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Aranda-Herrera B, Cruz TRADL, Jurado CA, Garcia-Contreras R. Anterior Hyperfunction Syndrome: Literature Review and Conceptual Model. Clin Pract 2024; 14:1584-1600. [PMID: 39194932 DOI: 10.3390/clinpract14040128] [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: 06/27/2024] [Revised: 07/26/2024] [Accepted: 08/02/2024] [Indexed: 08/29/2024] Open
Abstract
Combined Kelly syndrome, also known as anterior hyperfunction syndrome, is a complex pathological condition of the stomatognathic system, originally established by five characteristics but primarily triggered by edentulism, specifically, the absence of the upper and posterior mandibular teeth. This condition is characterized by a series of clinical features, such as bone loss, tuberosity growth, enamel wear, periodontal damage, muscle fatigue, pain, and temporomandibular joint issues. However, these features are not unique and rather reflect an oral hyperfunction state. There is a lack of consensus on the best way to assess and diagnose this condition, which is proposed to be understood as an "oral hyperfunction state" rather than a syndrome. This study aims to conduct a literature review to analyze the available information on anterior hyperfunction syndrome in dentistry, with the goal of proposing a conceptual model of the etiological risk factors that contribute to early diagnosis and the prevention of complications. This approach has important clinical implications, as it would allow for the early identification and management of risk factors, thus improving the quality of life of patients and preventing malpractice that could compromise their oral health.
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Affiliation(s)
- Benjamin Aranda-Herrera
- Interdisciplinary Research Laboratory, Nanostructures, and Biomaterials Area, National School of Higher Studies (ENES) Leon, National Autonomous University of Mexico (UNAM), Leon 37684, Mexico
| | | | - Carlos Alberto Jurado
- Operative Dentistry Division, Department of General Dentistry, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Rene Garcia-Contreras
- Interdisciplinary Research Laboratory, Nanostructures, and Biomaterials Area, National School of Higher Studies (ENES) Leon, National Autonomous University of Mexico (UNAM), Leon 37684, Mexico
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Ogino Y, Ayukawa Y. Anterior Hyperfunction by Mandibular Anterior Teeth: A Narrative Review. Healthcare (Basel) 2023; 11:2967. [PMID: 37998459 PMCID: PMC10671450 DOI: 10.3390/healthcare11222967] [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: 08/29/2023] [Revised: 11/08/2023] [Accepted: 11/10/2023] [Indexed: 11/25/2023] Open
Abstract
"Combination syndrome", defined by Kelly in 1972, is a challenging condition observed in a patient with an edentulous maxilla and a partially edentulous mandible with only mandibular anterior teeth. "Anterior hyperfunction syndrome" is regarded as a synonym of combination syndrome and was first described in 1994. Although these terms have been well known, the definition of "anterior hyperfunction" has not been described yet. This narrative review focused on anterior hyperfunction and discussed the etiology and the clinical managements. An electronic bibliographic search for this literature review was conducted in addition to the review of our clinical cases. The previous reports indicated that combination syndrome with all five features was rarely observed. The patients with anterior hyperfunction generally showed the loss of posterior occlusal supports and the loss of vertical dimension of occlusion. To manage anterior hyperfunction, these conditions should be improved using conventional removable prostheses and implant-supported prostheses. Anterior hyperfunction is attributed to mandibular anterior teeth and some interventions for mandibular anterior teeth are required in many cases. Additionally, it must be noted that implant-supported prostheses may lead to anterior hyperfunction. In conclusion, comprehensive approaches for the remaining teeth and the prostheses will be required to manage this complex condition.
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Affiliation(s)
- Yoichiro Ogino
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan;
| | - Yasunori Ayukawa
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan;
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
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Gaonkar SH, Aras MA, Chitre V, Mascarenhas K, Amin B, Rajagopal P. Survival rates of axial and tilted implants in the rehabilitation of edentulous jaws using the All-on-four™ concept: A systematic review. J Indian Prosthodont Soc 2021; 21:3-10. [PMID: 33835063 PMCID: PMC8061444 DOI: 10.4103/jips.jips_100_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Aim: The aim of this review was to evaluate the survival rate of axial and tilted implants in rehabilitation of edentulous jaws using all on four concept. Setting and Design: Systematic Review. Materials and Methods: A literature review was performed in MEDLINE, PubMed Central (PMC), Google scholar, Embase, Cochrane Central Register of Controlled Trials. Hand searches were conducted of the bibliographic of related journals and systematic reviews. A total of 380 articles were obtained from the intial screening process. Of these articles, 25 articles fulfilled the inclusion criteria. The authors performed evaluation of articles independently as well as data extraction and quality assessment. Statistical Analysis Used: Qualitative analysis. Results: The major prosthetic complication was the fracture of the acrylic prosthesis. The mean cumulative survival rate of implants (72-132 months) were 94% to 98%. The prosthesis survival rate (12 months) was between 99% to 100%. The averaged bone loss was 1.3 ±0.4 mm (12-60 months). No Significant difference was found between survival rates of axial and tilted implants nor between maxilla and mandible. Conclusion: All on four concept can be employed successfully in the edentulous patients with resorbed ridges while improving their quality of life and reducing morbidity. However,randomized clinical trials with large sampling size and long term follow up should be incorporated.
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Affiliation(s)
| | - Meena Ajay Aras
- Department of Prosthodontics, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Vidya Chitre
- Department of Prosthodontics, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Kennedy Mascarenhas
- Department of Prosthodontics, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Bhavya Amin
- Department of Prosthodontics, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Praveen Rajagopal
- Department of Prosthodontics, Goa Dental College and Hospital, Bambolim, Goa, India
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Evaluation of Quality of Life and Satisfaction in Patients with Fixed Prostheses on Zygomatic Implants Compared with the All-on-Four Concept: A Prospective Randomized Clinical Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073426. [PMID: 33806189 PMCID: PMC8037824 DOI: 10.3390/ijerph18073426] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/17/2021] [Accepted: 03/22/2021] [Indexed: 11/16/2022]
Abstract
Purpose: No published research has compared patients’ quality of life and satisfaction with fixed prostheses supported by zygomatic implants with those supported by all-on-four prostheses. The aim of this study was to evaluate patients’ quality of life and satisfaction with fixed prostheses on zygomatic implants compared with the all-on-four concept. Materials and Methods: A total of 80 patients with atrophic edentulous maxillae were randomized into two groups: Group 1 (rehabilitated with fixed prostheses supported by 2–4 zygomatic and 2–4 conventional implants in the anterior region) and Group 2 (fixed prostheses on four implants in the anterior region following an all-on-four concept). One year after placement of the definitive prostheses, patients completed OHIP-14 and satisfaction questionnaires. Results: In all seven domains of the OHIP-14 and in the overall scores, a worse quality of life was found in Group 2 patients, with statistically significant differences between the two groups (p ≤ 0.05). Patients with zygomatic implants were more satisfied with their prostheses, with a statistically significant difference (p < 0.001). Conclusions: According to the results of this study, rehabilitation of patients with edentulous atrophic maxillae with prostheses supported by zygomatic implants combined with anterior implants provided better patient quality of life and satisfaction than prostheses supported by four implants.
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Gracher AHP, de Moura MB, da Silva Peres P, Thomé G, Padovan LEM, Trojan LC. Full arch rehabilitation in patients with atrophic upper jaws with zygomatic implants: a systematic review. Int J Implant Dent 2021; 7:17. [PMID: 33634393 PMCID: PMC7907402 DOI: 10.1186/s40729-021-00297-z] [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: 04/16/2020] [Accepted: 01/28/2021] [Indexed: 11/10/2022] Open
Abstract
Background The main objective of this systematic review was to present the outcomes of the treatment with zygomatic implants (ZIs) in the rehabilitations of atrophic upper jaw. Findings An electronic database search in PubMed, along with a manual search, taking into account language and study period, was performed by two observers; any type of clinical trial and series that included the use of ZIs was used. In the search strategy, the following search terms were used: zygom* AND dental (Implant OR implants) AND edentulous NOT (biomechanic* OR finite element) NOT cadaver. The search was limited to English language, full text, and humans. Literature reviews and clinical case reports were not considered. Forty-two articles published between March 2003 and April 2019 were included in this analysis. The cases of 1247 patients were recovered; these patients received 2919 ZIs. Fifty-two ZIs were removed during the follow-up time. The survival rate of these implants was 98.22%, with a minimum follow-up of 1 month and a maximum of 228 months. Different surgical techniques were used to place ZIs; however, the intrasinusal technique was the most used (23 studies). Post-surgical sinusitis was the most common complication reported in the studies (39 cases). Conclusions Based on this review, ZIs were commonly used for rehabilitation of patients with atrophic upper jaw. The survival rates presented were high, and the surgical technique is dependent on the professional experience and the local anatomy. However, it needed additional clinical evidence on bone resorption, esthetic outcomes, and physiological characteristics.
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Affiliation(s)
| | - Marcos Boaventura de Moura
- Department of Occlusion, Fixed Prosthodontics and Dental Materials, School of Dentistry, Federal University of Uberlandia, Av. Pará 1720, Bloco 4LB, sala 39, Uberlandia, MG, 38405-902, Brazil.
| | | | - Geninho Thomé
- Department of Implantology, ILAPEO College, Curitiba, PR, Brazil
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Lee JH, Yeo ISL. Eleven-year follow-up of reconstruction with autogenous iliac bone graft and implant-supported fixed complete denture for severe maxillary atrophy: A case report. Medicine (Baltimore) 2020; 99:e18950. [PMID: 32118708 PMCID: PMC7478408 DOI: 10.1097/md.0000000000018950] [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: 11/25/2022] Open
Abstract
RATIONALE The iliac bone graft procedure is one of the treatment options for individuals with extremely resorbed alveolar bones. An autogenous block bone graft can allow the use of an implant-supported fixed dental prosthesis, rather than conventional removable dentures, by completely edentulous patients. However, the iliac bone graft technique is an invasive procedure and should be carefully selected based on its long-term clinical results. This case report describes 11-year long-term outcomes for implant-supported complete denture on the grafted iliac bone. PATIENT CONCERNS A 68-year-old Asian man was referred for oral rehabilitation with fixed dental prostheses. The patient had been unsatisfied with his removable dental prostheses in masticatory performance. DIAGNOSIS Radiographical examination revealed severely atrophied maxilla. INTERVENTIONS The atrophied maxilla was reconstructed with an iliac block bone graft, after which an implant-supported fixed complete denture was placed. OUTCOMES During 11 years of follow-up, several prosthetic and mechanical complications were encountered. Nevertheless, no biological complications were observed. Marginal bone levels around the implants were well-maintained on the radiographs after 11 years of prosthetic use. LESSONS Iliac bone graft can be chosen as a predictable treatment option that allows patients with extremely atrophic maxilla to use a fixed dental prosthesis instead of a removable denture.
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Affiliation(s)
- Jae-Hyun Lee
- Department of Prosthodontics, One-Stop Specialty Center, Seoul National University Dental Hospital
| | - In-Sung Luke Yeo
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea
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Araujo RZ, Santiago Júnior JF, Cardoso CL, Benites Condezo AF, Moreira Júnior R, Curi MM. Clinical outcomes of pterygoid implants: Systematic review and meta-analysis. J Craniomaxillofac Surg 2019; 47:651-660. [PMID: 30799134 DOI: 10.1016/j.jcms.2019.01.030] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 11/21/2018] [Accepted: 01/23/2019] [Indexed: 10/27/2022] Open
Abstract
The aim of this systematic literature review was to analyze clinical outcomes of pterygoid implant for the treatment of patients with atrophic posterior maxillae and to provide clinical recommendations for this dental implant technique. An extensive search of electronic databases (PubMed/Medline, Science Direct, Lilacs, Embase, and Cochrane Library) was conducted, for articles published between January 1995 and January 2018, to identify literature presenting clinical outcomes of pterygoid implants in the treatment of patients with atrophic posterior maxillae. The systematic review was performed in accordance with PRISMA/PICO statement guidelines, and the risk of bias was assessed (Australian National Health and Medical Research Council scale). The relative risk of implant failure was analyzed within a 95% confidence interval (95% CI). After screening 331 abstracts from the electronic databases, 36 full-text articles were accessed for eligibility, and a total of 6 studies were included in this systematic review (after applying the inclusion and exclusion criteria). All studies were retrospective in nature and were classified with a poor level of evidence. A total of 634 patients received 1.893 pterygoid implants, with a mean implant survival rate of 94.87%. The mean prevalence of implant failure was 0.056 with a 95% CI of 0.04-0.077. This study demonstrates that pterygoid implants can be successfully used in patients with atrophic posterior maxilla. However, the results should be interpreted with caution, given the presence of uncontrolled confounding factors in the included studies.
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Affiliation(s)
- Rafael Zetehaku Araujo
- Department of Oral Implantology and Dental Prosthesis, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil.
| | | | - Camila Lopes Cardoso
- Department of Oral Implantology, Universidade do Sagrado Coração, Bauru, São Paulo, Brazil
| | | | - Rosenvaldo Moreira Júnior
- Department of Oral and Maxillofacial Surgery, Universidade do Sagrado Coração, Bauru, São Paulo, Brazil
| | - Marcos Martins Curi
- Department of Oral and Maxillofacial Surgery, Hospital Santa Catarina, São Paulo, Brazil
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de Mello J, Faot F, Correa G, Chagas Júnior O. Success rate and complications associated with dental implants in the incisive canal region: a systematic review. Int J Oral Maxillofac Surg 2017; 46:1584-1591. [DOI: 10.1016/j.ijom.2017.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 03/06/2017] [Accepted: 05/04/2017] [Indexed: 01/22/2023]
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Chrcanovic BR, Albrektsson T, Wennerberg A. Tilted versus axially placed dental implants: a meta-analysis. J Dent 2014; 43:149-70. [PMID: 25239770 DOI: 10.1016/j.jdent.2014.09.002] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 08/30/2014] [Accepted: 09/03/2014] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES The purpose of the present review was to test the null hypothesis of no difference in the implant failure rate, marginal bone loss, and postoperative infection for patients being rehabilitated by tilted or by axially placed dental implants, against the alternative hypothesis of a difference. METHODS An electronic search without time or language restrictions was undertaken in July 2014. Eligibility criteria included clinical human studies, either randomised or not, interventional or observational. The estimates of an intervention were expressed in risk ratio (RR) and mean difference (MD) in millimetres. RESULTS The search strategy resulted in 44 publications. A total of 5029 dental implants were tilted (82 failures; 1.63%), and 5732 implants were axially placed (104 failures; 1.81%). The difference between the procedures did not significantly affect the implant failure rates (P=0.40), with a RR of 1.14 (95% CI 0.84-1.56). A statistically significant difference was found for implant failures when studies evaluating implants inserted in maxillae only were pooled (RR 1.70, 95% CI 1.05-2.74; P=0.03), the same not happening for the mandible (RR 0.77, 95% CI 0.39-1.52; P=0.45). There were no apparent significant effects of tilted dental implants on the occurrence of marginal bone loss (MD 0.03, 95% CI -0.03 to 0.08; P=0.32). Due to lack of satisfactory information, meta-analysis for the outcome 'postoperative infection' was not performed. CONCLUSIONS It is suggested that the differences in angulation of dental implants might not affect the implant survival or the marginal bone loss. The reliability and validity of the data collected and the potential for biases and confounding factors are some of the shortcomings of the present study. CLINICAL SIGNIFICANCE The question whether tilted implants are more at risk for failure than axially placed implants has received increasing attention in the last years. As the philosophies of treatment alter over time, a periodic review of the different concepts is necessary to refine techniques and eliminate unnecessary procedures. This would form a basis for optimum treatment.
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Affiliation(s)
| | - Tomas Albrektsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden; Department of Biomaterials, Göteborg University, Göteborg, Sweden
| | - Ann Wennerberg
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Patzelt SBM, Bahat O, Reynolds MA, Strub JR. The All-on-Four Treatment Concept: A Systematic Review. Clin Implant Dent Relat Res 2013; 16:836-55. [DOI: 10.1111/cid.12068] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Sebastian B. M. Patzelt
- Department of Prosthodontics; School of Dentistry; University Hospital; Freiburg Germany
- Department of Periodontics; School of Dentistry; University of Maryland Baltimore; Baltimore MD USA
| | | | - Mark A. Reynolds
- Department of Periodontics; School of Dentistry; University of Maryland Baltimore; Baltimore MD USA
| | - Joerg R. Strub
- Department of Prosthodontics; School of Dentistry; University Hospital; Freiburg Germany
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