METHODS: Relevant articles written in English only, before January 15, 2017, were identified using an electronic search in the PubMed, Scopus, and Google Scholar databases. Furthermore, a manual search of the related major journals was also conducted to identify more pertinent articles. The relevancy of the articles was verified by screening the title, abstract, and full text if they met the inclusion criteria. A total of 37 articles satisfied the criteria, from which data were extracted for qualitative synthesis.
RESULTS: Among the 37 included articles, 14 were without aging, 15 were natural or artificial accelerated aging, 7 were outdoor weathering, and 1 contained both artificial aging and outdoor weathering. Only 4 studies out of the 14 without aging had significant observations; whereas 9 articles with natural or artificial aging published significant results, and 3 out of 7 outdoor weathering articles showed significant changes in the evaluated silicone elastomers.
CONCLUSIONS: Despite the varying research, it seems that the single "ideal" maxillofacial prosthetic material that can provide sufficient resistance against different aging conditions is yet to be identified. Therefore, it is imperative for standardization organizations, the scientific community, and academia to develop modified prosthetic silicones possessing improved physical properties and color stability, limiting the clinical problems regarding degradation of maxillofacial prostheses.
MATERIALS AND METHODS: The flexural strength and flexural modulus, following thermal cycling (5000 cycles of 5-55°C) of 3 MCC-reinforced poly methyl methacrylate (PMMA) specimens were compared with the conventional and commercially available high-impact PMMA. The 3 test groups were represented by addition of various weight combinations of MCC and acrylic powders.
RESULTS: All 3 test groups with the addition of MCC demonstrated improved flexural strength and flexural modulus compared to the conventional resin, without and after thermal cycling. The highest mean flexural strength corresponded to the specimens reinforced with 5% MCC followed by 2% MCC.
CONCLUSION: Addition of MCC derived from OPEFB to PMMA may be a viable alternative to the existing, commercially available synthetic reinforced PMMA resins. The potential application of natural fillers in the fabrication of a reinforced denture base resin needs further study.
MATERIALS AND METHODS: Two reviewers independently searched two electronic databases, PubMed and Scopus. The search was complemented from references of included studies and published reviews. Studies published in the English language through January 2021 that had assessed and documented the clinical and radiographic failure of crown or FPD in vital permanent teeth due to pulpal or periapical pathology with a follow-up of at least 12 months were selected. Data screening, data collection and extraction of data was performed. Quality of studies involved was analyzed using the Newcastle-Ottawa Quality Assessment Scale for cohort studies. Meta-analysis was done using random effects model. Publication bias was assessed using funnel plots.
RESULTS: Electronic searches provided 10,075 records among which 20 studies were selected for systematic review and 7 studies were selected for meta-analysis. With respect to quality assessment, all the studies involved were considered as high quality as the score in scale ranged between 6 and 9 as per the Newcastle-Ottawa Quality Assessment Scale for cohort studies. The meta-analyses showed that there was no statistically significant difference in the incidence of the loss of pulp vitality or pulp necrosis through clinical and radiographic examination with the follow up period of 5 years: p < 0.001, 95% CI: 0.96-1.00, I2 = 77.84%; 10 years: p < 0.001, 95% CI: 0.88-0.95, I2 = 93.59%; 15 years: p < 0.001, 95% CI: 0.92-0.96, I2 = 94.83%; and 20 years: p < 0.001, 95% CI: 0.94-0.96, I2 = 95.01%.
CONCLUSIONS: The meta-analysis revealed clinical and radiographic success rate ranging between 92% to 98% at different follow up periods ranging between 5 years and 20 years. Future high-quality randomized clinical controlled trials with a larger population are required to confirm the evidence as only observational studies were considered in this paper.
MATERIALS AND METHODS: A gypsum mold was coated with clear acrylic spray. The coated mold was then used to produce modified silicone experimental specimens (n = 35). The surface roughness of the modified silicone elastomers was compared with that of the control specimens, which were prepared by conventional flasking methods (n = 35). An atomic force microscope (AFM) was used for surface roughness measurement of silicone elastomer (unmodified and modified), and a scanning electron microscope (SEM) was used to evaluate the topographic conditions of coated and noncoated gypsum and silicone elastomer specimens (unmodified and modified) groups. After the gypsum molds were characterized, the fabricated silicone elastomers molded on noncoated and coated gypsum materials were evaluated further. Energy-dispersive X-ray spectroscopy (EDX) analysis of gypsum materials (noncoated and coated) and silicone elastomer specimens (unmodified and modified) was performed to evaluate the elemental changes after coating was conducted. Independent t test was used to analyze the differences in the surface roughness of unmodified and modified silicone at a significance level of p < 0.05.
RESULTS: Roughness was significantly reduced in the silicone elastomers processed against coated gypsum materials (p < 0.001). The AFM and SEM analysis results showed evident differences in surface smoothness. EDX data further revealed the presence of the desired chemical components on the surface layer of unmodified and modified silicone elastomers.
CONCLUSIONS: Silicone elastomers with lower surface roughness of maxillofacial prostheses can be obtained simply by coating a gypsum mold.
MATERIALS AND METHODS: Candida albicans, Streptococcus mutans, and Staphylococcus aureus were incubated with modified and unmodified silicone groups (N = 35) for 30 days at 37°C. The counts of viable microorganisms in the accumulating biofilm layer were determined and converted to cfu/cm2 unit surface area. A scanning electron microscope (SEM) was used to evaluate the microbial adhesion. Statistical analysis was performed using t-test, one-way ANOVA, and post hoc tests as indicated.
RESULTS: Significant differences in microbial adhesion were observed between modified and unmodified silicone elastomers after the cells were incubated for 30 days (p < 0.001). SEM showed evident differences in microbial adhesion on modified silicone elastomer compared with unmodified silicone elastomer.
CONCLUSIONS: Surface modification of silicone elastomer yielding a smoother and less porous surface showed lower adhesion of different microorganisms than observed on unmodified surfaces.
MATERIALS AND METHODS: The flexural strength and flexural modulus of three OPEFB fiber-reinforced PMMA were compared with a conventional and a commercially available reinforced PMMA. The three test groups included OPEFB fibers of 0.5 mm thickness, 2.0 mm thickness, and OPEFB cellulose.
RESULTS: All test group specimens demonstrated improved flexural strength and flexural modulus over conventional PMMA. Reinforcement with OPEFB cellulose showed the highest mean flexural strength and flexural modulus, which were statistically significant when compared to the conventional and commercially reinforced PMMA used in this study. OPEFB fiber in the form of cellulose and 0.5 mm thickness fiber significantly improved flexural strength and flexural modulus of conventional PMMA resin. Further investigation on the properties of PMMA reinforced with OPEFB cellulose is warranted.
CONCLUSIONS: Natural OPEFB fibers, especially OPEFB in cellulose form, can be considered a viable alternative to existing commercially available synthetic fiber reinforced PMMA resin.
MATERIALS AND METHODS: An auricular prosthesis, a complete denture, and anterior and posterior crowns were constructed using conventional methods and laser scanned to create computerized 3D meshes. The meshes were optimized independently by four computer-aided design software (Meshmixer, Meshlab, Blender, and SculptGL) to 100%, 90%, 75%, 50%, and 25% levels of original file size. Upon optimization, the following parameters were virtually evaluated and compared; mesh vertices, file size, mesh surface area (SA), mesh volume (V), interpoint discrepancies (geometric similarity based on virtual point overlapping), and spatial similarity (volumetric similarity based on shape overlapping). The influence of software and optimization on surface area and volume of each prosthesis was evaluated independently using multiple linear regression.
RESULTS: There were clear observable differences in vertices, file size, surface area, and volume. The choice of software significantly influenced the overall virtual parameters of auricular prosthesis [SA: F(4,15) = 12.93, R2 = 0.67, p < 0.001. V: F(4,15) = 9.33, R2 = 0.64, p < 0.001] and complete denture [SA: F(4,15) = 10.81, R2 = 0.67, p < 0.001. V: F(4,15) = 3.50, R2 = 0.34, p = 0.030] across optimization levels. Interpoint discrepancies were however limited to <0.1mm and volumetric similarity was >97%.
CONCLUSION: Open-source mesh optimization of smaller dental prostheses in this study produced minimal loss of geometric and volumetric details. SculptGL models were most influenced by the amount of optimization performed.
MATERIALS AND METHODS: Three-dimensional solid models of the maxilla, mucosa, and denture of a selected edentulous patient were created using Mimics and CATIA software. The FEA model was created and duplicated in ANSYS 16.0 to perform two simulations for the IOD and the CD models. The values of maximum stress and strain and total deformation were obtained and compared to the outcomes of premaxilla resorption from a parallel clinical study.
RESULTS: The maximum principal stress in the premaxilla in the IOD model ranged from 0.019 to 0.336 MPa, while it ranged from 0.011 to 0.193 MPa in the CD model. The maximum principal strain in the IOD model was 1.75 times greater than that in the CD model. Total deformation was 1.8 times higher in the IOD model. Greater bone resorption was observed in regions of higher stress, which were on the occlusal and buccal sides of the premaxilla residual ridge.
CONCLUSION: Stress, strain, and total deformation values present in the premaxilla area beneath a CD were approximately two times greater in a comparison between an opposing mandibular two-IOD and an opposing mandibular CD. The results were consistent with a parallel clinical study in which the rate of premaxilla bone resorption was almost three times greater in the IOD group.
MATERIALS AND METHODS: 18 patients were rehabilitated with maxillary CD opposing mandibular IRO, and 4 patients were prescribed with conventional CD. Cone beam computed tomography (CBCT) scans of the maxilla were acquired before and 1 year post-treatment and converted into 3D models using Mimics research software. RRR was quantified by measuring the changes in bone volume following superimpositioning and sectioning of these models at the anterior maxillary region. Subsequently, the sectioned 3D models of the anterior maxilla were exported to 3-Matic software to reveal the predominant region and depth of RRR.
RESULTS: The mean reduction in bone volume of the anterior maxilla in the CD group was 2.60% (SD = 1.71%, range = -4.89 % to -0.92%, median = -2.30%), while the mean reduction in the IRO group was almost three times higher at 7.25% (SD = 3.16%, range = -13.25 to -1.50, median = -7.15%). The predominant areas of RRR were on the buccal and occlusal ridge of the anterior maxilla.
CONCLUSION: Within the limits of this study, it may be concluded that an IRO caused significantly higher RRR of the anterior maxilla than a CD.
MATERIALS AND METHODS: The test group included 9 participants rehabilitated by maxillary CD opposing mandibular IRO, while the control group consisted of 4 participants with CDs. Blood flow was measured by laser Doppler flowmetry (LDF) after denture removal for 0, 30, 60, and 90 minutes. RRR was quantified as reduction in bone volume a year post-treatment. The measurement of blood flow was then compared to the quantification of RRR.
RESULTS: The mean blood flow measure for the IRO group was significantly lower than CD after immediate denture removal and 30 minutes later. After 60 minutes, the mean difference was not significant between groups, and at 90 minutes, the mean blood flow of both groups equalized to reach a steady state of 377 BPU. The mandibular IRO had reduced the initial blood flow measure in the opposing anterior maxilla mucosa to almost a quarter (103 BPU) of the steady state value (377 BPU) compared to the CD, which reduced it to only about one half (183 BPU), suggesting greater blood flow disturbance in the IRO group. This result is in tandem with the greater reduction of bone volume observed in the IRO group, which was 7.3 ± 1.3% after a year, almost three times higher than CD group at 2.6 ± 1.7%.
CONCLUSION: IRO may cause significantly higher blood flow disturbance than CD and may have contributed to greater RRR in the anterior maxilla.
METHODS: An online electronic search was performed using the PubMed, Scopus, and Web of Science databases for in vitro studies published from 2010 to 2020 in English. The retrieved eligible studies that compared the fracture resistance of titanium and fiber posts on human teeth were selected. The pooled standardized mean difference (SMD) with a 95% confidence interval was calculated. In addition, the trial sequential analysis (TSA) was performed to test if the available studies are sufficient to make conclusive evidence.
RESULTS: Of the 1165 retrieved studies, 17 studies were included in the qualitative analysis, while 16 studies were included in the quantitative analysis. Because of the high heterogeneity among studies, data from 10 studies were pooled and submitted to TSA. A total of 852 teeth were evaluated for fracture of the posts in 27 independent comparison groups. The pooled effect of the residual studies revealed no significant difference between titanium and fiber posts (SMD = -0.12; 95% CI = -0.30, 0.06; p = 0.20). Results of the TSA revealed no conclusive evidence.
CONCLUSIONS: The results of the current evidence revealed no significant difference between fiber and titanium posts. The evidence is insufficient, and more standardized in vitro studies are required.