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Statement of Problem: Rehabilitation with wide-diameter reduced-length implants has become popular for patients with minimal vertical bone. However, a consensus on the benefits of this approach is lacking., Purpose: The purpose of this systematic review with meta-analysis was to evaluate the influence of wide compared with regular diameter on the clinical performance of short (<10 mm) and extrashort (≤6 mm) dental implants used for rehabilitations with single crowns, fixed partial dentures, or both, in the posterior region., Material and Methods: A search in 6 databases was conducted to select randomized controlled trials (RCTs) and nonrandomized controlled trials (N-RCTs). Five meta-analyses were performed, where the risk ratio (RR) was evaluated. The certainty of evidence was evaluated, and the risk of bias was determined from the Joanna Briggs Institute checklist., Results: Fourteen articles were included, 272 wide- and 478 regular-diameter implants. One study presented a low, 3 an unclear, and 11 a high risk of bias. Meta-analyses showed no statistical difference: implant survival, short dental implants in N-RCTs (up to 1 year - RR 1.01 [0.98; 1.03], 1 to 5 years - RR 1.01 [0.94; 1.08], more than 5 years - RR 1.01 [0.97; 1.06]), extrashort dental implants in N-RCTs (RR 1.04 [0.90; 1.20]), RCTs (RR 1.05 [0.88; 1.25]); implant success in N-RCTs (RR 1.01 [0.97; 1.05]); prosthesis success in N-RCTs (RR 1.01 [0.97; 1.05])., Conclusions: Short and extrashort dental implants with a wide and regular diameter appear to be clinically appropriate options for implant-supported posterior restorations, with high survival, success, and prosthesis success rates., (Copyright © 2023 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Purpose: To investigate the influence of different denture-bearing conditions on the masticatory function and patient-reported outcome measures (PROMs) of complete denture wearers., Methods: Sixty edentulous patients were selected and allocated into two groups according to the American College of Prosthodontics' (ACP) classification: non-atrophic (NAT) (Classes I and II) (n = 24) and atrophic (AT) (Classes III and IV) (n = 36). All patients received new complete dentures (CDs). The objective variables (masticatory performance and swallowing threshold) were assessed as well as the PROMs (oral health-related quality of life (OHIP-EDENT), patient satisfaction) and quality of the prosthesis, at baseline (using the old CD) and after 4 months new prostheses use. Data were analyzed by Mann-Whitney test followed by the Generalized Equations Estimation (GEE), linear regression and Chi-square test., Results: Higher masticatory performance was observed in the NAT group (p < .05) for both time points, baseline and after 4 months. However, compared to baseline, both groups showed significant masticatory improvement after 4 months (p < .05). Satisfaction and overall quality of life improved after 4 months with no difference between groups (p > .05). Regarding the quality of the CD, baseline results were significantly (p < .05) lower in the AT group, but after 4 months, no significant differences were found between groups and in intragroup analysis (p > .05)., Conclusions: The denture-bearing conditions seems to impact masticatory function, but the PROMs are barely affected., (© 2024 John Wiley & Sons Ltd.)

Statement of Problem: Although tapered and cylindrical implants have been widely used, a consensus on which macrogeometry offers better clinical performance is lacking., Purpose: The purpose of this systematic review and meta-analysis was to evaluate the influence of different macrogeometries (tapered and cylindrical) on the clinical performance of dental implants., Material and Methods: The study was registered in the international prospective register of systematic reviews (PROSPERO) database (CRD42022347436). A search for clinical studies was conducted in 6 databases to identify randomized controlled clinical trials that evaluated the effectiveness of tapered and cylindrical implants placed in the maxilla or mandible of adult patients that had at least 1 clinical performance parameter as outcome. The risk of bias was evaluated using the revised Cochrane Risk-of-Bias Tool (RoB 2) tool. Meta-analyses on implant survival and success, marginal bone loss (MBL), implant stability (ISQ), and torque insertion (TI) were performed, with the certainty of evidence evaluated using the grading of recommendations, assessment, development, and evaluations (GRADE) checklist., Results: Of the 18 included studies, 7 had a low risk, 6 had some concerns, and 5 had a high risk of bias. Meta-analyses of survival (RR 0.99 [0.97, 1.01]; P=.38; I2=0%), implant success (RR 1.06 [0.99, 1.13] P=.08 I2=0%), 1-month MBL (MD -0.11 [-0.33, 0.10] P=.31 I2=98%), 3 months MBL (MD -0.21 [-0.27, 0.16] P=.26 I2=98%), 6 months MBL (MD -0.29 [-0.60, 0.01] P=.06 I 2 =74%), 1-year MBL (MD 0.01 [-0.07, 0.09] P=.77 I2=98%) and after 2 years MBL (MD -0.04 [-0.14, 0.07] P=.52 I2=0%), ISQ at implant installation (MD 0.35 [-0.72, 1.42] P=.52 I2=0%), %), after 2 months (MD 0.90 [-1.08, 2.87] P=.37 I2=0%) and at 1 year (MD -0.02 [-1.07, 1.03] P=.97 I2=0%), and insertion torque (MD 3.10 [-1.71, 7.92] P=.21 I2=80%) were statistically similar. However, tapered implants showed higher ISQ than cylindrical implants after 3 months (MD 1.20 [0.39, 2.01] P=.004 I2=17%). The certainty of evidence for the analyzed parameters ranged from high to very low., Conclusions: Both macrogeometries present good clinical performance, with certainty of evidence ranging from high to very low. Tapered implants showed better secondary stability at 3 months after implant installation, but with low certainty of evidence., (Copyright © 2024 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: Implant-supported single crowns are more prone to screw loosening than splinted prostheses. Therefore, the locking taper system, which has a screwless abutment, may perform better when associated with this type of rehabilitation. However, systematic reviews on this system are lacking., Purpose: The purpose of this systematic review was to evaluate the clinical performance and complications of single crowns retained by the locking taper system., Material and Methods: This systematic review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) under CRD42020189921. An electronic search was made in 5 databases and 3 other sources up to February 2021 to select prospective clinical studies evaluating the performance of single crowns retained by the locking taper system by using the outcomes implant survival, success rate, complications, marginal bone loss (MBL), and prosthesis success rate. Four meta-analyses grouped according to the follow-up intervals were performed. The risk of bias of the selected studies was evaluated by using the RoB 2 checklist for randomized controlled trials (RCTs) and Downs and Black for uncontrolled studies., Results: Twelve studies were included: 9 prospective cohort studies and 3 RCTs. A survival rate of 99% (98% to 99%) and a success rate of 97% (92% to 99%) after 5 years were found. Of the total, 2.6% biological and 2.9% prosthetic complications were described. The prosthesis success rate was 97% (96% to 98%) after 5 years. An average of -0.73 mm (-0.93 to -0.52) was found for the MBL after 5 years. The risk-of-bias assessment showed 2 RCTs with high risk and 1 RCT with low risk of bias. Among uncontrolled studies, 2 were classified as poor and 7 as fair., Conclusions: Single crowns retained by locking taper implants can be safely indicated based on the high survival and success rates achieved in the long term, the maintenance of bone level stability over time, and the low incidence of complications., (Copyright © 2022 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objective: Stress distribution assessment by finite elements analysis in poly(etheretherketone) (PEEK) implant and abutment as retainers of single crowns in the anterior region., Materials and Methods: Five 3D models were created, varying implant/abutment manufacturing materials: titanium (Ti), zirconia (Zr), pure PEEK (PEEKp), carbon fiber-reinforced PEEK (PEEKc), glass fiber-reinforced PEEK (PEEKg). A 50 N load was applied 30 o off-axis at the incisal edge of the upper central incisor. The Von Mises stress (σvM) was evaluated on abutment, implant/screw, and minimum principal stress (σmin) and maximum shear stress (τmax) for cortical and cancellous bone., Results: The abutment σvM lowest stress was observed in PEEKp group, being 70% lower than Ti and 74% than Zr. On the implant, PEEKp reduced 68% compared to Ti and a 71% to Zr. In the abutment screws, an increase of at least 33% was found in PEEKc compared to Ti, and of at least 81% to Zr. For cortical bone, the highest τmax values were in the PEEKp group, and a slight increase in stress was observed compared to all PEEK groups with Ti and Zr. For σmin, the highest stress was found in the PEEKc. Stress increased at least 7% in cancellous bone for all PEEK groups., Conclusion: Abutments and implants made by PEEKc concentrate less σvM stress, transmitting greater stress to the cortical and medullary bone., Clinical Relevance: The best stress distribution in PEEKc components may contribute to decreased stress shielding; in vitro and in vivo research is recommended to investigate this., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Statement of Problem: Evidence regarding the retention system for a mandibular overdenture is important for treatment planning. However, the clinical performance of stud and ball attachments for mandibular overdenture retainers is unclear., Purpose: The purpose of this systematic review and meta-analysis was to compare the clinical performance and self-reported patient outcomes of ball and stud attachments as mandibular overdenture retainers., Material and Methods: Randomized (RCTs) and nonrandomized (N-RCTs) controlled clinical trials were selected based on the eligibility criteria. The risk of bias was assessed by using the Cochrane Collaboration Tools, and the certainty of the evidence (COE) by using the grades of recommendation, assessment, development, and evaluation (GRADE) workshop approach. Meta-analyses according to the follow-up period were performed for implant survival, prosthetic maintenance and complications, bleeding on probing (BoP), marginal bone loss (MBL), satisfaction, and oral health-related quality of life (OHRQoL)., Results: Thirteen RCTs and 4 N-RCTs were included. Twelve studies presented a high risk of bias. The stud demonstrated a lower risk ratio (RR) (P<.001) for maintenance and complications concerning the need for matrix activation (RR 7.12 [2.65, 19.15]) (very low COE) and new overdentures (RR 2.47 [1.02, 5.96]) (moderate COE), ranging from 1 to 5 years of follow-up. Mean difference (MD) for MBL after 1 (MD 0.40 [0.28, 0.52]; P<.001) and 5 years (MD 0.18 [0.16, 0.20]; P<.001) was higher for ball attachments than that for stud (very low COE) attachments. Stud attachments also improved satisfaction (P<.001) when compared with ball attachments (very low COE). Implant survival rate (high COE), BoP (very low COE), and OHRQoL (low COE) were similar for the attachments., Conclusions: Stud and ball attachments are clinically appropriate options as mandibular overdenture retainers and are capable of restoring OHRQoL. Nevertheless, the stud showed greater improvement in satisfaction and less prosthetic aftercare and MBL., (Copyright © 2022 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Background: Hepatic epithelioid hemangioendothelioma (HEHE) is a rare neoplastic disease of varied presentation and unspecific radiological signs in the early stages. The diagnostic delay can lead to metastatic disease, thus increasing the tumor burden and reducing the treatment options. HEHE is usually deemed a slow-growing tumor, but its speed of growth is poorly reported and still unknown., Case Description: In this case report, we documented a HEHE diagnosed in a young woman who had complaints of abdominal pain, weight loss and bloating for a long time. The typical findings observed in histological studies were not promptly recognized in the histological analyzes, even after two laparoscopic-guided liver biopsies, delaying the diagnosis until extrahepatic tumor spreading. Findings observed in computed tomography, magnetic resonance imaging and histological studies are presented. The coalescence of nodules and the rising of giant masses, occupying large parts of the liver in a specific time span, were registered and quantified. As opposed to prior reports, the results show that hepatic HEHE can grow rapidly, reinforcing the need of early diagnosis, thus avoiding the complications presented herein., Conclusions: The findings observed via radiological and histological imaging that could have avoided the diagnosis delay are depicted and discussed, showing that HEHE can rise faster than previously documented., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tgh.amegroups.com/article/view/10.21037/tgh-22-48/coif). FGR reports that the study was funded by São Paulo Research Cientific Foundation (FAPESP; Grant No. 2017/25592-9), but only the Institution received the payments. None of them was done for the researcher. The researcher has received funding from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). The funding is a scholarship for researchers according to their scientific production. The other authors have no conflicts of interest to declare., (2023 Translational Gastroenterology and Hepatology. All rights reserved.)