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  • Success and Complication Rates of Root-Filled Teeth Restored with Zirconia Posts: A Critical Review

    Success and Complication Rates of Root-Filled Teeth Restored with Zirconia Posts: A Critical Review

    PURPOSE: To study the complication and success ratesof root-filled teeth restored with zirconia posts in a critical review.

    MATERIALS AND METHODS: Anelectronic literature search in the MEDLINE, Cochrane Library, Ovid-EMBASE, andChinese National Knowledge Infrastructure (CNKI) databases was undertaken inDecember 2018. Other databases were also searched for gray literature, and theelectronic search was complemented by a manual search in the related reviewsand references of full-text articles. Initial screening of the titles andabstracts of eligible studies was conducted by two independent reviewers induplicate. Complication and success rates were extracted from the includedstudies and then pooled using a random- or fixed-effects model. Poissonregression was used to study the effect of core materials (resin vs composite).

    RESULTS: Among 431 screened articles, 2 prospectiveand 3 retrospective studies met the eligibility criteria and were included. Thepooled data showed that zirconia posts had a favorable 3-year success rate of97.4% (95% confidence interval [CI] 95.7% to 98.8%). The estimated 3-yearcatastrophic complication (ie, tooth extraction) rate was 0.09% (95% CI 0% to1.67%), and the estimated 3-year noncatastrophic complication rates were 0.24%(95% CI 0% to 1.16%) for post complications, 0.78% (95% CI 0% to 4.29%) forcrown complications, and 0.03% (95% CI 0% to 0.63%) for endodontic failures.

    CONCLUSION: Based on the limited number of clinicalcohort studies, zirconia posts appear to be suitable for use in post-and-coresystems. However, the studies included in this critical review had a relativelyhigh risk of bias, and further well-designed clinical studies, especiallylong-term randomized controlled trials, are required to confirm these findings.

    Xin Zhang / Xiang Pei / Xibo Pei / Qianbing Wan / Junyu Chen / Jian Wang

Implant Dentistry

  • The Effect of Crown-to-Implant Ratio on the Clinical Outcomes of Dental Implants: A Systematic Review

    The Effect of Crown-to-Implant Ratio on the Clinical Outcomes of Dental Implants: A Systematic Review

    PURPOSE: To analyze the effect ofcrown-to-implant (C/I) ratio over survival rate, marginal bone loss, andprosthetic complications of dental implants.

    MATERIALS ANDMETHODS: Electronic(PubMed, Ovid MEDLINE, and Cochrane Central) and manual searches for clinicaltrials with a minimum follow-up of 1 year were performed. Clinical andanatomical C/I ratios were obtained. Regression models were created to assessfor potential correlation between C/I ratio (anatomical and clinical) andsurvival rate, marginal bone loss, or prosthetic complications. A subgroupanalysis of 6-mm implants and a comparison of C/I ratios of > 1.5 versus =1.5 were also performed. The Newcastle-Ottawa Scale and Cochrane Risk of BiasTool For Randomized Controlled Trials were used to evaluate the risk of bias.

    RESULTS: An overall moderate risk of bias wasassessed among the selected articles. Linear regression analysis did not reveala significant correlation between anatomical C/I ratios and survival rate (P =.905), marginal bone loss (P = 0.33), or prosthetic complications (P = .67).Similarly, no significant correlation to survival rate and marginal bone loss(P = 0.42, P = 0.84) was observed in the articles providing the clinical C/Iratios.

    CONCLUSION: Increased C/I ratio does not seem tobe directly related with increased marginal bone loss and does not represent abiomechanical risk factor for the stability of the prosthesis and for thesurvival of dental implants.

    Andrea Ravidà / Shayan Barootchi / Aaeshah-Alkanderi / Lorenzo Tavelli / Fernando Suárez-López del A

Restorative Dentistry

  • Cervical margin relocation: case series and new classification system

    Cervical margin relocation: case series and new classification system

    PURPOSE: The present clinical study aimed toinvestigate the safety and feasibility of cervical marginal relocation (CMR)procedures in cases of deep caries involving supracrestal tissue attachment(STA).

    MATERIALS ANDMETHODS: Fifteen patientswere selected from those attending the Studio Ghezzi Dental Clinic, SettimoMilanese, Milan, Italy. After following an oral hygiene program with specificcounseling sessions, the selected patients were included in a periodicsupportive periodontal therapy program. Depending on the treatment theyreceived, the patients were divided into three groups according to a newclassification system: a) Class 1: Nonsurgical CMR; b) Class 2a: Surgical CMR(gingival approach); c) Class 2b: Surgical CMR (osseous approach). The primaryand secondary outcomes were pocket depth (PD) on probing and residual bleedingon probing (BOP) after 1 year.

    RESULTS: No differences were found among thethree CMR approaches for PD (overall mean value after 1 year: 2.5 ± 0.64 mm;overall mean value after 5.7 years: 2.3 ± 0.49 mm) or residual BOP (40% of thecases after 1 year).

    CONCLUSION: Based on the study results, theauthors can conclude that CMR procedures do not negatively affect theperiodontal health status of patients when the connective compartment of theSTA is not violated.

    Carlo Ghezzi / Gregory Brambilla / Alessandro Conti / Riccardo Dosoli / Federico Ceroni / Luca Ferra

Adhesive Dentistry

  • Aging Reduces the Anticaries Effect of Antibacterial Adhesive – An In Vitro Biofilm Study

    Aging Reduces the Anticaries Effect of Antibacterial Adhesive – An In Vitro Biofilm Study

    PURPOSE: This in vitro study investigatedwhether aging different restorative materials influences secondary cariesdevelopment using a short-term in vitro biofilm model, hypothesizing that the antibacterialadhesive employed may lose its effect over time.

    MATERIALS ANDMETHODS: Sixtyenamel-dentin blocks were divided into 6 groups with n = 10 per group. Thegroups were restored with three different restorative materials, of which eachsample contained an artificial gap: composite with conventional adhesive (CCA;negative control), composite with an antibacterial adhesive (CAA), and amalgam(A; positive control). Half of the groups were prepared fresh and half of thegroups were submitted to an aging protocol consisting of water storage,thermocycling, storage in human saliva, and storage in 0.9% saline solution.All specimens were subjected to an intermittent 1% sucrose biofilm model for 20days to create artificial caries lesions. Lesion progression in the enamel anddentin next to the different materials was measured as lesion depth (LD) andmineral loss (ML), using transverse wavelength independent microradiography(T-WIM). Regression analysis was used to evaluate the effect of aging on LD andML per restorative material, corrected for gap size.

    RESULTS: In the amalgam group, aging led toshallower lesions and less mineral loss. Fresh amalgam samples showed anaverage lesion depth of 156.65 ± 39.18 µm at wall dentin locations. Agedamalgam samples had an average lesion depth of 73.42 ± 73.50 µm. Fresh CAAsamples showed lower average surface mineral loss values (9104 ± 2631 µm•vol%)than did fresh CCA samples (13166 ± 4769 µm•vol%). After aging, this effect wasabsent, and the average mineral loss in the CAA group was 13382 ± 5586 µm•vol%,while in the CCA group it was 15518 ± 9283 µm•vol%.

    CONCLUSION: Aging can influence secondary cariesdevelopment either positively or negatively depending on the kind ofrestorative material. Antibacterial adhesives may lose their effectiveness overtime.

    Nicolien K. Kuper / Audrey C.C. Hollanders / Eline A.M. Dekkers / Tamires T. Maske / Marie-Charlotte