A systematic review and meta-analysis was performed to analyze the survival of onlay restorations in the posterior region, their clinical behavior according to the material used (ceramic reinforced with lithium disilicate, conventional feldspathic ceramic or reinforced with leucite; hybrid materials and composite), possible complications, and the factors influencing restoration success. The systematic review was based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement, without publication date or language restrictions. An electronic search was made in the PubMed, Scopus, Embase, and Cochrane databases. After discarding duplicate publications and studies that failed to meet the inclusion criteria, the articles were selected based on the population, intervention, comparison, outcome (PICO) question. The following variables were considered in the qualitative and quantitative analyses: restoration survival rate (determined by several clinical parameters), the influence of the material used upon the clinical behavior of the restorations, and the complications recorded over follow-up. A total of 29 articles were selected for the qualitative analysis and 27 for the quantitative analysis. The estimated restoration survival rate was 94.2%. The predictors of survival were the duration of follow-up (beta = −0.001; p = 0.001) and the onlay material used (beta = −0.064; p = 0.028). Composite onlays were associated with a lower survival rate over time. Onlays are a good, conservative, and predictable option for restoring dental defects in the posterior region, with a survival rate of over 90%. The survival rate decreases over time and with the use of composite as onlay material.
Immunoglobulin A (IgA), which is the first line of defense against upper respiratory tract viruses, has been related with training load management. This article aimed to systematically identify and summarize (1) the studies that have found a relationship between training load and salivary IgA in team sports, and (2) the studies that have highlighted a relationship between IgA and upper respiratory tract infection (URTI) in team sports. A systematic review of relevant articles was carried out using two electronic databases (PubMed and WoK) until 3 October 2020. From a total of 174 studies initially found, 24 were included in the qualitative synthesis. This systematic review confirmed that lower values of IgA occurred after greater training load (intensity/volume) and congested periods. In this scenario, a low level of IgA was correlated with higher URTI, which makes training load management mandatory to healthcare avoiding immunosuppression. Therefore, physical fitness and conditioning coaches should carefully manage training load progression, avoiding high-intensity sessions in two consecutive days. In addition, they should not program high-intensity training sessions during at least the two days following competition.
Purpose: The objective of this prospective randomized clinical trial (RCT) was to analyze and compare the clinical behavior of three types of prosthesis supported by single implants in the posterior region after three years of functional loading. Materials and methods: Seventy-five implants were divided into three groups according to the type of prosthetic restoration: screw-retained crown (group GS); cemented crown without finishing line (biologically oriented preparation technique) (group GBOPT); and conventional cemented crown with finishing line (group GCC). After three years in function, clinical parameters (presence of keratinized mucosa, probing depths, bleeding on probing, and radiographic bone loss) were compared between the three experimental groups. The possible correlation between soft tissue clinical parameters and bone loss was also analyzed. Results: Statistical analysis found significant differences in clinical parameters between the different types of crown, with the cemented restoration without finishing line (BOPT) presenting fewer complications and better peri-implant health outcomes including: significantly different KMW data (mm), with significant differences between groups GBOPT and GCC (p < 0.001, Kruskal–Wallis test), with GBOPT obtaining larger quantities of keratinized mucosa (KM); statistically significant differences in probing depth (PD) values between groups GBOPT and GCC (p = 0.010, Kruskal–Wallis test); significant differences in bleeding on probing (BOP) between groups GBOPT and GCC (p = 0.018, Chi2 test) in favor of GBOPT. Conclusions: Soft tissue behavior around implants is related to the type of prosthetic restoration used, with cemented prostheses with BOPT presenting better peri-implant soft tissue behavior.
Objective: To evaluate the influence of implant length on marginal bone loss, comparing implants of 4 mm, 6 mm, and >8 mm, supporting two splinted crowns after 36-month functional loading. Materials and Methods: this retrospective clinical trial evaluated the peri-implant behavior of splinted crowns (two per case) on pairs of implants of the same length placed in the posterior maxilla (molar area). Implants were divided into three groups according to length (Group 1: extra-short 4 mm; Group 2: short 6 mm; Group 3: conventional length >8 mm). Marginal bone loss was analyzed using standardized periapical radiographs at the time of loading and 36 months later. Results: 24 patients (19 women and 5 men) were divided into three groups, eight rehabilitations per group, in the position of the maxillary first and second molars. The 48 Straumann® Standard Plus (Regular Neck (RN)/Wide Neck (WN)) implants were examined after 36 months of functional loading. Statistical analysis found no significant differences in bone loss between the three groups (p = 0.421). No implant suffered biological complications or implant loss. Long implants were associated with less radiographic bone loss. Conclusions: extra-short (4 mm); short (6 mm); and conventional length (>8 mm) implants in the posterior maxilla present similar peri-implant bone loss and 100% survival rates in rehabilitation, by means of two splinted crowns after 36 months of functional loading. Implants placed in posterior positions present better bone loss results than implants placed in anterior positions, regardless of the interproximal area where bone loss is measured. Conventional length (>8 mm) implants show better behavior in terms of distal bone loss than short (6 mm) and extra-short (4 mm) implants.
Immunoglobulin A (IgA), which is the main effector against upper respiratory tract viruses such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been related to training load management. The aim of this systematic review was to establish the relationship between training load and salivary IgA based on current evidence in order to avoid immunosuppression after exercise and players´ vulnerability to virus contagion. A systematic review of relevant articles was carried out using two electronic databases (PubMed and Web of Science) until 19 May 2021. From a total of 127 studies initially found, 23 were included in the qualitative synthesis. These studies were clustered depending on stress level. The salivary IgA was analysed considering soccer-specific treadmill exercise and repeated sprint drills (n = 5), matches (n = 7), and during certain periods during the season or pre-season (n = 11). Repeated sprint ability tests and treadmill exercises are suitable exercises for the first steps on return to play periods yet still maintain social distance. A rest or moderate training sessions (technical/tactical) are suggested after official matches to ensure 16–18 h to recover IgA levels, while periods with multiple matches per week with limited recovery time should be avoided. Weekly training load should assume a small increment (<10%) to ensure IgA immune responses, especially, during the post coronavirus disease 2019 (COVID-19) season.
Rehabilitation with dental implants is not always possible due to the lack of bone quality or quantity, in many cases due to bone atrophy or the morbidity of regenerative treatments. We find ourselves in situations of performing dental prostheses with cantilevers in order to rehabilitate our patients, thus simplifying the treatment. The aim of this study was to analyze the mechanical behavior of four types of fixed partial dentures with posterior cantilevers on two dental implants (convergent collar and transmucosal internal connection) through an in vitro study (compressive loading and cyclic loading). This study comprised four groups (n = 76): in Group 1, the prosthesis was screwed directly to the implant platform (DS; n = 19); in Group 2, the prosthesis was screwed to the telescopic interface on the implant head (INS; n = 19); in Group 3, the prosthesis was cemented to the telescopic abutment (INC; n = 19); and in Group 4, the prosthesis was cemented to the abutment (DC; n = 19). The sets were subjected to a cyclic loading test (80 N load for 240,000 cycles) and compressive loading test (100 KN load at a displacement rate of 0.5 mm/min), applying the load until failure occurred to any of the components at the abutment–prosthesis–implant interface. Subsequently, an optical microscopy analysis was performed to obtain more data on what had occurred in each group. Results: Group 1 (direct screw-retained prosthesis, DS) obtained the highest mean strength value of 663.5 ± 196.0 N. The other three groups were very homogeneous: 428.4 ± 63.1 N for Group 2 (INS), 486.7 ± 67.8 N for Group 3 (INC), and 458.9 ± 38.9 N for Group 4 (DC). The mean strength was significantly dependent on the type of connection (p < 0.001), and this difference was similar for all of the test conditions (cyclic and compressive loading) (p = 0.689). Implant-borne prostheses with convergent collars and transmucosal internal connections with posterior cantilevers screwed directly to the implant connection are a good solution in cases where implant placement cannot avoid extensions.