Narrow-diameter implants in the anterior region: A meta-analysis.

PURPOSE: Implants in the anterior region are challenging, and literature reporting outcomes of narrow-diameter implants (NDIs) in anterior sites is scarce. This systematic review summarized evidence of functional and esthetic performance of anterior single crowns supported by NDIs. MATERIALS AND METHODS: Ten databases were searched to find studies evaluating anterior single crowns supported by NDIs. Risk of bias was assessed, and random-effects meta-analyses were applied to analyze mean differences in survival, success, and marginal bone level (MBL). The review was registered in the PROSPERO database (CRD42018089886). RESULTS: Twenty-one studies meeting the screening criteria were included for qualitative analysis, and three for meta-analysis. A total of 892 NDIs, placed in 736 patients, were analyzed. Follow-up duration varied from 12 months to 14 years (mean: 40 months), and 16 failures (implant loss) were recorded. Fixed-effect meta-analysis (I2 = 0%) of survival rate revealed a risk difference of 0.02 (95% CI: -0.03 to 0.08), between NDIs and controls (regular-diameter implants), without differences between groups (P = .39). Success rates ranged from 84.2% to 100% (mean: 95.2%). Random-effects meta-analysis (I2 = 56%) of MBL indicated a mean difference of 0.02 mm (95% CI: -0.21 to 0.25), without differences between groups (P = .87). CONCLUSION: Single crowns supported by NDIs are a predictable treatment, since their survival rate and MBL are comparable to those supported by regular-diameter implants. Due to data shortage reporting esthetic outcomes, more studies are needed to evaluate the long-term performance of the single crowns supported by NDIs in the anterior region.

Comparative analysis of imaging techniques for diagnostic accuracy of peri-implant bone defects: a meta-analysis.

OBJECTIVE: The aim of this study was to systematically review the literature regarding diagnostic accuracy of imaging techniques in detecting peri-implant bone defects. STUDY DESIGN: The search was performed in 8 electronic databases from April to May 2016 and updated in September 2016. Studies that assessed imaging techniques to detect peri-implant bone defects were analyzed. RESULTS: The search yielded 680 articles published from 1991 to 2016. Of these, 12 studies were considered eligible for this review. The selected studies evaluated the use of cone beam computed tomography (CBCT), intraoral radiography (IR), computed tomography, and panoramic radiography. The sensitivity for CBCT was 59%, whereas the specificity was 67%. For IR, the sensitivity was 60%, and the specificity was 59%. Area under the curve values in receiver operating characteristic (ROC) analysis were 69% for CBCT and 63% for IR. For CBCT, the highest value for positive predictive value was 0.94, negative predictive value was 0.98, positive likelihood ratio was 21.3, and negative likelihood ratio was 1.28. For IR, the highest positive predictive value was 1.0, negative predictive value 1.0, positive likelihood ratio 50.0, and negative likelihood ratio 0.70. The highest diagnostic odds ratio was 80 for CBCT and 4.45 for IR. No conclusion could be drawn for additional techniques. CONCLUSIONS: Both CBCT and IR showed a clinically acceptable performance for assessing peri-implant bone defects.

Computer-aided analysis of digital dental impressions obtained from intraoral and extraoral scanners.

STATEMENT OF PROBLEM: The internal and marginal adaptation of a computer-aided design and computer-aided manufacturing (CAD-CAM) prosthesis relies on the quality of the 3-dimensional image. The quality of imaging systems requires evaluation. PURPOSE: The purpose of this in vitro study was to evaluate and compare the trueness of intraoral and extraoral scanners in scanning prepared teeth. MATERIAL AND METHODS: Ten acrylic resin teeth to be used as a reference dataset were prepared according to standard guidelines and scanned with an industrial computed tomography system. Data were acquired with 4 scanner devices (n=10): the Trios intraoral scanner (TIS), the D250 extraoral scanner (DES), the Cerec Bluecam intraoral scanner (CBIS), and the Cerec InEosX5 extraoral scanner (CIES). For intraoral scanners, each tooth was digitized individually. Extraoral scanning was obtained from dental casts of each prepared tooth. The discrepancy between each scan and its respective reference model was obtained by deviation analysis (µm) and volume/area difference (µm). Statistical analysis was performed using linear models for repeated measurement factors test and 1-way ANOVA (α=.05). RESULTS: No significant differences in deviation values were found among scanners. For CBIS and CIES, the deviation was significantly higher (P<.05) for occlusal and cervical surfaces. With regard to volume differences, no statistically significant differences were found (TIS=340 ±230 µm; DES=380 ±360 µm; CBIS=780 ±770 µm; CIES=340 ±300 µm). CONCLUSIONS: Intraoral and extraoral scanners showed similar trueness in scanning prepared teeth. Higher discrepancies are expected to occur in the cervical region and on the occlusal surface.

Bone defect rehabilitation using lyophilized bone preshaped on a stereolithographic model.

Bone grafting provides ideal conditions to the patient's rehabilitation with dental implants. In addition, prototyped tridimensional models allow the surgical procedure to be simulated and enable important anatomic structures to be visualized. To present a bone defect rehabilitated with xenogenic bone preshaped on a stereolithographic model and the follow-up after 7 years of treatment. The present case report describes a bone defect rehabilitated with a lyophilized bone block preshaped on a stereolithographic model. The patient, a 56-year-old woman, was referred to the dental office presenting a bone defect in the anterior maxilla. Bone regeneration intervention was performed with xenogenic grafting and barrier membrane. The follow-up of the postoperative period and after 7 years is presented. After 7 years, the tomographic exam showed the maintenance of bone at the grafted site, representing the long-term success of the treatment.

CEREC Chairside System to Register and Design the Occlusion in Restorative Dentistry: A Systematic Literature Review.

OBJECTIVE: The aim of this review was to update the literature with regard to the digital methods available by CEREC Chairside system to register and design the occlusion, to report their efficacy and technical innovations in the field of Restorative Dentistry. A search strategy was performed using the key-words: "virtual articulator," or "CAD-CAM and occlusal recording," or "CAD-CAM and occlusion register," or "CAD-CAM and occlusal contacts," or "CAD-CAM and prosthesis." MATERIAL AND METHODS: Inclusion criteria comprised studies evaluating the use of digital methods available by CEREC System for occlusal registration and design during prosthodontics treatment. PubMed and Cochrane library and reference lists were searched up to January 2016. RESULTS: The search resulted in 280 articles after removing duplicates. Subsequently, 233 records were excluded and 49 studies were selected for reading in full. Eleven articles were considered eligible for the systematic review (4 in vitro and 7 clinical studies). CONCLUSION: Scientific evidence suggests that digital methods were accurate to register and design the occlusion of dental prostheses. Nevertheless, further clinical studies are required to establish a conclusion with regard to its accuracy in prosthodontics treatment. CLINICAL SIGNIFICANCE: Digital technologies allow the design of occlusal surfaces of CAD-CAM fabricated prostheses using innovative approaches. This systematic review aimed to update the literature to help dentists determine the most appropriate digital method to register and design the occlusal surface of CAD-CAM crowns. (J Esthet Restor Dent 28:208-220, 2016).

Surface roughness of composite resins subjected to hydrochloric acid.

The purpose of this study was to determine the influence of hydrochloric acid on surface roughness of composite resins subjected to brushing. Sixty samples measuring 2 mm thick x 6 mm diameter were prepared and used as experimental units. The study presented a 3x2 factorial design, in which the factors were composite resin (n=20), at 3 levels: microhybrid composite (Z100), nanofilled composite (FiltekTM Supreme), nanohybrid composite (Ice), and acid challenge (n=10) at 2 levels: absence and presence. Acid challenge was performed by immersion of specimens in hydrochloric acid (pH 1.2) for 1 min, 4 times per day for 7 days. The specimens not subjected to acid challenge were stored in 15 mL of artificial saliva at 37 oC. Afterwards, all specimens were submitted to abrasive challenge by a brushing cycle performed with a 200 g weight at a speed of 356 rpm, totaling 17.8 cycles. Surface roughness measurements (Ra) were performed and analyzed by ANOVA and Tukey test (p≤0.05). Surface roughness values were higher in the presence (1.07±0.24) as compared with the absence of hydrochloric acid (0.72±0.04). Surface roughness values were higher for microhybrid (1.01±0.27) compared with nanofilled (0.68 ±0.09) and nanohybrid (0.48±0.15) composites when the specimens were not subjects to acid challenge. In the presence of hydrochloric acid, microhybrid (1.26±0.28) and nanofilled (1.18±0,30) composites presents higher surface roughness values compared with nanohybrid (0.77±0.15). The hydrochloric acid affected the surface roughness of composite resin subjected to brushing.

Surface Roughness of Composite Resins Subjected to Hydrochloric Acid

The purpose of this study was to determine the influence of hydrochloric acid on surface roughness of composite resins subjected to brushing. Sixty samples measuring 2 mm thick x 6 mm diameter were prepared and used as experimental units. The study presented a 3x2 factorial design, in which the factors were composite resin (n=20), at 3 levels: microhybrid composite (Z100), nanofilled composite (FiltekTM Supreme), nanohybrid composite (Ice), and acid challenge (n=10) at 2 levels: absence and presence. Acid challenge was performed by immersion of specimens in hydrochloric acid (pH 1.2) for 1 min, 4 times per day for 7 days. The specimens not subjected to acid challenge were stored in 15 mL of artificial saliva at 37 oC. Afterwards, all specimens were submitted to abrasive challenge by a brushing cycle performed with a 200 g weight at a speed of 356 rpm, totaling 17.8 cycles. Surface roughness measurements (Ra) were performed and analyzed by ANOVA and Tukey test (p≤0.05). Surface roughness values were higher in the presence (1.07±0.24) as compared with the absence of hydrochloric acid (0.72±0.04). Surface roughness values were higher for microhybrid (1.01±0.27) compared with nanofilled (0.68 ±0.09) and nanohybrid (0.48±0.15) composites when the specimens were not subjects to acid challenge. In the presence of hydrochloric acid, microhybrid (1.26±0.28) and nanofilled (1.18±0,30) composites presents higher surface roughness values compared with nanohybrid (0.77±0.15). The hydrochloric acid affected the surface roughness of composite resin subjected to brushing.

Este estudo avaliou a influencia do ácido clorídrico na rugosidade superficial de resinas compostas submetidas a escovação. Sessenta corpos de prova medindo 2 mm de espessura x 6 mm de diâmetro foram confeccionados e utilizados como unidades experimentais. O presente estudo envolve uma análise fatorial 3x2, onde os fatores foram resina composta (n=20), com 3 níveis: resina composta microhíbrida (Z100), nanoparticulada (Filtek TM Supreme) e nanohíbrida (Ice); e desafio ácido (n=10), com 2 níveis: ausência e presença. O desafio ácido foi realizado por meio da imersão em ácido clorídrico (pH 1,2) por 4 h diárias, 1 min cada imersão, durante 7 dias. Os espécimes que não foram submetidos ao desafio ácido foram armazenados em 15 mL de saliva artificial a 37 °C. Todos os espécimes foram submetidos ao desafio abrasivo. O processo de escovação foi realizado com 200 g de peso, com velocidade de 356 rpm, totalizando 17,8 ciclos. As medidas de rugosidade superficial (Ra) foram realizadas e analisadas por meio da ANOVA e teste de Tukey (p<0,05). Os valores de rugosidade superficial foram maiores na presença (1,07±0,24)quando comparado com a ausencia do ácido hidroclorídrico (0,72±0,04). A resina microhíbrida (1,01±0,27) apresentou maior rugosidade superficial que as resinas nanoparticulada (0,68±0,09) e nanohíbrida (0,48±0,15) quando os espécimes não foram submetidos ao desafio ácido. Na presença do ácido hidroclorídrico, a resina microhíbrida (1,26±0,28) e a resina nanoparticulada (1,18±0,30) apresentou maior valor de rugosidade superficia comparado com a resina nanohíbrida (0.77±0.15). O ácido hidroclorídrico influenciou a rugosidade superficial da resina composta submetida a escovação.