ABSTRACT
Abstract The immediate loading of implant-assisted fixed prostheses in edentulous maxillae may achieve favorable success rates with reduced treatment time. An evidence summary of clinical trials is key to recommend loading protocols in these cases. Objectives To compare immediately loaded, fully implant-supported complete dentures to early and conventional/delayed loading in the edentulous maxillae of adult patients by a systematic review of controlled clinical trials (CCT). Methodology CCTs reports were identified up to January 17, 2019 from Cochrane Oral Health Group's Trial register, Cochrane Central Register of controlled trials (CENTRAL), MEDLINE (Ovid), BIOSIS, EMBASE, CINAHL, Web of Science, and DARE. Two independent reviewers screened titles/abstracts and confirmed inclusion using full texts. Data were extracted and quality assessed (Cochrane Risk of Bias tool) independently and in duplicate. Study heterogeneity prevented pooling by meta-analysis. Results Out of 1,052 candidate studies, four CCTs were included. Two trials had patient satisfaction as an outcome: (1) A randomized trial compared immediately and early loaded fixed dentures and found more satisfaction with the first after 12 months; (2) A non-randomized study found better satisfaction with immediate fixed dentures compared to conventional loading after 3 months (no more at 12 months). Regarding implant success and prosthetic complications, three trials did not report significant differences comparing immediate loading to other protocols. Conclusions This review found weak evidence of differences between immediate load and other loading regimens, regarding patient satisfaction and maintenance events/adversities. The potential of immediate loading for favorable results in edentulous maxillae reinforces the need for well-designed RCTs, for solid clinical guidelines. Registration number CRD42018071316 (PROSPERO database).
Subject(s)
Humans , Dental Prosthesis, Implant-Supported/methods , Denture, Complete , Immediate Dental Implant Loading/methods , Risk Factors , Treatment Outcome , Publication Bias , Controlled Clinical Trials as TopicABSTRACT
OBJECTIVES: To evaluate the color stability and hardness of two denture liners obtained by direct and indirect techniques, after thermal cycling and immersion in beverages that can cause staining of teeth. MATERIAL AND METHODS: Seventy disc-shaped specimens (18 x 3 mm) processed by direct (DT) and indirect techniques (IT) were made from Elite soft (n=35) and Kooliner (n=35) denture liners. For each material and technique, 10 specimens were subjected to thermal cycling (3,000 cycles) and 25 specimens were stored in water, coffee, tea, soda and red wine for 36 days. The values of color change, Shore A hardness (Elite soft) and Knoop hardness (Kooliner) were obtained. The data were subjected to ANOVA, Tukey's multiple-comparison test, and Kruskal-Wallis test (P<0.05). RESULTS: The thermal cycling promoted a decrease on hardness of Kooliner regardless of the technique used (Initial: 9.09± 1.61; Thermal cycling: 7.77± 1.47) and promoted an increase in the hardness in the DT for Elite Soft (Initial: 40.63± 1.07; Thermal cycling: 43.53± 1.03); hardness of Kooliner (DT: 8.76± 0.95; IT: 7.70± 1.62) and Elite Soft (DT: 42.75± 1.54; IT=39.30± 2.31) from the DT suffered an increase after the immersion in the beverages. The thermal cycling promoted color change only for Kooliner in the IT. Immersion in the beverages did not promote color change for Elite in both techniques. The control group of the DT of Kooliner showed a significant color change. Wine and coffee produced the greatest color change in the DT only for Elite Soft when compared to the other beverages. CONCLUSION: The three variation factors promoted alteration on hardness and color of the tested denture lining materials.
Subject(s)
Humans , Beverages , Denture Liners , Dental Materials/chemistry , Acrylic Resins/chemistry , Carbonated Beverages , Color , Colorimetry , Coffee/chemistry , Hardness , Immersion , Materials Testing , Polymerization , Polymethyl Methacrylate/chemistry , Spectrophotometry , Surface Properties , Silicone Elastomers/chemistry , Temperature , Time Factors , Tea/chemistry , Wine , Water/chemistryABSTRACT
This study evaluated the influence of methacrylic acid (MA) incorporation on hardness, roughness, and flexural strength of a denture base acrylic resin. Thirty-two circular and 40 rectangular specimens were divided into four groups, according to the concentration of MA substituted into the monomer component of a heat-polymerized acrylic resin, as follows: 0% (Control), 10%, 20% and 50% (v/v). The following properties were assessed: Vickers hardness, surface roughness, and flexural strength. Variables were analyzed by ANOVA/Tukeys test (α=.05). For the four incorporated MA concentrations (0%, 10%, 20% and 50%), the following results were obtained for hardness (19.0±1.4A, 19.6±1.3A, 19.6±0.9A, 14.2±0.6B VHN), surface roughness (0.26±0.05A, 0.17±0.01AB, 0.18±0.03AB, 0.13±0.03B μm) and flexural strengh (96.3±8.3A, 98.8±6.2A, 102.4±8.6A, 106.3±13.7A MPa). The incorporation of MA may cause slight changes in the structure of the tested material, as evidenced by the hardness test. However, the values for surface roughness reduced as MA concentration increased, suggesting that MA addition may improve the acrylic resin texture.
Este estudo avaliou a influência da incorporação do ácido metacrílico (AM) sobre a dureza, rugosidade e resistência flexural de uma resina acrílica para base de próteses removíveis. Trinta e dois espécimes circulares e 40 retangulares foram divididos em quatro grupos, conforme a concentração de AM substituído no componente monomérico de uma resina acrílica termopolimerizável: 0% (Controle), 10%, 20% e 50% (v/v). As seguintes propriedades foram avaliadas: dureza Vickers, rugosidade superficial e resistência flexural. As variáveis foram analisadas por meio de ANOVA seguida pelo teste de Tukey (α=0,05). Para as concentrações de AM incorporadas (0%, 10%, 20% e 50%), os seguintes resultados foram obtidos para a dureza (19,0±1,4A, 19,6±1,3A, 19,6±0,9A, 14,2±0,6B VHN), rugosidade superficial (0,26±0,05A, 0,17±0,01AB, 0,18±0,03AB, 0,13±0,03B μm) e resistência flexural (96,3±8,3A, 98,8±6,2A, 102,4±8,6A, 106,3±13,7A MPa). A incorporação do AM pode causar mudanças discretas nas propriedades estruturais do material testado, como evidenciado pelo teste de dureza. No entanto, os valores de rugosidade diminuíram em proporção ao acréscimo de AM, sugerindo que essa incorporação pode melhorar a textura da resina acrílica para base protética.
ABSTRACT
O estudo clínico randomizado (ECR) é uma das ferramentas mais poderosas para a obtenção de evidências para o cuidado à saúde. Apesar de algumas possíveis variações, baseiam se na comparação entre duas ou mais intervenções, as quais são controladas pelos pesquisadores e aplicadas de forma aleatória em um grupo de participantes. O objetivo deste artigo foi descrever aspectos relativos à validades externa e interna dos ECRs, bem como apresentar bases de dados para sua obtenção e ferramentas para avaliação de qualidade.
The randomized clinical trial (RCT) is one of the most powerful tools for the obtainment of evidence for health care. Despite some possible variations, they are based on the comparison between two or more interventions, which are controlled by researchers and randomly applied on a group of participants. The aim of this study was to describe aspects of external and internal validity of RCTs, as well as to present databases for their obtainment and quality assessment tools.