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Curado TFF, Nascimento LN, Silva JR, de Paula MS, Schimmel M, McKenna G, Leles CR. Mandibular overdenture retained by four one-piece titanium-zirconium mini implants: A 2-year RCT on patient-reported outcomes. J Dent 2024; 149:105267. [PMID: 39067647 DOI: 10.1016/j.jdent.2024.105267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 07/22/2024] [Accepted: 07/23/2024] [Indexed: 07/30/2024] Open
Abstract
AIM The positive impact of implant interventions on dental patient-reported outcomes is an essential parameter of treatment effectiveness. This study assessed the 2-year changes in patient satisfaction and oral health-related quality of life (OHRQoL) of edentulous patients treated with a four mini implant mandibular overdenture (IOD) METHODS: The study was planned as a 2 × 2 factorial randomized clinical trial that tested two surgical approaches (flapped or flapless) and two loading protocols (immediate and delayed) using a titanium-zirconium mini implant (Straumann Mini Implant System®) and a PEEK retentive system (Straumann® Optiloc® Retentive System). Outcome measures (OHIP-Edent scores and the McGill Denture Satisfaction questionnaire) were assessed before treatment and at the 3-, 6-, 12-, and 24-month follow-ups. The Friedman test and multiple regression using Generalized Estimating Equations (GEE) were used for data analysis, considering the per-protocol (PP) and intention-to-treat (ITT) approaches RESULTS: Seventy-four patients were randomized to the study groups. No implant failure occurred during the study period. Marked improvement in all post-treatment periods compared to baseline were observed for the two outcomes. No significant effect of patient's gender, age, and surgical protocol on the study outcomes. The effect of treatment provision was significant for the two outcomes in the PP and ITT approaches (p < 0.001). A barely significant positive effect of the immediate loading was observed for OHIP-Edent in the PP approach (p = 0.020) CONCLUSION: IOD treatment significantly improved patient-reported outcomes measures, with sustained benefits over the two years of overdenture use, and can be considered a promising treatment option in for the edentulous mandible.
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Affiliation(s)
| | | | | | | | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine of the University of Bern, Bern, Switzerland; Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Gerald McKenna
- Centre for Public Health, Queen's University Belfast, Belfast, UK; Clinic of General, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Cláudio Rodrigues Leles
- School of Dentistry, Federal University of Goias, Goiania, Brazil; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine of the University of Bern, Bern, Switzerland; Clinic of General, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
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Sun H, Yin X, Yang C, Kuang H, Luo W. Advances in autogenous dentin matrix graft as a promising biomaterial for guided bone regeneration in maxillofacial region: A review. Medicine (Baltimore) 2024; 103:e39422. [PMID: 39183415 PMCID: PMC11346879 DOI: 10.1097/md.0000000000039422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 08/01/2024] [Accepted: 08/02/2024] [Indexed: 08/27/2024] Open
Abstract
Autogenous dentin matrix (ADM), derived from a patient's extracted tooth, can be repurposed as an autologous grafting material in reconstructive dentistry. Extracted teeth provide a source for ADM, which distinguishes itself with its low rejection rate, osteoinductive capabilities and ease of preparation. Consequently, it presents a viable alternative to autogenous bone. Animal studies have substantiated its effective osteoinductive properties, while its clinical applications encompass post-extraction site preservation, maxillary sinus floor augmentation, and guided bone tissue regeneration. Nevertheless, the long-term efficacy of ADM applied in bone regeneration remains underexplored and there is a lack of standardization in the preparation processes. This paper comprehensively explores the composition, mechanisms underlying osteoinductivity, preparation methods, and clinical applications of ADM with the aim of establishing a fundamental reference for future studies on this subject.
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Affiliation(s)
- Honglan Sun
- Key Laboratory of Emergency and Trauma of Ministry of Education, Department of Stomatology, Key Laboratory of Hainan Trauma and Disaster Rescue, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China
- School of Stomatology, Hainan Medical University, Haikou, Hainan Province, China
| | - Xiaoyunqing Yin
- Key Laboratory of Emergency and Trauma of Ministry of Education, Department of Stomatology, Key Laboratory of Hainan Trauma and Disaster Rescue, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China
- School of Stomatology, Hainan Medical University, Haikou, Hainan Province, China
| | - Chao Yang
- Department of Stomatology, The People’s Hospital of Longhua, Shenzhen, Guangdong Province, China
- Research and Development Department, Shenzhen Uni-medica Technology Co., Ltd, Shenzhen, Guangdong Province, China
| | - Huifang Kuang
- Key Laboratory of Emergency and Trauma of Ministry of Education, Department of Stomatology, Key Laboratory of Hainan Trauma and Disaster Rescue, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China
- School of Stomatology, Hainan Medical University, Haikou, Hainan Province, China
| | - Wen Luo
- Key Laboratory of Emergency and Trauma of Ministry of Education, Department of Stomatology, Key Laboratory of Hainan Trauma and Disaster Rescue, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China
- School of Stomatology, Hainan Medical University, Haikou, Hainan Province, China
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Thoma D, Gil A, de Bruyckere T, Jung RE, Fukuba S, Ickroth A, Strauss FJ, Cosyn J. Early implant placement versus ridge preservation and delayed implant placement: Analysis of profilometric, clinician- and patient-reported outcomes from a two-centre RCT. Clin Oral Implants Res 2024. [PMID: 38963017 DOI: 10.1111/clr.14325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 05/28/2024] [Accepted: 06/18/2024] [Indexed: 07/05/2024]
Abstract
OBJECTIVES To compare early implant placement (EP) to alveolar ridge preservation and delayed implant placement (ARP/DP) in terms of contour changes, along with clinician- and patient-reported outcome measures (PROMs) until the delivery of the implant-supported restoration. MATERIALS AND METHODS Patients with a failing single tooth in the maxilla or mandible were recruited in two centres. After tooth extraction, patients were randomly assigned (1:1) to either EP or ARP/DP. At abutment connection and crown delivery, the buccal contour changes at 3 mm below the mucosal margin (primary outcome) along with clinician- (ease of treatment) and patient-reported outcomes were assessed using numeric rating scales and OHIP-14. RESULTS A total of 46 patients were analysed. The mean buccal contour at abutment connection decreased by -1.2 ± 0.6 mm in group EP and -1.6 ± 0.8 mm in group ARP/DP (estimated mean difference; 0.45 [95%CI, -0.02; 0.94]; p = .061) with no significant differences between the groups. ARP/DP was consistently easier than EP across all stages of the surgery (estimated mean difference; 2.0 [95%CI, 1.3; 2.7] p < .001): during flap elevation (EP: 4.8 vs. ARP/DP: 1.6), implant placement (EP: 5.7 vs. ARP/DP: 2.2) and wound closure (EP: 3.4 vs. ARP/DP: 1.6). Both interventions improved quality of life but patients who underwent ARP/DP were significantly more satisfied at the time of crown delivery (ARP/DP: 9.6 vs. EP: 9.1, p = .02). CONCLUSIONS EP and ARP/DP show no significant differences in buccal contour changes, aesthetics and patient-reported outcomes. However, ARP/DP is an easier procedure at all stages of the surgery compared to EP and could therefore be the preferred therapy for less experienced clinicians.
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Affiliation(s)
- Daniel Thoma
- Clinic of Reconstructive Dentistry, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Alfonso Gil
- Clinic of Reconstructive Dentistry, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Thomas de Bruyckere
- Department of Periodontology and Oral Implantology, Oral Health Sciences, Ghent University, Ghent, Belgium
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Shunsuke Fukuba
- Department of Periodontology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Axelle Ickroth
- Department of Periodontology and Oral Implantology, Oral Health Sciences, Ghent University, Ghent, Belgium
| | - Franz J Strauss
- Clinic of Reconstructive Dentistry, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
- Faculty of Dentistry, Universidad Finis Terrae, Santiago, Chile
| | - Jan Cosyn
- Department of Periodontology and Oral Implantology, Oral Health Sciences, Ghent University, Ghent, Belgium
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Zamora GP, Molina-González JM, Martínez-Marco JF, Ruiz AJO, Mardas N, Garcia-Sanchez R. Aesthetic outcomes of different materials for delayed, single-tooth restorations for immediately placed implants. A randomized controlled clinical trial. J Dent 2024; 146:105067. [PMID: 38763385 DOI: 10.1016/j.jdent.2024.105067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/21/2024] Open
Abstract
OBJECTIVES The aim of this study is to compare the aesthetic outcomes of metal porcelain (C), lithium disilicate (T1) and porcelain-layered zirconium (T2) immediate implant-supported single crowns in the anterior maxilla. MATERIALS AND METHODS Forty-five immediate dental implants were provided for 45 patients that required the extraction of a single tooth in the anterior maxilla. A temporary prosthesis was provided at 8 weeks after placement followed by the final prosthesis at 24 weeks post-implantation. The patients were randomly allocated into 3 groups: 15 patients in the control group (C) received a metal-porcelain restoration, 15 patients (T1) received a lithium disilicate (LD) restoration and 15 patients (T2) received a porcelain-layered, zirconium (Z) restoration. Pink (PES) and White (WES) esthetic scores, radiographic bone levels, periodontal parameters and patient's esthetic satisfaction using a visual analogue scale (VAS) were evaluated at the time of final restoration placement (t0) and at 12-months post-loading (t12). RESULTS No implants were lost during the duration of this study. Statistically significant higher WES and VAS scores (p < 0.05) were recorded in T1 vs C and T1 vs T2 groups respectively. Similar radiographic bone levels and periodontal parameters were recorded in all groups. CONCLUSION Within the limitations of this study, it was concluded that T1 restorations provided better WES outcomes when compared to C restorations and better VAS scores when compared to T2 restorations at 12 months post-loading. Besides, different material interphases did not have an impact in PES, bone levels or periodontal parameters. CLINICAL RELEVANCE There is limited data comparing aesthetic outcomes of implant supported single crowns made of different ceramic materials based on accepted and comparable indexes and the evaluation of the patient's perspective regarding these aesthetic outcomes.
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Affiliation(s)
| | | | | | | | - Nikos Mardas
- QMUL, Barts & The London School of Dentistry, London, United Kingdom
| | - Ruben Garcia-Sanchez
- Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; King's College London, London, United Kingdom.
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Hamdy A, Ibrahim SSA, Ghalwash D, Adel-Khattab D. Volumetric assessment of volume stable collagen matrix in maxillary single implant site development: A randomized controlled clinical trial. Clin Implant Dent Relat Res 2024. [PMID: 38938060 DOI: 10.1111/cid.13353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/26/2024] [Accepted: 05/28/2024] [Indexed: 06/29/2024]
Abstract
INTRODUCTION The stability of soft tissue volume around dental implants is an important factor for the final esthetic outcome. The main objective of this study was to compare volume stable collagen matrix (VCMX) versus connective tissue graft (CTG) in the augmentation of soft tissue profiles in single implant sites with a class I Siebert ridge defect. MATERIALS AND METHODS Twenty patients (14 females and 6 males) were enrolled in the present study. After implant placement and augmentation of the buccal defect by VCMX or CTG, post-operative evaluation of the volumetric changes at the augmented implant site was carried out at 3, 6, and 9 months as primary outcome, clinical and radiographic soft tissue thickness were carried out at baseline and 9-month intervals, visual analog scale (VAS) and oral health impact profile-14 (OHIP14) were recorded 2 weeks after the surgery. RESULTS A statistically significant difference in soft tissue volume was found between baseline and 3, 6, and 9 months postoperatively in both groups with the highest value at 9 months (136.33 ± 86.80) (mm3) in VCMX and (186.38 ± 57.52) (mm3) in CTG. Soft tissue thickness was significantly increased in both groups at 9 months in comparison to baseline. However, there was a significantly higher increase in soft tissue thickness at 9 months in CTG (3.87 ± 0.91) than in VCMX (2.94 ± 0.31). Regarding the radiographic soft tissue thickness, there was a statistically significant increase in both groups at 9 months in comparison to baseline. However, there was a statistically higher increase in the radiographic soft tissue thickness at 9 months in CTG (3.08 ± 0.97) than in VCMX (2.37 ± 0.29). VAS showed a statistically lower value in VCMX (0.4 ± 0.7) than CTG (2.8 ± 1.48). The OHIP recorded lower values in the VCMX group than the CTG group with no statistical significance. In addition, there was no difference in the PES between the two groups. CONCLUSION The present study showed that CTG and VCMX were both effective in soft tissue augmentation around implants in the esthetic zone. However, CTG proved more efficient in increasing peri-implant soft tissue volume and mucosal thickness around single implants at a 9-month follow-up period. VCMX was associated with less pain or discomfort and reduced patient morbidity, as reflected by the significantly reduced VAS value in the VCMX group.
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Affiliation(s)
- Ahmed Hamdy
- Periodontology and Diagnosis, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt
| | - Suzan Seif Allah Ibrahim
- Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Dentistry Ain Shams University, Cairo, Egypt
| | - Dalia Ghalwash
- Periodontology and Diagnosis, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt
| | - Doaa Adel-Khattab
- Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Dentistry Ain Shams University, Cairo, Egypt
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Sharka R. Psychometric properties of the Arabic version of the perceived prosthodontic treatment need scale: Exploratory and confirmatory factor analyses. PLoS One 2024; 19:e0298145. [PMID: 38319938 PMCID: PMC10846707 DOI: 10.1371/journal.pone.0298145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/17/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND It is crucial to take into account the concerns of dental patients about their prosthodontic needs when planning the course of treatment. However, there is a dearth of research that examines these needs among adult dental patients. OBJECTIVES This study aims to translate and validate the perceived prosthodontic treatment need scale (PPTN) in Arabic. METHODS The 17-item PPTN scale was translated from English into Arabic and completed by 206 patients seeking prosthodontic treatment in a dental hospital in Saudi Arabia. Data collection was carried out in September and October 2023. Exploratory factor analysis (EFA) was used to ascertain the underlying factor structure; a unidimensional scale was hypothesised and tested using confirmatory factor analysis (CFA), including several multiple model fit indices. The assessment of reliability was conducted using Cronbach's alpha. The convergent and discriminant validity of the final scale were examined. RESULTS EFA produced an 11-item scale distributed into three factors that explain 65.43% of the total variance with eigenvalues > 1. All items showed acceptable reliability, ranging from 0.65 to 0.84. The first factor pertained to social issues, while the second item was concerning dental appearance. Lastly, the third factor included functional difficulties associated with tooth loss or dental problems. The results of the CFA demonstrate a satisfactory level of model fit, with the standardised factor loadings ranging from 0.51 to 0.89. Convergent and discriminant validity of the model factors were established. CONCLUSION The translated questionnaire was deemed legitimate and would be useful in comprehending patients' perceived treatment requirements, hence contributing to the advancement of prosthodontic research and practical implementation.
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Affiliation(s)
- Rayan Sharka
- Department of Oral & Maxillofacial Surgery and Diagnostic Sciences, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
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Amid R, Moscowchi A, Azizi S, Hosseini M, Hartoonian S. Coverage stability of peri-implant soft tissue dehiscence: A systematic review and meta-analysis. J ESTHET RESTOR DENT 2024; 36:284-294. [PMID: 37494605 DOI: 10.1111/jerd.13113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/09/2023] [Accepted: 07/14/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE The occurrence of peri-implant soft tissue dehiscence, especially in the esthetic zone, can be challenging. This study sought to investigate how the passage of time affects the outcomes of treatment for peri-implant soft tissue dehiscence coverage. MATERIALS AND METHODS A literature search was performed up to April 2023 via PubMed, Scopus, and Web of Science to retrieve studies reporting the data on peri-implant soft tissue dehiscence of at least 2-time points (baseline and follow-up). Clinical trials with a minimum of 5 participants, reporting at least 1 primary outcome, and with a minimum follow-up of 3 months were included. The primary outcomes were the changes in dehiscence depth, complete coverage, and mean coverage at different time points. RESULTS Seven studies with 112 participants and 119 implants were included. Dehiscence depth increased insignificantly between 3 to 6 months. Although the dehiscence depth increased from 6 to 12 months in the tunnel group, it decreased in the coronally advanced group, and a slight decrease was observed from 12 to 72 months. Soft tissue thickness was the predictor for soft tissue margin stability. However, no significant relationship was found between the baseline dehiscence depth and complete coverage. CONCLUSIONS Within the limitations of this study, it seems prudent to wait at least 6 months to achieve a stable soft tissue margin. CLINICAL SIGNIFICANCE The occurrence of peri-implant soft tissue dehiscence, especially in the esthetic zone, can be a challenging complication. It is important not only to achieve coverage but also to ensure that the treatment results remain stable in the long term, in order to satisfy both patients and clinicians. A reasonable approach would be to wait for at least 6 months to achieve a stable soft tissue margin.
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Affiliation(s)
- Reza Amid
- Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Anahita Moscowchi
- Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soroush Azizi
- Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Matineh Hosseini
- Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Serlie Hartoonian
- Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Herce-López J, Pingarrón MDC, Tofé-Povedano Á, García-Arana L, Espino-Segura-Illa M, Sieira-Gil R, Rodado-Alonso C, Sánchez-Torres A, Figueiredo R. Customized Subperiosteal Implants for the Rehabilitation of Atrophic Jaws: A Consensus Report and Literature Review. Biomimetics (Basel) 2024; 9:61. [PMID: 38275459 PMCID: PMC10812919 DOI: 10.3390/biomimetics9010061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
(1) Background: The aim was to perform a literature review on customized subperiosteal implants (CSIs) and provide clinical guidelines based on the results of an expert consensus meeting held in 2023. (2) Methods: A literature search was performed in Pubmed (MEDLINE) in July 2023, including case series and cohort studies with a minimum follow-up of 6 months that analyzed totally or partially edentulous patients treated with CSIs. Previously, an expert consensus meeting had been held in May 2023 to establish the most relevant clinical guidelines. (3) Results: Six papers (four case series and two retrospective cohort studies) were finally included in the review. Biological and mechanical complication rates ranged from 5.7% to 43.8% and from 6.3% to 20%, respectively. Thorough digital planning to ensure the passive fit of the CSI is mandatory to avoid implant failure. (4) Conclusions: CSIs are a promising treatment option for rehabilitating edentulous patients with atrophic jaws; they seem to have an excellent short-term survival rate, a low incidence of major complications, and less morbidity in comparison with complex bone grafting procedures. As the available data on the use of CSIs are very scarce, it is not possible to establish clinical recommendations based on scientific evidence.
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Affiliation(s)
- Javier Herce-López
- Oral and Maxillofacial Surgeon, Virgen Macarena University Hospital, 41009 Seville, Spain;
| | | | - Álvaro Tofé-Povedano
- Oral and Maxillofacial Surgeon, Puerta del Mar University Hospital, 11009 Cádiz, Spain;
| | - Laura García-Arana
- Oral and Maxillofacial Surgeon, San Francisco de Asís University Hospital, 28002 Madrid, Spain;
| | | | - Ramón Sieira-Gil
- Oral and Maxillofacial Consultant, Hospital Clínic, Universitat de Barcelona, 08036 Barcelona, Spain;
| | | | - Alba Sánchez-Torres
- Professors of Oral Surgery, Faculty of Medicine and Health Sciences, Researchers at the IDIBELL Institute, University of Barcelona (Spain), 08907 Barcelona, Spain;
| | - Rui Figueiredo
- Professors of Oral Surgery, Faculty of Medicine and Health Sciences, Researchers at the IDIBELL Institute, University of Barcelona (Spain), 08907 Barcelona, Spain;
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Starch-Jensen T, Bruun NH, Spin-Neto R. Maxillary sinus membrane elevation and coagulum compared with maxillary sinus floor augmentation and a composite graft: A 1-year single-blinded randomized controlled trial. Clin Implant Dent Relat Res 2023; 25:1056-1068. [PMID: 37474448 DOI: 10.1111/cid.13251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/16/2023] [Accepted: 07/11/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE The aim was to evaluate the 1-year implant outcome and patient-related outcome measures (PROMs) after maxillary sinus membrane elevation and coagulum (test) compared with maxillary sinus floor augmentation and a 1:1 ratio of autogenous bone graft from the buccal antrostomy and deproteinised porcine bone mineral (DPBM) (control). MATERIALS AND METHODS Forty patients (30 female, 10 male) with a mean age of 50 years (range 25-71 years) and an alveolar ridge height between 4 and 7 mm were randomly allocated to test or control. Outcome measures included survival of suprastructures and implants, implant stability quotient, health status of the peri-implant tissue, peri-implant marginal bone loss, frequency of complications and PROMs using Oral Health Impact Profile-14 combined with questionnaires assessing patient's perception of the peri-implant soft tissue, implant crown, function of the implant, and total implant treatment outcome using visual analogue scale. Mean differences were expressed with standard deviation and 95% confidence interval. Level of significance was 0.05. RESULTS All suprastructures and implants were well-functioning after 1-year of functional implant loading. No significant difference in any of the applied outcome measures was observed between test and control. Both treatments revealed high patient satisfaction scores and significant improvement in oral health-related quality of life. CONCLUSION There were no significant differences in implant outcome and PROMs between test and control, after 1-year of functional implant loading. Neither of the treatments can therefore be considered better than the other. Thus, long-term randomized controlled trials are needed before definitive conclusions can be provided about the two treatment modalities.
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Affiliation(s)
- Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg University, Aalborg, Denmark
- Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Niels Henrik Bruun
- Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Section for Oral Radiology, Faculty of Health, Aarhus University, Aarhus, Denmark
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Esteve-Pardo G, De-Larriva E, Sanchez-Suarez LM, Sanchez-Nicolas JA, Bernabeu-Esclapez A, Esteve-Colomina L. How do implant patients experience complications? A cross-sectional multicentre pilot study. Clin Oral Implants Res 2023; 34:987-998. [PMID: 37416986 DOI: 10.1111/clr.14125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 05/29/2023] [Accepted: 06/20/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND This cross-sectional study aimed to quantify the impact of implant-related complications on perceived pain, functional impairment, concern, quality of life (QoL) and confidence which were the study's primary outcomes. MATERIALS AND METHODS Patients were recruited in five centres over 19 months. They completed a structured ad hoc questionnaire scoring pain, chewing ability, concern, QoL and confidence in future implant treatment. Some potential independent variables were also recorded. The data were analysed descriptively and with a multiple-stepwise regression model for correlations of the five primary variables with the other data. RESULTS The sample consisted of 408 patients, with prosthesis mobility being the most common complication (40.7%). Most patients (79.2%) consulted because of a complication, while 20.8% were asymptomatic and consulted regularly. Pain was correlated with symptoms at consultation and in biological/mixed complications (p < .001; R2 = 44.8%). Chewing impairment with implant loss, prosthesis fracture and removable implant-supported or total prostheses (p < .001; R2 = 42.8%); patient concern was correlated with the clinical symptoms and removable implant-supported prostheses (p < .001; R2 = 36.1%); impact on QoL was correlated with implant loss, prosthesis fracture and removable implant-supported prostheses (p < .001; R2 = 41.1%). Patient confidence was relatively independent and only impact on quality of life significantly influenced it (r = 0.73). CONCLUSIONS Implant-related complications moderately impaired patients' perceptions of pain, chewing ability, concern and QoL. Nevertheless, complications only slightly reduced their confidence in future implant treatment.
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Abou-Ayash S, Fonseca M, Pieralli S, Reissmann DR. Treatment effect of implant-supported fixed complete dentures and implant overdentures on patient-reported outcomes: A systematic review and meta-analysis. Clin Oral Implants Res 2023; 34 Suppl 26:177-195. [PMID: 37750530 DOI: 10.1111/clr.14065] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 02/22/2023] [Accepted: 03/14/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES To analyze the effect of implant treatment in edentulous patients rehabilitated with implant-supported fixed complete dentures (IFCDs) or implant overdentures (IODs) on dental patient-reported outcomes (dPROs). MATERIALS AND METHODS In January 2022, Medline, Embase, CINAHL, Cochrane Library, PubMed Central, Web of Science, and ClinicalTrials.gov were screened for prospective clinical studies on completely edentulous patients treated with IFCDs and/or IODs, reporting pre-treatment and follow-up dPROs. Hedges' g effect sizes (ES) with corresponding 95% confidence intervals (CI) were calculated. Afterward, meta-analyses were conducted using random effect models. RESULTS A total number of 1608 records was initially identified. Of those, 28 studies reporting dPROs from 1457 patients were finally included. The applied dental patient-reported outcome measures (dPROMs) included several versions of the Oral Health Impact Profile (OHIP) or specific items assessing satisfaction with Visual Analogue Scales (VAS). The overall ES was large for rehabilitation with IFCDs (1.68 [CI: 1.15, 2.20]) and IODs (1.26 [CI: 0.99, 1.52]) with no significant difference (p = .165) between the two. Denture stability was the only factor rated significantly higher for IFCDs (ES difference: 2.37 [CI: 0.21, 4.54]; p = .032). Subgroup analyses revealed moderately higher ES for IODs on two implants relative to one implant (ES difference: 0.73 [CI: 0.34, 1.12]; p < .001). CONCLUSIONS There is a strong positive effect of implant treatment in edentulous patients, independent of the type of prosthetic rehabilitation. In patients seeking high stability, IFCDs may be preferable. In mandibular IODs on a single implant, there was a significantly positive effect of an additional implant on dPROs.
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Affiliation(s)
- Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | - Manrique Fonseca
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | - Stefano Pieralli
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Daniel R Reissmann
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Freiburg, Freiburg im Breisgau, Germany
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12
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Avukat EN, Akay C, Mumcu E. Evaluation of bite force, quality of life, and patients' satisfaction in elderly edentulous patients using implant overdentures. J Adv Prosthodont 2023; 15:214-226. [PMID: 37662854 PMCID: PMC10471504 DOI: 10.4047/jap.2023.15.4.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/18/2023] [Accepted: 07/26/2023] [Indexed: 09/05/2023] Open
Abstract
Purpose This study aimed to compare the bite force (BF) between complete dentures and implant overdentures (IODs) retained by two mandibular implants. Additionally, we evaluated the quality of life (QoL) and patient satisfaction among individuals using IODs. In addition, the effects of demographic parameters such as age and sex, and clinical parameters such as implant length, implant diameter, attachment height, attachment color, and interimplant distance on BF, QoL, and patient satisfaction were evaluated. Materials and methods A total of 51 edentulous patients rehabilitated with the maxillary complete dentures and mandibular IODs retained by two implants were included in this study. BF was measured using a force meter pre- and post-implant in the same patients. Oral health-related quality of life (OHRQoL) was assessed with the Oral Health Impact Profile (OHIP-14) and patient satisfaction was assessed with the Visual Analog Scale (VAS) questionnaires. Results It was found that BF values were statistically higher for IODs than complete dentures (P < .001). In terms of attachment height of the OHIP scores, there was a significant difference in the psychological disability and social disability domains (P < .05). When examining the change in patient satisfaction as a function of sex, it was found that mandibular retention satisfaction differed significantly by sex (P < .05), but there was no significant difference in the other domains. Conclusion Within the limitations of this study, it was observed that the BF increased after the use of IODs. Several factors, including age, interimplant distance, attachment height, and attachment color, were found to impact OHRQoL. Sex and implant diameter were identified as factors affecting patient satisfaction.
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Affiliation(s)
- Esra Nur Avukat
- Department of Prosthodontics, Faculty of Dentistry, Eskişehir Osmangazi University, Eskisehir, Turkiye
| | - Canan Akay
- Department of Prosthodontics, Faculty of Dentistry, Eskişehir Osmangazi University, Eskisehir, Turkiye
- Advanced Material Technologies Application and Research Center, Eskişehir Osmangazi University, Eskisehir, Turkiye
- Translational Medicine Research and Clinical Center, Eskişehir Osmangazi University, Eskisehir, Turkiye
| | - Emre Mumcu
- Department of Prosthodontics, Faculty of Dentistry, Eskişehir Osmangazi University, Eskisehir, Turkiye
- Advanced Material Technologies Application and Research Center, Eskişehir Osmangazi University, Eskisehir, Turkiye
- Translational Medicine Research and Clinical Center, Eskişehir Osmangazi University, Eskisehir, Turkiye
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13
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Tomina DC, Petruțiu ȘA, Crișan B, Leucuța DC, Dinu CM. Influence of Periodontal Status and Prosthetic Treatment on Survival and Success Rates in Implant Therapy: A 5-Year Retrospective Follow-Up Study. J Clin Med 2023; 12:4275. [PMID: 37445310 DOI: 10.3390/jcm12134275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/30/2023] [Accepted: 06/24/2023] [Indexed: 07/15/2023] Open
Abstract
The objective of the present study was to evaluate the 5-year outcome of dental implant therapy and assess the survival, success, and biological and technical complications. A periodontal and prosthetic-oriented evaluation was conducted on the variables that can influence the long-term predictability of implant therapy. A total of 615 patients and 1427 dental implants from a private clinic (MedArtis Dent, Cluj-Napoca, Romania) were enrolled in the study. The study was a longitudinal cohort with data collected retrospectively from physical/digital dental records in combination with a cross-sectional clinical/radiological examination. Results showed that periodontal diagnosis at baseline had a significant impact on the marginal bone loss prediction. Data showed that the cylindrical implant with an internal 45° medium taper connection experienced a higher rate of bone resorption compared to the tapered implant with the 5° internal connection. Screw-retained restorations and overdentures showed a statistical decrease in the marginal bone level height when compared to the cemented restorations. Data from our study suggest that not only is there a powerful association between recall visits and the rate of complications in dental implant treatment, but a lack of professional maintenance predicts a higher bone level loss during the 5-year interval.
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Affiliation(s)
- Darius Cătălin Tomina
- Department of Periodontology, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Hațieganu, 400012 Cluj-Napoca, Romania
- MedArtis Dent Private Dental Clinic, 400130 Cluj-Napoca, Romania
| | - Ștefan Adrian Petruțiu
- Department of Periodontology, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Hațieganu, 400012 Cluj-Napoca, Romania
- MedArtis Dent Private Dental Clinic, 400130 Cluj-Napoca, Romania
| | - Bogdan Crișan
- MedArtis Dent Private Dental Clinic, 400130 Cluj-Napoca, Romania
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Hațieganu, 400012 Cluj-Napoca, Romania
| | - Daniel-Corneliu Leucuța
- Department of Medical Informatics and Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Cristian Mihail Dinu
- MedArtis Dent Private Dental Clinic, 400130 Cluj-Napoca, Romania
- Department of Oral and Cranio-Maxillofacial Surgery, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Hațieganu, 400012 Cluj-Napoca, Romania
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14
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Hurtgen A, Seidel L, Manni LL, Liegeois L, Lecloux G, Lambert F. Clinical and radiographic assessment of circular versus triangular cross-section neck implants in the posterior maxilla: Five-year follow-up of a randomized controlled trial. Clin Oral Implants Res 2023. [PMID: 37183773 DOI: 10.1111/clr.14082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 04/19/2023] [Accepted: 04/24/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVES Dental implants with a triangular neck design have been developed in order to maintain peri-implant bone. The primary aim of this randomized controlled trial (RCT) was to assess after 5 years the peri-implant bone stability and the peri-implant soft tissue conditions with this new triangular implant neck design compared to a conventional round neck implant design. MATERIAL AND METHODS This is a secondary evaluation of a RCT including 34 patients. Patients were recalled after 1, 3, and finally 5 years to assess implant survival and peri-implant bone levels using standardized radiographs. Peri-implant soft tissue health was also evaluated by recording probing depth, plaque index and Bleeding on Probing. Patient Reported Outcome Measures (PROMs) and the Pink Esthetic Score were also assessed. RESULTS No implant loss occurred during the 5-year follow up period. The mean ± SD proximal bone remodeling after 5 years reached 0.38 ± 0.39 mm for the circular design and 0.29 ± 0.58 mm for the triangular design (p = .49). Peri-implant soft tissue health parameters and PROMs were found to be comparable. Altogether, 80% of implants presented peri-implant mucositis whereas one implant (4%) displayed sings of peri-implantitis. CONCLUSION The 5-year evaluation of the triangular neck implants showed similar results to the circular neck implants.
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Affiliation(s)
- Alexandre Hurtgen
- Department of Periodontology, Oro-dental and Implant Surgery, University of Liège, Liege, Belgium
- Dental Biomaterial Research Unit, University of Liège, Liege, Belgium
| | - Laurence Seidel
- Department of Biostatistics, University Hospital Centre, CHU du Sart Tilman, Liège, Belgium
| | - Lou Li Manni
- Department of Periodontology, Oro-dental and Implant Surgery, University of Liège, Liege, Belgium
| | - Lemmy Liegeois
- Department of Periodontology, Oro-dental and Implant Surgery, University of Liège, Liege, Belgium
| | - Geoffrey Lecloux
- Department of Periodontology, Oro-dental and Implant Surgery, University of Liège, Liege, Belgium
- Dental Biomaterial Research Unit, University of Liège, Liege, Belgium
| | - France Lambert
- Department of Periodontology, Oro-dental and Implant Surgery, University of Liège, Liege, Belgium
- Dental Biomaterial Research Unit, University of Liège, Liege, Belgium
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15
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Pomares-Puig C, Sánchez-Garcés MA, Jorba-García A. Dynamic and static computer-assisted implant surgery for completely edentulous patients. A proof of a concept. J Dent 2023; 130:104443. [PMID: 36720424 DOI: 10.1016/j.jdent.2023.104443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES To assess the accuracy and patient reported outcome measures (PROMs) of the computer-guided "double factor" technique for treating fully edentulous patients. METHODS A proof of concept prospective study was designed. Ten consecutive patients requiring full arch dental implant supported rehabilitation in a private practice were enrolled between October 2021 and March 2022. All patients were treated by means of an All-on-four®, and implants were planned and placed according to the "double factor" technique. This technique merges the static and dynamic computer-guided surgical approach in the same surgery. The primary outcome was the accuracy of implant placement, measured by overlapping post- and pre-operative cone-beam computerized tomography with the implant planning. Additionally, PROMs and patient quality of life after surgery were evaluated using different questionnaires. Descriptive and bivariate data analyses were performed. Statistical significance was considered for p < 0.05. RESULTS A total of 48 implants were placed using the "double factor" technique, and 12 full-arch immediate loading prostheses were delivered. The mean angular deviation was 3.74° (standard deviation [SD]: 2). The total linear deviation at the apex and platform of the implant was 1.25 mm (SD: 0.55) and 1.42 mm (SD: 0.64), respectively. No statistically significant differences were found between tilted and axial implants, the upper and lower jaw, or the right and left side. High self-reported satisfaction was registered, and the Oral Health Impact Profile-14 (OHIP-14) score improved postoperatively (p = 0.002). CONCLUSIONS The "double factor" technique is a valid and accurate treatment approach for fully edentulous patients. CLINICAL SIGNIFICANCE The double factor technique merges the advantages of both the dynamic and static computer assisted surgery approaches, affording accurate and predictable results when treating fully edentulous patients in a minimally invasive manner.
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Affiliation(s)
| | - M Angeles Sánchez-Garcés
- Faculty of Medicine and Health Sciences, University of Barcelona, Researcher at the IDIBELL (Bellvitge Biomedical Research Institute), Barcelona, Spain.
| | - Adrià Jorba-García
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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16
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Abdelwahab D, Ezz AlArab A, El Nahass H. Soft tissue esthetics around immediately provisionalized delayed implants with and without connective tissue graft: A randomized clinical trial pilot study. Clin Implant Dent Relat Res 2023; 25:11-22. [PMID: 36579756 DOI: 10.1111/cid.13168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Evaluate the peri-implant soft tissue esthetics following a single, immediately provisionalized, delayed implant with/-out subepithelial connective tissue graft (SCTG). MATERIAL AND METHODS The eligible patients were randomized into two groups. Immediate provisionalization was performed with (test group: SCTGG) or without SCTG (control group: NGG). The soft tissue esthetics was assessed by Pink Esthetic Score (PES) and Mucosal Scarring Index (MSI), at 6 and 12 months, following final implant restoration. RESULTS The SCTGG, compared to NGG, yielded a 0.2 increased PES at 12 months (95% confidence interval (CI): -1, 1.4) and a 0.2 decreased MSI score (95% CI -0.9, 0.5) with no statistically significant differences in PES and MSI between both groups (p > 0.05). CONCLUSION Soft tissue grafting around immediately provisionalized delayed implants could exhibit comparable results to immediate provisionalization alone in terms of peri-implant soft tissue esthetics using PES and MSI (ClinicalTrials.gov Identifier: NCT03770975).
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Affiliation(s)
- Dina Abdelwahab
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Azza Ezz AlArab
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Hani El Nahass
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
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17
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Thoma DS, Gasser TJW, Hämmerle CHF, Strauss FJ, Jung RE. Soft tissue augmentation with a volume-stable collagen matrix or an autogenous connective tissue graft at implant sites: Five-year results of a randomized controlled trial post implant loading. J Periodontol 2023; 94:230-243. [PMID: 35904229 DOI: 10.1002/jper.22-0226] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Interventions to augment the mucosal thickness around dental implants are indicated to optimize esthetics and maintain peri-implant health. However, there is a lack of clinical data on the long-term performance of soft tissue substitutes, such as volume-stable collagen matrix (VCMX), compared to autogenous grafts, such as subepithelial connective tissue grafts (SCTGs). This randomized controlled trial aimed to assess 5-year data on clinical and radiographic outcomes at implant sites previously augmented with VCMX or SCTG. METHODS Twenty patients were randomly assigned for soft tissue augmentation with VCMX or SCTG at single implant sites. Following abutment connection, final restorations were inserted (baseline; BL) and patients were reexamined up to 5 years (FU-5). Measurements included clinical data, marginal bone levels, mucosal thickness, and ridge contour changes. Nonparametric tests and estimates were applied for the statistical analysis. RESULTS The median buccal mucosal thickness increased by 0.3 mm (Q1: -0.8; Q3: 1.0) in the VCMX group (P = 0.656) and 0.3 mm (Q1: 0.0; Q3: 1.0) in the SCTG group (P = 0.188) between BL and FU-5 (intergroup P = 0.752), while the ridge contour decreased by a median of -0.3 mm (-0.9; -0.1) (P = 0.078) for VCMX and -0.3 mm (-0.4; -0.2) (P = 0.039) for SCTG (intergroup P = 0.817). Peri-implant health was maintained in both groups with stable clinical and radiographic outcomes and without significant differences between the treatments. CONCLUSION Despite the limited power and considerable dropout rate in the present study, soft tissue augmentation at implant sites with either VCMX or SCTG resulted in similar stable peri-implant tissues, favorable esthetics, and clinically negligible contour changes at 5 years post loading.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Thomas J W Gasser
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Franz J Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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18
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Mancini L, Barootchi S, Thoma DS, Jung RE, Gallucci GO, Wang HL, Tavelli L. The peri-implant mucosa color: A systematic appraisal of methods for its assessment and clinical significance. Clin Implant Dent Relat Res 2023; 25:224-240. [PMID: 36646440 DOI: 10.1111/cid.13180] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/21/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Peri-implant mucosa color (PMC) seems to be one of the main parameters affecting the esthetic outcome of implant therapy. However, more emphasis should be given to its assessment and reporting. PURPOSE To describe the available evidence on methods to assess and report the color of the peri-implant mucosa (PMC) and the respective clinical relevance. MATERIAL AND METHODS A comprehensive electronic and manual search was performed to identify clinical studies reporting on PMC. RESULTS A total of 121 studies were included. PMC was evaluated at the time of the follow-up visit (chairside) in 45.5% studies. PMC assessment was performed qualitatively, by comparing PMC with adjacent and/or contralateral gingiva (78.6%) or quantitatively, using spectrophotometry (20.7%) or a software on clinical photographs (0.8%). The most performed method to assess PMC was through esthetic indices (76.9%), either at the time of the follow-up visit (chairside) or at later time point using photographs. Quantitative reporting of PMC included averages of points from esthetic indices or color differences to natural gingiva expressed with the CIELAB color system. PMC assessment allowed describing color discrepancies compared to natural gingiva, evaluating color changes over time, and comparing the outcomes of different treatment modalities. PMC assessment through spectrophotometry was additionally utilized to assess the role of mucosal thickness (MT) on PMC. CONCLUSIONS Various methods for PMC assessment and reporting were described, including visual assessment, mainly through esthetic indices, and spectrophotometry. PMC evaluation has allowed to demonstrate the factors affecting the color of the peri-implant soft tissue, such as the type of abutment/restoration, MT, and soft tissue augmentation.
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Affiliation(s)
- Leonardo Mancini
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.,Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.,Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA.,Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Shayan Barootchi
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA.,Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.,Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterial Science, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Hom-Lay Wang
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Lorenzo Tavelli
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA.,Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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19
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Starch-Jensen T, Bruun NH, Spin-Neto R. Outcomes following osteotome-mediated sinus floor elevation with Bio-Oss Collagen or no grafting material: a one-year single-blind randomized controlled trial. Int J Oral Maxillofac Surg 2023:S0901-5027(23)00001-2. [PMID: 36639342 DOI: 10.1016/j.ijom.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 01/13/2023]
Abstract
The objective of this single-blind randomized controlled trial was to test the hypothesis of no difference in implant treatment outcome and patient-reported outcome measures (PROMs) following osteotome-mediated sinus floor elevation with Bio-Oss Collagen (test) compared with no grafting material (control) after 1 year of implant loading. Forty healthy patients (27 female, 13 male) with a mean age of 49 years (range 24-74 years) were randomly allocated to the test or control group. Outcome measures included survival of the suprastructures and implants, peri-implant marginal bone loss, complications, and PROMs; the latter included the Oral Health Impact Profile-14 and a self-administered questionnaire with visual analogue scales to assess the peri-implant tissue, implant crown, function of the implant, total implant treatment outcome, and oral health-related quality of life. Mean differences were expressed with the standard deviation and 95% confidence interval. The level of significance was 0.05. Survival of the suprastructures and implants was 100% with both treatment modalities. No significant difference in any of the outcome measures was observed between the test and control groups. High patient satisfaction and a significant improvement in quality of life were observed with both treatment modalities. Consequently, no significant difference in implant treatment outcome between the test and control groups was revealed after 1 year of implant loading. Neither of the treatment modalities can therefore be considered better than the other.
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Affiliation(s)
- T Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital and Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
| | - N H Bruun
- Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - R Spin-Neto
- Department of Dentistry and Oral Health, Section of Oral Radiology, Faculty of Health, Aarhus University, Aarhus, Denmark
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20
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Basma HS, Saleh MHA, Abou-Arraj RV, Imbrogno M, Ravida A, Wang HL, Li P, Geurs N. Patient-reported outcomes of palatal donor site healing using four different wound dressing modalities following free epithelialized mucosal grafts: A four-arm randomized controlled clinical trial. J Periodontol 2023; 94:88-97. [PMID: 35754198 PMCID: PMC10087796 DOI: 10.1002/jper.22-0172] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/18/2022] [Accepted: 06/09/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The aim of this study was to compare the effects of four different commonly used wound dressings in improving patient reported outcomes (PROMS) after free epithelialized mucosal grafts (FEGs) harvesting. METHODS Following 72 FEGs harvesting from 72 patients, patients were assigned into four groups. CONTROL collagen plug + sutures (CPS); test: collagen plug with cyano-acrylate (CPC), platelet rich fibrin (PRF) + sutures, or palatal stent only (PS). Patients were observed for 14 days, with evaluation of pain level utilizing the visual analog scale, number of analgesics consumed, need for additional analgesics, amount of swelling, amount of bleeding, activity tolerance, and willingness for retreatment. RESULTS Compared to the control group all test groups indicated significant lower pain perception (P < 0.0001), lower analgesic consumption (P < 0.0001), and higher willingness for retreatment (P < 0.0001), while no statistically significant differences among test groups were observed. There were no statistically significant differences in amount of day-by-day swelling, bleeding, and activity tolerance among four groups. Compared to other groups, the PS had the lowest overall pain scores (over the 14-day period). Palatal thickness, graft length, graft width, and graft thickness did not appear to affect patient morbidity (P > 0.05). CONCLUSIONS All interventions significantly decreased pain perception compared to a hemostatic collagen sponge alone over the palatal donor site after FEG surgery. In the first few days after surgery, the use of a palatal stent seemed to be associated with less overall pain, pain pills consumed, and higher willingness of doing the same procedure again.
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Affiliation(s)
- Hussein S Basma
- Department of Periodontics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Ramzi V Abou-Arraj
- Department of Periodontics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Matthew Imbrogno
- Department of Periodontics, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Andrea Ravida
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Peng Li
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Nicolaas Geurs
- Department of Periodontics, University of Alabama at Birmingham, Birmingham, Alabama, USA
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21
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Zuercher AN, Ioannidis A, Hüsler J, Mehl A, Hämmerle CHF, Thoma DS. Randomized controlled pilot study assessing efficacy, efficiency, and patient-reported outcomes measures of chairside and labside single-tooth restorations. J ESTHET RESTOR DENT 2023; 35:74-83. [PMID: 35421283 DOI: 10.1111/jerd.12909] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To test whether or not a chairside workflow (CHAIR) is similar to a labside workflow (LAB) in terms of efficacy (primary outcome) and efficiency (secondary outcome). MATERIAL AND METHODS Eighteen subjects in need of a single-tooth restoration in the posterior region of the maxilla or mandible were consecutively recruited and randomly assigned to the CHAIR or LAB workflow. Patient-reported outcome measures (PROMs; efficacy) were assessed using a questionnaire with visual analog scale. The white AEsthetic score (WES) was applied to evaluate the AEsthetic outcome objectively. The clinical and laboratory time (efficiency) were recorded. Nonparametric methods were applied for the group comparisons. RESULTS The overall median AEsthetic evaluation after treatment was 10 (interquartile range = IQR: 9.5-10) in group CHAIR and 10 (IQR: 9.5-10) in-group LAB (Mann-Whitney [MW] test p = 1.000). The WES amounted to 4 (IQR: 3-5) (CHAIR) and to 8 (IQR: 7-9) (LAB) (MW test p < 0.0001). The median total working time for the clinician in-group CHAIR was 49.9 min. (IQR: 40.9-63.7) and 41.4 min. (IQR: 37.2-58.2) in-group LAB (MW test p = 0.387). CONCLUSIONS Subjective PROMs of single-tooth supported restorations fabricated in a CHAIR or LAB workflow led to similar scores of patients' satisfaction and a moderate negative correlation for the objective evaluation of the clinician in the LAB workflow. CLINICAL SIGNIFICANCE PROMs can be considered a key element in the decision-making process for restoring single-tooth restorations. The patients' perception of AEsthetics was similar for the CHAIR or LAB workflows. The additional efforts undertaken with the LAB workflow did not result in a patient benefit when compared to a CHAIR workflow.
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Affiliation(s)
- Anina N Zuercher
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Alexis Ioannidis
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Jürg Hüsler
- Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - Albert Mehl
- Department of Computerized Restorative Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Gintaute A, Zitzmann NU, Brägger U, Weber K, Joda T. Patient-reported outcome measures compared to professional dental assessments of monolithic ZrO 2 implant fixed dental prostheses in complete digital workflows: A double-blind crossover randomized controlled trial. J Prosthodont 2023; 32:18-25. [PMID: 35938349 PMCID: PMC10087166 DOI: 10.1111/jopr.13589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/02/2022] [Indexed: 01/25/2023] Open
Abstract
PURPOSE This double-blind randomized controlled trial analyzed patient-reported outcome measures in terms of subjective patient satisfaction compared to objective dental evaluation of prosthetic treatment with 3-unit monolithic zirconium dioxide implant fixed dental prostheses (iFDPs) in 3 digital workflows. MATERIAL AND METHODS Twenty patients were restored with 3 iFDPs each on Straumann TL-implants with 2 completely digital workflows using different intraoral optical scanning systems with model-free fabrication of the restoration (Trios 3/3Shape [Test-1]; Virtuo Vivo/Straumann [Test-2]), and mixed analog-digital workflow with conventional impressions and digitized gypsum casts (Impregum/3M Espe [Control]). The order of impression-taking and the prosthetic try-in were randomly allocated. Sixty iFDPs were compared for patient satisfaction and dental evaluation using ANOVA. RESULTS For iFDP evaluation, patients generally provided more favorable ratings than dental experts, regardless of the workflow. ANOVA revealed no significant difference for overall satisfaction when comparing Test-1, Test-2, or Control, either for patients (f-ratio: 0.13; p = 0.876) or dentist (f-ratio: 1.55: p = 0.221). Secondary, patients clearly favored the digital impression workflows over the conventional approach (f-ratio: 14.57; p < 0.001). Overall, the 3Shape workflow (Test-1) received the highest scores for all analyses. CONCLUSIONS The different digital workflows demonstrated minor influence on the subjective and objective evaluation of the monolithic zirconium dioxide iFDPs in nonesthetic regions; however, the dentist may significantly increase patient satisfaction by choosing intraoral scanning instead of conventional impressions. The dentist has to consider individual patients' needs to fulfill their expectations for a personalized solution.
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Affiliation(s)
- Aiste Gintaute
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Nicola U Zitzmann
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Urs Brägger
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Karin Weber
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Tim Joda
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland.,Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Thoma DS, Strauss FJ, Mancini L, Gasser TJW, Jung RE. Minimal invasiveness in soft tissue augmentation at dental implants: A systematic review and meta-analysis of patient-reported outcome measures. Periodontol 2000 2022; 91:182-198. [PMID: 35950734 DOI: 10.1111/prd.12465] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 06/10/2022] [Accepted: 06/23/2022] [Indexed: 11/29/2022]
Abstract
The aim of this study was to compare patient-reported outcome measures (PROMs) of soft tissue substitutes versus autogenous grafts for soft tissue augmentation procedures at implant sites. Comprehensive and systematic literature searches were performed until December 2021. A focused question was formulated based on the Population, Intervention, Comparison and Outcome criteria (PICO): In patients with dental implants undergoing soft tissue augmentation (P), do soft tissue substitutes (I) compared to autogenous soft tissue graft (SCTG [subepithelial connective tissue graft]) (C) limit the post-operative morbidity and other patient reported-outcomes measures (O). Randomized controlled clinical trials, prospective-, retrospective- and case-series studies were included. Meta-analyses were performed whenever possible and the results were expressed as weighted mean differences (WMD). A total of 29 clinical studies were included. For mucosal thickness gain, soft tissue substitutes significantly reduced the pain perception compared to SCTG (n = 4; WMD = 14.91 Visual Analog Scale [VAS] units; 95% confidence interval [CI] 6.42-23.40; P < .0006) based on a 0-100 VAS scale. Based on a 0-10 VAS scale, a borderline significance of pain reduction was found when soft tissue substitutes were applied (n = 4; WMD = 1.62 VAS units; 95% CI 0.01-3.23; P = .05). For keratinized tissue gain, soft tissue substitutes significantly reduced the pain perception after keratinized tissue augmentation compared to SCTG based on a 0-100 VAS scale (n = 2; WMD = 21.43 VAS units; 95% CI 12.58-30.28; P < .0001). Based on the 0-10 VAS scale, soft tissue substitutes significantly reduced the pain as compared to SCTG (n = 4; WMD = 1.65 VAS units; 95% CI 0.66-2.64; P = .001). Regarding pain medication, soft tissue substitutes required less painkillers (n = 6; WMD = 1.56 tablets; 95% CI 1.22-1.91; P < .00001) after soft tissue augmentation. The surgery time was significantly reduced when soft tissue substitutes were used (n = 5; WMD = 10.9 minutes; 95% CI 4.60-17.19; P < .00001). There were no significant differences in satisfaction, aesthetics, and quality of life (OHIP-14) between soft tissue substitutes and autogenous grafts following soft tissue augmentation at implants sites. Soft tissue substitutes, compared to autogenous grafts, significantly improve PROMs following soft tissue augmentation at implant sites. Soft tissue substitutes can reduce pain perception, amounts of painkillers and surgery time while achieving similar levels of patient´s satisfaction as autogenous grafts without impairing the clinical outcomes. The current evidence indicates that they constitute a valid and reliable alternative to minimize the invasiveness in soft tissue augmentation procedures at implant sites.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Franz J Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Leonardo Mancini
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Thomas J W Gasser
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
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Moreno LB, Colussi PRG, Marostega MG, Rosalen NP, Rösing CK, Muniz FWMG. Self-reported halitosis and associated factors among older adults: A cross-sectional study. J Oral Biol Craniofac Res 2022; 12:431-436. [DOI: 10.1016/j.jobcr.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/10/2022] [Accepted: 05/21/2022] [Indexed: 11/29/2022] Open
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25
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Hirani M, Devine M, Obisesan O, Bryant C. The use of three implants to support a fixed prosthesis in the management of the edentulous mandible: a systematic review. Int J Implant Dent 2022; 8:28. [PMID: 35713793 PMCID: PMC9206044 DOI: 10.1186/s40729-022-00423-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dental implants have been widely utilised as a treatment modality for prosthetic rehabilitation. The aim of this study was to evaluate the implant and prosthetic survival rate, changes in marginal bone level, and patient satisfaction outcomes with the use of three implants to support a fixed prosthesis in the edentulous mandible. METHODS A comprehensive electronic search was performed in the MEDLINE, Embase and Cochrane databases to retrieve studies that met the selection criteria. Sixteen articles were selected which consisted of two randomised controlled trials, eight prospective cohort studies, five retrospective studies and one case series. RESULTS A total of 2055 implants were placed in 685 patients with a mean age of 62.2 years. The mean cumulative implant survival rate was 96.2% over a mean follow-up period of 3.35 years. Mean marginal bone loss recorded was 1.25 mm and high patient satisfaction rates were reported across the studies. CONCLUSION The use of three implants to support a fixed prosthesis appears to be a successful approach to restoring the edentulous mandible in the short-to-medium term. Further longitudinal comparative studies are required to support longer-term success, and to guide minimum implant dimension requirements for the technique.
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Affiliation(s)
- Murtaza Hirani
- Department of Oral Surgery, King's College Dental Hospital, Bassemer Road, London, SE5 9RS, UK.
| | - Maria Devine
- Department of Oral Surgery, Eastman Dental Hospital, Huntley Street, London, WC1E 6DG, UK
| | - Olamide Obisesan
- Department of Oral Surgery, King's College Dental Hospital, Bassemer Road, London, SE5 9RS, UK
| | - Cathy Bryant
- Department of Oral Surgery, King's College Dental Hospital, Bassemer Road, London, SE5 9RS, UK
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Wu X, Ye M, Sun J, Yan Q, Shi B, Xia H. Patient-reported outcome measures following surgeries in implant dentistry and associated factors: a cross-sectional study. BMJ Open 2022; 12:e059730. [PMID: 35710257 PMCID: PMC9207936 DOI: 10.1136/bmjopen-2021-059730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES We aimed to evaluate the patient-reported outcome measures (PROMs) of dental implant surgeries and analyse the associated indicators. DESIGN A cross-sectional study design was used. SETTING Department of Oral Implantology, Hospital of Stomatology, Wuhan University (May 2020-April 2021). PARTICIPANTS Participants with missing teeth in need of implant-supported rehabilitation. INTERVENTIONS Dental implant placement and/or bone augmentation procedures. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was discomfort on postoperative day 1, measured using a numerical rating scale (NRS). Secondary outcomes included pain and anxiety during surgery; discomfort on postoperative days 3, 7 and 14; and post-surgical complications. RESULTS A total of 366 participants were included, of which 288 (78.7%) and 328 (89.7%) reported no to mild pain and anxiety (NRS 0-3) during surgery, respectively. The proportion of patients reporting discomfort decreased from postoperative day 1 (57.7%) to day 3 (36.1%) and day 7 (17.5%). The most frequent postoperative adverse events were pain and swelling. Patient-related factors (age, sex, smoking, alcohol consumption, history of periodontitis, and pain and anxiety during surgery) and surgery-related factors (type and extent of surgical procedure) were analysed. The factors associated with the severity of discomfort after surgery included alcohol consumption, pain perception during surgery, bone augmentation procedures and age (p<0.05). Similarly, the factors associated with the duration of discomfort included alcohol consumption, pain perception during surgery and age (p<0.05). CONCLUSIONS PROMs related to dental implant surgeries can be predicted using certain risk indicators. Alcohol consumption, pain during surgery and age were associated with discomfort following dental implant surgery.
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Affiliation(s)
- Xinyu Wu
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Mengjie Ye
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jiahui Sun
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qi Yan
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bin Shi
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Haibin Xia
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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Collins JR, Ogando BP, Hong H, Hou W, Romanos GE. Clinical and Radiographic Evaluation of a Novel Triangular Implant Neck Design: A Case Series. Dent J (Basel) 2022; 10:dj10060113. [PMID: 35735655 PMCID: PMC9221962 DOI: 10.3390/dj10060113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/06/2022] [Accepted: 06/15/2022] [Indexed: 02/04/2023] Open
Abstract
The objective of this study was to evaluate the clinical and radiographic behavior of a novel triangular neck implant configuration in partially edentulous patients. Sixteen patients with a mean age of 58.3 years, were rehabilitated with 25 implants inserted in the healed sites of the maxilla and mandible; implant diameter was Ø3.3 and 3.9 mm. Clinical and radiographic measurements were first performed at prosthesis delivery that served as baseline; they were further evaluated after a mean period of 15.6 months. The interproximal peri-implant bone levels were the primary outcome; the mesial and distal data were recorded and a mean value was calculated. Secondary outcomes included peri-implant probing depth (PPD) and bleeding on probing (BoP). The paired t-test was used to compare the radiographic and clinical outcomes between baseline and follow-up. The mean bone levels at the mesial and distal aspects at baseline were 0.45 (0.47) and 0.57 (0.69), respectively; at follow-up they were 0.59 (0.42) and 0.78 (0.59), respectively. The differences were not statistically significant. Similarly, no significant differences were found for the clinical parameters. Within the limitations of the present study, it could be concluded that this new triangular neck bone level implant macro-design was used successfully to treat partially edentulous patients. Larger controlled clinical studies are warranted to confirm the present radiographic and clinical findings.
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Affiliation(s)
- James Rudolph Collins
- Department of Periodontology, School of Dentistry, Pontificia Universidad Católica Madre y Maestra (PUCMM), Santo Domingo 10109, Dominican Republic; (J.R.C.); (B.P.O.)
| | - Brendha P. Ogando
- Department of Periodontology, School of Dentistry, Pontificia Universidad Católica Madre y Maestra (PUCMM), Santo Domingo 10109, Dominican Republic; (J.R.C.); (B.P.O.)
| | - Houlin Hong
- School of Public Health & Health Policy, City University of New York, New York, NY 10031, USA;
| | - Wei Hou
- Department of Family, Population and Preventive Medicine, School of Medicine, Stony Brook University, New York, NY 11794, USA;
| | - Georgios E. Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, New York, NY 11794, USA
- Correspondence:
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Abd El Rahim NS, Ashour AA. Assessment of Quality of Life and Supporting Structures in Implant Retained Mandibular Overdenture: A 5-Year Cohort Study. Clin Cosmet Investig Dent 2022; 14:171-182. [PMID: 35722442 PMCID: PMC9198266 DOI: 10.2147/ccide.s364814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/01/2022] [Indexed: 11/23/2022] Open
Abstract
Aim To assess oral health-related quality of life (OHRQoL), marginal bone loss (MBL), and changes in soft tissue including probing pocket depth and implant stability in 2 implants retained mandibular overdentures during 5 years follow-up periods. Methods Forty completely edentulous patients with age 51-64 years were recruited for that longitudinal cohort study. Complete dentures were performed for all participants. Two implants (3.6 × 11.5 mm) were installed in the canine areas of the mandible. OHRQoL and MBL measures were performed every 1 year for 5 years, while clinical measures were made every 6 months for 60 months. Data were examined using repeated ANOVA and Friedman test. Results Thirty-seven patients had 74 implants; with mean age 56 ± 3.6 years; 43% females (n = 16) and 57% males (n = 21) accomplished the study. There were statistically significant differences in OHRQoL, MBL, and changes in soft tissue, including probing pocket depth and implant stability in 2 implants retained mandibular overdentures during 5 years follow-up periods, p ≤ 0.05. Conclusion Mandibular overdentures retained by 2 implants provide a positive long-term effect on OHRQoL, MBL, probing pocket depth, and implant stability.
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Affiliation(s)
- Neveen S Abd El Rahim
- Department of Removable Prosthodontics, Faculty of Dental Medicine for Girls, Al- Azhar University, Cairo, Egypt
- Department of Removable Prosthodontics, College of Dentistry, Taibah University, Medina, Saudi Arabia
| | - Asmaa A Ashour
- Department of Removable Prosthodontics, Faculty of Dental Medicine for Girls, Al- Azhar University, Cairo, Egypt
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Kaddas C, Papamanoli E, Bobetsis YA. Etiology and Treatment of Peri-Implant Soft Tissue Dehiscences: A Narrative Review. Dent J (Basel) 2022; 10:dj10050086. [PMID: 35621539 PMCID: PMC9139705 DOI: 10.3390/dj10050086] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/29/2022] [Accepted: 05/12/2022] [Indexed: 02/07/2023] Open
Abstract
Implant soft tissue dehiscences compromise not only the aesthetics of the supported restorations but implant survival in the long run. The aim of this narrative review was to briefly present the causative factors of buccal peri-implant soft tissue dehiscences (PSTDs), how these are classified, and the current therapeutic approaches. Implant malposition and the thin peri-implant phenotype are the two major determinants for the occurrence of PSTDs, but other risk factors have also been identified. The most common surgical procedure for treating PSTDs is the split-thickness coronally advanced flap combined with either a connective tissue graft or acellular dermal matrix materials. However, depending on the class and subtype of the dehiscence, the combination of surgical techniques with modifications in the restoration may further ameliorate the final result. In general, within a five-year follow-up period, most techniques lead to a satisfactory aesthetic result, although full coverage of the implant/abutment surface is not always achievable, especially in more extended lesions.
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Affiliation(s)
- Charalampos Kaddas
- Private Practice, 115 27 Athens, Greece;
- Correspondence: (C.K.); (Y.A.B.); Tel.: +30-698-119-7563 (C.K.)
| | | | - Yiorgos A. Bobetsis
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, 115 27 Athens, Greece
- Correspondence: (C.K.); (Y.A.B.); Tel.: +30-698-119-7563 (C.K.)
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30
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Pol CWP, Raghoebar GM, Cune MS, Meijer HJA. Three-unit fixed dental prostheses supported by either two abutment implants or two abutment teeth: A comparative retrospective cohort study. Clin Exp Dent Res 2022; 8:497-505. [PMID: 35384361 PMCID: PMC9033541 DOI: 10.1002/cre2.562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 02/01/2022] [Accepted: 02/11/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES In general, similar restorative constructions are made on natural teeth and on dental implants. The assumption is made that implants and their restoration perform the same as natural roots and their prosthetic restoration. Evaluating cohorts of three-unit bridges on teeth and on implants, this retrospective clinical study aimed to compare implants and teeth as supporting units, including the reconstructions, in terms of survival, success, clinical, radiographic, and patient-reported outcomes. MATERIAL AND METHODS From an 8-year period, all patients treated with a posterior three-unit fixed reconstruction on either implants or teeth, with a follow-up of at least 2 years, were identified. For each implant-supported reconstruction, a comparable tooth-supported reconstruction was selected, based on the length of follow-up, the material of the reconstruction, and the location in either the maxilla or mandible. RESULTS For the Implant-group, 24 patients could be matched with 24 best matching patients with tooth-supported fixed dental prostheses (FPDs). Supporting implants and implant-supported reconstructions were all in function with a mean follow-up of 52 ± 23 months. Two tooth-supported reconstructions had been replaced (91.7% survival) (mean follow-up: 52 ± 19 months). Radiographic bone levels and soft tissue conditions were favorable in both groups with minor differences. There was no significant difference in overall patient satisfaction. The modified USPHS-score revealed an 87.5% overall success in the Implant-group and 91.7% in the Tooth-group. CONCLUSIONS Implant-supported three-unit FDPs are a reliable treatment option with survival and success rates not significantly different from the results of tooth-supported three-unit FDPs.
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Affiliation(s)
- Christiaan W P Pol
- Department of Oral Surgery and Implant Dentistry, Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marco S Cune
- Department of Oral Surgery and Implant Dentistry, Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Oral and Maxillofacial Surgery, Prosthodontics and Special Dental Care, St. Antonius Hospital Nieuwegein, Nieuwegein, The Netherlands.,Department of Oral and Maxillofacial Surgery, Prosthodontics and Special Dental Care, University of Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Henny J A Meijer
- Department of Oral Surgery and Implant Dentistry, Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Soetebeer M, Jennes ME, Antonoglou G, Al-Nawas B, Beuer F. Effectiveness of soft tissue augmentation procedures for coverage of buccal soft tissue dehiscence around dental implants. A systematic review. Clin Oral Implants Res 2022; 33 Suppl 23:125-136. [PMID: 35274392 DOI: 10.1111/clr.13918] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/05/2022] [Accepted: 02/12/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This systematic review evaluated the effectiveness of soft tissue augmentation procedures for complete coverage and mean coverage of buccal soft tissue dehiscence (BSTD) in patients with implant-supported restorations. METHODS Three databases were surveyed for randomized (RCTs), non-randomized controlled clinical trials (CCTs), cohort studies, case-control studies, and case series with a minimum of five patients per control or test group. Studies dealing with soft tissue augmentation procedures to cover BSTD-occurring during implant function and not due to the result of peri-implantitis-were included. Risk of bias was evaluated with RoB 2 or the National Institutes of Health's Quality Assessment. Whenever possible exploratory meta-analyses were performed to evaluate weighted mean effects (WME) for the different outcomes. The primary outcomes were percentage of complete coverage and mean coverage of BSTD. RESULTS Seven articles were included. Only one study was a RCT, with a high risk of bias. Meta-analyses showed that after 1 year (2 studies, n = 36 patients; WME = 70; 95% confidence interval [CI] = 50; 90; p = 0.23) as well as after 5 years (3 studies, n = 54 patients; WME = 70; 95%; CI = 60; 80; p = 0.44), complete coverage of BSTD could be achieved in 70% of the cases. CONCLUSION Based on limited evidence it can be concluded that BSTD can be substantially reduced with the use of soft tissue augmentation procedures. Further research with comparative trials using larger samples and longer follow-up periods is needed to study the stability of soft tissues in the long term.
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Affiliation(s)
- Maren Soetebeer
- Charité Center for Dental, Oral and Maxillary Medicine, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Berlin, Germany
| | - Marie-Elise Jennes
- Charité Center for Dental, Oral and Maxillary Medicine, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Berlin, Germany
| | - Georgios Antonoglou
- King´s College London, Faculty of Dentistry, Oral & Craniofacial Sciences University, London, UK
| | - Bilal Al-Nawas
- Johannes Gutenberg Universitat Mainz, Department of Oral and Maxillofacial Surgery, Mainz, Rheinland-Pfalz, Germany
| | - Florian Beuer
- Charité Center for Dental, Oral and Maxillary Medicine, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Berlin, Germany
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Hanozin B, Li Manni L, Lecloux G, Bacevic M, Lambert F. Digital vs. conventional workflow for one-abutment one-time immediate restoration in the esthetic zone: a randomized controlled trial. Int J Implant Dent 2022; 8:7. [PMID: 35129763 PMCID: PMC8821739 DOI: 10.1186/s40729-022-00406-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/31/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To compare short-term outcomes after immediate restoration of a single implant in the esthetic zone with one-abutment one-time technique comparing a conventional (control) vs. a fully digital workflow (test). MATERIALS AND METHODS Eighteen subjects were randomly assigned to the two groups, and a digital implant planning was performed for all. In the test group, a custom-made zirconia abutment and a CAD-CAM provisional crown were prepared prior to surgery; implants were placed using a s-CAIS guide allowing immediate restoration after surgery. In the control group, the implant was placed free-handed using a conventional surgical guide, and a custom-made zirconia abutment to support a stratified provisional crown was placed 10 days thereafter, based on a conventional impression. Implant accuracy (relative to the planning), the provisional restoration outcomes, as well as PROMs were assessed. RESULTS The implant positioning showed higher accuracy with the s-CAIS surgical guide compared to free-handed surgery (angular deviation (AD): 2.41 ± 1.27° vs. 6.26 ± 3.98°, p < 0.014; entry point deviation (CGD): 0.65 ± 0.37 mm vs. 1.27 ± 0.83 mm, p < 0.059; apical deviation (GAD): 1.36 ± 0.53 mm vs. 2.42 ± 1.02 mm, p < 0.014). The occlusion and interproximal contacts showed similar results for the two workflows (p = 0.7 and p = 0.69, respectively). The PROMs results were similar in both groups except for impression taking with intra-oral scanning preferred over conventional impressions (p = 0.014). CONCLUSIONS Both workflows allowed implant placement and immediate/early restoration and displayed similar clinical and esthetic outcomes. The fully digital workflow was associated with a more accurate implant position relative to planning. CLINICAL RELEVANCE Our results show that both conventional and digital workflow are predictive and provide similar clinical outcomes, with extra precision provided by digitalisation.
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Affiliation(s)
- Brieuc Hanozin
- Department of Periodontology, Oral and Implant Surgery, University Hospital of Liège, Domaine du Sart Tilman Bat B-35, 4000, Liège, Belgium
| | - Lou Li Manni
- Department of Periodontology, Oral and Implant Surgery, University Hospital of Liège, Domaine du Sart Tilman Bat B-35, 4000, Liège, Belgium
| | - Geoffrey Lecloux
- Department of Periodontology, Oral and Implant Surgery, University Hospital of Liège, Domaine du Sart Tilman Bat B-35, 4000, Liège, Belgium
| | - Miljana Bacevic
- Department of Periodontology, Oral and Implant Surgery, University Hospital of Liège, Domaine du Sart Tilman Bat B-35, 4000, Liège, Belgium.
- Dental Biomaterials Research Unit (d-BRU), University of Liège, 4000, Liège, Belgium.
| | - France Lambert
- Department of Periodontology, Oral and Implant Surgery, University Hospital of Liège, Domaine du Sart Tilman Bat B-35, 4000, Liège, Belgium
- Dental Biomaterials Research Unit (d-BRU), University of Liège, 4000, Liège, Belgium
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Abstract
Inappropriate and unnecessary implant therapy driven by an erroneous belief that dental implants provide enhanced function and esthetics over diseased or failing teeth has led to a growing burden of implant complications across the globe. Specifically, esthetic and biological complications frequently lead to the unfavorable prognosis of dental implants. Often, these cannot be managed predictably to improve the condition or satisfy patients' demands. In such circumstances, implant removal needs to be considered. Currently, minimally invasive methods based on reverse torque engineering are key to preserve peri-implant soft and hard tissues. Implant replacement is now feasible, as evidenced by the high survival rates of implants placed at previously failed sites. Notwithstanding these data, clinicians should still consider carefully the expendability of an implant and whether its replacement will satisfy the prosthetic, biomechanical, and esthetic demands of the patient. In the scenario where future implant placement is desired, protocols undertaken for soft/hard tissue grafting and implant placement should be based upon defect morphology and soft and hard-tissue characteristics. Currently, however, a lack of knowledge of the biological events and dimensional changes that arise following implant removal renders decision-making complex and challenging, and recommendations remain largely based upon empirical speculation. This chapter will review the indications for implant replacement for prosthetic, biomechanical, and esthetic complications, alongside considerations in decision-making, planning, implementation, and outcomes of implant replacement.
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Affiliation(s)
- Alberto Monje
- Department of Periodontics and Oral Medicine, School of Dental Medicine, University of Michigan, Ann Arbor, MI, USA.,Department of Periodontology, Universidad Internacional de Catalunya, Barcelona, Spain
| | - José Nart
- Department of Periodontology, Universidad Internacional de Catalunya, Barcelona, Spain
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Garcia‐Sanchez R, Dopico J, Kalemaj Z, Buti J, Pardo Zamora G, Mardas N. “Comparison of clinical outcomes of immediate versus delayed placement of dental implants. A systematic review and meta‐analysis”. Clin Oral Implants Res 2022; 33:231-277. [DOI: 10.1111/clr.13892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 12/01/2021] [Accepted: 12/27/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Ruben Garcia‐Sanchez
- King’s College London UK
- Guy's and St Thomas' NHS Foundation Trust London UK
- Universidad de Murcia Murcia Spain
| | - Jose Dopico
- Universidad de Santiago Santiago de Compostela Spain
| | | | | | | | - Nikos Mardas
- QMUL Barts & The London School of Dentistry London UK
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Yoo SY, Kim SK, Heo SJ, Koak JY. Clinical and radiographic evaluations of implants as surveyed crowns for Class I removable partial dentures: A retrospective study. J Adv Prosthodont 2022; 14:108-121. [PMID: 35601350 PMCID: PMC9095449 DOI: 10.4047/jap.2022.14.2.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/11/2022] [Accepted: 04/15/2022] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate survival rates and marginal bone loss (MBL) of implants in IC-RPDs. MATERIALS AND METHODS Seventy implants were placed and used as surveyed crowns in 30 RPDs. The survival rates and MBL around implants based on multiple variables, e.g., position, sex, age, opposing dentitions, splinting, type of used retainer, and first year bone loss, were analyzed. Patient reported outcome measures (PROMs) regarding functional/esthetic improvement after IC-RPD treatment, and complications were also inspected. RESULTS The 100% implant survival rates were observed, and 60 of those implants showed MBL levels less than 1.5 mm. No significant differences in MBL of implants were observed between implant positions (maxilla vs. mandible; P = .341) and type of used retainers (P = .630). The implant MBL of greater than 0.5 mm at 1 year showed significantly higher MBL after that (P < .001). Splinted implant surveyed crowns showed lower MBL in the maxilla (splinted vs. non-splinted; P = .037). There were significant esthetic/functional improvements observed after treatment, but there were no significant differences in esthetic results based on implant position (maxilla vs. mandible). Implants in mandible showed significantly greater improvement in function than implants in the maxilla (P = .002). Prosthetic complication of IC-RPD was not observed frequently. However, 2 abutment teeth among 60 were failed. The bone loss of abutment teeth was lower than MBL of implants in IC-RPDs (P = .001). CONCLUSION Class I RPD connected to residual teeth and strategically positioned implants as surveyed crowns can be a viable treatment modality.
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Affiliation(s)
- Soo-Yeon Yoo
- Department of Prosthodontics & Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Seong-Kyun Kim
- Department of Prosthodontics & Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Seong-Joo Heo
- Department of Prosthodontics & Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Jai-Young Koak
- Department of Prosthodontics & Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, Seoul, Republic of Korea
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Kunavisarut C, Santivitoonvong A, Chaikantha S, Pornprasertsuk-Damrongsri S, Joda T. Patient-reported outcome measures comparing static computer-aided implant surgery and conventional implant surgery for single-tooth replacement: A randomized controlled trial. Clin Oral Implants Res 2021; 33:278-290. [PMID: 34921690 DOI: 10.1111/clr.13886] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/03/2021] [Accepted: 11/29/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare static computer-aided implant surgery (s-CAIS) and conventional implant surgery (CIS) for single-tooth replacement in posterior sites in terms of patient-reported outcome measures (PROMs). METHODS Forty patients were divided into two groups for treatment with s-CAIS (Test) and CIS (Control). Patients' anxiety level was measured using the modified dental anxiety score before implant surgery. After surgery, patients completed two questionnaires for 7 days. The first questionnaire assessed pain level using a visual analog scale (VAS) and the incident rate of pain using a 5-point Likert scale; analgesic intake was also recorded. The second questionnaire investigated patients' oral health-related quality of life (OHRQoL) including postoperative symptoms, oral function, and daily activity. The difference between data was compared at significance level (α = 0.05). RESULTS There was no statistically significant difference in pretreatment dental anxiety level, postoperative pain scores, and OHRQoL between treatment groups. Overall, mild or moderate dental anxiety was reported by 70% and 20% of patients, respectively. Pain score was significantly reduced by postoperative Day 3 in the test group and Day 4 in the control group, compared with baseline. Both groups significant reduced analgesic intake by postoperative Day 5. Most OHRQoL-related complaints subsided approximately 3 days after surgery. CONCLUSIONS Overall, PROMs between s-CAIS and CIS were not significantly different for the single-tooth implant surgery in the posterior area. Postoperative symptoms after implant surgery still inevitably occurred, reflecting the normal process of oral wound healing.
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Affiliation(s)
| | | | - Sarunya Chaikantha
- Department of Oral and Maxillofacial Radiology, Mahidol University, Bangkok, Thailand
| | | | - Tim Joda
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
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Gotfredsen K, Hosseini M, Rimborg S, Özhayat E. Patient's perception of timing concepts in implant dentistry: A systematic review. Clin Oral Implants Res 2021; 32 Suppl 21:67-84. [PMID: 34642992 DOI: 10.1111/clr.13861] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/16/2021] [Accepted: 04/20/2021] [Indexed: 02/03/2023]
Abstract
Protocols for implant dentistry, most frequently include periods until healing of the extraction sockets and osseointegration of the implant. Deductional thinking imply that patients would prefer if treatment time in implant dentistry were reduced. AIM What is the patient perception of immediate or early implant placement or loading in comparison with traditional, delayed placement, and/or loading assessed by patient-reported outcome measures, as evidenced in randomized controlled clinical trials or prospective controlled studies? MATERIAL AND METHODS A systematic review was performed following the PRISMA guidelines with a literature search up to June 30. All hits were imported into Rayyan online software and analyzed by two authors for eligibility. Cochrane RoB2.0 and Newcastle-Ottawa Scale were used to evaluate risk of bias in the individual studies. RESULTS Of the initially 1439 articles, 76 underwent full-text analysis and finally 40 articles, representing 35 cohort studies, were included. The quality evaluation demonstrated some concerns among most of the studies. CONCLUSION a) There is no strong evidence to support that the time for implant placement or loading of implant-supported single or short-span reconstructions or overdentures influence patients´ discomfort, satisfaction with function or esthetics or overall satisfaction with the implant treatment. b) There is some evidence that studies including edentulous patients rehabilitated with implant-supported full-arch FDPs demonstrate more satisfied patients with immediate than for the early or delayed loaded implant reconstructions after short time, but the difference is not clear one year after treatment.
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Affiliation(s)
- Klaus Gotfredsen
- Section of Oral Rehabilitation, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mandana Hosseini
- Section of Oral Rehabilitation, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Susie Rimborg
- Faculty Library of Natural- and Health Sciences, Copenhagen University Library, Copenhagen University, Copenhagen, Denmark
| | - Esben Özhayat
- Section of Public Health Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Bishti S, Tuna T, Rittich A, Wolfart S. Patient-reported outcome measures (PROMs) of implant-supported reconstructions using digital workflows: A systematic review and meta-analysis. Clin Oral Implants Res 2021; 32 Suppl 21:318-335. [PMID: 34642981 DOI: 10.1111/clr.13846] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 07/09/2021] [Accepted: 07/20/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To summarize the existing evidence on patient-reported outcome measures (PROMs) of implant-supported restorations fabricated using a digital workflow in comparison to conventional manufacturing procedures. METHODS A PICO strategy was executed using an electronic and manual search focusing on clinical studies evaluating PROMs of implant-supported restorations. Only clinical trials assessing conventional versus digital workflows for implant-supported restorations were included. PROMS on implant impression procedures and fabrication of final restorations were evaluated using random and fixed effects meta-analyses, while implant planning/placement was reported descriptively. RESULTS Among 1062 titles identified, 14 studies were finally included, and only seven studies were eligible for meta-analysis. For implant planning and placement, only a qualitative analysis was possible due to heterogeneity between the studies. For impression procedures, the random effects model revealed statistically significant differences in taste, anxiety, nausea, pain, shortness of breath, and discomfort in favor of optical impressions. No significant difference in the subjective perception of the duration of an impression could be reported. For the final fabrication of restorations, no significant difference between veneered and monolithic posterior restorations was found in terms of esthetic, function, and general satisfaction. CONCLUSION Most of the studies reporting about PROMs were published during the last ten years and limited to implant-supported single crowns in the posterior region. Based on PROMs, no scientifically proven recommendation for guided implant placement could be given at this time. Patients showed high preference for optical impressions, whereas no differences between veneered and monolithic restorations could be reported.
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Affiliation(s)
- Shaza Bishti
- Department of Prosthodontics and Biomaterials, RWTH University, Aachen, Germany
| | - Taskin Tuna
- Department of Prosthodontics and Biomaterials, RWTH University, Aachen, Germany
| | - Anne Rittich
- Department of Prosthodontics and Biomaterials, RWTH University, Aachen, Germany
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, RWTH University, Aachen, Germany
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Starch-Jensen T, Bruun NH. Patient's perception of recovery after sinus membrane elevation and blood coagulum compared with 1:1 mixture of autogenous bone graft and deproteinized porcine bone mineral. Secondary outcomes from a single-blinded randomized controlled trial. Clin Oral Implants Res 2021; 33:65-77. [PMID: 34608673 DOI: 10.1111/clr.13866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/12/2021] [Accepted: 08/09/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The objective was to assess patient's perception of recovery after maxillary sinus membrane elevation (MSME) and blood coagulum (test) compared with maxillary sinus floor augmentation (MSFA) and 1:1 mixture of autogenous bone graft from the buccal antrostomy and deproteinized porcine bone mineral (DPBM) (control). MATERIALS AND METHODS Forty healthy patients were randomly allocated to test or control. Oral health-related quality of life (OHRQoL) was evaluated by Oral Health Impact Profile-14 (OHIP-14) at enrollment and 1 week postsurgical. Recovery was estimated by questionnaires and visual analog scale assessing pain, social and working isolation, physical appearance, eating and speaking ability, diet variations, sleep impairment, and discomfort after 1 week and 1 month. Mean differences were expressed with 95% confidence interval (CI). Association between OHRQoL and recovery was estimated. p-value below .05 was considered statistically significant. RESULTS Maxillary sinus membrane elevation revealed 2.1 less days of pain (p = .03, 95% CI: 0.2-4.1) and 1.2 days of sick leave (p = .01, 95% CI: 0.3-2.1) compared with MSFA. No significant difference was observed in eating and speaking ability, physical appearance, work performance, and sleep impairment. No significant association between impaired OHRQoL and recovery was observed. Females reported 4.77 higher OHIP-14 score compared with males (p = .01, 95% CI: 1.60-7.94), while association between age and OHIP-14 was -0.10 (p = .28, 95% CI: -0.28 to 0.08). CONCLUSION Maxillary sinus membrane elevation revealed significantly less days of pain and sick leave compared with MSFA. Harvesting of autogenous bone graft seems, therefore, to have a significant impact on perception of recovery.
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Affiliation(s)
- Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital and Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Niels Henrik Bruun
- Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
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Hatakeyama W, Takafuji K, Kihara H, Sugawara S, Fukazawa S, Nojiri T, Oyamada Y, Tanabe N, Kondo H. A review of the recent literature on maxillary overdenture with dental implants. J Oral Sci 2021; 63:301-305. [PMID: 34408111 DOI: 10.2334/josnusd.21-0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The recent literature on maxillary implant overdenture (IOD) was reviewed in order to clarify its predictability and establish treatment guidelines. Electronic searches were performed using PubMed, and articles about maxillary IOD written after 1990 were reviewed, focusing on the following items: I. implant survival rate, II. maxillary IOD survival rate, III. number of implants, IV. attachment type, V. follow-up period, VI. implant system, and VII. opposing dentition. The review revealed an implant survival rate of 61-100% and an overdenture survival rate of 72.4-100%. The attachments used included bars, balls, locators, and telescope crowns. The minimum and maximum observation periods were 12 months and 120 months, respectively, and the number of implants used for supporting IOD ranged from 2 to 8. At present, there is no strong evidence to indicate that maxillary IOD is clearly superior for all the items examined. However, the existing data indicate that maxillary IOD has almost the same therapeutic effect as fixed implant superstructures, and is a treatment option that can be actively adopted for patients in whom fixed superstructures cannot be applied for various reasons.
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Affiliation(s)
- Wataru Hatakeyama
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University
| | - Kyoko Takafuji
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University
| | - Hidemichi Kihara
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University
| | - Shiho Sugawara
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University
| | - Shota Fukazawa
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University
| | - Toshiki Nojiri
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University
| | - Yutaro Oyamada
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University
| | - Norimasa Tanabe
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University
| | - Hisatomo Kondo
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University
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Sanz-Martín I, Cha JK, Sanz-Sánchez I, Figuero E, Herrera D, Sanz M. Changes in peri-implant soft tissue levels following surgical treatment of peri-implantitis: A systematic review and meta-analysis. Clin Oral Implants Res 2021; 32 Suppl 21:230-244. [PMID: 34642993 DOI: 10.1111/clr.13840] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 07/29/2021] [Accepted: 08/02/2021] [Indexed: 11/27/2022]
Abstract
AIM To assess the changes in peri-implant soft tissue levels after the surgical treatment of peri-implantitis. METHODS Randomized controlled trials, controlled clinical trials, cohort studies and case series, evaluating the changes in the position of the mucosal margin before and after surgical treatment of peri-implantitis, were searched. Secondary outcomes were changes in keratinized mucosa (KM), radiographic bone levels, probing depths (PD), plaque indices, bleeding on probing and patient perception. Meta-analyses were performed to determine weighted mean differences (WMD) or effects (WME). RESULTS Twenty-six articles, reporting 20 investigations, were included. Reconstructive approaches yielded significantly less increase in mucosal recession, when compared to access flaps (n = 3, WMD = -1.35 mm, 95% confidence interval [CI] [-2.62; -0.07], p = .038). When comparing among reconstructive surgical interventions similar outcomes were observed irrespective of the use of a barrier membrane (n = 3, WMD = -0.01 mm, 95% CI [-0.15; 0.13], p = .917). When considering the effects over time, limited mucosal recession was observed after reconstructive procedures (n = 23, WME = 0.389 mm, 95% CI [0.204; 0.574]), p = .001), while increased recession was reported with either resective or access flap surgery (n = 6, WME = 1.21 mm, 95% CI [0.70; 1.72], p = <.001; and n = 3, WME = 0.95 mm, 95% CI [0.20; 2.10], p = .106; respectively). When resective and reconstructive approaches were combined the highest values on peri-implant recession were reported (n = 2, WME = 1.97 mm, 95% CI [0.81; 3.14], p < .001). Reconstructive surgical interventions were associated with greater radiographic bone level gains, while similar values were reported for PD reduction when comparing reconstructive, access and resective procedures. CONCLUSIONS Resective surgical procedures were associated with significant post-surgical recession while minimal recession was observed in regenerative interventions.
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Affiliation(s)
- Ignacio Sanz-Martín
- Private Practice, Lausanne, Switzerland
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Ignacio Sanz-Sánchez
- Department of Dental Clinical Specialties, University Complutense of Madrid, Madrid, Spain
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Elena Figuero
- Department of Dental Clinical Specialties, University Complutense of Madrid, Madrid, Spain
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - David Herrera
- Department of Dental Clinical Specialties, University Complutense of Madrid, Madrid, Spain
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Mariano Sanz
- Department of Dental Clinical Specialties, University Complutense of Madrid, Madrid, Spain
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
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Fonteyne E, Burms E, Matthys C, Van Lierde K, De Bruyn H. Four-implant-supported overdenture treatment in the maxilla. Part II: Speech- and oral health-related quality of life in patients with implant-supported overdentures in the maxilla-A prospective 3-year follow-up. Clin Implant Dent Relat Res 2021; 23:680-691. [PMID: 34378864 DOI: 10.1111/cid.13034] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/29/2021] [Accepted: 07/15/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Implant-supported overdentures (IOD) are becoming a more commonly used treatment in the dental practice and it risks causing speech problems. PURPOSE The aim of this study was investigating the changes in speech, satisfaction with speech, and overall oral health-related quality of life (OHRQoL) in edentulous patients during and after treatment with maxillary IODs. MATERIALS AND METHODS Twenty-one patients receiving an IOD participated in speech assessment. They were examined preoperatively with their conventional denture (CD) with full palatal coverage, after connection of the implant-bar connected denture, without palatal coverage, and 3 years thereafter. The examination included assessment of articulation in speech, OHRQoL based on total OHIP-14, and satisfaction with overall oral health and speech (visual analogue scale). RESULTS There was a reduction in mean number of articulation disorders from 1.00 at baseline to 0.55 at connection, although statistically insignificant (p = 0.059). Especially the /s/ sound is vulnerable. At 3 years follow-up, still 6/16 (37.5%) of the patients suffered from this speech problem. Overall satisfaction improved from 64.05/100 at baseline to 82.95/100 at connection (p = 0.008) and remained unchanged with 81.69/100 after 3 years follow-up. Patients' satisfaction with speech increased from 70.62/100 with CD to 82.63/100, 3 years follow-up (p = 0.009). Total OHIP-14 decreased from 21.45/56 with CD to 8.00/56 (p < 0.001) with IOD and 6.13/56 3 years after connection (p = 0.001). Significant improvement of all seven domains in OHRQoL was observed with IOD compared to CD. CONCLUSIONS Patients treated with maxillary IODs show improved OHRQoL 3 years after connection of the IOD compared to the CD. Even though patients reported improvement of satisfaction and OHRQoL, articulation disorders were still present, suggesting that patients should be informed about possible speech issues.
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Affiliation(s)
- Ester Fonteyne
- Periodontology and Oral Implantology, Department of Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Eline Burms
- Department of Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Carine Matthys
- Clinic for Removable Prosthodontics, Department of Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Kristiane Van Lierde
- Department of Speech, Language and Hearing Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Communication, University of Pretoria, Pretoria, South Africa
| | - Hugo De Bruyn
- Department of Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Dentistry, Radboud University Medical Center, Nijmegen, the Netherlands
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Sermsiripoca K, Pisarnturakit PP, Mattheos N, Pimkhaokham A, Subbalekha K. Comparing pre- and post-treatment patients' perceptions on dental implant therapy. Clin Implant Dent Relat Res 2021; 23:769-778. [PMID: 34346146 DOI: 10.1111/cid.13036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/01/2021] [Accepted: 07/26/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Appropriate patients' perceptions as one of Patient Reported Outcome Measures (PROMs), are shown to be critical for the sustainable success of implant therapy, little is known however of how they prospectively evolve throughout the treatment process. OBJECTIVE This study aimed to prospectively assess patients' perceptions before and after treatment with dental implants and to identify the impact of patients' characteristics on their perceptions. MATERIALS AND METHODS Patients' perceptions on implant therapy were prospectively assessed by means of purpose-made questionnaire, rating the extent of agreement/disagreement with a set of statements on a visual analog scale. The questionnaire was collected before initial consultation with the implant dentist and post-treatment at least 1 month after prosthetic loading of the implant. Changes in patients' perceptions were analyzed with the Wilcoxon signed-rank test. RESULTS Pretreatment questionnaire was collected from 359 patients. While 245 of them proceeded with implant therapy, 145 received final restoration within the timeframe of the study and completed the post-treatment questionnaires between 1 and 6 months after prosthesis delivery. The most common source of information was dental professions (72.4%). Although patients' perceptions were more realistic at post-treatment, few improper perceptions persisted as only 51% of patients agreed with the statement "There is a chance of dental implant failure," 28% agreed with the statement "Dental implants last longer than natural teeth," and higher percentage of patients agreed with "Dental implant therapy is appropriate for all patients." CONCLUSIONS Although patients appear to harbor more realistic perceptions of implant therapy, certain improper perceptions still persist at post-treatment. The design of appropriate patient educational program might be essential to correct misperceptions that might affect long term success of implant therapy. This study had been registered on Thai Clinical Trials Registry (TCTR) with the TCTR identification number: TCTR20181101001.
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Affiliation(s)
- Khunsiri Sermsiripoca
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | | | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Keskanya Subbalekha
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Fu X, Wang Y, Chen B, Tian J, Lin Y, Zhang Y. Patient-reported outcome measures and clinical outcomes following peri-implant vestibuloplasty with a free gingival graft versus xenogeneic collagen matrix: a comparative prospective clinical study. Int J Implant Dent 2021; 7:69. [PMID: 34337690 PMCID: PMC8326236 DOI: 10.1186/s40729-021-00356-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 05/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective of this study was to compare patient-reported outcome measures (PROMs) and clinical outcomes after augmentation with xenogeneic collagen matrix (XCM) or free gingival graft (FGG) during different postoperative phases. METHODS Forty-two patients (21 per group) with keratinized mucosa width (KMW) of < 2 mm at buccal implant sites in the posterior mandible were enrolled. All underwent vestibuloplasty and were allocated to either FGG (control) or XCM (test) group. Intraoperative morbidity of pain, stress, nausea, tolerance to time, and acceptance of surgery were evaluated immediately after surgery. The severity and duration of subjective pain, swelling, and bleeding were compared within a 2-week postoperative period. The willingness to retreat and satisfaction were assessed at 6 months. All PROMs were obtained using questionnaires and visual analog scales. The buccal KMW and other peri-implant parameters were also evaluated. RESULTS No significant between-group differences were observed in PROMs immediately after surgery, except acceptance of surgery (0, 0-30.0 vs. 30, 0-50.0, p = 0.025). At 2 weeks, pain severity (46.7 ± 25.9 vs 61.9 ± 20.2, p = 0.040) and duration (5.52 ± 3.57 vs 8.48 ± 2.80, p = 0.005) were significantly lower in the test group, and pain perception during speaking and chewing was significantly higher for FGG, with no significant between-group differences in swelling and bleeding. At 6 months, the test group showed a higher willingness to retreat (76% vs 43%, p = 0.021); however, satisfaction with treatment outcomes was similar in both groups. At 6 months, the gain of KMW was significantly higher in FGG than in XCM (XCM: 1.57 ± 1.69 mm, FGG: 2.68 ± 1.80 mm, p = 0.003). Other peri-implant parameters did not show significant differences. CONCLUSIONS Within the limitation of the present nonrandomized study, XCM demonstrated more positive PROMs than FGG during different postoperative phases, mainly for less pain perception during the early healing stage, but was inferior to FGG in terms of gain of KMW. For KMW augmentation in the posterior mandible, XCM may be indicated when patients can bear little pain. CLINICAL TRIAL REGISTRATION ChiCTR1900022575 , date of registration: 17/4/2019, retrospectively registered.
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Affiliation(s)
- Xiaojiao Fu
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Ying Wang
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Bo Chen
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Jiehua Tian
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Ye Lin
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China.
| | - Yu Zhang
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China.
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Wimmer L, Petrakakis P, El-Mahdy K, Herrmann S, Nolte D. Implant-prosthetic rehabilitation of patients with severe horizontal bone deficit on mini-implants with two-piece design-retrospective analysis after a mean follow-up of 5 years. Int J Implant Dent 2021; 7:71. [PMID: 34318379 PMCID: PMC8316513 DOI: 10.1186/s40729-021-00353-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 05/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As a consequence of tooth loss due to trauma or extraction, a reduced alveolar crest volume limits the deployment of standard implants in certain patient cases. For this reason, minimal-invasive treatment with mini-dental implants (MDI) might be an option to allow implant treatment even in cases with severe horizontal bone loss without augmentation measures. The aim of this retrospective cohort study was to investigate clinical and radiological implant, as well as patient-related parameters after treatment with MDI. RESULTS Clinical and radiological records of 19 female (82.6%) and 4 male patients (17.4%) (N = 23), who received 52 mini-dental implants with a two-piece design in a single surgical center between November 2011 and October 2018, were retrospectively analyzed. Implants were submitted to conventional loading on different types of screwed superstructures. Crestal bone loss was measured on standardized periapical radiographs. Patient-related outcome parameters (PROMs) were recorded during follow-up period. Mean clinical and radiological follow-up was 69.6 months (5.8 years) and 51.6 months (4.3 years), respectively. Three implants were lost in two patients, leading to an implant survival rate of 94.2%. Mean radiological crestal bone loss was 1.6 mm. Both amount of peri-implant recession and crestal bone loss were significantly correlated (r = 0.65; p < 0.001). Likewise, a significant correlation was observed between deeper probing depths and increased peri-implant bone loss (r = 0.41; p = 0.012). Alveolar ridges with a reduced alveolar crest width were significantly correlated with higher peri-implant bone loss as well (r = - 0.33; p = 0.011). No prosthetic complications were reported during follow-up. Extent of midfacial recession and papilla height loss had a significant negative impact on most of the PROMs. CONCLUSIONS Treatment with MDI seems to be a successful alternative treatment option, especially for elderly patients with reduced crest width at implant sites. Due to the good clinical results and high survival and success rates, this treatment option was associated with high patient satisfaction. Despite the promising results, particular consideration should be given to appropriate treatment planning in these patients due to the strong correlation between peri-implant soft-tissue parameters, crestal bone loss, and reduced alveolar crest width.
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Affiliation(s)
- Lukas Wimmer
- Clinic for Oral & Maxillofacial Surgery mkg-muc®, Munich, Germany.,Private Dental Practice, St. Johann, Salzburg, Austria
| | | | - Karim El-Mahdy
- Department of Restorative Dentistry & Periodontology, Dental School, Ludwig Maximilian University, Munich, Germany
| | - Surian Herrmann
- Clinic for Oral & Maxillofacial Surgery mkg-muc®, Munich, Germany
| | - Dirk Nolte
- Clinic for Oral & Maxillofacial Surgery mkg-muc®, Munich, Germany. .,Ruhr University Bochum, Bochum, Germany.
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46
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Garcia-Sanchez R, Mardas N, Buti J, Ortiz Ruiz AJ, Pardo Zamora G. Immediate implant placement in fresh alveolar sockets with a minimal split-thickness envelope flap: A randomised controlled clinical trial. Clin Oral Implants Res 2021; 32:1115-1126. [PMID: 34218469 DOI: 10.1111/clr.13806] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 06/17/2021] [Accepted: 06/22/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Comparing PES/WES scores, modified success rate, survival, success, buccal bone thickness and patient-reported outcomes of immediate dental implants placed in fresh alveolar sockets using a flap or a minimal split-thickness envelope flap (MSTEF). MATERIALS AND METHODS Implants following random assignment into a flap or MSTEF group were placed immediately in anterior and premolar areas. Guided bone regeneration and autogenous connective tissue graft were used in all cases. A temporary prosthesis was provided followed by the final prosthesis at 16-18 weeks. Success and survival rates together with radiographic buccal bone thickness and patient satisfaction were evaluated at 12-month post-loading. The aesthetic outcome was evaluated through the Pink (PES) and White (WES) Aesthetic Score by 8 blind clinicians of different training background and incorporated in modified success criteria. RESULTS 28 implants were placed on 28 patients. No statistically significant differences were noted in PES (10.54 control versus 10.80 test), WES scores (6.97 control versus 6.95 test) or success criteria including aesthetic parameters (modified success criteria) for the different specialty groups (Range 69%-92%). In addition, no statistically significant differences were noted in survival (100%), success (100%), buccal wall thickness between control (0.72 ± 0.22) and test group (0.92 ± 0.31) and patients' reported outcomes. CONCLUSIONS Immediate dental implant treatment with flap/ MSTEF provided similar mean PES/WES scores, modified success rate, survival, mean buccal bone levels and patients' satisfaction. However, aesthetic failures were common in both groups.
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Affiliation(s)
- Ruben Garcia-Sanchez
- Universidad de Murcia, Murcia, Spain.,Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Nikos Mardas
- QMUL, The London School of Dentistry, London, UK
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Afrashtehfar KI, Bryant SR. Understanding the Lived Experience of North American Dental Patients With a Single-Tooth Implant in the Upper Front Region of the Mouth: Protocol for a Qualitative Study. JMIR Res Protoc 2021; 10:e25767. [PMID: 33886491 PMCID: PMC8277304 DOI: 10.2196/25767] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 03/16/2021] [Accepted: 04/12/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Assessment of the subjective experiences of individuals with maxillary anterior (ie, the upper front region of the mouth) single-tooth implants is limited mainly to quantitative measurements of satisfaction with appearance. Interestingly, there is unexplained variability in the relationship between satisfaction and appearance. OBJECTIVE This qualitative study protocol aims to explore and better understand the satisfaction with appearance and function in a Canadian population with maxillary anterior single-tooth implants treated at a postgraduate university clinic. Thus, we aim to obtain diversity among participants relating to the identification of esthetically pleasing and displeasing cases from a clinician perspective. METHODS A qualitative research design using interpretative phenomenology analysis (IPA) will provide an adaptable inductive research approach. The participants will be recruited, and consent documents, photographs, digital intraoral scans, and self-administered questionnaire responses will be obtained from them. The transcribed verbatim data from audio-recorded, in-depth, semistructured, one-to-one interviews of the participants will be managed, coded, and analyzed thematically with computer-assisted qualitative data analysis software. The IPA will consider the COnsolidated criteria for REporting Qualitative (COREQ) guidelines when applicable. RESULTS For the qualitative interview, we plan to include at least eight patients to conduct up to 1.5 hours of open-ended interviews with each participant aided by an interview guide. Ethical approval was granted by the University of British Columbia Behavioral Research Ethics Board (H19-00107) in May 2019. Two American dental foundations funded this study. CONCLUSIONS The analysis in this study will elucidate the aspects (including their value) that influence participant satisfaction at different dental implant treatment stages. This will be the first qualitative study on this group of the population to explore and obtain a better understanding of their satisfaction with appearance and function, as well as any other patient-reported outcome measures that could be identified. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/25767.
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Affiliation(s)
- Kelvin Ian Afrashtehfar
- Division of Restorative Dental Sciences, Clinical Sciences Department, Ajman University, Ajman City, United Arab Emirates.,Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Berne, Switzerland.,Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Dubai, United Arab Emirates.,Department of Oral Surgery and Stomatology, Faculty of Medicine, University of Bern, Berne, Switzerland
| | - Stephen Ross Bryant
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada.,Division of Prosthodontics and Dental Geriatrics, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
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Yoo SY, Kim SK, Heo SJ, Koak JY, Jeon HR. Clinical Performance of Implant Crown Retained Removable Partial Dentures for Mandibular Edentulism-A Retrospective Study. J Clin Med 2021; 10:jcm10102170. [PMID: 34069868 PMCID: PMC8157346 DOI: 10.3390/jcm10102170] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/11/2021] [Accepted: 05/13/2021] [Indexed: 12/31/2022] Open
Abstract
The studies on implant-crown-retained removable partial dentures (IC-RPDs) for edentulism are scarce. The purpose of this study was to evaluate survival rates and marginal bone loss (MBL) of IC-RPDs compared to implant overdentures (IODs) in mandibular edentulism. Variables that influenced survival and marginal bone loss (MBL) of implants in both treatment modalities were analyzed and the functional/esthetic satisfaction of patients as well as prosthetic complications were also observed. Eighteen IC-RPDs with a total of 60 implant-supported survey crowns and 24 IODs with a total 94 implants retained with magnet attachments were observed. After a median observation period of 46.6 months (up to 149 months), we observed 98.3% implant survival rates for IC-RPDs and 92.5% for IODs. Kaplan–Meier survival curves based on the treatment modality showed that, at 96 months, cumulative survival rates were 98.3% in IC-RPD and 83.1% in IOD. For implant survival rates, no statistical differences were observed according to age, sex, opposing dentition, or implant positions (p = 0.515, 0.666, 0.201, 0.749, respectively). The implant MBL measurements for IC-RPD and IOD groups at the final recall check were 0.93 ± 1.22 mm and 2.12 ± 2.09 mm, respectively. Additionally, there were no significant differences between groups (p = 0.554). The implants with peri-implantitis at year 1 showed significantly higher MBL at final check-up (p < 0.001). The MBL of implants showed significant differences based on age (p = 0.008) and opposing dentition (p = 0.003). No significant differences of implant MBL were observed for the position of placed implants (p = 0.621) or sex (p = 0.666). Patient-reported outcome measures (PROMs) on functional and esthetic satisfaction were significantly improved after IC-RPD or IOD treatment (p < 0.001). The most frequent prosthetic complication of IC-RPD was clasp loosening, while for IOD group, it was attachment dislodgement. Within the limitations of this retrospective study, we concluded that IC-RPDs could be considered as a viable treatment option for edentulous patients who need few fixed abutments for satisfaction.
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Affiliation(s)
- Soo-Yeon Yoo
- Department of Prosthodontics and Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; (S.-Y.Y.); (S.-J.H.); (J.-Y.K.)
| | - Seong-Kyun Kim
- Department of Prosthodontics and Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; (S.-Y.Y.); (S.-J.H.); (J.-Y.K.)
- Correspondence: ; Tel.: +82-2-2072-3860
| | - Seong-Joo Heo
- Department of Prosthodontics and Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; (S.-Y.Y.); (S.-J.H.); (J.-Y.K.)
| | - Jai-Young Koak
- Department of Prosthodontics and Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; (S.-Y.Y.); (S.-J.H.); (J.-Y.K.)
| | - Hye-Rin Jeon
- Department of Computer Science, Columbia University, New York, NY 10027, USA;
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Farina R, Simonelli A, Franceschetti G, Travaglini D, Consolo U, Minenna L, Schincaglia GP, Riccardi O, Bandieri A, Trombelli L. Implant-supported rehabilitation following transcrestal and lateral sinus floor elevation: analysis of costs and quality of life from a bi-center, parallel-arm randomized trial. Minerva Dent Oral Sci 2021; 71:16-24. [PMID: 33988332 DOI: 10.23736/s2724-6329.21.04539-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AIM to comparatively evaluate costs and specific aspects of oral-health related quality of life (OhRQoL) related to the period between the surgery phase of transcrestal and lateral sinus floor elevation (tSFE and lSFE, respectively) and 6 months after delivery of implant-supported prosthesis. METHODS A bi-center, parallel-arm, randomized trial comparatively evaluating tSFE and lSFE when applied concomitantly with implant placement was conducted. At 6 months after prosthesis delivery, data on cost-associated items related to the post-surgery period and selected aspects of OhRQoL were collected. RESULTS Analyses of costs and quality of life was conducted on 56 patients (tSFE: 28; lSFE: 28) and 54 patients (tSFE: 26; lSFE: 28), respectively. Significantly lower dose of anesthetic (2 vs 3 vials), amount of xenograft (420 mg vs 1975 mg), and duration of surgery (54' vs 86') were observed for tSFE compared to lSFE. No significant differences in the number of additional surgical sessions, postoperative exams, specialist consultations and drug consumption were found between groups. In a limited fraction of patients in both groups, improvements were observed for pain (tSFE: 3.8%; lSFE: 7.4%), comfort in eating any food (tSFE: 11.5%; lSFE: 3.6%), self-consciousness (tSFE: 19.2%; lSFE: 14.3%), and satisfaction about life (tSFE: 19.2%; lSFE: 10.7%). CONCLUSIONS The surgery phase of maxillary sinus floor elevation is characterized by more favorable cost-associated items for tSFE compared to lSFE. Differently, tSFE and lSFE do not differ for either costs related to the post-surgery phases or impact of the implant-supported rehabilitation on specific aspects of OhRQoL.
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Affiliation(s)
- Roberto Farina
- Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy - .,Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy -
| | - Anna Simonelli
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy
| | | | - Domenico Travaglini
- Operative Unit of Dentistry and Maxillofacial Surgery, Department Integrated Activity - Specialist Surgeries, University-Hospital of Modena, Modena, Italy.,Department of Specialistic Surgeries Head-Neck, University of Modena and Reggio Emilia, Modena, Italy
| | - Ugo Consolo
- Operative Unit of Dentistry and Maxillofacial Surgery, Department Integrated Activity - Specialist Surgeries, University-Hospital of Modena, Modena, Italy.,Department of Specialistic Surgeries Head-Neck, University of Modena and Reggio Emilia, Modena, Italy
| | - Luigi Minenna
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy
| | - Gian Pietro Schincaglia
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy.,Department of Periodontics, School of Dentistry, West Virginia University, Morgantown WV, USA
| | - Orio Riccardi
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy.,Private practice Torre Pedrera, Rimini, Italy
| | - Alberto Bandieri
- Operative Unit of Dentistry and Maxillofacial Surgery, Department Integrated Activity - Specialist Surgeries, University-Hospital of Modena, Modena, Italy.,Department of Specialistic Surgeries Head-Neck, University of Modena and Reggio Emilia, Modena, Italy
| | - Leonardo Trombelli
- Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy.,Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy
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50
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Farhan FA, Sahib AJA, Fatalla AA. Comparison of the accuracy of intraoral digital impression system and conventional impression techniques for multiple implants in the full-arch edentulous mandible. J Clin Exp Dent 2021; 13:e487-e492. [PMID: 33981396 PMCID: PMC8106939 DOI: 10.4317/jced.57926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/20/2020] [Indexed: 11/25/2022] Open
Abstract
Background Several impression techniques, especially in combination with computer-aided design and computer-aided manufacturing (CAD/CAM), are used in increasing the accuracy of dental implantology and decreasing patient discomfort. The study was designed to examine the accuracy of the digital impression (DI) of multiple implants with an intraoral scanner (IOS) and compared with that of a conventional impression (CI).
Material and Methods Four dental implants were placed in teeth area #33, #36, #43 and 46# of the mandibular full-arch model. The implanted model was replicated by IOS and CI after fitting of scannable abutments over the implant screws. Then, a small hole was made on the scan region (as a reference point). Two types of CI techniques were used; dual-phase (DP) and monophase (MP). Stone casts were produced through a conventional close tray impression technique using die stone. The casts were scanned with a laboratory scanner. DI was attained by scanning the implanted model with the IOS. The control sample was accomplished by scanning the implanted model directly with a laboratory scanner. Dimensional accuracy was calculated by measuring the distances between the reference points of four measuring parameters as follows; A-B, B-C, C-D, and A-D using CAD software.
Results The mean values and standard deviation between the four parameters of different impression techniques (CI and DI) and the control group showed convergent value. One-way ANOVA test showed all CI techniques, except IOS, showed a significant differences from the control group.
Conclusions Compared with CI, the IOS was more accurate because no differences were observed between its measurements and those of the control model. CI is simple and reduces patient discomfort when used in fabricating multiple implants and allowing communication with dental technicians. Key words:Dimension accuracy, conventional impressions, digital impressions, multiple implants.
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Affiliation(s)
- Firas-Abdulameer Farhan
- PhD. Senior Lecturer, Department of Prosthodontic, College of Dentistry, University of Baghdad, Bab Al-Muadham campus of the University of Baghdad, 1417, Baghdad, Iraq
| | - Ali-Jameel-Abdul Sahib
- MSc. Assistant professor, Department of Prosthodontic, College of Dentistry, University of Baghdad, Bab Al-Muadham campus of the University of Baghdad, 1417, Baghdad, Iraq
| | - Abdalbseet-Ahmad Fatalla
- PhD. Professor, Department of Prosthodontic, College of Dentistry, University of Baghdad, Bab Al-Muadham campus of the University of Baghdad, 1417, Baghdad, Iraq
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