Less marginal bone loss around bone-level implants restored with long abutments: A systematic review and meta-analysis.

The aim of this study was to investigate the biological outcomes of bone-level implants restored with long vs. short abutments, with regard to the 'one abutment at one time' protocol. The systematic search was performed in five databases: MEDLINE (PubMed), EMBASE, Web of Science, Scopus, and CENTRAL for randomized controlled trials up to January 14, 2023. Data were collected for marginal bone loss, bleeding on probing, and probing pocket depth by two reviewers. As effect size measure, mean difference (MD), and risk ratio (RR) were used for continuous and categorical outcomes, R-statistics software was used for conducting statistical analyses. For quality and certainty assessment, Risk of Bias Tool 2, ROBINS-I, and GRADE approach were used. The search resulted in 4055 records without any duplicates. After title, abstract, and full-text analysis, eight articles were found eligible for inclusion. Bone-level and platform-switched implants presented less marginal bone loss after 6 months and 1 year as well, when long abutments were used (MD 0.63, 95% CI: [-0.16; 1.42]) and (MD 0.26, 95% CI: [-0.02; 0.53]). However, subgroup analysis revealed no difference in marginal bone loss when applying 'one abutment at one time' protocol (p = 0.973). Bleeding on probing and probing pocket depth presented similarly good results in both groups without almost any differences (RR 0.97, 95% CI: [0.76; 1.23]) and (MD -0.05, 95% CI: [-1.11; 1.01]). Longer abutments on bone-level implants seem to be a favorable choice for decreasing early marginal bone loss, irrespective of connection timing

The use of autogenous tooth bone graft is an efficient method of alveolar ridge preservation – meta-analysis and systematic review

Abstract Background Ridge resorption following tooth extraction may be reduced by alveolar ridge preservation (ARP). Previous randomized clinical trials and systematic reviews have suggested that autogenous tooth bone graft (ATB) can be an effective alternative material for ARP. However, the results are heterogeneous. Therefore, our research aimed to evaluate the efficacy of ATB in ARP. Methods A systematic search was conducted in Cochrane Library, Embase, MEDLINE and Scopus for studies published from inception to 31 November 2021. We searched searched for randomized, non-randomized controlled trials and case series reporting on ATB use for ARP. The primary outcome was the ridge width difference pre- and post-surgery, measured in millimetres (mm) measured on CBCT (cone beam computed tomography). The secondary outcomes were the histological results. We followed the PRISMA2020 recommendations for reporting our systematic review and meta-analysis. Results The analysis included eight studies for the primary and six for the secondary outcomes. The meta-analysis revealed a positive ridge preservation effect with a pooled mean difference ridge width change of -0.72 mm. The pooled mean residual graft proportion was 11.61%, and the newly formed bone proportion was 40.23%. The pooled mean of newly formed bone proportion was higher in the group where ATB originated from both the root and crown of the tooth. Conclusions ATB is an effective particulate graft material in ARP. Complete demineralization of the ATB tends to decrease the proportion of newly formed bone. ATB can be an attractive option for ARP. Trial registration The study protocol was registered on PROSPERO (CRD42021287890)

Additional file 1 of The use of autogenous tooth bone graft is an efficient method of alveolar ridge preservation – meta-analysis and systematic review

Additional file 1: Appendix Table 1. PRISMA 2020 Main Checklist. Appendix Table 2. Certainty of evidence for each meta-analysis based on the GRADE approach. Appendix Table 3. Changes in alveolar ridge width (mean ± standard deviation [SD]). Raw data of Radoczy Drajko et al. was also used (measurement at the crestal level). Appendix Table 4. Histological outcomes (mean ± standard deviation [SD]). Appendix Figure 1. Quality assessment based on Cochrane Risk of Bias Tool 2 (RoB 2) for randomized controlled trials. Appendix Figure 2. Quality assessment based on Cochrane risk of bias tool to assess non-randomized studies of interventions (ROBINS-I) for non-randomized studies of interventions. Appendix Figure 3. Funnel plots indicates the presence of statistical heterogeneity and cofounding factors affecting the primary outcome (alveolar ridge width changes). Appendix Figure 4. Funnel plots indicates the presence of statistical heterogeneity and cofounding factors affecting the residual graft proportion (%). Appendix Figure 5. Funnel plots indicates the presence of statistical heterogeneity and cofounding factors affecting the newly formed bone proportion (%). Appendix Figure 6. Funnel plots indicates the presence of statistical heterogeneity and cofounding factors affecting the connective tissue proportion (%). Appendix Figure 7. Pooled mean of residual graft proportion. Neither clinical, nor statistical significant difference can be observed between the subgroups. Appendix Figure 8. Pooled mean of newly formed bone proportion. A statistical significant difference can be observed between the subgroups. Appendix Figure 9. Pooled mean of connective tissue proportion. No statistical significant difference can be observed between the subgroups. Appendix Document 1. Search key. Appendix Document 2. Detailed statistical analysis. Appendix document 3. Detailed study charachteristics

Proceedings Of The 23Rd Paediatric Rheumatology European Society Congress: Part Two

PubMe