bluuebunny/crossref_metadata_2025 huggingface dataset:
The great imitator on the rise: ocular and optic nerve manifestations in patients with newly diagnosed syphilis
Authors: Klein Ainat , Fischer Naomi , Goldstein Michaella , Shulman Shiri , Habot‐Wilner Zohar
Published: October 2018

Purpose

Ocular manifestations of syphilis have been reported in 2–10% of systemic infection. The purpose of this study was to report the incidence of ocular syphilis and various ocular manifestations, particularly optic nerve involvement, in newly diagnosed cases.

Methods

This was a retrospective study. Medical records of newly diagnosed syphilis patients between January 2009 and January 2017 in a tertiary medical centre were reviewed.

Results

There were 123 new systemic syphilis cases out of 569,222 (0.02%) admissions to the Tel Aviv Medical Center during the study period. Ninety‐three of the 123 patients (76%) underwent ophthalmological examination. Twenty‐three of the 93 patients (25%, mean age 48.6 ± 12.9 years, 20 males) had ocular syphilis, and in 12/23 (52%) patients, the ocular symptoms and findings prompted syphilis investigation. Eighteen of the 23 (78%) had optic nerve involvement, and the most common was inflammatory disc oedema. Older age (p = 0.0005) and tertiary stage disease (p = 0.0441) were associated with ocular manifestations and the presence of optic nerve findings. Human immunodeficiency virus (HIV) was associated with ocular but not optic nerve findings. Treatment included intravenous penicillin G, and four patients with severe optic neuropathy were also treated with systemic corticosteroids. Visual acuity significantly improved in most patients (p < 0.05).

Conclusion

Ocular syphilis was found in one‐quarter of the patients diagnosed with systemic syphilis and preceded the diagnosis of systemic disease in one‐half of them. Optic nerve involvement was a common manifestation. A high index of suspicion for Treponema infection is required in patients presenting with optic nerve involvement to facilitate prompt diagnosis and treatment. Post‐treatment visual outcome was good.
Journeying with: Qualitative methodological engagements with pilgrimage
Authors: Scriven Richard
Published: October 2018

Autoethnography is increasingly being appreciated as a tool to engage with embodied practices and spatial performances by combining the experiences of both participants and researchers. This paper examines its deployment in the study of a walking pilgrimage on the mountain Criagh Patrick in Ireland. The significant growth of pilgrimage in recent decades has prompted the development of concepts and approaches to examine the motivations and experiences involved. Autoethnography enables the researcher to become a co‐participant, getting closer to the processes and substances of the activity. Using vignettes from the performance of the Criagh Patrick pilgrimage, I illustrate how this approach is enacted in the field providing embedded qualitative insight to this socio‐cultural phenomenon. The practical and analytical aspects of this process are discussed, alongside the multifaceted nature of contemporary pilgrimages.
Treating depression with adjunctive antipsychotics
Authors: Mulder Roger , Hamilton Amber , Irwin Lauren , Boyce Philip , Morris Grace , Porter Richard J. , Malhi Gin S
Published: October 2018

Objectives

To evaluate the efficacy and safety of using adjunctive antipsychotics in patients with major depressive disorder.

Method

Studies published since the last Cochrane review conducted in 2010 were identified via a literature search of recognised databases, using the keywords “adjunct*”, “augment*”, “antipsychotic” and “depression”, and systematically evaluated. A targeted review of relevant guidelines was undertaken.

Results

Adjunctive antipsychotics produce a small but significant improvement in depressive symptoms in most studies. Most of the studies focussed on patients with an inadequate response to antidepressants rather than patients with treatment resistant depression. Treatment guidelines were variable but generally supported the use of adjunctive antipsychotics while cautioning about the risk of side effects. Most were non‐specific about the length of time adjunctive antipsychotics should be prescribed.

Conclusions

The studies do not support the routine use of adjunctive antipsychotics in patients with an inadequate response to antidepressants. They may be beneficial when used short‐term in patients with treatment resistant depression who have specific symptoms (severe ruminations, melancholia, major sleep disturbance) that appear to respond well to adjunctive antipsychotics. There is no support for long‐term use. Research should focus on specifying which symptom profiles are responsive and how adjunctive antipsychotics compare to other strategies in treatment resistant depression.
Stakeholder engagement through empowerment: The case of coffee farmers
Authors: Civera Chiara , de Colle Simone , Casalegno Cecilia
Published: October 2018

While most studies on stakeholder engagement focus on high‐power stakeholders (typically, employees), limited attention has been devoted to the engagement of low‐power stakeholders. These have been defined as vulnerable stakeholders for their low capacity to influence corporations. Our research is framed around the engagement of low‐power stakeholders in the coffee industry who are, paradoxically, critical resource providers for the major roasters. Through the case study of Lavazza—the leading Italian roaster—we investigate empowerment actions addressed to smallholder farmers located in Brazil, India, East Africa, Haiti, and the Dominican Republic. We contribute to the theoretical discussion around engagement and empowerment by developing a framework linking together areas of empowerment (defined in the literature) and specific empowerment actions (emerging from our interviews). Our insights shed light on how organizations can design empowerment strategies leading to more effective stakeholder engagement and how empowerment actions can contribute to turn low‐power stakeholders into active business partners. We demonstrate that moving from a traditional competitive view of corporate–stakeholder relationships to a stakeholder theory view based on a logic of cooperative partnerships reinforces the idea that stakeholder engagement and empowerment are both entangled with the value creation process.
Tectonic controls on Miocene sedimentation in the Southern Taranaki Basin and implications for New Zealand plate boundary deformation
Authors: Bull Suzanne , Nicol Andrew , Strogen Dominic , Kroeger Karsten F. , Seebeck Hannu S.
Published: October 2018

Miocene strata in the southern Taranaki Basin (STB), up to 3 km thick, provide a distal record of erosion associated with plate boundary deformation in New Zealand. 2D and 3D seismic reflection data tied to drillhole stratigraphy have been used to constrain four main phases of basin development. These are: (a) Early Miocene (22–19 Ma) subsidence, dominantly bathyal water depths and deposition of minor submarine fans along the eastern basin margin. (b) Middle Miocene (19–14 Ma) widespread submarine fan deposition on a bathyal basin floor in the central STB. (c) Rapid Middle–Late Miocene (14–7 Ma) progradation of the shelf break northwards across the STB. (d) Widespread uplift and erosion of the STB during the latest Miocene–Pliocene (7–4.5 Ma). Bathyal water depths and fan deposition in the Early Miocene were influenced by vertical motions on major reverse faults and regional subsidence produced by subduction of the Pacific plate beneath northern New Zealand. Subsequent submarine fan deposition and northward shelf‐break progradation reflect increasing input of terrigenous material, primarily eroded from an uplifting region to the south of the STB. Sedimentation patterns in the STB are consistent with the age and locations of conglomerates deposited in onshore West Coast basins, related to this uplift and erosion. Sediment transport in the West Coast region was mainly parallel to NNE trending active reverse faults, and in the STB was perpendicular to the NE‐SW orientated shelf break, especially from ca. 14–7 Ma, when sedimentation rates exceeded fault‐displacement rates. Increases in sedimentation rates in the STB coincide with regional increases in the rates of shortening that appear to reflect plate boundary‐wide events and have been attributed to, or correlated with, increases in the plate convergence rate. Miocene sedimentation patterns in the STB thus reflect both intra‐basinal deformation and tectonic signals from the wider developing New Zealand plate boundary.
The impact of bowel and bladder problems on children's quality of life and their parents: A scoping review
Authors: Collis Dianne , Kennedy‐Behr Ann , Kearney Lauren
Published: October 2018

Background

Functional bladder and bowel problems are common in children and have a serious psychological as well as physical impact. The objective of this scoping review was to synthesise evidence on the impact of such conditions both on children's quality of life (QOL) and their parents.

Methods

The scoping review followed Arksey and O′Malley's framework. Relevant studies were identified by a comprehensive search of scientific databases. Inclusion criteria focused on children with bladder and bowel dysfunction, their QOL, and impact on parents. Studies were analysed for aims, study populations, measures, and results.

Results

A total of 783 records were retrieved with 30 meeting the criteria. Most studies found that QOL was reduced in children with nocturnal enuresis, day bladder dysfunction, bowel dysfunction, and combined bladder and bowel dysfunction. Parents' QOL and social–emotional functioning were also negatively affected.

Conclusions

Functional bladder and bowel problems should be identified and treated as early as possible to minimise negative impacts on QOL of children and their carers. Future research should focus on how to best provide early and effective intervention in the most accessible manner.
Linguistic and Cultural Variation in Early Color Word Learning
Authors: Forbes Samuel H. , Plunkett Kim
Published: October 2018

When and how do infants learn color words? It is generally supposed that color words are learned late and with a great deal of difficulty. By examining infant language surveys in British English and 11 other languages, this study shows that color word learning occurs earlier than has been previously suggested and that the order of acquisition of color words is similar in related languages. This study also demonstrates that frequency and syllabic complexity can be used to predict variability in infant color word learning across languages. In light of recent evidence indicating that color categories have universal biological foundations, these findings suggest that infants’ experience and linguistic exposure drive their shift to culturally and linguistically mediated adult‐like understandings of color words.
Effect of inbreeding on intellectual disability revisited by trio sequencing
Authors: Kahrizi Kimia , Hu Hao , Hosseini Masoumeh , Kalscheuer Vera M. , Fattahi Zohreh , Beheshtian Maryam , Suckow Vanessa , Mohseni Marzieh , Lipkowitz Bettina , Mehvari Sepideh , Mehrjoo Zohreh , Akhtarkhavari Tara , Ghaderi Zhila , Rahimi Maryam , Arzhangi Sanaz , Jamali Payman , Falahat Chian Milad , Nikuei Pooneh , Sabbagh Kermani Farahnaz , Sadeghinia Farnaz , Jazayeri Roshanak , Tonekaboni S. Hassan , Khoshaeen Atefeh , Habibi Haleh , Pourfatemi Fatemeh , Mojahedi Faezeh , Khodaie‐Ardakani Mohammad‐Reza , Najafipour Reza , Wienker Thomas F. , Najmabadi Hossein , Ropers Hans‐Hilger
Published: October 2018

In outbred Western populations, most individuals with intellectual disability (ID) are sporadic cases, dominant de novo mutations (DNM) are frequent, and autosomal recessive ID (ARID) is very rare. Because of the high rate of parental consanguinity, which raises the risk for ARID and other recessive disorders, the prevalence of ID is significantly higher in near‐ and middle‐east countries. Indeed, homozygosity mapping and sequencing in consanguineous families have already identified a plethora of ARID genes, but because of the design of these studies, DNMs could not be systematically assessed, and the proportion of cases that are potentially preventable by avoiding consanguineous marriages or through carrier testing is hitherto unknown. This prompted us to perform whole‐exome sequencing in 100 sporadic ID patients from Iran and their healthy consanguineous parents. In 61 patients, we identified apparently causative changes in known ID genes. Of these, 44 were homozygous recessive and 17 dominant DNMs. Assuming that the DNM rate is stable, these results suggest that parental consanguinity raises the ID risk about 3.6‐fold, and about 4.1 to 4.25‐fold for children of first‐cousin unions. These results do not rhyme with recent opinions that consanguinity‐related health risks are generally small and have been “overstated” in the past.
Long‐term biological complications of dental implants placed either in pristine or in augmented sites: A systematic review and meta‐analysis
Authors: Salvi Giovanni E. , Monje Alberto , Tomasi Cristiano
Published: October 2018

Aim

To investigate and compare the prevalence of biological complications and failure of implants placed in pristine vs. augmented sites after a mean observation period of at least 10 years.

Materials and methods

The focused question “In patients with osseointegrated dental implants, are there differences in biological complications and implant failure at implants placed in pristine vs. augmented sites?” was addressed using the Population, Exposure, Comparison and Outcome criteria. Electronic and manual searches supplemented by the screening of the grey literature were carried out. A case definition of peri‐implant mucositis and peri‐implantitis had to be specified. The binary random‐effects method was chosen to conduct meta‐analyses. Results are presented as Forest plots with weighted mean values and 95% confidence intervals (CI). The I2 statistic test was applied to quantify heterogeneity. The Newcastle‐Ottawa Scale and the parameters provided in the Cochrane Center and CONSORT statement were used for quality assessment. The results are reported according to the PRISMA guidelines.

Results

No randomized clinical trial (RCT) comparing the outcomes of implants placed in pristine vs. augmented sites was identified. Five case‐series studies, one case–control study, one cross‐sectional study and one RCT were eligible for qualitative and quantitative analyses. No statistically significant differences (p > .05) were observed between implants placed in pristine vs. augmented sites for any outcome variables both at patient and at implant levels, respectively. High heterogeneity concerning patient sampling, case definitions of biological complications and eligibility criteria was observed.

Conclusion

The studies included in the present systematic review did not directly address the focused questions. Hence, the outcomes of the meta‐analysis should be interpreted with caution due to high variability with respect to study design.
Systematic review of clinical and patient‐reported outcomes following oral rehabilitation on dental implants with a tapered compared to a non‐tapered implant design
Authors: Jokstad Asbjørn , Ganeles Jeffrey
Published: October 2018

Background

Dental implants are available in different shapes.

Aims

This systematic review aims to address whether tapered compared to non‐tapered implants demonstrate similar clinical and patient‐reported outcomes. The review follows the preferred reporting items for systematic reviews and meta‐analyses (PRISMA) format.

Materials & Methods

We searched electronic databases including MEDLINE through PubMed and the Cochrane Central Register of Controlled Trials for randomized clinical trials (RCT) that compare tapered versus non‐tapered implants with at least 10 treated participants and a minimum mean follow‐up time of 3 years. There were no restrictions to a particular treatment indication or outcome measures. Two authors independently conducted screening, risk of bias assessment, and data extraction of eligible trials in duplicate. We applied the Cochrane risk of bias assessment tool to consider risk of bias.

Results

We identified 18 different RCTs, of which three reported outcomes at 3 years or greater. The three trials described the results of 245 participants with 388 implants at 3 years, from the initially 306 participants with 494 implants at baseline. The three trials compared, respectively, two, two, and three different commercially available implant brands and reported only clinically insignificant differences. We judged all three trials to be at moderate risk of bias. The low number and heterogeneity of RCTs did not allow for meta‐analyses.

Discussion and conclusion

Appropriate professional judgment in clinical decision making must include a comprehensive diagnosis of the patient's jawbone quality and quantity and consideration of osteotomy protocol in accordance with the patient's treatment preferences, where the shape of the dental implant is only one contributory factor.
Accuracy of linear measurements on CBCT images related to presurgical implant treatment planning: A systematic review
Authors: Fokas George , Vaughn Vida M. , Scarfe William C. , Bornstein Michael M.
Published: October 2018

Objective

The aim of this systematic review was to identify, review, analyze, and summarize available evidence on the accuracy of linear measurements when using maxillofacial cone beam computed tomography (CBCT) specifically in the field of implant dentistry.

Material and methods

The search was undertaken in April 2017 in the National Library of Medicine database (Medline) through its online site (PubMed), followed by searches in the Cochrane, EMBASE, ScienceDirect, and ProQuest Dissertation and Thesis databases. The main inclusion criterion for studies was that linear CBCT measurements were performed for quantitative assessment (e.g., height, width) of the alveolar bone at edentulous sites or measuring distances from anatomical structures related to implant dentistry. The studies should compare these values to clinical data (humans) or ex vivo and/or experimental (animal) findings from a “gold standard.”

Results

The initial search yielded 2,516 titles. In total, 22 studies were included in the final analysis. Of those, two were clinical and 20 ex vivo investigations. The major findings of the review indicate that CBCT provides cross‐sectional images that demonstrate high accuracy and reliability for bony linear measurements on cross‐sectional images related to implant treatment. A wide range of error has been reported when performing linear measurements on CBCT images, with both over‐ and underestimation of dimensions in comparison with a gold standard. A voxel size of 0.3 to 0.4 mm is adequate to provide CBCT images of acceptable diagnostic quality for implant treatment planning.

Conclusions

CBCT can be considered as an appropriate diagnostic tool for 3D preoperative planning. Nevertheless, a 2 mm safety margin to adjacent anatomic structures should be considered when using CBCT. In clinical practice, the measurement accuracy and reliability of linear measurements on CBCT images are most likely reduced through factors such as patient motion, metallic artefacts, device‐specific exposure parameters, the software used, and manual vs. automated procedures.
Narrow‐diameter implants: A systematic review and meta‐analysis
Authors: Schiegnitz Eik , Al‐Nawas Bilal
Published: October 2018

Objectives

Narrow‐diameter implants (NDI) are claimed to be a reasonable alternative to bone augmentation procedures. The aim of this comprehensive literature review was to conduct a meta‐analysis comparing the implant survival of NDI and standard diameter implants (SDI) and to provide recommendations and guidelines for application of NDI.

Material and methods

An extensive systematic literature search was performed in the PubMed/MEDLINE and the Cochrane Library databases. NDI were classified into Category 1 (implant diameter <3.0 mm, “mini‐implants”), Category 2 (implant diameter 3–3.25 mm) and Category 3 (implant diameters 3.3–3.5 mm). Clinical studies at all levels of evidence with at least 10 patients included and a follow‐up time of at least 12 months were included. The primary outcome criterion was the survival rates of NDI.

Results

Seventy‐six studies were identified for qualitative and 16 studies for quantitative synthesis. Quality assessment illustrated a high risk of bias for the included literature. Mean implant survival rates were 94.7 ± 5%, 97.3 ± 5% and 97.7 ± 2.3% for Categories 1, 2 and 3. Meta‐analysis indicated a statistically significant lower implant survival of Category 1 NDI compared to SDI ([OR], 4.54; [CI], 1.51–13.65). For Category 2 and Category 3, no statistical significant differences in implant survival were seen compared to SDI ([OR], 1.06; [CI], 0.31–3.61 and [OR], 1.19; [CI], 0.83–1.70).

Conclusion

NDI of Category 1 performed statistically significantly worse than SDI and were mainly described for the rehabilitation of the highly atrophic maxilla or mandible. Category 2 and Category 3 NDI showed no difference in implant survival compared to SDI. Category 2 NDI were mostly used for the rehabilitation of limited interdental spaces in anterior single‐tooth restorations. NDI of Category 3 were described in all regions, including posterior single‐tooth restorations. However, resilient long‐term data and data on the possible risk of biological and technical complications with wide platform teeth on NDI are missing so far.
Implant placement and loading protocols in partially edentulous patients: A systematic review
Authors: Gallucci German O. , Hamilton Adam , Zhou Wenjie , Buser Daniel , Chen Stephen
Published: October 2018

Objectives

To systematically review the evidence for the clinical outcome of fixed implant prostheses treated with different combinations of implant placement and loading protocols in partially edentulous patients.

Materials and methods

An electronic search was performed in Medline, Embase, and Central to identify studies investigating the outcome of implants subjected to immediate placement + immediate restoration/loading (Type 1A), immediate placement + early loading (Type 1B), immediate placement + conventional loading (Type 1C), early placement + immediate restoration/loading (Type 2‐3A), early placement + early loading (Type 2‐3B), early placement + conventional loading (Type 2‐3C), late placement + immediate restoration/loading (Type 4A), late placement + early loading (Type 4B), late placement + conventional loading (Type 4C) with implant‐supported fixed dental prostheses (IFDPs) in partially edentulous patients. Only human studies with at least 10 cases and a minimum follow‐up time of 12 months, reporting on solid‐screw‐type implants with rough surfaces and an intra‐osseous diameter between 3 and 6 mm, were included. A cumulative survival rate for each type of the implant placement and loading protocols was weighted by the duration of follow‐up and number of implants.

Results

The search provided 5,248 titles from which 2,362 abstracts and 449 full‐text articles were screened. A total of 69 publications that comprised 23 comparative studies (15 randomized controlled trials, 7 controlled clinical trials) and 47 noncomparative studies (34 prospective cohort studies, 13 retrospective cohort studies) were included for analysis. Considerable heterogeneity in study design was found, and therefore, a meta‐analysis of controlled studies was not possible. The weighted cumulative survival rate of each type of placement and loading protocol was 98.4% (Type 1A), 98.2% (Type 1B), 96.0% (Type 1C), 100% (Type 2‐3B), 96.3% (Type 2‐3C), 97.9% (Type 4A), 98.3% (Type 4B), and 97.7% (Type 4C). Type 1C, Type 2‐3C, Type 4B, and Type 4C were scientifically and clinically validated (SCV). Type 1A, Type 1B, and Type 4A were clinically documented (CD), and Type 2‐3A and Type 2‐3B were clinically insufficiently documented (CID).

Conclusions

Evaluating outcomes in oral implantology by combining the placement and loading protocols are paramount. The selected loading protocol appears to influence the outcome of immediate implant placement.
Patient‐reported outcome measures of edentulous patients restored with implant‐supported removable and fixed prostheses: A systematic review
Authors: Yao Coral J , Cao Cong , Bornstein Michael M. , Mattheos Nikos
Published: October 2018

Objective

The aim of this systematic review was to compare patient‐reported outcomes measures (PROMs) of implant‐supported fixed complete dentures (IFCDs) and overdentures (IODs).

Material and methods

PubMed, Cochrane Library, EMBASE, Scopus and Web of Science were searched, complemented by manual search. Studies published in English up to November 2016 comparing removable with fixed implant‐supported prosthesis on fully edentulous patients were included. The review focused on impact on patients’ oral health‐related quality of life (OHRQoL), satisfaction or other patient‐reported outcomes measures.

Results

Of 1,563 initially screened articles, 13 studies including 8 prospective and 5 retrospective studies fulfilled the inclusion criteria. OHRQoL and patient satisfaction were the most common PROMs. When evaluating the levels of evidence, five of thirteen studies were graded as level III and seven reached level II. The only randomized control trial was rated as Ib. The methods used to evaluate PROMs were heterogeneous among studies, and there was a lack of standardization in the measurements employed. In general, IFCD and IOD showed no significant differences when compared for PROMs, with a slight trend of IFCD being superior to IOD in most included studies. However, conflicting results were observed in many aspects such as chewing function, phonetics‐related function, overall satisfaction and aesthetics.

Conclusions

Inconsistent results were observed in PROMs when comparing IFCD and IOD for fully edentulous patients. A guideline for standardizing the assessment of PROMs in clinical research is needed in order to produce more meaningful evidence‐based information.
Clinical outcomes of peri‐implantitis treatment and supportive care: A systematic review
Authors: Roccuzzo Mario , Layton Danielle M. , Roccuzzo Andrea , Heitz‐Mayfield Lisa J.
Published: October 2018

Objectives

To report the clinical outcomes for patients with implants treated for peri‐implantitis who subsequently received supportive care (supportive peri‐implant/periodontal therapy) for at least 3 years.

Material and methods

A systematic search of multiple electronic databases, grey literature and hand searching, without language restriction, to identify studies including ≥10 patients was constructed. Data and risk of bias were explored qualitatively. Estimated cumulative survival at the implant‐ and patient‐level was pooled with random‐effects meta‐analysis and explored for publication bias (funnel plot) at different time intervals.

Results

The search identified 5,761 studies. Of 83 records selected during screening, 65 were excluded through independent review (kappa = 0.94), with 18 retained for qualitative and 13 of those for quantitative assessments. On average, studies included 26 patients (median, IQR 21–32), with 36 implants (median, IQR 26–45). Study designs (case definitions of peri‐implantitis, peri‐implantitis treatment, supportive care) and population characteristics (patient, implant and prosthesis characteristics) varied markedly. Data extraction was affected by reduced reporting quality, but over 75% of studies had low risk of bias. Implant survival was 81.73%–100% at 3 years (seven studies), 74.09%–100% at 4 years (three studies), 76.03%–100% at 5 years (four studies) and 69.63%–98.72% at 7 years (two studies). Success and recurrence definitions were reported in five and two studies respectively, were heterogeneous, and those outcomes were unable to be explored quantitatively.

Conclusion

Therapy of peri‐implantitis followed by regular supportive care resulted in high patient‐ and implant‐level survival in the medium to long term. Favourable results were reported, with clinical improvements and stable peri‐implant bone levels in the majority of patients.
Effect of advanced age and/or systemic medical conditions on dental implant survival: A systematic review and meta‐analysis
Authors: Schimmel Martin , Srinivasan Murali , McKenna Gerald , Müller Frauke
Published: October 2018

Objectives

his review evaluated implant survival in geriatric patients (≥75 years) and/or the impact of systemic medical conditions.

Materials and Methods

Systematic literature searches were performed to identify studies reporting on geriatric subjects with dental implants and on implant patients who had any of the seven most common systematic conditions among geriatric patients. Meta‐analyses were performed on the postloading implant survival rates. The impact of systemic medical conditions and their respective treatment was qualitatively analyzed.

Results

A total of 6,893 studies were identified; of those, 60 studies were included. The fixed‐effects model revealed an overall implant survival of 97.3% (95%CI: 94.3, 98.7; studies = 7) and 96.1% (95%CI: 87.3, 98.9; studies = 3), for 1 and 5 years, respectively. In patients with cardiovascular disease, implant survival may be similar or higher compared to healthy patients. High implant survival rates were reported for patients with Parkinson's disease or diabetes mellitus typeII. In patients with cancer, implant survival is negatively affected, namely by radiotherapy. Patients with bone metastases receiving high‐dose antiresorptive therapy (ART) carry a high risk for complications after implant surgery. Implant survival was reported to be high in patients receiving low‐doseARTfor treatment of osteoporosis. No evidence was found on implant survival in patients with dementia, respiratory diseases, liver cirrhosis, or osteoarthritis.

Conclusions

Implant prostheses in geriatric subjects are a predictable treatment option with a very high rate of implant survival. The functional and psychosocial benefits of such intervention should outweigh the associated risks to common medical conditions.
Survival rates of short dental implants (≤6 mm) compared with implants longer than 6 mm in posterior jaw areas: A meta‐analysis
Authors: Papaspyridakos Panos , De Souza Andre , Vazouras Konstantinos , Gholami Hadi , Pagni Sarah , Weber Hans‐Peter
Published: October 2018

Purpose

To systematically review randomized controlled clinical trials (RCTs) reporting on the long‐term survival and failure rates, as well as the complications of short implants (≤6 mm) versus longer implants (>6 mm) in posterior jaw areas.

Materials and Methods

Electronic and manual searches were conducted to identify studies, specifically RCTs, reporting on short dental implants (≤6 mm) and their survival and complication rates compared with implants longer than 6 mm. Secondary outcomes analyzed were marginal bone loss and prosthesis survival rates.

Results

Ten RCTs fulfilled the inclusion criteria and featured a total of 637 short (≤6 mm) implants placed in 392 patients, while 653 standard implants (>6 mm) were inserted in 383 patients. The short implant survival rate ranged from 86.7% to 100%, whereas standard implant survival rate ranged from 95% to 100% with a follow‐up from 1 to 5 years. The risk ratio (RR) for short implant failure compared to standard implants was 1.29 (95% CI: 0.67, 2.50, p = 0.45), demonstrating that overall, short implants presented higher risk of failure compared to longer implants. The heterogeneity test did not reach statistical significance (p = 0.67), suggesting low between‐study heterogeneity. The prosthesis survival rates from the short implant groups ranged from 90% to 100% and from 95% to 100% for longer implant groups, respectively.

Conclusion

Short implants (≤6 mm) were found to have higher variability and lower predictability in survival rates compared to longer implants (>6 mm) after periods of 1–5 years in function. The mean survival rate was 96% (range: 86.7%–100%) for short implants, and 98% (range 95%–100%) for longer implants. Based on the quantity and quality of the evidence provided by 10 RCTs, short implants with ≤6 mm length should be carefully selected because they may present a greater risk for failure compared to implants longer than 6 mm.
Clinical performance of intentionally tilted implants versus axially positioned implants: A systematic review
Authors: Lin Wei‐Shao , Eckert Steven E.
Published: October 2018

Objectives

The aim of this review was to determine the clinical performance of dental implants that are intentionally tilted when compared with implants that are placed following the long axis of the residual alveolar ridge.

Materials and methods

A systematic review of the scientific literature using a predefined research question (PICO) and search strategy was undertaken. This search included five electronic databases. Two independent reviewers examined electronic databases and performed a manual review following search strategy to accomplish the item generation and reduction. Included articles were evaluated to determine the level of evidence. Data were extracted only from level I and level II studies, based on the Oxford Centre for Evidence‐based Medicine—Levels of Evidence (March 2009). If included studies were homogeneous in nature, data were to be accumulated. However, if included studies were heterogeneous in nature, only descriptive data would be reviewed and analyzed.

Results

A total of 811 articles were identified through the PICO question and search strategy. Detailed review of the abstracts and articles resulted in further item reduction, and 46 articles were included for full‐text review. A total of 42 articles were then selected for inclusion in the systematic review. The identified articles included two level I and 20 level II studies. In addition, 15 level IV, one gray literature, and four previous systematic reviews with meta‐analyses were also used in the study. The extracted data from the included studies demonstrated heterogeneity that prevented quantitative assessment, and only one level II study directly compared tilted and axially placed implants. Assessment of the descriptive data demonstrated no differences in implant survival, marginal bone loss, prosthesis survival, or patient‐reported outcome measures (PROMs) whether implants are placed axially or with intentional inclination of the coronal aspect of the implant toward the distal aspect of edentulous jaws.

Conclusions

Based upon the systematic review of the literature, an analysis of the descriptive data suggested no differences in clinical performance between implants that are placed in an axial position relative to the residual alveolar ridge when compared with implants that are intentionally tilted toward the distal aspect of edentulous jaws.
Group 2 ITI Consensus Report: Prosthodontics and implant dentistry
Authors: Morton Dean , Gallucci German , Lin Wei‐Shao , Pjetursson Bjarni , Polido Waldemar , Roehling Stefan , Sailer Irena , Aghaloo Tara , Albera Hugo , Bohner Lauren , Braut Vedrana , Buser Daniel , Chen Stephen , Dawson Anthony , Eckert Steven , Gahlert Michael , Hamilton Adam , Jaffin Robert , Jarry Christian , Karayazgan Banu , Laine Juhani , Martin William , Rahman Lira , Schlegel Andreas , Shiota Makato , Stilwell Charlotte , Vorster Christiaan , Zembic Anja , Zhou Wenjie
Published: October 2018

Objectives

Working Group 2 was convened to address topics relevant to prosthodontics and dental implants. Systematic reviews were developed according to focused questions addressing (a) the number of implants required to support fixed full‐arch restorations, (b) the influence of intentionally tilted implants compared to axial positioned implants when supporting fixed dental prostheses (FDPs), (c) implant placement and loading protocols, (d) zirconia dental implants, (e) zirconia and metal ceramic implant supported single crowns and (f) zirconia and metal ceramic implant supported FDPs.

Materials and methods

Group 2 considered and discussed information gathered in six systematic reviews. Group participants discussed statements developed by the authors and developed consensus. The group developed and found consensus for clinical recommendations based on both the statements and the experience of the group. The consensus statements and clinical recommendations were presented to the plenary (gathering of all conference attendees) and discussed. Final versions were developed after consensus was reached.

Results

A total of 27 consensus statements were developed from the systematic reviews. Additionally, the group developed 24 clinical recommendations based on the combined expertise of the participants and the developed consensus statements.

Conclusions

The literature supports the use of various implant numbers to support full‐arch fixed prostheses. The use of intentionally tilted dental implants is indicated when appropriate conditions exist. Implant placement and loading protocols should be considered together when planning and treating patients. One‐piece zirconia dental implants can be recommended when appropriate clinical conditions exist although two‐piece zirconia implants should be used with caution as a result of insufficient data. Clinical performance of zirconia and metal ceramic single implant supported crowns is similar and each demonstrates significant, though different, complications. Zirconia ceramic FDPs are less reliable than metal ceramic. Implant supported monolithic zirconia prostheses may be a future option with more supporting evidence.
A systematic review of the survival and complication rates of zirconia‐ceramic and metal‐ceramic single crowns
Authors: Pjetursson Bjarni E , Valente Nicola A , Strasding Malin , Zwahlen Marcel , Liu Shiming , Sailer Irena
Published: October 2018

Objectives

The aim of the present systematic review was to analyze the survival and complication rates of zirconia‐based and metal‐ceramic implant‐supported single crowns (SCs).

Materials and Methods

An electronic MEDLINE search complemented by manual searching was conducted to identify randomized controlled clinical trials, prospective cohort and retrospective case series on implant‐supported SCs with a mean follow‐up time of at least 3 years. Patients had to have been clinically examined at the follow‐up visit. Assessment of the identified studies and data extraction was performed independently by two reviewers. Failure and complication rates were analyzed using robust Poisson's regression models to obtain summary estimates of 5‐year proportions.

Results

The search provided 5,263 titles and 455 abstracts, full‐text analysis was performed for 240 articles, resulting in 35 included studies on implant‐supported crowns. Meta‐analysis revealed an estimated 5‐year survival rate of 98.3% (95% CI: 96.8–99.1) for metal‐ceramic implant supported SCs (n = 4,363) compared to 97.6% (95% CI: 94.3–99.0) for zirconia implant supported SCs (n = 912). About 86.7% (95% CI: 80.7–91.0) of the metal‐ceramic SCs (n = 1,300) experienced no biological/technical complications over the entire observation period. The corresponding rate for zirconia SCs (n = 76) was 83.8% (95% CI: 61.6–93.8). The biologic outcomes of the two types of crowns were similar; yet, zirconia SCs exhibited less aesthetic complications than metal‐ceramics. The 5‐year incidence of chipping of the veneering ceramic was similar between the material groups (2.9% metal‐ceramic, 2.8% zirconia‐ceramic). Significantly (p = 0.001), more zirconia‐ceramic implant SCs failed due to material fractures (2.1% vs. 0.2% metal‐ceramic implant SCs). No studies on newer types of monolithic zirconia SCs fulfilled the simple inclusion criteria of 3 years follow‐up time and clinical examination of the present systematic review.

Conclusion

Zirconia‐ceramic implant‐supported SCs are a valid treatment alternative to metal‐ceramic SCs, with similar incidence of biological complications and less aesthetic problems. The amount of ceramic chipping was similar between the material groups; yet, significantly more zirconia crowns failed due to material fractures.
Group 4 ITI Consensus Report: Risks and biologic complications associated with implant dentistry
Authors: Heitz‐Mayfield Lisa J. , Aaboe Merete , Araujo Mauricio , Carrión Juan B. , Cavalcanti Raffaele , Cionca Norbert , Cochran David , Darby Ivan , Funakoshi Eiji , Gierthmuehlen Petra C. , Hashim Dena , Jahangiri Leila , Kwon Yongdae , Lambert France , Layton Danielle M. , Lorenzana Eduardo R. , McKenna Gerald , Mombelli Andrea , Müller Frauke , Roccuzzo Mario , Salvi Giovanni E. , Schimmel Martin , Srinivasan Murali , Tomasi Cristiano , Yeo Alvin
Published: October 2018

Objectives

The aim of Working Group 4 was to address topics related to biologic risks and complications associated with implant dentistry. Focused questions on (a) diagnosis of peri‐implantitis, (b) complications associated with implants in augmented sites, (c) outcomes following treatment of peri‐implantitis, and (d) implant therapy in geriatric patients and/or patients with systemic diseases were addressed.

Materials and methods

Four systematic reviews formed the basis for discussion in Group 4. Participants developed statements and recommendations determined by group consensus based on the findings of the systematic reviews. These were then presented and accepted following further discussion and modifications as required by the plenary.

Results

Bleeding on probing (BOP) alone is insufficient for the diagnosis of peri‐implantitis. The positive predictive value of BOP alone for the diagnosis of peri‐implantitis varies and is dependent on the prevalence of peri‐implantitis within the population. For patients with implants in augmented sites, the prevalence of peri‐implantitis and implant loss is low over the medium to long term. Peri‐implantitis treatment protocols which include individualized supportive care result in high survival of implants after 5 years with about three‐quarters of implants still present. Advanced age alone is not a contraindication for implant therapy. Implant placement in patients with cancer receiving high‐dose antiresorptive therapy is contraindicated due to the associated high risk for complications.

Conclusions

Diagnosis of peri‐implantitis requires the presence of BOP as well as progressive bone loss. Prevalence of peri‐implantitis for implants in augmented sites is low. Peri‐implantitis treatment should be followed by individualized supportive care. Implant therapy for geriatric patients is not contraindicated; however, comorbidities and autonomy should be considered.
The accuracy of static computer‐aided implant surgery: A systematic review and meta‐analysis
Authors: Tahmaseb Ali , Wu Vivian , Wismeijer Daniel , Coucke Wim , Evans Christopher
Published: October 2018

Objectives

To assess the literature on the accuracy of static computer‐assisted implant surgery in implant dentistry.

Materials and Methods

Electronic and manual literature searches were conducted to collect information about the accuracy of static computer‐assisted implant systems. Meta‐regression analysis was performed to summarise the accuracy studies.

Results

From a total of 372 articles. 20 studies, one randomised controlled trial (RCT), eight uncontrolled retrospective studies and 11 uncontrolled prospective studies were selected for inclusion for qualitative synthesis. A total of 2,238 implants in 471 patients that had been placed using static guides were available for review. The meta‐analysis of the accuracy (20 clinical) revealed a total mean error of 1.2 mm (1.04 mm to 1.44 mm) at the entry point, 1.4 mm (1.28 mm to 1.58 mm) at the apical point and deviation of 3.5°(3.0° to 3.96°). There was a significant difference in accuracy in favour of partial edentulous comparing to full edentulous cases.

Conclusion

Different levels of quantity and quality of evidence were available for static computer‐aided implant surgery (s‐CAIS). Based on the present systematic review and its limitations, it can be concluded that the accuracy of static computer‐aided implant surgery is within the clinically acceptable range in the majority of clinical situations. However, a safety marge of at least 2 mm should be respected. A lack of homogeneity was found in techniques adopted between the different authors and the general study designs.
Performance and outcome of zirconia dental implants in clinical studies: A meta‐analysis
Authors: Roehling Stefan , Schlegel Karl A. , Woelfler Henriette , Gahlert Michael
Published: October 2018

Objectives

To evaluate implant survival, peri‐implant marginal bone loss, technical, and biological complications as well as aesthetic outcomes of zirconia implants in clinical studies.

Material and Methods

Electronic (Medline, Embase) and hand searches were performed to identify clinical studies published between January 2004 and March 2017 investigating zirconia dental implants with a mean follow‐up of at least 12 months. Primary outcomes were implant survival and peri‐implant marginal bone loss. Secondary outcomes included technical and biological complications as well as aesthetic outcomes. Meta‐analyses were performed to estimate implant survival and marginal bone loss.

Results

From 943 titles, 264 abstracts were selected. Subsequently, 80 full‐text articles were screened, and 18 studies were included for data extraction. One‐ (14 studies) and 2‐piece zirconia implants (4 studies) were investigated. Commercially available (CA) (510 implants, 398 patients) and not commercially available (NCA) zirconia implants (618 implants, 343 patients) were identified. For CA implants (follow‐up: 12–61.20 months), technical complications (1.6%), implant fractures (0.2%) and biological complications (4.2%) were reported. Meta‐analyses estimated 1‐ and 2‐year survival rates of 98.3% (95% CI: 97.0%–99.6%) and 97.2% (95% CI: 94.7%–99.7%), respectively, and a mean 1‐year marginal bone loss of 0.7 mm (95% CI: 0.4–1.0 mm).

Conclusions

Since 2004, the survival rates of CA implants significantly improved compared with NCA implants. CA 1‐piece zirconia implants showed similar 1‐ and 2‐year mean survival rates and marginal bone loss after 1 year compared with published data for titanium implants. However, more clinical long‐term data are needed to confirm the presently evaluated promising short‐term outcomes.