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Chittavoravanich N, Jirajariyavej B, Bencharit S, Thanasrisuebwong P. Comparison of Four Different Dental Implant Removal Techniques in Terms of the Weight and Volume of Bone Loss. Cureus 2024; 16:e61104. [PMID: 38919230 PMCID: PMC11197631 DOI: 10.7759/cureus.61104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2024] [Indexed: 06/27/2024] Open
Abstract
PURPOSE Several approaches have been suggested for implant removal. However, further research is necessary to review data regarding the amount of bone removed and the duration of removal time for different procedures. This study evaluates and compares various implant removal techniques. Materials and methods: A polyurethane block was scanned to create an implant surgical guide. Afterward, implant-guided surgery was performed on 60 simulated bone blocks. The implants were then separated into four groups and removed utilizing the counter-torque ratchet, trephine drills, burs, and piezosurgery. RESULTS For the weight of bone loss, there were significant differences in the median between the counter-torque ratchet technique (CTRT) and trephine (p < 0.01), CTRT and bur (p < 0.01), trephine and piezo (p < 0.01), and bur and piezo (p = 0.04). All groups, except CTRT and the piezo group, demonstrated a statistically significant difference (p < 0.01) in the procedure durations. Regarding the volume of bone loss, a statistically significant difference (p < 0.01) was found between each group. Conclusions: CTRT showed the least amount of bone loss. On the other hand, the trephine technique was demonstrated to be the fastest. It is essential to consider the limitations and risks when choosing the approach for implant removal.
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Affiliation(s)
| | | | - Sompop Bencharit
- Workman School of Dental Medicine, High Point University, High Point, USA
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2
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Wittneben JG, Abou-Ayash S, Gashi A, Buser D, Belser U, Brägger U, Sailer I, Gavric J. Implant-supported single all-ceramic crowns made from prefabricated (stock) or individualized CAD/CAM zirconia abutments: A 5 year randomized clinical trial. J ESTHET RESTOR DENT 2024; 36:164-173. [PMID: 38173277 DOI: 10.1111/jerd.13188] [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: 10/08/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024]
Abstract
AIM The aim of this randomized, prospective, and clinical multicenter study was to compare the overall clinical performance of two restorative options over a 5-year period: individualized CAD/CAM abutments veneered with a hand-layered ceramic, and prefabricated zirconium dioxide abutments veneered with press ceramic and inserted into a single edentulous gap in the anterior maxilla. MATERIALS AND METHODS Forty subjects were recruited from two universities: 20 from the University of XX and 20 from the University of XY. Each subject received an implant to restore a single edentulous gap in the maxillary anterior region (14-24 FDI). 20 patients were randomized into each Group. Group A received a one-piece single crown produced from a prefabricated zirconia abutment with pressed ceramic and Group B received an individualized CAD/CAM zirconia abutment with a hand-layered technique. After 5 years, the aesthetic and radiographic parameters were assessed. RESULTS Group A had four dropouts and one failure, resulting in a 95% survival rate and 95% success rate. Group B had two dropouts and two failures which resulted in a 90% survival rate and 90% success rate. No crestal bone level changes were observed, with a mean DIB of 0.06 mm in Group A and 0.09 mm in Group B. No statistically significant differences were present at baseline, 6 months, 1 year, 3 years, or 5 years for DIB values between time points and groups. Pink aesthetic score/white aesthetic score, Peri-Implant and Crown Index, and Implant Crown Aesthetic Index values were stable over time at all five points for both groups. CONCLUSION Both implant-supported restorative options represent a valuable treatment option for the restoration of implant crowns in the anterior maxilla. CLINICAL SIGNIFICANCE In general, the use of ceramic abutments in the anterior zone represents a valuable treatment procedure with both standardized and CAD/CAM individualized abutments and following the recommendations from the respective manufacturer(s).
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Affiliation(s)
- Julia-Gabriela Wittneben
- Private Practice, Zürich, Switzerland
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | | | - Daniel Buser
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Urs Belser
- Department of Reconstructive Dentistry, School of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Urs Brägger
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Irena Sailer
- Department of Reconstructive Dentistry, School of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Jelena Gavric
- Department of Reconstructive Dentistry, School of Dental Medicine, University of Geneva, Geneva, Switzerland
- Private Practice, Geneva, Switzerland
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3
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Gotfredsen K. Patient-reported outcomes for bone regenerative procedures. Periodontol 2000 2023; 93:270-276. [PMID: 37496403 DOI: 10.1111/prd.12500] [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: 02/06/2023] [Revised: 04/17/2023] [Accepted: 06/03/2023] [Indexed: 07/28/2023]
Abstract
Evidence-based dentistry used for decision-making and assessment of treatment includes three components: evidence from the literature, clinical expertise, and patient expectations. Patient satisfaction embraces affability, availability, and ability and can be examined using questionnaires or structured questions to the patient to evaluate patient perception of the treatment. The questions can be quantified using dichotomous, point, or visual analog scales. This would be a straightforward patient-reported outcome measure (PROM). Validated and specific oral health-related quality of life (OHRQoL) questionnaires such as the oral health impact profile (OHIP), oral impact on daily performance (OIDP), or the dental impact on daily living (DIDL) can be used as PROMs, and these measures are appropriate for population studies, where you can measure changes over time and differences between treatment groups. PROMs have shown to enhance patient engagement when integrated into clinical care. PROMs for bone regenerative procedures are mainly used as secondary outcome and are concentrating on the prosthetic outcome more than the pain, discomfort, anxiety, and cost of the surgical procedures. Surprisingly, most patients are satisfied and willing to have the procedures performed again. Whether this is recall bias or not and how the information's from the dentist and the team influence the patients answers to PROMs questionnaires are discussed. The importance of patient perspectives in bone regeneration procedures is obvious and combined with clinical outcome measures, it increases our ability to provide better care. Studies using PROMs as a primary outcome variable are required.
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Affiliation(s)
- Klaus Gotfredsen
- Section of Oral Rehabilitation, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, København, Denmark
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Moura DMD, de Araújo GM, de Araújo LNM, de Vasconcelos Gurgel BC, de Oliveira Dal Piva AM, Ozcan M, de Assunção E Souza RO. Clinical performance of monolithic polymer-infiltrated ceramic and lithium disilicate posterior crowns: A controlled, randomized, and double-blind clinical trial. J Prosthet Dent 2023:S0022-3913(23)00483-3. [PMID: 37690857 DOI: 10.1016/j.prosdent.2023.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 07/04/2023] [Accepted: 07/06/2023] [Indexed: 09/12/2023]
Abstract
STATEMENT OF PROBLEM The success rate of monolithic polymer-infiltrated ceramic posterior crowns after 1 year is unclear. PURPOSE The purpose of this controlled, randomized, and double-blind clinical trial was to evaluate the performance of posterior complete crowns in polymer-infiltrated and lithium disilicate ceramics and to assess the impact of oral rehabilitation on esthetic satisfaction, quality of life, and periodontal health. MATERIAL AND METHODS A total of 33 crowns were provided in 18 participants allocated to 2 groups: Control (Lithium disilicate-IPS e.max CAD; Ivoclar AG) and Experimental (Polymer-infiltrated ceramic-Vita Enamic; Vita Zahnfabrik). The crowns were evaluated before treatment (T0) and after 1 (T1), 6 (T2), and 12 (T3) months by using modified United States Public Health Service (USPHS) criteria, visual analog scales (VASs), oral impacts on daily performances (OIDP), and periodontal parameters. Survival analysis was performed by using Kaplan-Meier followed by the log-rank test (α=.05). The OIDP and USPHS data were analyzed descriptively while VASs for esthetic satisfaction and periodontal parameters were statistically evaluated by using the Mann-Whitney Friedman, and Wilcoxon post hoc tests. RESULTS For 18 participants with a mean age of 47.2 years, 19 crowns were manufactured in lithium disilicate and 14 in polymer-infiltrated ceramic. The Kaplan-Meier test revealed similar survival rates of 92.5% for polymer-infiltrated ceramic and 94.7% for lithium disilicate (P>.05). The analysis of periodontal parameters revealed a significant increase in the bleeding on probing (BOP) for polymer-infiltrated ceramics (P=.032) but for lithium disilicate, it was not significant (P=.387). CONCLUSIONS Survival rates between the evaluated materials were not significantly different, with acceptable clinical performance after 1 year of follow-up.
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Affiliation(s)
- Dayanne M D Moura
- Professor, State University of Rio Grande do Norte (UERN), Department of Dentistry, Caicó, RN, Brazil
| | - Gabriela M de Araújo
- Researcher, Federal University of Rio Grande do Norte (UFRN), Department of Dentistry, Natal, RN, Brazil
| | - Lidya N M de Araújo
- PhD student, Federal University of Rio Grande do Norte (UFRN), Department of Dentistry, Natal, RN, Brazil
| | | | - Amanda M de Oliveira Dal Piva
- Assistant Professor, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Department of Dental Materials Science, Amsterdam, the Netherlands
| | - Mutlu Ozcan
- Professor, University of Zurich, Department of Dental Medicine, Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Zurich, Switzerland
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Espona J, Vidal-Ponsoda C, Quintana P, Henarejos-Domingo V, Roig M. A fully digital protocol to provide a fixed interim complete denture for immediate loading for a completely edentulous patient: A dental technique. J Prosthet Dent 2023; 130:171-178. [PMID: 34711405 DOI: 10.1016/j.prosdent.2021.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
Abstract
Complete arch immediate-loading implant-supported prostheses can represent a major challenge for the patient and the dental team. Obtaining stable references and an accurate occlusal record after implant placement to provide an interim prosthesis is a difficult task and can deviate from the initial treatment plan. The described technique presents a fully digital protocol to provide an immediate complete arch implant-supported fixed interim prosthesis for edentulous patients by making postoperative cone beam computed tomography and intraoral digital scans that correlate with the previous plan.
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Affiliation(s)
- José Espona
- Associate Professor, Department of Restorative Dentistry, School of Dentistry, International University of Catalunya, Barcelona, Spain
| | - Carla Vidal-Ponsoda
- Resident, Department of Restorative Dentistry, School of Dentistry, International University of Catalunya, Barcelona, Spain
| | - Pau Quintana
- Assistant Professor, Department of Restorative Dentistry, School of Dentistry, International University of Catalunya, Barcelona, Spain
| | - Víctor Henarejos-Domingo
- Private practice, Barcelona, Spain; Associate Professor, Department of Restorative Dentistry, School of Dentistry, International University of Catalunya, Barcelona, Spain.
| | - Miguel Roig
- Chairman and Professor, Department of Restorative Dentistry, School of Dentistry, International University of Catalunya, Barcelona, Spain
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Shimogishi M, Kawakami S, Tachikawa N. Clinical Evaluation of Short (6 mm) and Longer Implants Placed Side by Side in Posterior Partially Edentulous Area: A 3-Year Observational Study. Int J Dent 2023; 2023:9086628. [PMID: 37456792 PMCID: PMC10348857 DOI: 10.1155/2023/9086628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 06/04/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023] Open
Abstract
Background Short implants have been proposed as an alternative solution for the rehabilitation of atrophic posterior region. Purpose To compare the clinical outcomes between 6 mm short implants and conventional implants placed under similar conditions of bone quality and occlusal loading. Materials and Methods Nine patients received atone 6 mm implant and one standard-length (8 mm length or longer) implants in a total of 10 partially edentulous areas. Implants were left submerged for 3-6 months healing period and the screw-retained splinted prostheses were delivered. When the provisional or final restoration was placed, and at each year after loading, standardized intraoral radiograph was taken for themarginal bone level (MBL) changes around the implants. Subsequently, the patients were recalled for the clinical examination evaluating the implant survival, sulcus bleeding index, suppuration, and the incidence of prosthetic complications at every 6 months after the definitive crown delivery. The observation period was continued to 3 years (mean follow-up was 3.4 ± 0.3 years) after functional loading. Results Nine patients (10 short implants and 10 standard length implants) were selected in this study. Cumulative survival rates of the short implants and standard-length implants were 100% in both groups, and no biological and prosthetic complication were found in 3 years observation period. Cortical bone thickness of implant insertion sites was 1.39 ± 0.45 mm at short implants and 1.38 ± 0.69 mm at standard-length implants, and trabecular bone computed tomography values of implant insertion sites was 424.1 ± 290.1 at short implants and 410.9 ± 267.9 at standard-length implants. The MBL changes were -0.30 ± 0.71 mm at short implants and -0.19 ± 0.78 mm at standard-length implants at 3 years follow-up visit. No significant difference was found in the average of MBL changes between implant length. Conclusions Within the limits of this study, it can be concluded that 6 mm short implants in a posterior edentulous region showed excellent results compared with conventional implants.
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Affiliation(s)
- Masahiro Shimogishi
- Department of Regenerative and Reconstructive Dental Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sawako Kawakami
- Department of Regenerative and Reconstructive Dental Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Noriko Tachikawa
- Department of Regenerative and Reconstructive Dental Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Kupka JR, Sagheb K, Al-Nawas B, Schiegnitz E. The Sympathetic Nervous System in Dental Implantology. J Clin Med 2023; 12:jcm12082907. [PMID: 37109243 PMCID: PMC10143978 DOI: 10.3390/jcm12082907] [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: 03/06/2023] [Revised: 04/07/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
The sympathetic nervous system plays a vital role in various regulatory mechanisms. These include the well-known fight-or-flight response but also, for example, the processing of external stressors. In addition to many other tissues, the sympathetic nervous system influences bone metabolism. This effect could be highly relevant concerning osseointegration, which is responsible for the long-term success of dental implants. Accordingly, this review aims to summarize the current literature on this topic and to reveal future research perspectives. One in vitro study showed differences in mRNA expression of adrenoceptors cultured on implant surfaces. In vivo, sympathectomy impaired osseointegration in mice, while electrical stimulation of the sympathetic nerves promoted it. As expected, the beta-blocker propranolol improves histological implant parameters and micro-CT measurements. Overall, the present data are considered heterogeneous. However, the available publications reveal the potential for future research and development in dental implantology, which helps to introduce new therapeutic strategies and identify risk factors for dental implant failure.
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Affiliation(s)
- Johannes Raphael Kupka
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, 55131 Mainz, Germany
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, 55131 Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, 55131 Mainz, Germany
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, 55131 Mainz, Germany
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8
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Naumann M, Scholz P, Krois J, Schwendicke F, Sterzenbach G, Happe A. Monolithic hybrid abutment crowns (screw-retained) versus monolithic hybrid abutments with adhesively cemented monolithic crowns. Clin Oral Implants Res 2023; 34:209-220. [PMID: 36692161 DOI: 10.1111/clr.14031] [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: 01/05/2022] [Revised: 12/30/2022] [Accepted: 01/02/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVES The objective of this study is to compare monolithic hybrid abutment crowns (screw-retained) versus monolithic hybrid abutments with adhesively cemented monolithic single-tooth crowns. MATERIALS AND METHODS Twenty subjects in need of an implant-borne restoration were randomly assigned to receive either a cement-retained (CRR) or a screw-retained (SRR) implant-supported monolithic lithium disilicate (LS2 ) reconstruction. Each patient received a titanium implant with in internal conic connection. After osseointegration and second-stage surgery, healing abutments were placed for about 10 days. The type of restoration (CRR vs. SRR) was randomly assigned, and the restorations were manufactured of monolithic LS2 . Both types of restorations, CRR and SRR, were based on a titanium component (Ti-base) that was bonded to the abutment (CRR) or the crown (SRR). The follow-up period for all restoration was 36 months. Clinical outcome was evaluated according to Functional Implant Prosthetic Score (FIPS). Quality of live (OHIP) and patient's satisfaction were assessed using patient-reported outcome measures (PROMs). Primary endpoint was loss of restoration for any reason. Kaplan-Meier curves were constructed and log-rank testing was performed (p < .05). RESULTS One restoration of group CRR failed after 6 months due to loss of adhesion between Ti-base and individual abutment. No further biological or technical failures occurred. Kaplan-Meier analysis showed no significant difference between both treatment options (p = .317). There was no statistically significant difference between both types of restoration, neither for FIPS, OHIP, treatment time nor patient satisfaction (p > .05). CONCLUSION Monolithic hybrid abutment crowns (screw-retained) and monolithic hybrid abutment with adhesively cemented monolithic crowns using lithium disilicate showed no statistically significant difference for implant-based reconstructions in this pilot RCT setting.
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Affiliation(s)
- Michael Naumann
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders-Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Patricia Scholz
- Clinic for Dental Prosthetics, Center for Dental, Oral and Maxillofacial Medicine, University Hospital Ulm, Ulm, Germany
| | - Joachim Krois
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Falk Schwendicke
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Guido Sterzenbach
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders-Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Arndt Happe
- Clinic for Dental Prosthetics, Center for Dental, Oral and Maxillofacial Medicine, University Hospital Ulm, Ulm, Germany
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Zuercher AN, Ioannidis A, Hüsler J, Mehl A, Hämmerle CHF, Thoma DS. Randomized controlled pilot study assessing efficacy, efficiency, and patient-reported outcomes measures of chairside and labside single-tooth restorations. J ESTHET RESTOR DENT 2023; 35:74-83. [PMID: 35421283 DOI: 10.1111/jerd.12909] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To test whether or not a chairside workflow (CHAIR) is similar to a labside workflow (LAB) in terms of efficacy (primary outcome) and efficiency (secondary outcome). MATERIAL AND METHODS Eighteen subjects in need of a single-tooth restoration in the posterior region of the maxilla or mandible were consecutively recruited and randomly assigned to the CHAIR or LAB workflow. Patient-reported outcome measures (PROMs; efficacy) were assessed using a questionnaire with visual analog scale. The white AEsthetic score (WES) was applied to evaluate the AEsthetic outcome objectively. The clinical and laboratory time (efficiency) were recorded. Nonparametric methods were applied for the group comparisons. RESULTS The overall median AEsthetic evaluation after treatment was 10 (interquartile range = IQR: 9.5-10) in group CHAIR and 10 (IQR: 9.5-10) in-group LAB (Mann-Whitney [MW] test p = 1.000). The WES amounted to 4 (IQR: 3-5) (CHAIR) and to 8 (IQR: 7-9) (LAB) (MW test p < 0.0001). The median total working time for the clinician in-group CHAIR was 49.9 min. (IQR: 40.9-63.7) and 41.4 min. (IQR: 37.2-58.2) in-group LAB (MW test p = 0.387). CONCLUSIONS Subjective PROMs of single-tooth supported restorations fabricated in a CHAIR or LAB workflow led to similar scores of patients' satisfaction and a moderate negative correlation for the objective evaluation of the clinician in the LAB workflow. CLINICAL SIGNIFICANCE PROMs can be considered a key element in the decision-making process for restoring single-tooth restorations. The patients' perception of AEsthetics was similar for the CHAIR or LAB workflows. The additional efforts undertaken with the LAB workflow did not result in a patient benefit when compared to a CHAIR workflow.
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Affiliation(s)
- Anina N Zuercher
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Alexis Ioannidis
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Jürg Hüsler
- Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - Albert Mehl
- Department of Computerized Restorative Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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10
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Zuercher AN, Mancini L, Naenni N, Thoma DS, Strauss FJ, Jung RE. The L-shape technique in guided bone regeneration with simultaneous implant placement in the esthetic zone: A step-by-step protocol and a 2-14 year retrospective study. J ESTHET RESTOR DENT 2023; 35:197-205. [PMID: 36165402 DOI: 10.1111/jerd.12965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To describe the methodology of the "L-shape" technique in guided bone regeneration (GBR) with simultaneous implant placement and report on the clinical, esthetic, and patient satisfaction outcomes up to 14 years of follow-up. MATERIAL AND METHODS Fourteen patients treated with the "L-shape" technique were included in this retrospective study. The L-shape technique was performed by trimming and placing a soft-type bone block made of deproteinized bovine bone mineral with 10% collagen at the buccal-occlusal aspect of the dental implant. The remaining gaps were filled with deproteinized bovine bone mineral granules and the augmented area was covered with a collagen membrane. The following parameters were recorded: probing depth (PD), bleeding on probing (BOP), plaque index (PI), keratinized tissue width (KT) and marginal bone level (MBL). Esthetic outcomes were assessed according to the pink esthetic score (PES) and the white esthetic score (WES). Patient satisfaction was evaluated by means of a numerical rating scale (0-10). The stability of each augmented site was assessed by measuring the volumetric changes between baseline (crown delivery) and the respective follow-up. RESULTS A total of 13 maxillary incisors and one maxillary canine in 14 patients were included. The mean follow-up period was 7.7 ± 3.8 years. PES values amounted to 10.7 ± 3.3 and WES to 8.8 ± 1.4. Patient satisfaction reached 9.4 ± 0.8. Mean PD at implant sites were 2.7 ± 0.7 mm while BOP amounted to 15.0 ± 0.2% and Pl to 5.0 ± 0.0%. Volumetric analyses revealed minimal changes at the augmented sites irrespective of the region of interest. Radiographic MBL remained relatively stable. CONCLUSIONS Within the limitation of the present study the L-shape augmentation procedure seems to be a reliable technique when performing GBR with simultaneous implant placement in the esthetic zone. Outcomes encompassed stable clinical and esthetic results accompanied by high levels of patient satisfaction. Future randomized controlled trials are warranted to confirm possible benefits of the L-shape technique over traditional approaches. CLINICAL SIGNIFICANCE The L-shape appears to be a simple yet promising technique in GBR with simultaneous implant placement that can easily be translated into clinical practice.
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Affiliation(s)
- Anina-Nives Zuercher
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Leonardo Mancini
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Nadja Naenni
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel-Stefan Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Franz-Josef Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Ronald-Ernst Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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11
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Gintaute A, Zitzmann NU, Brägger U, Weber K, Joda T. Patient-reported outcome measures compared to professional dental assessments of monolithic ZrO 2 implant fixed dental prostheses in complete digital workflows: A double-blind crossover randomized controlled trial. J Prosthodont 2023; 32:18-25. [PMID: 35938349 PMCID: PMC10087166 DOI: 10.1111/jopr.13589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/02/2022] [Indexed: 01/25/2023] Open
Abstract
PURPOSE This double-blind randomized controlled trial analyzed patient-reported outcome measures in terms of subjective patient satisfaction compared to objective dental evaluation of prosthetic treatment with 3-unit monolithic zirconium dioxide implant fixed dental prostheses (iFDPs) in 3 digital workflows. MATERIAL AND METHODS Twenty patients were restored with 3 iFDPs each on Straumann TL-implants with 2 completely digital workflows using different intraoral optical scanning systems with model-free fabrication of the restoration (Trios 3/3Shape [Test-1]; Virtuo Vivo/Straumann [Test-2]), and mixed analog-digital workflow with conventional impressions and digitized gypsum casts (Impregum/3M Espe [Control]). The order of impression-taking and the prosthetic try-in were randomly allocated. Sixty iFDPs were compared for patient satisfaction and dental evaluation using ANOVA. RESULTS For iFDP evaluation, patients generally provided more favorable ratings than dental experts, regardless of the workflow. ANOVA revealed no significant difference for overall satisfaction when comparing Test-1, Test-2, or Control, either for patients (f-ratio: 0.13; p = 0.876) or dentist (f-ratio: 1.55: p = 0.221). Secondary, patients clearly favored the digital impression workflows over the conventional approach (f-ratio: 14.57; p < 0.001). Overall, the 3Shape workflow (Test-1) received the highest scores for all analyses. CONCLUSIONS The different digital workflows demonstrated minor influence on the subjective and objective evaluation of the monolithic zirconium dioxide iFDPs in nonesthetic regions; however, the dentist may significantly increase patient satisfaction by choosing intraoral scanning instead of conventional impressions. The dentist has to consider individual patients' needs to fulfill their expectations for a personalized solution.
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Affiliation(s)
- Aiste Gintaute
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Nicola U Zitzmann
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Urs Brägger
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Karin Weber
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Tim Joda
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland.,Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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12
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Tsoi JKH, Ding H. A NARRATIVE REVIEW ON THE OVERLOOKED ASPECTS OF dPROs IN CONNECTION WITH DENTAL MATERIALS. J Evid Based Dent Pract 2023; 23:101796. [PMID: 36707171 DOI: 10.1016/j.jebdp.2022.101796] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/21/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Dentists use a large number of dental materials to treat patients, mainly for pain relief, improved oral function, and orofacial appearance purposes. These materials supposably have been clinically tested and registered before launching onto the market. In terms of clinical testing, despite various objective and subjective assessments that could be done, the dentist-centred outcomes and regulatory body requirements might not fully reflect the perspective of the patient. Thus, dental-patient reported outcomes (dPROs) might be useful in providing valuable self-perceived feedback to stakeholders across a long period of time about the materials... performances. METHODS AND RESULTS This narrative review evaluated various assessment dPROs tools and their applications to contemporary dental materials, trying to link up basic materials science and biomechanics with the patients... reported outcomes. CONCLUSIONS dPROs can eventually form a basis of value-based dentistry for dental materials that would be of importance in terms of research, regulatory and safety.
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Affiliation(s)
- James Kit-Hon Tsoi
- Dental Materials Science, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong SAR.
| | - Hao Ding
- Dental Materials Science, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong SAR
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13
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Wittneben J, Yilmaz B, Wismeijer D, Shahdad S, Brägger U, Abou‐Ayash S. Patient‐reported outcome measures focusing on the esthetics of implant‐compared to tooth‐supported single crowns—A systematic review and meta‐analysis. J ESTHET RESTOR DENT 2022; 35:632-645. [DOI: 10.1111/jerd.12983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/19/2022] [Accepted: 11/08/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Julia‐Gabriela Wittneben
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine University of Bern Bern Switzerland
- Department of Restorative Dentistry and Biomaterials Sciences Harvard School of Dental Medicine Boston Massachusetts USA
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine University of Bern Bern Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine University of Bern Bern Switzerland
| | - Daniel Wismeijer
- Department of Oral Implantology and Prosthetic Dentistry, ACTA University of Amsterdam and VU University Amsterdam The Netherlands
| | - Shakeel Shahdad
- Institute of Dentistry Queen Mary University of London London UK
- Restorative Dentistry The Royal London Dental Hospital London UK
| | - Urs Brägger
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine University of Bern Bern Switzerland
| | - Samir Abou‐Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine University of Bern Bern Switzerland
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14
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Monje A, Suárez-López Del Amo F. Application of biologics for ridge preservation/reconstruction after implant removal. Clin Adv Periodontics 2022; 12:270-276. [PMID: 35866264 DOI: 10.1002/cap.10218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/06/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND The purpose of this review was aimed at providing the rationale supported with a series of cases to apply biologics to enhance orchestrating the healing process at implant removal sites. SUMMARY Implant removal is commonly applied on a daily basis, in particular, in cases that exhibit esthetic failures linked to inadequate implant position or in cases of advanced peri-implantitis. Implant removal sites differ substantially from tooth extraction sockets. Implants are ankylosed within the alveolar bone, which therefore have neither mechanoreception nor the elasticity provided by periodontal ligament fibers. As a result, the bone-to-implant contact must be disrupted by means of using a reverse-torque device to minimize trauma. It is possible that the surrounding bone provides limited vascularity, which may interfere with the healing and bone forming process within the socket. Therefore, the use of biologics may enhance this healing and accelerate bone formation in sites where implants are removed due to hopeless functional or esthetic prognoses. CONCLUSION The use of biologics, in particular autologous blood-derived products, may enhance and boost the healing process to potentiate bone availability at a later stage during implant placement.
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Affiliation(s)
- Alberto Monje
- Department of Periodontology, International University of Catalonia, Barcelona, Spain.,Department of Periodontology, School of Dental Medicine, University of Michigan, Ann Arbor, Michigan, USA
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15
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Stünkel R, Zeller AN, Bohne T, Böhrnsen F, Wedi E, Raschke D, Kauffmann P. Accuracy of intraoral real-time navigation versus static, CAD/CAM-manufactured pilot drilling guides in dental implant surgery: an in vitro study. Int J Implant Dent 2022; 8:41. [PMID: 36198996 PMCID: PMC9535055 DOI: 10.1186/s40729-022-00430-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/11/2022] [Indexed: 11/18/2022] Open
Abstract
Background Nowadays, 3D planning and static for dynamic aids play an increasing role in oral rehabilitation of the masticatory apparatus with dental implants. The aim of this study is to compare the accuracy of implant placement using a 3D-printed drilling guide and an intraoral real-time dynamic navigation system. Methods A total of 60 implants were placed on 12 partially edentulous lower jaw models. 30 were placed with pilot drilling guides, the other half with dynamic navigation (DENACAM®). In addition, implant placement in interdental gaps and free-end situations were investigated. Accuracy was assessed by cone-beam computed tomography (CBCT). Results Both systems achieved clinically acceptable results, yet more accurate results regarding the offset of implant base and tip in several spatial dimensions were achieved using drilling guides (each p < 0.05). With regard to angulation, real-time navigation was more precise (p = 0.0016). Its inaccuracy was 3°; the template-guided systems was 4.6°. Median horizontal deviation was 0.52 mm at base and 0.75 mm at tip using DENACAM®. When using the pilot drill guide, horizontal deviation was 0.34 mm in the median and at the tip by 0.59 mm. Regarding angulation, it was found that the closer the drill hole was to the system's marker, the better navigation performed. The template did not show this trend (p = 0.0043; and p = 0.0022). Conclusion Considering the limitations of an in vitro study, dynamic navigation can be used be a tool for reliable and accurate implantation. However, further clinical studies need to follow in order to provide an evidence-based recommendation for use in vivo. Supplementary Information The online version contains supplementary material available at 10.1186/s40729-022-00430-6.
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Affiliation(s)
- Robert Stünkel
- Department of Maxillofacial Surgery, Georg August University, Göttingen, Germany
| | - Alexander-Nicolai Zeller
- Department of Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| | | | - Florian Böhrnsen
- Department of Maxillofacial Surgery, Georg August University, Göttingen, Germany
| | - Edris Wedi
- Department of Gastroenterology and Gastrointestinal Oncology, Interdisciplinary Endoscopy, University Medical Center, Georg August University, Göttingen, Germany
| | - David Raschke
- Department of Maxillofacial Surgery, Georg August University, Göttingen, Germany
| | - Philipp Kauffmann
- Department of Maxillofacial Surgery, Georg August University, Göttingen, Germany
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16
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Chacón R GJ, Retana L. The connective tissue graft as a membrane to improve esthetics according the defect. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:514-520. [PMID: 35569726 DOI: 10.1016/j.jormas.2022.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/21/2022] [Accepted: 04/20/2022] [Indexed: 06/15/2023]
Abstract
Dental implants are now one of the most useful therapies worldwide with higher rates of success from simple to complex cases, but also, with different results regarding the esthetics, cost and long-term success maintenance. In the beginning, dental implants therapy function and survival was the main goal. Nevertheless, through the years, the success criteria have increased, evolved, and improved beyond function to include esthetic and patient-related outcomes. Parallel to implant therapy, guide bone regeneration and periodontal plastic surgery have also evolved to achieve predictable, functional, and esthetic results in shallow and complex defects. However, they are mostly performed during different surgical procedures at different stages, raising the treatment time and cost for patients, directly related to the bio materials used and surgical times. The purpose of this case series is to present a simplified clinical scenario using a connective tissue graft as a membrane to improve esthetics and patient satisfaction while reducing treatment time and cost.
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Affiliation(s)
- Gerardo J Chacón R
- DDS, MSC Periodontics, Oral Surgeon, Dental Implant and Microplastic Surgery Specialist, International Lecturer, Guided Bone Regeneration Specialist, Private Practice, Medellin, Colombia.
| | - Luciano Retana
- DDS, MSC Prosthodontist, International Lecturer, Luisiana State University, United States
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17
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Limones A, Celemín-Viñuela A, Romeo-Rubio M, Castillo-Oyagüe R, Gómez-Polo M, Martínez Vázquez de Parga JA. Outcome measurements and quality of randomized controlled clinical trials of tooth-supported fixed dental prostheses: A systematic review and qualitative analysis. J Prosthet Dent 2022:S0022-3913(22)00282-7. [PMID: 36109260 DOI: 10.1016/j.prosdent.2022.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 11/16/2022]
Abstract
STATEMENT OF PROBLEM The lack of consensus regarding a standardized set of outcome measurements and noncompliance with current reporting guidelines in clinical trials of tooth-supported fixed dental prostheses (FDPs) hamper interstudy comparability, compromise scientific evidence, and waste research effort and resources in prosthetic dentistry. PURPOSE The primary objective of this systematic review was to identify all primary and secondary outcome measurements assessed in randomized controlled trials (RCTs) of tooth-supported FDPs. Secondary objectives were to assess their methodological quality by using the Cochrane Collaboration's risk of bias tool (RoB, v2.0) and their reporting quality by means of a standardized 16-item CONSORT assessment tool through published reports. MATERIAL AND METHODS An electronic search was conducted in MEDLINE, EMBASE, and Cochrane library to identify all RCT-related articles published in the past 10 years. Differences in RoB were tested with the Pearson chi-square test, and those in CONSORT score with the Student t test. RESULTS A total of 64 RCTs from 79 publications were deemed eligible. The diversity of outcome measures used in the field is apparent. Twenty percent of the included studies had a low RoB, 79% showed some concerns, and 1% had a high RoB. The mean ±standard deviation CONSORT compliance score was 22.56 ±3.17. Trials adhered to the CONSORT statement reported lower RoB than those that did not adhere (P<.001). RCTs with a low RoB reported more comprehensive adherence to CONSORT guidelines than those with some concerns (MD 4 [95% CI 1.52-6.48]; P=.004). CONCLUSIONS A standardized core outcome reporting set in clinical research on tooth-supported FDPs remains evident. Adherence to the CONSORT statement continues to be low, with some RoB concerns that can be improved.
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Affiliation(s)
- Alvaro Limones
- Student, Assistant Professor, Department of Conservative & Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain.
| | - Alicia Celemín-Viñuela
- Professor, Department of Conservative & Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain
| | - Marta Romeo-Rubio
- Professor, Department of Conservative & Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain
| | - Raquel Castillo-Oyagüe
- Cathedratic Professor, Department of Conservative & Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain
| | - Miguel Gómez-Polo
- Professor, Department of Conservative & Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain
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18
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Strauss FJ, Siegenthaler M, Hämmerle CHF, Sailer I, Jung RE, Thoma DS. Restorative angle of zirconia restorations cemented on non-original titanium bases influences the initial marginal bone loss: 5-year results of a prospective cohort study. Clin Oral Implants Res 2022; 33:745-756. [PMID: 35570366 PMCID: PMC9543966 DOI: 10.1111/clr.13954] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 04/27/2022] [Accepted: 05/05/2022] [Indexed: 11/29/2022]
Abstract
Aim To assess radiographic, restorative, clinical and technical outcomes as well as patient satisfaction of directly veneered zirconia restorations cemented on non‐original titanium bases over 5 years. Material and Methods Twenty‐four patients with a single missing tooth in the aesthetic zone were recruited. All patients received a two‐piece implant with a screw‐retained veneered zirconia restoration cemented extraorally on a titanium base abutment. Marginal bone levels (MBL), marginal bone changes, technical complications, patient satisfaction and clinical parameters including probing depth, bleeding on probing and plaque index were assessed at crown delivery (baseline), at 1 year (FU‐1) and 5 years (FU‐5) of follow‐up. To investigate the relationship between restorative angle and MBL as well as marginal bone changes (bone loss/bone gain), correlation tests and linear regression models were carried out. Results Twenty‐two patients were available for re‐examination at 5 years. The mean MBL amounted to 0.54 ± 0.39 mm at baseline, and to 0.24 ± 0.35 at FU‐5 (=bone gain) (p < .001). At FU‐1, a positive correlation (r = .5) between the mesial restorative angle and mesial MBL was found (p = .012). Marginal bone changes between baseline and FU‐1 at mesial sites were also positively correlated with the mesial restorative angle (r = .5; p = .037). Linear and logistic regression models confirmed that mesial marginal bone loss was significantly associated with the mesial restorative angle at FU‐1 (p < .05). At 5 years, these significant associations at mesial sites disappeared (p > .05). At distal sites, no correlations or associations between the restorative angle and MBL or marginal bone changes were found regardless of the time point. During the 5‐year follow‐up, 5 technical complications occurred, mainly within the first year and mostly chippings. All patients were entirely satisfied with their implant‐supported restoration at 5 years. Conclusion Within the limitations of the present study, the restorative angle of implant‐supported crowns on non‐original titanium bases might influence the initial marginal bone loss but without affecting their favourable long‐term clinical performance. A restorative angle of <40° may limit the initial marginal bone loss at implant‐supported crowns with titanium bases.
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Affiliation(s)
- Franz J Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Marina Siegenthaler
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Switzerland
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
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19
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Dobreva D, Gkantidis N, Halazonetis D, Verna C, Kanavakis G. Smile Reproducibility and Its Relationship to Self-Perceived Smile Attractiveness. BIOLOGY 2022; 11:biology11050719. [PMID: 35625447 PMCID: PMC9138875 DOI: 10.3390/biology11050719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 11/16/2022]
Abstract
The reproducibility of facial expressions has been previously explored, however, there is no detailed information regarding the reproducibility of lip morphology forming a social smile. In this study, we recruited 93 young adults, aged 21−35 years old, who agreed to participate in two consecutive study visits four weeks apart. On each visit, they were asked to perform a social smile, which was captured on a 3D facial image acquired using the 3dMD camera system. Assessments of self-perceived smile attractiveness were also performed using a VAS scale. Lip morphology, including smile shape, was described using 62 landmarks and semi-landmarks. A Procrustes superimposition of each set of smiling configurations (first and second visit) was performed and the Euclidean distance between each landmark set was calculated. A linear regression model was used to test the association between smile consistency and self-perceived smile attractiveness. The results show that the average landmark distance between sessions did not exceed 1.5 mm, indicating high repeatability, and that females presented approximately 15% higher smile consistecy than males (p < 0.05). There was no statistically significant association between smile consistency and self-perceived smile attractiveness (η2 = 0.015; p = 0.252), when controlling for the effect of sex and age.
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Affiliation(s)
- Denitsa Dobreva
- Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine UZB, University of Basel, Mattenstrasse 40, 4058 Basel, Switzerland; (D.D.); (C.V.)
| | - Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, 3001 Bern, Switzerland;
| | - Demetrios Halazonetis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, GR-11527 Athens, Greece;
| | - Carlalberta Verna
- Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine UZB, University of Basel, Mattenstrasse 40, 4058 Basel, Switzerland; (D.D.); (C.V.)
| | - Georgios Kanavakis
- Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine UZB, University of Basel, Mattenstrasse 40, 4058 Basel, Switzerland; (D.D.); (C.V.)
- Department of Orthodontics, Tufts University School of Dental Medicine, Boston, MA 02111, USA
- Correspondence:
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20
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Stefos S, Kourtis S, Vrekoussis T, Augoulea A, Kalantaridou S. Quality of Life in Menopausal Women with Dental Restorations and Implants. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2203151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim:
This multicenter study examined the relationship, possible interactions, and intermittent effects that dental implants and prostheses can have on menopausal women’s quality of life as well as provided information regarding the possible side effects of therapeutic regimens on menopause and osteoporosis or osteopenia.
Materials and Methods:
Questionnaires consisted of selected quality of life questions based on specific and additional medical and dental (mainly prosthodontic) questions, which were administered to 100 Greek menopausal/post-menopausal women (Age: Mean Value=63,62 years old) with osteopenia or with or without osteoporosis, with dental implants and implant restorations, or conventional prosthetic restorations visiting two University Hospitals. Menopausal/post-menopausal status was judged on the basis of either secondary, definitive amenorrhoea or based on follicular stimulation hormone (FSH) values, estradiol, and clinical risk factors.
Results:
Participants had a statistically significantly better “functional” and “psychological” feeling after prosthodontic rehabilitation with and without implants. Three out of four reported that their dentist informed them of the possible implant problems that might arise from osteoporosis and its treatment (medications). Moreover, osteopenia was found to be associated with a very lower problem percentage. The bisphosphonate treatment had the highest rate (80%) of reported implant problems than non-bisphosphonate treatment (30%). The hormone replacement therapy (HRT) for menopause was reported to be more associated with problems in implant placement (19%) than in those without treatment (27.3%).
Conclusion:
The questionnaires revealed a significant improvement concerning women’s life quality and well-documented information about the problems their dental implants and restorations may cause in association with menopause and/or osteoporosis.
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Sobczak B, Majewski P. An Integrated Fully Digital Prosthetic Workflow for the Immediate Full-Arch Restoration of Edentulous Patients-A Case Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074126. [PMID: 35409808 PMCID: PMC8998896 DOI: 10.3390/ijerph19074126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/23/2022] [Accepted: 03/28/2022] [Indexed: 11/16/2022]
Abstract
Digital prosthetic workflows may significantly increase the efficiency and predictability of the immediate rehabilitation of implant-supported fixed complete dentures. Advanced digital prosthetic workflows require exact and detailed virtual planning models. The direct generation of these models via direct digital impressions remains technique sensitive and demanding. This report illustrates an advanced digital workflow for accurate and efficient immediate full-arch restoration, with an aesthetically and anatomically adapted natural tooth-like prosthesis. The workflow application to fully edentulous arches, and arches with residual failing dentition, is presented. A key characteristic was efficiently integrating and interlinking the prosthetic and surgical workflows via denture replica surgical guides as landmarks for scan registration. This approach allowed for accurate implant placement and efficient and detailed anatomy-based chairside prosthetic planning, and for the manufacturing of the provisional and final restorations under detailed consideration of implant restoration, and the patient's macro-aesthetic and soft tissue anatomy.
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Affiliation(s)
- Barbara Sobczak
- Dr Sobczak Dental Clinic, 04-881 Warsaw, Poland
- Correspondence:
| | - Piotr Majewski
- Implant Dentistry Department, Dental Institute Collegium Medicum, Jagiellonian University, 31-155 Cracow, Poland;
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22
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Zaugg FL, Molinero-Mourelle P, Abou-Ayash S, Schimmel M, Brägger U, Wittneben JG. The influence of age and gender on perception of orofacial esthetics among laypersons in Switzerland. J ESTHET RESTOR DENT 2022; 34:959-968. [PMID: 35324054 PMCID: PMC9545702 DOI: 10.1111/jerd.12906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the perception and role of orofacial esthetics by laypersons, and how attitudes may be correlated with age and gender in Switzerland. MATERIAL AND METHODS Self-administrated questionnaires (SAQ) were distributed both conventionally and digitally to Swiss residents over 16 years of age (range 16-99 years). The participants were identified in the medical practice, at an open house of the ZMK Bern, in elderly care centers, and via the internet (Facebook and Instagram). To verify that the participants were Swiss residents and laypersons, they were checked by an operator (conventional) or were provided an exact description of eligible participants at the beginning of the SAQ (digital). The SAQ included 30 questions with multiple-choice responses and visual analogue scales (0-100) divided into four sections regarding dental appearance with respect to body esthetics, partner selection, employment and career opportunities, and overall health/quality-of-life. For statistical analysis, respondents were segregated into two age groups (<25 years and ≥25 years) and into two gender groups (male and female). Descriptive analyses, the Fisher exact test, and Welch's t-test were applied (α = 0.05). RESULTS Five hundred and two laypersons completed the SAQ. The study's hypothesis-that various age groups and genders have different perceptions of dental esthetics-was supported. The willingness to correct one's own dentition was lower among older participants (OR: 0.54; p = 0.001); charisma and dental esthetics were considered equally important with a trend toward charisma in both age groups (p = 0.003). The belief that excellent dentition improves employment chances at a job interview (OR: 0.47; p = 0.0003) was significantly lower among older participants, and the belief that dental correction would improve quality-of-life was significantly higher among older participants (OR: 1.81; p = 0.001). The assumption that individuals with attractive teeth appear happier was significantly lower among older respondents (OR: 0.67; p = 0.03). Women were less satisfied with their dental appearance and, proportionally, their willingness to receive correction was significantly higher (OR: 1.79; p = 0.01 and OR: 1.77; p = 0.002 relative to men, respectively). Moreover, male participants had a lower desire to have brighter teeth and undergo bleaching treatments (OR: 0.54; p = 0.002; OR: 0.53; p = 0.002). The proportion of men believing that having beautiful teeth improves attractiveness and employment chances was significantly lower (OR: 0.33; p = 0.02 and OR: 0.66; p = 0.04; respectively). CONCLUSIONS Within the limitations of this observational study, it was concluded that age and gender of laypersons in Switzerland have a significant impact on the perception of dental esthetics. CLINICAL SIGNIFICANCE Evaluating and quantifying perceptions of dental esthetics for daily life across various age groups and genders can improve clinicians' understanding of individual needs in order to offer patient-oriented dental care.
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Affiliation(s)
- Fiona-Leandra Zaugg
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Pedro Molinero-Mourelle
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Samir Abou-Ayash
- Section for Digital Implant and Reconstructive Dentistry [DIRecD], Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Urs Brägger
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Julia-Gabriela Wittneben
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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23
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Abstract
Inappropriate and unnecessary implant therapy driven by an erroneous belief that dental implants provide enhanced function and esthetics over diseased or failing teeth has led to a growing burden of implant complications across the globe. Specifically, esthetic and biological complications frequently lead to the unfavorable prognosis of dental implants. Often, these cannot be managed predictably to improve the condition or satisfy patients' demands. In such circumstances, implant removal needs to be considered. Currently, minimally invasive methods based on reverse torque engineering are key to preserve peri-implant soft and hard tissues. Implant replacement is now feasible, as evidenced by the high survival rates of implants placed at previously failed sites. Notwithstanding these data, clinicians should still consider carefully the expendability of an implant and whether its replacement will satisfy the prosthetic, biomechanical, and esthetic demands of the patient. In the scenario where future implant placement is desired, protocols undertaken for soft/hard tissue grafting and implant placement should be based upon defect morphology and soft and hard-tissue characteristics. Currently, however, a lack of knowledge of the biological events and dimensional changes that arise following implant removal renders decision-making complex and challenging, and recommendations remain largely based upon empirical speculation. This chapter will review the indications for implant replacement for prosthetic, biomechanical, and esthetic complications, alongside considerations in decision-making, planning, implementation, and outcomes of implant replacement.
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Affiliation(s)
- Alberto Monje
- Department of Periodontics and Oral Medicine, School of Dental Medicine, University of Michigan, Ann Arbor, MI, USA.,Department of Periodontology, Universidad Internacional de Catalunya, Barcelona, Spain
| | - José Nart
- Department of Periodontology, Universidad Internacional de Catalunya, Barcelona, Spain
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24
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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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25
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Walji MF, Spallek H, Kookal KK, Barrow J, Magnuson B, Tiwari T, Oyoyo U, Brandt M, Howe BJ, Anderson GC, White JM, Kalenderian E. BigMouth: development and maintenance of a successful dental data repository. J Am Med Inform Assoc 2022; 29:701-706. [PMID: 35066586 PMCID: PMC8922177 DOI: 10.1093/jamia/ocac001] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 12/10/2021] [Accepted: 01/20/2022] [Indexed: 12/27/2022] Open
Abstract
Few clinical datasets exist in dentistry to conduct secondary research. Hence, a novel dental data repository called BigMouth was developed, which has grown to include 11 academic institutions contributing Electronic Health Record data on over 4.5 million patients. The primary purpose for BigMouth is to serve as a high-quality resource for rapidly conducting oral health-related research. BigMouth allows for assessing the oral health status of a diverse US patient population; provides rationale and evidence for new oral health care delivery modes; and embraces the specific oral health research education mission. A data governance framework that encouraged data sharing while controlling contributed data was initially developed. This transformed over time into a mature framework, including a fee schedule for data requests and allowing access to researchers from noncontributing institutions. Adoption of BigMouth helps to foster new collaborations between clinical, epidemiological, statistical, and informatics experts and provides an additional venue for professional development.
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Affiliation(s)
- Muhammad F Walji
- Department of Diagnostics and Biomedical Sciences. School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Heiko Spallek
- Faculty of Dentistry. The University of Sydney, Sydney, Australia
| | - Krishna Kumar Kookal
- Department of Diagnostics and Biomedical Sciences. School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Jane Barrow
- Office of Global and Community Health. Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Britta Magnuson
- Department of Diagnostic Sciences. Tufts School of Dental Medicine, Boston, Massachusetts, USA
| | - Tamanna Tiwari
- Department of Community Dentistry & Population Health. University of Colorado School of Dental Medicine, Aurora, Colorado, USA
| | - Udochukwu Oyoyo
- Office of Dental Education Services. Loma Linda University School of Dentistry, Loma Linda, California, USA
| | - Michael Brandt
- Office of Information Resources. University of Buffalo School of Dental Medicine, Buffalo, New York, USA
| | - Brian J Howe
- Department of Family Dentistry. University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - Gary C Anderson
- Department of Developmental and Surgical Sciences. University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
| | - Joel M White
- Department of Preventive and Restorative Dental Science. School of Dentistry, University of California at San Francisco, San Francisco, California, USA
| | - Elsbeth Kalenderian
- Office of Global and Community Health. Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Department of Preventive and Restorative Dental Science. School of Dentistry, University of California at San Francisco, San Francisco, California, USA
- Department of Dental Management Sciences. School of Dentistry, University of Pretoria, Pretoria, South Africa
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26
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Appelstrand SB, Robertson A, Sabel N. Patient-reported outcome measures in individuals with amelogenesis imperfecta: a systematic review. Eur Arch Paediatr Dent 2022; 23:885-895. [PMID: 35896941 PMCID: PMC9750902 DOI: 10.1007/s40368-022-00737-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 07/13/2022] [Indexed: 10/16/2022]
Abstract
PURPOSE Amelogenesis imperfecta (AI) is a hereditary condition which affects the composition and structure of enamel in terms of hypoplasia and/or hypomineralization. The condition severely affects patients facing such difficulties as hypersensibility, loss of tooth substance and poor aesthetics. The objective is to perform a systematic review of patient-reported outcome measures (PROMs) in patients with amelogenesis imperfecta. METHODS Inclusion criteria were articles written in English, including PROMs from patients with amelogenesis imperfecta. The databases PubMed, Scopus and Web of Science were searched on April 27, 2022, and eligible articles were screened. Exclusion criteria were articles based on proxy reports and single case reports. RESULTS 405 studies were screened in terms of title and abstract, with 31 articles eligible for full-text screening, resulting in a total of 11 articles eligible for inclusion, (articles including 4-82 patients). The content was analyzed, resulting in the outcome divided into seven domains: Oral Health-Related Quality of Life (OHRQoL), Dental fear, Esthetics, Psychosocial factors, Function, Dental hypersensitivity, and Treatment outcome. CONCLUSION The limited quantity of research on PROMS from patients with AI indicates a significant impact of OHRQoL and daily life. A large variety of approaches have been presented in the articles. Patients report concerns of esthetics, hypersensitivity, function, and a general impact on well-being and social interaction. This highlights the importance for the need of early dental treatment. PROSPERO REGISTRATION NUMBER 256875.
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Affiliation(s)
- S. B. Appelstrand
- Public Dental Service, Region Västra Götaland, Västra Götaland, Sweden
| | - A. Robertson
- grid.8761.80000 0000 9919 9582Department of Pediatric Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - N. Sabel
- grid.8761.80000 0000 9919 9582Department of Pediatric Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
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27
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LIU YUNCHEN, SHIH MINGCHIEH, TU YUKANG. USING DENTAL PATIENT-REPORTED OUTCOMES (dPROs) IN META-ANALYSES: A SCOPING REVIEW AND METHODOLOGICAL INVESTIGATION. J Evid Based Dent Pract 2022; 22:101658. [DOI: 10.1016/j.jebdp.2021.101658] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/07/2021] [Accepted: 10/12/2021] [Indexed: 12/16/2022]
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28
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Hamdane K, Nasri W. Esthetic evaluation of single implant-supported prostheses: Comparative analysis of the reliability of the esthetic indices. J ESTHET RESTOR DENT 2021; 34:680-688. [PMID: 34971018 DOI: 10.1111/jerd.12862] [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: 08/27/2021] [Revised: 11/16/2021] [Accepted: 12/21/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To carry out a detailed analysis of four indices proposed for the esthetic evaluation of implant-supported single crowns in the anterior maxillary sector. MATERIAL AND METHODS Four esthetic indices were selected: the Pink and white esthetic score, the Copenhagen Index Score, the peri-implant and crown index (PICI), and the implant restoration esthetic index (IREI). The examiners were 15 expert subjects and 30 nonexpert ones. The intraclass correlation coefficient was used to assess reproducibility. The validity and the correlation of the esthetic indices results with the perception of nonexpert subjects were evaluated using the Pearson's correlation. RESULTS For inter- and intra-observer reproducibility, all the esthetic indices had an intraclass correlation coefficient value>0.8. As for validity, the highest correlation values were found for the PICI and for the IREI. The values of correlation with the perception of nonexpert subjects did not exceed 0.3 for all esthetic indices. CONCLUSIONS All esthetic indices evaluated presented good intra- and inter-rater reproducibility. Validity was considered satisfactory only for the PICI and the IREI. The correlation with the perception of nonexpert subjects showed a weak correlation with all the indices considered. CLINICAL SIGNIFICANCE An approved esthetic indice with proven reproducibility and validity could provide a better objective overview of one's own esthetic results in the daily practice. It could also help to record the results over time to analyze the stability of the treatment procedure. The esthetic results of the different surgical and prosthetic protocols can also be compared, which facilitates the analysis of the indications relevance and clinical effects. However, low reproducibility according to the specialty and the practitioner's level of expertise was observed. A heterogeneity of results was also noted when compared with those of nonexpert subjects.
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Affiliation(s)
- Khaireddine Hamdane
- Faculty of Dentistry of Monastir, Research Laboratory in Oral Health and Oral-Facial Rehabilitation, Monastir, Tunisia.,Periodontology Department of Monastir, Tunisia
| | - Wafa Nasri
- Faculty of Dentistry of Monastir, Research Laboratory in Oral Health and Oral-Facial Rehabilitation, Monastir, Tunisia.,Periodontology Department of Monastir, Tunisia
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29
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Nielsen HB, Schou S, Bruun NH, Starch-Jensen T. Professional and patient-reported outcomes of two surgical approaches for implant-supported single-crown restoration: 1-year results of a randomized controlled clinical trial. Clin Oral Implants Res 2021; 33:197-208. [PMID: 34866250 DOI: 10.1111/clr.13883] [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: 09/30/2020] [Revised: 11/17/2021] [Accepted: 11/25/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To test whether there is a difference in professional and patient-reported outcome measures (PROM) after single-crown restoration supported by short implants (SI) (6 mm) compared with standard length implants (SLI) (13 mm) in conjunction with maxillary sinus floor augmentation (MSFA) after 1 year of functional implant loading. MATERIAL AND METHODS Forty patients were randomly allocated to SI or SLI/MSFA. PROM included Oral Health Impact Profile (OHIP-14) questionnaire and subjective assessment of the peri-implant soft tissue (A), implant crown (B), implant function (C) and overall implant treatment outcome (D) using visual analogue scale (VAS). Professional assessment included pink aesthetic score (PES) and white aesthetic score (WES). RESULTS No significant differences in professional or PROM between the two treatment modalities were revealed at any time point (p > .05). OHIP-14 score decreased at baseline and 1 year after functional implant loading compared with preoperative measurements indicating improved quality of life with both treatment modalities. The 1-year mean VAS score was 9.4 (A), 9.3 (B), 9.6 (C) and 9.3 (D) for SI compared with 9.3 (A), 9.6 (B), 9.7 (C) and 9.2 (D) for SLI. The 1-year mean PES/WES scores were 11.3 and 8.1 for SI compared with 11.2 and 8.1 for SLI/MSFA. CONCLUSIONS Prosthetic rehabilitation of the posterior part of the maxilla with SI or SLI/MSFA revealed no significant differences in professional and PROM after 1 year of implant loading.
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Affiliation(s)
| | - Søren Schou
- Department of Periodontology, School of Dentistry, University of Copenhagen, Copenhagen, Denmark
| | - Niels Henrik Bruun
- Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
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30
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Kunavisarut C, Jarangkul W, Pornprasertsuk-Damrongsri S, Joda T. Patient-reported outcome measures (PROMs) comparing digital and conventional workflows for treatment with posterior single-unit implant restorations: A randomized controlled trial: PROMs comparing digital & conventional workflows. J Dent 2021; 117:103875. [PMID: 34728252 DOI: 10.1016/j.jdent.2021.103875] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/22/2021] [Accepted: 10/26/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES The aim of this randomized controlled trial (RCT) was to analyze patient-reported outcome measures (PROMs) of prosthetic therapy with monolithic implant crowns in completely digital workflows (test) with intraoral optical scanning (IOS) and conventional workflows (control) with conventional impressions. Secondary, an objective evaluation of the final implant restorations was performed using the Functional Implant Prosthodontic Score (FIPS). MATERIALS AND METHODS Forty patients who required an implant-supported single crown on posterior regions were randomly divided into test (n=20) and control (n=20) groups for impression taking. Each group was then equally separated into two subgroups according to the restorative material used: lithium disilicate (LS2, N!CE®, Straumann AG, Basel, Switzerland) or polymer-infiltrated ceramic networks (PICN, Enamic®, Vita, Bad Säckingen, Germany). Patient satisfaction was evaluated using PROM questionnaires with visual analog scales (VAS) after impression-taking and 1 week after prosthetic delivery. Patient satisfaction with the impression technique was assessed in six domains: length, comfort, anxiety, taste, nausea, and pain, whereas patient satisfaction with the final restoration was assessed in four domains: overall treatment outcome, functionality, esthetics, and cleanability. In addition, the final implant restorations were objectively assessed by an independent prosthodontist using the FIPS. Mann-Whitney U test was used to analyze the defined outcomes. Statistical analysis was completed with a level of significance set at α=0.05. RESULTS PROMs focusing on the impression technique demonstrated higher levels of patient satisfaction for IOS compared to conventional impressions, especially in terms of "taste irritation" (p=0.036); whereas no significant differences were found between both restorative CAD/CAM-materials. Mean FIPS values demonstrated similar results among subgroups. CONCLUSIONS Within the limitation of this study, both completely digital and conventional protocols provided great levels of patient satisfaction in implant rehabilitation of single-tooth gaps in posterior sites with monolithic implant crowns. The restorative material, LS2 versus PICN, does not impact patient satisfaction with their treatment. However, long-term followed up is required to ensure patient' satisfaction with the restorations.
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Affiliation(s)
- Chatchai Kunavisarut
- Department of Advanced General Dentistry, Mahidol University, Bangkok, Thailand.
| | - Worapat Jarangkul
- Education Program in Implant Dentistry, Mahidol University, Bangkok, Thailand
| | | | - Tim Joda
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
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31
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Pannuti CM, Costa FO, Souza NV, Retamal-Valdes B, Costa AA, Susin C, Feres M. Randomized clinical trials in periodontology: focus on outcomes selection. Braz Oral Res 2021; 35:e100. [PMID: 34586214 DOI: 10.1590/1807-3107bor-2021.vol35.0100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/31/2021] [Indexed: 12/19/2022] Open
Abstract
Randomized clinical trials (RCTs) are human studies carried out to compare different treatments or interventions, and their results are used to support clinical decision-making and improve patient care. Herein, the aim of this study was to review the selection process of study outcomes in periodontology. Primary outcomes should draw the main conclusions of the study, whereas secondary outcomes should only be used to help explain the main findings and generate future research hypothesis. Outcomes are classified as clinically relevant (CROs) or surrogate outcomes. CROs - the first option for primary outcome variables - should convey not only substantial health benefits, but also be deemed important by patients. In periodontology, tooth loss/retention and oral health-related quality of life (OHRQoL) are examples of CROs. While tooth loss has main limitations as a primary outcome, emerging evidence suggest that patient-reported outcome measures (PROMs) can accurately detect OHRQoL following periodontal therapy. When CROs cannot be assessed, validated surrogate outcomes can be used as proxies. Primary outcome variables should reflect a treatment endpoint at the patient level that can be easily used to inform decision-making in daily practice. These outcomes should allow the implementation of a treat-to-target concept in which the intervention can be clearly judged against a prespecified treatment target. Recently, the presence of at most 4 sites with periodontal probing depth ≥5 mm post-treatment was suggested as an effective endpoint for periodontal trials. In perspective, a combination of validated clinical parameters and PROMs will provide a more comprehensive assessment of periodontal treatments.
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Affiliation(s)
- Claudio Mendes Pannuti
- Universidade de São Paulo - USP, School of Dentistry, Department of Stomatology, São Paulo, SP, Brazil
| | - Fernando Oliveira Costa
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Clinic, Pathology and Dental Surgery, Belo Horizonte, MG, Brazil
| | - Nathalia Vilela Souza
- Universidade de São Paulo - USP, School of Dentistry, Department of Stomatology, São Paulo, SP, Brazil
| | - Belen Retamal-Valdes
- Universidade Guarulhos - UNG, Dental Research Division, Department of Periodontology and Oral Implantology, Guarulhos, SP, Brazil
| | - Amanda Almeida Costa
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Clinic, Pathology and Dental Surgery, Belo Horizonte, MG, Brazil
| | - Cristiano Susin
- University of North Carolina at Chapel Hill, Adams School of Dentistry, Division of Comprehensive Oral Health - Periodontology, Chapel Hill, NC, USA
| | - Magda Feres
- Universidade Guarulhos - UNG, Dental Research Division, Department of Periodontology and Oral Implantology, Guarulhos, SP, Brazil
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32
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Serra-Pastor B, Bustamante-Hernández N, Fons-Font A, Fernanda Solá-Ruíz M, Revilla-León M, Agustín-Panadero R. Periodontal Behavior and Patient Satisfaction of Anterior Teeth Restored with Single Zirconia Crowns Using a Biologically Oriented Preparation Technique: A 6-Year Prospective Clinical Study. J Clin Med 2021; 10:jcm10163482. [PMID: 34441778 PMCID: PMC8396819 DOI: 10.3390/jcm10163482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/02/2021] [Accepted: 08/05/2021] [Indexed: 01/02/2023] Open
Abstract
Objectives. The aim of this study was to analyze the behavior of the periodontal tissues around teeth in the anterior region when restored with zirconia single crowns, using a biologically oriented preparation technique (BOPT), over a 6-year follow-up. Methods. The study investigated tooth-supported single crowns in the anterior region that were fabricated with a zirconia core and feldspathic ceramic covering, in 34 patients. Follow-up analysis took place annually for 6 years, assessing periodontal responses by evaluating the following variables: plaque index (PI); probing depth (PD); gingival index (GI); gingival thickness adjacent to the restoration; and stability of the gingival margin (MS). Any (biological and mechanical) complications were also recorded, as well as the patients’ satisfaction with the treatment. Results. After 6 years’ follow-up, a low mean plaque index was obtained, probing depth was stable, and gingival thickness and margin stability had increased. Complications (biological and mechanical) did not present a statistically significant incidence and a crown survival rate of 97.2% was achieved. Patients’ satisfaction obtained a mean VAS score of 9.04 under 10. Conclusion. Teeth that are prepared with BOPT in the anterior region present good periodontal behavior around the restored teeth, particularly in terms of the stability of the gingival margin and increased gingival thickness. Single crowns prepared with BOPT obtain an excellent clinical survival rate, as well as a high score in patients’ satisfaction after 6 years.
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Affiliation(s)
- Blanca Serra-Pastor
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (B.S.-P.); (N.B.-H.); (A.F.-F.); (R.A.-P.)
| | - Naia Bustamante-Hernández
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (B.S.-P.); (N.B.-H.); (A.F.-F.); (R.A.-P.)
| | - Antonio Fons-Font
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (B.S.-P.); (N.B.-H.); (A.F.-F.); (R.A.-P.)
| | - María Fernanda Solá-Ruíz
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (B.S.-P.); (N.B.-H.); (A.F.-F.); (R.A.-P.)
- Correspondence:
| | | | - Rubén Agustín-Panadero
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (B.S.-P.); (N.B.-H.); (A.F.-F.); (R.A.-P.)
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33
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Garcia-Sanchez R, Mardas N, Buti J, Ortiz Ruiz AJ, Pardo Zamora G. Immediate implant placement in fresh alveolar sockets with a minimal split-thickness envelope flap: A randomised controlled clinical trial. Clin Oral Implants Res 2021; 32:1115-1126. [PMID: 34218469 DOI: 10.1111/clr.13806] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 06/17/2021] [Accepted: 06/22/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Comparing PES/WES scores, modified success rate, survival, success, buccal bone thickness and patient-reported outcomes of immediate dental implants placed in fresh alveolar sockets using a flap or a minimal split-thickness envelope flap (MSTEF). MATERIALS AND METHODS Implants following random assignment into a flap or MSTEF group were placed immediately in anterior and premolar areas. Guided bone regeneration and autogenous connective tissue graft were used in all cases. A temporary prosthesis was provided followed by the final prosthesis at 16-18 weeks. Success and survival rates together with radiographic buccal bone thickness and patient satisfaction were evaluated at 12-month post-loading. The aesthetic outcome was evaluated through the Pink (PES) and White (WES) Aesthetic Score by 8 blind clinicians of different training background and incorporated in modified success criteria. RESULTS 28 implants were placed on 28 patients. No statistically significant differences were noted in PES (10.54 control versus 10.80 test), WES scores (6.97 control versus 6.95 test) or success criteria including aesthetic parameters (modified success criteria) for the different specialty groups (Range 69%-92%). In addition, no statistically significant differences were noted in survival (100%), success (100%), buccal wall thickness between control (0.72 ± 0.22) and test group (0.92 ± 0.31) and patients' reported outcomes. CONCLUSIONS Immediate dental implant treatment with flap/ MSTEF provided similar mean PES/WES scores, modified success rate, survival, mean buccal bone levels and patients' satisfaction. However, aesthetic failures were common in both groups.
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Affiliation(s)
- Ruben Garcia-Sanchez
- Universidad de Murcia, Murcia, Spain.,Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Nikos Mardas
- QMUL, The London School of Dentistry, London, UK
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34
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The accuracy of single implant scans with a healing abutment-scanpeg system compared with the scans of a scanbody and conventional impressions: An in vitro study. J Dent 2021; 110:103684. [PMID: 33961938 DOI: 10.1016/j.jdent.2021.103684] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/29/2021] [Accepted: 05/02/2021] [Indexed: 02/01/2023] Open
Abstract
PURPOSE To compare the accuracy of polyvinylsiloxane (PVS) impressions and intraoral scans when a healing abutment-scanpeg system (HASP) or a conventional scanbody (CSB) was used on a single implant. MATERIALS AND METHODS A maxillary model with an implant (4.0 × 11 mm) (Neoss) and a CSB or an HASP (Neoss) was scanned by using a laboratory scanner (Ceramill Map 600; Amann Girrbach) (reference scans) and an intraoral scanner (Trios 3) (n = 10). PVS open-tray impressions were also made and stone casts of the model with a CSB were digitized with the laboratory scanner. Intraoral scanner and cast scans were superimposed to their reference scans. On superimposed scans, points were selected on HASP and CSB to calculate distance deviations (at points 1-4) and angular deviations (at points 5 and 6 on CSB and PVS, and 5-8 on HASP) between scans (trueness), and their variation (precision). The deviation data was analyzed with ANOVA and pairwise comparisons (trueness) with Tukey's adjustment, and F-tests (precision). RESULTS At point 1, PVS had lower trueness than CSB (difference in means (DIMs) = 0.184 mm, p = 0.006) and HASP (DIMs = 0.122 mm, p = 0.042). At point 3, CSB had higher trueness than HASP (DIMs = 0.134 mm, p = 0.001). Angular deviations with PVS were higher than with CSB (DIMs = 0.6°, p = 0.013) and HASP (DIMs = 0.7°, p = 0.005). CSB had higher precision than PVS (p < 0.05). HASP had higher precision than PVS for distance (Point 1)(p < 0.001) and angular deviations (p < 0.05). Deviation differences within the HASP parts were not significant. CONCLUSION The accuracy of intraoral scans and PVS impressions of an implant was similar. CLINICAL RELEVANCE The combined healing abutment-scanpeg system and the conventional scanbody can be recommended for scans of anterior single implants with the intraoral scanner used.
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Meira IA, Gama LT, Prado-Tozzi DA, Pinheiro MA, Rodrigues Garcia RCM. Speech in implant-supported and removable complete denture wearers: A systematic review. J Prosthet Dent 2021; 128:1230-1238. [PMID: 33865562 DOI: 10.1016/j.prosdent.2021.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 03/02/2021] [Accepted: 03/02/2021] [Indexed: 12/14/2022]
Abstract
STATEMENT OF PROBLEM Prosthetic rehabilitation, especially with removable complete dentures (CDs), can contribute to speech problems, although the prevalence of the problem is unclear. PURPOSE The purpose of this systematic review was to examine the influence of implant-supported fixed complete dentures (FCDs), implant-supported overdentures, and removable CDs on speech articulation disorders in patients with at least 1 completely edentulous jaw. MATERIAL AND METHODS This study was prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in the International Prospective Register of Systematic Reviews (CRD42020182705). The PubMed/Medline, Embase, Web of Science, Scopus, Latin American and Caribbean Health Sciences, Brazilian Clinical Trials Registry, and Cochrane Library databases were searched through April 2020 to identify clinical trials comparing maxillary and/or mandibular implant-supported dentures with removable CD use in terms of speech articulation in participants with at least 1 completely edentulous jaw. The risk of bias of selected studies was assessed with the Joanna Briggs Institute critical appraisal tools, and the quality of evidence was tested by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS Initially, 2586 articles were identified, and their titles and abstracts were read. Sixteen articles were read in full, and 8 studies (4 paired clinical trials and 4 cross-sectional studies) were included in this review. In total, 290 prosthesis users aged 29 to 90 years, approximately 44 of whom had hearing difficulties, were included. Four studies had a low risk of bias, and 4 studies had a high risk of bias. Distortions of the /s/ phoneme were observed more often in the first 6 months of maxillary FCD use than with removable CD use. Speech articulation did not differ between mandibular FCD and removable CD users. The quality of evidence for speech articulation disorders was low. CONCLUSIONS Given the low quality of evidence on speech articulation disorders, further research on speech articulation disorders in prosthesis wearers is needed.
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Affiliation(s)
- Ingrid Andrade Meira
- Graduate student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Lorena Tavares Gama
- Graduate student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | | | - Mayara Abreu Pinheiro
- Graduate student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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Wu X, Chen S, Ji W, Shi B. The risk factors of early implant failure: A retrospective study of 6113 implants. Clin Implant Dent Relat Res 2021; 23:280-288. [PMID: 33724690 DOI: 10.1111/cid.12992] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/09/2021] [Accepted: 02/28/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND The risk factors of early implant failure were controversial among previous studies, especially for implants in different sites. PURPOSE To analyze the rate and risk factors of early implant failure occurring before the placement of final prosthesis. MATERIALS AND METHODS A retrospective study was conducted based on electrical medical records of patients who received dental implant placement from 2015 to 2019. Generalized estimation equation analyses were used to explore potential risk factors influencing early implant failure. RESULTS Overall, 6113 implants in 3785 patients were included. The rate of early implant failure was 1.6% at patient level and 1.2% at implant level. The early implant failure was significantly associated with implants in the posterior maxilla, with specific surface modifications and in previously augmented sites (p < 0.05). Risk factors for maxillary implants included surface modification and bone augmentation procedures (p < 0.01), whereas risk factors for mandibular implants included gender and bone augmentation procedures (p < 0.05). For implants placed in previously augmented sites, implants placed in the anterior mandible had a higher risk of early failure (p < 0.05). CONCLUSIONS The risk factors for early implant failures varied among different sites; hence, they should be comprehensively considered in presurgical treatment plan.
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Affiliation(s)
- Xinyu Wu
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology, Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Si Chen
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology, Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), School and Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wei Ji
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology, Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), School and Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bin Shi
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology, Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), School and Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
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Boyce RA. Prosthodontic Principles in Dental Implantology: Adjustments in a Coronavirus Disease-19 Pandemic-Battered Economy. Dent Clin North Am 2021; 65:135-165. [PMID: 33213707 PMCID: PMC8180388 DOI: 10.1016/j.cden.2020.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
More patients are requesting fixed prosthesis to replace missing teeth. More than 5 million dental implants are placed annually in the United States. This number will decrease in 2020 owing to the coronavirus disease-19 pandemic. The edentulous patient has a decreased quality of life. Prosthodontic rehabilitation/reconstruction of edentulism improves overall quality of life. Patient-reported outcome measures are subjective reports of patients' perceptions of their oral health status and the impact that it has on their quality of life. This chapter contains a variety of prosthodontic principles for the reader to help satisfy the needs and expectations of the patient.
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Affiliation(s)
- Ricardo A Boyce
- The Brooklyn Hospital Center, 121 Dekalb Avenue, Box 187, Brooklyn, NY 11201, USA; New York University, College of Dentistry, New York, NY, USA.
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Borges GA, Barbin T, Dini C, Maia LC, Magno MB, Barão VAR, Mesquita MF. Patient-reported outcome measures and clinical assessment of implant-supported overdentures and fixed prostheses in mandibular edentulous patients: A systematic review and meta-analysis. J Prosthet Dent 2020; 127:565-577. [PMID: 33390270 DOI: 10.1016/j.prosdent.2020.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 02/07/2023]
Abstract
STATEMENT OF PROBLEM A consensus based on patients' perceptions as to whether to use overdentures or fixed prostheses to rehabilitate mandibular edentulous arches is limited. PURPOSE The purpose of this systematic review and meta-analysis was to compare the patient-reported outcome measures (PROMs) and clinical outcomes associated with implant-supported overdentures and fixed prostheses in edentulous mandibles. MATERIAL AND METHODS Nine electronic databases were searched for randomized clinical trials (RCTs) and nonrandomized clinical trials (N-RCTs). The risk of bias was assessed by the revised Cochrane risk of bias tool for RCTs (RoB 2) and N-RCT (ROBINS-I). Data sets for oral health-related quality of life (OHRQoL), satisfaction, survival rate, implant probing depth, and marginal bone loss were plotted, and the appropriate analyses were applied by using the Rev Man 5.3 software program. Certainty of evidence was also evaluated by means of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. RESULTS Ten eligible trials were included and evaluated quantitatively. For 3 domains of OHRQoL, fixed prostheses showed significantly higher quality of life when compared with overdentures regarding functional limitation (P<.001), physical disability (P=.001), and physical pain (P=.003). Fixed prostheses also improved satisfaction, when compared with overdentures for comfort (P=.02), ease of chewing (P<.001), retention (P<.001), and stability (P<.001). The same pattern was observed for overall OHRQoL (P=.01) and satisfaction (P=.01) in which fixed prostheses improved patient satisfaction. Only ease of cleaning presented greater satisfaction for the overdenture group. Clinical parameters did not differ statistically (P>.05) between both types of prosthesis. CONCLUSIONS Fixed rehabilitations for mandibular edentulous patients seem to be a well-accepted treatment from the patients' oral health perspective. However, mandibular overdentures are no less efficient than fixed prostheses in terms of clinical outcomes.
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Affiliation(s)
- Guilherme Almeida Borges
- PhD student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Thaís Barbin
- PhD student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Caroline Dini
- PhD student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Lucianne Cople Maia
- Full Professor, Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Marcela Baraúna Magno
- Postdoctoral Research Fellow, Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Valentim Adelino Ricardo Barão
- Assistant Professor, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Marcelo Ferraz Mesquita
- Full Professor, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil.
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Chochlidakis K, Fraser D, Lampraki E, Einarsdottir ER, Barmak AB, Papaspyridakos P, Ercoli C, Tsigarida A. Prosthesis Survival Rates and Prosthetic Complications of Implant-Supported Fixed Dental Prostheses in Partially Edentulous Patients. J Prosthodont 2020; 29:479-488. [PMID: 32364656 DOI: 10.1111/jopr.13185] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 04/26/2020] [Accepted: 04/27/2020] [Indexed: 12/25/2022] Open
Abstract
PURPOSE To determine the prevalence and distribution of prosthetic complications affecting implant-supported fixed dental prostheses (ISFDPs). MATERIALS AND METHODS Subjects previously treated with one or more ISFDP(s) were identified from an electronic health record search and recalled for comprehensive clinical examination. Past prosthesis failures and complications were identified from the patient records while any existing complications, not previously recorded, were assessed during examination. ISFDP survival and failure rates were calculated with Kaplan-Meier curves and life table analysis, while regression Poisson analysis was used to identify associations between outcomes and possible patient- and prosthesis-based risk factors. RESULTS Seventy-four subjects with 107 ISFDPs were enrolled in the study with a mean time between prosthesis delivery and exam of 3.14 years (range: 1.00-9.00 years). Four prostheses failed, resulting in a cumulative prosthesis survival rate of 96.26%. Prosthetic complications affected 48.59% of ISFDPs, the majority (94.87%) of them minor complications. Only the use of a nightguard was associated with a lower prevalence of prosthetic screw loosening (HR 0.11, 95% CI 0.02-0.59, p = 0.007) while no outcome differences were noted for other variables. Patient satisfaction was high regardless of presence or number of complications. CONCLUSIONS ISFDPs demonstrated a high survival rate and overall high, patient-reported satisfaction. Minor prosthetic complications were common but were only significantly associated with nightguard use.
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Affiliation(s)
- Konstantinos Chochlidakis
- Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - David Fraser
- Department of Periodontology, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | | | | | - Abdul Basir Barmak
- Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - Panos Papaspyridakos
- Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY.,Department of Prosthodontics, Tufts School of Dental Medicine, Boston, MA
| | - Carlo Ercoli
- Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - Alexandra Tsigarida
- Department of Periodontology, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
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De Bruyckere T, Cosyn J, Younes F, Hellyn J, Bekx J, Cleymaet R, Eghbali A. A randomized controlled study comparing guided bone regeneration with connective tissue graft to re-establish buccal convexity: One-year aesthetic and patient-reported outcomes. Clin Oral Implants Res 2020; 31:507-516. [PMID: 32011032 DOI: 10.1111/clr.13587] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 10/15/2019] [Accepted: 01/08/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To compare guided bone regeneration (GBR) with connective tissue graft (CTG) in terms of aesthetic and patient-reported outcomes (PROMs). MATERIALS AND METHODS Patients with a single tooth gap in the anterior maxilla and horizontal alveolar defect were enrolled in a single-blind RCT. All sites had a buccopalatal bone dimension of at least 6 mm, received a single implant and were randomly allocated to the control (GBR) or test group (CTG) to re-establish buccal soft tissue convexity. Primary outcomes were Pink Esthetic Score (PES) and Mucosal Scarring Index (MSI) assessed after 1 year. Secondary outcomes included PROMs registered during the early stages of healing and after 1 year. RESULTS Twenty-one patients were included per group (control: 11 females, mean age 51; test: nine females, mean age 48). Although there was no significant difference in the PES between the groups (control: 10.11; test: 10.48; p = .577), the MSI was significantly lower in the test (1.10) than in the control group (2.53) (p = .017). Based on descriptive statistics, the latter demonstrated wider scars, more colour mismatch and slightly more suture marks. However, these were not considered disturbing by the patients given similar VAS on soft tissue aesthetics (control: 84; test: 87). Oedema and haematoma were rated twice as high in the control group on at least two postoperative time points, and patients took more painkillers (7.10 vs. 4.86). OHIP-14 decreased in both groups between baseline and 1-year follow-up, indicative of less discomfort in daily life. Differences in MSI and PROMs between the groups may be explained by the need of a vertical releasing incision in order to achieve sufficient access for GBR, periosteal incisions and the use of biomaterials that may induce inflammation. CONCLUSION GBR and CTG resulted in favourable aesthetic outcomes as assessed by professionals and patients. However, given additional vertical and periosteal incisions, GBR resulted in more scarring, postoperative discomfort and a higher need for painkillers.
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Affiliation(s)
- Thomas De Bruyckere
- Vrije Universiteit Brussel (VUB), Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Brussels, Belgium.,Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Dental School, Ghent University, Ghent, Belgium
| | - Jan Cosyn
- Vrije Universiteit Brussel (VUB), Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Brussels, Belgium.,Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Dental School, Ghent University, Ghent, Belgium
| | - Faris Younes
- Vrije Universiteit Brussel (VUB), Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Brussels, Belgium.,Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Dental School, Ghent University, Ghent, Belgium
| | - Jade Hellyn
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Dental School, Ghent University, Ghent, Belgium
| | - Jonas Bekx
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Dental School, Ghent University, Ghent, Belgium
| | - Roberto Cleymaet
- Vrije Universiteit Brussel (VUB), Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Brussels, Belgium
| | - Aryan Eghbali
- Vrije Universiteit Brussel (VUB), Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Brussels, Belgium.,Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Dental School, Ghent University, Ghent, Belgium
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41
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Cagna DR, Donovan TE, McKee JR, Eichmiller F, Metz JE, Albouy JP, Marzola R, Murphy KR, Troeltzsch M. Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2019; 122:198-269. [PMID: 31405523 DOI: 10.1016/j.prosdent.2019.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 12/13/2022]
Abstract
This comprehensive review of the 2018 dental literature is provided to inform busy dentists about progress in the profession. Developed by the Committee on Scientific Investigation of the American Academy of Restorative Dentistry, each author brings discipline-specific expertise to one of the 8 sections of the report including (1) prosthodontics; (2) periodontics, alveolar bone, and peri-implant tissues; (3) implant dentistry; (4) dental materials and therapeutics; (5) occlusion and temporomandibular disorders; (6) sleep-related breathing disorders; (7) oral medicine and oral and maxillofacial surgery; and (8) dental caries and cariology. The report targets important information that will likely influence day-to-day treatment decisions. Each review is not intended to stand alone but to update interested readers so that they may visit source materials if greater detail is desired. As the profession continues its march toward evidence-based clinical decision-making, an already voluminous library of potentially valuable dental literature continues to grow. It is the intention of this review and its authors to provide assistance in navigating the extensive dental literature published in 2018. It is our hope that readers find this work useful in the clinical management of patients moving forward.
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Affiliation(s)
- David R Cagna
- Professor, Associate Dean, and Residency Director, Department of Prosthodontics, University of Tennessee Health Sciences Center, College of Dentistry, Memphis, Tenn.
| | - Terence E Donovan
- Professor and Head of Biomaterials, Department of Restorative Sciences, University of North Carolina School of Dentistry, Chapel Hill, NC
| | - James R McKee
- Private practice, Restorative Dentistry, Downers Grove, Ill
| | | | - James E Metz
- Private practice, Restorative Dentistry, Columbus, Ohio
| | - Jean-Pierre Albouy
- Assistant Professor, Department of Restorative Sciences, University of North Carolina School of Dentistry, Chapel Hill, NC
| | | | - Kevin R Murphy
- Associate Clinical Professor, Department of Periodontics, University of Maryland College of Dentistry, Baltimore, MD; Private practice, Periodontics and Prosthodontics, Baltimore, MD
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Feine J, Abou‐Ayash S, Al Mardini M, Santana RB, Bjelke‐Holtermann T, Bornstein MM, Braegger U, Cao O, Cordaro L, Eycken D, Fillion M, Gebran G, Huynh‐Ba G, Joda T, Levine R, Mattheos N, Oates TW, Abd‐Ul‐Salam H, Santosa R, Shahdad S, Storelli S, Sykaras N, Treviño Santos A, Stephanie Webersberger U, Williams MAH, Wilson TG, Wismeijer D, Wittneben J, Yao CJ, Zubiria JPV. Group 3 ITI Consensus Report: Patient‐reported outcome measures associated with implant dentistry. Clin Oral Implants Res 2018; 29 Suppl 16:270-275. [DOI: 10.1111/clr.13299] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 05/26/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Jocelyne Feine
- Oral Health and SocietyFaculty of DentistryMcGill University Montreal QC Canada
| | - Samir Abou‐Ayash
- Department of Reconstructive Dentistry and GerodontologySchool of Dental MedicineUniversity of Bern Bern Switzerland
| | - Majd Al Mardini
- Department of Dentistry and Maxillofacial ProstheticsPrincess Margaret Hospital Toronto ON Canada
- Private PracticeAlmardini Prosthodontics Hamilton ON Canada
| | - Ronaldo Barcelllos Santana
- Department of Reconstructive Dentistry and GerodontologySchool of Dental MedicineUniversity of Bern Bern Switzerland
| | | | - Michael M. Bornstein
- Implant DentistryFaculty of DentistryThe University of Hong Kong Hong Kong China
| | - Urs Braegger
- Department of Reconstructive Dentistry and GerodontologySchool of Dental MedicineUniversity of Bern Bern Switzerland
| | - Olivia Cao
- Implant DentistryFaculty of DentistryThe University of Hong Kong Hong Kong China
| | - Luca Cordaro
- Department of Periodontology and ProsthodonticsEastman Dental HospitalUniversity Policlinic Umberto I Rome Italy
| | | | - Mathieu Fillion
- Private PracticeDom'implant Formation Clermont‐Ferrand France
| | - Georges Gebran
- Department of Reconstructive Dentistry and GerodontologySchool of Dental MedicineUniversity of Bern Bern Switzerland
| | - Guy Huynh‐Ba
- PeriodonticsThe University of Texas Health Science Center at San Antonio – UTHSCSA San Antonio Texas
| | - Tim Joda
- Department of Reconstructive DentistryUniversity Center for Dental Medicine Basel UZBUniversity of Basel Basel Switzerland
- Department of Reconstructive Dentistry and GerodontologySchool of Dental MedicineUniversity of Bern Bern Switzerland
| | - Robert Levine
- Pennsylvania Center for Dental Implants & Periodontics Philadelphia Pennsylvania
| | - Nikos Mattheos
- Implant DentistryFaculty of DentistryThe University of Hong Kong Hong Kong China
| | - Thomas W. Oates
- Department of Advanced Oral Sciences & TherapeuticsSchool of DentistryUniversity of Maryland Baltimore Maryland
| | - Hani Abd‐Ul‐Salam
- Faculty of Dentistry, Oral & Maxillofacial SurgeryUniversity of Sharjah Sharjah United Arab Emirates
- Faculty of DentistryMcGill University Montreal QC Canada
- McGill University Continuing Dental Education for the Middle East & North Africa Montreal QC Canada
| | - Robert Santosa
- Private practiceMacquarie Central Prosthodontics Sydney NSW Australia
| | - Shakeel Shahdad
- Department of Restorative Dentistry, Barts and The London School of Medicine and DentistryQueen Mary University of London London UK
| | - Stefano Storelli
- Department of Biomedical, Surgical and Dental SciencesUniversity of Milan Milan Italy
| | - Nikitas Sykaras
- Department of Removable ProsthodonticsDental SchoolNational and Kapodistrian University of Athens Athens Greece
| | - Alejandro Treviño Santos
- Postdoctoral and Research DivisionFaculty of DentistryNational Autonomous University of Mexico, UNAM Mexico City Mexico
| | | | - Mary Ann H. Williams
- Health Science & Human Services LibraryUniversity of Maryland Baltimore Maryland
| | | | - Daniel Wismeijer
- Department of Oral Implantology and Prosthetic DentistryACTA (Academic Center for Dentistry Amsterdam Free University) Amsterdam The Netherlands
| | - Julia‐Gabriela Wittneben
- Department of Reconstructive Dentistry and GerodontologySchool of Dental MedicineUniversity of Bern Bern Switzerland
- Department of Restorative Dentistry and Biomaterials SciencesHarvard School of Dental Medicine Boston Massachusetts
| | - Coral Jie Yao
- Implant DentistryFaculty of DentistryThe University of Hong Kong Hong Kong China
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