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Percorrer por autor "Morena, Danilo"

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  • Comparative clinical behavior of zirconia versus titanium dental implants: a systematic review and meta-analysis of randomized controlled trials
    Publication . Morena, Danilo; Leitão-Almeida, Bruno; Pereira, Miguel; Resende, Rodrigo; Fernandes, Juliana Campos Hasse; Fernandes, Gustavo Vicentis Oliveira; Borges, Tiago
    Objective: The goal of this systematic review and meta-analysis was to assess whether there were clinically relevant differences in the treatment of edentulous areas comparing zirconia (Zr) and titanium (Ti) dental implants. The null hypothesis is that no differences can be observed in terms of the clinical parameters; the positive hypothesis I is that Zr implants have generally better results compared to Ti implants; and the positive hypothesis II is that Ti implants have a generally superior result than Zr implants. Methods: This review work was registered on the PROSPERO platform, and its development was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The electronic search process was conducted on three databases (PubMed/Scopus/Web of Science), including randomized controlled trials (RCTs) from the past 10 years (up to April 2024). Identified articles were analyzed and included/excluded based on pre-defined selection and exclusion criteria. The quality assessment and risk of bias were evaluated using a Cochrane risk-of-bias assessment tool specifically designed for randomized trials (RoB2). A meta-analysis was conducted to correlate different treatment options based on the described outcomes; a random-effects model was used in the analysis of the variables. The analysis of heterogeneity was conducted by means of Cochran’s Q-test and Higgins’ I2 statistic. Results: Six RCTs were enrolled; 152 patients (90 males and 62 females) and 448 implants (267 Zr and 181 Ti) were included. Dental implant placement involved both the maxillary and mandibular arches. The implant sites showed heterogeneity in receiving Zr and Ti dental implants; in particular, 22 dental implants were placed in the mid-palatal region and 426 dental implants in the alveolar region (255 were in Zr and 171 in Ti). Regarding the success rate, it was better for Zr but with no statistical difference (p > 0.05); bleeding on probing had slight differences between Ti with 0.34% ± 0.42 and Zr with 0.26% ± 0.36 (p > 0.05); plaque score showed 0.46 ± 0.47 for Ti compared to 0.44 ± 0.49 for Zr (p > 0.05); no statistically significant difference was observed for pink esthetic score (PES). Statistically significant results were found for survival rate, which favored Ti implants (77.6%) compared to Zr (70.3%) (p < 0.05), and for marginal bone loss, which showed less loss in Ti implants (0.18 mm ± 0.47) compared to 0.42 mm ± 0.40 in Zr at 12 months (p < 0.001). Conclusions: The present systematic review and meta-analysis identified the positive hypothesis I and rejected the null and positive hypothesis II; it was possible to conclude that Ti dental implants have a better survival rate and less marginal bone loss than Zr dental implants after 1-year follow-up.
    2024-07-31Artigo científico Acesso aberto Ver mais
  • Comparative outcomes between zirconia and titanium dental implants : a systematic review and meta-analysis of the literature
    Publication . Morena, Danilo; Borges, Tiago Gonçalves Ferreira; Almeida, Bruno Alexandre Morais Leitão de
    Introduction: In a world where the concept of "Metal Free" is becoming increasingly widespread, there is an observed rise in titanium allergies and hypersensitivity reactions related to titanium particles around implants. Consequently, the use of zirconia implants is being promoted. Despite titanium remaining the gold standard, there are clinical situations that require a different approach. This systematic review and meta-analysis aimed to assess whether there were clinically relevant differences in the treatment of edentulous areas between Zr dental implants and the established use of Ti dental implants. Materials and methods: This review work was registered on the PROSPERO platform, and its development was conducted in accordance with the PRISMA statement. The electronic search process was conducted on three databases (PubMed/Scopus/Web of Science), including randomized clinical trials from the past 10 years (up to April 2024). Identified articles were analyzed and included/excluded based on pre-defined selection and exclusion criteria. Results: Six randomized clinical trials with a follow-up of at least 3 months (152 patients and 448 implants) were selected. Significant differences were found in values related to survival rate and marginal bone loss at 12 months between Zr and Ti implants, necessitating further improvements in Zr implants and appropriate selection based on the prosthetic protocol. Conclusion: After careful analysis of the results obtained and within the limitations of this systematic review, it was possible to conclude that Ti dental implants have a better survival rate and inferior marginal bone loss when compared with Zr dental implants. Further randomized clinical studies comparing these two different implant materials with a long-term follow-up evaluation are needed.
    2024-07-16Dissertação de mestrado Acesso restrito Ver mais