Age-related satisfaction with complete dentures, desire for improvement and attitudes to implant treatment

Small-diameter titanium grade IV and titanium-zirconium implants in edentulous mandibles: Ten-year results from a double-blind, randomised controlled split-mouth core-trial

The goal of this extension study was to compare the 10-year outcome of 3.3 mm diameter titanium-zirconium (TiZr) or grade IV titanium (Ti) implants in mandibular implant-overdentures.

MATERIALS AND METHODS

This study is the 10-year follow-up from a randomised, controlled, double-blind, split-mouth multicentre clinical trial. Patients with edentulous mandibles had received two implants in the interforaminal region (bone-level, diameter 3.3 mm, microrough surface), one of TiZr (test) and one of Ti (control). Implant survival and success, plaque and sulcus bleeding indices, probing pocket depth, gingival margin, clinical attachment level and radiographic crestal bone levels were evaluated.

RESULTS

Fifty of 91 patients with implants were available for the 10-year examination and 36 patients were valid for the intent-to-treat (ITT) analysis. The implant success rate was calculated as 94.6% and 91.9% for the TiZr implants and the Ti implants respectively. Four implants were lost (TiZr = 1; Ti = 3) in the entire study period. Kaplan-Meier survival analyses estimated 10- year implant survival rate for TiZr to 98.9% and Ti 95.8%.The mean of total and functional crestal bone loss was 1.49 mm (±1.37 mm) and 0.82 mm (±1.09 mm) in the TiZr group and 1.56 mm (±1.34 mm) and 0.85 mm (±1.16 mm) in the Ti group.

CONCLUSIONS

This split-mouth design RCT on mandibular implant-overdentures evidenced, bearing in mind its follow-up time-related reduced cohort size, high 10-year implant success- and survival rates. These results confirm TiZr as well-suited implant material for realising small-diameter implants. Registered on www.

CLINICALTRIALS

gov: NCT01878331.

Exploratory analysis of demographic data, tobacco habits, and oral health-related quality of life among complete denture patients

Aim

The present study assessed the impact of demographics and tobacco habits on oral health related quality of life (OHRQoL) among complete denture patients.

Setting and Design

Prospective cohort study design.

Materials and Methods

Two hundred and eighty four edentulous patients, aged above 30 years, were chosen as the sample for the study after taking informed consent. Information regarding demographic data and smoking status was obtained from each participant. OHRQoL was evaluated using the Oral Health Impact Profile Edentulousness (OHIP EDENT) quantifying various domains, namely functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap.

Statistical Analysis Used

Data were analyzed using the Statistical Package for the Social Sciences version 23.0 (IBM; Chicago, Illinois, USA). Mann-Whitney U test was applied to find significant differences in OHRQoL between gender, age, and smoking status. P < 0.05 was considered to be statistically significant.

Results

It was seen that complete denture wearers above 65 years had higher OHIP EDENT scores as compared to younger counterparts suggesting the compromised quality of life in the functional domain which was statistically significant. Psychological discomfort was greater in females while physical disability seemed higher in males. Smoking was found to be a factor associated with decreased OHRQoL.

Conclusion

Older age groups, female gender, and smoking were factors associated with decreased OHRQoL among complete denture patients.

Bioactive Glass Applications in Dentistry

At present, researchers in the field of biomaterials are focusing on the oral hard and soft tissue engineering with bioactive ingredients by activating body immune cells or different proteins of the body. By doing this natural ground substance, tissue component and long-lasting tissues grow. One of the current biomaterials is known as bioactive glass (BAG). The bioactive properties make BAG applicable to several clinical applications involving the regeneration of hard tissues in medicine and dentistry. In dentistry, its uses include dental restorative materials, mineralizing agents, as a coating material for dental implants, pulp capping, root canal treatment, and air-abrasion, and in medicine it has its applications from orthopedics to soft-tissue restoration. This review aims to provide an overview of promising and current uses of bioactive glasses in dentistry.

Dental Implants - Perceiving Patients' Satisfaction in Relation to Clinical and Electromyography Study on Implant Patients

The aim of this study is to evaluate the satisfaction of patients with posterior implants in relation to the clinical success criteria and surface electromyography (sEMG) findings of the masseter and temporalis muscles. Total 42 subjects were investigated. Twenty one subjects with posterior dental implants were interviewed using a questionnaire and the clinical success criteria were determined based on The International Congress of Oral Implantologists. The myofunction of the masticatory muscles were assessed using sEMG (21 subjects) and compared to the control group of subjects without implants (21 subjects). Out of 21 subjects, all were satisfied with the aesthetics of their implant. Twenty of them (95.2%) were satisfied with its function and stability. As for clinical criteria, 100% (50) of the implants were successful with no pain, mobility or exudates. sEMG findings showed that patients have significantly lower (p<0.01) basal or resting median power frequency but with muscle burst. During chewing, control subjects showed faster chewing action. There was no difference in reaction and recovery time of clenching for both groups. In conclusion, the satisfaction of implant patients was high, and which was in relation to the successful clinical success criteria and sEMG findings.

Small-diameter titanium grade IV and titanium-zirconium implants in edentulous mandibles: five-year results from a double-blind, randomized controlled trial

BACKGROUND

The aim of this study was to compare the 5-year survival and success rates of 3.3 mm dental implants either made from titanium-zirconium (TiZr) alloy or from Grade IV titanium (Ti Grade IV) in mandibular implant-based removable overdentures.

METHODS

The core study had a follow-up period of 36 months and was designed as a randomized, controlled, double-blind, split-mouth multicenter clinical trial. Patients with edentulous mandibles received two Straumann Bone Level implants (diameter 3.3 mm, SLActive®), one of TiZr (test) and one of Ti Grade IV (control), in the interforaminal region. This follow-up study recruited patients from the core study and evaluated the plaque and sulcus bleeding indices, radiographic crestal bone level, as well as implant survival and success 60 months after implant placement.

RESULTS

Of the 91 patients who initially received implants, 75 completed the 36 month follow-up and 49 were available for the 60 month examination. Two patients were excluded so that a total of 47 patients with an average age of 72 ± 8 years were analysed. The characteristics and 36-month performance of the present study cohort did not differ from the non-included initial participants (p > 0.05). In the period since the 36-month follow-up examination, no implant was lost. The cumulative implant survival rate was 98.9 % for the TiZr group and 97.8 % for the Ti Grade IV group. Crestal bone level changes at 60 months were not different in the test and control group (TiZr -0.60 ± 0.69 mm and Ti Grade IV -0.61 ± 0.83 mm; p = 0.96). The cumulative implant success rate after 60 months was 95.8 and 92.6 % for TiZr and Ti Grade IV, respectively.

CONCLUSIONS

After 60 months, the positive outcomes of the 36 month results for TiZr and Ti Grade IV implants were confirmed, with no significant differences with regard to crestal bone level change, clinical parameters and survival or success rates. TiZr implants performed equally well compared to conventional Ti Grade IV 3.3 mm diameter-reduced implants for mandibular removable overdentures.

TRIAL REGISTRATION

Registered on www.clinicaltrials.gov: NCT01878331.

Assessment of demographic and clinical data related to dental implants in a group of Turkish patients treated at a university clinic

PURPOSE

This retrospective study analyzed the distribution of the dental implants with regards to age and gender of the patients and type of indication for the implant therapy, as well as the location, dimension and type of the implants.

MATERIALS AND METHODS

The data of demographics (age and gender), type of indication for implant therapy, anatomical location, dimensions (length and diameter) and type (bone and tissue level) of 1616 implants were recorded from patient charts between January 2000 and January 2010. Descriptive statistics were analyzed using a chi-squared test for demographic parameters, type of indication, tooth position, anatomical location, implant dimensions and type (α=.05).

RESULTS

The patient pool comprised of 350 women and 266 men, with a mean age of 52.12 ± 13.79 years. The difference in n% of the implants of the age groups was statistically significant between the types of indications. The difference in the position of the implants was statistically significant between the n% of the implants of all age groups. Gender did not significantly vary, except that the diameter of the implants was significantly higher for the standard diameter implants in males. The difference between the implant positions was statistically significant when considered according to indication. The relationship between implant length and anatomical location was statistically significant.

CONCLUSION

The indication for dental implant use is age dependent and the type and size of the implant seems to be strongly related to the location of the implant.

Effect of sociodemographic variables on complete denture satisfaction

PURPOSE

The objective of this study was to evaluate the effect of sociodemographic factors on quality of satisfaction towards denture treatment.

MATERIALS AND METHODS

One hundred subjects (filling inclusion criteria) who were wearing a denture for at least two months were enrolled and divided into five groups on the basis of sociodemographic variables (age, gender, literacy level, socio-economic and marital status). Questionnaires consisting of 38 questions (positive and negative attitude towards denture satisfaction) related to patients' perception of clinical outcome in different domains such as mastication, appearance, speech, comfort, health, denture care and social status were scored by the subjects. Questions reflecting positive attitude were scored as 2, 1, or 0 (yes, uncertain and no, respectively) and reversely for the negative questions. Statistical analysis was done by using Statistical Package for Social Sciences (α = .05).

RESULTS

Level of denture satisfaction was higher in age subgroup belonging to 45 - 65 years of age in relation to comfort, health and denture care. Female and male showed significant priority for denture treatment because of esthetic and function respectively. Level of satisfaction was statistically significant with literacy level. Upper high income group showed significantly higher level of satisfaction only in case of social status. Married group showed significantly higher satisfaction level only with comfort.

CONCLUSION

Patients' sociodemographic variables were influential factors on denture satisfaction.

Dental patients' awareness and knowledge in using dental implants as an option in replacing missing teeth: A survey in Riyadh, Saudi Arabia

AIM

The purpose of this survey was to assess the level, sources, and need for information about dental implants among a selected sample of dental patients in Riyadh, Saudi Arabia.

MATERIALS AND METHODS

Patients' knowledge and awareness in using dental implants as an option in replacing missing teeth were evaluated through a standardized self- explanatory questionnaire distributed in two places in Riyadh: Military Hospital and College of Dentistry, King Saud University (Darraiyah campus). The questionnaires were handed to the patients during their regular dental visits. A total of 379 subjects were included in this survey.

RESULTS

The results of this study indicate that 66.4% of the subjects knew about dental implants. The subjects' friends and their relatives were the main source of information about dental implants for 31.5% of the subjects, and dentists were the secondary source for 28.3% of the sample. About 82.4% of the subjects need more information about dental implants and 85.2% of them chose the dentist to be the desired source for such information, followed by the internet in 28.5% of the cases. Almost 74.4% of those surveyed did not know if their regular dentists use dental implants. High cost was the major factor in preventing patients from choosing implants in 86.5% of the cases while the long treatment time and fear of surgery was the factor in 71% and 68.6% of the subjects, respectively.

CONCLUSION

The results of this survey showed an acceptable level of awareness about dental implants among a selected sample of dental patients in Riyadh. It also showed the need for providing more general and accurate information to the patients about this treatment modality.

Implant survival rates for oral and maxillofacial surgery residents: a retrospective clinical review with analysis of resident level of training on implant survival

PURPOSE

This study evaluates dental implant survival rates in cases where surgery was performed by oral and maxillofacial residents and determines whether the level of resident training influenced the outcome of dental implant treatment.

PATIENTS AND METHODS

Retrospective review of all 2-stage implants placed between July 1, 2002 and June 30, 2004 by oral and maxillofacial surgery residents-in-training at the Washington Hospital Center was carried out. Patients were seen for follow-up at 1-week, 1-month, and 6-month intervals after implant surgery. The criteria for implant success in this study were based on clinical and radiographic evidence of implant osseointegration during the follow-up period. We evaluated implant survival rates and used Cox proportional hazards modeling to analyze whether level of resident training or location of implant placement influenced implant survival.

RESULTS

This study included 175 implants placed in 54 patients. The overall survival rate of implants placed by oral and maxillofacial surgery residents at all levels of training was 91%. No statistically significant difference in implant survival rates was observed as a function of the level of training of the resident surgeon (P = .89) or location of implant placement (P = .93).

CONCLUSION

Survival rates for implants placed by surgeons in training are comparable to rates reported in the literature. There was no statistically significant difference in survival rates when a comparison of level of training was taken into consideration. To our knowledge, this study is the first to examine implant survival rates as a function of surgeon experience in the setting of an oral and maxillofacial residency program and suggests that predictable outcomes in implant treatment are attainable by surgeons in training.

Implant Treatment in an Urban General Dentistry Residency Program: A 7-year Retrospective Study

Survival rates of multiple implant designs placed in various clinical situations average more than 90%. However, little data have been published on the survival rates of implants placed in dental residency programs. This study reports on the outcome of dental implants placed by first-year general dentistry residents in the University of Florida College of Dentistry–Jacksonville Clinic. The patients for this study received both surgical and restorative implant therapy from 1998 to 2005. A total of 263 patients (147 women, 116 men) were treated with dental implants. On average, a patient was 55.5 years old and received 3 implants. A variety of simple and complex restorative procedures were performed. Advanced general dentistry residents in conjunction with supervisory faculty treated all cases. The cumulative implant survival was 96.6%. Follow-up varied from 6 months to 7 years after placement. Cases included implants not yet loaded as well as implants loaded for 6 years or more. The findings of this study compare favorably with published studies and were unexpected in light of the residents' limited clinical experience.

Implant Treatment in an Urban General Dentistry Residency Program: A 4-Year Retrospective Study

Little data have been published on the survival rates of implants placed in dental residency programs. This study reports on the outcome of dental implants placed by first-year general dentistry residents in the University of Florida College of Dentistry–Jacksonville Clinic. The patients for this study received both surgical and restorative implant therapy from 1998 to 2002. A total of 108 patients (62 women, 46 men) were treated with dental implants. On average, a patient was 52.9 years old and received 2.6 implants. A variety of simple and complex restorative procedures were performed. Advanced general dentistry residents in conjunction with supervisory faculty treated all cases. The cumulative implant survival was 98.2%. Follow-up varied from 6 months to 4 years after placement. Cases included implants not yet loaded as well as implants loaded for 3 years or more. The findings of this study compare favorably with published studies and were unexpected in light of the residents' limited clinical experience.

Representative marketing-oriented study on implants in the Austrian population. II. Implant acceptance, patient-perceived cost and patient satisfaction

Oral implantology is an established subspecialty of restorative dental and oral surgery. While an extensive body of evidence on the fundamentals of osseointegration and associated factors has been published, marketing-oriented analyses based on representative public opinion polls of implant acceptance, patient-perceived cost and patient satisfaction are scarce. In this study, an attempt was made to address these points by questioning a representative sample of 1000 adults in the household setting. The interviewees were presented with 14 questions. Of those familiar with implants as one of the treatment alternatives, 61% reported they would accept implants if the need arose. Implant acceptance was highest among males and interviewees below the age of 30 years. The interest in implants increased with increasing family incomes. Four percent of those questioned already had implants. Twenty-five percent knew someone who had undergone implant treatment. All those questioned found implant-supported rehabilitation to be very expensive. Many of them blamed the dentists for the high cost. One detail was particularly evident: satisfaction among implanted patients was clearly higher than satisfaction rates perceived by them from what they were told about implants by others. First-hand experiences with implants proved to be less biased than reported second-hand information.

Representative marketing-oriented study on implants in the Austrian population. I. Level of information, sources of information and need for patient information

The number of dental implants inserted annually worldwide has been estimated to come close to a million. But the level of information available to patients about realistic, evidence-based treatment options by implants is often enough more than fragmentary, and what is disseminated by the media and the industry does not always reflect evidence-based empirical data. This survey of 1000 adults presented with 18 questions was designed to shed light on several points. These were (1). level of subjective patient information, (2). sources of information and prejudices, (3). future demand for implant treatment and target groups for patient information campaigns, and (4). potential misinformation, information deficits, discrepancies of information and how these come about. Of those questioned, 20% said unprompted that implants were a possibility to replace missing teeth. When prompted, 72% said that they knew about dental implants. Most of those questioned felt poorly informed about the options for replacing missing teeth and many knew less about implants than about other alternatives. The dentist was said to be the desired source of information, but 77% of those questioned reported that their dentists did not practice implant dentistry. More than 79% of those questioned did not know whether their dentist worked with implants. Forty-four percent thought that implants should only be placed by specially trained doctors. Sixty-one percent were of the opinion that dentists who provide implant dentistry were better qualified than their nonimplanting colleagues. Half of those questioned attributed implant failures to allergies and incompatibilities, the other half to poor medical care. Only 29% incriminated poor oral hygiene as a cause of implant failure. Future strategies should be geared to more professional public relations and patient information. Internationally operating qualified implant institutions could contribute much to balance discrepant information.

Success of dental implants in elderly people--a literature review

Implant-supported dentures seem particularly appropriate for the predicament of being elderly and becoming edentulous. The aim of this article was to review the literature on success of dental implants in elderly people. The results of two studies suggested that the treatment with implants can be considered safe and predictable for older as well as for younger patients. Three studies found no increased implant failure-rate in patients with a compromised medical status. Four studies revealed high success-rates of dental implants among groups of elderly people. Within the limitations of this review of the literature it can be concluded that old age does not seem to represent a factor of major prognostic significance in treatment with dental implants.

Clinical morbidity and sequelae of treatment with complete dentures

Wearing complete dentures may have adverse effects on the health of both the oral and the denture-supporting tissues. This article is a review of selected literature on the sequelae of treatment with complete dentures in the specific areas of residual ridge resorption, mucosal reactions, burning mouth syndrome, temporomandibular disorders, and patient satisfaction. Recent literature found with a Medline search from 1952 to 1996 is included in this review. Residual ridge resorption is an inevitable consequence of tooth loss and denture wearing, with no dominant causative factor having been found. Mucosal reactions have a multifactorial cause, most of which can be easily treated. Most patients are satisfied with their complete dentures. Correlations between anatomic conditions and denture quality and patient satisfaction are weak. Psychologic factors seem to be extremely important in the acceptance of and adaptation to removable dentures. There are still no reliable methods to predict the outcome of complete denture treatment and there are many problems related to treatment with complete dentures. Although the prevalence of an edentulous condition is decreasing, the great number of edentulous people warrants the continuing efforts of basic and clinical research on removable partial dentures. Complete denture prosthodontics will remain an important part of dental education and practice. In addition to clinical and technical skills, insight into patient behavior and psychology and communication techniques are also necessary.

Oral status and prosthetic factors related to residual ridge resorption in elderly subjects

Our earlier studies on edentulous elderly subjects have shown associations of severe resorption in the mandibular residual ridge with female gender and systemic diseases. The aim of this study was to examine whether other factors also were related to residual ridge resorption (RRR). Among 177 edentulous elderly subjects effects on RRR were investigated with regard to history of edentulousness and denture-wearing, the condition of the dentures and soft tissues, dental status of the opposing jaw, and oral hygiene habits. No significant association was found between degree of resorption and duration of edentulousness in either the mandible or the maxilla. RRR was related to denture quality (P < 0.05); however, severe resorption was not. In the maxilla previous use of removable partial dentures was a factor contributing to the resorption (odds ratio (OR), 2.4); flabby ridge was related to the severity of the resorption (OR, 2.4). This study showed local factors related to RRR more often in the maxilla than in the mandible, thus suggesting that severe resorption in the mandible is influenced more by systemic factors than by those investigated in this study.

Variables affecting denture satisfaction in Israeli elderly: a one year follow-up

The purpose of this study was to investigate patient satisfaction with complete dentures after one year of use and several potential mitigating factors in Israeli elderly. Eight-four patients who were 54 years of age or older and who were rehabilitated with complete dentures were recalled for examination 12-15 months later; 84.5% (n = 70) were interviewed and reexamined by calibrated examiners who judged all prostheses to be clinically acceptable. The mean age of participants was 71.90 years and two-thirds were females. Over 73% reported that they wore their dentures "always." Nearly 79% indicated that they were pleased with their denture appearance. Difficulties were reported by 28.2%, while 46.5% reported difficulties with chewing. Chewing problems were significantly related to swallowing problems (P < .001); food enjoyment "as much now as you did five years ago" (P < 0.001); difficulties speaking (P < 0.05); and "having sores under your dentures" (P < 0.01) which affected 28.2% of the survey group. Married elderly expressed higher satisfaction with denture comfort as compared to "single" patients, and patients suffering from any systemic chronic diseases were more dissatisfied with appearance. A summary satisfaction scale of 7 items was constructed (Cronbach alpha reliability 0.6834) and logistic regression performed to identify key model variables for overall satisfaction. Stat sign findings included: 1) immigration year; 2) neurological or psychological disorder; and 3) age. The model correctly classified 92.75%. Findings suggest that a variety of factors may influence denture satisfaction. Gathering detailed information by means of a questionnaire before new denture fabrication may be an important tool for the dentist in predicting and consequently enhancing patient satisfaction with complete dentures.