Search

Statement of problem The development of polymethyl methacrylate (PMMA) computer-aided design and computer-aided manufacturing (CAD-CAM) resin blocks with reported improved mechanical properties has simplified complete denture production. However, whether the objective of improved mechanical properties has been achieved compared with conventional heat-polymerized PMMA is not yet clear. Purpose The purpose of this systematic review and meta-analysis was to evaluate the mechanical properties of denture base resins manufactured by conventional heat-polymerization and by CAD-CAM in terms of flexural strength, flexural modulus, and surface roughness. Material and methods Electronic databases (PubMed/MEDLINE, Scopus, Web of Science) were independently searched by 2 researchers for relevant studies published up to November 2020. The population, intervention, comparison, and outcome (PICO) question was, “Does the conventionally manufactured, heat-polymerized PMMA resin, as a denture base, demonstrate the same mechanical properties as the CAD-CAM resin block?” In addition, a meta-analysis was based on the inverse variance method. Flexural strength, flexural modulus, and surface roughness were analyzed through the continuous outcome evaluated by mean difference and standard deviation, with 95% confidence intervals. To evaluated heterogeneity, the I2 value (≤25%=low, ≥50%=moderate and ≥75%=high) and the P value were considered. P Results Thirteen in vitro studies were included in the analysis. A total of 507 specimens were evaluated, 222 conventional and 285 CAD-CAM. In terms of flexural strength, the data showed no significant difference when conventional heat-polymerized PMMA was compared with CAD-CAM PMMA resins (P=.06; mean difference=18.28; 95% confidence interval:-0.42 to 36.97). In terms of flexural modulus, there was a significant difference for the CAD-CAM PMMA group (P=.01; mean difference=589.22; 95% confidence interval: 117.95 to 1060.48). In terms of surface roughness, a significant difference was observed between the groups (P=.02; mean difference=-0.53; 95% confidence interval: -0.97 to -0.09) with the conventional heat-polymerized PMMA resin having higher surface roughness values. Conclusions The mechanical properties of CAD-CAM PMMA resins were generally improved when compared with heat-polymerized polymethyl methacrylate resin.

The objective of this study was to compare, through a systematic review with a meta-analysis, the relative risks of arthroscopy and arthrocentesis in the temporomandibular joint. MEDLINE/PUBMED, EMBASE, Cochrane Library (CENTRAL), Web of Science, SCOPUS were the researched databases, as well as grey literature and manual searches. The search results showed 656 studies, but only five met the eligibility criteria. The evaluation included 194 joints (104 patients): 101 were arthroscopy and 93 arthrocentesis. Complications were observed in four patients undergoing arthroscopy (two with temporary facial paralysis and two with prolonged cervical oedema) and in three patients undergoing arthrocentesis (two with severe bradycardia and one with prolonged cervical oedema). The meta-analysis demonstrated a relative risk of 0.99 for complications after arthroscopy compared with arthrocentesis, but the results showed no statistical differences. In conclusion, this systematic review suggests that there is no increased risk of complications with arthroscopy than arthrocentesis. When complications were present, they were temporary.

Objective This review is to compare patient-satisfaction with ball-type overdenture attachment systems with others attachment systems. Material and methods This study was registered in PROSPERO (CRD42018097234) and adheres the PRISMA guidelines. Electronic searches on PubMed/MEDLINE, Scopus, Cochrane, and Web of Science databases for published articles were performed before October 2020. The PICO question was: “Do patients with a ball-type overdenture retention system have greater satisfaction, when compared to other attachment systems?” The evaluation of risk of bias was performed using the Cochrane risk of bias tool. Results After searching the databases, seven articles were selected out of a total of 2583. A total of 312 implants were placed in 139 patients, with a mean age of 65.9 years. The risk of bias in the included studies varied according to the different domains in a risk of uncertain bias or low bias risk. No difference was found between the ball attachment systems and the others systems, with respect to patient-satisfaction. The meta-analysis revealed no statistically significant difference between the ball systems and another systems (P = 0.11; MD: 10.90; 95% CI: −2.55 to 24.35). Conclusions Regarding patient general satisfaction, it was not possible to determine differences between the ball system and another types of attachment system for overdenture. The ball-type system was statistically superior only to the magnet system.

The impact of a complete denture on obstructive sleep apnea is not well understood. Therefore, this study aimed to evaluate the relationship between nighttime use of complete dentures and obstructive sleep apnea and determine if wearing a complete denture during sleep changes the degree of obstructive sleep apnea. This systematic review followed the notification items for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was recorded in the International Prospective Registry of Systematic Reviews (PROSPERO) under number CRD42020183167. An electronic search in the PubMed/MEDLINE, Scopus, and Cochrane Library databases for articles published until September 2020 was conducted. The search strategy used the terms (complete denture OR denture OR edentulous OR edentulism) AND (quality of sleep OR sleep OR apnea OR obstructive sleep apnea). Only prospective, retrospective, controlled, and randomized clinical studies of patients wearing complete dentures, studies comparing sleep with and without the prosthesis, and studies in which patients were diagnosed with obstructive sleep apnea by polysomnography were included in the review. In total, four articles were selected for the qualitative and quantitative analyses. A total of 144 patients, with an average age of 60 years, were studied. The meta-analysis showed that there was no statistical difference in the apnea-hypopnea index between using and not using the prosthesis during sleep. The use of complete dentures during sleep does not influence the degree of obstructive sleep apnea.

OBJECTIVE This study aimed to systematically review the literature regarding the surface roughness of polymethylmethacrylate (PMMA) for denture bases, disinfected with different chemical agents and analyse the outcomes of the included studies. BACKGROUND Various chemical disinfection protocols to clean the removable dental prosthesis are reported in the literature, however systematic reviews analysing the outcomes in the surface roughness of the PMMA are lacking. METHODS The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) checklist was used to structure this systematic review. The inclusion criteria were as follows: clinical trials, in vitro studies, studies in English and studies comparing the effects of chemical disinfection products on the surface roughness of PMMA. An electronic search was performed in the following databases: PubMed/MEDLINE, Scopus and Web of Science.; we also conducted a manual search for articles published in specific journals of dental prostheses and dental materials. RESULTS Thirteen in vitro studies in this systematic review and meta-analysis. According to the meta-analysis, the effects of 0.5% (P = .32; MD: 0.06; CI: -0.05 to 0.17; heterogeneity: P

Objective: This systematic review aims to assess the efficacy chlorhexidine chip as an adjunctive therapy of scaling and root planning on periodontal disease treatment. Material and methods: This study follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA) and was registered in the PROSPERO database (CRD42019148221). The search was performed in PubMed/MEDLINE, Scopus, and Cochrane databases until April 2020. The PICO question was: “Is the chlorhexidine chip (CHX) effective as an adjunctive therapy of scaling and root planning on periodontal disease treatment?”. Inclusion criteria involved: randomized controlled clinical trials, with a minimum of 15 patients included on the sample and each patient has two sites of probing depth of ≥5 mm; The minimum follow up was at least 1 months of follow-up and the outcomes present in the studies probing depth (PD), plaque index (PI) and clinical attachment level (CAL) after scaling and root planning (SRP). Results: After searching the databases, 13 articles were selected for qualitative and 8 for quantitative analysis. Were included 427 patients, with a mean age of 45.6 years. The results shown that the association of chlorhexidine chips to scaling and root planning reduce periodontal pocket depths (P

Statement of problem One-step dental implant surgery with a 1-piece implant has been introduced with the aim of simplifying and increasing the effectiveness of treatment and providing greater comfort for the patient. Whether these goals have been met compared with conventional 2-piece implants remains unclear. Purpose The purpose of this systematic review and meta-analysis was to compare the use of 1-piece versus 2-piece implants in terms of marginal bone loss and implant survival rate. Material and methods This systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was recorded in the International prospective register of systematic reviews (PROSPERO) database (CRD 42018095721). A literature search was conducted in the PubMed/MEDLINE, Web of Science, and Cochrane Library databases for articles published up to May 2018. The population, intervention, comparison, outcome (PICO) question was, “Do patients who received 1-piece implants show similar marginal bone loss, survival rates, and complications as those who receive 2-piece implants?” Results The meta-analysis was based on the Mantel-Haenszel and inverse variance methods. Implant survival rate was analyzed by using a dichotomous outcome, measured according to risk ratio (RR) and marginal bone loss by continuously evaluating the outcomes according to the mean difference (MD), both with a corresponding 95% confidence interval (CI). Five studies, including 270 participants with a mean age of 54.70 years and receiving 434 dental implants, were included. The mean follow-up period was 4 years. Meta-analysis did not reveal a significant difference in relation to implant survival rate (P=.85; RR: −0.89; CI: −0.27 to 2.98), as well as to marginal bone loss (P=.85; MD: −0.43; CI: −0.43 to −0.52). Conclusions One- and 2-piece implants demonstrated effectiveness in the rehabilitation of patients requiring dental implants.

This study evaluated IL-6 salivary levels as well as the +3954 polymorphism of IL-1β in patients with burning mouth syndrome and healthy individuals, through case-control studies. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We conducted this research in PubMed/MEDLINE, Cochrane Library and Web of Science databases. The risk of bias was measured based in the Newcastle-Ottawa Scale. Researches with a group of patients with burning mouth syndrome and a control group in which the presence of the +3954 polymorphism of IL-1β and/ or IL-6 salivary levels through non-stimulated saliva were evaluated to detect if this interleukin concentrations are increased in patients and if the polymorphism is a risk factor for this syndrome. We identified seven studies with total of 440 participants, 229 patients with burning mouth syndrome and 211 healthy controls, ages 24-84 years old. The female gender was predominant. Patients in the majority of studies did not present increased levels of IL-6 and the +3954 polymorphism of IL-1β is not a risk factor for this syndrome. A few studies researched biomarkers in this pathology and more investigations are required not only to identify salivary levels and the polymorphism evaluated, but also other interleukins and polymorphisms in order to clarify the etiopathogenesis of this syndrome as well as for propose new diagnostic methods and treatments.

The aim of this study was to perform a systematic review and meta-analysis to evaluate the efficacy of laser therapy on medication-related osteonecrosis of the jaw (MRONJ) treatment. This study followed PRISMA standards, and an electronic search was performed on the PubMed/MEDLINE, Scopus, and Cochrane databases. Eighty-nine articles were found. After reading the manuscripts, 15 articles remained for the review. Three of them were selected for meta-analysis. Female gender was predominant (72.5%), and mean age was 66.5 years. Follow-up varied between 3 and 80 months, and the most used bisphosphonate was zoledronic acid (71.6%). Stage II of MRONJ was the most prevalent (68.9%), and the mandible was the most affected site (64.5%). Qualitative data showed that treatment with laser surgery (Er:YAG) was most effective regarding complete healing of the lesion (90%) compared with other treatments. Meta-analysis data showed that low-level laser therapy (LLLT) was more effective than medical treatment (P = 0.006), and surgical treatment was more effective than LLLT (P = 0.008). Laser surgery was significantly superior to LLLT (p

Aim The aim of this study was to evaluate the available evidence to identify the influence of pterygomaxillary disjunction on the result of surgically assisted maxillary expansion. Background LeFort I type osteotomy with disjunction of the pterygomaxillary suture is a procedure widely used in maxillofacial surgery. However, the need for its performance during surgically assisted maxillary expansions has been discussed in literature, since serious complications can be caused during this stage. Review results Systematic review of articles was performed using three databases (PubMed, Web of Science, and Cochrane) published until May 2019. After applying the selection criteria, five articles were included in the systematic review, with a total of 141 patients. Meta-analysis showed the absence of significant difference between intervention and control groups in the preoperative period (standardized mean difference = -0.28; confidence interval, CI 95% = -0.81, 0.26; p = 0.31) and postoperative period (standardized mean difference = -0.12; 95% CI = -0.65, 0.42; p = 0.66). In general, the heterogeneity of statistical estimates was low (I2 = 0%). Conclusion No statistically significant difference was observed between control group (without pterygomaxillary disjunction) and intervention group (with pterygomaxillary disjunction). Clinical significance Based on the data analyzed in this systematic review, it could be concluded that pterygomaxillary disjunction is not a mandatory step to achieve satisfactory maxillary expansion. Thus, not performing pterygomaxillary disjunction can prevent complications and reduce surgical time.

The aim of the present study was to perform a systematic review and meta-analysis to assess the influence of bariatric surgery on the clinical periodontal conditions in patients with obesity. This review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and registered at the International Prospective Registry of Systematic Reviews (CRD42018099313). A search was conducted by 2 investigators in the PubMed/MEDLINE, Web of Science, and Cochrane Library databases for relevant articles published up to May 2018. The inclusion criteria were randomized controlled trials, prospective and retrospective studies, observational studies, longitudinal studies, and cohort studies with at least 3 months of follow-up. No language restrictions were imposed. The exclusion criteria were studies that did not evaluate or report the periodontal measurements, cross-sectional studies (without follow-up after surgery), studies that performed periodontal treatment, and those with insufficient periodontal data. The meta-analysis was based on the Mantel-Haenszel method and inverse variance. The quantitative analysis revealed no statistically significant differences with regard to bleeding on probing (P = .9; mean deviation: −.70; confidence interval = −11.43 to 10.04) or probing pocket depth (P = .41; mean deviation: −.46; confidence interval = −1.55 to .63) before and after intervention. Clinical attachment loss showed a statistically significant difference (P = .0002; mean deviation: .18; confidence interval = .07–.30). It can be concluded that bariatric surgery does not influence bleeding on probing or probing pocket depth, but leads to a worsening of clinical attachment loss.

PURPOSE To evaluate the vertical marginal (VM) and horizontal marginal (HM) misfit of frameworks made using different techniques. MATERIALS AND METHODS A total of 30 frameworks were divided into three groups of 10 samples each based on manufacturing technique: nichrome cast (G1), milled in zirconia (G2), and milled in wax and fused to metal (G3). Marginal misfit was measured using a three-dimensional optical microscope. RESULTS The highest VM misfit was in G3 (83.5 μm), followed by G1 (55 μm) and G2 (42 μm). The highest HM misfit was in G2 (118 μm), followed by G3 (102 μm) and G1 (-85 μm). CONCLUSION Frameworks milled in zirconia resulted in the lowest VM misfit, while frameworks filled in wax and fused to metal resulted in higher VM. The HM misfit was favorable in the lost-wax technique.

PURPOSE To assess the impact of temporomandibular disorders (TMD) on general health quality of life in a Brazilian population-based cross-sectional survey. MATERIALS AND METHODS A total of 1,643 patients were assessed using the World Health Organization Quality of Life Bref (WHOQOL-Bref) and the Research Diagnostic Criteria for Temporomandibular Disorders Axes I and II (RDC/TMD). Cross-tabulation of the data was carried out to compare TMD subjects to controls in all domains of the WHOQOL-Bref and the RDC/TMD. RESULTS TMD subjects had significantly worse quality of life than controls in Axes I and II of the RDC/TMD and in all WHOQOL-Bref domains except for disc displacement. Osteoarthrosis was significantly different only in the WHOQOL-Bref physical domain. CONCLUSION TMD subjects had worse general health quality of life, particularly in Axis I groups with higher pain/disability levels (muscle disorders/arthralgia/arthritis).

Bariatric surgery is the most effective treatment for morbid obesity, but it can cause numerous adverse effects. This systematic review and meta-analysis aimed to evaluate whether bariatric surgery changes patient salivary flow. We searched for articles in the Web of Science, Pubmed/MEDLINE, and Scopus databases using the search terms “oral health AND bariatric surgery OR gastrectomy OR obesity surgery.” We recovered 845 articles. After the removal of duplicates and exclusions, eight studies remained. Of them, five showed no significant difference in salivary flow values, two showed an increase in flow rate, and one showed a reduction in flow rate (p

PURPOSE To compare the marginal vertical misfit between implant-supported frameworks fabricated using CAD/CAM systems and the conventional technique (lost-wax casting). MATERIALS AND METHODS This review was performed according to PRISMA criteria and registered on PROSPERO (CRD42017055685). An electronic search was performed independently by two examiners in the MEDLINE (Pubmed), Embase, Web of Science, and Cochrane Library databases to find studies published up to April 2018. RESULTS The database search yielded 507 references. After removing duplicate references, 384 studies remained. Eleven in vitro studies were selected according to the eligibility criteria (inter-reader κ = 0.88). Nine different CAD/CAM systems were used to fabricate 172 frameworks of different materials, including zirconia, monolithic lithium disilicate, and metallic alloys. Subgroup analyses were performed for different types and retention systems of the frameworks. In the general analysis, marginal misfit observed with the CAD/CAM systems was lower than with the conventional method (P = .003), as was observed in the subgroup analysis for single-unit frameworks (P < .00001). For fixed (P = .89), cemented (P = .60), and screwed (P = .18) frameworks, no significant difference was observed between the evaluated techniques. CONCLUSION The CAD/CAM systems showed improved marginal fit over the conventional lost-wax casting technique for fabricating single-unit frameworks; however, in the subgroup analyses, no difference was observed for the fixed implant-supported type or for the retention systems evaluated.

Made available in DSpace on 2018-12-11T17:21:16Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-01-01 Statement of problem: The decision to splint or to restore independently generally occurs during the planning stage, when the advantages and disadvantages of each clinical situation are considered based on the proposed treatment. However, clinical evidence to help clinicians make this decision is lacking. Purpose: The purpose of this systematic review and meta-analysis was to assess the marginal bone loss, implant survival rate, and prosthetic complications of splinted and nonsplinted implant restorations. Material and methods: This study was designed according to the Cochrane criteria for elaborating a systematic review and meta-analysis and adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Also, this review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42017080162). An electronic search in the PubMed/MEDLINE, Cochrane Library, and Scopus databases was conducted up to November 2017. A specific clinical question was structured according to the population, intervention, comparison, outcome (PICO) approach. The addressed focused question was “Should the restoration of adjacent implants be splinted or nonsplinted?” The meta-analysis was based on the Mantel-Haenszel and inverse variance methods to assess the marginal bone loss, implant survival, and prosthetic complications of splinted and nonsplinted implant restorations. Results: Nineteen studies were selected for qualitative and quantitative analyses. A total of 4215 implants were placed in 2185 patients (splinted, 2768; nonsplinted, 1447); the mean follow-up was 87.8 months (range=12-264 months). Quantitative analysis found no significant differences between splinted and nonsplinted restorations for marginal bone loss. The assessed studies reported that 75 implants failed (3.4%), of which 24 were splinted (99.1% of survival rate) and 51 were nonsplinted (96.5% of survival rate). Quantitative analysis of all studies showed statistically significant higher survival rates for splinted restorations than for nonsplinted restorations. Ceramic chipping, screw loosening, abutment screw breakage, and soft tissue inflammation were reported in the selected studies. The quantitative analysis found no statistically significant difference in the prosthetic complications of splinted and nonsplinted restorations. Conclusions: Within the limitations of this systematic review and meta-analysis, it was concluded that there was no difference in the marginal bone loss and prosthetic complications of splinted and nonsplinted implant restorations; this is especially true for restorations in the posterior region. However, splinted restorations were associated with decreased implant failure. Associate Professor Department of Prosthodontics Presidente Prudente Dental School University of Western São Paulo (UNOESTE) Adjunct Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University (UNESP) Doctoral student Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University (UNESP) Graduate student Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University (UNESP) Full Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School (UNESP) Universidade Estadual Paulista Adjunct Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University (UNESP) Doctoral student Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University (UNESP) Graduate student Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University (UNESP) Full Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School (UNESP) Universidade Estadual Paulista

Made available in DSpace on 2021-06-25T10:40:21Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Statement of problem: A consensus regarding the biomechanical effects of vertical bone loss in normal and osteoporotic bone tissue according to different implant-abutment interfaces is lacking. Purpose: The purpose of this finite element analysis study was to evaluate the effect of vertical bone loss (without bone loss; with 1.5-mm bone loss; with 3-mm bone loss; and with 4.5-mm bone loss) in normal and osteoporotic bone that received a Ø4×10-mm implant with different implant-abutment connections (external connection [external hexagon] and internal connection [Morse taper]) by using 3D finite element analysis. Material and methods: Sixteen 3D models were simulated. Axial and oblique forces of 200 N and 100 N, respectively, were applied on the occlusal surfaces of the prostheses. Maximum principal stress and microstrain were determined from the bone tissue of each model. von Mises stress analysis was used to evaluate the stress distribution in implants and prosthetic components (fixation screws, abutment, and crown). Results: The results showed higher stress concentrations in models with bone loss as increased vertical bone loss contributed to higher stress and microstrain in the bone tissue, regardless of the quality of bone and implant-abutment connection. Osteoporotic bone contributed to increase in microstrain in the trabecular bone. The internal connection showed lower stress than the external connection implants only in models without marginal bone loss. Furthermore, higher stress concentrations were observed in the implants and fixation screws in models with increased bone loss and external connection implants, mainly under oblique loading. Osteoporotic bone did not affect stress distribution in the implants and prosthetic components. Conclusions: Progressive bone loss contributed to higher stress in the bone tissue, implants, and prosthetic components. The osteoporotic bone affects only the microstrain in the trabecular bone, but not the stress in the implants and prosthetic components. The internal connection implants showed lower stress in the cortical bone only in models without bone loss, while external connection implants exhibited higher stress in the implants and screws under oblique loading. Adjunct Professor Division of Prosthodontics Department of Dentistry Federal University of Juiz de Fora (UFJF-GV) Associate Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School Universidade Estadual Paulista (UNESP) Researcher Tridimensional Technology Division Renato Archer's Information Technology Center Department Prosthodontics Presidente Prudente Dental School University of the West of São Paulo (UNOESTE) PhD student Department of Dental Materials and Prosthodontics Araçatuba Dental School Universidade Estadual Paulista (UNESP) Titular Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School Universidade Estadual Paulista (UNESP) Associate Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School Universidade Estadual Paulista (UNESP) PhD student Department of Dental Materials and Prosthodontics Araçatuba Dental School Universidade Estadual Paulista (UNESP) Titular Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School Universidade Estadual Paulista (UNESP) FAPESP: 2009/16164-7 FAPESP: 2015/24442-8 CNPq: 306288/2016-8

Made available in DSpace on 2021-06-25T10:28:10Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-04-01 Background: This photoelastic analysis evaluated stress distribution in different osteosynthesis systems, conventional and locking, used for treatment of mandibular angle fractures with a single plate. Material and Methods: Angle fractures were simulated in mandibles made of photoelastic resin. Following Champy’s method, plate osteosynthesis was performed. The samples were divided into five groups: Group 1, non-fractured mandible; Group 2, two screws were installed in each segment using a conventional system; Group 3, two screws were installed in each segment using a locking system; Group 4, three screws were installed in the proximal segment and four screws in the distal segment using a conventional plate; Group 5, three screws were installed in the proximal segment and four screws in the distal segment using a locking plate. In universal testing machine coupled to a polariscope, a load was applied to the first molar 10 times. The 50 images were randomly numbered and analyzed qualitatively and quantitatively by two raters. Results: The locking system promoted better stress distribution along the osteosynthesis. The locking system redu- ced stress magnitude in the distal segment, with a significant between-group difference (P≤ 0.001). Conclusions: The locking plate/screw system can distribute stress more evenly throughout the osteosynthesis, especially when long seven-hole plates are used. Department of Oral and Maxillofacial Surgery Universidade do Oeste Paulista (UNOESTE), R. José Bongiovani, 700 Department of Prosthodontics UNOESTE, R. José Bongiovani, 700 Department of Health Sciences Universidade do Sagrado Coração, R. Irmã Arminda, 10-50 Department of Dental Materials and Prosthodontics School of Dentistry Universidade Estadual Paulista (UNESP) Department of Oral and Maxillofacial Surgery Universidade do Sagrado Coração, R. Irmã Arminda, 10-50 Department of Dental Materials and Prosthodontics School of Dentistry Universidade Estadual Paulista (UNESP)

Made available in DSpace on 2022-05-01T05:29:33Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) This article describes a technique for making complete-arch implant-supported fixed prostheses by using intraoral scanning and computer-aided design and computer-aided manufacturing (CAD-CAM) technology for the fabrication of a metal substructure and conventional processing for the prosthesis base. For this, a device was designed to accurately capture the position of multiple implants and the associated digitalized surgical guide, and the metal substructure was planned and milled directly in cobalt-chromium. The color of the gingiva and artificial teeth was selected by using the intraoral scanner software program, and the prosthesis base was processed conventionally. The straightforward methods used to fabricate the prostheses eliminated possible errors associated with conventional substructure casting and occlusal registration. PhD student Department of Dentistry Federal University of Rio Grande do Norte (UFRN) Collaborating Professor Department of Dentistry Federal University of Rio Grande do Norte (UFRN) Professor Department of Dentistry State University of Rio Grande do Norte (UERN) PhD student Department of Dental Materials and Prosthodontics São Paulo State University (UNESP) Professor Titular Department of Dental Materials and Prosthodontics São Paulo State University (UNESP) Professor Titular Department of Dentistry Federal University of Rio Grande do Norte (UFRN) PhD student Department of Dental Materials and Prosthodontics São Paulo State University (UNESP) Professor Titular Department of Dental Materials and Prosthodontics São Paulo State University (UNESP)

Statement of problem Denture adhesives are widely used products, but limited evidence regarding their toxicity is available. Purpose The purpose of this scoping review was to map the existing literature on the toxic potential of denture adhesives. Material and methods This scoping review was structured based on the 5-step methodology proposed by Arksey and O’Malley and The Joanna Briggs Institute Manual for Evidence Synthesis and followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. The methods were registered on the Open Science Framework ( ). The following research question was formulated: Are there any toxic effects related to the use of denture adhesives? The electronic literature search was performed independently by 2 authors in the following databases: PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library. The inclusion criteria were in vitro and clinical studies; studies that evaluated the cytotoxic properties of denture adhesives as local or systemic implications; and studies published in English. Results The search conducted in October 2020 provided 1099 articles. In total, 33 studies were included, 14 in vitro and 19 clinical studies. Commercially available denture adhesives have a dose-dependent cytotoxic effect on fibroblasts and keratinocytes, with poor cell recovery noted in older human fibroblasts. Patients presented different levels of neurologic or hematological alterations associated with the excessive use of denture adhesives. Conclusions Most commercially available denture adhesives have a dose-dependent cytotoxic effect, and the use of well-adapted removable dental prostheses, proper patient follow-ups, and correct instructions for their use when indicated should be a priority.

The aim of this systematic review and meta-analysis (SRM) was to assess the postoperative pain (PP) after non-surgical endodontic retreatment (NSER) in a one visit compared to multiple visits. The PICO question used was "Does NSER in patients with unsatisfactory endodontic treatment in a one-visit visit have a similar PP to that of NSER in multiple visits?"This systematic review followed PRISMA and was registered in PROSPERO (CRD42019136700). Searches were performed in the PubMed/MEDLINE, Scopus, and the Cochrane Library databases for articles published until September 2020. The eligible criteria were randomized clinical trials (RCTs). The meta-analysis was based on the Mantel-Haenszel. The PP after the retreatment was analyzed using a dichotomous outcome, measured according to risk ratio (RR) when p 0.05. The Cochrane scale was used to assess risk of bias, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence.Four studies were included. In general analysis without considering intensity, one-visit NSER presented lower PP than the multiple visits only for 1 and 30 days [(RR = 0.67; CI: 0.48 to 0.93; p = 0.02), and (RR = 0.09; CI: 0.01 to 0.66; p = 0.02)], respectively. Regarding sub-analysis considering the intensity, one visit present lower mild PP when compared with multiple visits [(RR = 0.54; CI: 0.30, 0.96; p = 0.04); (RR = 0.33; CI: 0.12, 0.88; p = 0.03); and (RR = 0.12; CI: 0.02, 0.86; p = 0.03)], respectively. However, sub-analysis for moderate and severe PP showed no significant difference, independently of period evaluated (p 0.05). Regarding the risk of bias analysis, a low risk was observed for most domains, except allocation that was considered unclear, while the certainty of evidence for each analysis was considered low.Within the limitations of study, the one and multiple visit can be considered adequate, because both present a similar occurrence of PP, except for mild pain. However, due to the low number of studies, further well conducted and standardized RCTs are needed to reassess these results.Both therapies of endodontic retreatment can be considered in clinical practice. Therefore, the endodontist must consider the patient's individual characteristics and experience to consider the best treatment approach.

The objective of this study was to perform a quality analysis of systematic reviews with meta-analyses that focused on the comparison of platform-switching (implant-abutment mismatching) and platform-matched (PM) implants. The assessment of multiple systematic reviews (AMSTAR) and Glenny (Checklist) Scales were used to qualify the studies. PubMed, Scientific Electronic Library Online (SciELO), Web of Science (formerly ISI Web of Knowledge), and Cochrane databases were searched, by topic, for systematic reviews on dental implants with switching platforms. A total of 8 systematic reviews, including 7 studies with meta-analyses, were selected. The AMSTAR scale indicated a high (n = 6) to moderate (n = 2) score for the included studies. The quantitative analysis indicated that platform-switching implants preserved more bone tissue when compared with platform-matched implants (6 meta-analyses; P < .001, smaller mean difference: −0.29 mm, 95% CI: −0.38, −0.19 and greater mean difference: −0.49 mm, 95% CI: −0.73, −0.26). Quantitative analysis based on 7 systematic reviews with meta-analysis indicated positive peri-implant bone preservation for implants restored with an implant-abutment mismatching (PSW). Further, there is evidence to improve the design of current systematic reviews. Future systematic reviews in this thematic area should consider searches in gray literature and different databases and include only randomized controlled clinical studies.

Made available in DSpace on 2020-12-10T19:44:27Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-01-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Purpose: To verify the prevalence of sleep disorders in temporomandibular disorders (TMD) subjects in a Brazilian population-based, cross-sectional survey (N = 1,643). Materials and Methods: Patients were assessed with the Research Diagnostic Criteria for TMD (RDC/TMD) Axes I and II and the Sleep Assessment Questionnaire. Student t test and Pearson chi-square test were used for continuous and categorical data analyses, respectively. Results: TMD subjects had significantly worse sleep disorders than controls (Graded Chronic Pain Severity categories I through IV vs 0, respectively) in RDC/TMD Axis II variables. Sleep disorders were also worse in the Axis I TMD groups (myofascial pain and arthralgia/osteoarthritis/osteoarthrosis), with the exception of disc displacements. Conclusion: TMD subjects had worse sleep disorders, mainly in Axis I TMD groups, with higher pain/disability levels. Brazilian Dent Assoc, Specialty Program Temporomandibular Disorders & O, Porto Alegre, RS, Brazil Pontificia Univ Catolica Rio Grande do Sul, Sch Hlth Sci, Postgrad Program Dent Prosthodont, Porto Alegre, RS, Brazil Vale Rio Sinos Univ UNISINOS, Postgrad Program Publ Hlth, Sao Leopoldo, Brazil State Univ Sao Paulo, Aracatuba Fac Dent, Dept Dent Mat & Prosthodont, Sao Paulo, SP, Brazil Pontificia Univ Catolica Rio Grande do Sul, Sch Humanities, Postgrad Program Social Work, Porto Alegre, RS, Brazil State Univ Sao Paulo, Aracatuba Fac Dent, Dept Dent Mat & Prosthodont, Sao Paulo, SP, Brazil CAPES: 001

Objective The aim of this systematic review was to compare outcomes between surgical and non-surgical treatment of actinic cheilitis (AC). Materials and methods A systematic review and meta-analysis based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses guideline were performed. A search of PubMed/MEDLINE, Web of Science, and Cochrane Library databases was conducted. Articles were selected based on the inclusion criteria: randomized clinical trials, prospective/retrospective studies, and case series with at least 10 patients, with a minimum follow-up period of 6 months. A weighted remission rate (RER) and recurrence rate (RR) with a 95% confidence interval was performed. Data analysis was performed using a comprehensive meta-analysis software. Results A total of 283 ACs in 10 studies were included. About 2.5% surgically treated cases underwent malignant transformation. The weighted remission rate was higher for surgical (92.8%) compared to non-surgical treatment (65.9%). The recurrence rate was lower for surgical (8.4%) compared to non-surgical treatment (19.2%). Conclusion In this systematic review, the surgical treatment was more favorable than non-surgical for AC. Meanwhile, further studies are needed that should maximize methodological standardization and have greater rigor of the data collection process.

No consensus has been reached on the use of dental implants in human immunodeficiency virus (HIV)-positive patients. This systematic review evaluated dental implants in HIV-positive patients in terms of implant survival and success rates, marginal bone loss, and complications. The review was conducted according to the PRISMA checklist. Two independent reviewers performed a comprehensive search of the PubMed/MEDLINE, Scopus, and Cochrane Library databases for studies published until October 2017. Six studies were selected for review. In total, 821 implants were placed: 493 in 169 HIV-positive patients, and 328 in 135 HIV-negative patients. The mean duration of follow-up was 47.9 months. Weighted mean survival rate, success rate, and marginal bone loss values were calculated for the HIV-positive patients. Mean survival and success rates at the patient level (according to the number of patients) were 94.76% and 93.81%, respectively; when calculated at the implant level (according to the number of implants), these rates were 94.53% and 90.37%, respectively. Mean marginal bone loss was 0.83mm at the patient level and 0.99mm at the implant level. Thus, dental implants are suitable for the rehabilitation of HIV-positive patients with controlled risk factors and normal CD4+ cell counts.

Made available in DSpace on 2018-12-11T17:19:58Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-09-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) The purpose of this study was to analyze the stress distribution of bone tissue around implants with different implant-abutment interfaces: platform switching (PSW); external hexagon (EH) and Morse taper (MT) with different diameters (regular: Ø 4 mm and wide: Ø 5 mm), bone types (I–IV) and subjected to axial and oblique load conditions using three-dimensional finite element analysis (3D-FEA). Sixteen 3D models of various configurations were simulated using InVesalius, Rhinoceros 3D 4.0, and SolidWorks 2011 software, and processed using Femap 11.2 and NeiNastran 11.0 programs. Axial and oblique forces of 200 N and 100 N, respectively, applied at the occlusal surface of prostheses. Maximum principal stress values were obtained from the peri-implant cortical bone of each model. Statistical analyses were performed using ANOVA and Tukey's test for maximum principal stress values. Oblique loading showed higher tensile stress than axial loading (P < 0.001). Wide-diameter implants showed lower stress concentration rather than regular-diameter implants, regardless of both connection and bone type (P < 0.001). Under axial loading, wide-diameter EH implants with regular platforms showed more favorable stress distribution than PSW implants for axial loading (P < 0.001); however, under oblique loading, PSW implants exhibited lower stress concentrations (P < 0.001). Regular-diameter MT implants showed lower stress than EH implants (P < 0.001). Bone type IV showed higher stress in the cortical region than bone types I and II (P < 0.001), but no significant difference when compared with bone type III (P > 0.05). The conclusion drawn from this in silico is that MT implants should be considered for use in situations that preclude the placement of wide-diameter implants, particularly where bone types III and IV are concerned. Department of Dental Materials and Prosthodontics Araçatuba Dental School UNESP - Univ Estadual Paulista Department of Health Sciences University of Sacred Heart – USC Department of Restorative Dentistry Federal University of Alfenas Department Prosthodontics Presidente Prudente Dental School University of Western São Paulo - UNOESTE Department of Dental Materials and Prosthodontics Araçatuba Dental School UNESP - Univ Estadual Paulista FAPESP: 09/16164-7 CNPq: 303874/2010-4

Splinted and unsplinted overdenture attachment systems have unique advantages and disadvantages. The aim of the present systematic review was to determine the influence of splinted and unsplinted overdenture attachment systems on the marginal bone loss, prosthetic complications and implant survival rate. PubMed/MEDLINE, Scopus and Cochrane databases were searched for articles published up to October 2017, using the following search terms: "overdenture AND attachment OR overdenture AND bar OR overdenture splinted." The PICO question "Do splinted overdenture attachment systems promote better clinical results in comparison to unsplinted systems?" was evaluated. Eligible studies included randomized controlled clinical trials, prospective studies with at least 10 participants and a minimum follow-up of 6 months, and studies published in English that compared splinted and unsplinted attachment systems within the same study. The 95% confidence interval (CI) was considered for all outcomes analysed. After completion of the different steps in the article selection process, nine articles were included in the qualitative and quantitative analyses. A total of 984 implants were placed in 380 patients (mean age: 62.8 years). The meta-analysis demonstrated no statistically significant differences between splinted and unsplinted attachment systems with regard to marginal bone loss (P = .39; MD: -0.11; 95% CI: -0.37 to 0.14), complications (P = .31; RR: 1.26; CI: 0.80-1.99) and implant survival rate (P = .14; RR: 0.37% CI: 0.10-1.36). In addition, splinted and unsplinted overdenture attachment systems achieved similar results with regard to marginal bone loss, prosthetic complications and implant survival rate.

Made available in DSpace on 2021-06-25T11:01:47Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Statement of problem: Whether providing an occlusal device for a patient with bruxism and an implant-supported fixed dental prosthesis leads to improved biomechanics is unclear. Purpose: The purpose of this 3D finite element analysis (FEA) study was to evaluate the biomechanical behavior of 3-unit implant-supported prostheses under parafunctional forces with and without an occlusal device. Materials and methods: Eight 3D models consisting of a posterior (type IV) maxillary bone block with 3 external hexagon implants (Ø4.0×7.0 mm) and 3-unit implant-supported prostheses with different crown connections (splinted or unsplinted) and an occlusal device under functional and parafunctional loading were simulated. The abutment screws were evaluated by von Mises stress maps, and the bone tissue by maximum principal stress and microstrain maps by using a finite element software program. Results: An occlusal device improved the biomechanical behavior of the prostheses by reducing stress in the abutment screws and stress and strain in the bone tissue. However, the use of an occlusal device was not sufficiently effective to negate the biomechanical benefit of splinting. Conclusions: The use of splinted crowns in the posterior maxillary region with an occlusal device was the most effective method of reducing stress in the abutment screws and stress and strain in the bone tissue when parafunction was modeled. Graduate student Department of Prosthodontics Presidente Prudente Dental School University of Western São Paulo - UNOESTE Associate Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School (UNESP) Univ Estadual Paulista Adjunct Professor Department of Dentistry (Division of Prosthodontics) Federal University of Juiz de Fora Campus Avançado Governador Valadares (UFJF/GV) Associate professor Department of Endodontics Presidente Prudente Dental School University of Western São Paulo - UNOESTE Full Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School (UNESP) Univ Estadual Paulista Associate professor Department of Prosthodontics Presidente Prudente Dental School University of Western São Paulo - UNOESTE Associate Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School (UNESP) Univ Estadual Paulista Full Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School (UNESP) Univ Estadual Paulista

The aim of this systematic review and meta-analysis was to compare the survival rate of the implants and the peri-implant tissue changes associated with implants inserted in fresh extraction sockets and those inserted in healed sockets. This review has been registered at PROSPERO under the number CRD42016043309. A systematic search was conducted by two reviewers independently in the databases PubMed/MEDLINE, Embase, and the Cochrane Library using different search terms; articles published until November 2016 were searched for. The searches identified 30 eligible studies. A total of 3,049 implants were installed in a total of 1,435 patients with a mean age of 46.68 years and a minimum of 6 months of follow-up. The survival rate of delayed implants (98.38%) was significantly greater than immediate implants (95.21%) ( p =.001). For the marginal bone loss ( p =.32), implant stability quotients values ( p =.44), and pocket probing depth ( p =.94) there was no significant difference between the analysed groups. The immediate implants placed in fresh sockets should be performed with caution because of the significantly lower survival rates than delayed implants inserted in healed sockets.

The aim of this systematic review is to evaluate the relationship between two methods used to assess implant stability, investigating whether both provide similar implant stability assessments for the same clinical case.A literature search was conducted on MEDLINE-PubMed and Scopus databases, without limitation of the publication period, up to November 2015. The following key words were used, with associations among them: "dental implant," "dental implants," "Osstell," "resonance frequency analysis," "implant stability quotient," "ISQ," "Periotest," "Periotest value," and "PTV." Inclusion criteria were English language, prospective, retrospective, and randomized controlled clinical trials that evaluated implant stability through use of resonance frequency analysis (RFA) and damping capacity analysis (DCA). The study should assess implant stability of only a specific region for all patients or discriminate results evaluated for each region if the analysis had been made in various regions; RFA and DCA should have been applied in the same implants and periods. Studies have been carefully selected, and data of interest were tabulated.Six studies met the inclusion criteria. Although there was significant numerical correlation between values obtained by both methods, data showed that less than half (46%) of cases coincided in relation to implant stability classification.It can be considered that there is not always a consensus and standardization in the classification of implant stability related to the values obtained by RFA and DCA devices, which could create disagreements and miscommunication among dentistry professionals.

This systematic review evaluated the efficacy of the morning fasting serum C-terminal telopeptide (CTX) test in predicting the development of bisphosphonate-related osteonecrosis of the jaw (BRONJ). A comprehensive search of studies published up to March 2016, and listed in the PubMed/MEDLINE, Web of Science, and Cochrane Library databases, was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This review has been registered in the PROSPERO international prospective register of systematic reviews (CRD42016036717). The search identified 542 publications; eight studies were finally deemed eligible for inclusion according to the study criteria. These studies included a total 1442 patients (mean age 66.7 years). The most prescribed drug was alendronate, with osteoporosis being the most frequent indication for the prescription of bisphosphonates. Tooth extraction was the most common trigger for BRONJ. Of all patients evaluated after bisphosphonate treatment, only 24 (1.7%) developed BRONJ. All eight of the selected studies found that CTX levels were not predictive of the development of BRONJ. In conclusion, this systematic review indicates that the CTX test has no predictive value in determining the risk of osteonecrosis in patients taking bisphosphonates.

Statement of problem How the performance of dental implants is related to their occlusogingival placement, crestal or subcrestal, is unclear. Purpose The purpose of this systematic review and meta-analysis was to evaluate marginal bone loss, implant survival rate, and peri-implant soft tissue parameters between implants placed at the crestal and subcrestal bone level. Material and methods Two independent reviewers searched the PubMed/MEDLINE, Embase, and Cochrane Library databases for randomized clinical trials published up to September 2020. The meta-analysis was based on the Mantel-Haenszel and the inverse variance methods (α=.05). Results The search identified 928 references, and 10 studies met the eligibility criteria. A total of 393 participants received 709 implants, 351 at crestal bone levels and 358 at subcrestal bone levels. Meta-analysis indicated that crestal bone level implants showed similar marginal bone loss to that seen with subcrestal bone level implants (mm) (P=.79), independent of the subcrestal level (P=.05) and healing protocol (P=.24). The bone level implant placement did not affect the implant survival rate (P=.76), keratinized tissue (mm) (P=.91), probing depth (mm) (P=.70), or plaque index (%) (P=.92). Conclusions The evidence suggests that both approaches of implant placement are clinically acceptable in terms of peri-implant tissue parameters and implant-supported restoration survival.

Obstructive sleep apnea (OSA) has many effects on subjective parameters of the disease, such as reduction in quality of life (QoL), sleep quality (SQ), and increases in daytime sleepiness. Studies have reported the beneficial effect of exercise training on OSA severity; however, whether it improves subjective parameters remains unclear. The purpose of the present review was to investigate the effect of exercise training on QoL, daytime sleepiness, and SQ in adults with OSA by summarizing the results of clinical trials. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered in PROSPERO. A systematic review of the PubMed, Scopus, and Cochrane (CENTRAL) databases was conducted. Risk of bias analysis was performed using the Cochrane tool, and Review Manager version 5.2 (R Foundation for Statistical Computing, Vienna, Austria) was used to perform the meta-analysis. Of the 1573 studies initially retrieved, 8 relevant studies with 228 participants were included in the analysis. The studies presented moderate risk of bias. Exercise training significantly improved QoL (mean difference, 12.9 [95% confidence interval (CI) 6.4 to 19.5]) and SQ (mean difference, −2.0 [95% CI -3.6 to −0.5]), and reduced daytime sleepiness (mean difference, −3.7 [95% CI -6.1 to −1.2]), and OSA severity (mean difference, −11.4 [95% CI -13.4 to −9.4 events/h]). Thus, physical exercise training was effective in improving subjective parameters and reducing the severity of OSA. Additional randomized clinical trials, however, should be performed to confirm these findings.

Statement of problem A consensus on the clinical performance in dental implants placed with different insertion torques is lacking. Purpose The purpose of this systematic review and meta-analysis was to evaluate the effect of high insertion torque compared with regular or low torques during dental implant placement in terms of implant survival rate and marginal bone loss. Material and methods Two independent reviewers searched electronic databases for studies published until April 2019. The population, intervention, comparison, outcome (PICO) question was “Do patients who receive implants with a high torque (equal or higher than 50 Ncm) show similar implant survival rates and marginal bone loss as compared with those who receive implants with a regular or low torque (less than 50 Ncm)?”. The meta-analysis was based on the Mantel-Haenszel (MH) and the inverse variance (IV) methods (α=.05). Results The search yielded 6 articles, which included 389 patients (mean age: 55.28 years) who had received 651 dental implants (437 with high torque and 214 with low or regular torque). Most studies evaluated delayed loading, except 1 study that evaluated immediate implant loading (n=50 for each group). Low or regular insertion torque had a high failure rate (4.2%) compared with high insertion torque (1.1%), chiefly because of immediate loading. However, the meta-analysis indicated no significant difference between high- and regular- or low-torque implant placement in implant survival rate (P=.52, risk ratio [RR]: 0.51, 95% confidence interval [CI]: 0.06-4.06) and marginal bone loss (P=.30, mean difference [MD]: 0.15, 95% CI: -0.14 to 0.44). Conclusions A high insertion torque during implant placement does not affect implant survival rate or marginal bone loss. However, further research is recommended to reassess this clinical performance.

Made available in DSpace on 2020-12-12T02:26:23Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-01-01 We aimed to conduct an analysis of the systematic reviews (SRs) in literature about the implant survival rate (ISR) and marginal bone loss (MBL) in diabetic and nondiabetic patients. This work was registered in The International Prospective Register of Systematic Reviews (CRD42018095314) and was developed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Cochrane Library Handbook. A search was performed on PubMed, Cochrane, Scopus, Embase, and LILACS. The PICO (problem/patient/population, intervention/indicator, comparison, outcome) question was ‘‘Do the survival rates of dental implants and marginal bone loss differ between diabetic and nondiabetic patients?’’ A total of 130 articles were retrieved. After eliminating repetitions, 118 were reviewed. Finally, 6 SRs were included. All the reviews indicated that there is no effect of diabetes on the ISR; however, a negative effect of the disease can be observed in MBL. Analysis of the quality of the studies was performed using the assessment of SRs in dentistry (Glenny Scale) and Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2). Glenny Scale showed a moderate to high quality of the included studies. In contrast, AMSTAR 2 pointed out a critically low level for 4 studies, with no study fulfilling the criteria for high quality. It may be concluded that there is no effect of diabetes on the ISR; however, a negative effect of the disease can be observed on MBL. Department of Prosthodontics Faculty of Dentistry Pernambuco University (UPE) Department of Dental Materials and Prosthodontics Sao Paulo State University (UNESP) Pró-Reitoria de Pesquisa e Pós-graduação (PRPPG) Universidade do Sagrado Coração (USC) Department of Buco Maxillo Facial Surgery Faculty of Dentistry Pernambuco University (UPE) Department of Dental Materials and Prosthodontics Sao Paulo State University (UNESP)

Purpose To assess the current diagnostic methods for sleep bruxism (SB). Materials and methods This review of the literature evaluates all available instrumental and noninstrumental methods of bruxism/SB diagnosis. Results SB diagnosis can be performed using self-reports and clinical examination, but these methods have little agreement with polysomnography. Two portable electromyography/electrocardiography appliances have been validated against polysomnography (BiteStrip and Bruxoff), but they are indicated only for primary SB. Polysomnography is considered the gold standard and is indicated for secondary SB; however, it is expensive and time-consuming. Conclusion No perfect method of SB diagnosis exists, and future research should concentrate on improving SB self-reports.

Statement of problem Although recent studies have reported the success of implant-supported monolithic restorations, consensus on the use of monolithic ceramic restorations is lacking. Purpose The purpose of this systematic review and meta-analysis was to evaluate the survival and biological and technical complication rates of monolithic single crowns and fixed partial dentures (FPDs). Material and methods An electronic search was conducted by 2 independent authors on the PubMed/MEDLINE, Scopus, and Cochrane Library databases. The Newcastle-Ottawa scale and Cochrane risk of bias tool were used to assess the quality and risk of bias of the included studies. Meta-analysis was performed by using the R software program. Results The search identified 763 articles, 18 of which met the eligibility criteria. A total of 15 studies evaluated monolithic ceramic single crowns, and 4 studies evaluated FPDs. The studies included 1061 monolithic single crowns (524 lithium disilicate, 461 zirconia, and 76 polymer-infiltrated ceramic network [PICN]) and 104 FPDs (36 lithium disilicate and 68 zirconia). Meta-analysis of single-arm studies indicated the proportion of survival, biological, and technical complication rates of 1% (95% confidence interval [CI]: 0% to 3%), 1% (CI: 0% to 4%), and 2% (CI: 1% to 4%), respectively, for single crowns, independent of ceramic material, and 3% (CI: 0% to 34%), 5% (CI: 1% to 21%), and 5% (CI: 1% to 21%) for FPDs, respectively. Only 5 studies performed a direct comparison between monolithic and veneered ceramic restorations, and no significant difference was observed in terms of survival (risk ratio [RR]: 0.68; CI: 0.25-1.91; P=.96), biological (RR: 0.69; CI: 0.31-1.53; P=.35), and technical complication rates (RR: 0.87; CI: 0.40-1.88; P=.29). Conclusions The use of monolithic ceramic can be considered a favorable treatment for tooth-supported single crowns and FPDs, with high survival and low complication rates. However, further randomized controlled trials are needed to reassess these clinical performances, mainly by comparing them with the performance of veneered restorations.

Made available in DSpace on 2020-12-12T01:47:57Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-01-01. Added 1 bitstream(s) on 2021-07-15T15:25:42Z : No. of bitstreams: 1 S1806-83242019000100401.pdf: 337461 bytes, checksum: 4be2e93b58644ca2b45a155e7886709f (MD5) The objective of this systematic review and meta-analysis was to evaluate the effect of welding techniques on implant-supported prostheses and determine whether they contribute to a better adaptation compared with a one-piece cast. A search was conducted using the PubMed/MEDLINE, Embase, and Cochrane Library databases, and articles published until November 2017 were obtained from these databases. This review followed the PRISMA criteria and is registered on the PROSPERO platform (CRD42017081865). The PICO question was Do welding procedures in one-piece cast implant-supported frameworks influence implant/abutment-framework marginal misfits? Eleven studies were selected for a qualitative analysis, and seven studies were selected for a quantitative analysis. A total of 189 specimens were fabricated using different materials (cp-Ti, Ni-Cr, Cr-Co, and noble alloys), and welding techniques such as laser welding, conventional welding, tungsten inert gas, and brazing were applied. A vertical marginal misfit was measured using an optical microscope, a stereomicroscope, and/or a scanning electron microscopy. The qualitative analysis in the studies demonstrated a positive effect of the welding techniques on the adaptation of the infrastructures. The meta-analysis confirmed the results (p < 0.00001; MD:-36.14; 95%CI:-48.69 to-23.59). Within the limitations of this study and regarding the heterogeneity of the samples, we conclude that the soldering point technique is effective for obtaining relatively low values of marginal misfit, with laser welding as the most effective technique. However, additional studies were recommended due to the heterogeneity of different variables (alloys, connection, and misfit evaluation) in the included studies. Universidade Estadual Paulista-Unesp Araçatuba Dental School Department of Dental Materials and Prosthodontics Universidade de Pernambuco-UPE Universidade Estadual Paulista-Unesp Araçatuba Dental School Department of Dental Materials and Prosthodontics

The objective of the present study was to analyze the stress and microstrain on cortical bone tissue caused by occlusal forces on three-unit implant-supported prostheses placed in the maxillary posterior region through varying configuration factors and implant lengths using 3D finite element analysis. Fifteen three-dimensional models were simulated with the support of the In Vesalius, SolidWorks 2016, and Rhinoceros 4.0 software programs. Each three-dimensional model included a maxillary bone block corresponding to the region from the 1st premolar to the 1st right molar with three EH implants measuring 4.0 mm in diameter, which supported the three-unit metal-ceramic screw-retained prosthesis through varying configuration factors (single-unit and splinted crowns: straight-line and tripod design) and implant lengths (10, 8.5, and 7 mm × Ø4 mm). The FEMAP 11.4.2 program was used to generate the finite element models in the pre- and post-processing phases. Bone tissue was analyzed using Maximum Principal Stress (MPa) and Microstrain (με) maps. The highest stress/microstrain values were observed in oblique loading. In addition, splinting associated with the offset configuration generated improved biomechanical behavior. Furthermore, the association of short implants with longer implants did not exhibit any biomechanical benefits. Moreover, a reduced implant length (i.e., 7 mm) generated unfavorable biomechanical behavior. Splinting was effective in reducing the stress/microstrain on cortical bone tissue, especially when associated with the offset configuration of the implants. Also, an increased implant length decreased the stress/microstrain in the bone tissue, and splinted short implants presented similar biomechanical behavior to short implants associated with longer implants. El objetivo del presente estudio fue analizar la tensión y microdeformación del tejido óseo cortical generada por las fuerzas oclusales sobre las prótesis de tres elementos implantosoportados, variando la unión y longitud de los implantes, instalados en la región posterior del maxilar. Quince modelos tridimensionales se simularon y cada modelo tridimensional consistió en un bloque óseo maxilar referido a la región de la 1ª PM a la 1ª M derecha, presentando tres implantes de hexágono externo (HE) de 4.0 mm de diámetro, soportando una prótesis metalocerámica atornillada, variando el factor unión (coronas unitarias y ferulizadas: rectas y en posición tripoide), longitud con implantes (10 mm, 8,5 mm y 7 mm Ø4 mm). El análisis del tejido óseo se realizó utilizando los mapas de Máxima Máxima Tensión (MPa) y Microdeformación (µε). Los mayores valores de la tensión/microdeformación se observaron en la carga oblicua. El entablillado asociado al posicionamiento del trípode generó un mejor comportamiento biomecánico. La asociación de implantes cortos con implantes más largos no ha demostrado un beneficio biomecánico. La reducción de la longitud del implante (7 mm) generó un comportamiento biomecánico desfavorable. La ferulización fue eficaz para reducir la tensión/microdeformación del tejido óseo cortical, especialmente cuando se asocia con el posicionamiento trípode de los implantes. El aumento de la longitud del implante disminuyó la tensión/microdeformación en el tejido óseo. Los implantes ferulizados cortos mostraron un comportamiento biomecánico similar al de los implantes cortos asociados con implantes más largos. O objetivo do presente estudo foi analisar a tensão e a microdeformação do tecido ósseo cortical geradas pelas forças oclusais sobre próteses de três elementos implantossuportadas, variando o fator união e comprimento dos implantes, instaladas na região posterior de maxila. Quinze modelos tridimensionais foram simulados com auxílio dos programas In Vesalius, SolidWorks 2016, Rhinoceros 4.0. Cada modelo tridimensional foi constituído de um bloco ósseo maxilar referente à região do 1º PM ao 1º M direito, apresentando três implantes do tipo hexágono externo (HE) de 4,0 mm de diâmetro, suportando prótese de três elementos metalocerâmica parafusada, variando o fator união (coroas unitárias e esplintadas: em linha reta e em posicionamento tripoidal), comprimento com implantes (10 mm, 8,5 mm e 7 mm de Ø4 mm). O programa FEMAP 11.4.2 foi utilizado para gerar os modelos de elementos finitos nas fases de pré- e pós-processamento. A análise do tecido ósseo foi feita utilizando os mapas de Tensão Máxima Principal (MPa) e Microdeformação (µε). Os maiores valores de tensão/microdeformação foram observados no carregamento oblíquo. A esplintagem associada ao posicionamento tripoidal gerou melhor comportamento biomecânico. A associação de implantes curtos com implante de maior comprimento não demonstrou benefício biomecânico. A redução do comprimento do implante (7 mm) gerou um comportamento biomecânico desfavorável. A esplintagem foi efetiva na redução de tensão/microdeformação do tecido ósseo cortical, principalmente quando associada ao posicionamento tripoidal dos implantes. O aumento do comprimento do implante diminuiu a tensão/microdeformação no tecido ósseo. Implantes curtos esplintados mostraram comportamento biomecânico similar a implantes curtos associados a implantes de maior comprimento.

The aim of this systematic review was to compare the clinical performance of calcium hydroxide (Ca(OH)2) as an intracanal medicament alone or combined with other antimicrobial agents. The PICO question was “Is the antibacterial effectiveness of calcium hydroxide paste as an intracanal medication combined with other drugs greater than that of calcium hydroxide paste alone in apical periodontitis?” The study was carried out according PRISMA guidelines and is registered in PROSPERO (CRD42020205741). Searches were performed in the PubMed/MEDLINE, Web of Science and Cochrane databases without publication date restrictions. Inclusion: randomized clinical trials, non-randomized intervention studies, studies including a minimum of 10 patients, studies comparing the use of Ca(OH)2 alone and in combination with other compounds, studies evaluating primary and permanent teeth with apical periodontitis, and studies including teeth not submitted to retreatment. The Cochrane risk-of-bias tool for randomized clinical trials (RoB 2.0) was used to assess the internal validity (risk of bias) of the included studies. A total of 986 articles were retrieved and 12 randomized clinical trials were selected, totaling 499 patients included in the studies. The effectiveness of Ca(OH)2 plus chlorhexidine was similar to that of Ca(OH)2 alone in eight articles, while a better antibacterial effect was reported in three studies. The combination with ciprofloxacin was more effective than the use of Ca(OH)2 alone in the only study that tested this antibiotic. In teeth with asymptomatic apical periodontitis, the effectiveness of the combination of antimicrobial agents with Ca(OH)2 was similar to that of Ca(OH)2 alone. El objetivo de esta revisión sistemática fue comparar el rendimiento clínico del hidróxido de calcio (Ca(OH)2) como medicamento intracanal solo o combinado con otros agentes antimicrobianos. La pregunta de PICO fue "Es la eficacia antibacteriana de la pasta de hidróxido de calcio como medicamento intracanal combinado con otros fármacos mayor que la de la pasta de hidróxido de calcio sola en la periodontitis apical?" El estudio se realizó según las directrices PRISMA y está registrado en PROSPERO (CRD42020205741). Las búsquedas se realizaron en las bases de datos PubMed / MEDLINE, Web of Science y Cochrane sin restricciones de fecha de publicación. Inclusión: ensayos clínicos aleatorizados, estudios de intervención no aleatorizados, estudios que incluyan un mínimo de 10 pacientes, estudios que comparen el uso de Ca(OH)2 solo y en combinación con otros compuestos, estudios que evalúen dientes primarios y permanentes con periodontitis apical y estudios. incluidos los dientes no sometidos a retratamiento. Se utilizó la herramienta Cochrane de riesgo de sesgo para ensayos clínicos aleatorios (RoB 2.0) para evaluar la validez interna (riesgo de sesgo) de los estudios incluidos. Se recuperaron un total de 986 artículos y se seleccionaron 12 ensayos clínicos aleatorizados, con un total de 499 pacientes incluidos en los estudios. La eficacia del Ca(OH)2 más clorhexidina fue similar a la del Ca(OH)2 solo en ocho artículos, mientras que en tres estudios se informó un mejor efecto antibacteriano. La combinación con ciprofloxacina fue más eficaz que el uso de Ca(OH)2 solo en el único estudio que probó este antibiótico. En dientes con periodontitis apical asintomática, la eficacia de la combinación de agentes antimicrobianos con Ca(OH)2 fue similar a la del Ca(OH)2 solo. O objetivo desta revisão sistemática foi comparar o desempenho clínico do hidróxido de cálcio (Ca(OH)2) como um medicamento intracanal sozinho ou combinado com agentes antimicrobianos. A pergunta do PICO era “A eficácia antibacteriana da pasta de hidróxido de cálcio como medicamento intracanal combinado com outras drogas é maior do que a da pasta de hidróxido de cálcio sozinha na periodontite apical?” O estudo foi realizado de acordo com as diretrizes PRISMA e registrado no PROSPERO (CRD42020205741). As pesquisas foram realizadas nas bases de dados PubMed / MEDLINE, Web of Science e Cochrane sem restrições de data de publicação. Inclusão: ensaios clínicos randomizados, estudos de intervenção não randomizados, estudos com mínimo de 10 pacientes, estudos comparando o uso de Ca(OH)2 sozinho e combinação com outros compostos, estudos avaliando dentes decíduos e permanentes com periodontite apical e estudos incluindo dentes não submetidos a retratamento. A ferramenta de risco de viés Cochrane para ensaios clínicos randomizados (RoB 2.0) foi usada para avaliar a validade interna dos estudos incluídos. Um total de 986 artigos foram recuperados e 12 ensaios clínicos randomizados selecionados, totalizando 499 pacientes incluídos nos estudos. A eficácia do Ca(OH)2 mais clorexidina foi semelhante ao Ca(OH)2 sozinho em oito artigos, enquanto um melhor efeito antibacteriano foi relatado em três estudos. A combinação com ciprofloxacino foi mais eficaz do que o uso de Ca(OH)2 sozinho no único estudo que testou esse antibiótico. Na periodontite apical assintomática, a eficácia da combinação de agentes antimicrobianos com Ca(OH)2 foi semelhante à do Ca (OH) 2 sozinho.

Made available in DSpace on 2018-12-11T17:04:13Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-01-25 The aim of study was to evaluate the stress distribution in implant-supported prostheses and peri-implant bone using internal hexagon (IH) implants in the premaxillary area, varying surgical techniques (conventional, bicortical and bicortical in association with nasal floor elevation), and loading directions (0°, 30° and 60°) by three-dimensional (3D) finite element analysis. Three models were designed with Invesalius, Rhinoceros 3D and Solidworks software. Each model contained a bone block of the premaxillary area including an implant (IH, Ø4 × 10 mm) supporting a metal-ceramic crown. 178 N was applied in different inclinations (0°, 30°, 60°). The results were analyzed by von Mises, maximum principal stress, microstrain and displacement maps including ANOVA statistical test for some situations. Von Mises maps of implant, screws and abutment showed increase of stress concentration as increased loading inclination. Bicortical techniques showed reduction in implant apical area and in the head of fixation screws. Bicortical techniques showed slight increase stress in cortical bone in the maximum principal stress and microstrain maps under 60° loading. No differences in bone tissue regarding surgical techniques were observed. As conclusion, non-axial loads increased stress concentration in all maps. Bicortical techniques showed lower stress for implant and screw; however, there was slightly higher stress on cortical bone only under loads of higher inclinations (60°). Department of Dental Materials and Prosthodontics Aracatuba Dental School UNESP–Univ Estadual Paulista Department of Pediatric and Community Dentistry Aracatuba Dental School UNESP–Univ Estadual Paulista Department of Operative Dentistry School of Dentistry Federal University of Alfenas–UNIFAL-MG Department of Dental Materials and Prosthodontics Aracatuba Dental School UNESP–Univ Estadual Paulista Department of Pediatric and Community Dentistry Aracatuba Dental School UNESP–Univ Estadual Paulista

Made available in DSpace on 2018-12-11T17:02:25Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-11-17 The aim of this study was to assess stress/strain of different implant modeling simplifications by 3D-FEA. Three variation of external hexagon implant (Ã 3.75 Ã 10Â mm) supporting one molar crown were simulated: A (no threads); B (slightly threads simplification); C (original design). 200Â N (axial) and 100Â N (oblique) were applied. Cortical bone was evaluated by maximum principal stress and microstrain qualitatively and quantitatively (ANOVA and Tukey post hoc (pÂ

Statement of problem No consensus has been reached on which retention system, cement- or screw-retained, is best to avoid bone loss around the implant of a fixed implant-supported restoration. Purpose The purpose of this systematic review and meta-analysis was to compare cement- and screw-retained retention systems in fixed implant-supported restorations in terms of marginal bone loss, implant survival, and prosthetic complications. Material and methods A comprehensive search of studies published from January 1995 to March 2015 and listed in the PubMed/MEDLINE, Embase, Scopus and the Cochrane Library databases was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The meta-analysis was based on the Mantel-Haenszel and inverse variance methods. Marginal bone loss was the continuous outcome measure evaluated by mean difference (MD), and implant survival and prosthetic complications were the dichotomous outcome measures evaluated by risk ratio (RR), both with corresponding 95% confidence intervals (CI). Results The 20 studies selected for review evaluated 2139 participants, whose mean age was 47.14 years and who had received 8989 dental implants. The mean follow-up was 65.4 months (range: 12-180 months). Results of the MD for marginal bone loss showed statistically significant differences in favor of the cement-retained prosthesis ( P =.04; MD: −0.19; CI: −0.37 to −0.01). The implant survival rate was higher for the cement-retained prosthesis ( P =.01; RR: 0.49; CI: 0.28 to 0.85), and the prosthetic complication rate was higher for the screw-retained prosthesis ( P =.04; RR: 0.52; CI: 0.28 to 0.98). Additional analysis of the mean plaque index did not show differences between retention systems ( P =.58; MD: 0.13; CI: −0.32 to 0.57). Conclusions The current meta-analysis indicated that cement-retained, fixed implant-supported restorations showed less marginal bone loss than screw-retained, fixed implant-supported restorations during the follow-up period, which ranged from 12 to 180 months. However, the small difference between the mean values may not show clinical significance. The rates of prosthetic complication and implant survival also compared favorably with cement-retained prostheses.

This systematic review evaluated the effect on bone formation and implant survival of combining platelet-rich plasma (PRP) with bone grafts in maxillary augmentation. A comprehensive review of articles listed in the PubMed/MEDLINE, Embase, and Cochrane Library databases covering the period January 2000 to January 2015 was performed. The meta-analysis was based on bone formation for which the mean difference (MD, in millimetres) was calculated. Implant survival was assessed as a dichotomous outcome and evaluated using the risk ratio (RR) with 95% confidence interval (CI). The search identified 3303 references. After inclusion and exclusion criteria were applied, 17 studies were selected for qualitative analysis and 13 for quantitative analysis. A total of 369 patients (mean age 51.67 years) and 621 maxillary sinus augmentations were evaluated. After the data analysis, additional analyses were performed of the implant stability quotient, marginal bone loss, and alveolar bone height measured by MD. The results showed no significant difference in implant stability (P=0.32, MD 1.00, 95% CI -0.98 to 2.98), marginal bone loss (P=0.31, MD 0.06, 95% CI -0.05 to 0.16), alveolar bone height (P=0.10, MD -0.72, 95% CI -1.59 to 0.14), implant survival (P=0.22, RR 1.95, 95% CI 0.67-5.69), or bone formation (P=0.81, MD -0.63, 95% CI -5.91 to 4.65). In conclusion, the meta-analysis indicates no influence of PRP with bone graft on bone formation and implant survival in maxillary sinus augmentation.

Made available in DSpace on 2018-12-11T17:00:46Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-03-01 The aim of this study was to perform a systematic review and meta-analysis to evaluate the possible benefits of platform-switching (PSW) implants when compared to regular platform (RP) implants in the categories of bone preservation and longevity. This systematic review and meta-analysis was performed in accordance with the PRISMA statement, PICO question, and Jadad scale. The relative risk (RR) of failure and the mean difference for marginal bone loss were calculated considering a confidence interval (CI) of 95%. Heterogeneity and subgroup analyses were performed, and funnel plots drawn. Twenty-five studies (17 randomized controlled trials (RCTs) and eight prospective studies) involving 1098 patients and 2310 implants were analysed. The meta-analysis revealed a significant reduction in crestal bone loss for PSW implants compared with RP implants (-0.41 mm, 95% CI -0.52 to -0.29, P < 0.00001). However, there was no statistically significant difference in implant failure (RR 1.10, 95% CI 0.6-2.02, P = 0.75). A reduction in bone loss with PSW implants was observed for the following subgroups: RCTs only, implants in the maxilla, and implants in the mandible. PSW implants presented lower bone resorption compared with RP implants. RCTs should be done to explain the possible biases. Department of Health Sciences Sacred Heart University USC, 10-50 Irmã Arminda Department of Dental Materials and Prosthodontics Dental School of Araçatuba UNESP - Universidade Estadual Paulista Department of Scientific Methodology and Statistics Bauru School of Dentistry USP - University of São Paulo Department of Dental Materials and Prosthodontics Dental School of Araçatuba UNESP - Universidade Estadual Paulista

Made available in DSpace on 2018-12-11T16:41:48Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-03-01. Added 1 bitstream(s) on 2019-10-09T18:28:35Z : No. of bitstreams: 1 S1807-59322016000300156.pdf: 786719 bytes, checksum: 50096c581bd12397c174be8494c376dc (MD5) OBJECTIVE: The aims of this study were to examine the trans- and postoperative systemic characteristics of patients undergoing dental implant surgery and to investigate the relationship between pre- and post- surgery anxiety levels. MATERIAL AND METHODS: Thirty-nine patients were analyzed in 3 call centers to determine anxiety levels, pain levels, and preoperative and postoperative histories using the State–Trait (STAI) questionnaire. RESULTS: A total of 93 dental implants were installed, with a success rate of 100%. The most frequently reported systemic disease was hypertension. There was a significantly higher rate of effective clamping (torque) to the mandibular bone than to the maxillary bone. The association between postoperative surgical complications and longer operative time was not significant, but there was a significant correlation between the alteration of mouth opening and daily routine activities and a significant decrease in anxiety levels between the day of surgery and the postoperative time point (p=0.006). CONCLUSION: A longer surgical time was associated with surgery-related complications and with a higher anxiety index on the preoperative evaluation. Departamento de Odontologia Material e Prótese Dentária Departamento de Cirurgia e Clínica Integrada Universidade Estadual Paulista (UNESP), Faculdade de Odontologia Pública

The purpose of this study was to evaluate the marginal adaptation of fixed dental prosthesis frameworks fabricated by computer-aided design/computer-assisted manufacture (CAD/CAM) with three different systems of data acquisition.A total of 50 specimens were fabricated as follows: using the conventional method (Ni-Cr) (n=10); iTero/industrial milling (Group 1, n=10); Cerec Bluecam/industrial milling (Group 2, n=10); 3S/industrial milling (Group 3, n=10); and Cerec BlueCam/Sirona milling (Group 4, n=10). The specimens were numbered and randomized, and the vertical marginal discrepancy was analyzed.Intraobserver analysis indicated no statistically significant difference (paired t test, P=.822) between periods before and after analysis. The conventional method (321 μm) showed greater discrepancy when compared with the CAD/CAM system (89 μm) (P.001). The intraoral system showed a lower rate of marginal discrepancy when compared with the extraoral system (3S) (P.001). The closed system presented a higher marginal discrepancy (114 μm) than the open intraoral system (iTero) at P.001. In addition, the intraoral system when open showed statistically significant differences in mean marginal discrepancy values compared with the same system in closed condition (P.05).The CAD/CAM systems showed less marginal discrepancy than the conventional method for the fabrication of the frameworks.

The aim of this study was to report a patient of rehabilitation with removable partial denture retained by implants in-patient who suffered injury after firearm shooting. A 19-year-old man presented to the hospital of the Val Paraíso city after being hit by a bullet in the right on the face, affecting the teeth 12 to 16. The surgery to remove the shards of teeth, and bullet was performed. Surgical team opted for installation of implants without bone grafts; however, due to extensive loss of alveolar bone, only 3 tilted implants (2 Ø3.75 × 8.5 mm and 1 Ø3.75 × 10 mm) were installed. After recovery, the patient was referred to the Araçatuba Dental School-UNESP for the rehabilitation on the affected region. The difficulty of rehabilitation with conventional fixed prostheses was verified during the prosthetic phase. This way, it was opted for rehabilitation with removable partial dentures associated with dental implant. Two attachment system ERA (ERA, Sterngold) were positioned in the bar to make the removable partial denture. After 5 years of follow-up, the authors can conclude that the use of removable partial denture retained by implants is effective for functional and aesthetic rehabilitation, favoring socialization and self-esteem of the patient.

This study aimed to perform a systematic review and meta-analysis to evaluate the preemptive action of the combination of corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs) or both drugs singly after third molars surgery. It was performed a search on the PubMed/MEDLINE, Scopus, and Cochrane databases, according to the PRISMA criteria, with no time restrictions up to March 2020. The postoperative pain was evaluated, qualitatively, through the visual analogue scale (VAS) and the number of rescue analgesics (NRA). The edema and trismus were evaluated in a qualitative way through linear measures. Besides that, a meta-analysis of the post-operative pain (VAS) was performed. It was found 103 articles, which four articles were selected according to the inclusion and exclusion criteria. A total of 208 patients was evaluated and the combination of corticosteroids and NSAIDs showed great behavior in the preemptive action after third molars surgery for all the parameters evaluated when compared to both drugs singly. Meta-analysis about the VAS showed that the combination of drugs reduced significantly the postoperative pain when compared to the NSAIDs singly (P

The aim of this review was to evaluate the impact of the vomer flap on craniofacial growth in patients with cleft lip and palate. The review was conducted according to the PRISMA checklist and is registered in the International Prospective Register of Systematic Reviews (PROSPERO - CRD42018095714). Two investigators performed the research using the PubMed/MEDLINE, Embase, and Web of Science databases for studies published until November 2018. The focused question was 'Does the vomer flap have a lesser impact on craniofacial growth in patients with cleft lip and palate?'. A total of 13 articles was selected for this review, comparing the vomer flap technique with other flap surgery techniques. The outcomes analyzed were: facial development (primary outcome); and the growth of the maxilla and mandible, occlusion, occurrence of fistula, and speech development (secondary outcomes). It was concluded that there is no difference in impact between vomer flap and the other flap surgery techniques on craniofacial development.