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Passia N, Kern M. The Single Midline Implant in the Edentulous Mandible-Current Status of Clinical Trials. J Clin Med 2023; 12:jcm12113773. [PMID: 37297967 DOI: 10.3390/jcm12113773] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
The single midline implant in the edentulous mandible is a treatment concept that has often been controversially discussed. Nearly 30 years ago, the first available clinical results revealed high implant survival rates and remarkable improvements in oral comfort, function, patient satisfaction and oral health-related quality of life for edentulous patients compared to the situation with no implant. However, the clinical trials were predominantly conducted with a small number of patients over a short to medium follow-up period. Today, numerous clinical investigations on the single midline implant in the edentulous mandible, which increasingly include longer-term observation periods, are available. It is the aim of this overview to present the current literature and to highlight the clinical problems. This article is a 2023 update of a review published by the authors in the German language in 2021 in the German journal Implantologie. In total, 19 prospective clinical trials with a follow-up period of 0.5-10 years were analyzed. Over this observation period, single implants with modern rough implant surfaces in the edentulous mandible reveal high implant survival rates of between 90.9 and 100% when a conventional delayed loading protocol was applied.
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Affiliation(s)
- Nicole Passia
- Department of Prosthodontics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University at Kiel, Arnold-Heller-Str. 3, Haus B, 24105 Kiel, Germany
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Sailer I, Karasan D, Todorovic A, Ligoutsikou M, Pjetursson BE. Prosthetic failures in dental implant therapy. Periodontol 2000 2022; 88:130-144. [PMID: 35103329 PMCID: PMC9305548 DOI: 10.1111/prd.12416] [Citation(s) in RCA: 65] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Both fixed and removable implant-supported prostheses are well-established methods for replacing missing teeth in partially or fully edentulous patients. Numerous systematic reviews have been performed in recent years to evaluate the survival and complication rates of implant-retained fixed dental prostheses and implant-retained overdentures, displaying high 5-year survival rates ranging from 97.1% for fixed dental prostheses to 95%-100% for implant-retained overdentures. However, the survival rates only represent the prostheses remaining in use for a defined follow-up time, and do not account for the potential prosthetic complications that may have arisen and influence the general success of the implant treatment. The most common technical complications of fixed implant-retained single crowns are crown fracture, fractures of ceramic implant abutments, and esthetic problems. The predominant technical complication at multiple-unit, implant-retained fixed dental prostheses is fracture/chipping of the veneering ceramic. Reported technical complications for implant-retained overdentures are overdenture fracture or chipping of the veneer materials, whereas mechanical complications include implant fracture, attachment failure, and attachment housing or insert complications. To reduce the risk of such failures, a comprehensive pretreatment diagnostic work-up is essential, including defining the prosthetic goal with the aid of a wax-up or set-up and the associated ideal, prosthetically oriented three-dimensional implant position. Furthermore, selection of the ideal type of prosthesis, including the respective implant components and materials, is important for clinical long-term treatment success.
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Affiliation(s)
- Irena Sailer
- Division of Fixed Prosthodontics and BiomaterialsUniversity Clinics for Dental MedicineUniversity of GenevaGenevaSwitzerland
| | - Duygu Karasan
- Division of Fixed Prosthodontics and BiomaterialsUniversity Clinics for Dental MedicineUniversity of GenevaGenevaSwitzerland
| | - Ana Todorovic
- Division of Fixed Prosthodontics and BiomaterialsUniversity Clinics for Dental MedicineUniversity of GenevaGenevaSwitzerland
- Division of ProsthodonticsFaculty of Dental MedicineUniversity of BelgradeBelgradeSerbia
| | - Maria Ligoutsikou
- Division of Fixed Prosthodontics and BiomaterialsUniversity Clinics for Dental MedicineUniversity of GenevaGenevaSwitzerland
| | - Bjarni Elvar Pjetursson
- Division of Fixed Prosthodontics and BiomaterialsUniversity Clinics for Dental MedicineUniversity of GenevaGenevaSwitzerland
- Department of Reconstructive DentistryFaculty of OdontologyUniversity of IcelandReykjavikIceland
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Chaar MS, Naguib AA, Abd Alsamad AM, Ahmed DF, Abdel Nabi N, Kern M. Vascular and neurosensory evaluation in relation to lingual canal anatomy after mandibular midline implant installation in edentulous patients. Clin Oral Investig 2022; 26:3311-3323. [PMID: 34985576 PMCID: PMC8898232 DOI: 10.1007/s00784-021-04312-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 11/20/2021] [Indexed: 11/24/2022]
Abstract
Objectives The aim of this study is to investigate vascular and neurosensory complications in edentulous patients following the installation of mandibular midline single implants in relation to lingual canals. Materials and methods After performing a cone beam computed tomography scan for the 50 recruited patients, the relationship between the potential implant site and the lingual canals was assessed, and all vascular and neurosensory complications were recorded. Results Six patients (12%) reported profuse bleeding during implant placement, and 13 (26%) reported transient neurosensory changes, which were resolved after 3 months. According to the virtual implant planning, 44 patients (88%) would have their implants touching the lingual canals, six of them reported vascular changes (14%), and 12 out of 44 patients reported neurosensory changes (27%). For the six patients who would have their implants not touching the lingual canals, one patient reported transient neurosensory changes. Conclusions The mandibular lingual canals are constant anatomic landmarks. Injury to the supra-spinosum lingual canals may occur during midline implant placement, depending on the implant length and the bone height. Clinical relevance Despite that injury to the supra-spinosum lingual canals during implant insertion does not result in permanent vascular or neurosensory complications, caution is required to avoid the perforation of the lingual cortices.
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Affiliation(s)
- Mohamed Sad Chaar
- Department of Prosthodontics, Propaedeutic and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany.
| | - Amr Ahmed Naguib
- Department of Removable Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Ahmed Mohamed Abd Alsamad
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Dina Fahim Ahmed
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Nouran Abdel Nabi
- Department of Removable Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutic and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany
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Single-implant mandibular overdentures: Clinical, radiographic, and patient-reported outcomes after a 5-year follow-up. J Prosthet Dent 2021; 128:949-955. [PMID: 33640091 DOI: 10.1016/j.prosdent.2021.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 01/14/2021] [Accepted: 01/14/2021] [Indexed: 11/21/2022]
Abstract
STATEMENT OF PROBLEM Previous studies on single-implant mandibular overdentures have reported favorable results for clinical and patient-reported outcomes. However, information from longer term clinical studies is lacking. PURPOSE The purpose of this clinical study was to assess clinical, radiographic, and patient-reported outcomes of edentulous individuals rehabilitated with single-implant mandibular overdentures after a 5-year follow-up. MATERIAL AND METHODS A prospective clinical study was performed including completely edentulous individuals who received new conventional complete dentures and then an external hexagon implant in the mandibular midline region, followed by the incorporation of a retention system (O-ring/ball attachment; Neodent). Data collection occurred at baseline and 3, 6, 12, 24, and 60 months after implant loading. Assessed outcomes included implant stability, peri-implant soft tissue condition, peri-implant marginal bone level, satisfaction with the prostheses, and oral health-related quality of life (OHRQoL). Clinical maintenance events were also recorded. Descriptive statistics, incidence rates, Wilcoxon Signed Ranks test, and Generalized Estimating Equation regression were used for data analysis (α=.05). RESULTS Thirty of 34 eligible participants attended the 5-year follow-up visit, mean ±standard deviation age was 68.1 ±7.8 years, and 70% were women. The overall implant survival rate was 88.9%. After 5 years, the OHRQoL showed statistically significant improvement for all evaluation periods compared with baseline (P<.001). Regarding satisfaction with the mandibular denture, a significant increase was found between all evaluation periods compared with baseline in terms of comfort, stability, and ability to masticate (P<.001). Implant stability significantly increased (P=.003), and a mean bone loss of 1.46 mm was observed compared with baseline measures. The most frequent maintenance event was replacement of the O-ring matrix (n=80). Twenty-one midline fractures of the overdenture occurred in 14 study participants. No significant changes in peri-implant soft tissue conditions were observed. CONCLUSIONS A single-implant mandibular overdenture effectively maintained the positive effect of the intervention on oral health-related quality of life and patient satisfaction, stable peri-implant condition, and acceptable rates of prosthetic events.
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Aldhohrah T, Mashrah MA, Wang Y. Effect of 2-implant mandibular overdenture with different attachments and loading protocols on peri-implant health and prosthetic complications: A systematic review and network meta-analysis. J Prosthet Dent 2021; 127:832-844. [PMID: 33546861 DOI: 10.1016/j.prosdent.2020.12.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/17/2020] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Abstract
STATEMENT OF PROBLEM A systematic review of the effect of different overdenture attachments with different loading protocols on peri-implant health is lacking. PURPOSE The purpose of this systematic review and network meta-analysis was to evaluate the effect of different overdenture attachments with delayed or immediately loaded 2-implant-retained mandibular overdentures on peri-implant tissue health. MATERIAL AND METHODS A comprehensive search of the PubMed, EMBASE, and Cochrane library was conducted to identify eligible randomized controlled trials (RCTs). The outcomes were marginal bone loss, probing depth, plaque index, bleeding on probing, implant survival rate, and prosthetic complications. The Bayesian network meta-analysis accompanied by a random effect model and 95% credible intervals was calculated. RESULTS Sixteen RCT (n=599 participants receiving 1198 dental implants) were included. Five common overdenture attachment systems with delayed or immediate loading were compared. The difference in marginal bone loss and probing depth was not statistically significant when comparing different overdenture attachments with different loading protocols. The rank probability test showed that bar+ immediate loading ranked highest (63.8%) in terms of marginal bone loss, whereas ball+ delayed loading (73.3%) ranked highest in terms of probing depth. The implant survival rate was 100% for the LOCATOR+ delayed loading, resilient telescopic+ delayed loading, and magnet+ immediate loading; however, bar+ delayed loading, ball+ delayed loading, magnet+ delayed loading, LOCATOR+ immediate loading, ball+ immediate loading, and bar+ immediate loading had survival rates of 99.1%, 98.8%, 96.0%, 94.7%, 93.1%, and 91.2%, respectively. CONCLUSIONS All types of overdenture attachment with immediate loading or delayed loading had a similar effect on peri-implant health. Bar+ immediate loading was associated with the least marginal bone loss, whereas ball+ delayed loading showed the least probing depth.
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Affiliation(s)
- Taghrid Aldhohrah
- Postgraduate student, Department of Prosthodontic, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University and Guangdong Key Laboratory of Stomatology, Guangzhou, Guangdong, PR China
| | - Mubarak Ahmed Mashrah
- Assistant professor, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, PR China
| | - Yan Wang
- Professor, Department of Prosthodontic, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University and Guangdong Key Laboratory of Stomatology, Guangzhou, Guangdong, PR China.
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Borges GA, Barbin T, Dini C, Maia LC, Magno MB, Barão VAR, Mesquita MF. Patient-reported outcome measures and clinical assessment of implant-supported overdentures and fixed prostheses in mandibular edentulous patients: A systematic review and meta-analysis. J Prosthet Dent 2020; 127:565-577. [PMID: 33390270 DOI: 10.1016/j.prosdent.2020.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 02/07/2023]
Abstract
STATEMENT OF PROBLEM A consensus based on patients' perceptions as to whether to use overdentures or fixed prostheses to rehabilitate mandibular edentulous arches is limited. PURPOSE The purpose of this systematic review and meta-analysis was to compare the patient-reported outcome measures (PROMs) and clinical outcomes associated with implant-supported overdentures and fixed prostheses in edentulous mandibles. MATERIAL AND METHODS Nine electronic databases were searched for randomized clinical trials (RCTs) and nonrandomized clinical trials (N-RCTs). The risk of bias was assessed by the revised Cochrane risk of bias tool for RCTs (RoB 2) and N-RCT (ROBINS-I). Data sets for oral health-related quality of life (OHRQoL), satisfaction, survival rate, implant probing depth, and marginal bone loss were plotted, and the appropriate analyses were applied by using the Rev Man 5.3 software program. Certainty of evidence was also evaluated by means of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. RESULTS Ten eligible trials were included and evaluated quantitatively. For 3 domains of OHRQoL, fixed prostheses showed significantly higher quality of life when compared with overdentures regarding functional limitation (P<.001), physical disability (P=.001), and physical pain (P=.003). Fixed prostheses also improved satisfaction, when compared with overdentures for comfort (P=.02), ease of chewing (P<.001), retention (P<.001), and stability (P<.001). The same pattern was observed for overall OHRQoL (P=.01) and satisfaction (P=.01) in which fixed prostheses improved patient satisfaction. Only ease of cleaning presented greater satisfaction for the overdenture group. Clinical parameters did not differ statistically (P>.05) between both types of prosthesis. CONCLUSIONS Fixed rehabilitations for mandibular edentulous patients seem to be a well-accepted treatment from the patients' oral health perspective. However, mandibular overdentures are no less efficient than fixed prostheses in terms of clinical outcomes.
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Affiliation(s)
- Guilherme Almeida Borges
- PhD student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Thaís Barbin
- PhD student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Caroline Dini
- PhD student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Lucianne Cople Maia
- Full Professor, Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Marcela Baraúna Magno
- Postdoctoral Research Fellow, Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Valentim Adelino Ricardo Barão
- Assistant Professor, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Marcelo Ferraz Mesquita
- Full Professor, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil.
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Kern M, Behrendt C, Fritzer E, Kohal RJ, Luthardt RG, Maltzahn NFV, Rädel M, Reissmann DR, Schwindling FS, Wolfart S, Passia N. 5-year randomized multicenter clinical trial on single dental implants placed in the midline of the edentulous mandible. Clin Oral Implants Res 2020; 32:212-221. [PMID: 33258136 DOI: 10.1111/clr.13692] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This multicenter randomized controlled clinical trial was conducted to investigate whether the loading protocol of single dental implants placed in the midline of edentulous mandibles will influence the implant survival or prosthetic maintenance. MATERIALS AND METHODS In total, 158 patients were randomly assigned either to the immediate loading group (n = 81) or to the delayed loading group (n = 77). All implants were loaded with an overdenture retained by a ball attachment. RESULTS After 5 years, 102 patients attended the follow-up investigation. Immediately loaded single implants in the midline of the edentulous mandible revealed a statistically significant lower survival rate than implants loaded conventionally over an observation period of 5 years. In the immediate loading group, 9 implants failed within the first three months of implant loading. No further implant loss was recorded for this group. Two implants failed in the delayed loading group, whereas one implant had to be removed during second-stage surgery and the second five years after implant loading. Non-inferiority of the survival rate of the midline implant of the immediate loading group, compared with the delayed loading group, could not be shown (p = .79, CI immediate loading: 74.9%; 100.0%, CI delayed loading: 73.0%; 100.0%). The observed difference in implant survival between the two treatment groups over time was statistically significant. CONCLUSIONS The results of the present study indicate that immediate loading of a single mandibular implant in the edentulous mandible should be considered only in exceptional cases.
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Affiliation(s)
- Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University at Kiel, Kiel, Germany
| | - Christoph Behrendt
- Department of Prosthodontics, Gerodontology and Biomaterials, Greifswald University Hospital, Greifswald, Germany
| | - Elfriede Fritzer
- Center for Clinical Studies, University Hospital Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Ralf J Kohal
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center - University Hospital Freiburg, Freiburg, Germany
| | - Ralph G Luthardt
- Center of Dentistry, Department of Prosthetic Dentistry, Ulm University Hospital, Ulm, Germany
| | - Nadine Frfr V Maltzahn
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover, Germany
| | - Michael Rädel
- Faculty of Medicine Carl Gustav Carus, TU Desden, Dresden, Germany
| | - Daniel R Reissmann
- Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Nicole Passia
- Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University at Kiel, Kiel, Germany.,Universitätsklinikum Schleswig-Holstein - Campus Kiel
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A prospective cohort on the incidence of fractures in single-implant mandibular overdentures. J Dent 2020; 103:103521. [DOI: 10.1016/j.jdent.2020.103521] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/07/2020] [Accepted: 10/31/2020] [Indexed: 12/18/2022] Open
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Borges GA, Presotto AGC, Caldas RA, Pisani MX, Mesquita MF. Is one dental mini-implant biomechanically appropriate for the retention of a mandibular overdenture? A comparison with Morse taper and external hexagon platforms. J Prosthet Dent 2020; 125:491-499. [PMID: 32278498 DOI: 10.1016/j.prosdent.2020.01.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/27/2020] [Accepted: 01/27/2020] [Indexed: 11/16/2022]
Abstract
STATEMENT OF PROBLEM Limited information is available to clinicians on the use of dental mini-implants (MI) as opposed to standard-diameter implants (SDIs) for the stabilization of implant-retained mandibular overdentures (MOs). PURPOSE The purpose of this in vitro and finite element analysis study was to analyze and compare the biomechanical behavior of MOs with either 1 or 2 implants with external hexagon (EH), Morse taper (MT) SDIs, and MIs. MATERIAL AND METHODS Thirty photoelastic models (n=30) of each group (n=5) of SDIs (EH-1, EH-2, MT-1, MT-2) and MI (MI-1, MI-2) were fabricated for posterior, peri-implant, and total maximum shear stress evaluation by quantitative photoelastic analysis. One specimen of each group was further used to create the 6 computational models to be analyzed by finite element analysis. The maximum von Mises values and stress maps were plotted for each ductile component. Two types of load were applied to the overdenture: a150-N load bilaterally and simultaneously on the first molar and a 100-N load on the incisal edge of the central incisors at a 30-degree angle. The data were subjected to the 2-way ANOVA test and the Tukey honestly significant difference test (α=.05). RESULTS The EH-2 and MT-2 showed the lowest posterior (P<.001) and total (P<.05) mean shear stress values. For peri-implant shear stress, no difference was found among all groups (P>.05). Regardless of the loading area, the MI-1 and MI-2 groups showed the lowest von Mises stress values. However, for implant housing, the MI-1 group, under incisor loading, presented greater stress, followed by MT-1, EH-1, EH-2, MI-2, and MT-2. The attachment was the most overloaded structure, with high values under incisor loading, especially for the groups with 2 implants (MT-2, EH-2) as compared with the other models. CONCLUSIONS Biomechanically, regardless of the implant number, MI is a promising rehabilitation method with similar peri-implant shear stress and lower von Mises stress on the implant when compared with SDIs for MOs.
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Affiliation(s)
- Guilherme Almeida Borges
- Doctoral student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Anna Gabriella Camacho Presotto
- Research Fellow, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Ricardo Armini Caldas
- Professor, Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil.
| | - Marina Xavier Pisani
- Research Fellow, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Marcelo Ferraz Mesquita
- Full Professor, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
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The lingual foramina, a potential risk in oral surgery. A retrospective analysis of location and anatomic variability. Ann Anat 2020; 231:151515. [PMID: 32229242 DOI: 10.1016/j.aanat.2020.151515] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 02/22/2020] [Accepted: 03/02/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE This study evaluates the mandibular lingual foramina (LF) using computed tomographic imaging data from a large Central European cohort, focusing on the most relevant anatomical parameters. We aimed to examine whether there are differences in key parameters between ethnic groups, or based on age and gender. Additionally, we analyze the potential effect of tooth loss on the LF and discuss risk management options before and during surgery. METHODS 460 CT scans of adults (273 females and 186 males) were examined. The number, the location and the diameter of the median and lateral LF were assessed for each patient. The data was analyzed statistically, whereby a p-value lower than 0.05 was considered as significant. RESULTS Median and lateral LF were present in 95,9%, and 38,9% of patients, respectively. Male patients had a greater number of LF than females. While the majority of median LF (62%) was located above the mental spine, the majority of lateral LF was located below (84%). The diameter of lateral LF (1,15 mm ± 0,33) was smaller than for median LF (1,22 mm ± 0,35), as well the lateral canals (4,8 mm ± 1,28) were shorter than the median canals (5,32 mm ± 1,74). Lateral LF were equidistant to the symphysis (13,89 ± 3,63 mm) on either side. Critical diameter size >1 mm was found in about 2/3 of our cases. The distance from the foramen to the residual ridge was ∼7 mm less in edentulous patients compared to dentulous patients. CONCLUSION The median LF is a near-obligatory structure of the mandible, while the lateral LF is a frequently encountered structure. Age does not seem to affect the frequency of LF. Edentulous patients did not show differences regarding the presence of the LF, but their vertical osseous dimension was diminished by 7 mm and they may, therefore, be at an increased risk of adverse surgical incidents. The main findings of this study relate to the substantial variability in the anatomy and location of the LF and confirm with previous studies. As the LF can be reliably detected using CT/CBCT, the use of three-dimensional-imaging is recommended prior to conducting oral surgery. Careful pre-operative planning and accurate anatomical information may help to avoid surgical complications. To ascertain the potential significance of ethnicity on LF, more data need to be collected using standardized methodologies. A definitive conclusion on the impact of ethnicity on LF thus cannot currently be drawn based on the results of our study and those available from the published medical literature.
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Gibreel M, Lassila LV, Närhi TO, Perea-Lowery L, Vallittu PK. Fatigue resistance of a simulated single LOCATOR overdenture system. J Prosthet Dent 2019; 122:557-563. [DOI: 10.1016/j.prosdent.2018.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 11/08/2018] [Accepted: 11/08/2018] [Indexed: 02/06/2023]
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AbdelAal M, Fayyad A, Sheta N, AbdelNabi N, ELFar MM. Oral Health-Related Quality of Life in Single Implant Mandibular Overdenture Retained by CM LOC versus Ball Attachment: A Randomized Controlled Trial. Open Access Maced J Med Sci 2019; 7:3642-3646. [PMID: 32010392 PMCID: PMC6986501 DOI: 10.3889/oamjms.2019.792] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 09/21/2019] [Accepted: 09/22/2019] [Indexed: 11/11/2022] Open
Abstract
AIM: This randomised clinical study aimed to detect whether CMLOC attachment could improve Oral Health-Related Quality of Life (OHRQOL) when compared to ball attachment. METHODS: Eighty edentulous patients were recruited to receive a single symphyseal implant for mandibular overdenture, after three months, randomisation was done to divide them into two groups; Dalbo ball (control group) and Cendres and Metaux locator (CM-LOC) (intervention) attachments respectively, oral health impact profile for edentulous patients (OHIP-EDENT)questionnaire was recorded before implant placement, two weeks after pick up, at 3, 6, 9, and 12 months. RESULTS: Results revealed a lack of statistical significance between the two groups except for psychological discomfort at 2 weeks after pick-up (p-value = 0.029) CONCLUSION: Single implant overdenture is a simple, reliable treatment modality for treating edentulous mandible and both CM LOC and Ball attachments are good alternatives for such treatment modality.
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Affiliation(s)
- Marwa AbdelAal
- Department of Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Ahmed Fayyad
- Department of Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Nora Sheta
- Department of Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Nouran AbdelNabi
- Department of Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Passia N, Oberbillig F, Goulioumis V, Naumova EA, Kern M, Arnold W. Three-Dimensional Reconstruction of the Genial Spinal Canal. Clin Anat 2019; 33:1102-1108. [PMID: 31688952 DOI: 10.1002/ca.23512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 10/17/2019] [Accepted: 10/26/2019] [Indexed: 01/01/2023]
Abstract
The aim of this anatomical study was to investigate the genial spinal canal histologically and to reconstruct it three-dimensionally to improve understanding of its anatomy and to reveal any differences between dentate and edentulous specimens. Two tissue blocks from the mandible between the left and right second incisors, one dentate and one edentulous, were fixed in 4.5% formaldehyde, decalcified and embedded in paraffin. Serial histological sections were prepared, stained with Azan and examined microscopically. Additionally, three-dimensional models of the blocks were reconstructed using microphotographs of the sections. The genial spinal canal in the dentate specimen contained a neurovascular bundle, which branched into a nerve innervating the incisor and a neurovascular bundle, whereas that in the edentulous specimen contained some nerves for vestibular gingival innervation and a vascular bundle. The results suggest differences in the genial spinal canal between dentate and edentulous mandibles. Further research is needed to confirm this finding. Clin. Anat., 33:1102-1108, 2020. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Nicole Passia
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany
| | - Franziska Oberbillig
- Department of Biological and Material Sciences in Dentistry, Faculty of Health, School of Dentistry, Witten/Herdecke University, Witten, Germany
| | - Vlasios Goulioumis
- Department of Operative and Preventive Dentistry, Faculty of Health, School of Dentistry, Witten/Herdecke University, Witten, Germany
| | - Ella A Naumova
- Department of Biological and Material Sciences in Dentistry, Faculty of Health, School of Dentistry, Witten/Herdecke University, Witten, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany
| | - Wolfgang Arnold
- Department of Biological and Material Sciences in Dentistry, Faculty of Health, School of Dentistry, Witten/Herdecke University, Witten, Germany
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Taha NEKS, Dias DR, Oliveira TMC, Souza JAC, Leles CR. Patient satisfaction with ball and Equator attachments for single‐implant mandibular overdentures: A short‐term randomised crossover clinical trial. J Oral Rehabil 2019; 47:361-369. [DOI: 10.1111/joor.12895] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/19/2019] [Accepted: 09/19/2019] [Indexed: 12/16/2022]
Affiliation(s)
| | - Danilo Rocha Dias
- Department of Oral Rehabilitation School of Dentistry Federal University of Goias Goiania Brazil
| | | | - João Antônio Chaves Souza
- Department of Stomatological Sciences School of Dentistry Federal University of Goias Goiania Brazil
| | - Cláudio Rodrigues Leles
- Department of Oral Rehabilitation School of Dentistry Federal University of Goias Goiania Brazil
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15
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Ten-year clinical outcome of single implant-retained mandibular overdentures—A prospective pilot study. J Dent 2019; 82:63-65. [DOI: 10.1016/j.jdent.2019.01.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 01/18/2019] [Accepted: 01/21/2019] [Indexed: 12/17/2022] Open
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16
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Clinical viability of single implant-retained mandibular overdentures: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2018; 47:1166-1177. [DOI: 10.1016/j.ijom.2018.01.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 01/13/2018] [Accepted: 01/30/2018] [Indexed: 12/18/2022]
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17
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Ástvaldsdóttir Á, Boström AM, Davidson T, Gabre P, Gahnberg L, Sandborgh Englund G, Skott P, Ståhlnacke K, Tranaeus S, Wilhelmsson H, Wårdh I, Östlund P, Nilsson M. Oral health and dental care of older persons-A systematic map of systematic reviews. Gerodontology 2018; 35:290-304. [PMID: 30129220 DOI: 10.1111/ger.12368] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 07/01/2018] [Accepted: 07/10/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To examine the current knowledge on oral health status and dental care of older persons through a systematic mapping of systematic reviews of low or moderate risk of bias. BACKGROUND Geriatric dentistry covers all aspects of oral health and oral care of older persons. Oral health is part of general health and contributes to a person's physical, psychological and social wellbeing. METHODS A literature search was performed in three different databases (PubMed, The Cochrane Library and Cinahl) within 12 domains: Dental caries, periodontitis, Orofacial pain and temporomandibular joint (TMJ) pain, mucosal lesions, oral motor function, dry mouth, halitosis, interaction between oral status and other medical conditions, ability to interrelate and communicate, quality of life, ethics and organisation of dental care for older persons. Systematic reviews were identified and scrutinised, highlighting scientific knowledge and knowledge gaps. RESULTS We included 32 systematic reviews of which 14 were judged to be of low/moderate risk of bias. Most of the domains lack systematic reviews with low or moderate risk of bias. In two of the domains evidence was identified; in institutionalised people aged 65 or older, effective oral hygiene can prevent pneumonia. Furthermore, there is an evidence of a relationship between malnutrition (protein energy-related malnutrition, PEM) and poor appetite and edentulousness. CONCLUSIONS There is an urgent need for further research and evidence-based knowledge within most domains in geriatric dentistry and in other fields related to oral health and dental care for older persons striving for multi-disciplinary research programmes.
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Affiliation(s)
| | - Anne-Marie Boström
- Division of nursing, Department of Neurobiology, Care Sciences and Society, Karolinska institutet, Huddinge, Sweden.,Theme Aging, Karolinska University Hospital, Huddinge, Sweden.,Department of nursing, Western Norway University of Applied Sciences, Haugesund, Norway
| | - Thomas Davidson
- Division of health Care Analysis, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Health Technology Assessment-Odontology (HTA-O), Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Pia Gabre
- Department of Preventive Dentistry, Public Dental Health, Uppsala County Council, Uppsala, Sweden.,Department of Cariology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars Gahnberg
- Department of Preventive Dentistry, Public Dental Service, Region Västra Götaland, Sweden.,Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gunilla Sandborgh Englund
- Department of Dental Medicine, Karolinska institutet, Stockholm, Sweden.,Academic Center of Geriatric Dentistry, Karolinska institutet, Stockholm, Sweden
| | - Pia Skott
- Academic Center of Geriatric Dentistry, Karolinska institutet, Stockholm, Sweden
| | - Katri Ståhlnacke
- Public Dental Services, Region Örebro County, Sweden.,Faculty of Health and Medicine, Örebro University, Örebro, Sweden
| | - Sofia Tranaeus
- Department of Dental Medicine, Karolinska institutet, Stockholm, Sweden.,Health Technology Assessment-Odontology (HTA-O), Faculty of Odontology, Malmö University, Malmö, Sweden
| | | | - Inger Wårdh
- Department of Dental Medicine, Karolinska institutet, Stockholm, Sweden.,Academic Center of Geriatric Dentistry, Karolinska institutet, Stockholm, Sweden
| | - Pernilla Östlund
- Health Technology Assessment-Odontology (HTA-O), Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Mikael Nilsson
- Health Technology Assessment-Odontology (HTA-O), Faculty of Odontology, Malmö University, Malmö, Sweden
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18
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Reissmann DR, Enkling N, Moazzin R, Haueter M, Worni A, Schimmel M. Long-term changes in oral health-related quality of life over a period of 5 years in patients treated with narrow diameter implants: A prospective clinical study. J Dent 2018; 75:84-90. [PMID: 29852211 DOI: 10.1016/j.jdent.2018.05.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 05/24/2018] [Accepted: 05/27/2018] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess long-term changes in oral health-related quality of life (OHRQoL) over a period of 5 years in patients treated with narrow diameter implants (NDI) in the mandible for support of an overdenture. METHODS In this prospective clinical study, a consecutive sample of 20 edentulous patients who had worn sufficient complete dentures for at least 12 weeks was provided with four immediately loaded one-piece titanium NDIs in the mandible. The German 49-item version of the Oral Health Impact Profile (OHIP) was applied to assess OHRQoL at baseline and all follow-ups (4 and 8 weeks, 3, 6, and 12 months, and 3 and 5 years after treatment was finished). RESULTS Before treatment, OHRQoL was substantially impaired indicated by high OHIP summary score (39.9 points). Four weeks after treatment, a substantial treatment-induced drop of OHRQoL impairment was observed (21.8 OHIP points), and at all follow-ups, OHIP scores were lower than at baseline (15.9-26.5 OHIP points; ANOVA: p<.001). Based on mixed-effect linear regression analyses, the treatment-induced effect on OHRQoL improvement over the entire study period was statistically significant for the OHIP summary scores as well as for all four OHIP domains: Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact (all: p<.001). CONCLUSIONS This study suggests that four immediately loaded NDIs for the support of conventional complete dentures in edentulous patients with substantially impaired OHRQoL may lead to a long-lasting treatment-induced improvement in OHRQoL. CLINICAL SIGNIFICANCE The provision of four NDI in the edentulous mandible is a promising treatment option for patients with substantial OHRQoL impairment and a positive attitude towards implant treatment. Furthermore, patients can be informed that improvements in OHRQoL are expected to last for at least 5 years.
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Affiliation(s)
- Daniel R Reissmann
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Norbert Enkling
- Department of Prosthodontics, Preclinical Education and Dental Material Science, University of Bonn, Bonn, Germany; Department of Reconstructive Dentistry and Gerodontology, Division of Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Rim Moazzin
- Department of Reconstructive Dentistry and Gerodontology, Division of Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Marius Haueter
- Department of Reconstructive Dentistry and Gerodontology, Division of Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | | | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, Division of Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
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19
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Amaral CF, Gomes RS, Rodrigues Garcia RC, Del Bel Cury AA. Stress distribution of single-implant–retained overdenture reinforced with a framework: A finite element analysis study. J Prosthet Dent 2018; 119:791-796. [DOI: 10.1016/j.prosdent.2017.07.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/19/2017] [Accepted: 07/19/2017] [Indexed: 11/29/2022]
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20
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Nogueira TE, Aguiar FMO, de Barcelos BA, Leles CR. A 2-year prospective study of single-implant mandibular overdentures: Patient-reported outcomes and prosthodontic events. Clin Oral Implants Res 2018; 29:541-550. [DOI: 10.1111/clr.13151] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2018] [Indexed: 11/30/2022]
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21
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Amaral CFD, Pinheiro MA, Rodrigues Garcia RCM. Reinforcement of Single Implant‐Retained Mandibular Overdenture with a Cobalt‐Chromium Framework before Implant Surgery. J Prosthodont 2017; 28:844-848. [DOI: 10.1111/jopr.12732] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2017] [Indexed: 11/30/2022] Open
Affiliation(s)
- Camilla Fraga do Amaral
- Department of Prosthodontics and Periodontology, Piracicaba Dental SchoolUniversity of Campinas Piracicaba São Paulo Brazil
| | - Mayara Abreu Pinheiro
- Department of Prosthodontics and Periodontology, Piracicaba Dental SchoolUniversity of Campinas Piracicaba São Paulo Brazil
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22
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Stilwell C. Mandibular Implant Overdentures: Treatment and Medico-Legal Considerations. Prim Dent J 2017; 6:28-35. [PMID: 29258637 DOI: 10.1308/205016817822230265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The concept of a two-implant overdenture as the minimum standard of care or first choice treatment for the edentulous mandible was first proposed in 2002 and has since been backed by an overwhelming body of evidence supporting greater patient satisfaction and improved quality of life. This article examines the implant overdenture concept and its various options and discusses best practice from both the patient's and a medico-legal standpoint.
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23
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Kern M, Att W, Fritzer E, Kappel S, Luthardt RG, Mundt T, Reissmann DR, Rädel M, Stiesch M, Wolfart S, Passia N. Survival and Complications of Single Dental Implants in the Edentulous Mandible Following Immediate or Delayed Loading: A Randomized Controlled Clinical Trial. J Dent Res 2017; 97:163-170. [PMID: 29045800 PMCID: PMC6029143 DOI: 10.1177/0022034517736063] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
It was the aim of this 24-mo randomized controlled clinical trial to investigate
whether the survival of a single median implant placed in the edentulous
mandible to retain a complete denture is not compromised by immediate loading.
Secondary outcomes were differences in prosthetic complications between the
loading principles. Each of the 158 patients who received an implant was
randomly assigned to the immediate loading group (n = 81) or the delayed loading group (n = 77). Recall visits were performed 1 mo after implant placement
(for only the delayed loading group) and 1, 4, 12, and 24 mo after implant
loading. Nine implants failed in the immediate loading group, all within the
first 3 mo of implant loading, and 1 implant failed in the delayed loading group
prior to loading. Noninferiority of implant survival of the immediate loading
group, as compared with the delayed loading group, could not be shown (P = 0.81). Consistent with this result, a secondary
analysis with Fisher exact test revealed that the observed difference in implant
survival between the treatment groups was indeed statistically significant
(P = 0.019). The most frequent prosthetic
complications and maintenance interventions in the mandible were retention
adjustments, denture fractures, pressure sores, and matrix exchanges. There was
only 1 statistically significant difference between the groups regarding the
parameter “fracture of the denture base in the ball attachment area” (P = 0.007). The results indicate that immediate
loading of a single implant in the edentulous mandible reveals inferior survival
than that of delayed loading and therefore should be considered only in
exceptional cases (German Clinical Trials Register: DRKS00003730).
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Affiliation(s)
- M Kern
- 1 Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University at Kiel, Kiel, Germany
| | - W Att
- 2 Department of Prosthodontics, University Hospital Freiburg, Freiburg, Germany
| | - E Fritzer
- 3 Center for Clinical Studies, Christian-Albrechts University at Kiel, Kiel, Germany
| | - S Kappel
- 4 Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - R G Luthardt
- 5 Department of Prosthetic Dentistry, Center of Dentistry, Ulm University Hospital, Ulm, Germany
| | - T Mundt
- 6 Department of Prosthodontics, Gerodontology and Biomaterials, Greifswald University Hospital, Greifswald, Germany
| | - D R Reissmann
- 7 Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Rädel
- 8 Department of Prosthodontics, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - M Stiesch
- 9 Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover, Germany
| | - S Wolfart
- 10 Department of Prosthodontics and Biomaterials, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - N Passia
- 1 Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University at Kiel, Kiel, Germany
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24
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Single mandibular implant study (SMIS) − masticatory performance − results from a randomized clinical trial using two different loading protocols. J Dent 2017; 65:64-69. [DOI: 10.1016/j.jdent.2017.07.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/19/2017] [Accepted: 07/07/2017] [Indexed: 12/17/2022] Open
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25
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Nogueira TE, Dias DR, Leles CR. Mandibular complete denture versus single-implant overdenture: a systematic review of patient-reported outcomes. J Oral Rehabil 2017; 44:1004-1016. [PMID: 28805255 DOI: 10.1111/joor.12550] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2017] [Indexed: 11/28/2022]
Abstract
The single-implant mandibular overdenture (SIMO) has been proposed as an alternative for edentulous patients who are poorly adapted to their dentures due to low retention and stability of the conventional mandibular complete denture (CD). However, there is a lack of evidence regarding the effectiveness of SIMO, which can be measured by examining patient perception of treatment effects. The aim of this systematic review was to assess the comparative results of CD and SIMO treatments using patient-reported outcome measures. A literature search was carried out in PubMed, Scopus and Cochrane Central databases. The search included studies published up to July 2017. The focus question was: 'Do single-implant mandibular overdentures improve patient-reported outcomes compared to conventional complete dentures in edentulous patients?' Eligible studies were randomised clinical trials (RCT) and prospective studies. After initial screening for eligibility and full-text analysis, 11 studies were included for data extraction and quality assessment (five parallel-group RCTs, two crossover RCTs and four prospective studies). All studies reported marked improvement in satisfaction with the dentures and quality of life measures after SIMO treatment, irrespective of variations in implant treatment protocols and retention systems. Methodological considerations revealed a lack of evidence from RCTs on the comparative effectiveness of the two treatment strategies. Hence, although available evidence suggests considerable improvement in patient-reported outcomes following the insertion of a single implant to retain a mandibular denture, further well-designed comparative studies between SIMO and CD are required to improve the level of evidence and to support the indication of SIMO treatment in routine practice.
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Affiliation(s)
- T E Nogueira
- Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Brazil
| | - D R Dias
- Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Brazil
| | - C R Leles
- Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Brazil
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26
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Passia N, Att W, Freitag-Wolf S, Heydecke G, von Königsmark V, Freifrau von Maltzahn N, Mundt T, Rädel M, Schwindling FS, Wolfart S, Kern M. Single mandibular implant study - denture satisfaction in the elderly. J Oral Rehabil 2017; 44:213-219. [DOI: 10.1111/joor.12473] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2016] [Indexed: 11/30/2022]
Affiliation(s)
- N. Passia
- Department of Prosthodontics, Propaedeutics and Dental Materials; Christian-Albrechts University at Kiel; Kiel Germany
| | - W. Att
- Department of Prosthodontics; University Hospital Freiburg; Freiburg Germany
| | - S. Freitag-Wolf
- Center for Clinical Studies; Christian-Albrechts University at Kiel; Kiel Germany
| | - G. Heydecke
- Center for Dental and Oral Medicine, Department of Dental Prosthetics; University Medical Center Hamburg Eppendorf; Hamburg Germany
| | - V. von Königsmark
- Center of Dentistry, Department of Prosthetic Dentistry; Ulm University Hospital; Ulm Germany
| | | | - T. Mundt
- Department of Prosthodontics, Gerodontology and Biomaterials, Greifswald; University Hospital; Greifswald Germany
| | - M. Rädel
- Department of Prosthetic Dentistry, Dresden University of Technology; University Carl Gustav Carus; Dresden Germany
| | - F. S. Schwindling
- Department of Prosthodontics; Heidelberg University Hospital; Heidelberg Germany
| | - S. Wolfart
- Department of Prosthodontics and Biomaterials; University Hospital Aachen; Aachen Germany
| | - M. Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials; Christian-Albrechts University at Kiel; Kiel Germany
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27
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Pain and discomfort following immediate and delayed loading by overdentures in the single mandibular implant study (SMIS). Clin Oral Investig 2016; 21:635-642. [DOI: 10.1007/s00784-016-1930-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 07/28/2016] [Indexed: 10/21/2022]
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28
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Birkenfeld F, Becker M, Sasse M, Gassling V, Lucius R, Wiltfang J, Kern M. Detection of the genial spinal canal in atrophic mandibles with a CBCT: a cadaver study. Dentomaxillofac Radiol 2014; 44:20140290. [PMID: 25411711 DOI: 10.1259/dmfr.20140290] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The use of a single midline implant to retain a complete mandibular denture when more implants cannot be used is an incipient treatment modality. However, in the mandibular symphysis, the genial spinal canal (GSC) is an anatomical structure with neurovascular content that can be harmed during dental implant surgery. The purpose of the present study was to use CBCT of edentulous atrophic cadaver mandibles and evaluate how often the simulated placement of a single midline implant would contact the GSC if present. METHODS CBCT scans of 47 edentulous cadaver mandibles were performed. A digital simulation of the placement of a single midline implant (3.8 × 11.0 mm) was performed, and the implant-GSC contact was evaluated. RESULTS A GSC was detected in the CBCT scan of all atrophic mandibles. In 42 cases (89.4%), the single midline implant contacted the GSC. On average, the five cases without GSC contact had a higher alveolar ridge (4.1 mm) and a lower GSC (0.79 mm) than did the cases with GSC contact. CONCLUSIONS CBCT scans can adequately detect the GSC during pre-surgical diagnostics. There is a high risk of implant-GSC contact during surgery of the anterior mandible. However, the clinical relevance of such a contact is not known yet, because none of the clinical studies evaluating a single midline implant has reported any implant-GSC contact-related complications.
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Affiliation(s)
- F Birkenfeld
- 1 Department of Oral-Maxillofacial-Surgery, University Hospital Schleswig-Holstein, Kiel, Germany
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