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Thakrar T, Kumar A, Göthberg C, Grigoriadis A. Evaluation of jaw function, oral health-related quality of life, and nutritional status during oral rehabilitation procedures - a pilot study. Acta Odontol Scand 2024; 82:18-24. [PMID: 37623701 DOI: 10.1080/00016357.2023.2250423] [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: 04/14/2023] [Revised: 07/31/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023]
Abstract
AIMS To evaluate limitations in jaw function, oral health-related quality of life (OHRQoL), and nutritional status during extensive oral rehabilitation procedures. MATERIAL METHODS Fourteen participants (mean age ± SD: 70 ± 3.8) undergoing major oral rehabilitation involving the restoration of a minimum of eight teeth were recruited in the study. Jaw function limitations scores (JFLS), oral health-impact profile (OHIP), and nutritional status were measured at different time points during, six months, and one year after the rehabilitation procedures. Nutritional status was evaluated by measuring the body weight and arm and calf muscle circumference. The effect of time points on the measured variables was evaluated with Friedman's test. Trends in nutritional status were evaluated with linear regression analysis. RESULTS The results of the analysis showed significant main effects of time points on the JLFS (p < .001) and OHIP scores (p = .005). However, there was no effect of time points on the body weight (p = .917) and calf muscle circumference (p = .424), but a significant effect on arm circumference (p = .038). Further, there was a decreasing trend for body weight (64.3%), arm (71.4%), and calf circumference (64.3%) in the majority of the patients. CONCLUSION The results of the preliminary study suggest that people undergoing extensive oral rehabilitation procedures show improvement in jaw function and an increase in OHRQoL after the rehabilitation procedure. Despite no major changes in the nutritional indicators, most patients showed a negative trend in their body weight, arm circumference, and calf circumference, suggesting that they may be susceptible to nutritional changes.
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Affiliation(s)
- Tina Thakrar
- Department of Prosthetic Dentistry, Folktandvården Eastman Institute, Stockholm, Sweden
| | - Abhishek Kumar
- Unit of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
- Academic Center for Geriatric Dentistry, Stockholm, Sweden
| | - Catharina Göthberg
- Department of Prosthetic Dentistry, Institute for Postgraduate Dental Education, Jonkoping, Sweden
| | - Anastasios Grigoriadis
- Unit of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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Srinivasan M, Kamnoedboon P, Angst L, Müller F. Oral function in completely edentulous patients rehabilitated with implant-supported dental prostheses: A systematic review and meta-analysis. Clin Oral Implants Res 2023; 34 Suppl 26:196-239. [PMID: 37750517 DOI: 10.1111/clr.14068] [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: 10/28/2022] [Revised: 03/10/2023] [Accepted: 03/30/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES This review evaluated the effects of rehabilitation with implant-supported prostheses on the oral function of completely edentulous adults. MATERIALS AND METHODS Systematic literature searches were performed to identify records reporting on oral function in completely edentulous adults rehabilitated with implant-supported prostheses. Meta-analyses were performed on various outcomes including bite force, masticatory performance, muscle activity, mandibular movement/chewing pattern, and salivary flow. RESULTS 5507 records were identified. Thirty studies qualified for data extraction and analysis. The kappa (𝛋) for the search and identification strategy ranged between 0.50 and 1.00. Meta-analysis was performed grouping the studies by outcomes and split by time points of 6-12 months, 12-36 months, and >36 months after implant therapy. The meta-analyses revealed a significant improvement in oral function of completely edentulous adults after rehabilitation with implant-supported prostheses at 6-12 months (Z = -4.895, p < .001; 95% CI: -0.703, -0.301; τ2 = .609; Q = 114.953, df = 17, p < .001; I2 = 85.2%), at 12-36 months (Z = -4.886, p < .001; 95% CI: -0.580, -0.248; τ2 = .908; Q = 280.611, df = 35, p < .001; I2 = 87.5%) and at more than 36 months (Z = -9.108, p < .001; 95% CI: -1.472, -0.951; τ2 = .019; Q = 7.918, df = 7, p = .340; I2 = 11.6%). The included studies demonstrated a low to moderate risk of bias. CONCLUSIONS This systematic review concluded that the oral function of completely edentate adults significantly improved with implant-supported/retained prostheses, even when only one jaw received implant therapy. Therefore, implant therapy should be promoted for edentulous adults to alleviate the shortcomings of conventional complete removable dental prostheses.
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Affiliation(s)
- Murali Srinivasan
- Clinic of General-, Special Care, and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Porawit Kamnoedboon
- Clinic of General-, Special Care, and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Lea Angst
- Clinic of General-, Special Care, and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
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López-Valverde N, Aragoneses J, López-Valverde A, Rodríguez C, Macedo de Sousa B, Aragoneses JM. Role of chitosan in titanium coatings. trends and new generations of coatings. Front Bioeng Biotechnol 2022; 10:907589. [PMID: 35935477 PMCID: PMC9354072 DOI: 10.3389/fbioe.2022.907589] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/04/2022] [Indexed: 01/03/2023] Open
Abstract
Survival studies of dental implants currently reach high figures. However, considering that the recipients are middle-aged individuals with associated pathologies, research is focused on achieving bioactive surfaces that ensure osseointegration. Chitosan is a biocompatible, degradable polysaccharide with antimicrobial and anti-inflammatory properties, capable of inducing increased growth and fixation of osteoblasts around chitosan-coated titanium. Certain chemical modifications to its structure have been shown to enhance its antibacterial activity and osteoinductive properties and it is generally believed that chitosan-coated dental implants may have enhanced osseointegration capabilities and are likely to become a commercial option in the future. Our review provided an overview of the current concepts and theories of osseointegration and current titanium dental implant surfaces and coatings, with a special focus on the in vivo investigation of chitosan-coated implants and a current perspective on the future of titanium dental implant coatings.
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Affiliation(s)
- Nansi López-Valverde
- Department of Medicine and Medical Specialties, Faculty of Health Sciences, Universidad Alcalá de Henares, Madrid, Spain
| | - Javier Aragoneses
- Department of Medicine and Medical Specialties, Faculty of Health Sciences, Universidad Alcalá de Henares, Madrid, Spain
| | - Antonio López-Valverde
- Department of Surgery, University of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- *Correspondence: Antonio López-Valverde,
| | - Cinthia Rodríguez
- Department of Dentistry, Universidad Federico Henríquez y Carvajal, Santo Domingo, Dominican Republic
| | - Bruno Macedo de Sousa
- Institute for Occlusion and Orofacial Pain, Faculty of Medicine, University of Coimbra, Polo I‐Edifício Central Rua Larga, Coimbra, Portugal
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Ma H, Van Dessel J, Shujaat S, Bila M, Sun Y, Politis C, Jacobs R. Long-term survival of implant-based oral rehabilitation following maxillofacial reconstruction with vascularized bone flap. Int J Implant Dent 2022; 8:15. [PMID: 35378661 PMCID: PMC8980171 DOI: 10.1186/s40729-022-00413-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 03/15/2022] [Indexed: 12/02/2022] Open
Abstract
Aim The aim of the study was to assess the 5-year cumulative survival rate of implant-based dental rehabilitation following maxillofacial reconstruction with a vascularized bone flap and to investigate the potential risk factors which might influence the survival rate. Materials and methods A retrospective cohort study was designed. Inclusion criteria involved 18 years old or above patients with the availability of clinical and radiological data and a minimum follow-up 1 year following implant placement. The cumulative survival rate was analyzed by Kaplan–Meier curves and the influential risk factors were assessed using univariate log-rank tests and multivariable Cox-regression analysis. Results 151 implants were assessed in 40 patients with a mean age of 56.43 ± 15.28 years at the time of implantation. The mean number of implants placed per patient was 3.8 ± 1.3 with a follow-up period of 50.0 ± 32.0 months. The cumulative survival at 1-, 2- and 5-years was 96%, 87%, and 81%. Patients with systemic diseases (HR = 3.75, 95% CI 1.65–8.52; p = 0.002), irradiated flap (HR = 2.27, 95% CI 1.00–5.17; p = 0.05) and poor oral hygiene (HR = 11.67; 95% CI 4.56–29.88; p < 0.0001) were at a significantly higher risk of implant failure. Conclusion The cumulative implant survival rate was highest at 1st year followed by 2nd and 5th year, indicating that the risk of implant failure increased over time. Risk indicators that seem to be detrimental to long-term survival include poor oral hygiene, irradiated flap and systemic diseases. Supplementary Information The online version contains supplementary material available at 10.1186/s40729-022-00413-7.
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Affiliation(s)
- Hongyang Ma
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, Campus Sint-Rafaël, Kapucijnenvoer 33, 3000, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Jeroen Van Dessel
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, Campus Sint-Rafaël, Kapucijnenvoer 33, 3000, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Sohaib Shujaat
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, Campus Sint-Rafaël, Kapucijnenvoer 33, 3000, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Michel Bila
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, Campus Sint-Rafaël, Kapucijnenvoer 33, 3000, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Yi Sun
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, Campus Sint-Rafaël, Kapucijnenvoer 33, 3000, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Constantinus Politis
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, Campus Sint-Rafaël, Kapucijnenvoer 33, 3000, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, Campus Sint-Rafaël, Kapucijnenvoer 33, 3000, Leuven, Belgium. .,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium. .,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Duong HY, Roccuzzo A, Stähli A, Salvi GE, Lang NP, Sculean A. Oral health-related quality of life of patients rehabilitated with fixed and removable implant-supported dental prostheses. Periodontol 2000 2022; 88:201-237. [PMID: 35103325 PMCID: PMC9304161 DOI: 10.1111/prd.12419] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Dental implants have become a mainstream treatment approach in daily practice, and because of their high survival rates over time, they have become the preferred treatment option for prosthetic rehabilitation in many situations. Despite the relatively high predictability of implant therapy and high costs to patients, patient perceptions of success and patient-reported outcome measures have become increasingly significant in implant dentistry. Increasing numbers of publications deal with oral health-related quality of life and/or patient-reported outcome measures. The aim of this paper was to provide an overview of the available evidence on oral health-related quality of life of fully and partially dentate patients rehabilitated with fixed and removable implant-supported dental prostheses. A comprehensive electronic search was performed on publications in English up to 2021. A selection of standardized questionnaires and scales used for the evaluation of oral health-related quality of life were analyzed and explained. The analysis encompassed three aspects: a functional evaluation of oral health-related quality of life, an esthetic assessment of oral health-related quality of life, and a cost-related evaluation of oral health-related quality of life for rehabilitation with dental implants. The data demonstrated that the preoperative expectations of patients markedly affected the outcomes perceived by the patients. As expected, reconstructions supported by implants substantially improved the stability of conventional dentures and allowed improved function and patient satisfaction. However, from a patient's perspective, oral health-related quality of life was not significantly greater for dental implants compared with conventional tooth-supported prostheses. The connection of the implants to the prostheses with locators or balls indicated high oral health-related quality of life. The data also suggest that patient expectation is not a good predictor of treatment outcome. In terms of esthetic outcomes, the data clearly indicate that patients' perceptions and clinicians' assessments differed, with those of clinicians yielding higher standards. There were no significant differences found between the esthetic oral health-related quality of life ratings for soft tissue-level implants compared with those for bone-level implants. Comparison of all-ceramic and metal-ceramic restorations showed no significant differences in patients' perceptions in terms of esthetic outcomes. Depending on the choice of outcome measure and financial marginal value, supporting a conventional removable partial denture with implants is cost-effective when the patient is willing to invest more to achieve a higher oral health-related quality of life. In conclusion, the oral health-related quality of life of patients rehabilitated with implant-supported dental prostheses did not show overall superiority over conventional prosthetics. Clinicians' and patients' evaluations, especially of esthetic outcomes, are, in the majority of cases, incongruent. Nevertheless, patient-reported outcomes are important in the evaluation of function, esthetics, and the cost-effectiveness of treatment with implant-supported dental prostheses, and should be taken into consideration in daily practice.
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Affiliation(s)
- Ho-Yan Duong
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Niklaus P Lang
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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