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Identified Studies (identified + studies)
Selected AbstractsAssessing quality in community pharmacyINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 3 2008Mrs. Devina Halsall PhD student Objective This review aimed to identify English-language instruments used to assess quality in community pharmacy and to evaluate their reported validity, reliability, feasibility and acceptability. Method A systematic review was conducted to identify literature relating to the use of instruments to assess quality in community pharmacy. The electronic databases searched included Embase, International Pharmaceutical Abstracts, Medline, e-PIC and Pharmline, covering the period of time between January 1990 and March 2007. Reference lists of identified studies and websites of pharmacy bodies were also searched. Key findings Ten instruments were identified from Canada, Malta, the UK and the US. These were used for quality-assurance and/or quality-improvement purposes and focused on: clinical governance systems; organisational culture/maturity; safety (climate and systems); effectiveness of pharmacy services; and stakeholders' feedback on services. The assessments were at different stages of development, and the majority had not been tested for construct validity, reliability and feasibility. Conclusions Assessments with high validity and reliability give a good indication of the quality of care provided and can indicate areas for improvement. Further research is needed to establish a composite view of quality in community pharmacy; and many of the instruments identified required validation. [source] Implementing cognitive services in community pharmacy: a review of facilitators used in practice changeINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 3 2006Alison S Roberts research fellow Objective To investigate facilitators of change in community pharmacy and their use in the implementation of cognitive pharmaceutical services (CPS). Method Relevant literature published in English was identified through searches of online databases (no date limits), texts, conference proceedings, and bibliographies of identified literature. Literature that involved a discussion of facilitators of community pharmacy practice change in relation to the implementation and/or delivery of CPS was selected for review. Some of the identified studies were conceptual in nature, and although they were selected in the same way as the empirical research papers, were not able to be critically reviewed in an equivalent manner. A narrative, rather than systematic review, was considered more appropriate. Key findings The identified facilitators exist at two levels: the individual (e.g. knowledge) and the organisation (e.g. pharmacy layout). Few studies identified or measured facilitators drawn from experience, with many based on the views of researchers or participants in the studies, in reaction to identified barriers to CPS implementation. Purposive sampling was common in the reviewed studies, limiting the generalisability of the findings. Conclusion Although a number of facilitators have been identified in the literature, it appears that little consideration has been given to how they can best be used in practice to accelerate CPS implementation. Identifying facilitators at both individual and organisational levels is important, and future research should focus not only on their identification in representative populations, but on how they should be incorporated into programmes for CPS delivery. [source] Living with chronic heart failure: a review of qualitative studies of older peopleJOURNAL OF ADVANCED NURSING, Issue 5 2008Doris S.F. Yu Abstract Title.,Living with chronic heart failure: a review of qualitative studies of older people Aim., This paper is a report of a systematic review of qualitative studies of how older people live with chronic heart failure. Background., Chronic heart failure is a global epidemic mainly affecting an ageing population. Understanding how older people live with this disease is important to help promote their adjustment to the distressing illness experience. Data sources., Eligible studies published in 1997,2007 were identified from several databases (Medline, CINAHL, PsycINFO and Sociological Abstracts). A manual search was conducted of bibliographies of the identified studies and relevant journals. Review methods., Two researchers independently reviewed the studies and extracted the data. Key concepts from the papers were compared for similarities and differences. The transactional model of stress was used to guide data synthesis. Findings., Fourteen qualitative studies were identified. Most described the illness experiences of older people with chronic heart failure and associated coping strategies. There was some emerging work exploring the adjustment process. The findings indicated that living with chronic heart failure was characterized by distressing symptoms, compromised physical functioning, feelings of powerlessness and hopelessness, and social and role dysfunction. There were gender differences in the way the disease was conceived. Adjustment required patients to make sense of the illness experience, accept the prognosis, and get on with living with the condition. Conclusion., Empowering older people to manage chronic heart failure, instilling hope and bolstering support system are means of promoting successful adjustment to the disease. Further research needs to explore the cultural differences in the adjustment process. [source] The experience of living with a chronic illness during adolescence: a critical review of the literatureJOURNAL OF CLINICAL NURSING, Issue 23 2008Rachel M Taylor Aims., To identify and critique literature on the adolescent lived experience of chronic illness; describe the lived experience; and to make recommendations for clinical practice. Background., Young people with chronic illness have the same developmental issues as those who are healthy. However, development can be disrupted by treatment and repeated hospitalisation. While the physical consequences of chronic illness on development have been established, the subjective personal experience is less known. Design., Literature review. Methods., Electronic databases and hand searches were made of the literature published between January 1990,September 2007. Literature was eligible for inclusion if it involved adolescents between 10,19 years, and published in English and used qualitative methods of data collection. Methodological quality was assessed using the criteria described by Cesario et al. [Journal of Obstetrics, Gynaecology and Neonatal Nursing 31 (2002) 31]. Conclusions., Twenty studies were identified involving young people with a wide variety of chronic illnesses. The study quality was variable, however, generally the majority was assessed as being good or fair. Seven common themes were found between the identified studies: developing and maintaining friendships; being normal/getting on with life; the importance of family; attitude to treatment; experiences of school; relationship with the healthcare professionals; and the future. Relevance to practice., As there was commonality in themes between studies strategies to lessen the burden of chronic illness during adolescence do not necessarily need to be disease specific. Nurses need to focus on treating the young person rather than their illness. [source] Model-based cost-effectiveness analysis of interventions aimed at preventing medication error at hospital admission (medicines reconciliation)JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 2 2009Jonathan Karnon MSc PhD Abstract Rationale, Medication errors can lead to preventable adverse drug events (pADEs) that have significant cost and health implications. Errors often occur at care interfaces, and various interventions have been devised to reduce medication errors at the point of admission to hospital. The aim of this study is to assess the incremental costs and effects [measured as quality adjusted life years (QALYs)] of a range of such interventions for which evidence of effectiveness exists. Methods, A previously published medication errors model was adapted to describe the pathway of errors occurring at admission through to the occurrence of pADEs. The baseline model was populated using literature-based values, and then calibrated to observed outputs. Evidence of effects was derived from a systematic review of interventions aimed at preventing medication error at hospital admission. Results, All five interventions, for which evidence of effectiveness was identified, are estimated to be extremely cost-effective when compared with the baseline scenario. Pharmacist-led reconciliation intervention has the highest expected net benefits, and a probability of being cost-effective of over 60% by a QALY value of £10 000. Conclusions, The medication errors model provides reasonably strong evidence that some form of intervention to improve medicines reconciliation is a cost-effective use of NHS resources. The variation in the reported effectiveness of the few identified studies of medication error interventions illustrates the need for extreme attention to detail in the development of interventions, but also in their evaluation and may justify the primary evaluation of more than one specification of included interventions. [source] Early Hepatic Artery Thrombosis after Liver Transplantation: A Systematic Review of the Incidence, Outcome and Risk FactorsAMERICAN JOURNAL OF TRANSPLANTATION, Issue 4 2009J. Bekker To clarify inconsistencies in the literature we performed a systematic review to identify the incidence, risk factors and outcome of early hepatic artery thrombosis (eHAT) after liver transplantation. We searched studies identified from databases (MEDLINE, EMBASE, Science Citation Index) and references of identified studies. Seventy-one studies out of 999 screened abstracts were eligible for this systematic review. The incidence of eHAT was 4.4% (843/21, 822); in children 8.3% and 2.9% in adults (p < 0.001). Doppler ultrasound screening (DUS) protocols varied from ,no routine' to ,three times a day.' The median time to detection was at day seven. The overall retransplantation rate was 53.1% and was higher in children (61.9%) than in adults (50%, p < 0.03). The overall mortality rate of patients with eHAT was 33.3% (range: 0,80%). Mortality in adults (34.3%) was higher than in children (25%, p < 0.03). The reported risk factors for eHAT were, cytomegalovirus mismatch (seropositive donor liver in seronegative recipient), retransplantation, arterial conduits, prolonged operation time, low recipient weight, variant arterial anatomy, and low volume transplantation centers. eHAT is associated with significant graft loss and mortality. Uniform definitions of eHAT and uniform treatment modalities are obligatory to confirm these results and to obtain a better understanding of this disastrous complication. [source] Electrical stimulation as an adjunct to spinal fusion: A meta-analysis of controlled clinical trialsBIOELECTROMAGNETICS, Issue 7 2002Masami Akai Abstract This study was a meta-analysis to examine whether electrical stimulation has a specific effect on spinal fusion. Little evidence exists on the efficacy of electrical stimulation for improving fusion rate of spinal fusion surgery. Using MEDLINE (1966,2000) and EMBASE (1985,1999), a search for articles was carried out using the Medical Subject Headings: (1) electric stimulation or electromagnetic fields, (2) spinal fusion, (3) controlled or clinical trial, and (4) human. Data were extracted from all the hit articles and additionally collected from appropriate journal lists. A total of five randomized controlled trials (RCT) on bones assessing healing of spinal fusion were identified and scored on methodological quality. All the identified studies reported positive findings, but the quality score of each trial showed wide flaws. Because of relatively homogenous subjects who had spine fusion and radiographic assessment from these studies, pooling of the data was able to be performed. Excluding one trial with the lowest score, the combined results of four trials, whose major endpoints were the success rate of the fusion, revealed a statistically significant effect of electrical stimulation with various techniques, but the selected trials still showed wide variation in view of stimulation modalities and treatment protocol. The pooled result of the studies in this review revealed the efficacy of electrical stimulation based on proved methodological quality. As problems on therapeutic modality and protocol remain, there is a further need for improvement in design to constitute acceptable proof and to establish treatment programs that better demonstrate electrical stimulation effects on spinal fusion. Bioelectromagnetics 23:496,504, 2002. © 2002 Wiley-Liss, Inc. [source] Evidence-Based Strategies for Reducing Cesarean Section Rates: A Meta-AnalysisBIRTH, Issue 1 2007Nils Chaillet PhD ABSTRACT: Background: Canada's cesarean section rate reached an all-time high of 22.5 percent of in-hospital deliveries in 2002 and was associated with potential maternal and neonatal complications. Clinical practice guidelines represent an appropriate mean for reducing cesarean section rates. The challenge now lies in implementing these guidelines. Objectives of this meta-analysis were to assess the effectiveness of interventions for reducing the cesarean section rate and to assess the impact of this reduction on maternal and perinatal mortality and morbidity. Methods: The Cochrane Library, EMBASE, and MEDLINE were consulted from January 1990 to June 2005. Additional studies were identified by screening reference lists from identified studies and expert suggestions. Studies involving rigorous evaluation of a strategy for reducing overall cesarean section rates were identified. Randomized controlled trials, controlled before-and-after studies, and interrupted time series studies were evaluated according to Effective Practice and Organisation of Care Group criteria. Results: Among the 10 included studies, a significant reduction of cesarean section rate was found by random meta-analysis (pooled RR = 0.81 [0.75, 0.87]). No evidence of publication bias was identified. Audit and feedback (pooled RR = 0.87 [0.81, 0.93]), quality improvement (pooled RR = 0.74 [0.70, 0.77]), and multifaceted strategies (pooled RR=0.73 [0.68, 0.79]) were effective for reducing the cesarean section rate. However, quality improvement based on active management of labor showed mixed effects. Design of studies showed a higher effect for noncontrolled studies than for controlled studies (pooled RR = 0.76 [0.72, 0.81] vs 0.92 [0.88, 0.96]). Studies including an identification of barriers to change were more effective than other interventions for reducing the cesarean section rate (pooled RR = 0.74 [0.71, 0.78] vs 0.88 [0.82, 0.94]). Among included studies, no significant differences were found for perinatal and neonatal mortality and perinatal and maternal morbidity with respect to the mode of delivery. Only 1 study showed a significant reduction of neonatal and perinatal mortality (p < 0.001). Conclusions: The cesarean section rate can be safely reduced by interventions that involve health workers in analyzing and modifying their practice. Our results suggest that multifaceted strategies, based on audit and detailed feedback, are advised to improve clinical practice and effectively reduce cesarean section rates. Moreover, these findings support the assumption that identification of barriers to change is a major key to success. (BIRTH 34:1 March 2007) [source] A systematic review of the survival and complication rates of resin-bonded bridges after an observation period of at least 5 yearsCLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2008Bjarni E. Pjetursson Abstract Objectives: The objectives of this systematic review were to assess the 5-year survival of resin-bonded bridges (RBBs) and to describe the incidence of technical and biological complications. Methods: An electronic Medline search complemented by manual searching was conducted to identify prospective and retrospective cohort studies on RBBs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data extraction were performed independently by two reviewers. Failure and complication rates were analyzed using random-effects Poissons regression models to obtain summary estimates of 5-year proportions. Results: The search provided 6110 titles and 214 abstracts. Full-text analysis was performed for 93 articles, resulting in 17 studies that met the inclusion criteria. Meta-analysis of these studies indicated an estimated survival of RBBs of 87.7% (95% confidence interval (CI): 81.6,91.9%) after 5 years. The most frequent complication was debonding (loss of retention), which occurred in 19.2% (95% CI: 13.8,26.3%) of RBBs over an observation period of 5 years. The annual debonding rate for RBBs placed on posterior teeth (5.03%) tended to be higher than that for anterior-placed RBBs (3.05%). This difference, however, did not reach statistical significance (P=0.157). Biological complications, like caries on abutments and RBBs lost due to periodontitis, occurred in 1.5% of abutments and 2.1% of RBBs, respectively. Conclusion: Despite the high survival rate of RBBs, technical complications like debonding are frequent. This in turn means that a substantial amount of extra chair time may be needed following the incorporation of RBBs. There is thus an urgent need for studies with a follow-up time of 10 years or more, to evaluate the long-term outcomes. [source] A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 yearsCLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2004II. Combined tooth, implant-supported FPDs Abstract Objectives: The objective of this systematic review was to assess the 5- and 10-year survival of combined tooth,implant-supported fixed partial dentures (FPDs) and the incidence of biological and technical complications. Methods: An electronic MEDLINE search supplemented by manual searching was conducted to identify prospective and retrospective cohort studies on FPDs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data abstraction was performed independently by two reviewers. Failure and complication rates were analyzed using random-effects Poisson regression models to obtain summary estimates of 5- and 10-year survival proportions. Results: From a total of 3844 titles and 560 abstracts, 176 articles were selected for full-text analysis, and 13 studies met the inclusion criteria. Meta-analysis of these studies indicated an estimated survival of implants in combined tooth,implant-supported FPDs of 90.1% (95 percent confidence interval (95% CI): 82.4,94.5%) after 5 and 82.1% (95% CI: 55.8,93.6%) after 10 years. The survival rate of FPDs was 94.1% (95% CI: 90.2,96.5%) after 5 and 77.8% (95% CI: 66.4,85.7%) after 10 years of function. There was no significant difference in survival of tooth and implant abutments in combined tooth,implant FPDs. After an observation period of 5 years, 3.2% (95% CI: 1.5,7.2%) of the abutment teeth and 3.4% (95% CI: 2.2,5.3%) of the functionally loaded implants were lost. After 10 years, the corresponding proportions were 10.6% (95% CI: 3.5,23.1%) for the abutment teeth and 15.6% (95% CI: 6.5,29.5%) for the implants. After a 5 year observation period, intrusion was detected in 5.2% (95% CI: 2,13.3%) of the abutment teeth. Intrusion of abutment teeth were almost exclusively detected among non-rigid connections. Conclusion: Survival rates of both implants and reconstructions in combined tooth,implant-supported FPDs were lower than those reported for solely implant-supported FPDs (Pjetursson et al. 2004). Hence, planning of prosthetic rehabilitation may preferentially include solely implant-supported FPDs. However, anatomical aspects, patient centered issues and risk assessments of the residual dentition may still justify combined tooth,implant-supported reconstructions. It was evident from the present search that tooth,implant-supported FPDs have not been studied to any great extent and hence, there is a definitive need for more longitudinal studies examining these reconstructions. Résumé L'objectif de cette revue systématique a été de vérifier la survie à cinq et dix années de prothèses partielles fixées portées sur implants et dents et l'incidence des complications techniques et biologiques. Une recherche Medline ainsi que manuelle ont identifié les études prospectives et rétrospectives avec un suivi d'au minimum cinq années. Les patients avaient dû subir un examen clinique lors de ce suivi. L'identification des études et l'analyse des données ont été effectuées indépendamment par deux personnes. Les taux d'échecs et de complications ont été analysés en utilisant les modèles de régression Poisson avec effets hasard pour obtenir des estimations à cinq et dix ans. De 3 844 titres et 560 résumés, 176 articles ont été sélectionnés pour l'analyse approfondie et treize études atteignaient les critères d'inclusion. La méta-analyse de ces études indiquaient une estimation de survie des implants en combinaison des prothèses fixées sur implants et dents de 90,1%(intervalle de confidence 95% : 82,4 à 94,5%) après cinq années et de 82,1% (55,8 à 93,6% après dix années. Le taux de survie de ces prothèses étaient de 94,1% (90,2 à 96,5%) après cinq ans et de 77,8% (66,4 à 85,7%) après dix années. Il n'y avait aucune différence significative dans la survie des piliers dentaires et implantaires dans ces prothèses sur implants et dents. Après une observation de cinq années, 3,2% (1,5 à 7,2%) des piliers dentaires et 3,4% (2,2 à 5,3%) des implants ont été perdus. Après dix années, les proportions correspondantes étaient de 10,6 % (3,5 à 23,1%) pour les dents et de 15,6%(6,5%à 29,5%) pour les implants. Après une observation de cinq années, l'intrusion a été détectée dans 5,2% (2,0 à 13,3%) des dents piliers. L'intrusion des dents piliers étaient presque exclusivement détectée le long des connexions non-rigides. Le taux de survie de ces prothèses sur pilier dents et implants étaient inférieur à celui rapporté pour le même type de prothèse seulement placé sur implants (Pjetursson et al. 2004). Le plan de prothèse pourrait donc avoir une préférence pour ne placer des prothèses que sur des implants. Cependant les aspects anatomiques, le respect du patient et les risques pour la dentition résiduelle peuvent justifier les reconstructions sur implants et dents. Il était évident que lors de la recherche présente les bridges sur implants et dents n'avaien pas été beaucoup étudiés; il s'avère donc nécessaire de débuter davantage d'études longitudinales. Zusammenfassung Ziel: Ziel dieser systematischen Übersicht war einerseits die Bestimmung der Überlebenszeit von kombiniert zahn-implantat-getragenem festsitzendem Zahnersatz (FPDs) nach 5 und 10 Jahren und andererseits die Häufigkeit von biologischen und technischen Komplikationen zu beschreiben. Methoden: Man führte eine manuell ergänzte elektronische Medline-Suche durch, um prospektive und retrospektive Kohortenstudien über FPDs mit einer durchschnittlichen Beobachtungszeit von mindestens 5 Jahren zu identifizieren. Die Patienten mussten bei den Nachkontrollen auch klinisch untersucht worden sein. Die Aufnahme der ausgewählten Studien und die Abstraktion der Daten wurde von zwei Personen unabhängig voneinander durchgeführt. Mit Hilfe eines Poission Regressionsmodells analysierte man die Misserfolgs- und Komplikationsraten und erhielt so zusammenfassende schätzwerte für die über lebenswahrscheindichkeit nach 5 und 10 Jahren. Resultate: Die Suche lieferte 3844 Titel und 560 Abstracts. Die Analyse des gesamten Textes erfolgte bei 176 Artikeln, von denen aus 13 Studien, die Einschlusskriterien erfüllten. Die Meta-Analyse dieser Studien ergab eine geschätzte Überlebensrate der Implantate in gemischt zahn-implantat-getragenen FPDs von 90.1% (95% CI: 82.4,94.5%) nach 5 Jahren und 82.1% (95% CI: 55.8,93.6%) nach 10 Jahren. Die Überlebensrate der FPDs betrug 94.1% (95% CI: 90.2,96.5%) nach 5 Jahren und 77.8% (95% CI: 66.4,85.7%) nach 10 Jahren in Funktion. Man fand bei den kombiniert zahn-implantat-getragenen FPDs keine signifikanten Unterschiede bei der Überlebensrate von Zahn- und Implantatpfeilern. Nach einer Beobachtungszeit von 5 Jahren waren 3.2% (95% CI: 1.5,7.2%) der Pfeilerzähne und 3.4% (95% CI: 2.2,5.3%) der funktionell belasteten Implantate verloren gegangen. Nach 10 Jahren betrugen die entsprechenden Werte 10.6% (95% CI: 3.5,23.1%) für die Pfeilerzähne und 15.6% (95% CI: 6.5,29.5%) für die Implantate. Nach einer Beobachtungszeit von 5 Jahren konnte man bei 5.2% (95% CI: 2,13.3%) der Pfeilerzähne eine Intrusion feststellen. Eine Intrusion war fast ausschliesslich bei nicht-starren Verbindungen festzustellen. Zusammenfassung: Die Überlebensraten für Implantate und Rekonstruktionen in kombiniert zahn-implantat-getragenen FPDs waren tiefer als die, welche in der Partnerstudie (Pjetursson et al. 2004) für allein implantat-getragene FPDs festgestellt worden sind. Daher müsste die Planung von prothetischen Rehabilitationen eigentlich vorzüglich mit rein implantat-getragenen FPDs durchgeführt werde. Anatomische Aspekte, patientenspezifische Gründe und die Risikoanalysen der Restbezahnung können aber weiterhin kombiniert zahn-implantat-getragene Rekonstruktionen rechtfertigen. Bei dieser Untersuchung wurde klar, dass die zahn-implantat-getragenen FPD's noch nicht in grösserem Ausmass studiert worden sind, was einen dringenden Bedarf an weiteren Lanzeitstudien, die diese Rekonstruktionen erforschen, zeigt. Resumen Objetivos: El objetivo de esta revisión sistemática fue valorar la supervivencia de dentaduras parciales fijas soportadas por implantes (FPDs) y describir la incidencia de complicaciones biológicas y técnicas. Métodos: Se llevó a cabo una búsqueda electrónica por Medline complementada con una búsqueda manual para identificar estudios cohorte prospectivos y retrospectivos acerca de FPDs con un tiempo de seguimiento medio de al menos 5 años. Los pacientes tenían que haber sido examinados clínicamente en la visita de seguimiento. La valoración de los estudios encontrados y de la abstracción de datos se llevó a cabo independientemente por dos revisores. Los índices de fracaso y complicación se analizaron usando modelos de regresión de efectos aleatorios de Poisson para obtener estimaciones de los sumarios de las proporciones de supervivencia a los 5 y 10 años. Resultados: De un total de 3844 títulos y 560 resúmenes, se seleccionaron 176 artículos para análisis, y 13 estudios coincidieron con los criterios de inclusión. Un meta análisis de estos estudios indicaron una supervivencia estimada de los implantes en FPDs soportados por dientes e implantes combinados del 90.1% (95% CI: 82.4,94.5%) tras 5 años, y 82.1% (95% CI: 55.8,93.6%) tras 10 años. El índice de supervivencia de los FPDs fue del 94.1% (95% CI: 90.2,96.5%) tras 5 años, y 77.8% (95% CI: 66.4,85.7%) tras 10 años en función. No hubo diferencias significativas en la supervivencia de los pilares de implantes o dientes en FPDs de dientes e implantes combinados. Tras un periodo de observación de 5 años, el 3.2% (95% CI: 1.5,7.2%) de los dientes pilares y 3.4% (95% CI: 2.2,5.3%) de los implantes en carga funcional se perdieron. Tras 10 años, las proporciones correspondientes fueron del 10.6% (95% CI: 3.5,23.1%) para los dientes pilares y 15.6% (95% CI: 6.5,29.5%) para los implantes. Tras un periodo de observación de 5 años, se detectó intrusión en 5.2% (95% CI: 2,13.3%) de los dientes pilares. La intrusión de los dientes pilares se casi exclusivamente detectada entre las conexiones no rígidas. Conclusión: Los índices de supervivencia de los implantes y las reconstrucciones en FPDs soportadas por dientes e implantes combinados fueron menores que los reportados para FPDs soportados por implantes únicamente (Pjetursson et al. 2004). Por lo tanto, la planificación de la rehabilitación prostética puede incluir preferentemente FPDs soportados solo por implantes. De todos modos, los aspectos anatómicos, las necesidades exactas del paciente y las valoraciones de riesgo de la dentición residual pueden todavía justificar las reconstrucciones soportadas por dientes e implantes combinados. Fue evidente de la presente búsqueda que los FPDs soportados por dientes e implantes no han sido estudiados extensamente y por lo tanto, existe definitivamente una necesidad para mas estudios longitudinales que examinen estas reconstrucciones. [source] | ||||||||||