Search

Purpose: The purpose of this systematic review was to review clinical studies of fixed tooth-supported prostheses, and to assess the quality of evidence with an emphasis on the assessment of the reporting of outcome measurements. Multiple hypotheses were generated to compare the effect of study type on different outcome modifiers and to compare the quality of publications before and after January 2005., Materials and Methods: An electronic search was conducted using specific databases (MEDLINE via Ovid, EMBASE via Ovid, Cochrane Library) through July 2012. This was complemented by hand searching the past 10 years of issues of the Journal of Oral Rehabilitation, Journal of Prosthetic Dentistry, Journal of Prosthodontics, and the International Journal of Prosthodontics. All experimental and observational clinical studies evaluating survival, success, failure, and complications of tooth-supported extracoronal fixed partial dentures, crowns, and onlays were included. No restrictions on age or follow-up time were placed., Results: The electronic search generated 14,869 papers, of which 206 papers were included for full-text review. Hand-searching added 23 papers. Inclusion criteria were met by 182 papers and were included for the review. The majority were retrospective studies. Only 8 (4.4%) were randomized controlled trials. The majority of the studies measured survival and failure, and few studies recorded data on success; however, more than 60% of the studies failed to define survival, success, and failure. Many studies did not use any standardized criteria for assessment of the quality of the restorations and, when standardized criteria were used, they were modified, thereby not allowing for comparisons with other studies. There was an increase of 21.8% in the number of studies evaluating outcome measurements of all-ceramic restorations in past 8 years., Conclusions: Prosthodontic literature presents with a reduced percentage of RCTs compared to other disciplines in dentistry. The overall quality of recording prosthodontic outcome measurements has not improved greatly in the past 8 years., (© 2014 by the American College of Prosthodontists.)

Weight loss is common in systemic immunoglobulin light chain amyloidosis but there are limited data on the impact of nutritional status on outcome. Using the Patient-Generated Subjective Global Assessment (PG-SGA) score, we prospectively examined nutritional status in 110 consecutive newly-diagnosed, treatment-naïve patients with immunoglobulin light chain amyloidosis attending the UK National Amyloidosis Centre. At study entry, 72 of 110 (66%) patients had a PG-SGA score of 4 or over, indicating malnutrition requiring specialist nutritional intervention. Number of amyloidotic organs, elevated alkaline phosphatase, presence of autonomic neuropathy and advanced Mayo disease stage were independently associated with poor nutritional status (P<0.05). Quality of life was substantially poorer among those with higher PG-SGA scores (P<0.001). Furthermore, PG-SGA score was a powerful independent predictor of patient survival (P=0.02). Malnutrition is prevalent and is associated with poor quality of life and reduced survival among patients with systemic immunoglobulin light chain amyloidosis. The PG-SGA score would be an appropriate tool to evaluate whether nutritional intervention could improve patient outcomes.

Addition-reaction silicone impression (PVS) materials are hydrophobic. Hydrophobicity of the impression material may interfere with the wetting of the tooth, resulting in void formation. The study investigates whether conditioning teeth with Chlorhexidine-gluconate based mouthwashes can reduce the hydrophobicity and the number of voids on PVS impressions. Impression material contact angle specimens on bovine tooth surfaces were measured using a Reflex Microscope. PVS impressions (President) were made of untreated bovine teeth in three groups (1, 2 and 3) and fourth group used Impregum polyether impression material: Group I was used as a control group, and original and mint flavoured Corsodyl (Chlorhexidine) mouthwashes were used as clinical surfactants in Groups 2 and 3, respectively. Contact angle readings were recorded on each side of every impression in each of the four groups and compared by an analysis of variance. In the second part of the study, the numbers of air voids on impression surfaces were visually recorded. The proportions of air voids in the groups were compared using a Chi-squared test. The mean angle for Group 3 with mint flavoured Corsodyl mouthwash was significantly smaller than that of any of the other groups (P < 0.05). The only statistically significant (P < 0.01) comparisons of the proportions of air voids were between Group 4 and each of the other experimental groups, with the percentage of voids being significantly greater in Group 4. Although Corsodyl mint significantly reduced the mean contact angle it did not significantly reduce the percentage of voids on impression surfaces.

Evaluation was undertaken of the interface dimensions of MOD ceramic onlays fabricated using the Cerec 3 system. A master die was prepared on a maxillary second premolar Ivorine tooth from which 20 Cerec 3 onlays and 20 feldspathic onlays were made. A total of 80 cement analogues were produced using elastomeric impression material and sectioned orthogonally. Interface dimension was measured using Image Analysis Software. The ceramic onlays constructed using Cerec 3 demonstrated significantly larger cement lute space compared with laboratory produced feldspathic porcelain onlays with mean thickness of 201.3 +/- 78.0 microm and 139.7 +/- 49.7 microm respectively (P < 0.001). Large interface dimensions were particularly noted in the proximal boxes. The multiple variables involved in the construction of the Cerec onlays as well as the complexity of the onlay design may be contributing factors to the large cement space.