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1.
Int J Oral Maxillofac Surg ; 51(3): 412-425, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-34391592

RESUMEN

The objective of this systematic review was to assess whether the use of topical anesthetics reduces the perception of pain during puncture and anesthetic infiltration. Twenty-two randomized controlled clinical trials, published in English on or before August 6, 2020, were found in the PubMed/MEDLINE, Scopus, and Cochrane Library databases. Risk of bias was determined for randomization and other issues. A total of 1029 patients were evaluated using parameters such as type of topical anesthetic, application site, and pain (measured on a scale). Some studies assessed more than one topical anesthetic. Seventeen of them showed a reduction in pain from needle puncture and four from infiltration. Meta-analyses for some results showed considerable statistical heterogeneity. Regarding pain during needle puncture of the maxilla, statistically significant differences were observed in the topical anesthetics group, in both the vestibular (P = 0.0002) and palatal (P = 0.005) region. This was different from the mandible, for which there was no statistically significant difference (P = 0.07). With regard to pain caused by anesthetic infiltration in the maxilla, there was no difference in the use of anesthetic in relation to the control group (P = 0.11). Given these findings, using topical anesthetics only relieves pain during needle puncture and in the maxilla. PROSPERO 2020: CRD42020206362.


Asunto(s)
Anestésicos Locales , Lidocaína , Anestésicos Locales/uso terapéutico , Humanos , Dolor/etiología , Dolor/prevención & control , Dimensión del Dolor/métodos , Percepción , Punciones/efectos adversos , Ensayos Clínicos Controlados Aleatorios como Asunto
2.
Int J Oral Maxillofac Surg ; 51(3): 355-365, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-34238645

RESUMEN

The aim of this study was to evaluate the efficacy of low-level light therapy (LLLT) in improving pain, oedema, and neurosensory disorders of the inferior alveolar nerve (IAN) after orthognathic surgery. This systematic review was performed in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Searches were conducted in the PubMed, Embase, and Web of Science databases for randomized clinical trials (RCTs) published up to September 2020. After evaluating eligibility, 15 RCTs were selected. None of the studies reported an evaluation of all of the outcomes within the same publication. It was possible to determine the effect of LLLT in controlling pain following orthognathic surgery. Of the three studies evaluating this outcome, all observed a positive effect. Of the four studies that evaluated oedema, two found a positive effect. Of the 11 studies that evaluated neurosensory disorders of the IAN, all of them observed a positive effect, at least in one of the sensory evaluation tests. A meta-analysis was not possible due to the heterogeneity across studies. Considering the limitations of this review, but given the fact that LLLT is a minimally invasive intervention, its use merits consideration in immediate postoperative orthognathic surgery.


Asunto(s)
Terapia por Luz de Baja Intensidad , Cirugía Ortognática , Edema/prevención & control , Humanos , Dolor , Manejo del Dolor
3.
Br J Oral Maxillofac Surg ; 59(10): 1166-1173, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34274169

RESUMEN

The objective of this study was to compare, through a systematic review with a meta-analysis, the relative risks of arthroscopy and arthrocentesis in the temporomandibular joint. MEDLINE/PUBMED, EMBASE, Cochrane Library (CENTRAL), Web of Science, SCOPUS were the researched databases, as well as grey literature and manual searches. The search results showed 656 studies, but only five met the eligibility criteria. The evaluation included 194 joints (104 patients): 101 were arthroscopy and 93 arthrocentesis. Complications were observed in four patients undergoing arthroscopy (two with temporary facial paralysis and two with prolonged cervical oedema) and in three patients undergoing arthrocentesis (two with severe bradycardia and one with prolonged cervical oedema). The meta-analysis demonstrated a relative risk of 0.99 for complications after arthroscopy compared with arthrocentesis, but the results showed no statistical differences. In conclusion, this systematic review suggests that there is no increased risk of complications with arthroscopy than arthrocentesis. When complications were present, they were temporary.


Asunto(s)
Artrocentesis , Trastornos de la Articulación Temporomandibular , Artroscopía , Edema , Humanos , Articulación Temporomandibular , Resultado del Tratamiento
4.
Int J Oral Maxillofac Surg ; 50(2): 242-250, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32921557

RESUMEN

The purpose of this systematic review was to compare computer-guided (fully guided) and freehand implant placement surgery in terms of marginal bone loss, complications, and implant survival. This review followed the PRISMA guidelines and was registered in the PROSPERO database (CRD42019135893). Two independent investigators performed the search of the PubMed/MEDLINE, Scopus, and Cochrane Library databases for studies published up to April 2020 and identified 1508 references. After a detailed review, only four studies were considered eligible. These studies involved a total of 154 patients with 597 dental implants and a mean follow-up period of 2.25 years. There was no difference between computer-guided surgery and freehand surgery in terms of the marginal bone loss (mean difference -0.11mm, 95% confidence interval (CI) -0.27 to 0.04mm; P=0.16), mechanical complications (risk ratio (RR) 0.85, 95% CI 0.36-2.04; P=0.72), biological complications (RR 1.56, 95% CI 0.42-5.74; P=0.51), and implant survival rate (RR 0.53, 95% CI 0.11-2.43; P=0.41). This meta-analysis demonstrated that both computer-guided and freehand surgeries yielded similar results for marginal bone loss, mechanical and biological complications, and implant survival rate.


Asunto(s)
Implantes Dentales , Computadores , Implantación Dental Endoósea , Fracaso de la Restauración Dental , Humanos
5.
Eur J Prosthodont Restor Dent ; 29(2): 76-83, 2021 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-33146474

RESUMEN

This study aimed to assess the effects of splinting in 3-unit implant-supported prostheses with varying the splinting factor, length of the implant, and the diameter of the 1°molar (1°M) implant on cortical bone tissue (CBT). Twelve 3D models were simulated, which represented the posterior maxillary with 3 implants, supporting 3-unit FDP varying the splinting factor (single-unit crowns, splinted crowns straight-line and offset implant configuration [OIC]), length of the implant (7mm and 8,5mm), and the diameter of the 1°M (Ø4 mm and Ø5 mm). The CBT was analyzed by maximum principal stress and microstrain maps. The increase in implant diameter improved the biomechanical behavior of rehabilitation. The increase of the implant diameter in the 1°M associated with OIC generated the best biomechanical behavior for CBT. The splinting was effective in decreasing stress and microstrain, mainly when associated with OIC and implant diameter of Ø5 in the 1°M. The effect of increasing the diameter of the implant referring to the 1°M for single-unit crowns was more effective than the effect of the splinting of implants with Ø4 mm in straight-line. The diameter and splinting factors showed to be more important than implant length to reduce the stress and microstrain on CBT.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Fenómenos Biomecánicos , Coronas , Diseño de Prótesis Dental , Análisis del Estrés Dental , Análisis de Elementos Finitos , Estrés Mecánico
6.
Oper Dent ; 45(6): 589-597, 2020 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-32502260

RESUMEN

CLINICAL RELEVANCE: The use of laser light during bleaching will not reduce the incidence or severity of sensitivity and will not increase the degree of color change compared with nonlaser light sources. SUMMARY: Objective: To evaluate whether the use of laser during in-office bleaching promotes a reduction in dental sensitivity after bleaching compared with other light sources.Methods: The present review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and is registered with PROSPERO (CDR42018096591). Searches were conducted in the PubMed/Medline, Web of Science, and Cochrane Library databases for relevant articles published up to August 2018. Only randomized clinical trials among adults that compared the use of laser during in-office whitening and other light sources were considered eligible.Results: After analysis of the texts retrieved during the database search, six articles met the eligibility criteria and were selected for the present review. For the outcome dental sensitivity, no significant difference was found favoring any type of light either for intensity (mean difference [MD]: -1.60; confidence interval [CI]: -3.42 to 0.22; p=0.09) or incidence (MD: 1.00; CI: 0.755 to 1.33; p=1.00). Regarding change in tooth color, no significant differences were found between the use of the laser and other light sources (MD: -2.22; CI: -6.36 to 1.93; p=0.29).Conclusions: Within the limitations of the present study, laser exerts no influence on tooth sensitivity compared with other light sources when used during in-office bleaching. The included studies demonstrated that laser use during in-office bleaching may have no influence on tooth color change.


Asunto(s)
Sensibilidad de la Dentina , Blanqueadores Dentales , Blanqueamiento de Dientes , Diente , Adulto , Humanos , Peróxido de Hidrógeno , Luz , Blanqueamiento de Dientes/efectos adversos
7.
Oper Dent ; 45(6): 598-607, 2020 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-32503033

RESUMEN

CLINICAL RELEVANCE: One-step self-etch adhesive systems provide a clinical time gain, decreasing the number of clinical steps. When a clinician is able to follow a simpler process of adhesion there is less chance of adhesive failure. SUMMARY: Objective: A systematic review and meta-analyses were performed to evaluate whether one-step self-etching (1SSE) adhesive systems are as effective as two-step self-etching (2SSE) adhesives in noncarious cervical lesion (NCCL) restorations.Methods: This systematic review was conducted according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and recorded in the PROSPERO (CRD42018096747). Electronic systematic searches were conducted in the following databases: PubMed/MEDLINE, Scopus, and Cochrane Library for published articles. Only randomized clinical trials that compared 1SSE with 2SSE adhesives systems were selected. The outcomes were retention, postoperative sensitivity, secondary caries, color match, marginal discoloration, marginal adaptation, and anatomical form.Results: The searches resulted in 476 studies. After applying the eligibility criteria, five randomized controlled trials were selected in which 822 restorations in NCCLs were distributed in 237 patients. The results showed no statistical difference between 1SSE and 2SSE in relation to retention (p=0.23; relative risk [RR]=1.55; 95% confidence interval [CI]=0.76, 3.19), postoperative sensitivity ( p=0.50; RR=3.00; 95% CI=0.13, 70.64), Secondary caries (p=0.63; RR=0.68; 95% CI=0.14, 3.31), color match (p=0.41; RR=0.64; 95% CI=0.23, 1.83), marginal discoloration (p=0.93; RR=1.02; 95% CI=0.65, 1.61), and anatomical form (p=0.56; RR=1.38; 95% CI=0.46, 4.13). However there was statistical difference in relation to marginal adaptation ( p=0.01; RR=1.95; 95% CI=1.14, 3.34).Conclusion: This systematic review with meta-analysis revealed that both 1SSE and 2SSE adhesive systems have comparable clinical effectiveness in a follow-up period of 12 to 24 months, except in relation to marginal adaptation.


Asunto(s)
Restauración Dental Permanente , Recubrimientos Dentinarios , Adhesivos , Resinas Compuestas , Cementos Dentales , Adaptación Marginal Dental , Humanos , Cementos de Resina , Cuello del Diente
8.
Oper Dent ; 45(3): 265-275, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32396502

RESUMEN

OBJECTIVE: The aim of this systematic review and meta-analysis was to evaluate a high concentration of hydrogen peroxide (35%) regarding tooth sensitivity and color change in tooth bleaching in comparison to low concentrations (6% to 20%). METHODS AND MATERIALS: This review was conducted using the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and is registered on the Prospective Register of Systematic Reviews (CRD42017064493). The PICO question was "Does a concentration of hydrogen peroxide ≥35% using in-office bleaching procedure contribute to greater tooth sensitivity?" A search was made in PubMed/MEDLINE, Scopus, and the Cochrane Library. RESULTS: Fourteen studies were selected for the qualitative analysis and seven for quantitative analysis. A total of 649 patients were evaluated (mean age: 36.32 years; range: 13.9 to 31 years), and the follow-up period ranged from one week to 12 months. The meta-analysis demonstrated that tooth sensitivity was higher in the patients submitted to treatment involving a high concentration of hydrogen peroxide (0.67; 95% confidence interval [CI]: 0.44 to 1.03; p=0.04; I 2 : 56%), and a significant difference was found regarding objective color ΔE (1.53; 95% CI: 2.99 to 0.08; p<0.0001; I 2 : 82%) but no significant difference was found regarding subjective color ΔSGU (0.24; CI: 0.75 to 1.23; p<0.00001; I 2 : 89%). CONCLUSIONS: This study indicated that a lower concentration of hydrogen peroxide causes less tooth sensitivity and better effectiveness in objective color change (ΔE); however, there is no difference between them related to subjective color (ΔSGU).


Asunto(s)
Sensibilidad de la Dentina , Blanqueadores Dentales , Blanqueamiento de Dientes , Preescolar , Color , Humanos , Peróxido de Hidrógeno , Lactante , Resultado del Tratamiento
9.
Int J Oral Maxillofac Surg ; 49(9): 1220-1231, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29685387

RESUMEN

No consensus has been reached regarding the influence of the flapless and open-flap surgical techniques on the placement of dental implants. This systematic review compared the effects of flapless implant placement and implant placement with elevation of the mucoperiosteal flap in terms of marginal bone loss, implant survival rate and complications rates. This review followed PRISMA guidelines and was registered in PROSPERO with the registration number CRD42017071475. Two independent reviewers performed a comprehensive search of the PubMed/MEDLINE, Scopus, and Cochrane Library databases for studies published until December 2017. The search identified 559 references. After a detailed review, 24 studies were assessed for eligibility. A total of 1025 patients who had received a total of 1873 dental implants were included. There were no significant differences between the flapless and open-flap surgical techniques in terms of implant survival rates (P=0.34; risk ratio (RR): 1.36; confidence interval (CI): 0.72-2.56), marginal bone loss (P=0.23; MD: -0.20; CI: -0.52-0.13), or complication rates (P=0.67; RR: 1.10; CI: 0.70-1.73). The current meta-analysis showed that the implant survival rate, marginal bone levels, and complications of flapless surgery were similar to those of open-flap surgery over a mean follow-up period of 21.62 months.


Asunto(s)
Implantación Dental Endoósea , Implantes Dentales , Humanos , Colgajos Quirúrgicos
10.
Oper Dent ; 45(2): E66-E76, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31750804

RESUMEN

OBJECTIVE: This systematic review evaluates the effect of preemptive analgesia on tooth sensitivity induced by in-office tooth bleaching. METHODS: The review was structured based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist. The methods were recorded at PROSPERO (CRD42018095440). Randomized clinical trials, studies published in English, and studies in which the efficacy of preemptive analgesia with analgesic and anti-inflammatory medications prior to in-office tooth bleaching was compared with that of placebo were included. PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library were used for searching. The electronic search provided 373 articles, and seven of them were selected based on the inclusion criteria. RESULTS: Immediately after time point, a significant reduction of dental sensitivity was observed in the drug group compared to the control group (p=0.02; mean difference [MD]: -0.90; confidence interval [CI]: -1.63 to -0.16), while there was no significant difference at up to one-hour (p=0.22; MD: -0.42; CI: -1.09 to -0.25), at 1-24-hour (p=0.88; MD: -0.05; CI: -0.61 to 0.72), or 24-48-hour (p=0.69; MD: 0.05; CI: -0.21 to 0.32) time points. The incidence of sensitivity during the procedure was not statistically different between the groups (p=0.64; MD: 0.91; CI: 0.92 to 1.15). The nonsteroidal anti-inflammatory drug group showed a statistically significant reduction (p=0.04; MD: -0.69; CI: -1.36 to -0.03) in tooth sensitivity compared with the other groups. CONCLUSIONS: This systematic review and meta-analysis demonstrated that the medications analyzed did not interfere with the incidence of sensitivity symptoms. Regarding the intensity, no difference was observed between the drug and placebo groups at the up to one-hour, 1-24-hour, or 24-48-hour time points, and there was a statistically significant difference at the zero-hour time point in favor of the drug group. However, based on the variables that influenced this result, it should be considered with prudence because a small difference was observed.


Asunto(s)
Sensibilidad de la Dentina , Blanqueadores Dentales , Blanqueamiento de Dientes , Diente , Analgésicos , Humanos
11.
Int J Oral Maxillofac Surg ; 48(9): 1241-1249, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30792086

RESUMEN

The aim of this systematic review was to test the following hypotheses: (1) that there is no difference in implant survival rate between individuals with overweight or obesity and those who are within the ideal weight range; (2) that there are no differences between these groups regarding indicators of peri-implant health. Two independent reviewers performed a literature search of the PubMed/MEDLINE, Scopus, and Cochrane Library databases for studies published up to April 1, 2018. A meta-analysis was performed to determine the risk difference for implant failure and mean difference for marginal bone loss, probing depth, and bleeding on probing. Six studies were selected for review, involving a total of 746 patients with 986 implants: 609 in overweight or obese individuals and 377 in individuals within the ideal weight range. The findings of this systematic review indicate that the first hypothesis should be accepted, since no statistically significant difference in implant survival rate was found between individuals with overweight/obesity and those within the ideal weight range (P=0.64). The second hypothesis was rejected, as the review indicated a difference in marginal bone loss (P<0.00001), probing depth (P<0.00001), and bleeding around dental implants (P<0.00001).


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Fracaso de la Restauración Dental , Humanos , Obesidad , Complicaciones Posoperatorias
12.
Int J Oral Maxillofac Surg ; 48(10): 1355-1366, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29759309

RESUMEN

The aim of this review was to test the hypothesis of no difference in the efficacy of bone regeneration when using stem cells in maxillary sinus floor augmentation surgery in comparison to other grafts. Nine randomized clinical trials and one follow-up study involving human subjects were identified through a search of the PubMed/MEDLINE, Scopus, Cochrane, and Web of Science databases, supplemented by a hand search. No significant difference between groups was found for the implant survival rate, increase in bone height, marginal bone loss following implant placement, or new bone formation. With regard to the residual bone graft, an effect favouring the graft group at 3-4months (P=0.001) and favouring the stem cell group at 6months (P=0.01) was found. Analyses of the subgroup in which the BMAC system extraction method was used in combination with Bio-Oss, revealed no difference in new bone formation; however, the results for residual bone graft at 3months favoured the control graft (Bio-Oss) (P=0.01), but at 6months favoured the stem cells (Bio-Oss+BMAC system) (P=0.01). Based on all findings, the use of stem cells does not contribute significantly to greater implant survival rates or the efficacy of bone regeneration following sinus lift procedures.


Asunto(s)
Sustitutos de Huesos , Implantes Dentales , Elevación del Piso del Seno Maxilar , Trasplante Óseo , Implantación Dental Endoósea , Estudios de Seguimiento , Humanos , Seno Maxilar , Ensayos Clínicos Controlados Aleatorios como Asunto , Células Madre
13.
Oper Dent ; 44(3): E105-E117, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-29893625

RESUMEN

OBJECTIVE: A systematic review and meta-analyses were performed to evaluate the efficacy of tooth color change and sensitivity of teeth following in-office bleaching with and without light gel activation in adult patients. METHODS: This review was registered at PROSPERO (CRD 42017060574) and is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Electronic systematic searches of PubMed/MEDLINE, Web of Science, and the Cochrane Library were conducted for published articles. Only randomized clinical trials among adults that compared in-office bleaching with and without light activation with the same bleaching gel concentrations were selected. The outcomes were tooth color change and tooth sensitivity prevalence and intensity. RESULTS: Twenty-three articles from 1054 data sources met the eligibility criteria. After title and abstract screening, 39 studies remained. Sixteen studies were further excluded. Twenty-three studies remained for qualitative analyses and 20 for meta-analyses of primary and secondary outcomes. No significant differences in tooth color change or tooth sensitivity incidence were found between the compared groups; however, tooth sensitivity intensity decreased when light sources were applied. CONCLUSION: The use of light sources for in-office bleaching is not imperative to achieve esthetic clinical results.


Asunto(s)
Sensibilidad de la Dentina , Blanqueadores Dentales , Blanqueamiento de Dientes , Diente , Adulto , Humanos , Peróxido de Hidrógeno
14.
Int J Oral Maxillofac Surg ; 48(1): 118-131, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-29941229

RESUMEN

The aim of this systematic review was to identify randomized, placebo-controlled clinical trials investigating the effectiveness of corticosteroids in the control of pain, oedema, and trismus following third molar surgery, and to analyse the effects of the type of drug administered and the time and route of drug administration on the outcomes of interest. Searches were performed in the PubMed, Scopus, and Cochrane Library databases. This review was structured according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The search identified 1223 studies. After assessing eligibility based on the inclusion and exclusion criteria, 17 studies were selected for the qualitative analysis (a total of 730 patients aged 15-45 years). Ten studies were included in the meta-analysis, which was performed using Review Manager software. The corticosteroids were effective in controlling pain (P=0.002; mean difference -17.38, 95% confidence interval -24.81 to -9.95) and trismus (P<0.00001; mean difference 6.10, 95% confidence interval 3.42 to 8.77). With the exception of the submucosal route, the route of administration did not appear to affect the outcomes. The administration of a corticosteroid in the preoperative phase was superior to its use in the postoperative phase for the control of trismus.


Asunto(s)
Corticoesteroides/uso terapéutico , Edema/tratamiento farmacológico , Tercer Molar/cirugía , Dolor Postoperatorio/tratamiento farmacológico , Extracción Dental , Diente Impactado/cirugía , Trismo/tratamiento farmacológico , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto
16.
J Oral Rehabil ; 45(8): 647-656, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-29761853

RESUMEN

Splinted and unsplinted overdenture attachment systems have unique advantages and disadvantages. The aim of the present systematic review was to determine the influence of splinted and unsplinted overdenture attachment systems on the marginal bone loss, prosthetic complications and implant survival rate. PubMed/MEDLINE, Scopus and Cochrane databases were searched for articles published up to October 2017, using the following search terms: "overdenture AND attachment OR overdenture AND bar OR overdenture splinted." The PICO question "Do splinted overdenture attachment systems promote better clinical results in comparison to unsplinted systems?" was evaluated. Eligible studies included randomized controlled clinical trials, prospective studies with at least 10 participants and a minimum follow-up of 6 months, and studies published in English that compared splinted and unsplinted attachment systems within the same study. The 95% confidence interval (CI) was considered for all outcomes analysed. After completion of the different steps in the article selection process, nine articles were included in the qualitative and quantitative analyses. A total of 984 implants were placed in 380 patients (mean age: 62.8 years). The meta-analysis demonstrated no statistically significant differences between splinted and unsplinted attachment systems with regard to marginal bone loss (P = .39; MD: -0.11; 95% CI: -0.37 to 0.14), complications (P = .31; RR: 1.26; CI: 0.80-1.99) and implant survival rate (P = .14; RR: 0.37% CI: 0.10-1.36). In addition, splinted and unsplinted overdenture attachment systems achieved similar results with regard to marginal bone loss, prosthetic complications and implant survival rate.


Asunto(s)
Pérdida de Hueso Alveolar/fisiopatología , Prótesis Dental de Soporte Implantado , Retención de Dentadura/instrumentación , Oseointegración/fisiología , Pérdida de la Inserción Periodontal/fisiopatología , Implantes Dentales , Diseño de Dentadura , Ajuste de Precisión de Prótesis , Prótesis de Recubrimiento , Humanos , Pérdida de la Inserción Periodontal/diagnóstico
17.
Int J Oral Maxillofac Surg ; 47(10): 1336-1342, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29555240

RESUMEN

No consensus has been reached on the use of dental implants in human immunodeficiency virus (HIV)-positive patients. This systematic review evaluated dental implants in HIV-positive patients in terms of implant survival and success rates, marginal bone loss, and complications. The review was conducted according to the PRISMA checklist. Two independent reviewers performed a comprehensive search of the PubMed/MEDLINE, Scopus, and Cochrane Library databases for studies published until October 2017. Six studies were selected for review. In total, 821 implants were placed: 493 in 169 HIV-positive patients, and 328 in 135 HIV-negative patients. The mean duration of follow-up was 47.9 months. Weighted mean survival rate, success rate, and marginal bone loss values were calculated for the HIV-positive patients. Mean survival and success rates at the patient level (according to the number of patients) were 94.76% and 93.81%, respectively; when calculated at the implant level (according to the number of implants), these rates were 94.53% and 90.37%, respectively. Mean marginal bone loss was 0.83mm at the patient level and 0.99mm at the implant level. Thus, dental implants are suitable for the rehabilitation of HIV-positive patients with controlled risk factors and normal CD4+ cell counts.


Asunto(s)
Implantes Dentales , Fracaso de la Restauración Dental , Seropositividad para VIH , Pérdida de Hueso Alveolar , Humanos , Complicaciones Posoperatorias
18.
Int J Oral Maxillofac Surg ; 47(9): 1166-1177, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29459128

RESUMEN

The aim of this meta-analysis was to verify the clinical viability of single implant-retained mandibular overdentures (SIMO). An electronic search of the PubMed and Cochrane databases was performed (end date July 2017); this was supplemented by a manual search of the literature. Only prospective clinical trials and randomized controlled trials (RCTs) that evaluated SIMO with a minimum follow-up of 12 months were included. The meta-analysis was based on the Mantel-Haenszel method. Dental implant and prosthetic failure were the dichotomous outcome measures; these were evaluated through the risk ratio (RR) and odds ratio (OR), with corresponding 95% confidence intervals (CI). Of 499 articles identified, nine fulfilled the inclusion criteria. A total of 205 implants were placed in patients with a mean age of 64.1 years; the cumulative survival rate was 96.6% over a mean follow-up period of 37.3 months. The procedure used (SIMO vs. two implant-retained mandibular overdenture) did not affect dental implant failure (P=0.45) or prosthetic failure (P=0.65): RR 1.06 (95% CI 0.91-1.23) and RR 0.88 (95% CI 0.51-1.51), respectively; OR 2.56 (95% CI 0.27-24.39; P=0.41) and OR 0.44 (95% CI 0.15-1.26; P=0.13), respectively. Within the limitations of this systematic review and meta-analysis, SIMO with a complete denture as the opposing arch may be considered an alternative treatment for completely edentulous patients. However, this study also confirmed the need for more RCTs on this topic.


Asunto(s)
Prótesis Dental de Soporte Implantado , Prótesis de Recubrimiento , Mandíbula , Implantes Dentales de Diente Único , Diseño de Prótesis Dental , Fracaso de la Restauración Dental , Humanos
19.
J Oral Rehabil ; 45(4): 344-354, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29314199

RESUMEN

No consensus has been reached regarding the best occlusal scheme for making complete dentures. Thus, the purpose of this systematic review was to compare bilateral balanced occlusion (BBO) with other occlusal schemes (canine guidance, lingualised occlusion and zero degree) in complete dentures. The schemes were compared in terms of quality of life/satisfaction and masticatory performance. Two independent reviewers performed a comprehensive search of studies published in or before October 2017 using the PubMed/MEDLINE, Scopus and Cochrane Library databases. The search was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The focused question was: "In conventional complete denture, is BBO better than lingualised occlusion, canine guidance and zero degree in terms of quality of life, patient satisfaction and masticatory performance/muscle activity?" Seventeen studies were selected for analysis. In total, there were 492 patients with a mean age of 64.78 years and a mean follow-up duration of 2.96 months (range: 1-6 months). All studies compared BBO with the other occlusal schemes. Eleven studies evaluated the influence of the occlusal scheme designs on quality of life and satisfaction, and 8 studies evaluated masticatory performance and muscle activity between BBO and the other occlusion schemes. The present systematic review indicated that BBO does not confer better quality of life/satisfaction or masticatory performance and muscle activity. Thus, lingualised occlusion can be considered a predictable occlusal scheme for complete dentures in terms of quality of life/satisfaction and masticatory performance, while canine guidance can be used to reduce muscular activity.


Asunto(s)
Oclusión Dental Balanceada , Dentadura Completa , Masticación/fisiología , Boca Edéntula/cirugía , Oclusión Dental Balanceada/normas , Diseño de Dentadura , Humanos , Boca Edéntula/fisiopatología , Satisfacción del Paciente , Calidad de Vida
20.
Int J Oral Maxillofac Surg ; 47(4): 480-491, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-28651805

RESUMEN

There is currently no consensus regarding the survival rate of osseointegrated implants in patients with osteoporosis. A systematic review with meta-analysis was performed to evaluate the survival rate of implants in such patients. The PubMed/MEDLINE, Web of Science, Cochrane Library, and SciELO databases were used to identify articles published up to September 2016. The systematic review was performed in accordance with PRISMA/PICO requirements and the risk of bias was assessed (Australian National Health and Medical Research Council scale). The relative risk (RR) of implant failure and mean marginal bone loss were analyzed within a 95% confidence interval (CI). Fifteen studies involving 8859 patients and 29,798 implants were included. The main outcome of the meta-analysis indicated that there was no difference in implant survival rate between patients with and without osteoporosis, either at the implant level (RR 1.39, 95% CI 0.93-2.08; P=0.11) or at the patient level (RR 0.98, 95% CI 0.50-1.89; P=0.94). However, the meta-analysis for the secondary outcome revealed a significant difference in marginal bone loss around implants between patients with and without osteoporosis (0.18mm, 95% CI 0.05-0.30, P=0.005). Data heterogeneity was low. An increase in peri-implant bone loss was observed in the osteoporosis group. Randomized and controlled clinical studies should be conducted to analyze possible biases.


Asunto(s)
Implantación Dental Endoósea , Implantes Dentales , Fracaso de la Restauración Dental , Osteoporosis/complicaciones , Humanos
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