1
|
Vardić A, Puljak L, Galić T, Viskić J, Kuliš E, Poklepović Peričić T. Heterogeneity of outcomes in randomized controlled trials on implant prosthodontic therapy is hindering comparative effectiveness research: meta-research study. BMC Oral Health 2023; 23:908. [PMID: 37993826 PMCID: PMC10666438 DOI: 10.1186/s12903-023-03658-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 11/12/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Consistency in outcomes across clinical trials allows for comparing and combining results from different studies. A core outcome set (COS), representing a minimally agreed standardized group of outcomes that should be monitored and measured through research in a specific field of medicine, is not yet available for trials in implant prosthodontic (dental implant) therapy. This meta-research study aimed to analyze outcomes used in clinical trials on implant prosthodontic therapy. METHODS We searched the Cochrane Oral Health Group (COHG) register to identify systematic reviews of interventions in implant prosthodontic therapy published by October 2023. From the randomized controlled trials (RCTs) included in the relevant reviews, we extracted data on the characteristics of the included trials and the outcomes used. We categorized outcomes into domains. RESULTS From 182 systematic reviews in the COHG register, we included 11 systematic reviews on dental implant therapy. The reviews included 117 unique RCTs with 4725 participants, published from 1995 to 2020, which analyzed 74 different outcomes. Using different definitions, implant failure was analyzed in 73 RCTs. Seventeen RCTs did not define implant failure. Failure was most often (30 RCTs) followed up for one year. Only one RCT assessed implant failure after five years. Trials used 17 definitions of implant failure, while 17 trials did not report on the criteria of implant failure. Complications were analyzed in 48 RCTs, although they were not clearly defined in 12 RCTs. Failure of prosthodontic supra-structure was analyzed in 74 RCTs, with definitions of failure and criteria not clearly defined in 44 RCTs. Trials considered adverse events, peri-implant tissue health, patient attitudes, and other outcomes, including cost, aesthetics, or procedure duration. These outcomes were often different between trials. Twenty-six outcomes were used only once per study. CONCLUSIONS Clinical trials in implant prosthodontics used different outcomes, different definitions of outcomes and used different times to monitor them. Standardization of outcomes is necessary to allow comparability and evidence synthesis about the effectiveness of implant prosthodontic therapy.
Collapse
Affiliation(s)
- Ante Vardić
- Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
| | - Livia Puljak
- Center for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Zagreb, Croatia.
| | - Tea Galić
- Department of Prosthodontics, Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
| | - Joško Viskić
- Department of Fixed Prosthodontics, University of Zagreb School of Dental Medicine, Zagreb, Croatia
| | - Ena Kuliš
- Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
| | - Tina Poklepović Peričić
- Department of Prosthodontics, Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
| |
Collapse
|
2
|
Thiha A, Ibrahim F, Joseph K, Petrović B, Kojić S, Dahlan NA, Jamaluddin NF, Qureshi S, Stojanović GM. A novel microfluidic compact disc to investigate electrochemical property changes between artificial and real salivary samples mixed with mouthwashes using electrical impedance analysis. PLoS One 2023; 18:e0280381. [PMID: 36795661 PMCID: PMC9934320 DOI: 10.1371/journal.pone.0280381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/26/2022] [Indexed: 02/17/2023] Open
Abstract
Diagnosing oral diseases at an early stage may lead to better preventive treatments, thus reducing treatment burden and costs. This paper introduces a systematic design of a microfluidic compact disc (CD) consisting of six unique chambers that run simultaneously from sample loading, holding, mixing and analysis. In this study, the electrochemical property changes between real saliva and artificial saliva mixed with three different types of mouthwashes (i.e. chlorhexidine-, fluoride- and essential oil (Listerine)-based mouthwashes) were investigated using electrical impedance analysis. Given the diversity and complexity of patient's salivary samples, we investigated the electrochemical impedance property of healthy real saliva mixed with different types of mouthwashes to understand the different electrochemical property which could be a foundation for diagnosis and monitoring of oral diseases. On the other hand, electrochemical impedance property of artificial saliva, a commonly used moisturizing agent and lubricant for the treatment of xerostomia or dry mouth syndrome was also studied. The findings indicate that artificial saliva and fluoride-based mouthwash showed higher conductance values compared to real saliva and two other different types of mouthwashes. The ability of our new microfluidic CD platform to perform multiplex processes and detection of electrochemical property of different types of saliva and mouthwashes is a fundamental concept for future research on salivary theranostics using point-of-care microfluidic CD platform.
Collapse
Affiliation(s)
- Aung Thiha
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Biomedical Engineering, Centre for Innovation in Medical Engineering (CIME), Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Fatimah Ibrahim
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Biomedical Engineering, Centre for Innovation in Medical Engineering (CIME), Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
- Centre for Printable Electronics, Universiti Malaya, Kuala Lumpur, Malaysia
- Microwave Research Institute, Universiti Teknologi MARA, Shah Alam, Selangor, Malaysia
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- * E-mail: (FI); (BP)
| | - Karunan Joseph
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Biomedical Engineering, Centre for Innovation in Medical Engineering (CIME), Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Bojan Petrović
- Department of Dental Medicine, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- * E-mail: (FI); (BP)
| | - Sanja Kojić
- Faculty of Technical Science, University of Novi Sad, Novi Sad, Serbia
| | - Nuraina Anisa Dahlan
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Biomedical Engineering, Centre for Innovation in Medical Engineering (CIME), Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Nurul Fauzani Jamaluddin
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Biomedical Engineering, Centre for Innovation in Medical Engineering (CIME), Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Saima Qureshi
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | | |
Collapse
|
3
|
Salles MM, de Cássia Oliveira V, Macedo AP, Silva-Lovato CH, de Freitas de Oliveira Paranhos H. Effectiveness of Brushing Associated With Oral Irrigation in Maintenance of Peri-Implant Tissues and Overdentures: Clinical Parameters and Patient Satisfaction. J ORAL IMPLANTOL 2021; 47:117-123. [PMID: 32662827 DOI: 10.1563/aaid-joi-d-19-00092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Hygiene of implant-supported prostheses and the health of peri-implant tissues are considered to be predictive factors of successful prosthetic rehabilitation. Therefore, the purpose of this study was to evaluate the effectiveness of brushing associated with oral irrigation measured as biofilm-removing capacity, maintenance of healthy oral tissues, and patient satisfaction. A randomized, crossover clinical trial was conducted with 38 patients who wore conventional maxillary complete dentures and mandibular overdentures retained by the O-ring system. The patients were instructed to use the following hygiene methods for 14 days: mechanical brushing (MB; brush and dentifrice, control) and MB with oral irrigation (Waterpik [WP], experimental). Biofilm-removing capacity and maintenance of healthy oral tissues were evaluated by the modified plaque index (PI), gingival index (GI), probing depth (PD), and bleeding on probing index (BP) recorded at baseline and after each method. In parallel, patients answered a specific questionnaire using a visual analog scale after each hygiene method. Data were analyzed by Friedman and Wilcoxon tests (α = .05). The results showed significantly lower PI, GI, PD, and BP after application of the hygiene methods (P < .001) than those observed at baseline. However, no significant difference was found between MB and WP. The responses to the satisfaction questionnaire for both methods showed high mean values for all questions, with no statistically significant difference found between the answers given after the use of MB and WP (P > .05). The findings suggest that WP was effective in reducing PI, GI, PD, and BP indices and provided a high level of patient satisfaction.
Collapse
Affiliation(s)
- Marcela Moreira Salles
- Department of Dental Materials and Prosthodontics, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Viviane de Cássia Oliveira
- Department of Dental Materials and Prosthodontics, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ana Paula Macedo
- Department of Dental Materials and Prosthodontics, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Cláudia Helena Silva-Lovato
- Department of Dental Materials and Prosthodontics, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | |
Collapse
|
4
|
Sommer M, Zimmermann J, Grize L, Stübinger S. Marginal bone loss one year after implantation: a systematic review of different loading protocols. Int J Oral Maxillofac Surg 2020; 49:121-134. [DOI: 10.1016/j.ijom.2019.03.965] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 03/08/2019] [Accepted: 03/18/2019] [Indexed: 12/24/2022]
|
5
|
Zimmermann J, Sommer M, Grize L, Stubinger S. Marginal bone loss 1 year after implantation: a systematic review for fixed and removable restorations. Clin Cosmet Investig Dent 2019; 11:195-218. [PMID: 31406478 PMCID: PMC6642649 DOI: 10.2147/ccide.s208076] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 04/27/2019] [Indexed: 11/23/2022] Open
Abstract
This systematic review analyses the difference of the mean marginal bone loss (MBL) 1 year after implantation depending on the fixation of the restoration. 889 publications on controlled clinical trials were identified, and based on inclusion and exclusion criteria, 22 studies were selected. Related to fixed restorations, the lowest MBL was 0.05±0.67 mm and the highest 1.37±0.5 mm. The MBL for removable restorations ranged from 0.13±0.35 mm to 1.03±0.65 mm. Three studies analyzed the MBL around implants of overdentures in the lower jaw. The estimate for this restoration type was 0.476 mm (95% CI: −0.305 to 1.258). 19 randomized controlled studies dealt with restorations which were fixed to the implants. The estimate for the mean MBL was 0.459 mm (95% CI: 0.325–0.593). There was a decrease in 1-year implant survival with an increase of 1 mm MBL (−0.083%; 95% CI: −0.179 to 0.0123; p=0.083) in fixed restorations. The difference in MBL between fixed and removable restorations was 0.363 mm (95% CI: −0.319 to 1.044; p=0.279). This systematic review indicates that implants with fixed and with removable restorations lead to comparable MBL.
Collapse
Affiliation(s)
- Jennifer Zimmermann
- Hightech Research Center, Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Melanie Sommer
- Hightech Research Center, Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Leticia Grize
- Swiss Tropical and Public Health Institute , Basel, Switzerland.,University of Basel , Basel, Switzerland
| | - Stefan Stubinger
- Hightech Research Center, Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| |
Collapse
|
6
|
Beline T, Garcia CS, Ogawa ES, Marques ISV, Matos AO, Sukotjo C, Mathew MT, Mesquita MF, Consani RX, Barão VAR. Surface treatment influences electrochemical stability of cpTi exposed to mouthwashes. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2015; 59:1079-1088. [PMID: 26652467 DOI: 10.1016/j.msec.2015.11.045] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 08/10/2015] [Accepted: 11/16/2015] [Indexed: 11/26/2022]
Abstract
The role of surface treatment on the electrochemical behavior of commercially pure titanium (cpTi) exposed to mouthwashes was tested. Seventy-five disks were divided into 15 groups according to surface treatment (machined, sand blasted with Al2O3, and acid etched) and electrolyte solution (artificial saliva — control, 0.12% chlorhexidine digluconate, 0.05% cetylpyridinium chloride, 0.2% sodium fluoride, and 1.5% hydrogen peroxide) (n = 5). Open-circuit-potential and electrochemical impedance spectroscopy were conducted at baseline and after 7 and 14 days of immersion in each solution. Potentiodynamic test and total weight loss of disks were performed after 14 days of immersion. Scanning electron microscopy, energy dispersive spectroscopy, white light interferometry and profilometry were conducted for surface characterization before and after the electrochemical tests. Sandblasting promoted the lowest polarization resistance (Rp) (P b .0001) and the highest capacitance (CPE) (P b .006), corrosion current density (Icorr) and corrosion rate (P b .0001). In contrast, acid etching increased Rp and reduced CPE, independent to the mouthwash; while hydrogen peroxide reduced Rp (P b .008) and increased Icorr and corrosion rate (P b .0001). The highest CPE values were found for hydrogen peroxide and 0.2% sodium fluoride. Immersion for longer period improved the electrochemical stability of cpTi (P b .05). In conclusion, acid etching enhanced the electrochemical stability of cpTi. Hydrogen peroxide and sodium fluoride reduced the resistance to corrosion of cpTi, independent to the surface treatment. Chlorhexidine gluconate and cetylpyridinium chloride did not alter the corrosive behavior of cpTi.
Collapse
Affiliation(s)
- Thamara Beline
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Av Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil; IBTN/Br - Institute of Biomaterials, Tribocorrosion and Nanomedicine, Brazilian Branch, Brazil
| | - Camila S Garcia
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Av Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil
| | - Erika S Ogawa
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Av Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil; IBTN/Br - Institute of Biomaterials, Tribocorrosion and Nanomedicine, Brazilian Branch, Brazil
| | - Isabella S V Marques
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Av Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil
| | - Adaias O Matos
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Av Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil; IBTN/Br - Institute of Biomaterials, Tribocorrosion and Nanomedicine, Brazilian Branch, Brazil
| | - Cortino Sukotjo
- Department of Restorative Dentistry, University of Illinois at Chicago, College of Dentistry, 801 S Paulina, Chicago, IL 60612, USA; IBTN - Institute of Biomaterials, Tribocorrosion and Nanomedicine, USA
| | - Mathew T Mathew
- IBTN - Institute of Biomaterials, Tribocorrosion and Nanomedicine, USA; Department of Orthopedic Surgery, Rush University Medical Center, 1611 W Harrison, Chicago, IL 60612, USA
| | - Marcelo F Mesquita
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Av Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil
| | - Rafael X Consani
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Av Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil
| | - Valentim A R Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Av Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil; IBTN/Br - Institute of Biomaterials, Tribocorrosion and Nanomedicine, Brazilian Branch, Brazil.
| |
Collapse
|
7
|
Wang Y, Zhang Y, Miron RJ. Health, Maintenance, and Recovery of Soft Tissues around Implants. Clin Implant Dent Relat Res 2015; 18:618-34. [PMID: 25873299 DOI: 10.1111/cid.12343] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The health of peri-implant soft tissues is one of the most important aspects of osseointegration necessary for the long-term survival of dental implants. PURPOSE To review the process of soft tissue healing around osseointegrated implants and discuss the maintenance requirements as well as the possible short-comings of peri-implant soft tissue integration. MATERIALS AND METHODS Literature search on the process involved in osseointegration, soft tissue healing and currently available treatment modalities was performed and a brief description of each process was provided. RESULTS The peri-implant interface has been shown to be less effective than natural teeth in resisting bacterial invasion because gingival fiber alignment and reduced vascular supply make it more vulnerable to subsequent peri-implant disease and future bone loss around implants. And we summarized common procedures which have been shown to be effective in preventing peri-implantitis disease progression as well as clinical techniques utilized to regenerate soft tissues with bone loss in advanced cases of peri-implantitis. CONCLUSION Due to the difference between peri-implant interface and natural teeth, clinicians and patients should pay more attention in the maintenance and recovery of soft tissues around implants.
Collapse
Affiliation(s)
- Yulan Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST), Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yufeng Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST), Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Richard J Miron
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST), Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| |
Collapse
|
8
|
Corrosion kinetics and topography analysis of Ti–6Al–4V alloy subjected to different mouthwash solutions. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2014; 43:1-10. [DOI: 10.1016/j.msec.2014.06.033] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 05/30/2014] [Accepted: 06/30/2014] [Indexed: 11/18/2022]
|
9
|
Faverani LP, Barão VAR, Ramalho-Ferreira G, Ferreira MB, Garcia-Júnior IR, Assunção WG. Effect of bleaching agents and soft drink on titanium surface topography. J Biomed Mater Res B Appl Biomater 2013; 102:22-30. [DOI: 10.1002/jbm.b.32949] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 03/17/2013] [Accepted: 03/27/2013] [Indexed: 12/23/2022]
Affiliation(s)
- Leonardo P. Faverani
- Department of Surgery and Integrated Clinic; Aracatuba Dental School; Univ Estadual Paulista (UNESP); Aracatuba SP Brazil
| | - Valentim A. R. Barão
- Department of Prosthodontics and Periodontics; Piracicaba Dental School, University of Campinas (UNICAMP); Piracicaba SP Brazil
| | - Gabriel Ramalho-Ferreira
- Department of Surgery and Integrated Clinic; Aracatuba Dental School; Univ Estadual Paulista (UNESP); Aracatuba SP Brazil
| | - Mayara B. Ferreira
- Department of Dental Materials and Prosthodontics; Aracatuba Dental School, Univ Estadual Paulista (UNESP); Aracatuba SP Brazil
| | - Idelmo R. Garcia-Júnior
- Department of Surgery and Integrated Clinic; Aracatuba Dental School; Univ Estadual Paulista (UNESP); Aracatuba SP Brazil
| | - Wirley G. Assunção
- Department of Dental Materials and Prosthodontics; Aracatuba Dental School, Univ Estadual Paulista (UNESP); Aracatuba SP Brazil
| |
Collapse
|
10
|
Cairo F, Sanz I, Matesanz P, Nieri M, Pagliaro U. Quality of reporting of randomized clinical trials in implant dentistry. A systematic review on critical aspects in design, outcome assessment and clinical relevance. J Clin Periodontol 2012; 39 Suppl 12:81-107. [DOI: 10.1111/j.1600-051x.2011.01839.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Francesco Cairo
- Department of Periodontology; University of Florence; Florence; Italy
| | - Ignacio Sanz
- Department of Periodontology; Universidad Complutense ; de; Madrid; Madrid; Spain
| | - Paula Matesanz
- Department of Periodontology; Universidad Complutense ; de; Madrid; Madrid; Spain
| | - Michele Nieri
- Department of Periodontology; University of Florence; Florence; Italy
| | - Umberto Pagliaro
- Department of Periodontology; University of Florence; Florence; Italy
| |
Collapse
|
11
|
Vere J, Joshi R. Quality assessment of randomised controlled trials of dental implant surgery and prosthodontics published from 2004 to 2008: a systematic review. Clin Oral Implants Res 2011; 22:1338-45. [DOI: 10.1111/j.1600-0501.2010.02124.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
|
12
|
Grusovin MG, Coulthard P, Worthington HV, George P, Esposito M. Interventions for replacing missing teeth: maintaining and recovering soft tissue health around dental implants. Cochrane Database Syst Rev 2010; 2010:CD003069. [PMID: 20687072 PMCID: PMC6866073 DOI: 10.1002/14651858.cd003069.pub4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND It is important to institute an effective supportive therapy to maintain or recover soft tissue health around dental implants. Different maintenance regimens have been suggested, however it is unclear which are the most effective. OBJECTIVES To assess the effects of different interventions for 1) maintaining and 2) recovering soft tissue health around osseointegrated dental implants. SEARCH STRATEGY We searched the Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. Handsearching included several dental journals. We checked the bibliographies of the identified randomised controlled trials (RCTs) and relevant review articles for studies outside the handsearched journals. We wrote to authors of all identified RCTs, to more than 55 oral implant manufacturers and to an Internet discussion group to find unpublished or ongoing RCTs. No language restrictions were applied. The last electronic search was conducted on 2 June 2010. SELECTION CRITERIA All randomised controlled trials comparing agents or interventions for maintaining or recovering healthy tissues around dental implants. DATA COLLECTION AND ANALYSIS Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two review authors. Results were expressed as random-effects models using standardised mean differences for continuous data and risk ratios for dichotomous data with 95% confidence intervals. MAIN RESULTS Five trials compared interventions for maintaining soft tissue health around implants and a further six trials compared interventions to recover soft tissue health where there was evidence of peri-implant mucositis. No statistically significant differences were found between the effectiveness of powered versus manual toothbrushes for either maintaining or recovering soft tissue health. There was no statistically significant difference found between different types of self administered antimicrobials for maintaining soft tissue health (hyaluronic acid gel compared to chlorhexidine gel, amine fluoride/stannous fluoride mouthwash compared to chlorhexidine mouthwash) and triclosan dentifrice compared to sodium fluoride dentifrice showed no statistically significant difference in recovering soft tissue health. However chlorhexidine irrigation was more effective in reducing plaque and marginal bleeding scores compared to chlorhexidine mouthwash and Listerine mouthwash was found to be statistically significantly better than placebo with regard to reducing mean plaque scores and marginal bleeding scores. When interventions administered by dental professional were compared there was no statistically significant difference found between chlorhexidine and physiologic solutions as irrigants at second stage surgery to maintain health of soft tissues. In patients with peri-implant mucositis two trials evaluated interventions performed by dental professionals. There was no statistically significant difference between mechanical debridement followed by either minocycline or chlorhexidine gel, or between debridement with a titanium curette compared to an ultrasonic debridement tool. AUTHORS' CONCLUSIONS There was only low quality evidence for which are the most effective interventions for maintaining or recovering health of peri-implant soft tissues. The included RCTs had short follow-up periods and few subjects and although overall the risk of bias of the studies was either low or unclear, only single trials were available for each outcome. There was no reliable evidence as to which regimens are most effective for long term maintenance. This should not be interpreted as meaning that current maintenance regimens are ineffective. There was weak evidence that antibacterial mouthrinses are effective in reducing plaque and marginal bleeding around implants. More RCTs should be conducted in this area. In particular, there is a definite need for trials powered to find possible differences, using primary outcome measures and with much longer follow up. Such trials should be reported according to the CONSORT guidelines (www.consort-statement.org/).
Collapse
Affiliation(s)
| | - Paul Coulthard
- Institute of Dentistry, Queen Mary University of LondonDean's Office, Floor 5, Turner StreetLondonUKE1 2AD
| | - Helen V Worthington
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthCoupland Building 3Oxford RoadManchesterUKM13 9PL
| | | | - Marco Esposito
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthCoupland Building 3Oxford RoadManchesterUKM13 9PL
| | | |
Collapse
|
13
|
Grusovin MG, Coulthard P, Jourabchian E, Worthington HV, Esposito MAB. Interventions for replacing missing teeth: maintaining and recovering soft tissue health around dental implants. Cochrane Database Syst Rev 2008:CD003069. [PMID: 18254015 DOI: 10.1002/14651858.cd003069.pub3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND It is important to institute an effective supportive therapy to maintain or recover soft tissue health around dental implants. Different maintenance regimens have been suggested, however it is unclear which are the most effective. OBJECTIVES To test the null hypotheses of no difference between different interventions (1) for maintaining healthy peri-implant soft tissues, and (2) for recovering soft tissue health, against the alternative hypothesis of a difference. SEARCH STRATEGY We searched the Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. Handsearching included several dental journals. We checked the bibliographies of the identified randomised controlled trials (RCTs) and relevant review articles for studies outside the handsearched journals. We wrote to authors of all identified RCTs, to more than 55 oral implant manufacturers and to an internet discussion group to find unpublished or ongoing RCTs. No language restrictions were applied. The last electronic search was conducted on 13 June 2007. SELECTION CRITERIA All randomised controlled trials comparing agents or interventions for maintaining or recovering healthy tissues around dental implants. DATA COLLECTION AND ANALYSIS Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two review authors. Results were expressed as random-effects models using standardised mean differences for continuous data and risk ratios for dichotomous data with 95% confidence intervals. MAIN RESULTS Eighteen RCTs were identified. Nine of these trials, which reported results from a total of 238 patients, were included. Follow ups ranged between 6 weeks and 1 year. No meta-analysis could be made since every RCT tested different interventions. Listerine mouthwash showed a reduction of 54% in plaque and 34% in marginal bleeding compared with a placebo. Two trials evaluated the efficacy of powered and sonic toothbrushes compared to manual toothbrushing and showed no statistically significant differences, though more patients liked the sonic brush. No statistical differences were found between brushing with a hyaluronic or a chlorhexidine gel, between cleaning with an etching gel or manually, between injecting a chlorhexidine or a physiologic solution inside the implant's inner part and between submucosal minocycline and a chlorhexidine gel. When an amine fluoride/stannous fluoride (AmF/SnF(2)) mouthrinse was compared with a chlorhexidine one, no statistically significant differences were found for implant failures and staining index while patients preferred and had less taste change with the AmF/SnF(2) mouthrinse. Self administered subgingival chlorhexidine irrigation resulted in statistically significantly lower plaque and marginal bleeding than a chlorhexidine mouthwash, however the mouthwash was given at a suboptimal dosage. AUTHORS' CONCLUSIONS There was only little reliable evidence for which are the most effective interventions for maintaining or recovering health of peri-implant soft tissues. The included RCTs had short follow-up periods and few subjects. There was not any reliable evidence for the most effective regimens for long term maintenance. This should not be interpreted as current maintenance regimens are ineffective. There was weak evidence that Listerine mouthwash, used twice a day for 30 seconds, as an adjunct to routine oral hygiene, is effective in reducing plaque and marginal bleeding around implants. More RCTs should be conducted in this area. In particular, there is a definite need for trials powered to find possible differences, using primary outcome measures and with much longer follow up. Such trials should be reported according to the CONSORT guidelines (http://www.consort-statement.org/).
Collapse
Affiliation(s)
- M G Grusovin
- School of Dentistry, Department of Oral and Maxillofacial Surgery, University of Manchester, Higher Cambridge Street, Manchester, UK M15 6FH.
| | | | | | | | | |
Collapse
|
14
|
Kozlovsky A, Artzi Z, Hirshberg A, Israeli-Tobias C, Reich L. Effect of local antimicrobial agents on excisional palatal wound healing: a clinical and histomorphometric study in rats. J Clin Periodontol 2007; 34:164-71. [PMID: 17309591 DOI: 10.1111/j.1600-051x.2006.01033.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To assess the effect of topically applied antimicrobial agents on palatal excisional wound in rats. MATERIALS AND METHODS Excisional wounds, 5 mm in diameter, were made in the centre of the palate of 125 Wistar male rats. In four experimental groups, chlorhexidine digluconate (CHX) 0.12% solution, 1% CHX gel, phenolic compounds solution (Listerine), amine/stannous fluoride solution (Meridol) and saline solution as a control group were applied daily for 1 min. The wound area was measured photographically and the epithelialization rate was determined histologically at 3, 7, 14 and 21 days post-surgery. RESULTS The mean wound area and mean distance between the epithelial margins decreased significantly with time (p<0.001) in experimental and control groups, with the greatest wound area reduction and rate of epithelialization on day 14. A significantly superior rate of wound epithelialization (p=0.03) was presented following use of 1% CHX gel and Listerine and a comparatively inferior one when the Meridol solution was applied. CONCLUSIONS Each tested antimicrobial agent when applied on an excisional wound with epithelial and connective tissue deficiency did not have a negative effect on the rate of wound closure. The best results were achieved with 1%CHX gel and Listerine.
Collapse
Affiliation(s)
- Avital Kozlovsky
- Department of Periodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
| | | | | | | | | |
Collapse
|
15
|
Kozlovsky A, Artzi Z, Moses O, Kamin-Belsky N, Greenstein RBN. Interaction of chlorhexidine with smooth and rough types of titanium surfaces. J Periodontol 2006; 77:1194-200. [PMID: 16805682 DOI: 10.1902/jop.2006.050401] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Chlorhexidine (CHX) digluconate exerts plaque inhibitory efficacy in the natural dentition environment due to a superior degree of persistence at the tooth surface. The purpose of the present study was to assess the interaction of CHX with titanium surfaces to estimate its antiplaque potential in the peri-implant environment. METHODS Saliva-coated machined smooth (S) and sand-blasted acid-etched rough (R) titanium disks were soaked in either 0.1% or 0.2% CHX solution. After 24 hours, CHX amounts that were adsorbed, washed out, and desorbed from the titanium surfaces were determined spectrophotometrically at 230 nm. The antibacterial activity of CHX-treated titanium disks was assessed by measuring bacterial inhibition zones on Streptococcus mutans lawns. RESULTS Titanium disks adsorbed 3% to 8% of the available CHX, which was significantly higher with 0.2% CHX (P<0.001) than with 0.1% CHX and two-fold higher on the R titanium disks compared to S titanium surface (P<0.001). After rinsing with water, 2.2% of the adsorbed CHX was washed out. Over 24 hours, S- and R-type disks released 1.1% and 0.6% of the adsorbed agent, respectively. Larger bacterial inhibition zones were obtained with 0.2% CHX and in R disks compared to S disks. CONCLUSIONS CHX displayed persistence at the titanium surface. The adsorption level and bacterial growth inhibition were affected by CHX concentration and titanium surface characteristics, with higher levels of adsorption and antibacterial activity with 0.2% CHX and rough titanium surface. The slow CHX release rate suggests persistence of this agent at the titanium-pellicle surface, which can provide a long-term antiplaque effect.
Collapse
Affiliation(s)
- Avital Kozlovsky
- Department of Periodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
| | | | | | | | | |
Collapse
|