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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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Hamilton A, Gonzaga L, Amorim K, Wittneben JG, Martig L, Morton D, Martin W, Gallucci GO, Wismeijer D. Selection criteria for immediate implant placement and immediate loading for single tooth replacement in the maxillary esthetic zone: A systematic review and meta-analysis. Clin Oral Implants Res 2023; 34 Suppl 26:304-348. [PMID: 37750515 DOI: 10.1111/clr.14109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 05/20/2023] [Accepted: 05/31/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES The aim of this study was to review available evidence for Type 1A (immediate implant placement and immediate loading) of single tooth replacement in the maxillary esthetic zone. MATERIALS AND METHODS An electronic search was conducted utilizing the databases of MEDLINE, Embase, and Cochrane to identify publications reporting on the outcomes of Type 1A for single tooth replacement in the maxillary esthetic zone. The success and survival rates of the included articles were reported, which were further categorized according to the clinical criteria reported in Type 1A. Mean survival rates were univariately compared between risk groups and additionally between studies published before and since 2012 using bias-corrected and study size-weighed bootstrap tests. A study time-correcting meta-analysis was then performed to obtain an overall effect for the study pool. RESULTS A total of 3118 publications were identified in the search, with a total of 68 articles included. A mean number of implants per study were 37.2 and mean follow-up was 2.8 years. All the included studies utilizing Type 1A report highly selective inclusion and exclusion criteria. Univariate risk group comparison determined that studies before 2012 report a significantly lower mean survival rate (difference of -1.9 percentage points [PP], 95% CI: [-0.3, -4.0], p = .02), facial gap dimension had an impact on survival rates (+3.1 PP [0.2, 5.3] for width >2 mm, p = .04), as well as presence of endodontic infection (+2.6 PP [0.9, 5.1], p = .004). CONCLUSIONS Type 1A has a high survival rate in studies reporting strict patient and site selection criteria. Further research is required to assess esthetic and functional success with Type 1A treatments.
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Affiliation(s)
- Adam Hamilton
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia, Australia
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Luiz Gonzaga
- Center for Implant Dentistry, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Karina Amorim
- Center for Implant Dentistry, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | | | | | - Dean Morton
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - William Martin
- Center for Implant Dentistry, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2022; 128:248-330. [PMID: 36096911 DOI: 10.1016/j.prosdent.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/15/2022] [Accepted: 07/15/2022] [Indexed: 11/23/2022]
Abstract
The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2021 dental literature in restorative dentistry to inform busy dentists regarding noteworthy scientific and clinical progress over the past year. Each member of the committee brings discipline-specific expertise to coverage of this broad topical area. Specific subject areas addressed, in order of the appearance in this report, include COVID-19 and the dental profession (new); prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders; sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence daily dental treatment decisions with an emphasis on future trends in dentistry. With the tremendous volume of dentistry and related literature being published daily, this review cannot possibly be comprehensive. Rather, its purpose is to update interested readers and provide important resource material for those interested in pursuing greater details on their own. It remains our intent to assist colleagues in negotiating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the patients and dental problems they encounter.
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Waltenberger L, Wolfart S. SafetyCrown: a patient-centered, fully digital concept for immediate implant restoration following the one-abutment/one-time concept-a pilot case series of a new treatment concept. Int J Implant Dent 2022; 8:35. [PMID: 36068381 PMCID: PMC9448843 DOI: 10.1186/s40729-022-00434-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/20/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The patient-centered SafetyCrown-workflow enables the immediate restoration of posterior missing teeth and short free-end situations following one-abutment/one-time within three visits and only one surgical approach. This prosthodontic rehabilitation aims to combine the advantages of cemented and screw-retained restorations. REPORT The concept has been performed with 4 restorations in 3 patients and followed up for up to 1 year (mean: 11.2 months) without technical and/or biological complication. Visit 1: Intraoral optical impression, CBCT, and tooth shade selection. Virtual implant planning is performed, and a surgical guide is printed. After exporting the planned implant position, a tooth-colored abutment is fabricated from zirconia with a 1-mm supragingival cementation line, adhesively bonded to a titanium base. Visit 2: Fully navigated implant placement with insertion of the definitive abutment. Subsequently, optical impressions are prepared for A: immediate restoration using a PMMA crown without functional contacts; B: definitive crown fabricated from monolithic zirconia and individualized. The localization of the screw channel is marked using stain thus permitting precise screw channel access, if necessary. Visit 3: After osseointegration of the implant, the definitive crown is adhesively cemented supragingival. In a retrospective analysis of PROMs ('How stressful was the treatment process […]?' (0 = not stressful at all, 100 = very stressful), mean VAS score for SafetyCrown of 14 (SD 11.7) and 29.8 (SD 23.1) for standard procedure were present. CONCLUSION The SafetyCrown offers a shortened, patient-oriented concept for implant-supported single-tooth reconstructions omitting second-stage surgery. Clinical performance and hypothesized prosthodontic benefits require confirmation via an RCT.
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Affiliation(s)
- Lukas Waltenberger
- Department of Prosthodontics and Biomaterials, Centre for Implantology, University Hospital Aachen, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Centre for Implantology, University Hospital Aachen, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
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Donos N, Asche NV, Akbar AN, Francisco H, Gonzales O, Gotfredsen K, Haas R, Happe A, Leow N, Navarro JM, Ornekol T, Payer M, Renouard F, Schliephake H. Impact of timing of dental implant placement and loading: Summary and consensus statements of group 1-The 6th EAO Consensus Conference 2021. Clin Oral Implants Res 2021; 32 Suppl 21:85-92. [PMID: 34642977 DOI: 10.1111/clr.13809] [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: 06/08/2021] [Accepted: 06/08/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVES This publication reports on the EAO workshop group 1 summaries, discussions and consensus statements based on four systematic reviews evaluating the impact of timing of dental implant placement and loading. MATERIALS AND METHODS The first of the systematic reviews was on the influence of the timing of implant placement and loading in the biological outcomes of implant-supported fixed partial dentures. The second systematic review evaluated the influence of the timing of implant placement and loading on the aesthetic outcomes in single-tooth implants. The third systematic review was on the long-term outcomes of maxillary single-tooth implants in relation to timing protocols of implant placement and loading and the fourth on patient's perception of timing concepts in implant dentistry. The group evaluated these systematic reviews, provided comments and additions as required and agreed on the relevant consensus statements as well as on clinical and research recommendations. RESULTS Different timings of implant placement/loading presented with high implant survival rates. The systematic reviews evaluated from this working group provided a number of conclusions based on the available/current literature. However, the specific topic of timing is an area that further research is required in order to provide detailed guidelines for the different protocols to be employed.
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Affiliation(s)
- Nikos Donos
- Centre for Oral Clinical Research, Barts and The London, School of Medicine and Dentistry, Queen Mary University of London (QMUL, London, UK
| | - Nele Van Asche
- Centre for Periodontology and Oral Implants, KULeuven, Leuven, Belgium
| | - Aron Naim Akbar
- Health Technology Assessment-Odontology (HTA-O), Malmö University, Malmö, Sweden
| | - Helena Francisco
- Departamento de Cirurgia Oral e Implantologia, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - Oscar Gonzales
- Department of Periodontology, Complutense University of Madrid, Madrid, Spain.,Department of Periodontology and Periodontal-Prosthesis, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Klaus Gotfredsen
- Oral Rehabilitation, Copenhagen University Hospital, Copenhagen, Denmark
| | - Robert Haas
- Academy for Oral Implantology, Vienna, Austria
| | - Arndt Happe
- Department of Prosthetic Dentistry, University Ulm Center of Dentistry, Germany and Private Practice, Münster, Germany
| | - Natalie Leow
- Periodontology Unit, UCL-Eastman Dental Institute, London, UK
| | | | - Turker Ornekol
- Cosmodent Center for Dentistry and Dental Implants, Istanbul, Turkey
| | - Michael Payer
- Department of Oral Surgery and Orthodontics, University Clinic of Dental Medicine & Oral Health, Medical University of Graz, Graz, Austria
| | | | - Henning Schliephake
- Department of Oral & Maxillofacial Surgery, University Medicine-Augusta-University, Göttingen, Germany
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