ABSTRACT
Aim: To systematically review existing scientific literature to determine, compare and evaluate the sinus complication and survival rates of quad zygoma against two zygomatic implants with combination of two regular implants in atrophic maxilla in adults. Methods: Review was performed in accordance with preferred reporting items for systematic reviews and meta-analysis guidelines and registered in PROSPERO-CRD42023392721 Electronic databases like PubMed, Google scholar and EBSCO host were searched from 2000 to December 2022 for studies reporting treatment of Atrophic maxilla with either quad zygoma or two zygomatic implants in combination with two regular implants. Quality assessment was evaluated using Cochrane risk of bias-2 tool for randomized controlled trials (RCT). The risk of bias summary graph and risk of bias summary applicability concern was plotted using RevMan software version 5.3. The odds ratio (OR) and standardized mean difference (SMD) were used as summary statistic measure with random effect model and p value < 0.05 as statistically significant. Results: Eleven studies fulfilled the eligibility criteria and were included in qualitative synthesis, of which only nine studies were suitable for meta-analysis. The pooled estimate through the odds ratio 0.59 signifies that the quad zygomatic implants on an average has 0.59 (0.18-1.93) times or odds of developing sinus complications while the SMD signifies that better survival rate (SR) on an average is 0.35 (- 0.61 to 1.30) times more by two zygomatic implants with combination of two regular implants as compared to quad zygomatic implants (p > 0.05). Publication bias through the funnel plot showed asymmetric distribution with systematic heterogeneity. Conclusion: Two zygomatic implants in combination with two regular implants provides better survival rate and less sinus complications compared to quad zygoma in atrophic maxilla. Despite the high SR observed, there is a need to conduct more randomized controlled clinical trials to examine their efficacy in comparison with other techniques.
ABSTRACT
Introduction: The aim of this study was to compare the efficacy of pre-adjusted three-dimensional (3D) plating system employing 3D printing with conventional 3D plating in the management of mandibular fractures. Materials and Methods: A randomised, clinical trial was conducted where the study sample (n = 20) was divided into two groups. In Group 1, 3D plate and in Group 2, pre-bent 3D plate was fixed to the fracture site. The parameters assessed were number of bends required for adaptation, duration of fixation, pain, occlusal stability, reduction in lingual splaying and post-operative complications. Results: Statistically significant difference was seen for the number of bends required (P = 0.000, P < 0.01) and duration of fracture fixation (P = 0.001, P < 0.01). There was statistically significant difference between the values of pain during the adaptation of 3D plate (P = 0.033, P < 0.05). Discussion: The application of pre-adjusted 3D plate is superior to conventional 3D plating in terms of reducing number of bends, duration of fixation and pain during adaptation.
ABSTRACT
Aim: Surgical management of mandibular symphysis and parasymphysis fractures has evolved from rigid fixation to semi-rigid fixation with miniplate osteosynthesis. Various miniplate systems have been developed in recent years including three-dimensional miniplate, microplates and bioresorbable plate, and their advantages and disadvantages have been compared and studied. To overcome the shortcomings of 3D plating system such as difficulty in adaptation and fixation in fractures involving the mental nerve, a novel Z plate has been designed by our institute. Material and Methodology: An in vitro study was performed to evaluate the biomechanical behaviour of the newly designed Z plate with 3D plate and two-miniplate system using finite element analysis. Results: Our study showed total structural deformation of 0.17 mm and 0.31 mm of newly designed Z plate after canine loading and molar loading, respectively. The equivalent von Mises force for plate after canine loading had shown the following results-Z plate showed values of 121.3 MPa and 58.40 MPa after molar loading. Conclusion: Our study concluded that the Z plate produces lowest stresses, lesser total structural deformation, superior stability and support in comparison with the 3D plate and two-miniplate system.
ABSTRACT
Objectives: Dental implants play a significant role in functional rehabilitation of the oral cavity after debilitating jaw surgeries for oral cavity cancers followed by radiotherapy. Design: The meta-analysis was done using Preferred Reporting Items for Systematic Review (PRISMA) guidelines published from January 1947 till August 2020. Twenty three articles consisting of 1246 participants with 4838 implants were included in our analysis. Results: The mean age of the included participants was 51.4 years. 2186 and 1685 implants were placed on irradiated and non-irradiated jaws and showed a success rate of 82.47% and 89.37% respectively. Correspondingly, publication bias of p value = 0.2129 and p-value = 0.6525 was found by Egger's and Begg's test respectively for pooled data of 16 studies. The implant success rate of 70.4% on maxillary bone and 94.5% were observed on mandibular bone. Timing of implant placement and its influence on survival rate have resulted in a 75.5% survival rate of dental implants when placed primarily in comparison with 87.7% on delayed placement. The waiting interval of 14 months in delayed implant placement has shown better results. Conclusion: Presence of radiotherapy does not play a significant role in the success rate of dental implants in oral cavity cancers. However, delayed implant placement may have a better chance of survival. Supplementary Information: The online version contains supplementary material available at 10.1007/s12663-022-01686-6.
