An Overview of Systematic Reviews and Meta-analyses Evaluating Different Impression Techniques for Implant-Supported Prostheses in Partially and Completely Edentulous Arches.

PURPOSE: To summarize the evidence and determine the most effective impression technique for implant-supported prostheses in terms of accuracy, time efficiency, and patient preference in partially and completely edentulous arches. MATERIALS AND METHODS: The searches were performed independently up to April 30, 2021 by two review authors through the Cochrane Oral Health Review, MEDLINE/PubMed, LILACS, and Science Direct databases. Moreover, manual and gray literature searches were performed to identify further potential reviews. Only English language-based systematic reviews with and without meta-analyses evaluating the different dental implant impression techniques were included. The outcomes assessed were accuracy, time efficiency, and patient preference. The methodologic quality of the included reviews was investigated by using the R-AMSTAR tool, and the degree of overlap of primary studies was assessed by calculating the percentage of corrected covered area (CCA) as proposed by Pieper et al.64 Results: The qualitative analysis included a total of 28 reviews, 8 of which included meta-analyses, published between 2008 and 2021, involving a total of 42 clinical trials and 203 laboratory studies. Digital vs conventional implant impression techniques were compared in 17 reviews, different digital impressions in 3 reviews, and different conventional impression techniques in the remaining reviews. Overall, the methodologic quality assessed by using the R-AMSTAR tool was moderate (mean: 26.7 ± 5.5) with slight overlap of primary studies (CCA; 5.23%). CONCLUSION: Within an overall moderate methodologic quality, the digital implant impressions showed favorable outcomes in terms of accuracy, time efficiency, and patient preference in partially edentulous arches involving three or fewer implants. However, the accuracy of full-arch digital impressions involving multiple implants is not satisfactory and needs significant improvements. Hence, future studies following stringent guidelines and robust methodology are recommended to substantiate the findings of this overview and provide a high level of evidence.

Histologic Assessment of Peri-implant Tissues Around Endosseous Dental Implants Placed Along with Intentionally Retained Root Fragment in Animal Models: A Systematic Review.

PURPOSE: To evaluate whether the placement of endosseous dental implants along with intentionally retained root fragments enhances peri-implant histologic characteristics and outcomes in healthy animal models. MATERIALS AND METHODS: Two review authors independently performed electronic literature searches across the PubMed/MEDLINE, LILACS, EBSCOhost, and Science Direct databases by using different keywords and Medical Subject Headings terms to identify relevant articles. Only preclinical animal trials evaluating the histology of peri-implant tissues around endosseous dental implants placed along with intentionally retained root fragments were included in the review. The risk of bias assessment was investigated using the Systematic Review Centre for Laboratory animal Experimentation (SYRCLE) tool, and the reporting quality of each trial was evaluated using the Animal Research: Reporting in Vivo Experiments guidelines. RESULTS: Seven preclinical trials including a total of 33 animals and 155 endosseous dental implants were eligible for the analysis. One trial reported the histologic assessment of peri-implant tissues around endosseous dental implants with ankylotic root fragments, whereas the other six studies used nonankylotic root fragments. The effects of the length of retained root fragments on peri-implant tissues were reported in two trials that showed contrasting results. The effects of the width of retained root fragments were assessed in two trials reporting that a remaining thickness < 2 mm and buccal bone thickness > 3 mm favors alveolar bone preservation over a period of 12 weeks. Although the mean quality assessment score for all preclinical trials was moderately high, the summary for the risk of bias presented a high risk. CONCLUSION: Limited data and short-term preclinical evidence showed optimal peri-implant histologic findings of endosseous dental implants placed along with intentionally retained root fragments. However, further preclinical histologic evaluation with homogenous populations and long-term controlled clinical studies are needed to substantiate its applicability in clinical situations.

Overview of Systematic Reviews and Meta-analyses Investigating the Efficacy of Different Nonsurgical Therapies for the Treatment of Peri-implant Diseases.

PURPOSE: To summarize the methodologic quality and outcome measures from systematic reviews and meta-analyses evaluating the efficacy of different nonsurgical therapies for the treatment of peri-implant diseases. MATERIALS AND METHODS: Two review authors independently searched for systematic reviews and meta-analyses evaluating the efficacy of different nonsurgical therapies for treatment of peri-implant diseases in three different databases: MEDLINE, Embase, and the Cochrane Library. In addition, journals with a high impact factor in the fields of periodontics, prosthodontics, oral maxillofacial surgery, and implant dentistry were analyzed for potential reviews. The search was implemented from January 2010 through August 2020. Eligible reviews were screened and assessed to determine the characteristics and outcome measures. Furthermore, two review authors independently evaluated the methodologic quality by using the AMSTAR tool and the checklist proposed by Glenny et al. The interrater agreement was assessed by using the Cohen kappa coefficient. The assessment of correlation between the findings of the AMSTAR tool and Glenny et al checklist was performed by using the Spearman correlation. RESULTS: Fifteen systematic reviews and 12 meta-analyses were evaluated based on the inclusion criteria. One review investigated the efficacy of growth factors and another investigated glycine powder air polishing, 5 evaluated the role of antimicrobial photodynamic therapy, 8 assessed the effect of laser therapy, and 13 compared the different nonsurgical therapies with the surgical therapies for the treatment of peri-implant diseases. The quality assessment score evaluated by the AMSTAR checklist ranged from 5 to 11 with a mean of 7.5 ± 1.8, whereas the score evaluated by the Glenny et al checklist ranged from 3 to 14 with a mean of 9.7 ± 2.8. Spearman correlation analysis between these two tools reported a high correlation (r = 0.91) that was statistically significant (P < .001). CONCLUSION: The summarized evidence of this overview shows that the different nonsurgical therapies are effective for the treatment of peri-implant mucositis. The lack of sufficient long-term data involving large datasets results in their inconclusive efficacy in the treatment of peri-implantitis. However, the summary is determined from the moderate quality of evidence. Hence, future well-designed high-quality trials are encouraged to reassess the findings.

Biomechanical and histomorphometric analysis of endosteal implants placed by using the osseodensification technique in animal models: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: Osseodensification, a counterclockwise drilling technique for the placement of endosseous implants is a popular clinical technique. However, the effect of the osseodensification technique on primary implant stability, bone-implant contact, and bone area frequency occupancy is unclear. PURPOSE: The purpose of this systematic review and meta-analysis was to investigate the biomechanical and histomorphometric outcomes of endosteal implants placed by using the osseodensification technique in animal models. MATERIAL AND METHODS: An electronic search through Medline/PubMed, Lilacs, and Science Direct databases, and an additional manual search of the reference list of included articles was conducted by using specific keywords and Medical Subject Headings (MeSH) terms for articles in the English language and published up to April 31, 2020. Only animal studies comparing the biomechanical and histomorphometric outcomes of endosteal implants placed by using the osseodensification and conventional drilling protocol were included. The SYstematic Review Center for Laboratory animal Experimentation (SYRCLE) tool was used to determine the risk of bias assessment, and the quality of included studies was assessed by using Animal Research: Reporting in Vivo Experiments (ARRIVE) guidelines. RESULTS: Nine studies were included. The results of the meta-analysis showed that the pooled weighted mean difference of the insertion torque value for the primary implant stability of endosseous dental implants placed by using the osseodensification technique was 2.270 (95% confidence interval [CI]=1.147 to 3.393; P<.001), the weighted mean difference of the percentage of bone-implant contact at 3 weeks was 0.487 (95% CI=0.220 to 0.754; P=.114), the weighted mean difference of the percentage of bone-implant contact at 6 weeks was 0.565 (95% CI=0.219 to 0.911; P=.448), the weighted mean difference of the percentage of bone area frequency occupancy at 3 weeks was 0.679 (95% CI=0.265 to 1.093; P=.073), and the weighted mean difference of the percentage of bone area frequency occupancy at 6 weeks was 0.391 (95% CI=-0.204 to 0.986; P=.027). CONCLUSIONS: Limited data from animal studies suggest that the primary implant stability, bone-implant contact, and bone area frequency occupancy significantly improved for the endosteal implants placed by using the osseodensification technique compared with conventional drilling protocol. However, additional laboratory and clinical studies are recommended to provide stronger evidence.

Autogenous bone ring for vertical bone augmentation procedure with simultaneous implant placement: A systematic review of histologic and histomorphometric outcomes in animal studies.

STATEMENT OF PROBLEM: The performance of the autogenous bone ring (ABR) technique used for the vertical bone augmentation procedure has not yet been determined. PURPOSE: The purpose of this systematic review was to investigate whether the ABR technique for the vertical bone augmentation procedure with simultaneous implant placement enhances the histologic and histomorphometric outcomes in surgically created bone defects in animal models. MATERIAL AND METHODS: An electronic search of 3 databases, Medline/PubMed, Science Direct, Lilacs, and a manual search of a reference list of relevant studies were performed. Only animal studies regarding vertical bone augmentation by using the ABR technique with simultaneous implant placement in surgically created bone defects were included in the review. The SYstematic Review Center for Laboratory Animal Experimentation tool was used to determine the risk of bias assessment, and the quality of included studies was assessed by using the Animal Research: Reporting in Vivo Experiments guidelines. RESULTS: Five studies were included in the qualitative analysis based on the inclusion and exclusion criteria. One study comparing the ABR technique with the bovine and biphasic ring reported a high percentage of bone area and bone implant contact of the ABR at 5 weeks of osseointegration. Similar histologic findings were reported in another study at 4 months of healing, but contrasting data were reported at 8 months. Another study reported an increase in the percentage of bone area and bone implant contact of the ABR technique from 3 months to 6 months of osseointegration. Two studies reported an increase in the percentage of bone area, and 1 study reported a decrease in the mean of bone implant contact, both with simultaneous and staged implant procedures. CONCLUSION: Based on the limited available studies, the use of the ABR technique for the vertical bone augmentation procedure with simultaneous implant placement presented optimal histologic and histomorphometric outcomes in surgically created bone defects in animal models. However, the results of the current review are not sufficiently robust to support the use of the ABR technique for vertical bone augmentation in humans.

Flexural Strength of Surface-Treated Heat-Polymerized Acrylic Resin after Repair with Aluminum Oxide-Reinforced Autopolymerizing Acrylic Resin.

BACKGROUND: A fracture of denture base in situ often occurs through a fatigue mechanism, which over a period of time leads to the formation of small cracks, resulting in fracture. AIM AND OBJECTIVE: To evaluate the flexural strength of repaired heat-polymerized acrylic resin, with different percentage of aluminum oxide (Al2O3) added to the repair resin and effect of two different surface treatments on the flexural strength of repaired heat-polymerized acrylic resin and also to evaluate quantification of filler particles using scanning electron microscopy. MATERIALS AND METHODOLOGY: Fifty specimens of heat-polymerized acrylic resin were prepared according to the American Dental Association specification no. 12 (65 mm × 10 mm × 2.5 mm). Al2O3<50 nm particle size was silanized using metal alloy primer before incorporation in polymer. Two different percentages of Al2O3 nanoparticles, that is, 1% and 1.5% were added to autopolymerizing acrylic resin which was used as repairing material. RESULTS: The study showed that repair resin incorporated with 1.5% Al2O3 in the group surface treated with silicon carbide paper improved the flexural strength of denture base resin. A proper filler distribution and deep penetration within the polymer matrix were observed by scanning electron microscope in the same group.