosthesis; however, systematic reviews on their influence on masticatory performance are lacking. PURPOSE: The purpose of this systematic review was to evaluate the efficiency of denture adhesives in improving the masticatory performance of users of complete dentures (CD). MATERIAL AND METHODS: This systematic review was organized from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist, and the methods were registered on the international prospective register of systematic reviews (PROSPERO-CRD42020187385). The focus question was as follows: "Does the use of denture adhesives improve the masticatory performance of patients with removable dental prostheses?" The databases PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library were used to extract information. RESULTS: The search yielded 1338 articles, of which 6 met the inclusion criteria and were selected. All included studies were crossover randomized controlled trials including bimaxillary edentulous individuals. Masticatory performance was evaluated by using a comminution and sieve method. CONCLUSIONS: Denture adhesives significantly increased the masticatory performance of CD users.

Does non-surgical periodontal treatment influence on rheumatoid arthritis? A systematic review and meta-analysis.

OBJECTIVE: The objective of this systematic review was to evaluate the efficacy of non-surgical periodontal therapy on rheumatoid arthritis activity. MATERIAL AND METHODS: Articles published until April 2019 were electronically searched and screened using PubMed / MEDLINE, Scopus, and Cochrane databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). This study was recorded in the international PROSPERO database (CRD42019132205). The PICO question (population, intervention, comparison, results) was: in adult patients with rheumatoid arthritis and periodontitis (P), does non-surgical periodontal treatment (I), as compared to no treatment (C), provides better outcomes in rheumatoid arthritis activity (O). RESULTS: After searching the databases, seven articles were selected for qualitative and five for quantitative analysis. The total number of participants included was 292, with an average age of 50.5 years. All patients had rheumatoid arthritis and periodontal disease. Non-surgical periodontal treatment significantly reduced Disease Activity Score 28 (P = 0.004; I2 = 92%) and erythrocyte sedimentation rate (P = 0.01; I2 = 78%), but with no significant effect on C-reactive protein (P = 0.34; I2 = 92%). CONCLUSIONS: It can be concluded that non-surgical periodontal treatment can benefit patients with rheumatoid arthritis.

Impact of artificial teeth occlusal morphology on bimaxillary denture treatment in elderly: a clinical trial.

PURPOSE: To evaluate the performance of complete dentures (CD) with anatomical and nonanatomical teeth in completely edentulous elderly individuals regarding oral health-related quality of life (OHRQoL), satisfaction, masticatory performance (MP), need for adjustment after CD placement, and patient preference for occlusal type. MATERIALS AND METHODS: A randomized crossover clinical trial comprising 50 edentulous elderly individuals was conducted. The participants were divided into two groups: AT-NT (rehabilitated initially with anatomical teeth and 3 months later with nonanatomical teeth) and NT-AT (rehabilitated initially with nonanatomical teeth and 3 months later with anatomical teeth). OHRQoL was analyzed using the OHIP-EDENT; a satisfaction questionnaire was applied; MP was evaluated by the median particle size (×50) after chewing an artificial test food; and the number of adjustments of the prosthesis base was assessed quantitatively. RESULTS: Overall, 34 elderly individuals (mean age: 69 years) were analyzed. No significant difference was observed between CD users with anatomical and nonanatomical teeth for OHRQoL (P = .674), satisfaction (P = .725), MP (P = .849), or number of adjustments (P = .135). Most subjects (52.9%) did not express a preference for any occlusal surface type. However, among those with a preference, the majority (32.4%) opted for nonanatomical teeth. CONCLUSION: Both posterior tooth types are eligible for oral rehabilitation in elderly users of conventional CDs, as the variables were not influenced by occlusal morphology. However, further studies are warranted in highly resorbed mandibular edges or in cases of adaptation difficulties, as the results may differ.

The influence of crown-to-implant ratio in single crowns on clinical outcomes: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: A consensus about the effect of crown-to-implant (C/I) ratio in single crowns regarding the implant survival rate and marginal bone loss (MBL) is lacking. PURPOSE: The purpose of this systematic review and meta-analysis was to evaluate the influence of C/I ratio in implant-supported single crowns on clinical outcomes. MATERIAL AND METHODS: The search was made in the PubMed/MEDLINE, Scopus, and the Cochrane Library databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria and registered with the International Prospective Register of Systematic Reviews (PROSPERO: CRD42018095711). The focused question was "Does the crown-to-implant ratio influence clinical outcomes for implant-supported single crowns?" RESULTS: Five direct comparative studies were included (C/I ratio ≤1 or >1, or ≤2 or >2), including a total of 262 participants with a mean age of 54.5 years. The meta-analysis comparing C/I ratio between ≤1 or >1 revealed no significant differences (P=.18; risk difference:-0.05; 95% confidence interval: -0.11 to 0.02) in terms of implant survival rate; the same was true for C/I ratio between <2 or ≥2 (P=.05; risk difference:-0.06; 95% confidence interval: -0.12 to -0.00), both analysis were made with a mean follow-up period was 36 months. The mean MBL was calculated based in the qualitative data for each C/I ratio: ≤1 (0.15 mm [-0.34 to 0.34]); >1 (0.07 mm [-0.29 to 0.22]); <2 (1.32 mm [0.38-0.9]); and ≥2 (1.37 mm [-0.02 to 0.91]). The qualitative data reported that the most common mechanical complication was screw loosening, and the most common biological complication was peri-implantitis. CONCLUSIONS: The meta-analysis revealed no relationship between categories of C/I ratio for implant survival rate. The qualitative data also suggested that MBL increased as the C/I ratio increased.

Evaluation of Marginal Misfit of Implant-Supported Fixed Prostheses Made Using Different Techniques.

PURPOSE: To evaluate the vertical marginal (VM) and horizontal marginal (HM) misfit of frameworks made using different techniques. MATERIALS AND METHODS: A total of 30 frameworks were divided into three groups of 10 samples each based on manufacturing technique: nichrome cast (G1), milled in zirconia (G2), and milled in wax and fused to metal (G3). Marginal misfit was measured using a three-dimensional optical microscope. RESULTS: The highest VM misfit was in G3 (83.5 µm), followed by G1 (55 µm) and G2 (42 µm). The highest HM misfit was in G2 (118 µm), followed by G3 (102 µm) and G1 (-85 µm). CONCLUSION: Frameworks milled in zirconia resulted in the lowest VM misfit, while frameworks filled in wax and fused to metal resulted in higher VM. The HM misfit was favorable in the lost-wax technique.

Implantes tipo plataforma modificada: revisión de literatura / Implants modified platform type: literature review

El propósito de esta revisión fue explorar el concepto de Plataforma modificada en Implantología y su desempeño clínico. La definición de plataforma modificada será considerada junto con una revisión de literatura pertinente, con la finalidad de proveer directrices basadas en evidencias científicas. Fueron utilizadas las siguientes bases de datos: Pubmed, Biblioteca Cochrane e ISI. Los criterios de inclusión fueron: artículos clínicos, de laboratorio y de revisión sobre el tema, en lengua inglesa. Fueron seleccionados 40 artículos, utilizando los descriptores "plataforma switching dental implants", "platform shifting and dental implants", "expanded platform dental implant". De acuerdo con esta revisión, los implantes plataforma modificada presentan una tasa de remodelación ósea ( media < 1mm) más favorable que los implantes convencionales. Este hecho parece ser resultante de un conjunto de factores biológicos y mecánicos. El concepto de plataforma modificada tiene importante relevancia en el área estética

The purpose of this revision was to explore the concept of Platform Switching in implantology and its acting in the clinical practice. The concept of platform switching will be considered together with a revision of pertinent literature, with the purpose of providing guidelines based on scientific evidences. The following databases were used: Pubmed, Library Cochrane and ISI in the last 17 years. The inclusion approaches were: clinical articles, laboratorials and of revision on the topic, in English language. 41 articles were selected, using the describers "platform switching dental implants", "platform shifting and dental implants", "expanded platform dental implant". In accordance with this revision, implant them platform switching they present a rate of more favorable bony remodeling that you implant them conventional. This fact seems to be resulting of a group of biological factors and mechanics. The concept of platform switching has important relevance in the aesthetic area