Systematic review of clinical applications of cad/cam technology for craniofacial implants placement and manufacturing of nasal prostheses

© 2021 by the authors. Licensee MDPI, Basel, Switzerland.The aim of this systematic review was to gather the clinical and laboratory applications of CAD/CAM technology for preoperative planning, designing of an attachment system, and manufacturing of nasal prostheses. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, an electronic search was carried out. Only human clinical studies involving digital planning for the rehabilitation of facial defects were included. A total of 21 studies were included with 23 patients, which were virtually planned through different planning software. The most common preoperative data for digital planning were CT scans in nine cases, CBCT in six cases, and laser scans in six cases. The reported planning softwares were Mimics in six cases, Geomagic Studio software in six cases, ZBrush in four cases, and Freeform plus software in four cases. Ten surgical templates were designed and printed to place 36 implants after digital planning, while post-operative assessment was done in two cases to check the accuracy of planned implants. Digital 3D planning software was reported for presurgical planning and craniofacial implants placement, fabrication of molds, designing of implants, designing of retentive attachments, and printing of silicone prostheses. Digital technology has been claimed to reduce the clinical and laboratory time; however, the equipment cost is still one of the limitations

Type i collagen-based devices to treat nerve injuries after oral surgery procedures. A systematic review

The regeneration of nerve injuries after oral surgery procedures is a quite often attempted procedure in dental medicine. Despite several proposed technical approaches, there is still a lack of consensus on which should be considered the gold standard procedure, even-though in the last decades, the use of collagen-based devices allowing a tension-free direct neurorrhaphy has been used. A systematic search of multiple electronic databases and hand searching was conducted to assess the level of evidence behind the use of type I collagen devices to treat nerve injuries after oral surgery procedures. After screening, four articles (one case series and three retrospective studies) including overall 65 patients suffering from inferior alveolar (IAN)/lingual nerve (LN) injury after mandibular wisdom tooth extraction, met the inclusion criteria and could be included. The Oxford Centre for evidence-based medicine (OCEBM) scaling system was used to evaluate the quality of the included studies. Positive clinical results in terms of sensorial improvements were recorded at least 3 months after surgery, even-though the overall level of evidence is low. The use of collagen membranes to enhance nerve regeneration in oral surgery results in promising results. Nevertheless, additional clinical comparative trials with larger sample sizes are needed

Periodontal disease and vitamin D deficiency in pregnant women: Which correlation with preterm and low-weight birth?

Periodontal disease seems to be correlated with low vitamin D serum levels, preterm birth (PTB) and low birth weight (LBW), although the literature still lacks a consensus. This study aimed to investigate this correlation in a cohort of pregnant women over 20 weeks of gestation from the University Hospital “Maggiore della Carità”, Novara, Italy. We assessed serum levels of vitamin D and oral health status through the following indexes: Oral Hygiene Index (OHI), Plaque Control Record (PCR), Gingival Bleeding Index (GBI), and Community Periodontal Index of Treatment Needs (CPTIN). Moreover, we assessed the number of PTB and LBW among the newborns. Out of 121 pregnant women recruited, 72 (mean age 29.91 ± 3.64 years) were included. There was a statistically significant correlation between preterm and OHI > 3 (p = 0.033), and between LBW and OHI > 3 (p = 0.005) and CPITN = 3 (p = 0.027). Both pregnant women with vitamin D deficiency ((25-hydroxy-vitamin D) < 30 ng/mL) and PTB plus LBW newborns were significantly correlated (p < 0.05) with poor levels of all oral health status indexes during pregnancy. Furthermore, these conditions (women with hypovitaminosis D and combination of PTB and LBW) were shown to be significantly correlated (p < 0.001). Taken together, our findings reported a high prevalence of PTB and LBW with poor oral health and vitamin D deficiency in pregnant women

Global prevalence of edentulism and dental caries in middle-aged and elderly persons. A systematic review and meta-analysis.

OBJECTIVE The aim of the study was to analyze data collected from studies worldwide on the prevalence of edentulism and dental caries, in community-dwellers aged ≥ 45 years. DATA Inclusion criteria; participants aged ≥ 45 years, community-dwellers. Exclusion criteria; participants aged < 45 years, in nursing homes, data obtained from dental clinics or pre-2005. The quality assessment tool by The National Heart, Lung and Blood Institute for Observational Cohort and Cross-sectional studies was used. Meta-analysis using the random-effects model (95% confidence interval) was done with data on participants who were edentulous and/or had active dental caries and stratified by regions of the world, age and Gross National Income per capita. Limitations in the data arose from several factors such as design of the studies included differences in socioeconomic status and access to health care among different countries. SOURCES Embase, MEDLINE via Pubmed and Scopus, manual searches, from January 2016, restricted to English. Experts from different countries were contacted to identify National oral health surveys (NOHS) conducted from 2010 onwards. STUDY SELECTION Eighty-six papers and seventeen NOHS were selected for data extraction. Majority of the studies (n=69) were cross-sectional and of fair quality. 1.1% - 70%, 4.9% - 98% prevalence of edentulism and dental caries, respectively. 22%, 45% estimated random-effects pooled prevalence of edentulism and dental caries, respectively. CONCLUSIONS Within the limitations of this study, the findings indicate that untreated dental caries and tooth loss are prevalent on a global level with wide variations among different countries, age groups and socioeconomic status. CLINICAL SIGNIFICANCE The findings demonstrate the reality of the new cohort of older adults, with higher tooth retention implying more dental caries incidence and the need for different care strategies to ensure better oral health. Large variations and difficulty in making comparisons among different countries highlight the need for more standardized, regular research