Clinical Outcomes of Maxillary Sinus Floor Perforation by Dental Implants and Sinus Membrane Perforation during Sinus Augmentation: A Systematic Review and Meta-Analysis.

The aim of the present systematic review was to investigate the clinical outcomes after the perforation of the maxillary sinus by dental implants, or after maxillary sinus membrane perforation during sinus lift procedure. Twenty-nine publications were included. Failure rates of implants in cases where perforation of sinus floor had happened (11 studies) was generally low, and only one case of transient sinusitis was reported. The estimated failure rate of these implants was 2.1% (SE 1.0%, p = 0.035). There were 1817 implants (73 failures) placed in augmented sinuses in which the sinus membrane was perforated and 5043 implants (274 failures) placed in sinuses with no perforated membrane, from 18 studies. The odds of implant failure difference between the groups were not significant (OR 1.347, p = 0.197). log OR of implant failure between perforated and non-perforated membrane groups did not significantly change with the follow-up time (-0.004/month; p = 0.500). In conclusion, implant failure rate is generally low either for implants penetrating in the floor of the maxillary sinus or implants placed in augmented sinuses in which the sinus membrane was perforated. The prevalence of postoperative infection/sinusitis is low, and it may depend either on the dimensions of the perforation or on the anatomical predisposition.

A Prospective Report of the Clinical Outcome of TiUnite Implants at 20 Years of Follow-up.

PURPOSE: To present a survival analysis of 133 consecutively placed moderately rough implants, all with a total follow-up of 20 years. MATERIALS AND METHODS: A total of 133 implants of the same brand placed in 46 patients at the same county clinic in Sweden were followed up prospectively over 20 years and analyzed for survival and bone height, the latter evaluated in periapical radiographs. RESULTS: A total of 7 implants failed, 4 of which were in the same patient. Implant failure was associated with a combination of smoking and bruxism in 5 of the 7 failed cases. A 20-year survival rate of 94.7% was observed. Average marginal bone loss (MBL) at 20 years of follow-up was 0.543 ± 1.193 mm, with 9 implants having more than 2 mm of MBL. A total of 20 patients with 25 implants dropped out of the study; however, if death of the patient is excluded as a dropout reason, only 3 implants in 3 patients were unaccounted for. CONCLUSIONS: Good clinical results in the 95% survival range were observed with moderately rough implants over a 20-year follow-up period.

Immediate implant placement in the anterior mandible: a cone beam computed tomography study.

BACKGROUND: The placement of implants into the alveolar socket right after tooth extraction is called immediate implant placement (IIP). This approach has its particularities depending on which region of the jaws is involved. The anterior mandible region is peculiar due to the presence of mandibular incisors, which have the shortest roots among all permanent teeth. PURPOSE: This study aimed to investigate the factors that could be associated with the risk of either cortical bone wall perforation or invasion of the 2 mm secure distance from the surrounding anatomical structures (defined as unsafe implant placement), with IIP in the maxillary aesthetic zone, in a cone-beam computed tomography (CBCT) virtual study. MATERIALS AND METHODS: CBCT exams from 239 eligible subjects were investigated. Implants were virtually placed in two distinct positions: prosthetically-driven (along the long axis of the existing tooth) and bone-driven position (according to the available bone and with regard to nearby anatomical structures). Correlation between several variables was tested, and binary logistic regression analysis in order to assess of the possible associations between covariates and unsafe placement was performed. RESULTS: Safe placing implants was significantly higher for the bone-driven in comparison to the prosthetically-driven position (22.2% vs. 3.3%, respectively), and the 2-mm secure distance from anatomical structures was not possible to respect in the majority of cases (77.6% vs. 82.9%, respectively). Covariates associated with a higher risk of unsafe placement were tooth region (CI in relation to IL and CA), decrease of labial concavity angle (LCA), decrease of mandible basal bone height (MBBH), and decrease in mandibular bone thickness at the tooth apex level (MBT0). CONCLUSION: The possibility of safely placing immediate implants in the anterior mandible is significantly higher for bone-driven than in prosthetically driven position. Presurgical virtual planning with CBCT is a great tool for minimizing the risk of implant unsafe placement with regards to the anatomical conditions in the mandible.

Pyodermatitis-pyostomatitis vegetans: a case report and systematic review focusing on oral involvement.

BACKGROUND: Pyodermatitis-pyostomatitis vegetans (PPV) is a rare mucocutaneous disease characterized by multiple pustules and it is considered a marker for inflammatory bowel disease (IBD). The oral manifestations of this condition are referred to as pyostomatitis vegetans (PSV). PURPOSE: To investigate which features could help in establishing the diagnosis of PSV, with or without cutaneous lesions, based on information retrieved from all cases of PSV described in the literature. A case of PV from the authors was also included in the analysis. METHODS: An electronic search was undertaken, last updated in August 2022. Inclusion criteria included publications reporting cases of PSV, with the diagnosis confirmed by the pathological examination of oral or skin lesions, and presence of IBD. RESULTS/CONCLUSIONS: Sixty-two publications with 77 cases of PSV and an associated IBD were included. Features that are helpful in establishing the diagnosis of PSV are snail track appearance of oral lesions, an associated IBD (which is not always symptomatic), evidence of intraepithelial clefting on microscopic examination of oral lesions, and peripheral blood eosinophilia. A gold standard for the management of PSV does not exist and high-level evidence is limited. There is no established therapeutic protocol for PSV and management primarily consists of topical and/or systemic corticosteroids, antirheumatic drugs (sulfasalazine, mesalazine), monoclonal antibody (infliximab, adalimumab) immunosuppressives (azathioprine, methotrexate), antibiotics (dapsone), or a combination of these. The risk of recurrence of oral lesions is considerable when the medication dose is decreased or fully interrupted.

Hypertension and Dental Implants: A Systematic Review and Meta-Analysis.

PURPOSE: The aim of the present systematic review was to investigate the influence of hypertension on the dental implant failure rate. METHODS: An electronic search was undertaken in four databases, plus a manual search of journals. The I2 statistic was used to check heterogeneity and the inverse-variance method was used for the meta-analysis. The estimate of relative effect for dichotomous outcome was expressed as an odds ratio (OR). RESULTS: The review included 24 publications. There were 4874 implants (257 failures) placed in hypertensive patients and 16,192 implants (809 failures) placed in normotensive patients. A pairwise meta-analysis showed that implants in hypertensive patients did not have a higher risk of failure than implants placed in normotensive patients (OR 1.100, p = 0.671). The log OR of implant failure between hypertensive and normotensive patients did not significantly change with the follow-up time (p = 0.824). CONCLUSIONS: This review suggests that implants in hypertensive patients do not present higher odds of failure in comparison to normotensive patients. However, further research on this topic, with the use of more rigorous criteria to diagnose patients as being hypertensive, as well as clearer information about the pharmacological management of the condition in the patients, is recommended.

Survival of fixed prosthetic restorations on vital and nonvital teeth: A systematic review.

PURPOSE: To evaluate the survival rate of full-coverage tooth-supported fixed prosthetic restorations, single crowns (SCs), and fixed dental prostheses (FDPs), taking into consideration the potential influence of tooth-vitality, presence and type of post, and type of prosthetic restoration material. MATERIALS AND METHODS: In October 2022, two authors independently conducted a search in PubMed, Web of Science, and Scopus electronic databases as well as a hand search to identify clinical human studies on full-coverage SCs and FDPs supported by vital and/or non-vital abutments and/or a combination of both, with a minimum observation period of 24 months. RESULTS: Out of 4198 studies identified through the database search and 22 through hand searching, 26 studies fulfilled the inclusion criteria and were included in the analysis of the present systematic review. Included studies scored six points and more according to Newcastle-Ottawa Scale (NOS). The highest estimated 5-year survival rate was observed for (metal-ceramic and all-ceramic) SCs on vital teeth (98.3%; 95% CI [98.1, 98.6%]) and all ceramic SCs on non-vital teeth with fiber post (95.0%; 95% CI [94.5-95.4%]). Metal-ceramic SCs on vital teeth (97.1%; 95% CI [95.6-98.7%]) showed a statistically significant higher estimated 5-year survival rate compared to metal-ceramic SCs with cast metal post (90.7%; 95% CI [87.4-94.0%], P < 0.001), fiber post (91.3%; 95% CI [90.9-91.6%], P < 0.001) and without post (85.7%; 95% CI [80.7, 90.6%], P < 0.032). All-ceramic SCs with fiber post had a statistically significant higher estimated 5-year survival rate (95.0%; 95% CI [94.5-95.4%]) compared to metal-ceramic SCs on non-vital teeth with fiber post (91.3%; 95% CI [90.9-91.6%], P < 0.001). SCs (all-ceramic and metal-ceramic) with fiber post had a statistically significantly higher estimated 5-year survival rate of (92.7%; 95% CI [92.4-92.9%]) than SCs made of metal-ceramic and retained by cast metal post (90.7%; 95% CI [87.4-94.0%], P < 0.001). For FDPs, the 5-year survival rate was significantly higher for FDPs on vital abutments (84.9%; 95% CI [75.9, 93.9%]) compared to FDPs retained by non-vital abutment/s (81.3%; 95% CI [80.3, 82.2%], P = 0.049) irrespective to presence, type of post, and FDPs material. The results are limited by the limited number of studies and the presence of uncontrolled confounding clinical variables. CONCLUSIONS: Within the limitations of the study, tooth vitality is suggested to contribute positively to the survival of SCs and FDPs.

Bruxism and dental implants: A systematic review and meta-analysis.

BACKGROUND: Overload from bruxism may affect survival of dental implants. OBJECTIVES: To evaluate implant failure and marginal bone loss (MBL) in patients presenting with probable bruxism compared to non-bruxers. The study was registered in PROSPERO (CRD42021238397). METHODS: An electronic search September 2022 in PubMed/Medline, Web of Science and Science Direct was combined with a hand search. Two independent reviewers carried out abstract screening, full-text assessment, quality assessment (National Institutes of Health tool) and data extraction. Only studies that provided information on self-report and clinical examination needed for the diagnosis of at least 'probable' bruxism were included. A pairwise random-effect meta-analysis was carried out. RESULTS: In total 1338 studies were identified, and after screening and full-text assessment 27 studies that presented data on 2105 implants in probable bruxers and 10 264 implants in non-bruxers were included, with 138 and 352 implant failures in respective groups. the meta-analysis showed that implants placed in probable bruxers had a higher risk of failure than in non-bruxers (OR 2.189; 95% CI 1.337, 3.583, p = .002). A meta-regression showed that follow-up time did not affect this OR. Eighteen studies provided general data on MBL but did not report results separated between bruxers and non-bruxers. Therefore, an analysis of MBL was not possible. CONCLUSION: The results of the present systematic review show that implants placed in probable bruxers present a significantly higher risk of failure than implants placed in non-bruxers. This should be considered in treatment planning and management of implant patients.

Smartphone application to report awake bruxism: Development and testing of the Swedish version and a pilot study to evaluate family history in young adults and their parents.

BACKGROUND: Together with psychosocial and hereditary factors, bruxism is a possible risk factor for orofacial pain. Bruxism is defined as a masticatory muscle activity characterized by repetitive or sustained tooth contact, or by bracing or thrusting of the mandible. A smartphone application to report awake bruxism (AB) has been developed and translated into more than 25 languages. OBJECTIVE(S): To translate the application into Swedish, adapt it to Swedish culture and conduct a study to evaluate the usability of the application for studies on family history and associated risk factors. METHODS: Translation and cultural adaption of the Swedish version of the application (BruxApp) was carried out in a four-step sequential process. Ten young adults (22-30 years) were recruited together with ten parents (42-67 years) and reported their AB with the application over two seven-day periods. Pain, stress and parafunctional behaviours were assessed by questionnaires. RESULTS: The back translation check showed minimal discrepancies between the translation and the English version. Participants did not report any problems with the application. Response rates for both groups were 65%. A difference in frequency of AB was shown between young adults and parents (22.0% vs. 12.5%, p < .001). A positive moderate correlation was found between AB and stress (r = 0.54, p = .017). CONCLUSION: The use of application strategies enables data collection on AB which can be used in both clinical and research settings. The results suggest that the Swedish version is ready for implementation and for studies on the relationships between AB, family history and psychosocial factors.

Clinical outcomes of zirconia implants: a systematic review and meta-analysis.

PURPOSE: To assess the clinical outcomes of zirconia dental implants based on an updated systematic literature review. METHODS: An electronic search was performed in three databases, last updated in June 2023, supplemented by hand searching. The eligibility criteria were clinical studies reporting patients rehabilitated with zirconia implants. The cumulative survival rate (CSR) of implants was calculated. A meta-analysis for marginal bone loss (MBL) under different follow-up times and a meta-regression assessing the relationship between mean MBL and follow-up were done. RESULTS: Twenty-five studies were included (4017 implants, 2083 patients). Seven studies had follow-up longer than 60 months. 172 implants failed, after a mean of 12.0 ± 16.1 months (min-max 0.3-86.0), of which 47 early failures, and 26 due to implant fracture, the majority in narrow-diameter implants. The 10-year CSR was 95.1%. Implants with coronal part prepared by drills presented statistically significant lower survival than non-prepared implants (p < 0.001). Two-piece implants presented lower survival than one-piece implants (p = 0.017). Implants discontinued from the market presented lower survival than the commercially available ones (p < 0.001). The difference in survival was not significant between implants in maxilla and mandible (p = 0.637). The mean MBL fluctuated between 0.632 and 2.060 mm over long periods of observation (up until 132 months). There was an estimated MBL increase of 0.005 mm per additional month of follow-up. CONCLUSION: Zirconia implants present high 10-year CSR and short-term low MBL. The review was registered in PROSPERO (CRD42022342055). CLINICAL RELEVANCE: The clinical outcomes observed for zirconia dental implants are very promising, although these have not yet been extensively studied as titanium alloy implants.

Difference in marginal bone loss around implants between short implant-supported partial fixed prostheses with and without cantilever: a retrospective clinical study.

PURPOSE: To investigate the influence of cantilever prosthetic arm on the marginal bone loss (MBL) over time around dental implants supporting short fixed partial dentures (FPDs), in a record-based retrospective study. METHODS: All cases of 3-unit implant-supported FPDs, supported by 2-3 implants, from the database of cases treated at one specialist clinic were considered for inclusion. Only implants with a minimum of 36 months of radiological follow-up were considered. Univariate linear regression models were used to compare MBL over time between 12 clinical covariates, after which a linear mixed-effects model was built. RESULTS: One-hundred-thirty-nine patients (64 men, 75 women) with 164 3-unit implant-supported FPDs (333 implants supporting non-cantilevered FPDs, 94 supporting cantilevered FPDs) were included in the study. The patients were followed up clinically and radiographically for a mean of 154.1 ± 78.0 (min-max, 37.3-364.6) and 132.9 ± 77.3 months (min-max, 36.8-329.9), respectively. The total number of marginal bone level double measurements (mesial and distal sides of each implant) was 2909. FPDs with cantilever presented an estimated greater MBL over time compared to FPDs without cantilever. Bruxism, sex (women), implant (modified) surface, and (poor) bone quality were also associated with higher MBL over time. CONCLUSIONS: The use of a cantilever extension is suggested to negatively affect the bone marginal level over time around implants supporting 3-unit FPDs. Due to the small difference of the estimated MBL over long periods of follow-up between the groups, it is a matter of debate if the observed negative effect may be of clinical significance.

Bisphosphonates and Dental Implants: A Systematic Review and Meta-Analysis.

The purpose of the present systematic review was to investigate the influence of bisphosphonates (BPs) on the dental implant failure rate and marginal bone loss (MBL). An electronic search was undertaken in three databases, plus a manual search of journals. Meta-analyses were performed, besides a meta-regression in order to verify how the log odds ratio (OR) was associated with follow-up time. The five- and ten-year estimated implant survivals were calculated. The review included 33 publications. Altogether, there were 1727 and 21,986 implants placed in patients taking and not taking BPs, respectively. A pairwise meta-analysis (26 studies) showed that implants in BP patients had a higher failure risk in comparison to non-BP patients (OR 1.653, p = 0.047). There was an estimated decrease of 0.004 in log OR for every additional month of follow-up, although it was not significant (p = 0.259). The global estimated implant survival in patients taking BPs after 5 and 10 years was 94.2% (95% CI, 94.0-94.4) and 90.1% (95% CI, 89.8-90.3), respectively. It was not possible to make any reliable analysis concerning MBL, as only two studies reported MBL results separated by groups. There is a 65.3% higher risk of implant failure in patients taking BPs in comparison to patients not taking this class of drugs.

Risk Factors Associated with Failure and Technical Complications of Implant-Supported Single Crowns: A Retrospective Study.

Background and Objectives: Implant-supported single crowns have become a routine approach for the replacement of missing single teeth, being considered as one of the most common ways of rehabilitation when adjacent teeth are healthy. The present retrospective study aimed to investigate the risk factors possibly associated with failure and technical complications of implant-supported single crowns and their supporting implants. Materials and Methods: Patients treated at one faculty (2009-2019) were considered for inclusion. Complications investigated included ceramic fracture/chipping, crown loss of retention/mobility, crown failure/fracture, loosening/loss/fracture of prosthetic screw, and implant failure/fracture. Any condition/situation that led to the removal/replacement of crowns (implant failure not included) was considered prosthesis failure. Univariate/multivariate Cox regression models were used to evaluate the associations between clinical covariates and failure. Results: 278 patients (358 crowns) were included. Mean ± SD follow-up was 56.5 ± 29.7 months. Seven implants (after a mean of 76.5 ± 43.7 months) and twenty crowns (21.3 ± 23.5 months) failed. The cumulative survival rate (CSR) for crowns was 93.5% after 5, remaining at 92.2% between 6 and 11 years. The most common reasons for crown failure were porcelain large fracture (n = 6), crown repeatedly loose (n = 6), and porcelain chipping (n = 5). Men and probable bruxism were identified in the Cox regression model as being associated with crown failure. The most common observed technical complications were mobility of the crown and chipping of the ceramic material, with the latter being observed even in crowns manufactured of monolithic zirconia. Cases with at least one technical complication (not considering loss of screw hole sealing) were more common among probable bruxers than in non-bruxers (p = 0.002). Cases of ceramic chipping were more common among bruxers than in non-bruxers (p = 0.014, log-rank test). Conclusions: Probable bruxism and patient's sex (men) were factors associated with a higher risk of failure of implant-supported single crowns.

Clinical outcomes of tooth-supported monolithic zirconia vs. porcelain-veneered zirconia fixed dental prosthesis, with an additional focus on the cement type: a systematic review and meta-analysis.

PURPOSE: To compare the failure rates and the prevalence of technical complications between full-coverage tooth-supported monolithic zirconia (MZ) and porcelain-veneered zirconia (PVZ) fixed dental prosthesis, based on a systematic literature review. METHODS: An electronic search was performed in three databases, supplemented by hand searching. Several statistical methods were used. RESULTS: Seventy-four publications reported 6370 restorations (4264 PVZ; 2106 MZ; 8200 abutment teeth; 3549 patients), followed up until 152 months. A total of 216 prostheses failed, and survival was statistically significant different between groups. PVZ had higher occurrence of complications than MZ; the difference was especially greater for either minor or major chipping. The difference in prevalence of either minor or major chipping was statistically significant for PVZ prostheses between cementation with glass ionomer and adhesive resin cement (higher), adhesive resin and resin-modified glass ionomer cement (RMGIC, higher), and between RMGIC (higher) and glass ionomer cement. For MZ the difference was significant only for minor chipping between RMGIC (higher) and adhesive resin cement. Abutment teeth to PVZ prostheses more often lost vitality. Decementation was not observed with RMGIC. Air abrasion did not seem to clinically decrease the decementation risk. The 5-year difference in the occurrence of minor or major chipping between MZ and PVZ prostheses was statistically significant, but nor for catastrophic fracture. CONCLUSION: Tooth-supported PVZ prostheses present higher failure and complication rates than MZ prosthesis. The difference in complications is striking when it comes to chipping. CLINICAL RELEVANCE: Awareness of the outcome differences between different types of zirconia prostheses is important for clinical practice.

Influence of Crown-Implant Ratio and Implant Inclination on Marginal Bone Loss around Dental Implants Supporting Single Crowns in the Posterior Region: A Retrospective Clinical Study.

The aim of this present record-based retrospective study was to investigate the influence of the crown-implant ratio (CIR) and implant inclination in relation to the occlusal plane on the marginal bone loss (MBL) around dental implants supporting single crowns in the posterior region of the jaws. All the cases of implant-supported single crowns in the premolar and molar regions were initially considered for inclusion. Only implants not lost, with baseline radiographs taken within 12 months after implant placement and with a minimum of 36 months of radiological follow-up, were considered for the analysis of MBL. Univariate linear regression models were used to compare MBL over time between 12 clinical covariates, after which a linear mixed-effects model was built. After the exclusion of 49 cases, a total of 316 implant-supported single crowns in 234 patients were included. The results from the statistical models suggested that implant inclination and anatomical- and clinical CIR (the main related factors investigated in the study) were not statistically significantly related to MBL over time. Age (older people), tooth region (premolar), and bruxism (bruxers) had a statistically significant influence on MBL over time.

Frequency of Smoking and Marginal Bone Loss around Dental Implants: A Retrospective Matched-Control Study.

This dental record-based retrospective study aimed to compare the marginal bone loss (MBL) around dental implants in a group of smokers in relation to a matched group of non-smokers, with a special focus on five different frequencies of daily smoking (non-smokers, and frequency of 1-5, 6-10, 11-15, and 20 cig./day). Only implants with a minimum of 36 months of radiological follow-up were considered. Univariate linear regression models were used to compare MBL over time between 12 clinical covariates, after which a linear mixed-effects model was built. After matching of the patients, the study included 340 implants in 104 smokers, and 337 implants in 100 non-smokers. The results suggested that smoking degree (greater MBL for higher degrees of smoking), bruxism (greater MBL for bruxers), jaw (greater MBL in maxilla), prosthesis fixation (greater MBL for screw-retained prosthesis), and implant diameter (greater MBL for 3.75-4.10 mm) had a significant influence on MBL over time. There appears to be a positive correlation between the degree of smoking and the degree of MBL, meaning, the higher the degree of smoking, the greater the MBL. However, the difference is not apparent for different degrees of smoking when this is high, namely above 10 cigarettes per day.

Marginal bone loss around dental implants: comparison between diabetic and non-diabetic patients-a retrospective clinical study.

OBJECTIVES: The aim of the present retrospective study was to compare the marginal bone loss (MBL) around dental implants in a group of diabetic patients in relation to a matched group of non-diabetic patients. MATERIALS AND METHODS: The present dental record-based retrospective study included patients selected from individuals treated with dental implants at one specialist clinic in Malmö, Sweden. Patients were excluded if they had history of periodontitis and/or were treated for periodontal disease. The study group included 710 implants installed in 180 patients (mean age 60.3±13.0 years), 349 implants in 90 diabetic (21 T1DM and 69 T2DM patients), and 361 implants in 90 non-diabetic patients. RESULTS: The results suggested that jaw (greater MBL in the maxilla), diabetes (greater MBL for diabetic patients, and worse for T1DM patients), bruxism (greater MBL for bruxers), and smoking (greater MBL for smokers and former smokers) had a statistically significant influence on MBL over time. CONCLUSIONS: Patients with diabetes have an estimated greater MBL over time compared to non-diabetic patients. The difference was greater in patients with diabetes type 1 compared to patients with diabetes type 2. Bruxism, smoking, and implant location (maxilla) were also associated with a higher loss of marginal bone around implants over time. CLINICAL RELEVANCE: Awareness of the possible influence of diabetes on the long-term outcomes of dental implant treatment is important, in order to be able to minimize the possibility of a high MBL with time, which can eventually lead to the loss of the implant.

Marginal bone loss around dental implants: comparison between matched groups of bruxer and non-bruxer patients: A retrospective case-control study.

PURPOSE: To compare marginal bone loss (MBL) around dental implants in a group of bruxers in relation to a matched group of non-bruxers. METHODS: The present record-based retrospective study included patients selected from individuals treated with dental implants at one specialist clinic in Malmö. Only implants not lost and with baseline radiographs taken within 12 months after implant placement and with a minimum of 36 months of radiological follow-up were considered for inclusion. Univariate linear regression models and a linear mixed-effects model were performed. RESULTS: Two hundred and four patients (104 bruxers, 100 non-bruxers), with a total of 811 implants (416 in bruxers, 395 in non-bruxers) were included in the study. The results of the linear mixed-effects model suggested that bruxism, smoking, age, region of the jaws, implant diameter, and prosthesis type had a statistically significant influence on MBL over time. Individuals who are both bruxers and smokers showed greater MBL when compared to individuals who are either a bruxer or smoker, or neither (p < 0.001). CONCLUSIONS: Bruxism is suggested to increase the risk of MBL over time, as well as higher age, smoking, and the combination of bruxism and smoking. Other factors that showed a correlation with increased MBL were implant diameter, region of the jaws, and prosthesis type, but it is not possible to draw robust conclusions for these factors, as the categories of these variables were very unbalanced.

Long-term retrospective clinical study of tooth-supported fixed partial dentures: A multifactorial analysis.

PURPOSE: To assess the influence of several factors on the survival of tooth-supported fixed partial dentures (FPDs) with vital and non-vital abutments. METHODS: The present retrospective cohort study was based on the records of patients treated with 3-to-7-unit tooth-supported FPDs with a minimum follow-up time of 6 months after prosthesis delivery. Cumulative survival rate (CSR) was calculated over the maximum follow-up period. Cox regression models were used to evaluate the association between the clinical covariates and prosthesis failure. RESULTS: A total of 331 FPDs in 229 patients were included. The CSRs were 90.1% and 77.6% after 5 and 10 years and 67.9% and 52.1% after 15 and 20 years, respectively. Tooth-supported FPD failure was more prevalent within the first years of prosthesis delivery. Loss of one or more abutment teeth and loss of prosthesis retention were the main reasons for failure. Smoking and type of prosthesis material significantly influenced the survival of FPDs. Abutment vitality, position of the non-vital abutment, or prosthesis length did not show any significant influence on the occurrence of prosthesis failure. CONCLUSIONS: Smoking and the type of prosthesis material are suggested to contribute to an increased rate of FPD failure irrespective of abutment vitality.

Comparison of survival outcomes between ameloblastic carcinoma and metastasizing ameloblastoma: A systematic review.

PURPOSE: To investigate and compare the demographic data, occurrence of recurrence and metastasis, and survival prognosis between ameloblastic carcinoma (AC) and metastasizing ameloblastoma (MA), based on appropriate and currently accepted eligible diagnostic criteria, in a systematic review of the literature. METHODS: An electronic search was undertaken, last updated in December 2021. Eligibility criteria included publications having enough clinicopathological information to confirm the diagnosis of these tumors. RESULTS: Seventy-seven publications reporting 85 ACs and 43 MAs were included. Both tumors were more frequent in mandible and showed different clinical profiles regarding patients' sex and age. There was no difference in the estimated cumulative survival between patients diagnosed with these tumors. Metastases mainly affected the lungs, followed by cervical lymph nodes. The mean time between the first metastasis and the last follow-up was higher for MA (p = 0.021). In addition, MA patients remained alive longer than AC patients after the first metastasis diagnosis (p = 0.041). Considering only the cases that metastasized, a higher ratio of AC patients died in comparison to MA patients (p = 0.003). The occurrence of recurrence was associated with a conservative primary treatment with both AC (p < 0.001) and MA tumors (p = 0.017). Multiple recurrent events were associated with conservative primary therapies with MA (p < 0.001) but not with AC (p = 0.121). CONCLUSION: In addition to some demographic differences, ACs that metastasize present a worse prognosis than MA. As conservative procedures are associated with multiple recurrent events, this treatment modality should be avoided for both tumors.

Risk Factor Assessment for Survival of Removable Partial Dentures and Their Abutment Teeth: A Retrospective Analysis.

PURPOSE: To investigate the risk factors related to failure of removable partial dentures (RPDs) and to compare the survival of RPDs when abutment teeth have good vs reduced bone support. MATERIALS AND METHODS: In this longitudinal patient record-based cohort study with a mean follow-up of 44.9 months, Cox regression models were used to evaluate the associations between clinical covariates and abutment tooth failure, as well as prosthesis failure. RESULTS: A total of 142 patients and 172 RPDs were included. Of the 172 prostheses, 64 (nearly 40%) failed after a mean time of about 4 years. Loss of abutment teeth was the main reason leading to RPD failure, followed closely by poor fit and adaptation. No factor was shown to be statistically significant at the prosthesis level. Women (Hazard Ratio [HR] = 0.542), endodontic treatment (HR = 3.460), presence of post and core (HR = 0.302), presence of a prosthetic crown (HR = 3.403), and abutment tooth type (in relation to incisor: canine HR = 0.196, premolar HR = 0.449) were the risk factors statistically significantly associated with the loss of abutment teeth. The pre-prosthesis amount of bone support of the teeth did not affect their prognosis as abutments for RPDs. CONCLUSION: RPD treatment modality presented a high failure rate after a mean follow-up of 4 years. Vital abutment teeth had a better survival rate than the ones treated endodontically (whether restored with or without a post and core); nevertheless, the amount of bone support did not affect their survival.