Patients with Thyroid Disorder, a Contraindication for Dental Implants? A Systematic Review.

The thyroid gland is composed of the thyroid follicles, considered to be the functional units of the thyroid gland. The synthesis of the thyroid hormones occurs in these follicles. Triiodothyronine (T3) and thyroxine (T4) are the thyroid hormones and affect metabolic processes all through the body. This systematic evaluation was performed to answer the following PICO question: "Can patients with thyroid disorders undergo dental implant rehabilitation with the same survival rate as patients without thyroid disorders?". A systematic review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements to gather available and current evidence of thyroid disorders and its relationship with dental implants. The electronic search, in the PubMed and Cochrane databases, yielded 22 articles. Out of the 22 articles, only 11 fulfilled the inclusion criteria. Manual research of the reference list yielded no additional papers. According to the SORT criteria and answering our PICO question, level B can be established to conclude that patients with thyroid disorders can be rehabilitated with dental implants, with similar survival rates as patients without thyroid disorders. Papers with higher scientific evidence and bigger sample size should be carried out.

An analysis of the prevalence of peripheral giant cell granuloma and pyogenic granuloma in relation to a dental implant.

BACKGROUND: The aim of the present investigation was to evaluate the literature recurrence of peripheral giant cell granuloma and pyogenic granuloma associated with dental implants. It's important to know the characteristics present in these lesions and possible effects on the prognosis of dental implants. METHODS: An electronic search without time restrictions was done in the databases: PubMed/Medline. With the keywords "Granuloma" OR "Granuloma, Giant Cell" OR "peripheral giant cell" OR "Granuloma, Pyogenic" AND "Dental implants" OR "Oral implants". RESULTS: After applying the inclusion and exclusion criteria, a total of 20 articles were included, which reported 32 lesions (10 pyogenic granulomas, 21 peripheral giant cell granulomas and one peripheral giant cell granuloma combined with peripheral ossifying fibroma, all associated with implants). According to our review, these lesions are more frequent in males and in the posterior region of the mandible. Both excision and curettage of the lesion, compared to only excision, presented similar recurrences (40%). Explantation of the implant was performed in 41% of cases without additional recurrences. The results are not statistically significant when comparing one lesion to the other in terms of explantation (p = 0.97), recurrence (p = 0.57) or bone loss (p = 0.67). CONCLUSIONS: The main therapeutic approach is tissue excision. The lesions show a high recurrence rate (34.4%), which often requires explantation of the associated implant. This recurrence rate is not affected by curettage after excision.

Evaluation of the quality of life and satisfaction in patients using complete dentures versus mandibular overdentures. Systematic review and meta-analysis.

BACKGROUND: The World Health Organization (WHO) recognizes edentulism as a physical impairment that results in a negative impact in the daily activities. OBJECTIVE: The study aimed to compare the satisfaction and the quality of life, in patients treated with implant retained overdentures with two mandibular implants (IOD) against those with mandibular conventional complete dentures (CCD). METHODS: Different search strategies were used to screen for articles in Pubmed/Medline, Cochrane Library and Scielo of the last 17 years (2003-2020). The keywords used were: "quality of life OR satisfaction" AND "complete denture OR conventional denture" AND "overdenture OR implant retained." RESULTS: Six articles and two more were added by manual search. The population was 400 in the CCD and 412 for IOD. The mean age was 64.3 ± 6.41 years. The group was comprised of 283 men and 427 women. The scores obtained in the visual analog scale (VAS) before and after the treatment were statistically significant in favor of the IOD for overall satisfaction, (WMD: 12.329; 95% CI: 4.873 to 19.784, p-value = 0.001), comfort, speech and stability. For esthetics and chewing there was non-significant improvement while hygiene worsened for the IOD. For the comparison after the treatment between both treatment modalities a statistically significant improvement was found in overall satisfaction (WMD: 14.408; 95% CI: 8.589 to 20.226, p-value < 0.001), comfort, speech, chewing and stability in favor of the IOD but not in esthetics or hygiene. CONCLUSIONS: This systematic review and meta-analysis show the superiority of the IOD, despite is not achieved in all aspects.

Oral Lichen Planus and Dental Implants: Protocol and Systematic Review.

A systematic review was conducted to answer the following PICO question: "Can patients diagnosed with oral lichen planus (OLP) be rehabilitated with dental implants as successfully as patients without OLP?". A systematic review of the literature was done following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements to gather available and current evidence of oral lichen planus and its relationship with dental implants. The synthesis of results was performed using a Binary Random-Effects Model meta-analysis. Summary measures were odds ratios (ORs), frequencies, and percentages comparing the survival rate of dental implants placed in patients with OLP vs. those in patients without OLP. The electronic search yielded 25 articles, after removing the duplicated ones, 24 articles were selected. Out of the 24 articles, only 15 fulfilled the inclusion criteria. According to the results of the meta-analysis, with a total sample of 48 patients with OLP and 49 patients without OLP, an odds ratio of 2.48 (95% CI 0.34-18.1) was established, with an I2 value of 0%. According to the Strength of Recommendation Taxonomy (SORT) criteria, level A can be established to conclude that patients with OLP can be rehabilitated with dental implants.

The Application of Statins in the Regeneration of Bone Defects. Systematic Review and Meta-Analysis.

This systematic review aims to analyze the effect of the local application of statins in the regeneration of non-periodontal bone defects. A systematic study was conducted with the Pubmed/Medline, Embase, Cochrane Library and Scielo databases for in vivo animal studies published up to and including February 2019. Fifteen articles were included in the analysis. The local application of the drug increased the percentage of new bone formation, bone density, bone healing, bone morphogenetic protein 2, vascular endothelial growth factor, progenitor endothelial cells and osteocalcin. Meta-analyses showed a statistically significant increase in the percentage of new bone formation when animals were treated with local statins, in contrast to the no introduction of filling material or the introduction of polylactic acid, both in an early (4-6 weeks) and in a late period (12 weeks) (mean difference 39.5%, 95% confidence interval: 22.2-56.9, p <0.001; and mean difference 43.3%, 95% confidence interval: 33.6-52.9, p < 0.001, respectively). Basing on the animal model, the local application of statins promotes the healing of critical bone size defects due to its apparent osteogenic and angiogenic effects. However, given the few studies and their heterogenicity, the results should be taken cautiously, and further pilot studies are necessary, with radiological and histological evaluations to translate these results to humans and establish statins' effect.