Available online ---KEYWORDS bleaching; carbamide peroxide; hydrogen peroxide; restorative material Abstract In recent years, there has been an increased demand for improvement in the appearance of natural teeth. The conservative technique of tooth bleaching has gained attention and acceptance from both patients and clinicians. Despite increased popularity, there is controversy surrounding the adverse effects of bleaching on dental restorative materials. This article reviews the effects of bleaching agents on major categories of dental restorative materials and provides evidence-based recommendations to the clinicians and researchers. Current literature reveal that bleaching might have a detrimental effect on restorative materials. However, because of the variability in experimental design, there is a lack of consensus concerning the bleaching effects on restorative materials. A standardized and reproducible guideline for assessment of bleaching effects on restorative materials needs to be established and verified by future studies.

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Background The aim of this study is to evaluate the implant survival/success rate, gain in alveolar bone height, crestal bone loss, and complications associated with implants placed in the posterior maxilla after osteotome sinus floor elevation without bone substitutes. Methods The electronic databases, such as MEDLINE, EMBASE, CENTRAL, and SCOPUS were systematically and manually searched for publications in peer-reviewed journals. The included articles were subjected to qualitative and quantitative analyses, and the meta-analysis was carried out for single-arm studies. Methodological quality assessment was made for all the included studies. Results The included studies were of moderate quality, with the overall implant success and survival rates of 98.3% and 97.9% respectively. The most frequent intra-surgical complication was sinus membrane perforation, accounting for 3.08% of the total implants with reported perforations. The overall crestal bone loss in patients with immediate implants placed with OSFE after a 5-year follow-up was 0.957 mm 95%CI (0.538, 1.377). Conclusion Within the limitations of this review, it can be concluded that the survival and success rates of implants placed immediately along with OSFE without any bone substitutes are acceptable and show adequate implant stability with less crestal bone loss over 5 years.

Clinicians treating overdenture patients need to know if immediate loading and conventional loading results in similar outcomes. This study aimed to perform a systematic literature search of studies comparing immediate and conventional loading of mandibular overdentures irrespective of the number of implants and conduct a meta-analysis of implant failure and marginal bone loss (MBL). A literature search of PubMed, ScienceDirect, Ovoid, Springer, and Google Scholar databases was performed for randomized controlled trials (RCTs) comparing immediate vs conventional loading of mandibular overdentures. The primary outcome was implant failure and the secondary outcome was marginal bine loss (MBL). A descriptive analysis was performed for other outcomes. Thirteen trials were included. Only one trial compared the immediate and delayed loading of single implant-supported overdenture. Seven trials used two implants, one trial used three implants while four trials used four implants. Meta-analysis indicated no statistically significant difference in implant failure and MBL between immediate and conventional loading of two-implant and four-implant supported overdentures. Descriptive analysis indicated no difference in peri-implant tissue indices, implant stability, and quality of life outcomes between the two loading protocols.There may be no difference in implant failure and MBL with immediate loading or conventional loading of two and four-implant supported mandibular overdentures. Literature review indicates that there may be no difference in peri-implant tissue indices, implant stability, and QoL outcomes between the two loading protocols. The overall quality of evidence is moderate. Further, adequately powered RCTs are required to strengthen the evidence.

Objective: The current review aimed to assess the efficacy of adjunctive chlorhexidine (CHX) in the non-surgical treatment of peri-implantitis/peri-implant mucositis. Methods: PubMed, Embase, Science Direct, CENTRAL, and Google Scholar databases were searched up to 10th March 2022 for relevant randomized controlled trials or controlled clinical trials. Results: Fourteen studies were included. Meta-analysis revealed significantly lower probing depths in peri-implant mucositis patients using CHX adjuncts as compared to controls (SMD: -1.49 95% CI: -2.56, -0.42 I2=95% p=0.006). However, the same effect was not noted in peri-implantitis (SMD: -1.18 95% CI: -0.04, 2.40 I2=96% p=0.06). CHX was not found to improve bleeding of probing in peri-implant mucositis while sufficient data was unavailable for peri-implantitis. Results on other outcome variables were conflicting. Conclusion: Evidence on the efficacy of adjunctive CHX for peri-implant mucositis is conflicting. Similarly, strong conclusions on the effect of CHX for peri-implantitis cannot be drawn due to limited number of studies. Overall, there seems to be a trend of non-significant impact of CHX on outcomes of peri-implant mucositis as well as peri-implantitis. doi: https://doi.org/10.12669/pjms.39.2.7253 How to cite this: Ye M, Liu W, Cheng S, Yan L. Efficacy of Adjunctive Chlorhexidine in non-surgical treatment of Peri-Implantitis/Peri-Implant Mucositis: An updated systematic review and meta-analysis. Pak J Med Sci. 2023;39(2):---------. doi: https://doi.org/10.12669/pjms.39.2.7253 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.