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See WL, Khoo TL, Mohan M, Nimbalkar S, Patil PG. Effect of surgical and prosthodontic protocols of distal extension implant-supported removable partial dentures on clinical and patient-reported outcomes: A systematic review. J Prosthet Dent 2024:S0022-3913(24)00213-0. [PMID: 38653688 DOI: 10.1016/j.prosdent.2024.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 03/14/2024] [Accepted: 03/14/2024] [Indexed: 04/25/2024]
Abstract
STATEMENT OF PROBLEM Standard surgical and prosthodontic protocols for managing partially dentate patients with implant-supported removable partial dentures (ISRPDs) are lacking. PURPOSE The purpose of this systematic review was to determine clinical and patient-reported outcome measures (PROMs) in patients provided with ISRPDs in distal edentulous arches based on different surgical and prosthodontic protocols. MATERIAL AND METHODS An electronic and manual literature search was conducted in 3 databases, PubMed/MEDLINE, SCOPUS, and Cochrane Library, for clinical studies on distal extension ISRPDs related to clinical and patient-reported outcomes. Kennedy Class I and II arches described in articles published from January 2000 to December 2023 were included. Clinical parameters regarding implant type, location, loading protocols, and implant survival rate and PROMs including masticatory performance, esthetics, and overall satisfaction were compared. The risk of bias was determined by using the Cochrane Risk of Bias Tool 2.0 (RoB 2.0). RESULTS An initial total of 103 studies were identified, but only 11 articles were selected after implementing the inclusion and exclusion criteria. Ten studies evaluated PROMs, and 6 studies evaluated clinical outcomes (5 studies evaluated both). The implant survival rate ranged from 91.7% to 100%, with no clear differentiation among the studies with immediate or delayed loading protocols. Most studies described implants positioned in the molar region. In general, patient satisfaction and oral health-related quality of life (OHRQoL) improved significantly with ISRPDs compared with conventional removable partial dentures (RPDs) or RPDs with healing abutments. Posttreatment clinical outcomes revealed stable peri-implant health with no significant bone loss or prosthetic complications. No specific implant configuration, including implant type and location or attachment system, appeared to be better than another. Ball attachments were the commonly used attachments. Two studies were of high risk and 3 studies of low risk. The remaining 6 studies were judged to have some concerns based on the RoB 2.0 analysis. CONCLUSIONS Providing an ISRPD improved patient satisfaction, OHRQoL, and the clinical outcomes in distal extension situations, with most studies positioning the implants in the molar region. The type of attachment did not significantly affect the outcomes, although ball attachments were the most used attachment in ISRPDs.
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Affiliation(s)
- Wye Lum See
- Predoctoral student, Division of Restorative Dentistry, School of Dentistry, IMU University, Kuala Lumpur, Malaysia
| | - Teck Long Khoo
- Predoctoral student, Division of Restorative Dentistry, School of Dentistry, IMU University, Kuala Lumpur, Malaysia
| | - Mandakini Mohan
- Senior Lecturer in Prosthodontics, Division of Restorative Dentistry, School of Dentistry, IMU University, Kuala Lumpur, Malaysia
| | - Smita Nimbalkar
- Lecturer in Orthodontics, Division of Oral Health Sciences, School of Dentistry, IMU University, Kuala Lumpur, Malaysia
| | - Pravinkumar G Patil
- Lecturer in Prosthodontics, Division of Restorative Dentistry, School of Dentistry, IMU University, Kuala Lumpur, Malaysia.
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Kuroshima S, Ohta Y, Uto Y, Al-Omari FA, Sasaki M, Sawase T. Implant-assisted removable partial dentures: Part I. a scoping review of clinical applications. J Prosthodont Res 2024; 68:20-39. [PMID: 37164658 DOI: 10.2186/jpr.jpr_d_22_00252] [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] [Indexed: 05/12/2023]
Abstract
PURPOSE This scoping review aimed to systematically map research regarding implant-assisted removable partial dentures (IARPDs), and identify existing gaps in knowledge. STUDY SELECTION Two reviewers independently conducted a search of the MEDLINE-PubMed and Scopus databases according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) extension for Scoping Review and included articles published in English up to August 31, 2022, including human studies, reviews, and in vitro studies. Expert opinions, animal studies, and clinical studies involving complete overdentures were excluded, and ten aspects for establishing the treatment strategy for IARPDs were examined. RESULTS One hundred and twelve articles were chosen. There were two treatment modalities: IARPDs retained by implant- and tooth-supported surveyed single crowns (SCs) or fixed partial dentures (FPDs). In IARPDs retained by tooth-supported surveyed SCs or FPDs, the survival rate of dental implants for IARPDs was relatively higher with a wide range of marginal bone loss and many complications, but with improved functional performance, oral health-related quality of life, and patient satisfaction. There were limited data on survival or success rates and designs of IARPDs, attachment selections, length and diameter, inclination, placement sites, and loading protocols of implants, regardless of prosthetic types. There was limited information on maxillary IARPDs except for survival rates of implants. CONCLUSIONS Although IARPDs could become a useful treatment strategy, there is limited scientific consensus with gaps in knowledge about their use. Additional well-designed clinical and in vitro studies are necessary to scientifically establish IARPDs as definitive prostheses in implant dentistry.
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Affiliation(s)
- Shinichiro Kuroshima
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yoshikazu Ohta
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yusuke Uto
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Farah A Al-Omari
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Muneteru Sasaki
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Takashi Sawase
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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Ichikawa H, Yoda N, Ogawa T, Iwamoto M, Kawata T, Egusa H, Sasaki K. Impact of implant location on load distribution of implant-assisted removable partial dentures: a review of in vitro model and finite-element analysis studies. Int J Implant Dent 2023; 9:31. [PMID: 37725286 PMCID: PMC10509086 DOI: 10.1186/s40729-023-00500-3] [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: 02/20/2023] [Accepted: 09/06/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Appropriate load distribution among the supporting elements is essential for the long-term success of implant-assisted removable partial dentures; however, there is little information available on load distribution. PURPOSE This study aimed to evaluate the effect of implant location on load distribution in implant-assisted removable partial dentures by reviewing in vitro models and finite-element analysis studies. MATERIALS AND METHODS English-language studies which examined the load distribution of implant-assisted removable partial dentures and were published between January 2001 and October 2022 were extracted from PubMed, ScienceDirect, and Scopus online databases, and manual searching. Two reviewers selected the articles based on the predetermined inclusion and exclusion criteria, followed by data extraction and analysis. RESULTS Forty-seven studies were selected after evaluating the titles and abstracts of 264 articles; two were identified manually. After screening the text, 12 studies were included: six in vitro model experiments and six finite-element analysis studies. All included studies used a mandibular free-end missing model (Kennedy Class I or II). The influence of implant location on load distribution to the abutment tooth, implant, and mucosa under the denture base was summarized in three cases: implant at the premolar, first molar, and second molar region. Due to differences in the measurement method of load distribution and loading condition to the denture, the results differed among the studies. CONCLUSIONS The implant location in implant-assisted removable partial dentures can affect load distribution to the supporting elements, such as the abutment tooth, implant, and mucosa under the denture base.
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Affiliation(s)
- Hiromi Ichikawa
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-Machi, Sendai, Miyagi, 980-8575, Japan
- Dental Technical Training School attached to Nihon University School of Dentistry, Tokyo, Japan
| | - Nobuhiro Yoda
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-Machi, Sendai, Miyagi, 980-8575, Japan.
- Department of Prosthodontics, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, 60132, Indonesia.
| | - Toru Ogawa
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-Machi, Sendai, Miyagi, 980-8575, Japan
| | - Maya Iwamoto
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-Machi, Sendai, Miyagi, 980-8575, Japan
| | - Tetsuo Kawata
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-Machi, Sendai, Miyagi, 980-8575, Japan
| | - Hiroshi Egusa
- Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, 980-8575, Japan
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-Machi, Sendai, Miyagi, 980-8575, Japan
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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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Watanabe M, Kanazawa M, Sato D, Uehara Y, Miyayasu A, Iwaki M, Komagamine Y, Naing ST, Katheng A, Kusumoto Y, Abe Y, Baba K, Minakuchi S. Oral function of implant-assisted removable partial dentures with magnetic attachments using short implants: A prospective study. Clin Oral Implants Res 2022; 33:1265-1272. [PMID: 36222311 DOI: 10.1111/clr.14008] [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: 10/22/2021] [Revised: 09/22/2022] [Accepted: 10/02/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVES This prospective study aimed to compare the oral functions of removable partial dentures (RPDs) with those of implant-assisted removable partial dentures (IARPDs) with short implants and magnetic attachments in patients with mandibular Kennedy class I and II. MATERIAL AND METHODS Thirty participants with mandibular Kennedy class I or II and at least three distal missing teeth were recruited. Oral functions, including mixing ability, comminuting ability, maximum bite force, and occlusal contact area, were assessed for RPDs (stage 0), IARPDs with healing caps (stage 1), and IARPDs with magnetic attachments (stage 2). The implants were loaded with occlusal force in stages 1 and 2. Finally, the data of the 27 participants who completed the evaluation at stage 2 were analyzed. The Wilcoxon signed-rank test with Bonferroni correction was used to assess the differences in the oral functions among the different stages. RESULTS The implant survival rate was 93.8%. There were significant differences in the comminuting ability and occlusal contact area between stages 0 and 2 (p < .001 and p = .036, respectively) and stages 1 and 2 (p = .003 and p = .015, respectively). Regarding the maximum bite force, there was a significant difference between stages 1 and 2 (p = .018). However, there was no significant difference in the mixing ability between the three stages. CONCLUSIONS Within the limitations of this study, it was concluded that IARPDs in the mandible with short implants and magnetic attachments may improve oral functions.
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Affiliation(s)
- Masataka Watanabe
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Manabu Kanazawa
- Digital Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Daisuke Sato
- Department of Implant Dentistry, School of Dentistry, Showa University, Tokyo, Japan
| | - Yoko Uehara
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Anna Miyayasu
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Maiko Iwaki
- Digital Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuriko Komagamine
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sai Tun Naing
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Awutsadaporn Katheng
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuriko Kusumoto
- Department of Prosthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Yuka Abe
- Department of Prosthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Kazuyoshi Baba
- Department of Prosthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Shunsuke Minakuchi
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Chen YC, Lin CL, Yu CH, Chang HC, Lin YM, Lin JW. Biomechanical Analysis of Mandibular Implant-Assisted Removable Partial Denture with Distal Extension. J Med Biol Eng 2022. [DOI: 10.1007/s40846-022-00738-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bandiaky ON, Lokossou DL, Soueidan A, Le Bars P, Gueye M, Mbodj EB, Le Guéhennec L. Implant-supported removable partial dentures compared to conventional dentures: A systematic review and meta-analysis of quality of life, patient satisfaction, and biomechanical complications. Clin Exp Dent Res 2022; 8:294-312. [PMID: 35014207 PMCID: PMC8874059 DOI: 10.1002/cre2.521] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/24/2021] [Accepted: 12/01/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES The purpose of this systematic review and meta-analysis was to compare implant-supported removable partial dentures (ISRPDs) with distal extension removable partial dentures (DERPDs) in terms of patient-reported outcome measures (PROMs: patients' quality of life and satisfaction) and to determine mechanical and biological complications associated with ISRPDs. MATERIAL AND METHODS An electronic search was performed on four databases to identify studies treating Kennedy class I or II edentulous patients and which compared ISRPDs with DERPDs in terms of PROMS and studies, which evaluated mechanical and biological complications associated ISRPDs. Two authors independently extracted data on quality of life, patient satisfaction, and biomechanical complications from these studies. The risk of bias was assessed for each study, and for PROMs, the authors performed a meta-analysis by using a random-effects model. RESULTS Thirteen articles were included based on the selection criteria. The difference in mean scores for quality of life (30.5 ± 1.8; 95% confidence interval [CI], 24.9-36.1) and patient satisfaction (-20.8 ± 0.2; 95% CI, -23.7 to -17.8) between treatments with conventional and implant-supported removable dentures was statistically significant (p < .05). Implant-supported removable dentures improved patients' overall quality of life and satisfaction. Some mechanical and biological complications, such as clasp adjustment, abutment or implant loosening, marginal bone resorption, and peri-implant mucositis, were noted in ISRPDs during patient follow-up. Studies assessing PROMs were very heterogeneous (I2 = 65%, p = .85; I2 = 75%, p = .88). CONCLUSIONS ISRPDs significantly improved quality of life and patient satisfaction. Some mechanical and biological complications have been associated with ISRPDs treatment, requiring regular monitoring of patients to avoid the occurrence of these complications.
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Affiliation(s)
| | | | - Assem Soueidan
- Department of Periodontology, Rmes U1229University of NantesNantesFrance
| | | | - Moctar Gueye
- Department of Odontology, Clinic of Fixed and Removable ProsthodonticsUniversity of DakarDakarSenegal
| | - Elhadj B. Mbodj
- Department of Odontology, Clinic of Fixed and Removable ProsthodonticsUniversity of DakarDakarSenegal
| | - Laurent Le Guéhennec
- Department of Prosthetic Dentistry, Faculty of DentistryUniversity of NantesNantesFrance
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Putra Wigianto AY, Goto T, Iwawaki Y, Ishida Y, Watanabe M, Ichikawa T. Treatment outcomes of implant-assisted removable partial denture with distal extension based on the Kennedy classification and attachment type: a systematic review. Int J Implant Dent 2021; 7:111. [PMID: 34773513 PMCID: PMC8590637 DOI: 10.1186/s40729-021-00394-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 11/07/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Implant-assisted removable partial dentures (IARPDs) have recently become popular, but little information is available on the treatment outcomes based on the Kennedy classification and attachment types. OBJECTIVE The objective of this review was to evaluate the treatment outcomes of IARPD delivered for distal extension edentulous areas based on the differences in the Kennedy classification and attachment type. MATERIALS AND METHODS English-language clinical studies on IARPD published between January 1980 and February 2020 were collected from MEDLINE (via PubMed), the Cochrane Library (via the Cochrane Central Register of Controlled Trials), Scopus online database, and manual searching. Two reviewers selected the articles based on pre-determined inclusion and exclusion criteria, followed by data extraction and analysis. RESULTS Eighty-one studies were selected after evaluating the titles and abstracts of 2410 papers. Nineteen studies were finally included after the perusal of the full text. Fourteen studies focused on Class I, 4 studies investigated both Class I and II, and only 1 study was conducted on Kennedy's class II. Eight types of attachments were reported. The ball attachment was the most frequently used attachment, which was employed in 8 of the included studies. The implant survival rate ranged from 91 to 100%. The reported marginal bone loss ranged from 0.3 mm to 2.30 mm. The patient satisfaction was higher with IARPD than with conventional RPDs or that before treatment. The results of prosthetic complications were heterogeneous and inconclusive. CONCLUSION IARPD exhibited favorable clinical outcomes when used as a replacement for distal extension edentulous areas. The comparison between the clinical outcomes of Kennedy's class I and II was inconclusive owing to the lack of studies focusing on Kennedy Class II alone. The stud attachment was the most commonly used type in IARPDs. Overall, the different attachment systems did not influence the implant survival rate and patient satisfaction. Further high-quality studies are needed to investigate the attachment systems used in IARPD.
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Affiliation(s)
- Adityakrisna Yoshi Putra Wigianto
- Department of Prosthodontics & Oral Rehabilitation, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima, 770-8504, Japan
| | - Takaharu Goto
- Department of Prosthodontics & Oral Rehabilitation, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima, 770-8504, Japan.
| | - Yuki Iwawaki
- Department of Prosthodontics & Oral Rehabilitation, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima, 770-8504, Japan
| | - Yuichi Ishida
- Department of Prosthodontics & Oral Rehabilitation, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima, 770-8504, Japan
| | - Megumi Watanabe
- Department of Prosthodontics & Oral Rehabilitation, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima, 770-8504, Japan
| | - Tetsuo Ichikawa
- Department of Prosthodontics & Oral Rehabilitation, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima, 770-8504, Japan
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Murakami K, Ayukawa Y, Ogino Y, Nakagawa A, Horikawa T, Yamaguchi E, Takaki K, Koyano K. Clinical effectiveness of implant support for distal extension removable partial dentures: functional evaluation using occlusal force measurement and masticatory efficiency. Int J Implant Dent 2021; 7:101. [PMID: 34632540 PMCID: PMC8502720 DOI: 10.1186/s40729-021-00381-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/13/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Implant-supported removable partial dentures (ISRPD) are supported at the free-end region with implant retainers. As implant retainers prevent denture settlement and facilitate denture retention, this is intended to improve masticatory performance in comparison with that of conventional removable dentures. In the present study, we evaluated the effect of implant retainers at the free-end region of removable dentures on occlusal force and masticatory efficiency using a pressure-sensitive sheet, and measured glucose concentration in saliva after mastication with gummy candy. METHODS In the present study, the occlusal force and masticatory efficiency of 13 subjects were measured in the following three conditions: without dentures (Condition 1), wearing dentures but not supported by implants (Condition 2), and wearing dentures supported by implants (ISRPD) (Condition 3). All data were statistically compared. RESULTS Regarding the occlusal force, Condition 3 showed significantly higher scores than the other conditions; however, there were no significant differences between Conditions 1 and 2. Regarding the masticatory efficiency, Condition 3 showed significantly higher scores than Condition 2. CONCLUSIONS With ISRPD, the occlusal force and masticatory efficiency were increased in comparison with those with conventional removable dentures.
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Affiliation(s)
- Kei Murakami
- Kei Dental Clinic, 1-9-25 Jyozan-ohdomo, Nishi-ku, Kumamoto, 8600067, Japan. .,Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 8128582, Japan.
| | - Yasunori Ayukawa
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 8128582, Japan
| | - Yoichiro Ogino
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 8128582, Japan
| | - Akinari Nakagawa
- Nakagawa Dental Clinic, 2377 Sonezaki, Tosu City, Saga, 8410025, Japan
| | - Tadashi Horikawa
- Horikawa Dental Clinic, 1-10-23 Saburo, Higashi-ku, Kumamoto, 8620922, Japan
| | - Eishi Yamaguchi
- Let's Dental Clinic, 2-2-18 Shinhoka, Higashi-ku, Kumamoto, 8620921, Japan
| | - Kimiyasu Takaki
- Takaki Dental Clinic, 1329-1 Waifu, Kikuchi City, Kumamoto, 8611331, Japan
| | - Kiyoshi Koyano
- Division of Advanced Dental Devices and Therapeutics, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 8128582, Japan
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Ozel GS, Ozyilmaz OY, Inan O. Stress Analysis of Implant-Supported Removable Partial Denture with Anterior Fixed Prostheses and Conventional Implant-Supported Overdentures in the Edentulous Mandible. JOURNAL OF ADVANCED ORAL RESEARCH 2021. [DOI: 10.1177/23202068211030127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aim: To compare new design implant-supported removable partial dentures retained with anterior fixed prosthesis with a conventional locater and bar attached implant overdenture prostheses retained by two or four implants via photoelastic stress analysis. Materials and Methods: Seven edentulous mandibuler acryclic models prepared and divided into two main groups; two to four implant models, subgroup separation as stated; for two implant models overdenture with locator attachment, crown design retained removable prosthesis with clasp retention, bridge design retained removable prosthesis with clasp retention, bridge design retained removable prosthesis with precision attachment retention; and for four implant models prosthesis with bar attachment overdenture, fixed bridge design retained removable prosthesis with clasp retention, fixed retained removable prosthesis with precision attachment retention. A 300 N load was applied to the first premolars. Photoelastic stress analysis method that is a specific method concerning stress visualization, and does not require statistical analysis, was used. The stress distributions were seen in optically using a poloriscope. Results: In the models with two implant-retained removable partial dentures, the stress distribution was found to be lower than that with the four implant-retained removable partial dentures. Nonsplinted implants caused high stress around the distal implant on the loading side. Conclusion: The stress loads were transmitted to other implants by splinting. Implant-supported removable partial dentures with an anterior fixed prosthetic design show lower stress distributions compared with bar retained prosthesis. These dentures appear to be advantageous in terms of stress transmission.
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Affiliation(s)
- Gulsum Sayin Ozel
- Department of Prosthodontics, School of Dentistry, Istanbul Medipol University, Bagcilar, Istanbul, Turkey
| | - Ozgun Yusuf Ozyilmaz
- Faculty of Dentistry, Department of Prosthodontics, Bezmialem Vakif University, Istanbul, Turkey
| | - Ozgur Inan
- Faculty of Dentistry, Department of Prosthodontics, Selcuk University, Konya, Turkey
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Enkling N, Nauli J, Kraus D, Wittneben JG, Schimmel M, Abou-Ayash S. Short strategic implants for mandibular removable partial dentures: One-year results from a pilot randomized crossover abutment type study. Clin Oral Implants Res 2021; 32:1176-1189. [PMID: 34352145 PMCID: PMC9292160 DOI: 10.1111/clr.13815] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 12/30/2022]
Abstract
Objectives The present pilot study analyzed two abutment types (a retentive ball and a non‐retentive dome) in implant‐assisted removable partial dentures (IARPDs) on 6 mm short implants with respect to clinical, radiological, and patient‐reported outcomes (PROs), during the first year. Materials and Methods Two implants were placed bilaterally in mandibular molar sites, converting existing free‐end removable partial dentures (RPDs) to IARPDs. Twelve subjects were randomized to initially receive either the dome (Group A, n = 6) or the ball abutment (Group B, n = 6). After eight weeks, the abutments were exchanged. After another 8 weeks, the participants were given the choice of one of the abutments. Mean values and standard deviations (SD) were calculated, and random‐effect linear regression analyses were applied to analyze marginal bone level alterations and PROs (α < .05). Results Twelve participants were included in the study; however, one dropout occurred. Patient ratings increased significantly in both study groups. The majority of the participants (82%) ultimately chose the ball abutment. The implant survival rate was 100%, and the success rate was 90.9% twelve months after implant placement (mean peri‐implant bone‐loss: −1.2; SD: 0.6 mm) without a statistically significant difference between the study groups, in terms of clinical‐ and radiological outcomes. Conclusion Placing 6 mm short implants at mandibular molar sites of RPD wearers seems to be a viable treatment option, based on this investigation with a short‐term follow‐up. Although only minor differences between the two abutments were observed, patients seem to prefer the ball over the dome abutment.
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Affiliation(s)
- Norbert Enkling
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland.,Department of Prosthodontics, Preclinical Education and Dental Materials Science, University of Bonn, Bern, Switzerland
| | - Joël Nauli
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | - Dominik Kraus
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, University of Bonn, Bern, Switzerland
| | | | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
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12
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Lemos CAA, Nunes RG, Santiago-Júnior JF, Marcela de Luna Gomes J, Oliveira Limirio JPJ, Rosa CDDRD, Verri FR, Pellizzer EP. Are implant-supported removable partial dentures a suitable treatment for partially edentulous patients? A systematic review and meta-analysis. J Prosthet Dent 2021; 129:538-546. [PMID: 34330529 DOI: 10.1016/j.prosdent.2021.06.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 06/12/2021] [Accepted: 06/14/2021] [Indexed: 12/30/2022]
Abstract
STATEMENT OF PROBLEM A consensus on the clinical performance of implant-supported removable partial dentures (ISRPDs) is lacking. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate the clinical performance of ISRPDs in terms of the implant survival rates, marginal bone loss, and patient-reported outcome measures (PROMs). MATERIAL AND METHODS Four electronic databases (MEDLINE/PubMed, EMBASE, Web of Science, and Cochrane Library) were independently searched by 2 reviewers for articles published up to December 2020. A single-arm meta-analysis was performed to evaluate the implant survival rates and marginal bone loss by using the R program. The Cochrane collaboration tool was used to evaluate the risk of bias of randomized controlled trials (RCTs), and the Newcastle-Ottawa scale for non-RCT studies. RESULTS Sixteen studies were included, with a total of 334 participants and a mean age of 58 years. The participants received a total of 581 dental implants, 475 conventional and 106 mini-implants. All included studies reported implant survival rate above 90% (range: 92% to 100%). Meta-analysis indicated a high proportion of implant survival rates of 3% (95% confidence interval [CI]: 2% to 5%) and a low mean raw score of marginal bone loss 0.98 mm (CI: 0.61 to 1.36 mm). Compared with conventional RPDs, improved patient quality of life and satisfaction were reported by studies that evaluated ISRPDs. RCT studies exhibited a low risk of bias for most domains, while most non-RCT studies were classified as good quality. CONCLUSIONS ISRPDs exhibited high implant survival rates and acceptable bone loss with improvement in the quality of life and satisfaction of patients when compared with conventional RPDs. Therefore, they can be considered suitable for the rehabilitation of partially edentulous patients.
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Affiliation(s)
- Cleidiel Aparecido Araujo Lemos
- Adjunct Professor, Department of Dentistry (Division of Prosthodontics), Federal University of Juiz de Fora (UFJF), Campus Avançado de Governador Valadares, School of Dentistry, Governador Valadares, State of Minas Gerais, Brazil.
| | - Rafaela Gaião Nunes
- Graduate, Departament of Dental Materials and Prosthodontics, São Paulo State Univeristy (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | | | - Jéssica Marcela de Luna Gomes
- Postgraduate Student, Departament of Dental Materials and Prosthodontics, São Paulo State Univeristy (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | - João Pedro Justino Oliveira Limirio
- Postgraduate Student, Departament of Dental Materials and Prosthodontics, São Paulo State Univeristy (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | - Cléber Davi Del Rei Daltro Rosa
- Postgraduate Student, Departament of Dental Materials and Prosthodontics, São Paulo State Univeristy (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | - Fellippo Ramos Verri
- Adjunct Professor, Departament of Dental Materials and Prosthodontics, São Paulo State Univeristy (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | - Eduardo Piza Pellizzer
- Full Professor, Departament of Dental Materials and Prosthodontics, São Paulo State Univeristy (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
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13
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Zhang H, Ramos V, Bratos M, Liu PP, He W. Effect of the attachments on clinical outcomes of mandibular distal extension implant-supported removable partial dentures: A systematic review. J Prosthet Dent 2021; 128:1211-1220. [PMID: 34301416 DOI: 10.1016/j.prosdent.2021.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 04/10/2021] [Accepted: 04/12/2021] [Indexed: 02/08/2023]
Abstract
STATEMENT OF PROBLEM Healing abutments and attachments have been used for implant-supported removable partial dentures (ISRPDs). However, the effects of these abutments and attachments on the clinical outcomes of the implants and prostheses are elusive because of the lack of standardized research protocols. PURPOSE The purpose of this systematic review was to determine the clinical outcomes of mandibular distal extension ISRPDs with healing abutments and attachments by analyzing qualified studies. MATERIAL AND METHODS An electronic and manual literature search was conducted on PubMed, Web of Science, Scopus, Embase, and Cochrane Library databases including articles published in English from 1980 to 2020. Publications of clinical outcome studies on the mandibular distal extension ISRPDs with healing abutments or attachments were screened by inclusion and exclusion criteria. Clinical outcomes of removable partial dentures (RPDs) and ISRPDs with different types of abutments or attachments were compared by using patient-reported outcome measures, implant survival rate, masticatory performance, and implant- or prosthesis-related complications. Study designs and clinical outcome data were extracted and analyzed. The evidence of the selected studies and degree of recommendation were made according to the Oxford Centre for Evidence-based Medicine, and the risk of bias of the studies was assessed based on Newcastle-Ottawa criteria. RESULTS Of 541 articles initially identified after removing duplicate records, 11 articles were selected by applying the inclusion and exclusion criteria, by inter-viewer agreement, and by hand searching. Nine prospective cohort studies, 1 retrospective cohort study, and 1 randomized controlled trial were included with evidence levels assessed at 1b, 2b, and 2c. The risk of bias varied from 5 to 8 out of 9. Patient overall satisfaction, oral health-related quality of life (OHRQoL) scores, and masticatory ability were significantly improved for ISRPDs with either healing abutments, ball, or LOCATOR attachments when compared with RPDs. The implant survival rate varied from 92% to 97% at 2 to 10 years for ball attachment and was 100% at 1 year for LOCATOR attachment-supported ISRPDs. Marginal bone loss (MBL) varied from 0 to 1 mm in all studies, although LOCATOR attachments had significantly less MBL compared with ball attachments. The maximal pocket depth and bleeding on probing index around implants at 1 year were 1.7 to 1.8 mm and 0.1 to 0.3. Loose healing caps were the main mechanical complication of implants. There were more prosthetic complications in ISRPDs with ball attachments than RPDs at 10-year follow-up, including gold matrix loosening, loss of retention, and denture base fractures. No direct comparisons were made of patient-reported outcomes or prosthetic complications between ball and LOCATOR attachment-supported ISRPDs. CONCLUSIONS Healing abutments and attachments (ball or LOCATOR) improved patient-reported outcomes and the masticatory function of mandibular distal extension ISRPDs. However, insufficient evidence was found to determine the relative effectiveness of different attachment systems on the clinical outcomes of mandibular distal extension ISRPDs. Abutment loosening was the most frequent mechanical complication for healing abutments. More prosthetic complications were associated with ball attachment-supported ISRPDs than RPDs. The major weaknesses of this systematic review were the relatively moderate level of evidence and the publication language, since implant attachments are used in many non-English speaking countries.
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Affiliation(s)
- Hai Zhang
- Associate Professor, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash.
| | - Van Ramos
- Clinical Associate Professor, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash
| | - Manuel Bratos
- Private practice, Madrid, Spain; Affiliate Assistant Professor, Department of Restorative Dentistry, University of Washington, Seattle, Wash
| | - Pearl Pei Liu
- Post-doctoral Fellow, Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, PR China
| | - Wei He
- Lecturer, The First Affiliated Hospital of Nanchang University, Nanchang, PR China; Visiting Scholar, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash
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In Vitro Assessment of the Effect of Implant Position on Biomechanical Behaviors of Implant-Supported Removable Partial Dentures in Kennedy Class II Condition. MATERIALS 2021; 14:ma14092145. [PMID: 33922523 PMCID: PMC8122922 DOI: 10.3390/ma14092145] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/14/2021] [Accepted: 04/21/2021] [Indexed: 12/28/2022]
Abstract
The purpose of this study was to investigate the effects of implant position and loading position on biomechanical behaviors using implant-supported removable partial denture (ISRPD) models in a simulated Kennedy class Ⅱ partially edentulous mandible. Three types of Kennedy class Ⅱ mandibular acrylic resin models (a conventional RPD without support by an implant—CRPD; models with an implant placed at first molar (#46)—MP-ISRPD— and second molar (#47)—DP-ISRPD) were used to measure vertical displacement of the RPD, mesio-distal displacement of the abutment tooth, and bending moment of the abutment tooth and implant under one-point loading. The variables at three respective loading points (#45, #46 and #47) were compared statistically. Vertical displacement was suppressed in ISRPDs compared to the CRPD, and significant effects were identified under loading at the implant position. The largest meiso-distal displacement was observed in MP-ISRPD under #47 loading. Bending moments of the abutment tooth and implant were significantly higher in MP-ISRPD than in DP-ISPRD. In MP-ISRPD, a higher bending moment of the abutment tooth under #45 and #47 loading was detected, although the bending moment in DP-ISRPD was almost zero. The results of this study suggested that MP-ISRPD shows the specific biomechanical behaviors, although DP-ISRPD might provide biomechanical benefits under all one-point loading conditions.
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15
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Mechanical Evaluation of Implant-Assisted Removable Partial Dentures in Kennedy Class I Patients: Finite Element Design Considerations. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11020659] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The main purpose of this work was to construct a clinically valid numerical model of a mandibular Kennedy class I patient rehabilitated with a conventional removable partial denture and another two with implant-assisted removable partial dentures at two different implant locations. The selected patient was classified as ASA I and its mandible geometry reconstruction was performed by the conversion of the Cone-Beam computed Tomography (CBCT) scan raw medical data into a 3D model and subsequent conversion to a CAD file by reverse engineering methods. The soft tissue and removable denture geometries were also included in the CAD model as well as implants, ball attachments and matrix. Moreover, periodontal ligament was modelled by offsetting the mesh of the root surface of each tooth. The finite element results showed that the installation of a dental implant in each of the bilateral edentulous regions helps providing support and retention to the extension bases of the Removable Partial Denture (RPD) and significantly reduces the vertical and anterior-posterior displacements, regardless of its position.
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16
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Nogawa T, Saito M, Murashima N, Takayama Y, Yokoyama A. Influence of rigidity of retainers on dynamic behavior of implant-supported removable partial dentures. Int J Implant Dent 2020; 6:60. [PMID: 33089410 PMCID: PMC7578214 DOI: 10.1186/s40729-020-00260-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 09/02/2020] [Indexed: 01/14/2023] Open
Abstract
Background Implant-supported removable partial dentures (ISRPDs) are an effective treatment for partially edentulous patients. ISRPDs improve patients’ satisfaction and oral function to a greater extent than RPDs by improving denture stability and enhancing support. However, the effect of a type of direct retainer on displacement of the abutment teeth and dentures in ISRPDs remains unclear. Therefore, we made a resin mandibular model of unilateral mandibular distal-extension partial edentulism for mechanical simulation and compared the dynamic behavior of the abutment teeth and the denture base among different tooth-borne retainers with various rigidities for RPDs and ISRPDs. Methods A resin mandibular model for mechanical simulation that had unilateral mandibular distal-extension edentulism and was missing the first molar, second molar, first premolar, and second premolar, and a denture fabricated from the patient’s computed tomography images were used. Three types of direct retainers with different connecting rigidities were evaluated. The vertical displacement of the denture base and buccal and lingual sides and the mesial displacement of the abutment teeth were measured. Results Regardless of the rigidity of the direct retainers and loading positions, the displacement of the denture bases in the ISRPDs was significantly smaller than that in the RPDs (P < 0.001). There was no significant difference in vertical displacement of the denture bases among direct retainers with various connecting rigidities in the ISRPDs. Conversely, horizontal displacement of the abutment teeth in both the RPDs and ISRPDs tended to be larger with the cone crown telescope, which has high rigidity, than with the cast cingulum rest and wire clasp, which have much lower rigidities. Conclusion Our results suggested that cast cingulum rest and wire clasps as direct retainers are appropriate ISRPDs to minimize denture movement and suppress displacement of the remaining teeth in patients with unilateral mandibular distal-extension partial edentulism.
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Affiliation(s)
- Toshifumi Nogawa
- Preventive Dentistry, Hokkaido University Hospital, Sapporo, Japan.
| | - Masayasu Saito
- Oral Functional Prosthodontics, Division of Oral Functional Science, Facility of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Naomichi Murashima
- Oral Functional Prosthodontics, Division of Oral Functional Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | | | - Atsuro Yokoyama
- Oral Functional Prosthodontics, Division of Oral Functional Science, Facility of Dental Medicine, Hokkaido University, Sapporo, Japan
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17
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Srinivasan M, Schimmel M, Buser R, Maniewicz S, Herrmann FR, Müller F. Mandibular two-implant overdentures with CAD-CAM milled bars with distal extensions or retentive anchors: A randomized controlled trial. Clin Oral Implants Res 2020; 31:1207-1222. [PMID: 32965052 DOI: 10.1111/clr.13668] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 08/28/2020] [Accepted: 09/11/2020] [Indexed: 01/23/2023]
Abstract
OBJECTIVE This randomized controlled trial (RCT) aimed to demonstrate the non-inferiority of mandibular 2-implant overdentures (IODs) on a CAD-CAM milled bar with long distal extensions (MBDE) against IODs on retentive anchors (RA). METHODS Forty edentulous participants rehabilitated with a maxillary conventional denture and a mandibular 2-IOD participated in this trial. They were randomized into two groups [Control group (CG): RA + gold matrices; Experimental group (EG): MBDE + gold clip]. The outcomes included implant survival rate (ISR), chewing efficiency [quantitative (VoH) and subjective (SA) assessments], peri-implant marginal bone levels (PI-MBL), maximum bite force (MBF), and patient-reported outcomes [oral health impact profile (OHIP-EDENT), and denture satisfaction index (DSI)]. Outcomes were recorded at baseline (BL), two weeks (T0 ), 6 months (T1 ), and at 1 year (T2 ) after the intervention. Intra- and inter-group analyses were performed using regression models with ⍺=0.05. RESULTS 38 participants completed the T2 visit (CG: n = 19, age = 74.7 ± 7.8 years; EG: n = 19, age = 70.3 ± 10.7 years). At T2 , there was no implant loss in either of the groups (ISR = 100%). There were no significant differences between the groups for the PI-MBL changes (p = .754). Improvements occurred faster in the EG than in the CG, but over the observation time, there were no differences between the trial groups for VoH, MBF, OHIP-EDENT, and the DSI, except for SA being significantly better in the EG group (p = .022). CONCLUSIONS The results of this RCT confirm that mandibular 2-IODs with a CAD-CAM milled bar with long distal extensions are not an inferior treatment to the conventional IODs on retentive anchors in the short term (1 year).
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Affiliation(s)
- Murali Srinivasan
- Center of General, Special Care, & 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
| | - Martin Schimmel
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.,Division of Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Ramona Buser
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - François R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatics, Geneva University Hospitals, Trois-Chêne, Geneva, Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.,Service of Geriatrics, Geneva University Hospitals, Geneva, Switzerland
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18
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Kang SH, Kim SK, Heo SJ, Koak JY. Survival rate and clinical evaluation of the implants in implant assisted removable partial dentures: surveyed crown and overdenture. J Adv Prosthodont 2020; 12:239-249. [PMID: 32879715 PMCID: PMC7449826 DOI: 10.4047/jap.2020.12.4.239] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/25/2020] [Accepted: 06/01/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate survival rates of the implants used in implant assisted removable partial dentures (IARPDs). MATERIALS AND METHODS The study was conducted on 21 patients who were treated with IARPDs. The mean follow-up period for IARPD patients ranged from 12 to 185 months (mean 47.9 months). A total of 58 implants were used for IARPDs in two different modalities: 41 for surveyed crowns and 17 for overdentures. The survival of implants was determined by clinical and radiographic evaluations considering relevant factors: location, RPD classification, opposing dentition, splinting, and implant diameter. RESULTS The survival rate of total 58 implants was 93.1%: 95.1% for implants supporting surveyed crowns and 88.2% for implants used in overdentures. Considering only the implants supporting surveyed crown, regular diameter implants showed a higher survival rate than narrow or wide diameter implants. CONCLUSION The survival rate of the implants used in IARPDs was 93.1% (surveyed crown: 95.1%, overdenture: 88.2%).
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Affiliation(s)
- Soo-Hyun Kang
- Department of Prosthodontics & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Seong-Kyun Kim
- Department of Prosthodontics & Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Seong-Joo Heo
- Department of Prosthodontics & Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Jai-Young Koak
- Department of Prosthodontics & Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, Seoul, Republic of Korea
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19
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Retrospective clinical evaluation of implant-assisted removable partial dentures combined with implant surveyed prostheses. J Prosthet Dent 2020; 126:76-82. [PMID: 32792143 DOI: 10.1016/j.prosdent.2020.04.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 04/16/2020] [Accepted: 04/16/2020] [Indexed: 01/11/2023]
Abstract
STATEMENT OF PROBLEM Implant-assisted removable partial dentures (IARPDs) have been proposed as a treatment option for partially edentulous patients. However, evidence regarding the outcome of implant-assisted removable partial dentures with implant surveyed prostheses is limited. PURPOSE The purpose of this retrospective clinical study was to evaluate the clinical status and complications of IARPDs combined with implant surveyed prostheses in terms of clinical tissue condition, marginal bone resorption, and prosthetic complications. MATERIAL AND METHODS Patients treated with IARPDs combined with implant surveyed prostheses who had worn an IARPD for at least 12 months were included. Twenty-four participants (25 prostheses, 12 maxillary, and 13 mandibular) were evaluated, with 80 implants used as abutments for IARPDs. The average follow-up period was 27.6 months, and the maximum follow-up was 78 months. Implant cumulative survival rate, marginal bone resorption, probing depth, peri-implant inflammation, bleeding, plaque, calculus, and complications were evaluated. RESULTS No implant failure occurred, and all implants functioned without clinical mobility. Mean marginal bone resorption of implants at 1 year after loading was 0.77 ±0.63 mm, and mean probing depth was 3.4 ±0.1 mm. No patient developed peri-implantitis, and no implant failed. Two clasp fractures, 1 rest fracture, 1 decementation, and 1 fracture of porcelain on an implant surveyed prosthesis were detected at 12 months after loading. CONCLUSIONS Well-planned IARPDs using implant surveyed prostheses were clinically successful. Longitudinal and systematic clinical studies are necessary to confirm these results.
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20
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Park J, Lee J, Shin S, Kim H. Effect of conversion to implant‐assisted removable partial denture in patients with mandibular Kennedy classification Ⅰ: A systematic review and meta‐analysis. Clin Oral Implants Res 2020; 31:360-373. [DOI: 10.1111/clr.13574] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/14/2019] [Accepted: 01/04/2020] [Indexed: 01/23/2023]
Affiliation(s)
- Jin‐Hong Park
- Department of Prosthodontics Institute for Clinical Dental Research Korea University Medicine Korea University Seoul Korea
| | - Jeong‐Yol Lee
- Department of Prosthodontics Institute for Clinical Dental Research Korea University Medicine Korea University Seoul Korea
| | - Sang‐Wan Shin
- Department of Prosthodontics Institute for Clinical Dental Research Korea University Medicine Korea University Seoul Korea
| | - Hyun‐Jung Kim
- Department of Preventive Medicine College of Medicine Korea University Seoul Korea
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21
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Arat Bilhan S, Geckili O, Cilingir A, Bozdag E, Bilhan H. Evaluation of two interforaminal implants and implant-assisted removable dentures on stress distribution: an in vitro study. J Korean Assoc Oral Maxillofac Surg 2019; 45:199-206. [PMID: 31508352 PMCID: PMC6728619 DOI: 10.5125/jkaoms.2019.45.4.199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/02/2018] [Accepted: 10/05/2018] [Indexed: 01/12/2023] Open
Abstract
Objectives In mandibular edentulism, the treatment option with a two-interforaminal implant-retained bridge and a removable partial denture is rarely evaluated in literature. The aim of this in vitro study was to evaluate the stress distribution of this treatment option by comparing it with traditional treatment options with interforaminal implants in the edentulous mandible. Materials and Methods Two interforaminal implants were placed in a formalin-fixed cadaver mandible, and overdentures with three different types of attachments were fabricated: (1) two ball attachments and an overdenture, (2) a Dolder bar and an overdenture, and (3) screw-retained two-implant inter-canine porcelain fused to a metal bridge and an implant-assisted removable denture (IARD) with precision attachments. Three biting conditions were generated for each denture type, and the strains were documented under vertical loading of 100 N. Results The calculated strain values from measured strains in all measurement sites and loading conditions for the screw-retained two-implant inter-canine porcelain fused to a metal bridge and a cast framework partial denture with precision attachments situation were lower than in the other scenarios (P<0.05). Conclusion Within the limitations of the present study, it can be concluded that an IARD may be a reasonable and valuable alternative to ball attachments or a bar in two interforaminal implants, especially when the patients prefer to be able to show their teeth even when they take out their removable dentures.
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Affiliation(s)
| | - Onur Geckili
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Altug Cilingir
- Department of Prosthodontics, Faculty of Dentistry, Trakya University, Edirne, Turkey
| | - Ergun Bozdag
- Lab of Strength of Materials and Biomechanics, Faculty of Mechanical Engineering, Istanbul Technical University, Istanbul, Turkey
| | - Hakan Bilhan
- Department of Periodontology, School of Dentistry, Faculty of Health, University Witten/Herdecke, Witten, Germany
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22
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Disha V, Čelebić A, Rener-Sitar K, Kovačić I, Filipović-Zore I, Peršić S. Mini Dental Implant-Retained Removable Partial Dentures: Treatment Effect Size and 6-Months Follow-up. Acta Stomatol Croat 2018; 52:184-192. [PMID: 30510294 PMCID: PMC6238870 DOI: 10.15644/asc52/3/2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Objective The aim was to compare esthetic outcomes, masticatory performance and a comfort of removable partial denture (RPD) wearing after receiving: clasp-retained RPD (C-RPD) or mini dental implant-retained RPD (MDI-RPD) in the mandible. Materials and Methods A sample of 88 patients (Kennedy Class I) with all posterior teeth missing and a linear support for a RPD participated. A total of 52 patients (36 females, 16 males; 56 to 84 years old) participated in the C-RPD group and 36 patients (26 females, 10 males; 43 to 81 years old) in the MDI-RPD group. All MDIs were placed adjacent to the last remaining mandibular anterior tooth or one tooth length posteriorly. The new RPDs had Co-Cr frameworks with lingual plate major connectors; the MDI-RPDs were retained by O-ball matrices and the C-RPDs with clasps. Patients answered questions at pre-treatment and post-treatment stages and after 6-months follow-up: how satisfied they had been with esthetic appearance, how confident they were while chewing hard food, how satisfied they were with food comminution and they also evaluated a comfort of RPD wearing. The 0-10 visual-analogue scale was used. Statistics included descriptive methods, t-tests and the standardized effect-size calculation. Results The MDI-RPD wearers were more satisfied with their post-treatment esthetics, food comminution, a comfort with RPDs and had better confidence while chewing than the C-RPD wearers. The MDI-RPD wearers reported larger positive effect of the treatment. The results were consistent throughout the first 6-months period. Conclusion The MDI-RPD patients showed superior outcomes than the C-RPD patients after the treatment and over the 6-month period.
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Affiliation(s)
- Visar Disha
- - Private Dental office, Priština, Republic of Kosovo
| | - Asja Čelebić
- - Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Croatia
| | | | - Ines Kovačić
- - Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Croatia
| | - Irina Filipović-Zore
- - Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Croatia
| | - Sanja Peršić
- - Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Croatia
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A Clinical Retrospective Study of Distal Extension Removable Partial Denture with Implant Surveyed Bridge or Stud Type Attachment. BIOMED RESEARCH INTERNATIONAL 2017; 2017:7140870. [PMID: 28497062 PMCID: PMC5401718 DOI: 10.1155/2017/7140870] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 03/29/2017] [Indexed: 11/17/2022]
Abstract
This study was performed to make comparative analysis of the clinical findings between the two different types of the implant-assisted removable partial dentures: removable partial dentures using implant surveyed bridge as an abutment (ISBRPD) and overdenture type of removable partial denture using implant attachment (IARPD). Implant cumulative survival rate, marginal bone resorption, probing depth, peri-implant inflammation, bleeding, plaque, calculus, and complications were evaluated on 24 patients who were treated with implants in conjunction with removable partial denture and have used them for at least 1 year (ISCRPD: n = 12; IARPD: n = 12). There was no failed implant and all implants were functioning without clinical mobility. Marginal bone loss of ISCRPD (1.44 ± 0.57 mm) was significantly lower than that of IARPD (p < 0.05). There was no significant difference in probing depth, peri-implant inflammation, bleeding, and plaque between the two groups (p > 0.05), while the calculus was significantly more observed in ISCRPD group than in IARPD group (p < 0.05). The retention loss of IARPD was the most common complication. Within the limits of the present study, it was found that well-planned ISBRPD was clinically appropriate. Longitudinal and systematic clinical studies are necessary to confirm these results.
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Jensen C, Speksnijder CM, Raghoebar GM, Kerdijk W, Meijer HJA, Cune MS. Implant-supported mandibular removable partial dentures: Functional, clinical and radiographical parameters in relation to implant position. Clin Implant Dent Relat Res 2017; 19:432-439. [DOI: 10.1111/cid.12484] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 01/20/2017] [Accepted: 02/23/2017] [Indexed: 01/02/2023]
Affiliation(s)
- Charlotte Jensen
- Department of Fixed and Removable Prosthodontics and Biomaterials; Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen; Groningen the Netherlands
| | - Caroline M. Speksnijder
- Department of Oral & Maxillofacial Surgery and Special Dental Care; University Medical Center Utrecht, University of Utrecht; Utrecht the Netherlands
| | - Gerry M. Raghoebar
- Department of Oral and Maxillofacial Surgery; University Medical Center Groningen, University of Groningen; Groningen the Netherlands
| | - Wouter Kerdijk
- Department of Public and Individual Oral Health, Center for Dentistry and Oral Hygiene; University Medical Center Groningen, University of Groningen; Groningen the Netherlands
| | - Henny J. A. Meijer
- Department of Fixed and Removable Prosthodontics and Biomaterials; Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen; Groningen the Netherlands
- Department of Oral and Maxillofacial Surgery; University Medical Center Groningen, University of Groningen; Groningen the Netherlands
| | - Marco S. Cune
- Department of Fixed and Removable Prosthodontics and Biomaterials; Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen; Groningen the Netherlands
- Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care; St. Antonius Hospital Nieuwegein; Nieuwegein the Netherlands
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25
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Finite element analysis of implant-assisted removable partial dentures: Framework design considerations. J Prosthet Dent 2017; 118:177-186. [PMID: 28089330 DOI: 10.1016/j.prosdent.2016.10.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 10/31/2016] [Accepted: 10/31/2016] [Indexed: 11/20/2022]
Abstract
STATEMENT OF PROBLEM Connecting an acrylic resin base to both a metal framework and a rigidly fixed implant may affect the rotational displacement of the prosthesis during loading. PURPOSE The purpose of this finite element analysis study was to analyze the effect of connecting a denture base metal framework to an implant with the aim of decreasing the rotational movement of an implant-assisted removable partial denture. MATERIAL AND METHODS A mesial occlusal rest direct retainer and a distal occlusal rest direct retainer were modeled and adapted to incorporate a modified denture base metal framework in the connection area for each model. The stress and deformation patterns of the prosthesis structure were determined using finite element analysis and compared for both situations. RESULTS A maximum von Mises stress of 923 MPa was observed on the metal framework of the prosthesis with a mesial occlusal rest, and the maximum value was 1478 MPa for the distal occlusal rest. A maximum von Mises stress of 17 MPa occurred on the acrylic resin denture base for the mesial occlusal rest, and a maximum von Mises stress of 29 MPa occurred for the distal occlusal rest. CONCLUSIONS The distal occlusal rest direct retainer is stiffer than the mesial design and undergoes approximately 66% less deformation. The modified denture base framework with an I-bar and distal occlusal rest design provides more effective support to the acrylic resin structure.
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