Impact of Different Surgeons on Dental Implant Failure

PURPOSE

To assess the influence of several factors on the prevalence of dental implant failure, with special consideration of the placement of implants by different dental surgeons.

MATERIALS AND METHODS

This retrospective study is based on 2,670 patients who received 10,096 implants at one specialist clinic. Only the data of patients and implants treated by surgeons who had inserted a minimum of 200 implants at the clinic were included. Kaplan-Meier curves were stratified with respect to the individual surgeon. A generalized estimating equation (GEE) method was used to account for the fact that repeated observations (several implants) were placed in a single patient. The factors bone quantity, bone quality, implant location, implant surface, and implant system were analyzed with descriptive statistics separately for each individual surgeon.

RESULTS

A total of 10 surgeons were eligible. The differences between the survival curves of each individual were statistically significant. The multivariate GEE model showed the following variables to be statistically significant: surgeon, bruxism, intake of antidepressants, location, implant length, and implant system. The surgeon with the highest absolute number of failures was also the one who inserted the most implants in sites of poor bone and used turned implants in most cases, whereas the surgeon with the lowest absolute number of failures used mainly modern implants. Separate survival analyses of turned and modern implants stratified for the individual surgeon showed statistically significant differences in cumulative survival.

CONCLUSION

Different levels of failure incidence could be observed between the surgeons, occasionally reaching significant levels. Although a direct causal relationship could not be ascertained, the results of the present study suggest that the surgeons' technique, skills, and/or judgment may negatively influence implant survival rates.

Oral health-related quality of life in pediatric patients under general anesthesia: A prospective study

Our goal was to evaluate how dental treatments under general anesthesia (GA) affect the quality of life by a prospective pair-matched design. Pediatric patients, who had received dental treatments under GA, were enrolled and were asked to complete the Early Childhood Oral Health Impact Scale (ECOHIS) before the treatment and 1 month after the treatment. To shield the observed impacts, a pair-matched control group was performed. Patients in the control group were also required to complete the ECOHIS at these different points in time. In both groups, the items of troubled sleep and oral/dental pain scored highest, whereas avoiding smiling or laughing and avoiding talking scored lowest before the treatment. The total mean score in the 2 groups was 13.1 and 13.7, respectively, and there was no significant statistical difference (P > 0.05). However, the total mean score was 1.9 in the experimental group after the treatment and smaller compared with the control group (1.9 vs. 4.7, P < 0.001). The majority of the items in both groups had an apparent effect size and the total mean effect in the experimental group was greater than that in the control group (85.5% vs. 65.7%, P < 0.001). Therefore, dental treatment under GA could provide better quality of life restoration compared with treatment over multiple visits.

How to Bridge Research Results to Everyday Clinical Care?

Laboratory and clinical studies are essential to the advancement of sciences. However, a significant gap exists between the research findings and clinical practice. Therefore, research findings can be of little importance if their outcome cannot be directly or indirectly applied to everyday clinical care or readily translated. This paper focuses on how we can shorten the gap between the generation of new knowledge and their implementation into everyday clinical care. A new model is discussed where clinicians are the ones generating the research idea are paired with researchers. They collaborate on studies whose results are readily applicable to everyday practice. Partnering with health providers on studies that address everyday clinical research questions is a potential solution to speed up the translation of the research findings. Generating clinically applicable results can better improve the health of the public. Quoting Dr. Lawrence W. Green: "If we want more evidence-based practice, we need more practice-based evidence." This paper presents the practice-based research model as a solution to address this knowledge gap.

Mother-child interactions and young child behavior during procedural conscious sedation

BACKGROUND

As many preschoolers are not able to cooperate with health-related invasive procedures, sedation can help with the child's comfort and allow the intervention to be done. It is scarcely known how parents affect children's behavior during dental treatment under conscious sedation. The aim of this exploratory study was to analyze the association between mother-child interactions in day-to-day family life and preschool children's behavior during dental treatment under conscious sedation.

METHODS

This cross-sectional study included 27 children aged 2-6 years and their mothers. The children's behavior during dental treatment under conscious sedation was verified through the analysis of videos and using an observational scale. Social skills of mothers were verified through interviews using the Parental Educative Social Skills Interview Script (RE-HSE-P); the sum of the scores allowed the establishment of the categories "clinical" and "non-clinical". We presented descriptive analyses and bivariate associations.

RESULTS

Children's overall behavior during dental sedation was: very poor (n = 2), poor (n = 1), regular (n = 2), good (n = 9), very good (n = 9) and excellent (n = 4). Social skills varied: parental educational social skills (n = 24 clinical vs. n = 3 non-clinical); child social skills (n = 20 vs. n = 7), context variables (n = 15 vs. n = 12), negative educational practices (n = 12 vs. n = 15), child behavior problems (n = 7 vs. n = 20). There was no association between child behavior under sedation and social skills categories (P > 0.05).

CONCLUSIONS

The majority of interviewed mothers reported issues in parental educational social skills and child social skills, which did not affect the outcomes of the children's behavior during the procedural conscious sedation.

Fundamentals of occlusion and restorative dentistry. Part I: basic principles

This article presents the basic principles of dental occlusion and an overview of this subject area, which is important for dental professionals. Clinical relevance: A sound knowledge of dental occlusion is important in order to improve dental treatment outcome and achieve a long-lasting restoration.

The Interplay of Orthodontics, Periodontics, and Restorative Dentistry to Achieve Aesthetic and Functional Success

Previously dentists focused on repair and maintenance of function. However, the emphasis of many patients and dentists is now on esthetics. Often there is a need for the disciplines of orthodontics, periodontics, restorative dentistry, and maxillofacial surgery to work together in order to achieve optimum results. Currently the sequencing planning process begins with esthetics and then function, structure, and ultimately biology.

The Ability of Dental Specialists to Distinguish Lateral Incisor Metal-Free From Porcelain-Fused-to-Metal Implant Supported Crowns

The objective of this study was to evaluate the ability of dental specialists to distinguish lateral incisor metal-free from porcelain-fused-to-metal implant supported crowns in the anterior region. Five single-tooth implants in the maxillary lateral incisor region were restored with two types of implant-supported crowns (porcelain-fused-to-metal and metal-free). Photographs were presented to 20 evaluators. The evaluators had to answer whether the crown was: metal-free, porcelain-fused-to-metal or they could not tell the difference. The results showed that groups 1 (all participants), 3 (Restorative & Prosthodontic specialists), 4 (graduated 10 years) and 5 (graduated > 10 years) failed to respond correctly (P > 0.05) to which type of crown was presented to them. Group 2 (Periodontology & Implantology specialists) showed an accuracy rate of 35.6% (P = 0.009), in relation to metal-free crowns, 5.6 which is below the random index. The authors concluded that the evaluators from the 5 groups studied were unable to significantly distinguish which type of crown was used in the 10 presented situations.

Periodontal health--challenges in restorative dentistry

As the population ages and life expectancy increases, clinicians today find themselves in the wake of an ever-growing demand for high-quality aesthetic dental treatment, by increasingly informed patients. The long-term success of both cosmetic and restorative dentistry is dependent on well designed restorations and the health of the periodontal tissues. Overhanging restorations, full crown restorations with poor marginal fit, and implant-supported prosthetics with inadequate hygiene access all increase the risk for periodontal sequelae and interproximal caries. When planning restorative treatment, consideration should be given to the restorative design, the need for hygiene access and the location of intended implants. In addition, the patient's manual dexterity and ability to manipulate oral hygiene aids is a crucial consideration, as is adequate access for the hygienist to manually debride and maintain the restorations.