Current status of the reporting quality of abstracts in systematic reviews related to implant dentistry: a literature survey.

The aim of this study was to assess the reporting quality of abstracts in systematic reviews (SRs) related to implant dentistry and to assess the possible factors associated with the reporting quality. Abstracts of SRs in the field of implant dentistry, published in the last 5 years, were searched. The reporting quality was assessed and scored using the PRISMA for Abstracts checklist (PRISMA-A). The overall PRISMA-A score (OPS) and relative score (OPS%) per review were calculated according to adherence to the criteria presented in the checklist. Multivariable linear regression was performed to identify possible factors associated with reporting quality. Overall, 310 SRs were eligible for this study. Based on the maximum PRISMA-A score (score of 12), the mean OPS was 6.5 and OPS% was 54.2%. The items 'title', 'objectives', and 'number of included studies' were those most frequently reported in the abstracts, while the items 'registration' and 'funding' were the least reported. According to multivariable linear regression, the geographical origin of the articles was the only factor associated with better quality of abstract reporting, with higher OPS for SRs from Europe when compared to North America (coefficient 0.73; P = 0.049). The reporting quality of abstracts in SRs related to implant dentistry is suboptimal and needs to be improved. Journals should encourage adherence to reporting checklists in SRs.

Is there any biomaterial substitute for peri-implant soft tissue phenotype modification? A network meta-analysis of the appraisal literature.

Evidence shows that an increased width and thickness of the keratinized mucosa favours peri-implant health. The aim of this network meta-analysis was to compare the clinical effects of alternative biomaterials for peri-implant soft tissue phenotype modification (PSPM) in patients with dental implants when compared to autologous tissue grafts. An electronic search without language or date limitations was performed in four databases and the grey literature for articles published until November 2020. The eligibility criteria included randomized clinical trials (RCTs) evaluating the clinical outcomes of biomaterials for PSPM. A pairwise and network meta-analysis was conducted for each parameter to assess and compare the outcomes between the different treatment arms for the primary and secondary outcomes. A total of 11 RCTs were included in this review. The free gingival graft (FGG) showed the best clinical effect for increasing keratinized mucosa width (KMW). When compared in a network, the FGG demonstrated the best treatment ranking of probability results, followed by connective tissue graft (CTG), acellular dermal matrix (ADM), and xenogeneic collagen matrix (XCM). For the parameters 'mucosa thickness' and 'participant satisfaction with aesthetics', the results were CTG > ADM > XCM and XCM > ADM > CTG, respectively. Autogenous tissue grafts (FGG/CTG) demonstrate the best results in increasing KMW and mucosa thickness when compared to the other biomaterials.

Osteonecrosis and osteomyelitis of the jaw associated with tumour necrosis factor-alpha (TNF-α) inhibitors: a systematic review.

Tumour necrosis factor-α (TNF-α) inhibitors are increasingly being used as immunomodulators to manage inflammatory conditions such as rheumatoid arthritis and Crohn's disease. Reported serious side effects include an increased incidence of lymphoma and greater susceptibility to infections such as tuberculosis. The aim of this systematic review was to find out whether there is an associated risk of medication-related osteonecrosis of the jaw (MRONJ). Three authors independently searched PubMed, MEDLINE, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials for published reports of oral osteonecrosis (ONJ) or osteomyelitis (OM) in patients who took anti TNF-α drugs and had no history of antiangiogenic agents or antiresorptive treatment. All types of studies on humans treated with TNF-α inhibitors were considered. Only six were eligible for analysis, and all were independently assessed for risk of bias. They included six patients with ONJ or OM that was attributed solely to TNF-α inhibitors. The most common site of ONJ was the posterior mandible (n=5). The mean (SD) duration of anti-TNF-α treatment before the development of bony lesions was 62.5 (47.4) months. Invasive surgery was reported as a precipitating factor in five cases, and the ONJ/OM resolved with conservative management in five. Although all the studies were judged to be at high risk of bias, the limited data suggest that some patients will potentially develop ONJ/OM as a result of treatment with TNF-α inhibitors. Studies of higher quality are now needed to establish the relative risk of MRONJ in patients who take them.

Hydrophilic modification of sandblasted and acid-etched implants improves stability during early healing: a human double-blind randomized controlled trial.

A randomized controlled trial was performed to evaluate and compare the changes in implant stability quotient (ISQ) of implants of the same brand, design, length, and diameter but with two different surface treatments, placed in the posterior mandible: sandblasted and acid-etched (SAE) and chemically modified SAE (hydrophilic). Twenty implants of the same design, length, and diameter (cylindrical and compressive, 3.75×11mm) but with different surface treatments (control group: 10 SAE; test group: 10 modified SAE) were randomly assigned to placement in the posterior mandibular region in 20 different patients. ISQ values were assessed in a blinded manner for six consecutive weeks. The maximum and minimum ISQ values observed during follow-up were 76.0 and 48.5, respectively, in the test group, and 76.0 and 49.0, respectively, in the control group. There was no statistically significant difference (P=0.19) in ISQ variation for the test group implants (modified SAE). Comparison between the test and control groups revealed a significant difference in the measurements: the ISQ in the test group was higher than that in the control group during the follow-up period (parametric Mann-Whitney test). This study demonstrated that implants with a modified SAE surface installed in the posterior mandible showed higher and faster ISQ stability during the healing period when compared to implants with a SAE surface.

Impact of bisphosphonate therapy on dental implant outcomes: An overview of systematic review evidence.

The purpose of this overview was to assess the methods, quality, and outcomes of systematic reviews conducted to evaluate the impact of bisphosphonates on dental implants and the risk of developing bisphosphonate-related osteonecrosis of the jaw after dental implant surgery. An electronic search without date or language restriction was performed in the PubMed/MEDLINE, Cochrane CENTRAL, Web of Science, and LILACS databases (to January 2018). Eligibility criteria included systematic reviews that evaluated the impact of bisphosphonates on implant outcomes. The quality assessment of the included reviews was done using AMSTAR 2 guidelines. The protocol of this overview was registered in PROSPERO (CRD42018089617). The search and selection process yielded seven reviews, published between 2009 and 2017. None of the systematic reviews included in this study obtained the maximum score in the quality assessment. The scientific evidence available demonstrates that patients with a history of bisphosphonate use do not present a higher risk of dental implant failure or marginal bone loss compared to patients who have not used bisphosphonates. The literature also suggests that patients who undergo surgical trauma during the installation of dental implants may be more susceptible to bisphosphonate-related osteonecrosis of the jaw.

The ability of topical and systemic statins to increase osteogenesis around dental implants: a systematic review of histomorphometric outcomes in animal studies.

The purpose of this systematic review was to evaluate the quantitative histomorphometric outcomes of animal studies investigating statins as a pro-osteogenic agent to enhance the osseointegration of dental implants. Some animal studies have suggested a beneficial action of statins on bone tissue. Electronic and manual literature searches, without date or language restriction, ​​were performed by two independent review authors up to February 2017. Eligibility criteria included animal trials quantitatively analysing the pro-osteogenic effect of statins on dental implants. The quality of the included studies was assessed using the ARRIVE guidelines. The search and selection process yielded 12 studies, published between 2004 and 2015. The experimental animals models used were rats and dogs. The statins used in the studies were simvastatin and fluvastatin, which were administered locally or systemically, or applied to the implant surface. All of the selected studies showed a statistically significant positive effect of statins on bone formation around implants. The mean quality assessment score (ARRIVE) of the studies was 11.5±2.27 out of a possible total of 25 points. The histomorphometric data from available preclinical studies suggest a positive effect of statins on increasing osteogenesis around dental implants.

Alveolar ridge preservation using a non-resorbable membrane: randomized clinical trial with biomolecular analysis.

The aim of this randomized clinical trial was to evaluate the newly formed tissues in post-extraction sockets and to compare ridge dimensional changes with and without the use of a dense polytetrafluoroethylene membrane (d-PTFE). Twenty human extraction sockets (lower molars and premolars) received either an intentionally exposed d-PTFE membrane (test group) or no biomaterial (control group). After 4 months, during preparation for implant placement, bone and gingival tissues were collected for histological and biomolecular analysis. Clinically, the test and control groups showed mean gains of keratinized gingiva of 4.30±1.20mm and 2.50±2.20mm, respectively. A reduction in ridge width was observed in the control (2.90±2.70mm) and test (3.30±2.00mm) groups. The bone height alteration ranged from a reduction of 0.12±1.60mm to a gain of 0.60±3.60mm on average for both groups. Analysis of gene expression (OPG/RANKL) in gingival fibroblasts and osteoblasts revealed no difference between the two groups. Ridge preservation using the d-PTFE membrane increased the formation of keratinized tissue. A reduction in width and mild reduction/gain in height of the alveolar ridge was observed in both groups. The membrane had no influence on the healing process.

Maxillary sinus floor elevation with simultaneous implant placement without grafting materials: a systematic review and meta-analysis.

The present study aimed to conduct a systematic review and meta-analysis on the effectiveness of maxillary sinus floor elevation and immediate implant installation without the use of grafting material. An electronic search without date or language restriction ​​was performed in PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, Embase, and the grey literature, to May 2016. Eligibility criteria encompassed prospective and retrospective cohort studies, controlled clinical trials, and randomized clinical trials. The search and selection process yielded 18 studies, published between 2005 and 2016. A meta-analysis was conducted only for experimental studies comparing sinus floor elevation with and without grafting material; results were expressed as the standardized mean difference (SMD) or risk ratio (RR) with the 95% confidence interval (CI). An average gain in bone height of 4.7mm over an average 39.4 month period was observed in the sinus elevated without grafting material. Regarding implants, there was a cumulative average survival rate of 97%. On meta-analysis, bone gain (P=0.98) and implant survival (P=0.13) did not differ significantly between sinuses lifted with or without grafting material, with a SMD of 0.01 (95% CI -0.42 to 0.44) and with a RR of 0.55 (95% CI 0.26 to 1.19), respectively.

Quality assessment of systematic reviews of the significance of keratinized mucosa on implant health.

The aim of this overview was to assess the methods, quality, and outcomes of systematic reviews conducted to evaluate the importance of keratinized mucosa (KM) for the maintenance of peri-implant tissue health in humans. An electronic search was conducted without date or language restriction using the MEDLINE/PubMed, Cochrane Library, Web of Science, and Embase databases up to December 2015. The eligibility criteria included systematic reviews with/without meta-analysis and with a focus on the influence of KM on peri-implant health around implants. Two independent authors performed the quality analysis of the reviews with the AMSTAR guidelines and another checklist proposed in 2003. After screening, four systematic reviews were selected. The present study demonstrated the existence of structural and methodological variability among the systematic reviews with/without meta-analysis. None of the systematic reviews that were included in the study obtained the maximum score in the two quality analyses performed. All systematic reviews included reported a positive association between an adequate KM width (≥2mm) and peri-implant health. There is still insufficient data on the long-term survival and success rates of dental implants. Prospective studies evaluating the importance of KM for the long-term maintenance of dental implants are needed.

The impact of diabetes on dental implant failure: a systematic review and meta-analysis.

The aim of this study was to investigate the hypothesis that there is no difference in implant failure rate or marginal bone loss between type 1 or 2 diabetes subjects and non-diabetic subjects. An electronic search was conducted, without restrictions on date or language, in the PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, and EMBASE databases, and in the grey literature, through August 2015. The eligibility criteria included prospective and retrospective cohort studies and randomized controlled trials. The initial search resulted in 1093 titles from PubMed/MEDLINE, 164 from the Cochrane Central Register of Controlled Trials, 134 from Web of Science, 228 from EMBASE, and four from the grey literature. Following the search and selection process, 14 studies published between 2000 and 2015 were included in this systematic review. According to the risk of bias analysis, all studies were classified as high quality. The results of this systematic review suggest that the number of implant failures does not differ between diabetic and non-diabetic subjects. Additionally, the results of the comparison between type 1 and 2 diabetes subjects showed no difference in the number of failures. With regard to marginal bone loss, there was a statistically significant difference favouring non-diabetic subjects.

Quality assessment of systematic reviews on alveolar socket preservation.

The aim of this overview was to evaluate and compare the quality of systematic reviews, with or without meta-analysis, that have evaluated studies on techniques or biomaterials used for the preservation of alveolar sockets post tooth extraction in humans. An electronic search was conducted without date restrictions using the Medline/PubMed, Cochrane Library, and Web of Science databases up to April 2015. Eligibility criteria included systematic reviews, with or without meta-analysis, focused on the preservation of post-extraction alveolar sockets in humans. Two independent authors assessed the quality of the included reviews using AMSTAR and the checklist proposed by Glenny et al. in 2003. After the selection process, 12 systematic reviews were included. None of these reviews obtained the maximum score using the quality assessment tools implemented, and the results of the analyses were highly variable. A significant statistical correlation was observed between the scores of the two checklists. A wide structural and methodological variability was observed between the systematic reviews published on the preservation of alveolar sockets post tooth extraction. None of the reviews evaluated obtained the maximum score using the two quality assessment tools implemented.

Effect of submucosal injection of dexamethasone after third molar surgery: a meta-analysis of randomized controlled trials.

The aim of this meta-analysis was to analyse the effectiveness of submucosal injection of dexamethasone to control the postoperative signs and symptoms resulting from impacted third molar surgery. An electronic search was conducted, without restriction on date or language, in the PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, and Web of Science databases until June 2015 . The eligibility criteria included non-randomized or randomized clinical trials in humans. After the search and selection process, eight articles were included. The fixed-effects or random-effects model, depending on heterogeneity, was built on the inverse-variance method used. The estimations of intervention were expressed as the mean difference (MD) in millimetres. The results of this meta-analysis suggest that the submucosal injection of dexamethasone presents a reduction in the postoperative signs and symptoms resulting from impacted third molar surgery, especially those associated with oedema and pain. In relation to trismus, the meta-analysis showed no statistically significant difference between dexamethasone and the placebo solution.

Immediate versus conventional loaded single implants in the posterior mandible: a meta-analysis of randomized controlled trials.

The purpose of this meta-analysis was to compare implant survival, marginal bone loss, and complications between immediate and conventional loading of single implants installed in the posterior mandible. An extensive electronic search was performed of PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials to identify relevant articles published up to January 2015. After the selection process, five studies met the eligibility criteria and were included. The results of the meta-analysis were expressed in terms of the odds ratio (OR) or standardized mean difference (SMD), with a confidence interval (CI) of 95%. Results were pooled according to heterogeneity using the fixed- or random-effects model. There was no statistically significant difference between the two techniques (immediate loading vs. conventional loading) with regard to implant survival (OR 1.71, 95% CI 0.40 to 7.36; P=0.47). There was no statistically significant difference in marginal bone loss (SMD -0.58, 95% CI -1.55 to 0.38; P=0.24). The reported mechanical and biological complications were common to both types of intervention, with the exception of probing depth, which was greater following the immediate loading technique (SMD 0.13, 95% CI -0.19 to 0.44), although this was not statistically significant (P=0.43).

Success of dental implants in smokers and non-smokers: a systematic review and meta-analysis.

The purpose of this review was to test the null hypothesis of no difference in marginal bone loss and implant failure rates between smokers and non-smokers with respect to the follow-up period. An extensive electronic search was performed in PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials to identify relevant articles published up to February 2015. The eligibility criteria included randomized and non-randomized clinical studies. After an exhaustive selection process, 15 articles were included. The meta-analysis was expressed in terms of the odds ratio (OR) or standardized mean difference (SMD) with a confidence interval (CI) of 95%. There was a statistically significant difference in marginal bone loss favouring the non-smoking group (SMD 0.49, 95% CI 0.07-0.90; P=0.02). An independent analysis revealed an increase in marginal bone loss in the maxilla of smokers, compared to the mandible (SMD 0.40, 95% CI 0.24-0.55; P<0.00001). A statistically significant difference in implant failure in favour of the non-smoking group was also observed (OR 1.96, 95% CI 1.68-2.30; P<0.00001). However, the subgroup analysis for follow-up time revealed no significant increase in implant failure proportional to the increase in follow-up time (P=0.26).

Implant survival rates, marginal bone level changes, and complications in full-mouth rehabilitation with flapless computer-guided surgery: a systematic review and meta-analysis.

This systematic review evaluated the implant survival rate, changes in marginal bone level, and complications associated with guided surgery for the treatment of fully edentulous patients followed up for longer than 1 year. A comprehensive literature search was conducted in MEDLINE/PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) to retrieve studies published up until July 2014 that met predefined eligibility criteria. Thirteen studies were included. In studies on the guided surgery technique, a survival rate of 97.2% and a mean marginal bone loss of 1.45 mm were found during 1-4 years of follow-up. However, associated complications, such as implant loss, prosthesis or surgical guide fractures, and low primary stability, were often found, and there is a learning curve to achieve treatment success. Further longitudinal comparative studies should improve the technique and its success rate.

Effect of autologous platelet concentrates for alveolar socket preservation: a systematic review.

The current literature was reviewed to evaluate the effect of autologous plasma concentrates on the preservation of extraction sockets. A comprehensive literature search was performed from October 2013 to February 2014 in the MEDLINE/PubMed and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Four studies, published between the years 2010 and 2013, met the eligibility criteria and were included in the review. There were 102 extractions (55 tests, 47 controls) in 82 patients. There was considerable heterogeneity between studies with regard to the design, follow-up time, surgical techniques, and method of preparation of plasma concentrates, and therefore the data could not be analyzed quantitatively. The use of plasma concentrates seems to accelerate healing and soft tissue epithelialization in extraction sockets and reduce postoperative pain and discomfort. However, there is no evidence to date to confirm that plasma concentrates improve hard tissue regeneration.

Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review.

The aim of this systematic review was to evaluate the survival and success rates of osseointegrated implants determined in longitudinal studies that conducted a follow-up of at least 10 years. A broad electronic search was conducted in MEDLINE/PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) for relevant publications in indexed journals, evaluating the clinical performance of dental implants. Using inclusion and exclusion criteria, two reviewers analyzed titles, abstracts, and complete articles, prioritizing studies of the randomized clinical trial type. A total of 23 articles were included in this review. Ten prospective studies, nine retrospective studies, and four randomized clinical trials, which evaluated 7711 implants, were selected. The mean follow-up time of the studies included was 13.4 years. All of the studies reported survival rates and mean marginal bone resorption values, with cumulative mean values of 94.6% and 1.3mm, respectively. Fourteen studies related success rates. Taking into consideration the disparate outcome measures employed to assess dental implant performance and within the limitations of this systematic review, we may affirm that osseointegrated implants are safe and present high survival rates and minimal marginal bone resorption in the long term.