Immediate loading of definitive restorations in partially edentulous patients requiring an implant-supported prosthesis: A scoping review.

STATEMENT OF PROBLEM: Interest is growing in immediately loading definitive implant-supported prostheses. However, it appears that implant protocols are evolving faster than their scientific validation. PURPOSE: The purpose of this scoping review was to identify the current trends, feasibility, and clinical outcomes of a specific clinical loading scenario (type A), where a single definitive implant-retained restoration is delivered within 3 days. The focus question was "In partially edentulous patients requiring an implant-retained prosthesis (population), is immediate loading with a definitive restoration (concept) a viable treatment option (context)?" MATERIAL AND METHODS: An electronic search was conducted in the PubMed, CENTRAL, Scopus, Embase, and Web of Science databases. Two authors independently reviewed the studies, screened titles and abstracts, and performed full-text analysis. Cross-reference checks within the bibliography of included studies, relevant reviews, and guideline were conducted. Bibliometric information and study details were extracted. RESULTS: The search identified 2568 titles after removing duplicates. Four studies involving 91 participant and 100 implant-retained restorations were included in this scoping review. The selected articles were a randomized controlled trial (RCT), a prospective clinical study, and the remaining 2 were case series. The follow-up periods investigated ranged from 6 to 26 months. All studies evaluated marginal bone loss as a primary outcome, and only 1 implant failure was reported. Patient-reported outcome measures were favorable, and no major biological or technical complications were reported in any study. CONCLUSIONS: Immediate loading with a definitive restoration within 3 days appears to be a suitable approach in specific clinical situations.

Use of optical see-through head-mounted devices in dentistry - a scoping review.

AIM: The aim of this scoping review was to identify the scientific evidence related to the utilization of Optical See- Through Head-Mounted Display (OST-HMD) in dentistry, and to determine future research needs. METHODS: The research question was formulated using the "Population" (P), "Concept" (Cpt), and "Context" (Cxt) framework for scoping reviews. Existing literature was designated as P, OST-HMD as Cpt, and Dentistry as Cxt. An electronic search was conducted in PubMed, Embase, Web of Science, and CENTRAL. Two authors independently screened titles and abstracts and performed the full-text analysis. RESULTS: The search identified 286 titles after removing duplicates. Nine studies, involving 138 participants and 1760 performed tests were included in this scoping review. Seven of the articles were preclinical studies, one was a survey, and one was a clinical trial. The included manuscripts covered various dental fields: three studies in orthodontics, two in oral surgery, two in conservative dentistry, one in general dentistry, and the remaining one in prosthodontics. Five articles focused on educational purposes. Two brands of OST-HMD were used: in eight studies HoloLens Microsoft was used, while Google Glass was utilized in one article. CONCLUSIONS: The overall number of included studies was low; therefore, the available data from this review cannot yet support an evidence-based recommendation for the clinical use of OST-HMDs. However, the existing preclinical data indicate a significant capacity for clinical and educational implementation. Further adoption of these devices will facilitate more reliable and objective quality and performance assessments, as well as more direct comparisons with conventional workflows. More clinical studies must be conducted to substantiate the potential benefits and reliability for patients and clinicians.

Magnetic resonance imaging for jawbone assessment: a systematic review.

PURPOSE: To evaluate the accuracy of magnetic resonance imaging (MRI) for jawbone assessment compared to reference-standard measurements in the literature. MATERIALS AND METHODS: An electronic database search was conducted in PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Library in June 2022, and updated in August 2023. Studies evaluating the accuracy of MRI for jawbone assessment compared with reference-standard measurements (histology, physical measurements, or computed tomography) were included. The outcome measures included bone histomorphometry and linear measurements. The risk of bias was assessed by the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). The review was registered in the PROSPERO database (CRD42022342697). RESULTS: From 63 studies selected for full-text analysis, nine manuscripts were considered eligible for this review. The studies included assessments of 54 participants, 35 cadavers, and one phantom. A linear measurement error ranging from 0.03 to 3.11 mm was shown. The accuracy of bone histomorphometry varies among studies. Limitations of the evidence included heterogeneity of MRI protocols and the methodology of the included studies. CONCLUSION: Few studies have suggested the feasibility of MRI for jawbone assessment, as MRI provides comparable results to those of standard reference tests. However, further advancements and optimizations are needed to increase the applicability, validate the efficacy, and establish clinical utility of these methods.

Microbiota associated with peri-implantitis-A systematic review with meta-analyses.

AIM: To answer the following PECO question: "In systemically healthy human subjects (P), which are the differences between peri-implantitis (E) and peri-implant health/mucositis (C) in terms of bacterial presence/count (O)?" MATERIALS AND METHODS: Cross-sectional studies fulfilling specific inclusion criteria established to answer the PECO question were included. Two review authors independently searched for studies, screened the titles and abstracts, did full-text analysis, extracted the data from the included reports, and performed the risk of bias assessment through an adaptation of the Newcastle/Ottawa tool for cross-sectional studies and of the JBI critical appraisal checklist. In case of disagreement, a third reviewer author took the final decision. Study results were summarized using random effects meta-analyses. RESULTS: A total of 12 studies were included, involving 1233 participants and 1513 implants. Peri-implantitis was associated with the presence of S. epidermidis (Odds ratio, OR = 10.28 [95% Confidence interval, CI: 1.26-83.98]), F. nucleatum (OR = 7.83 [95% CI: 2.24-27.36]), T. denticola (OR = 6.11 [95% CI: 2.72-13.76]), T. forsythia (OR = 4.25 [95% CI: 1.71-10.57]), P. intermedia (OR = 3.79 [95% CI: 1.07-13.35]), and P. gingivalis (OR = 2.46 [95% CI: 1.21-5.00]). Conversely, the presence of A. actinomycetemcomitans (OR = 3.82 [95% CI: 0.59-24.68]), S. aureus (OR = 1.05 [95% CI: 0.06-17.08]), and C. rectus (OR = 1.48 [95% CI: 0.69-3.17]) was not associated with peri-implantitis. CONCLUSIONS: Peri-implantitis is associated with the presence of S. epidermidis and specific periodontopathogens (P. gingivalis, T. forsythia, T. denticola, F. nucleatum, and P. intermedia). (CRD42021254589).

Minimal invasiveness at dental implant placement: A systematic review with meta-analyses on flapless fully guided surgery.

Flapless and fully guided implant placement has the potential to maximize efficacy outcomes and at the same time to minimize surgical invasiveness. The aim of the current systematic review was to answer the following PICO question: "In adult human subjects undergoing dental implant placement (P), is minimally invasive flapless computer-aided fully guided (either dynamic or static computer-aided implant placement (sCAIP)) (I) superior to flapped conventional (free-handed implant placement (FHIP) or cast-based/drill partially guided implant placement (dPGIP)) surgery (C), in terms of efficacy, patient morbidity, long-term prognosis, and costs (O)?" Randomized clinical trials (RCTs) fulfilling specific inclusion criteria established to answer the PICO question were included. Two review authors independently searched for eligible studies, screened the titles and abstracts, performed full-text analysis, extracted the data from the published reports, and performed the risk of bias assessment. In cases of disagreement, a third review author took the final decision during ad hoc consensus meetings. The study results were summarized using random effects meta-analyses, which were based (wherever possible) on individual patient data (IPD). A total of 10 manuscripts reporting on five RCTs, involving a total of 124 participants and 449 implants, and comparing flapless sCAIP with flapped FHIP/cast-based partially guided implant placement (cPGIP), were included. There was no RCT analyzing flapless dynamic computer-aided implant placement (dCAIP) or flapped dPGIP. Intergroup meta-analyses indicated less depth deviation (difference in means (MD) = -0.28 mm; 95% confidence interval (CI): -0.59 to 0.03; moderate certainty), angular deviation (MD = -3.88 degrees; 95% CI: -7.00 to -0.77; high certainty), coronal (MD = -0.6 mm; 95% CI: -1.21 to 0.01; low certainty) and apical (MD = -0.75 mm; 95% CI: -1.43 to -0.07; moderate certainty) three-dimensional bodily deviations, postoperative pain (MD = -17.09 mm on the visual analogue scale (VAS); 95% CI: -33.38 to -0.80; low certainty), postoperative swelling (MD = -6.59 mm on the VAS; 95% CI: -19.03 to 5.85; very low certainty), intraoperative discomfort (MD = -9.36 mm on the VAS; 95% CI: -17.10 to -1.61) and surgery duration (MD = -24.28 minutes; 95% CI: -28.62 to -19.95) in flapless sCAIP than in flapped FHIP/cPGIP. Despite being more accurate than flapped FHIP/cPGIP, flapless sCAIP still resulted in deviations with respect to the planned position (intragroup meta-analytic means: 0.76 mm in depth, 2.57 degrees in angular, 1.43 mm in coronal, and 1.68 in apical three-dimensional bodily position). Moreover, flapless sCAIP presented a 12% group-specific intraoperative complication rate, resulting in an inability to place the implant with this protocol in 7% of cases. Evidence regarding more clinically relevant outcomes of efficacy (implant survival and success, prosthetically and biologically correct positioning), long-term prognosis, and costs, is currently scarce. When the objective is to guarantee minimal invasiveness at implant placement, clinicians could consider the use of flapless sCAIP. A proper case selection and consideration of a safety margin are, however, suggested.

The Lateral Border of Scapula for Alveolar Ridge Reconstruction: A Prospective Clinical Study.

PURPOSE: The purpose of this prospective clinical study was to evaluate the efficiency of alveolar ridge reconstruction with the lateral border of scapula (LBS) prior to implant placement and to assess onlay graft retention and bone resorption during a short term of function. MATERIALS AND METHODS: A total of 25 partially or fully edentulous patients with severe alveolar bone atrophy received ridge reconstruction with grafts harvested from the LBS. Histologic analysis of bone grafts was performed. Six months after augmentation, patients underwent CBCT and received dental implants. After another 3 months, healing abutments and implant-supported dentures were placed. Patients were followed for an average of 24 months. RESULTS: Thirteen patients received primary bone grafting from LBS. Twelve patients experienced unsuccessful ridge reconstruction with other grafts before and were secondarily augmented with LBS. The average dimensions of LBS grafts were 6.3 × 2.3 × 1.2 cm. Histologic analysis confirmed the cortical nature of the graft. No donor-site complications occurred, and arm movements were restored within 2 weeks. Following augmentation, two patients had sutures disrupted that healed uneventfully after revision. The average resorption of LBS grafts after 6 months was 12.2% ± 3.0%. At the time of implant placement, the dimension of the ridge was 12.3 ± 2.0 mm and 6.9 ± 1.6 mm in height and width, respectively. The survival rate of the 174 implants placed was 98.3%. CONCLUSION: LBS can be used as an alternative extraoral grafting site for extensive ridge reconstruction prior to implant placement.