ABSTRACT
STATEMENT OF PROBLEM: Evidence on the long-term clinical assessment and longevity of ceramic veneers bonded to different substrates is limited. PURPOSE: The purpose of this systematic review and meta-analysis was to evaluate the effect of various substrates, including enamel, dentin, or an existing composite resin restoration, on the clinical survival and complication rates of ceramic veneers. MATERIAL AND METHODS: The PubMed, Scopus, and the Cochrane Library electronic databases were searched, and related journals were hand searched without time or language restrictions to identify clinical trials that compared the survival rate and clinical complication rates when bonding ceramic veneers to different tooth substrates. The success rate of the included participants was estimated by the number of veneers that did not require a clinical intervention, and the survival rate by all veneers that did not fail absolutely. The risk difference (RD) with 95% confidence intervals (CIs) for dichotomous outcomes was used to quantify the intervention effect. RESULTS: Of 973 screened articles, 6 clinical studies were included. The survival and success rates varied depending on the bonding substrate. Enamel-bonded veneers had almost perfect rates of survival (99% with a range of 98% to 100%) and success (99% with a range of 98% to 100%). Veneers bonded to composite resin or surfaces with minimal dentin exposure had slightly lower survival rates (94% with a range of 91% to 97% and 95% with a range of 91% to 100%, respectively) and success rates (70% with a range of 60% to 80% and 95% with a range of 90% to 99%). Severe dentin exposure significantly decreased both survival rates (91% with a range of 84% to 98%) and success rates (74% with a range of 64% to 85%). The combined findings suggested that ceramic veneers bonded to enamel had fewer clinical complications (RD: -0.04; 95% CI: -0.09 to 0.02) and lower failure rates (RD: -0.13; 95% CI: -0.32 to 0.07) compared with those bonded to exposed dentin. Additionally, veneers attached to teeth with minimal dentin exposure were significantly less likely to require clinical interventions (RD: -0.16; 95% CI: -0.31 to -0.01) and had a reduced incidence of failure (RD: -0.08; 95% CI: -0.17 to 0.01) compared with those with severe dentin exposure. CONCLUSIONS: Ceramic veneers bonded to enamel showed higher survival and success rates with lower clinical incidences of complications and failure than those bonded to dentin or teeth with existing composite resin restorations.
ABSTRACT
STATEMENT OF PROBLEM: The evidence regarding the application of artificial intelligence (AI) in identifying dental implant systems is currently inconclusive. The available studies present varying results and methodologies, making it difficult to draw definitive conclusions. PURPOSE: The purpose of this systematic review with meta-analysis was to comprehensively analyze and evaluate articles that investigate the application of AI in identifying and classifying dental implant systems. MATERIAL AND METHODS: An electronic systematic review was conducted across 3 databases: MEDLINE/PubMed, Cochrane, and Scopus. Additionally, a manual search was performed. The inclusion criteria consisted of peer-reviewed studies investigating the accuracy of AI-based diagnostic tools on dental radiographs for identifying and classifying dental implant systems and comparing the results with those obtained by expert judges using manual techniques-the search strategy encompassed articles published until September 2023. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the quality of included articles. RESULTS: Twenty-two eligible articles were included in this review. These articles described the use of AI in detecting dental implants through conventional radiographs. The pooled data showed that dental implant identification had an overall accuracy of 92.56% (range 90.49% to 94.63%). Eleven studies showed a low risk of bias, 6 demonstrated some concern risk, and 5 showed a high risk of bias. CONCLUSIONS: AI models using panoramic and periapical radiographs can accurately identify and categorize dental implant systems. However, additional well-conducted research is recommended to identify the most common implant systems.
ABSTRACT
The mandibular implant-retained overdentures (MIRO) are a highly successful prosthetic treatment option. However, an argument still present regarding its design and type of attachment system. This systematic review and meta-analysis aimed to perform a qualitative and quantitative analysis of the scientific literature regarding the telescopic attachments versus other attachment systems retaining mandibular implant overdentures. Manual and electronic database (PubMed and Cochrane) searches were performed to identify randomized controlled trials (RCTs) comparing telescopic versus other attachment systems. Independently, two investigators extracted the trials' data. The Cochrane tool was used for assessing the quality of included studies. Meta-analyses were performed for the included RCTs and reported the same outcome measures. Nine RCTs were identified. Three RCTs (corresponding to four publications) were included in the study. The other five trials were excluded from the study. The meta-analysis revealed no difference between telescopic crowns and ball attachment retaining mandibular implant overdenture as regards prosthodontic maintenance. Regarding peri-implant conditions, ball-retained mandibular overdenture showed statistically significant more probing depth around implants records in ball-retained overdenture when compared to the telescopic group. However, there are no statistically significant differences between two interventions in regard to marginal bone loss, bleeding index, gingival index, and plaque index. In conclusions, no significant differences in prosthodontic maintenance and peri-implant condition between telescopic attachments and ball attachments retaining MIRO. However, this should be considered with caution because of a limited number of included studies.
