Restorative strategies for weakened roots: Systematic review and Meta-analysis of in vitro studies

Objective: This study evaluated fracture resistance values and failure mode of weakened roots restored with cast post and core, fiber post and anatomical posts. Materials and methods: In vitrostudies, published in English, Portuguese and Spanish, that evaluated weakened roots restored with at least two of mentioned strategies were searched for in three databases MEDLINE, PubMed and Scopus until June 2017; there was no restriction regarding the publication year. Fracture resistance values were obtained, and the following comparisons: cast post and core vs. fiber post and vs. anatomical post and fiber post vs. anatomical post were performed. Meta-analyses were conducted using the random effects model to calculate the combined effect of the difference between the averages. Six articles were included in the study. Results: There was no significant difference between the fracture resistance values, but more catastrophic failures were observed on cast post and core, and the included studies presented a low risk of bias for the most domains. Conclusion: It was concluded that weakened roots restored with the searched strategies seem to have similar fracture strength, but fiber and anatomic post decreases the possibility of catastrophic failure.KeywordsReview; Root; Dental restoration.

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Comparative Evaluation of Fracture Resistance of Endodontically Treated Teeth Restored with Resin Fiber Post and Stainless Steel Post: An In Vitro Study

Dental Journal of Advance Studies ◽

10.1055/s-0038-1672019 ◽

2015 ◽

Vol 03 (02) ◽

pp. 080-084

Author(s):

Vijay Singh ◽

Poonam Bogra ◽

Saurabh Gupta ◽

Navneet Kukreja ◽

Neha Gupta

Keyword(s):

Stainless Steel ◽

Fracture Resistance ◽

Testing Machine ◽

Compressive Force ◽

Control Group ◽

Fiber Post ◽

Endodontically Treated Teeth ◽

Group I ◽

Significant Difference

AbstractFracture resistance of endodontically treated teeth restored with post. Aims: This study aims to compare the fracture resistance of endodontically treated teeth restored with resin fiber and stainless steel post. Commercially available prefabricated resin fiber post(Dentsply Maillefer Easy Post), prefabricated stainless steel post(Coltene/Whaledent Parapost) were used. Methods and Material: Forty five maxillary central incisors were obturated and divided into 3 groups: Control Group (Group I) without any post (n = 15), Resin Fiber Post Group (Group II) (n = 15) and Stainless Steel Post Group (Group III) (n = 15). In all Groups except control group, post space was prepared; a post was cemented, and a core build-up was provided. All the specimens were subjected to compressive force under a universal testing machine until fracture. Statistical analysis used: The results were analyzed using the variable analysis test (ANOVA). Results: One-way analysis of variance revealed significant difference among test groups. The control group demonstrated highest fracture resistance (925.2183 N), followed by the resin fiber post group (486.7265 N) and stainless steel post group (423.539N). Conclusions: Teeth restored with resin fiber post showed higher fracture resistance values than prefabricated stainless steel post.

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Alternative Tendon Coaptations to the Pulvertaft Weave Technique: A Systematic Review and Meta-Analysis of Biomechanical Studies

Hand ◽

10.1177/15589447211043213 ◽

2021 ◽

pp. 155894472110432

Author(s):

Emily M. Graham ◽

Jeremie D. Oliver ◽

Russell Hendrycks ◽

Dino Maglic ◽

Shaun D. Mendenhall

Keyword(s):

Systematic Review ◽

Yield Strength ◽

Random Effects ◽

Meta Analysis ◽

Dichotomous Data ◽

Inverse Variance ◽

Significant Difference ◽

Alternative Techniques ◽

Meta Analyses

Background The Pulvertaft weave technique (PT) is frequently used during tendon repairs and transfers. However, this technique is associated with limitations. In this systematic review and meta-analysis, quantitative and qualitative analyses were performed on in vitro, biomechanical studies that compared the PT with alternative techniques. Methods Articles included for qualitative and/or qualitative analysis were identified following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies included in the meta-analysis were analyzed either as continuous data with inverse variance and random effects or as dichotomous data using a Mantel-Haenszel analysis assuming random effects to calculate an odds ratio. Results A comprehensive electronic search yielded 8 studies meeting inclusion criteria for meta-analysis. Two studies with a total of 65 tendon coaptations demonstrated no significant difference in strength between the PT and traditional side-to-side (STS) techniques ( P = .92). Two studies with a total of 43 tendon coaptations showed that the STS with 1 weave has a higher yield strength than the PT ( P = .03). Two studies with a total of 62 tendon repairs demonstrated no significant difference in strength between the PT and the step-cut (SC) techniques ( P = .70). The final 2 studies included 46 tendon repairs and demonstrated that the wrap around (WA) technique has a higher yield strength than the PT ( P < .001). Conclusions The STS, SC, and WA techniques are preferred for improving tendon form. The STS and WA techniques have superior yield strengths than the PT, and the SC technique withstands similar stress to failure as the PT.

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Effects of Aging on the Color and Translucency of Monolithic Translucent Y-TZP Ceramics: A Systematic Review and Meta-Analysis of In Vitro Studies

BioMed Research International ◽

10.1155/2021/8875023 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Chang-yuan Zhang ◽

Check Agingu ◽

James Kit Hon Tsoi ◽

Hao Yu

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Tetragonal Zirconia ◽

In Vitro Studies ◽

Cochrane Library ◽

Hydrothermal Aging ◽

Significant Difference ◽

Effects Of Aging ◽

Meta Analyses

Background. Monolithic restorations made of translucent yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) have become popular over the past few decades. However, whether aging affects the color and translucency of monolithic translucent Y-TZP is unclear. Objective. The aim of this systematic review and meta-analysis of in vitro studies was to evaluate the effects of aging on the color and translucency of monolithic translucent Y-TZP ceramics. Materials and Methods. This systematic review/meta-analysis was reported according to the PRISMA statement and registered in the OSF registries (https://osf.io/5qjmu). Four databases including Medline via the PubMed, Embase, and Web of Science databases and the Cochrane Library were searched using no publication year and language limits. The last search was executed on November 20, 2020. In vitro studies comparing the translucency and/or color of monolithic translucent Y-TZP ceramics before and after simulated aging were selected. Meta-analyses were performed using Review Manager software (version 5.3, Cochrane Collaboration, Oxford, UK) with random-effects models at a significance level of 0.05. A risk-of-bias assessment was also performed for the included studies. Results. Of the 188 potentially relevant studies, 13 were included in the systematic review. The hydrothermal aging duration ranged from 1 to 100 h at relatively similar temperatures (~134°C). In the general meta-analyses, the aged Y-TZP ceramics exhibited similar translucency parameter (TP), L ∗ , and b ∗ values compared with the nonaged controls ( P = .73 , P = .49 , and P = .62 , respectively). Moreover, there was a significant difference between the aged and nonaged Y-TZP ceramics in the a ∗ value ( P = .03 ; MD = − 0.26 ; 95% CI = − 0.51 to − 0.02 ), favoring the nonaged Y-TZP ceramics. The subgroup analyses showed that the duration of aging contributed to changes in the translucency and color of the Y-TZP ceramics. Conclusions. The optical properties of monolithic translucent Y-TZP ceramics were stable after hydrothermal aging at 134°C and 0.2 MPa for ≤20 h. Moreover, clinically unacceptable changes in the translucency and color of monolithic translucent Y-TZP ceramics were found after hydrothermal aging for >20 h.

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The Effect of Varying Ferrule Modes on Fracture Resistance of Canines Restored with One-Piece Milled Zirconia Post and Core

Advanced Materials Research ◽

10.4028/www.scientific.net/amr.624.98 ◽

2012 ◽

Vol 624 ◽

pp. 98-102

Author(s):

Yao Kun Zhang ◽

Long Quan Shao ◽

Ruo Yu Liu ◽

Lin Lin Wang ◽

Jun Ai ◽

...

Keyword(s):

Fracture Resistance ◽

In Vitro Study ◽

Significant Difference ◽

Zirconia Crowns ◽

Group A ◽

Post And Core ◽

Resistance Decrease ◽

Group B ◽

Group D

The aim of this invitro study was to evaluate the fracture resistance of endodontically treated canines restored with one-piece milled zirconia post and core in the varying ferrule modes. Fifty recently extracted human maxillary canines were endodontically treated and randomly divided into 5 groups of 10 specimens each. According to the defect degree of ferrule, intact ferrule was classified as group A and served as control, 2 mm ferrule height without buccal ferrule was classified as group B, 2 mm ferrule height without mesial and buccal ferrule was classified as group C, 2 mm ferrule height without mesial, buccal and lingual ferrule was classified as group D, no ferrule preparation was classified as group E. All of the teeth were restored with one-piece milled zirconia post and core, and zirconia crowns. The teeth were prepared to standardized specifications. The restored teeth were loaded to fracture at a 135° angle to their long axis, at a cross-head speed 0.5 mm/min, and the load (N) at failure was recorded. Statistical analysis was performed by SNK pairwise multiple comparisons (α=0.05). The mean fracture resistance of five groups as follows: 1019.30±139.01N for group A, 861.20±105.67N for group B, 833.70±100.56N for group C, 733.20±96.91N for group D, 698.00±99.90N for group E. The fracture resistance of restored teeth between group B and group C, group D and group E had no statistically significant difference(P>0.05). The fracture resistance of the rest pairwise group comparisons had statistically significant difference(P<0.05). Increasing the absence degree of ferrule, it was found that the fracture resistance decrease. The buccal and lingual ferrule were more important than mesial ferrule for enhanced fracture resistance. This in vitro study supports evidence that reserving the buccal and lingual ferrule is a key point to increase the fracture resistance of canines restored with one-piece milled zirconia post and core.

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Effect of Direct Composite and Indirect Ceramic Onlay Restorations on Fracture Resistance of Endodontically Treated Maxillary Premolars

Frontiers in Dentistry ◽

10.18502/fid.v17i8.4126 ◽

2020 ◽

Author(s):

Haleh Kazemi Yazdi ◽

Niusha Sohrabi ◽

Shahbaz Nasser Mostofi

Keyword(s):

Fracture Resistance ◽

Maximum Load ◽

Pairwise Comparisons ◽

Chi Square ◽

Significant Difference ◽

Tensile Forces ◽

Chi Square Test ◽

Maxillary Premolars ◽

The Difference

Objectives: Fracture of endodontically treated restored teeth is a common concern. Premolars are subjected to high shear and tensile forces. This study aimed to assess the fracture resistance and fracture mode of endodontically treated premolars restored with direct and indirect onlay restorations. Materials and Methods: In this in-vitro experimental study, 45 human maxillary premolars were divided into three groups (n=15) of control (sound teeth), direct onlay, and indirect onlay. In groups 2 and 3, the teeth underwent endodontic treatment. Mesio-occluso-distal cavities were prepared and restored with direct composite (P60) and indirect IPS e.max ceramic onlays, respectively. The teeth were subjected to vertical forces after cyclic loading. The maximum load causing fracture was recorded in Newtons. Data were analyzed using analysis of variance, chi-square test, and Tukey’s test. Results: The highest and the lowest fracture resistances were noted in sound teeth and direct onlay restorations, respectively. The difference in fracture resistance was significant among the three groups (P<0.001). Pairwise comparisons revealed a significant difference in the fracture resistance of sound teeth and the two restoration groups (P<0.001). However, the difference in the fracture resistance of direct and indirect onlay restorations was not significant (P=0.6). Chi-square test showed a significantly higher frequency of irreparable fractures in the indirect onlay group (P=0.005). Conclusion: Direct and indirect onlay restorations were not significantly different in terms of the fracture resistance but the frequency of irreparable fractures was higher in indirect restorations.

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The differences in Hg content released from high copper amalgam and silverfil argentum restoration into artificial saliva after one week of soaking (in vitro)

Padjadjaran Journal of Dentistry ◽

10.24198/pjd.vol20no2.14139 ◽

2008 ◽

Vol 20 (2) ◽

Author(s):

Deriz Rieskanoerbachra Wisuardy ◽

Endang Sukartini ◽

Milly Armilia

Keyword(s):

Artificial Saliva ◽

Atomic Absorption Spectrophotometry ◽

Dental Restoration ◽

Test Method ◽

Amalgam Restoration ◽

High Copper ◽

Study Results ◽

Quasi Experimental ◽

The Difference

Dental restoration is a treatment in dentistry that very often implemented. One of the restoration materials used is an amalgam. Amalgam has some deficiencies, among others, the presence of free Hg. The purpose of this study was to find out the difference in Hg content released from two different kinds of amalgam, namely, high copper amalgam and silverfil argentum carried out in vitro. This study was carried out on thirty premolar teeth of the maxilla which underwent class one occlusal restoration. The Hg content released was measured using the Atomic Absorption Spectrophotometry (AAS). This was a quasi-experimental study. The study results analyzed using the independent t paired statistical test method indicated that after one week of immersion, the average Hg content released from high copper amalgam restoration was 10,695 ng/mL and from silverfil argentum restoration was 5,602 ng/mL. The conclusion of the study was that there was a difference in Hg content released from high copper amalgam restoration and silverfil argentum restoration. The Hg content released from high copper amalgam restoration was higher than the Hg content released from silverfil argentum restoration.

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A Systematic Review of the Various Effect of Arsenic on Glutathione Synthesis In Vitro and In Vivo

BioMed Research International ◽

10.1155/2020/9414196 ◽

2020 ◽

Vol 2020 ◽

pp. 1-22

Author(s):

Shanshan Ran ◽

Jiaqing Liu ◽

Shugang Li

Keyword(s):

Meta Analysis ◽

Arsenic Exposure ◽

In Vitro Studies ◽

In Vivo Studies ◽

Glutathione Synthesis ◽

P38 Inhibitor ◽

Significant Difference ◽

The Difference

Background. Arsenic is a toxic metalloid widely present in nature, and arsenic poisoning in drinking water is a serious global public problem. Glutathione is an important reducing agent that inhibits arsenic-induced oxidative stress and participates in arsenic methylation metabolism. Therefore, glutathione plays an important role in regulating arsenic toxicity. In recent years, a large number of studies have shown that arsenic can regulate glutathione synthesis in many ways, but there are many contradictions in the research results. At present, the mechanism of the effect of arsenic on glutathione synthesis has not been elucidated. Objective. We will conduct a meta-analysis to illustrate the effects of arsenic on GSH synthesis precursors Glu, Cys, Gly, and rate-limiting enzyme γ-GCS in mammalian models, as well as the regulation of p38/Nrf2 of γ-GCS subunit GCLC, and further explore the molecular mechanism of arsenic affecting glutathione synthesis. Results. This meta-analysis included 30 studies in vivo and 58 studies in vitro, among which in vivo studies showed that arsenic exposure could reduce the contents of GSH (SMD=−2.86, 95% CI (-4.45, -1.27)), Glu (SMD=−1.11, 95% CI (-2.20,-0.02)), and Cys (SMD=−1.48, 95% CI (-2.63, -0.33)), with no statistically significant difference in p38/Nrf2, GCLC, and GCLM. In vitro studies showed that arsenic exposure increased intracellular GSH content (SMD=1.87, 95% CI (0.18, 3.56)) and promoted the expression of p-p38 (SMD=4.19, 95% CI (2.34, 6.05)), Nrf2 (SMD=4.60, 95% CI (2.34, 6.86)), and GCLC (SMD=1.32, 95% CI (0.23, 2.41)); the p38 inhibitor inhibited the expression of Nrf2 (SMD=−1.27, 95% CI (-2.46, -0.09)) and GCLC (SMD=−5.37, 95% CI (-5.37, -2.20)); siNrf2 inhibited the expression of GCLC, and BSO inhibited the synthesis of GSH. There is a dose-dependent relationship between the effects of exposure on GSH in vitro. Conclusions. These indicate the difference between in vivo and in vitro studies of the effect of arsenic on glutathione synthesis. In vivo studies have shown that arsenic exposure can reduce glutamate and cysteine levels and inhibit glutathione synthesis, while in vitro studies have shown that chronic low-dose arsenic exposure can activate the p38/Nrf2 pathway, upregulate GCLC expression, and promote glutathione synthesis.

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The Obstetric Consequences of Female Genital Mutilation/Cutting: A Systematic Review and Meta-Analysis

Obstetrics and Gynecology International ◽

10.1155/2013/496564 ◽

2013 ◽

Vol 2013 ◽

pp. 1-15 ◽

Cited By ~ 63

Author(s):

Rigmor C. Berg ◽

Vigdis Underland

Keyword(s):

Systematic Review ◽

Female Genital Mutilation ◽

Meta Analysis ◽

Genital Mutilation ◽

Obstetric Lacerations ◽

Study Results ◽

Significant Difference ◽

Delivery Obstetric ◽

Meta Analyses ◽

Female Genital

Various forms of female genital mutilation/cutting (FGM/C) have been performed for millennia and continue to be prevalent in parts of Africa. Although the health consequences following FGM/C have been broadly investigated, divergent study results have called into question whether FGM/C is associated with obstetric consequences. To clarify the present state of empirical research, we conducted a systematic review of the scientific literature and quantitative meta-analyses of the obstetric consequences of FGM/C. We included 44 primary studies, of which 28 were comparative, involving almost 3 million participants. The methodological study quality was generally low, but several studies reported the same outcome and were sufficiently similar to warrant pooling of effect sizes in meta-analyses. The meta-analyses results showed that prolonged labor, obstetric lacerations, instrumental delivery, obstetric hemorrhage, and difficult delivery are markedly associated with FGM/C, indicating that FGM/C is a factor in their occurrence and significantly increases the risk of delivery complications. There was no significant difference in risk with respect to cesarean section and episiotomy. These results can make up the background documentation for health promotion and health care decisions that inform work to reduce the prevalence of FGM/C and improve the quality of services related to the consequences of FGM/C.

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Laser Influence on Dental Sensitivity Compared to Other Light Sources Used During In-office Dental Bleaching: Systematic Review and Meta-analysis

Operative Dentistry ◽

10.2341/19-064-l ◽

2020 ◽

Vol 45 (6) ◽

pp. 589-597

Author(s):

BGS Casado ◽

EP Pellizzer ◽

JR Souto Maior ◽

CAA Lemos ◽

BCE Vasconcelos ◽

...

Keyword(s):

Randomized Clinical Trials ◽

Color Change ◽

Meta Analysis ◽

Present Review ◽

Cochrane Library ◽

Light Sources ◽

Eligibility Criteria ◽

Tooth Color ◽

Significant Difference ◽

Meta Analyses

Clinical Relevance The use of laser light during bleaching will not reduce the incidence or severity of sensitivity and will not increase the degree of color change compared with nonlaser light sources. SUMMARY Objective: To evaluate whether the use of laser during in-office bleaching promotes a reduction in dental sensitivity after bleaching compared with other light sources. Methods: The present review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and is registered with PROSPERO (CDR42018096591). Searches were conducted in the PubMed/Medline, Web of Science, and Cochrane Library databases for relevant articles published up to August 2018. Only randomized clinical trials among adults that compared the use of laser during in-office whitening and other light sources were considered eligible. Results: After analysis of the texts retrieved during the database search, six articles met the eligibility criteria and were selected for the present review. For the outcome dental sensitivity, no significant difference was found favoring any type of light either for intensity (mean difference [MD]: −1.60; confidence interval [CI]: −3.42 to 0.22; p=0.09) or incidence (MD: 1.00; CI: 0.755 to 1.33; p=1.00). Regarding change in tooth color, no significant differences were found between the use of the laser and other light sources (MD: −2.22; CI: −6.36 to 1.93; p=0.29). Conclusions: Within the limitations of the present study, laser exerts no influence on tooth sensitivity compared with other light sources when used during in-office bleaching. The included studies demonstrated that laser use during in-office bleaching may have no influence on tooth color change.

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Systematic Review: Allogenic Use of Stromal Vascular Fraction (SVF) and Decellularized Extracellular Matrices (ECM) as Advanced Therapy Medicinal Products (ATMP) in Tissue Regeneration

International Journal of Molecular Sciences ◽

10.3390/ijms21144982 ◽

2020 ◽

Vol 21 (14) ◽

pp. 4982 ◽

Cited By ~ 1

Author(s):

Pietro Gentile ◽

Aris Sterodimas ◽

Jacopo Pizzicannella ◽

Laura Dionisi ◽

Domenico De Fazio ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Stromal Vascular Fraction ◽

Lateral Epicondylitis ◽

Medicinal Products ◽

Advanced Therapy Medicinal Products ◽

Advanced Therapy ◽

Meta Analyses ◽

Clinical Experiments

Stromal vascular fraction (SVF) containing adipose stem cells (ASCs) has been used for many years in regenerative plastic surgery for autologous applications, without any focus on their potential allogenic role. Allogenic SVF transplants could be based on the possibility to use decellularized extracellular matrix (ECM) as a scaffold from a donor then re-cellularized by ASCs of the recipient, in order to develop the advanced therapy medicinal products (ATMP) in fully personalized clinical approaches. A systematic review of this field has been realized in accordance with the Preferred Reporting for Items for Systematic Reviews and Meta-Analyses-Protocols (PRISMA-P) guidelines. Multistep research of the PubMed, Embase, MEDLINE, Pre-MEDLINE, PsycINFO, CINAHL, Clinicaltrials.gov, Scopus database, and Cochrane databases has been conducted to identify articles and investigations on human allogenic ASCs transplant for clinical use. Of the 341 articles identified, 313 were initially assessed for eligibility on the basis of the abstract. Of these, only 29 met all the predetermined criteria for inclusion according to the PICOS (patients, intervention, comparator, outcomes, and study design) approach, and 19 have been included in quantitative synthesis (meta-analysis). Ninety-one percent of the studies previously screened (284 papers) were focused on the in vitro results and pre-clinical experiments. The allogenic use regarded the treatment of perianal fistulas, diabetic foot ulcers, knee osteoarthritis, acute respiratory distress syndrome, refractory rheumatoid arthritis, pediatrics disease, fecal incontinence, ischemic heart disease, autoimmune encephalomyelitis, lateral epicondylitis, and soft tissue defects. The information analyzed suggested the safety and efficacy of allogenic ASCs and ECM transplants without major side effects.

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