RESUMO
OBJECTIVES: To evaluate the survival rate of ceramic and indirect composite inlays, onlays, and overlays manufactured according to different methods (CAD/CAM, pressable, and stratified). MEDLINE, EMBASE, and Cochrane Library databases were searched for published articles. Risk of bias, data extraction, subgroup analysis, meta-analysis, and GRADE was performed. MATERIALS AND METHODS: Prospective, retrospective, or RCT studies, without restriction of language, from 1983 to 2019, with follow-up ≥5 years, reporting survival rates were screened independently by two reviewers in accordance with eligibility criteria. RESULTS: A total of 13 articles (12 for ceramic, one for indirect composite) met the inclusion criteria. No articles were included regarding crystalline ceramic. The estimated cumulative survival rate for CAD/CAM was 97% after 5 years and 89% after 10 years; for pressable was 95% after 5 years, and for stratified was 88% after 5 years and 93% after 10 years. CONCLUSIONS: Regardless of the manufacturing method, vitreous ceramic inlays, onlays, and overlays showed high survival, providing evidence that these restorations are a safe treatment. CLINICAL RELEVANCE: Vitreous ceramic inlays, onlays, and overlays showed high survival, regardless of the manufacturing method, providing evidence that these restorations are a safe treatment.
Assuntos
Cerâmica , Resinas Compostas , Porcelana Dentária , Falha de Restauração Dentária , Estudos Prospectivos , Estudos Retrospectivos , Taxa de SobrevidaRESUMO
Photobiomodulation (PBM) therapy displays relevant properties for tissue healing and regeneration, which may be of interest for the tissue engineering field. Here, we show that PBM is able to improve cell survival and to interact with recombinant human Bone Morphogenetic Protein 4 (rhBMP4) to direct and accelerate odonto/osteogenic differentiation of dental derived mesenchymal stem cells (MSCs). MSCs were encapsulated in an injectable and thermo-responsive cell carrier (Pluronic® F-127) loaded with rhBMP4 and then photoactivated. PBM improved MSCs self-renewal and survival upon encapsulation in the Pluronic® F-127. In the presence of rhBMP4, cell odonto/osteogenic differentiation was premature and markedly improved in the photoactivated MSCs. An in vivo calvarial critical sized defect model demonstrated significant increase in bone formation after PBM treatment. Finally, a balance in the reactive oxygen species levels may be related to the favorable results of PBM and rhBMP4 association. PBM may act in synergism with rhBMP4 and is a promise candidate to direct and accelerate hard tissue bioengineering.
Assuntos
Proteína Morfogenética Óssea 4/administração & dosagem , Portadores de Fármacos , Terapia com Luz de Baixa Intensidade/métodos , Células-Tronco Mesenquimais/efeitos dos fármacos , Células-Tronco Mesenquimais/efeitos da radiação , Poloxâmero/química , Engenharia Tecidual/métodos , Alicerces Teciduais , Adolescente , Adulto , Animais , Proteína Morfogenética Óssea 4/química , Regeneração Óssea , Diferenciação Celular/efeitos dos fármacos , Diferenciação Celular/efeitos da radiação , Proliferação de Células/efeitos dos fármacos , Proliferação de Células/efeitos da radiação , Autorrenovação Celular/efeitos dos fármacos , Autorrenovação Celular/efeitos da radiação , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos da radiação , Células Cultivadas , Humanos , Hidrogéis , Injeções , Lasers Semicondutores , Terapia com Luz de Baixa Intensidade/instrumentação , Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais/metabolismo , Camundongos Nus , NF-kappa B/metabolismo , Osteogênese/efeitos dos fármacos , Osteogênese/efeitos da radiação , Osso Parietal/lesões , Osso Parietal/patologia , Osso Parietal/cirurgia , Espécies Reativas de Oxigênio/metabolismo , Fatores de Tempo , Adulto JovemRESUMO
Endotoxins released in the dental root by Gram-negative microorganisms can be neutralized by calcium hydroxide, when this medication is applied inside the root canal for at least seven days. However, several clinical situations demand faster root canal decontamination. Thus, for faster endotoxin neutralization, endodontists are seeking additional treatments. The in vitro study tested whether or not intracanal Nd:YAG laser irradiation would be able to neutralize endotoxin within the human dental root canal in a single session. Twenty-four human teeth with one root were mounted between two chambers. After conventional endodontic treatment, root canals were contaminated with Escherichia coli endotoxin. Then they were irradiated or not (controls) in contact mode with an Nd:YAG laser (1.5 W, 15 Hz, 100 mJ and pulse fluency of 124 J/cm2). The endotoxin activity was measured using the limulus lysate technique and data were statistically compared (p≤0.05). The concentration of active endotoxin measured in the negative control group was significantly lower than that of the positive control group (p=0.04). The concentrations of endotoxin in both irradiated groups were significantly lower than that of the positive control group (p=0.027) and similar to that of negative control group (p=0.20). A single session of intracanal Nd:YAG laser irradiation is able to neutralize endotoxin in the dental root tissues.
