ABSTRACT
BACKGROUND: Association of tooth loss and nutritional status has been widely researched with conflicting results. This overview aimed to analyse and summarize findings from systematic reviews on association of tooth loss with nutritional status, in view of their quality assessment and methodological characteristics. METHODS: Overview was conducted as per Cochrane Overviews of Reviews guidelines. 5 databases (PubMed, Dentistry and Oral Sciences Source, Scopus, Cochrane Register of Systematic Reviews, Epistemonikos.org) and one online source (Google Scholar) were searched for systematic reviews published between 2010 - July 2022, with inclusion criteria; population: participants aged 18 years or above, intervention/exposure: loss of teeth, comparison: not applicable, outcome: nutritional status, study: systematic reviews and meta-analysis. Reviews on association of prosthetic interventions with nutritional status were not included. Data were extracted for study characteristics, details of primary studies, and main findings. Narrative synthesis of data, overlap of primary studies and quality assessment of studies were done using AMSTAR 2 tool (A Measurement Tool to Assess Systematic Reviews). RESULT: Of 1525 articles found, seven systematic reviews were selected (four were systematic reviews, three were systematic reviews with meta-analysis). Five studies showed some or positive association, one found weak association and for one study the association was unclear. Overlap of primary studies was 'very slight'. Meta-analysis of two studies concluded fully or partially edentulous individuals were more likely to be malnourished or at risk of malnutrition, (RR = 1.095, 95% CI 1.007 to 1.190, p = 0.033. RR = 1.22; 95% CI 1.11 to 1.32 p < 0.01), but one found that edentulism was not associated with malnutrition. (RR = 1.072, 95% CI 0.9657-1.200). Quality assessment revealed four studies were 'high', one was 'low' and two were 'critically low.' CONCLUSION: This overview confirms the association between tooth loss and nutritional status specially in elderly. It is evident that tooth loss increases the likelihood of poor nutritional status. Overall, studies show high heterogeneity in the methodology and quality assessment reveals low confidence in the available evidence. Future studies should use standard assessment tools for tooth loss and nutritional status.
Subject(s)
Nutritional Status , Systematic Reviews as Topic , Tooth Loss , Humans , Tooth Loss/complications , AdultABSTRACT
PURPOSE: To compare the influence of 0, 45 and 90 degrees build direction on fracture load and surface roughness of additively manufactured three-unit fixed provisional restoration, and to compare with provisionals fabricated using conventional materials. MATERIAL AND METHODS: Mandibular typodont right second molar and premolar were prepared for missing mandibular first molar to receive three-unit fixed partial denture. Six groups of 10 samples each, 3-unit provisionals were fabricated using additional manufacturing at 0,45 and 90 degrees, heat polymerized polymethyl methacrylate, auto polymerizing resin and bis-acryl composites resins and tested for fracture load and surface roughness. One way ANOVA and Tukey tests were used to analyze the data. RESULTS: For fracture load, lowest mean value was obtained for auto polymerizing bis-acrylic resin (464.9N) and highest value for 0 degree (596 N), while surface roughness values were lowest for heat polymerized polymethyl methacrylate (0.132µm), and the highest for auto polymerizing polymethyl methacrylate (0.836 µm). Significant differences were obtained between three build directions for fracture load and surface roughness (p=0.001); in all pairwise comparisons except between 0 and 90 degrees (p=0.502) for fracture load; and between all three build directions for surface roughness (p=0.01). On comparing with other provisional materials, significant difference (p=0.001) was observed between all groups. Conclusion- Build direction affected the mechanical properties of additively manufactured three-unit provisionals with 0 degree printed provisionals showing highest fracture load and lowest surface roughness. On comparing with other provisional materials, 0 degree showed highest fracture load, with surface roughness similar to heat polymerized provisionals.
ABSTRACT
STATEMENT OF PROBLEM: The congruence of surgical implant placement with the preplanned position is important for anatomic and prosthetic precision, minimal complications, and increased longevity. The influence of implant placement timing on the surgical deviations in single posterior implants is unclear. PURPOSE: The purpose of this clinical study was to compare deviations between preplanned and single posterior immediate and delayed implants placed using computer-guided digital light processing (DLP) surgical guides fabricated using intraoral scanning and cone beam computed tomography (CBCT). MATERIAL AND METHODS: Implant surgery was performed on 24 participants requiring single immediate or delayed implants in the posterior maxillary and mandibular regions, for which the surgical site data were obtained from CBCT and intraoral scanning. Subsequently, virtual implant planning and DLP surgical guides were fabricated. Preimplant and postimplant placement CBCT scans were overlapped, and mean deviations for the immediate and delayed implant groups were calculated. The groups were compared with unpaired t tests (α=.05). RESULTS: A total of 24 implants were placed, 12 in each group. In participants who received immediate implant placement, the mean ±standard deviation angular deviation, linear deviation at shoulder, linear deviation at apex, and vertical deviation were 1.03 ±0.70 degrees, 0.26 ±0.30 mm, 0.23 ±0.24 mm, and 0.39 ± 0.34 mm, respectively. In participants who received delayed implant treatment, the deviations were 0.53 ±0.60 degrees, 0.15 ±0.18 mm, 0.25 ±0.33 mm, and 0.17 ±0.10 mm, respectively. Significant differences between the 2 groups were found in the vertical deviation (P<.05). CONCLUSIONS: The timing of the single posterior placement was associated with different deviations in the vertical direction. All deviations obtained were below the recommended values. DLP surgical guides fabricated from intraoral and CBCT scans provided accurate implant placement in immediate and delayed single posterior implants.