Accuracy of artificial intelligence in implant dentistry: A scoping review with systematic evidence mapping.

STATEMENT OF PROBLEM: The use of artificial intelligence (AI) in dentistry has grown. However, the accuracy of clinical applications in implant dentistry is still unclear. PURPOSE: The purpose of this scoping review with systematic evidence mapping was to identify and describe the available evidence on the accuracy and clinical applications of AI in implant dentistry. MATERIAL AND METHODS: An electronic search was performed in 4 databases and nonpeer-reviewed literature for articles published up to November 2023. The eligibility criteria comprised observational and interventional studies correlating AI and implant dentistry. A bibliographic mapping and quality analysis of the included studies was conducted. Additionally, the accuracy rates of each AI model were evaluated. RESULTS: Twenty-six studies met the inclusion criteria. A significant increase in evidence has been observed in recent years. The most commonly found applications of AI in implant dentistry were for the recognition of implant systems followed by surgical implant planning. The performance of AI models was generally high (mean of 88.7%), with marginal bone loss (MBL) prediction models being the most accurate (mean of 93%). Regarding the place of publication, the Asian continent represented the highest number of studies, followed by the European and South American continents. CONCLUSIONS: Evidence involving AI and implant dentistry has grown in the last decade. Although still under development, all AI models evaluated demonstrated high accuracy and clinical applicability. Further studies evaluating the clinical efficacy of AI models in implant dentistry are essential.

Survival and complications of zygomatic implants compared to conventional implants reported in longitudinal studies with a follow-up period of at least 5 years: A systematic review and meta-analysis.

BACKGROUND: Zygomatic implants (ZI) have been frequently indicated to rehabilitate patients with extensive atrophies in alternatives to major bone reconstructions. It can be installed inside the maxillary sinus, called instrasinus zygomatic implant (IZI) or outside the maxillary sinus (EZI), depending on the surgery technique. OBJECTIVE: To evaluate the survival and complication rates of ZI in longitudinal studies when compared with conventional implants (CI). METHODS: An electronic search was performed in five databases and in Gray literature for articles published until April, 2022. The eligibility criteria comprised observational cohort studies (prospective or retrospective) and randomized clinical trials (RCTs) with at least 5 years of follow-up, reporting survival rate of ZI versus CI. A meta-analysis was conduct with 18 studies. RESULTS: A total of 5434 implants (2972 ZI and 2462 CI) were analyzed in 1709 patients. The mean survival rate was 96.5% ± 5.02 and 95.8% ± 6.36 for ZI and CI, respectively (mean follow-up time of 78 months). There were observed no statistically significant between ZI and CI in prospective studies (risk ratio [RR] of 1.21; 95% confidence intervals [CIs]: 0.28 to 5.28; chi-squared [Chi2 ] = 11.37; I2  = 56%; degrees of freedom [df] = 5; z-score = 0.25; P = 0.80), retrospective studies IZI (RR of 1.29; 95% CIs: 0.52 to 3.23; Chi2  = 4.07; I2  = 2%; df = 4; z-score = 0.55; P = 0.58) and retrospective studies EZI (RR of 0.72; 95% CIs: 0.31 to 1.66; Chi2  = 1.99; I2  = 0%; df = 3; z-score = 0.78; P = 0.44). The biological complications most related to ZI was sinusitis, followed by infection and oroantral communication. CONCLUSION: ZI have a high long-term survival rate (96.5% with a mean of 91.5 months of follow-up), showing no significant difference when compared with CI. The most prevalent biological complication is sinusitis, being most commonly to the IZI technique. This systematic review (SR) was registered in INPLASY under number INPLASY202280025.

Clinical Comparation of Extra-Short (4 mm) and Long (>8 mm) Dental Implants Placed in Mandibular Bone: A Systematic Review and Metanalysis.

This systematic review (SR) aimed to evaluate implant survival rate, marginal bone loss (MBL), and biological/prosthetic complications of extra-short 4 mm dental implants. An electronic search without language or date restrictions was performed in five databases and in gray literature for articles published until August 2020. Prospective cohort studies and randomized clinical trials (RCTs) that evaluated the clinical performance of extra-short 4 mm dental implants were included. Studies were independently assessed for risk of bias using the Cochrane Collaboration's tool. The protocol of this SR was registered in the PROSPERO database under number CRD42019139709. Four studies were included in the present SR. There was no significant difference in implant survival rate (p = 0.75) between extra-short 4 mm and long implants. After 12 months of function, the extra-short implants had a significantly (p = 0.003) lower marginal bone loss (MBL) rate when compared to long implants. Extra-short implants had a lower number of biological and prosthetic complications when compared to long implants. After 12 months of follow-up, extra-short 4 mm dental implants placed in the mandible exhibit satisfactory clinical outcomes concerning implant survival rate and MBL when compared to longer implants, with a low number of biological and prosthetic complications. A higher number of RCTs with longer follow-up is necessary for the future.

Clinical efficacy of simvastatin gel combined with polypropylene membrane on the healing of extraction sockets: A triple-blind, randomized clinical trial.

OBJECTIVES: This study aimed to evaluate dimensional changes, level of soft tissue healing, and pain/discomfort perception in post-extraction sockets filling with 1.2% simvastatin (SIM) gel covered with polypropylene membranes (PPPM). MATERIAL AND METHODS: Twenty-six post-extraction sockets of posterior teeth were randomly allocated in two groups: (a) socket filling with 1.2% SIM gel and covered with PPPM (n = 13) and (b) socket filling with placebo gel and covered with PPPM (n = 13). Cone-beam computed tomography (CBCT) images before and 90 days after the extraction enabled alveolar bone dimensional changes calculation using horizontal and vertical measurements. The measurements occurred at three different levels for thickness located 1, 3, and 5 mm from the top of the bone crest. The vertical (depth) measure was assessed from the most apical portion of the socket to the bone crest's most coronal portion. Seven days after the extractions, the level of soft tissue healing and pain perception were also analyzed. RESULTS: After 90 days of extractions, the dimensional changes in thickness in the test group were significantly smaller in sections A (p = .044), B (p = .036) and C (p = .048) when compared to the control group. The test group showed a significantly lower height-dimensional change than the control group (p < .0001). Soft tissue healing index (p = .63), perception of pain (p = .23), and number of analgesics consumed (p = .25) were similar between groups. CONCLUSIONS: Simvastatin at 1.2% compared with placebo effectively reduced the dimensional changes in post-extraction sockets covered with PPPM. There was no significant difference in the level of soft tissue healing and postoperative pain between the test and control groups.

Atrophic Maxilla Rehabilitation Through Dental Implants Using the V-4 Strategy Associated With Guided Surgery: A Case Report and Technique Description.

Atrophic maxilla rehabilitation through dental implants is always a challenging procedure. However, alternative approaches such as guided surgery and the installation of short implants are progressively supplanting more invasive bone regeneration procedures. A V-4 technique described in 2016 facilitates the installation of dental implants in patients with atrophic maxilla; however, its authors recommend incision, flap opening, and elevation of the anterior area of the maxillary sinuses. This case report describes a less invasive proposal for modifying the technique through the association of guided surgery, which improves implant placement accuracy, shortens surgical time, and reduces morbidity.

Immunological response of allogeneic bone grafting: A systematic review of prospective studies.

BACKGROUND: Although widely used, the potential for immunological sensitization of allogeneic bone grafts is still controversial in the literature. This systematic review aimed to evaluate the immune response of allogeneic bone graft procedures in humans. METHODS: An electronic search without language or date restrictions occurred in four databases for articles published until July 2019. Eligibility criteria included prospective cohort studies, controlled clinical trials, and randomized clinical trials that evaluated the potential of allogeneic bone grafts in sensitized immune system in humans through immunological or biological analysis. The protocol number of this SR registered in PROSPERO is CDR42019135491. RESULTS: The search and selection process yielded eight prospective cohort studies published between 1984 and 2019. The percentage of patients' sensitization analyzed by human leukocyte antigens ranged from 21% to 67%, with a cumulative mean of 48 ± 17.3%. Bone soluble protein analysis demonstrates the sensitization of 55% of patients after allograft bone grafts. Also, a high level of circulating cell-free DNA took place in the immediate postoperative period. CONCLUSION: Although studies report a low incidence of local complications, an average of 48% of the patients remain with the immune system sensitized after receiving allogeneic bone grafts. Future studies should better address the local and systemic consequences of such sensitization.

Association between biomarkers and medication-related osteonecrosis of the jaws: a systematic review.

OBJECTIVES: Our aim was to conduct a systematic review (SR) of the literature assessing the role of human biomarkers in the diagnosis or prognostication of medication-related osteonecrosis of the jaws (MRONJ). STUDY DESIGN: An electronic search without date or language restriction was carried out in PubMed/MEDLINE, the Cochrane Central Register of Controlled Trials, Web of Science, and LILACS for publications until March 2018. In addition, a manual search in the gray literature was conducted. The search process was performed by 2 independent reviewing authors. Eligibility criteria included randomized and nonrandomized clinical trials, prospective or retrospective cohorts, case controls, and case series evaluating the association between biomarkers and MRONJ. The protocol of this SR was registered in PROSPERO under number CRD42018095886. RESULTS: The search and selection process yielded 19 studies (2 case series, 6 case-control studies, 9 prospective cohort studies, and 2 retrospective studies) published between 2008 and 2018. Twenty-four biomarkers collected from serum, saliva, and urine were investigated by these studies. Eleven biomarkers were possibly related to MRONJ; however, no consensus is observed in the literature with regard to the sensitivity and clinical effectiveness of these biomarkers. CONCLUSIONS: Although many biomarkers have been associated with MRONJ, the present SR found scarce clinical evidence supporting the use of these biomarkers for the diagnosis and prognosis of MRONJ.

Clinical efficacy of xenogeneic collagen matrix in the treatment of gingival recession: a systematic review and meta-analysis.

Objective: The aim of this systematic review (SR) was to evaluate the effects of xenogenic collagen matrix (XCM) on the outcomes of clinical treatments of patients with Miller class-I or -II gingival recessions. Materials and methods: Articles that were published before March 2018 were electronically searched in four databases without any date or language restrictions and manually searched in regular journals and gray literature. The eligibility criteria comprised randomized controlled trials (RCTs) and prospective controlled trials with follow-up periods of 6 months or more that compared the performance of XCM in the treatment of Miller class-I or -II gingival recessions. This SR was registered in PROSPERO under number CRD42018106118. Results: Nine RCTs published between 2010 and 2018 were included in this SR. The percentage of root coverage (RC) was significantly higher (p = .0003) when gingival recessions were treated with XCM when compared to coronally advanced flap (CAF) alone. In addition, the parameters of keratinized mucosa width (KMW) (p = .006) and gingival thickness (GT) (p = .0003) were also improved when the XCM was used in comparison to the CAF alone. There was not a statistically significant difference (p = .22) between the clinical attachment level (CAL) achieved with the use of XCM and that achieved with CAF alone. RC with the use of XCM, when compared to connective tissue grafts (CTGs) (p = .09) and enamel matrix derivative (EMD) (p = .62), there was no significant difference; however, XCM yielded lower RC than CTG in the treatment of Miller class-I or -II gingival recessions. Conclusions: Based on both the individual studies' outcomes and the pooled estimates, it can be concluded that the use of XCM improves the RC, KMW and GT in the treatment of gingival recessions when compared to CAF alone and may be a viable alternative to use of CTG.