Longevity of metal-ceramic single crowns cemented onto resin composite prosthetic cores with self-adhesive resin cement: an update of a prospective analysis with up to 106 months of follow-up.

OBJECTIVES: To evaluate the longevity of metal-ceramic single crowns cemented onto resin composite prosthetic cores using a self-adhesive resin cement in a prospective clinical descriptive study. METHODS: A total of 152 teeth were endodontically treated and received resin composite prosthetic cores and metal-ceramic crowns cemented with a self-adhesive resin cement. The patients included in the sample were recalled for clinical and radiography evaluation in an up-to-106-month period after the final cementation procedures, with an average of 62 months of follow-up. 91.5% of the sample (142 teeth) were evaluated regarding the treatment survival rate, analyzed considering the loss of crown retention (crown debonding) and tooth loss as the primary outcome. In addition, post debonding, and root fracture occurrences were also recorded as secondary outcomes to evaluate the success rate of the prosthetic treatment. The aesthetic parameters were also evaluated according to the FDI criteria. The Kaplan-Meier method and Cox regression with 95% confidence interval were applied for the statistical analysis. RESULTS: Regarding the primary outcome, the metal-ceramic crowns cemented with self-adhesive resin cement presented a high survival rate (91.5%), with 8 crown debondings and 3 tooth losses (1 due to caries and 2 due to periodontal disease) occurring after the evaluation period. For secondary outcomes, 9 root fractures and 4 post debondings occurred, generating a success rate of 72%. All crowns had a score 1 on the FDI criteria, indicating that they were clinically excellent or very good regarding the aesthetic parameters. CONCLUSION: The metal-ceramic crowns luted with a self-adhesive resin cement presented a survival rate of 91.5% after an average of 62 months of follow-up. Furthermore, the restorations remained aesthetically satisfactory over time, without changes that would indicate prosthetic retreatment. A success rate of 72% was obtained considering the secondary outcome, mainly related to intraradicular retainer failures (root fractures or post debonding). CLINICAL SIGNIFICANCE: The self-adhesive resin cement is clinically indicated for cementation of metal-ceramic crowns onto resin composite prosthetic cores.

Survival rate and treatment success of glass fiber posts cemented with two adhesive cementation strategies after up to 106 months: a randomized clinical trial.

OBJECTIVES: The objective of this study is to evaluate the longevity of two fiber post cementation strategies in a prospective, multicenter, non-inferiority, double-blind randomized controlled trial. METHODS: A total of 152 teeth, with adequate endodontic treatment and loss of coronal structure and bilateral simultaneous posterior occlusal contacts, were randomly allocated to receive glass fiber posts cemented with a conventional cementation strategy (CRC group: adhesive system + resin cement) (Adper Single Bond + RelyX ARC; 3 M-ESPE) or a self-adhesive cementation strategy (SRC group: self-adhesive resin cement; RelyX U100/U200; 3 M-ESPE). The patients were recalled annually for clinical and radiographical evaluation with a 93% recall rate (142 teeth, with 74 at CR groups and 68 at SRC group). The primary outcome was survival rate, considering the fiber post debonding (loss of retention). The secondary outcome included the success rate of the prosthetic treatment with crown debonding, post fracture, and tooth loss (not related to post failure). Both outcomes were evaluated annually. The Kaplan-Meier method and Cox regression with 95% confidence interval were used for the statistical analysis. RESULTS: For the primary outcome (failures directly related to fiber posts cementation strategy), there were 4 fiber post debondings (2 per group), 8 root fractures (3 for SRC group and 5 for CRC group), and one mixed failure (debonding combined with root fracture for CRC), with both strategies presenting similar survival rates (p = 0.331), with 88.9% for the CRC group and 90.9% for the SRC group. For the secondary outcome (failures not related to fiber post cementation strategies), there were 8 crown debondings, 3 post fractures, and 3 tooth losses, with no statistically difference between groups (p = 0.701), with 77% for SRC and 82% for CRC. CONCLUSION: Fiber post cementation strategies with conventional or self-adhesive resin cement presents similar tooth survival and success rates. TRIAL REGISTRATION: NCT01461239 CLINICAL RELEVANCE: Both adhesive cementation strategies led to high survival and success rates and are indicated for fiber post cementation, even after a long follow-up period (up to 106 months).

Influence of post type on periapical status: a prospective study in a Brazilian population.

OBJECTIVES: This prospective study assessed the effect of post type used to restore endodontically treated teeth in the onset, progression, and remission of periapical lesions. MATERIALS AND METHODS: One hundred and forty teeth (92 patients) were endodontically treated and received a glass fiber post or a cast metal post and a final restoration at a University Clinic by undergraduate students. All patients were followed up for a mean period of 5.1 ± 2.2 years. Periapical Index (PAI) was used for endodontic assessment. Two calibrated and blind examiners assessed the radiographs. The longevity of the endodontic treatment was analyzed using Kaplan-Meier statistics. RESULTS: Of the included teeth, 67.1% received glass fiber posts while 32.9% received cast metal posts. There were 4 endodontic failures, two glass fiber posts with a PAI = 3 in the baseline and PAI = 4 in the last follow-up, and one PAI = 4 in baseline and last follow-up. One cast metal post-failure was PAI = 4 in the baseline and the last follow-up. After 9.4 years, the overall success rate of the endodontic treatment was 97.1% (p = 0.7). CONCLUSIONS: The tested posts presented similar endodontic healing. Precautions taken during endodontic therapy, post cementation, and final restoration are more likely to be responsible for the success of endodontic treatment rather than a specific type of post. Clinical relevance The type of post is not related to the success of the endodontic treatment.

Comparison of material properties and biofilm formation in interim single crowns obtained by 3D printing and conventional methods.

STATEMENT OF PROBLEM: Three-dimensionally printed interim restorations are among the recent technological advancements in dentistry. However, evidence of their performance is lacking. PURPOSE: The purpose of this in vitro study was to compare the properties of interim restorations made by 3D printing with different technologies, laser stereolithography (SLA), technology and selective laser sintering (SLS) with those obtained by conventional techniques from acrylic resin and bis-acryl resin. MATERIAL AND METHODS: Four different groups (acrylic resin, bis-acryl resin, SLS, SLA) were tested for flexural strength, Vickers microhardness, fatigue test, compressive strength, surface roughness before and after polishing, and biofilm formation. Specimens were made in the form of rectangular blocks, disks, and single crowns by following the manufacturing technique of each material. One-way ANOVA was used to test biofilm formation, Vickers microhardness, and the results of the 3-point bend flexural test, while the paired t test was used to assess differences in surface roughness between the materials (α=.05 for all tests). RESULTS: The highest Vickers microhardness value was for acrylic resin interim crowns, while the elastic moduli were lower for both the 3D printed materials. Only the SLA resin fractured during the fatigue test. For surface roughness, a statistically significant difference was found among the studied materials (P<.001), with SLA resin and bis-acryl resin having the lowest values. No statistically significant differences were found for biofilm formation (P>.05). CONCLUSIONS: SLS resin had favorable results for the Vickers microhardness, higher maximum flexural strength, and peak stress in load-to-fracture tests, the fatigue test, and biofilm formation compared with acrylic resin and bis-acryl resin, while SLA resin showed favorable results only for biofilm formation and surface roughness.

Short versus standard implants associated with sinus floor elevation: An umbrella review of meta-analyses of multiple outcomes.

STATEMENT OF PROBLEM: Bone loss in the edentulous posterior maxilla complicates dental implant placement. In spite of the evidence available, there is continued uncertainty about the benefit of short implants for different outcomes. PURPOSE: The purpose of this review was to evaluate the existing evidence for short and standard implants in association with sinus floor elevation regarding implant survival, marginal bone loss, and complications by using an umbrella review of the evidence across meta-analysis of interventional studies. MATERIAL AND METHODS: Medline, Scopus, and Cochrane Library were searched to identify systematic reviews and meta-analyses comparing short implants and standard implants associated with sinus floor elevation. Data extraction and methodological quality (AMSTAR-2) was assessed by 2 authors independently. Outcomes were categorized and tabulated to assess effectiveness. Qualitative data were analyzed using thematic synthesis. The certainty of the evidence was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. RESULTS: From 2011 studies, 7 systematic reviews (66 studies) were included as per the eligibility criteria. There was no statistically significant difference between groups for implant survival (risk ratio=1.08; P=.79), and the qualitative analysis did not show differences for prosthetic outcomes. Standard implants were associated with fewer prosthetic complications in the quantitative analysis (risk ratio=3.27; P<.01), but no difference was found between the treatments in the qualitative analysis. Short implants showed reduced marginal bone loss (0.98 ±0.12 mm; mean difference=-0.22; P<.01) and better biologic outcomes (risk ratio=0.16; P<.01). Patient satisfaction was similar for both groups, whereas costs and time for the procedure favored short implants. The quality of the evidence was graded as "critically low" (57.1% of the reviews) and "low." There was a high certainty of evidence for implant survival, whereas marginal bone loss and complications had moderate certainty. CONCLUSIONS: Short implants had a better or equal performance compared with standard implants for all outcomes assessed. However, assumptions were based on reviews with low or critically low quality of the evidence, suggesting the development of high-quality systematic reviews in this field.

Transparency in clinical trials: Adding value to paediatric dental research.

BACKGROUND: Even though considered as studies with high methodological power, many RCTs in paediatric dentistry do not have essential quality items in their design, development, and report, making results' reliability questionable, replication challenging to conduct, wasting time, money, and efforts, and even exposing the participants to research for no benefit. AIM: We addressed the main topics related to transparency in clinical research, with an emphasis in paediatric dentistry. DESIGN: We searched for all controlled clinical trials published from January 2019 up to July 2020 in the three paediatric dentistry journals with high journal Impact Factor, indexed on Medline. These papers were assessed for transparency according to Open Science practices and regarding reporting accuracy using some items required by CONSORT. RESULTS: 53.6% of the studies declared registration, 75% had sample size calculation, 98.2% reported randomisation, and from those, 65.4% explained the randomisation method. Besides that, no study shared their data, and 6.8% were published in open access format. CONCLUSIONS: Unfortunately, a large proportion of RCTs in paediatric dental research show a lack of transparency and reproducibility.

Systematic reviews in restorative dentistry: discussing relevant aspects.

OBJECTIVE: This article aims to discuss key aspects of systematic reviews (SR) focusing on the improvement of the conduct and reporting. METHODS: Important aspects of SRs, such as prospective registration of the review protocol, basic structure, inclusion criteria, use of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement, confidence in the results and future directions are discussed. To determine relevant aspects, a search was conducted without date limitations in PubMed (October 15th, 2017) to identify SRs written in English evaluating clinical performance of direct composite resin restoration in permanent posterior teeth or comparing direct composite resin with other material/techniques. The quality of SRs included was assessed using the Assessing the Methodological Quality of Systematic Reviews 2 tool. RESULTS: Fifteen SRs were included. The overall confidence in the results of SRs was classified as critically low. Some aspects should be highlighted: SRs of in vitro studies are an important tool in restorative dentistry, and initiatives such as the PRISMA Statement and PROSPERO should be considered a standard code of practice. CONCLUSIONS: The compliance with and awareness of the discussed aspects may be a significant feature of the improvement of SR quality in the dentistry. CLINICAL SIGNIFICANCE: Initiatives such as the PRISMA Statement and PROSPERO should be taken in account by systematic reviewers in dentistry to improve the conduct and reporting of SRs, and to make their reviews are more clinically helpful.

Influence of different implant-abutment connection designs on the mechanical and biological behavior of single-tooth implants in the maxillary esthetic zone: A systematic review.

STATEMENT OF PROBLEM: A consensus regarding which implant-abutment connection type would perform best in the anterior maxilla is lacking. PURPOSE: The purpose of this systematic review was to determine the best implant-abutment connection type for anterior single-tooth implants considering esthetics, success, and survival rates. MATERIAL AND METHODS: An electronic search was conducted in MEDLINE, Scopus, Embase, and the Cochrane Library databases to identify clinical studies on single-tooth implants with external and internal hexagon, and/or Morse taper connections. These studies needed to describe at least one of the following outcomes: esthetic score, survival/success rate, or marginal bone loss. The included studies and reports were assessed for bias using the Cochrane risk of bias tool. RESULTS: Of the 891 articles identified, 29 were selected and analyzed. The most common technical complications were abutment screw loosening and crown-cement loosening, while dehiscence and recession were the most common biological complications. The most frequent complications were dehiscence for external hexagon, crown-cement loosening for the internal hexagon, and ceramic fracture for the Morse taper. Esthetics were favorable for all connections, but the internal hexagon performed better. However, better results for marginal bone loss, success, and survival were found for the Morse taper. The global annual failure rate was 0.90% and 0.2% for Morse taper, 0.3% for external hexagon, and 2.2% for internal hexagon. CONCLUSIONS: This review suggests that Morse taper performs better for survival, success, and marginal bone loss. Internal hexagon performed better for esthetic parameters. Additional controlled studies are needed to provide stronger evidence because the evidence generated in this study was considered low.

Chemical hygiene protocols for complete dentures: A crossover randomized clinical trial.

STATEMENT OF PROBLEM: Clinical evidence on the best chemical protocol for the disinfection and removal of biofilm from complete dentures is lacking. PURPOSE: The purpose of this crossover randomized clinical trial was to assess the effectiveness of various chemical hygiene clinical protocols in reducing the microbial viability of biofilm formed on complete dentures. MATERIAL AND METHODS: In this triple-blind (participants, dentist, and outcome evaluator) study, complete denture wearers without candidiasis were randomly divided into 4 groups (n=40) according to the chemical hygiene protocol: water (placebo), 0.5% sodium hypochlorite solution, 0.12% chlorhexidine gluconate solution, and 5% sodium bicarbonate solution. The biofilm formed on the palate intaglio and denture teeth was collected and assessed in each experimental phase for quantitative microbial viability at the seventh and 14th day after using the chemical protocol. RESULTS: Two participants were lost. Data were analyzed by MANOVA and Tukey HSD tests. Soaking dentures was not effective in decreasing Candida albicans, C. non-albicans, and lactobacillus counts. The use of sodium hypochlorite and chlorhexidine decreased total microorganisms and Streptococcus mutans counts for both palate and teeth compared with water and sodium bicarbonate. The intaglio of the dentures always presented higher microbial counts than did the denture teeth. CONCLUSIONS: The use of sodium hypochlorite and chlorhexidine and mechanical cleansing with a toothbrush decreased microbial viability in healthy complete denture wearers.

Randomized clinical trial of the influence of impression technique on the fabrication of cast metal posts.

STATEMENT OF PROBLEM: Direct and indirect techniques are used for intracanal impression and fabrication of cast metal posts. However, whether those techniques affect the accuracy of cast metal posts is unknown. PURPOSE: The purpose of this randomized clinical trial was to evaluate the accuracy of cast metal posts depending on tooth position and impression technique. MATERIAL AND METHODS: Endodontically treated teeth (anterior or posterior) planned to receive cast metal posts and complete crowns were randomized according to impression technique (direct or indirect). Impressions were made by 2 operators, and time for the impression was recorded. All impressions and cast metal posts were photographed to assess any possible differences between techniques in length of the cast metal post. RESULTS: All cast metal posts were shorter than the impressions. The mean reduction for the metal posts was 2.3% for direct in anterior teeth, 5.7% for direct in posterior teeth, 6.3% for indirect in anterior teeth, and 7.2% for indirect in posterior teeth (all P<.05). Statistically significant differences were found between time of technique and tooth position (P=.031), with the direct technique more time consuming than the indirect technique (P<.001) for both tooth positions. For the indirect technique, the impression times for both tooth groups were similar (P=.459). CONCLUSIONS: Both of the intracanal impression techniques resulted in cast posts that were shorter than the impressed post space. The discrepancy was greatest for the indirect technique. Nevertheless, all posts were considered clinically acceptable and were cemented.

Although Cast Post and Cores Present Acceptable Survival, Patient-related Factors May Influence Survival.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Survival of teeth treated with cast post and cores: A retrospective analysis over an observation period of up to 19.5 years. Raedel M, Fiedler C, Jacoby S, Boening KW. J Prosthet Dent 2015;114(1):40-5. SOURCE OF FUNDING: Information not available TYPE OF STUDY/DESIGN: Retrospective cohort study.

Resilient Attachments as an Alternative to Conventional Cast Clasp Removable Partial Denture: 3-Year Follow-up.

The present clinical report describes the prosthodontic management for a patient with uncontrolled bleeding and diabetes mellitus treated with a maxillary complete denture and a mandibular partial fixed dental prosthesis designed to interface with a removable cast framework partial denture retained by 2 ERA attachments. This approach was undertaken to improve both retention and stability of the distal extension Kennedy Class I removable partial denture. The rehabilitation provided better anterior esthetics than if treated with a conventional clasp retained removable partial denture, by employing a simple, practical design and offering a significant biomechanical advantages, restoring both oral health and function. Thus, this treatment modality, involving an ERA system and transfixation in fixed crowns, is an effective treatment and can be indicated as a clinical alternative for edentulous and partially edentulous patients with systemic disorders or for patients in economic situations that might preclude implant-based rehabilitation.

Tooth wear and bruxism: A scoping review.

OBJECTIVE: This study presents a scoping review to determine the association between tooth wear and bruxism. DATA: A protocol was developed a priori (Open Science Framework (DOI 10.17605/OSF.IO/CS7JX)). Established scoping review methods were used for screening, data extraction, and synthesis. Risk of bias was assessed using JBI tools. Direct associations between tooth wear and bruxism were assessed. SOURCES: Embase, SCOPUS, Web of Science, Cochrane, and PubMed were searched. STUDY SELECTION: Any clinical study containing tooth wear and bruxism assessment done on humans in any language was included. Animal, in-vitro studies and case reports were excluded. CONCLUSIONS: Thirty publications reporting on the association between tooth wear and bruxism were included. The majority of publications were cross-sectional studies (90%) while only three were longitudinal (10%). Eleven papers assessed definitive bruxism for analysis (instrumental tools), one paper assessed probable bruxism (clinical inspection with self-report) and eighteen assessed possible bruxism (self-report). Of the eleven papers assessing definitive bruxism, eight also reported outcomes of non-instrumental tools. Tooth wear was mostly scored using indexes. Most studies reported no or weak associations between tooth wear and bruxism, except for the studies done on cervical tooth wear. When bruxism assessment was done through self-report, more often an association was found. Studies using multivariate analyses did not find an association between tooth wear and bruxism, except the cervical wear studies. Evidence shows inconclusive results as to whether bruxism and tooth wear are related or not. Therefore, well-designed longitudinal trials are needed to address this gap in the literature. CLINICAL SIGNIFICANCE: Based on the evidence, dental clinicians should not infer bruxism activity solely on the presence of tooth wear.

5.5-year-survival of CAD/CAM resin-based composite restorations in severe tooth wear patients.

OBJECTIVES: Aim of this prospective study was to assess full mouth rehabilitation of severe tooth wear patients using minimally invasive CAD/CAM resin-based composite (RBC) restorations and direct veneers by evaluating restoration survival up to 5.5-years. METHODS: Twenty-two patients with generalized severe tooth wear with functional and/or esthetic problems were included. Following minimally invasive preparation, CAD/CAM RBC restorations (LAVA Ultimate,3M) were adhesively luted, direct RBC veneers (Filtek Supreme XTE, 3M) were applied in the aesthetic region. Patients were recalled after 1m,1y,3y,5y and seen in between recalls by their general dentists or at the clinical study center if complaints occurred. Failures were categorized as F1 (severe deficiencies requiring replacement/extraction), F2 (localized deficiencies requiring re-cementation/repair) and F3 (small chippings requiring refurbishment/monitoring). Survival of indirect restorations was evaluated using lifetables and Kaplan-Meier-graphs, distinguishing between failure categories and tooth type (front teeth=FT, premolars=PM, molars=M). F1 + F2 and F1 + F2 + F3 failures were analyzed using Cox regression on the variables tooth type/ location, age, gender and VDO increase (p < 0.05). RESULTS: 568 indirect restorations and 200 direct veneers in 21 patients evaluated for up to 5.5-years. For indirect restorations, 96 failures were recorded (F1:6;F2:41;F3:49) and annual failure rates were 0.29%(FT), 1.56%(PM), 2.93%(M) for F1 +F2 and 0.53%(FT), 2.42%(PM), 6.11%(M) for F1 + F2 + F3. Reasons for failure were chipping fracture (48), adhesive fracture (32), complete debonding (7), caries (4), endodontic treatment (1) and reasons unknown (documentation general dentists, 4). Molar tooth type had a statistically significantly increased probability of failure compared with front teeth and premolars for F1 + F2 + F3 (p < 0.006). Direct veneer restorations showed 18 failures (F1:2;F2:9;F3:7). SIGNIFICANCE: Minimally invasive CAD/CAM RBC restorations combined with direct RBC veneers showed an acceptable clinical mid-term survival for restorative rehabilitation of severely worn dentitions.

Single crown vs. composite for glass fiber post-retained restorations: An 8-year randomized clinical trial.

OBJECTIVES: This study aimed to compare the success and survival rates of metal-ceramic crowns and composite resin restorations applied in root filled teeth that received a glass fiber post. METHODS: A prospective, randomized controlled trial, with equivalent parallel groups was designed. Eighty-two teeth were randomly allocated to the metal-ceramic or composite resin groups. Multivariate Cox regression analysis with shared frailty for patients and Kaplan-Meier curves were performed using success and survival rates (p<0.05). RESULTS: Seventy-five post-retained restorations (34 metal-ceramic crowns and 41 composite restorations) in 62 patients were analyzed. The median follow-up was 8.1 years [IQR 4.0-9.9]. Twenty-seven failures were observed. Twenty-two failures (81.5 %) were observed in the composite resin group, of which six (27.3 %) were not repairable. Five failures (18.5 %) were observed in the metal-ceramic crown group, of which three (66.6 %) were non-repairable. The cumulative success rate at 8 years was 85.0 % for crowns (AFR=1.31 %) and 43.2 % for composite resins (AFR=6.58 %), while the survival rate was 93.8 % for crowns (AFR=0.52 %) and 97.6 % for composite resins (AFR=0.20 %). Considering the success rates, adjusted multivariate Cox regression showed that composite resin had a Hazard Ratio of 5.07 (95 %CI, 1.99-12.89) greater than the metal-ceramic crown. No significant difference in the failure risk was observed when the survival rates were considered (HR=0.38, 95 %CI (0.10 - 1.44), p = 0.156). Co-variables did not affect the success and survival rates (p>0.05). CONCLUSIONS: Metal-ceramic crowns showed a higher success rate than composite restorations. The survival rates were similar, but composite restorations presented a higher need for repairs. CLINICAL SIGNIFICANCE: Post-retained composite restorations may need more reinterventions during the lifecycle, although more preservation of sound tooth structure is expected with a large restoration of resin post-and-core. These aspects have to be discussed with the patient for decision-making planning.

Are Open Science Practices in Dentistry associated with higher Altmetric scores and citation rates?

AIM: Open science, a set of principles and practices, aims to make scientific research more accessible and accountable, benefiting scientists and society. This study evaluated whether adopting open science practices (OSPs) correlates with higher citation rates and Altmetric scores. METHODS: A random sample of randomised clinical trials (RCTs) on dental caries published between 2000 and 2022 was selected. A systematic PubMed search identified relevant RCTs, and data on OSPs - study registration, open methodology, open software, open scripts, open analysis plan, open data, open peer review, and open access (OA) - were manually collected by two independent assessors. The Robot Reviewer tool automatically evaluated the risk of bias (RoB). Outcomes included the total number of citations and the Altmetric Attention Score. Associations between OSPs, RoB, and other explanatory variables with the outcomes were assessed using binomial negative regression analysis, and expressed as Incidence Rate Ratio (IRR; α =.05). RESULTS: In total, 323 papers were analysed. At least one OSP was adopted in 57.5% (n=186) of the articles, dropping to 39.6% (n=128) without OA. Papers with protocol registration (IRR: 1.45; 95% CI: 1.15, 1.82) and OA publication (IRR: 1.24; 95% CI: 1.01, 1.53) had higher citation rates. Conversely, papers in full OA journals had fewer citations (IRR: 0.67; 95% CI: 0.52, 0.87). After adjusting for RoB, low-risk studies showed higher citation rates (IRR: 1.48; 95% CI: 1.14, 1.91), while OA lost significance. For Altmetric scores, registered and OA manuscripts showed higher scores (IRR: 3.74; 95% CI: 2.00, 7.01; IRR: 1.69; 95% CI: 1.04, 2.75), with registration remaining significant after adjusting for RoB and impact factor (IRR: 3.71; 95% CI: 1.97-6.99). CONCLUSION: The adoption of OSPs demonstrated a partial correlation with citation rates and Altmetric scores in RCTs on dental caries; however, these effects are complex and seem more related to the journal's impact factor. CLINICAL SIGNIFICANCE: The citations and the attention to clinical trials in dentistry, which could drive clinical decision-making and the elaboration of policies and recommendations, seem to be driven more by the journal's prestige than by the adoption of OSPs.

Antibacterial agents in composite restorations for the prevention of dental caries.

BACKGROUND: Dental caries is a multifactorial disease in which the fermentation of food sugars by bacteria from the biofilm (dental plaque) leads to localised demineralisation of tooth surfaces, which may ultimately result in cavity formation. Resin composites are widely used in dentistry to restore teeth. These restorations can fail for a number of reasons, such as secondary caries, and restorative material fracture and other minor reasons. From these, secondary caries, which are caries lesions developed adjacent to restorations, is the main cause for restorations replacement. The presence of antibacterials in both the filling material and the bonding systems would theoretically be able to affect the initiation and progression of caries adjacent to restorations. This is an update of the Cochrane review published in 2009. OBJECTIVES: To assess the effects of antibacterial agents incorporated into composite restorations for the prevention of dental caries. SEARCH METHODS: We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 23 July 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 6), MEDLINE via OVID (1946 to 23 July 2013) and EMBASE via OVID (1980 to 23 July 2013). We searched the US National Institutes of Health Trials Register (http://clinicaltrials.gov), the metaRegister of Controlled Trials (www.controlled-trials.com) and the World Health Organization International Clinical Trials Registry platform (www.who.int/trialsearch) for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: Randomised controlled trials comparing resin composite restorations containing antibacterial agents with composite restorations not containing antibacterial agents. DATA COLLECTION AND ANALYSIS: Two review authors conducted screening of studies in duplicate and independently, and although no eligible trials were identified, the two authors had planned to extract data independently and assess trial quality using standard Cochrane Collaboration methodologies. MAIN RESULTS: We retrieved 308 references to studies, none of which matched the inclusion criteria for this review and all of which were excluded. AUTHORS' CONCLUSIONS: We were unable to identify any randomised controlled trials on the effects of antibacterial agents incorporated into composite restorations for the prevention of dental caries. The absence of high level evidence for the effectiveness of this intervention emphasises the need for well designed, adequately powered, randomised controlled clinical trials. Thus, conclusions remain the same as the previously published review, with no included clinical trials.

Prevention and treatment of Candida colonization on denture liners: a systematic review.

STATEMENT OF PROBLEM: Denture liners are well known for their poor physical properties that favor the accumulation of plaque and colonization by Candida species, which can irritate the oral tissues and lead to denture stomatitis. PURPOSE: A systematic review was conducted to determine the feasibility of a prevention protocol for Candida colonization in denture liners and an effective treatment after the fungi has colonized the material. MATERIAL AND METHODS: Clinical and in vitro investigations that assessed the treatment and/or prevention of Candida colonization and biofilm formation in denture liners were selected according to the PRISMA statement. Seven electronic databases were searched from 1950 to April 2012 with the keywords "denture liner" OR "reline*" OR "tissue conditioner" AND "Candida" OR "denture stomatitis" OR "oral candidiasis" OR "antifungal agents" OR "denture clean*". RESULTS: The incorporation of nystatin (in general, 500 000 units) into tissue conditioners to prevent the onset of the disease and immersion in sodium hypochlorite for disinfection were the methods most often described in this systematic review, and both methods were able to prevent or inhibit Candida colonization, depending on their concentrations. The 0.5% sodium hypochlorite concentration can disinfect tissue conditioners and denture liners. Microwave irradiation has also been described an alternative method of disinfection. Because of a lack of standardized results (especially with regard to the method used to perform microbial counts), a meta-analysis could not be performed. CONCLUSIONS: The literature suggests that the use of 0.5% sodium hypochlorite can help disinfect denture liners and tissue conditioners. The incorporation of nystatin in those materials is also able to treat or prevent oral candidiasis. However, as most of the studies were in vitro, there is insufficient reliable evidence to truly provide recommendations regarding the ideal cleaning method or whether the addition of antifungal agents is worthwhile. Well-designed randomized controlled trials are needed to provide answers to these questions.

An alternative method for the fabrication of a root-supported overdenture: a clinical report.

The preservation of teeth to support an attachment-retained overdenture is an appropriate and stable alternative to extractions and complete dentures. A key to success is the strategic selection of teeth for retention. This clinical report discusses a method for fabricating an overdenture based on a combination of direct and indirect impression techniques. This technique is a simple and time-efficient alternative to traditional methods that aids in overcoming difficulties in fabricating overdentures.