Oral status, oral hygiene, and patient satisfaction in the elderly with dental implants dependent on substantial needs of care for daily living

The effect of individuals' oral hygiene habits and knowledge levels on peri-implant health and disease: a questionnaire-based observational study

BACKGROUND

Peri-implant disease and health are associated with microbial dental plaque. Therefore, oral hygiene plays a role in preventing and treating these diseases. This study aimed to determine the relationships among knowledge of peri-implant status, oral hygiene habits, and peri-implant disease and health.

METHODS

A total of 144 implants in nonsmokers with controlled systemic disease were included in the study. Peri-implant disease and the conditions of the implants were determined with periodontal indices and radiographs based on the 2017 World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions and The EFP S3 level clinical practice guideline. Individuals were asked 66 questions regarding demographic information, oral hygiene habits and history, and knowledge of peri-implant diseases. One-way ANOVA was used to compare the three peri-implant disease and condition categories.

RESULTS

There was a significant difference between groups regarding toothpaste type (p < 0.05). Gum protection toothpaste was greater in the peri-implant health group. Patients' use of interdental products was very low; often, no products were used for implant prosthesis. There was no significant difference among the groups regarding oral hygiene product use or oral hygiene habits (p > 0.05). There was a significant difference between groups regarding frequency of visit (p < 0.05). The frequency of visits to the dentist for pain was greater for individuals with peri-implantitis. There is a significant difference between the groups' answers for the causative and initiating factors of peri-implant disease (p < 0.05). The peri-implant health group answered that microbial dental plaque is the most crucial initiating factor of peri-implant diseases, and bleeding on probing is the most critical determinant of peri-implant diseases at a higher rate than the other groups.

CONCLUSIONS

Patients' oral hygiene habits and knowledge levels are almost similar according to peri-implant status. Knowledge does not reflect a patient's oral hygiene behavior. Clinicians should ensure that individuals' oral hygiene practices align with their increased awareness regarding peri-implant illnesses.

5-year randomized multicenter clinical trial on single dental implants placed in the midline of the edentulous mandible

OBJECTIVES

This multicenter randomized controlled clinical trial was conducted to investigate whether the loading protocol of single dental implants placed in the midline of edentulous mandibles will influence the implant survival or prosthetic maintenance.

MATERIALS AND METHODS

In total, 158 patients were randomly assigned either to the immediate loading group (n = 81) or to the delayed loading group (n = 77). All implants were loaded with an overdenture retained by a ball attachment.

RESULTS

After 5 years, 102 patients attended the follow-up investigation. Immediately loaded single implants in the midline of the edentulous mandible revealed a statistically significant lower survival rate than implants loaded conventionally over an observation period of 5 years. In the immediate loading group, 9 implants failed within the first three months of implant loading. No further implant loss was recorded for this group. Two implants failed in the delayed loading group, whereas one implant had to be removed during second-stage surgery and the second five years after implant loading. Non-inferiority of the survival rate of the midline implant of the immediate loading group, compared with the delayed loading group, could not be shown (p = .79, CI immediate loading: 74.9%; 100.0%, CI delayed loading: 73.0%; 100.0%). The observed difference in implant survival between the two treatment groups over time was statistically significant.

CONCLUSIONS

The results of the present study indicate that immediate loading of a single mandibular implant in the edentulous mandible should be considered only in exceptional cases.

Oral health and oral care in short-term care: prevalence, related factors and coherence between older peoples' and professionals' assessments

Background

Oral health is important for well‐being and overall health. Older peoples′ oral health is well described in the residential care context, but remains understudied in short‐term care.

Objective

The aim of this study was to describe oral health, daily oral care and related factors among older people in short‐term care and to compare self‐perceived oral health with professional assessment.

Materials and methods

This cross‐sectional study included 391 older people in 36 short‐term units in 19 Swedish municipalities. Oral health was assessed professionally by clinical oral assessment and the Revised Oral Assessment Guide (ROAG). The older peoples’ perceptions of their own oral health were measured with a global question on self‐perceived oral health. Self‐care ability was assessed with Katz Index of Activities of Daily Living (Katz‐ADL).

Results

Mean age was 82.9 years, 19% of participants were totally edentulous, and 43% had ≥20 teeth. Almost 60% had coating or food debris on their teeth, but only 19% received help with daily oral care. Those who were dependent on help with self‐care had around a sixfold higher risk of having oral problems. There was a low level of agreement between the clinical assessment based on ROAG and self‐perceived oral health.

Conclusion

Professionals’ assessments of oral health differed considerably from the older peoples′ own assessments. A higher risk of oral problems and more occurrence of coating or food debris or broken teeth were seen among those dependent on help with self‐care (ADL). This study indicates that in order to improve older peoples′ oral health and oral care we need to provide person‐centred oral care and to develop a close collaboration between nursing and dental staff.

Mouthrinse recommendation for prosthodontic patients

Different reasons can contribute to classifying dental prosthesis wearers as high-risk individuals in relation to dental biofilm accumulation. These include a past history of oral disease, age and additional retentive areas. Other common complaints include inflammation and halitosis. Moreover, prosthesis replacement and prosthetic pillar loss are generally associated with caries and periodontal disease recurrence. Therefore, the present study undertook to make a critical review of the literature, aiming at discussing the main aspects related to chemical agent prescriptions for dental prosthesis wearers. Most of the articles were selected based on relevance, methods and availability in regard to the specific subject under investigation, without considering publication year limitations. Different types of prostheses and their impact on teeth and other oral tissues were reported. It was demonstrated that there is greater biofilm buildup and increased inflammatory levels in the presence of different types of prostheses, suggesting that additional measures are required both on population-wide and individual levels in order to control these factors. Mechanical control consists of a combination of manual or electric toothbrush and toothpaste, as well as specific devices for interdental cleaning. Although many chemical agents exhibit antimicrobial benefits when used for prosthesis disinfection, only a few agents can be used safely without causing damage. Regarding the selection of antiseptics by the overall population, chlorhexidine is the most indicated in the short term and in sporadic cases. The most indicated adjuncts to overcome the deficiencies and limitations of daily mechanical biofilm control are products containing essential oils as active ingredients.