Does arthroscopy cause more complications than arthrocentesis in patients with internal temporomandibular joint disorders? Systematic review and meta-analysis.

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.

Is there an association between overweight/obesity and dental implant complications? A systematic review and meta-analysis.

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).

Efficacy of corticosteroids versus placebo in impacted third molar surgery: systematic review and meta-analysis of randomized controlled trials.

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.

Splinted and unsplinted overdenture attachment systems: A systematic review and meta-analysis.

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.

Bilateral balanced occlusion compared to other occlusal schemes in complete dentures: A systematic review.

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.

Three-dimensional finite element analysis of stress distribution in retention screws of different crown-implant ratios.

The retaining screw of the implant-supported dental prosthesis is the weakest point of the crown/implant system. Furthermore, crown height is another important factor that may increase the lever arm. Therefore, the aim of this study was to assess the stress distribution in implant prosthetic screws with different heights of the clinical crown of the prosthesis using the method of three-dimensional finite element analysis. Three models were created with implants (3.75 mm × 10 mm) and crowns (heights of 10, 12.5 and 15 mm). The results were visualised by means of von Mises stress maps that increased the crown heights. The screw structure exhibited higher levels of stresses in the oblique load. The oblique loading resulted in higher stress concentration when compared with the axial loading. It is concluded that the increase of the crown was damaging to the stress distribution on the screw, mainly in oblique loading.