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Curado TFF, Nascimento LN, Silva JR, de Paula MS, Schimmel M, McKenna G, Leles CR. Mandibular overdenture retained by four one-piece titanium-zirconium mini implants: A 2-year RCT on patient-reported outcomes. J Dent 2024; 149:105267. [PMID: 39067647 DOI: 10.1016/j.jdent.2024.105267] [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: 05/07/2024] [Revised: 07/22/2024] [Accepted: 07/23/2024] [Indexed: 07/30/2024] Open
Abstract
AIM The positive impact of implant interventions on dental patient-reported outcomes is an essential parameter of treatment effectiveness. This study assessed the 2-year changes in patient satisfaction and oral health-related quality of life (OHRQoL) of edentulous patients treated with a four mini implant mandibular overdenture (IOD) METHODS: The study was planned as a 2 × 2 factorial randomized clinical trial that tested two surgical approaches (flapped or flapless) and two loading protocols (immediate and delayed) using a titanium-zirconium mini implant (Straumann Mini Implant System®) and a PEEK retentive system (Straumann® Optiloc® Retentive System). Outcome measures (OHIP-Edent scores and the McGill Denture Satisfaction questionnaire) were assessed before treatment and at the 3-, 6-, 12-, and 24-month follow-ups. The Friedman test and multiple regression using Generalized Estimating Equations (GEE) were used for data analysis, considering the per-protocol (PP) and intention-to-treat (ITT) approaches RESULTS: Seventy-four patients were randomized to the study groups. No implant failure occurred during the study period. Marked improvement in all post-treatment periods compared to baseline were observed for the two outcomes. No significant effect of patient's gender, age, and surgical protocol on the study outcomes. The effect of treatment provision was significant for the two outcomes in the PP and ITT approaches (p < 0.001). A barely significant positive effect of the immediate loading was observed for OHIP-Edent in the PP approach (p = 0.020) CONCLUSION: IOD treatment significantly improved patient-reported outcomes measures, with sustained benefits over the two years of overdenture use, and can be considered a promising treatment option in for the edentulous mandible.
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Affiliation(s)
| | | | | | | | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine of the University of Bern, Bern, Switzerland; Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Gerald McKenna
- Centre for Public Health, Queen's University Belfast, Belfast, UK; Clinic of General, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Cláudio Rodrigues Leles
- School of Dentistry, Federal University of Goias, Goiania, Brazil; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine of the University of Bern, Bern, Switzerland; Clinic of General, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
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Schimmel M, Araujo M, Abou-Ayash S, Buser R, Ebenezer S, Fonseca M, Heitz-Mayfield LJ, Holtzman LP, Kamnoedboon P, Levine R, McKenna G, Maniewicz S, Matarazzo F, Mattheos N, Papaspyridakos P, De Souza AB, Srinivasan M, Stilwell C, Weber HP. Group 4 ITI Consensus Report: Patient benefits following implant treatment in partially and fully edentulous patients. Clin Oral Implants Res 2023; 34 Suppl 26:257-265. [PMID: 37750516 DOI: 10.1111/clr.14145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/07/2023] [Accepted: 07/11/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES The aim of Working Group 4 was to address patient benefits associated with implant dentistry. Focused questions on (a) dental patient-reported outcomes (dPROs), (b) improvement in orofacial function, and (c) preservation of orofacial tissues in partially and fully edentulous patients following provision of implant-retained/supported dental prostheses were addressed. MATERIALS AND METHODS Three systematic reviews formed the basis for discussion. Participants developed statements and recommendations determined by group consensus based on the findings of the systematic reviews. These were then presented and accepted following further discussion and modifications as required by the plenary of the 7th ITI Consensus Conference, taking place in 2023 in Lisbon, Portugal. RESULTS Edentulous patients wearing complete dentures (CD) experience substantial improvements in overall dPROs and orofacial function following treatment with either complete implant-supported fixed dental prostheses (CIFDP) or implant overdentures (IODs). With respect to dPROs, mandibular IODs retained by two implants are superior to IODs retained by one implant. However, increasing the number of implants beyond two, does not further improve dPROs. In fully edentulous patients, rehabilitation with CIFDP or IOD is recommended to benefit the preservation of alveolar bone and masseter muscle thickness. CONCLUSIONS Completely edentulous patients benefit substantially when at least the mandible is restored using an CIFDP or an IOD compared to CD. In fully edentulous patients, implant prostheses are the best option for tooth replacement. The availability of this treatment modality should be actively promoted in all edentulous communities, including those with limited access and means.
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Affiliation(s)
- 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
| | - Mauricio Araujo
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Ramona Buser
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | | | - Manrique Fonseca
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | | | - Lucrezia Paterno Holtzman
- Department of Periodontics and Prosthodontics, Eastman Dental Hospital, University Policlinic "La Sapienza", Rome, Italy
| | - Porawit Kamnoedboon
- Clinic of General, Special Care, and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Chulalongkorn University, Bangkok, Thailand
| | - Robert Levine
- Kornberg School of Dentistry at Temple University, Philadelphia, Pennsylvania, USA
| | - Gerry McKenna
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Flavia Matarazzo
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Panos Papaspyridakos
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | | | - Murali Srinivasan
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
- Clinic of General, Special Care, and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Charlotte Stilwell
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
- Private Practice, London, UK
| | - Hans Peter Weber
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
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3
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Srinivasan M, Kamnoedboon P, Angst L, Müller F. Oral function in completely edentulous patients rehabilitated with implant-supported dental prostheses: A systematic review and meta-analysis. Clin Oral Implants Res 2023; 34 Suppl 26:196-239. [PMID: 37750517 DOI: 10.1111/clr.14068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/10/2023] [Accepted: 03/30/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES This review evaluated the effects of rehabilitation with implant-supported prostheses on the oral function of completely edentulous adults. MATERIALS AND METHODS Systematic literature searches were performed to identify records reporting on oral function in completely edentulous adults rehabilitated with implant-supported prostheses. Meta-analyses were performed on various outcomes including bite force, masticatory performance, muscle activity, mandibular movement/chewing pattern, and salivary flow. RESULTS 5507 records were identified. Thirty studies qualified for data extraction and analysis. The kappa (𝛋) for the search and identification strategy ranged between 0.50 and 1.00. Meta-analysis was performed grouping the studies by outcomes and split by time points of 6-12 months, 12-36 months, and >36 months after implant therapy. The meta-analyses revealed a significant improvement in oral function of completely edentulous adults after rehabilitation with implant-supported prostheses at 6-12 months (Z = -4.895, p < .001; 95% CI: -0.703, -0.301; τ2 = .609; Q = 114.953, df = 17, p < .001; I2 = 85.2%), at 12-36 months (Z = -4.886, p < .001; 95% CI: -0.580, -0.248; τ2 = .908; Q = 280.611, df = 35, p < .001; I2 = 87.5%) and at more than 36 months (Z = -9.108, p < .001; 95% CI: -1.472, -0.951; τ2 = .019; Q = 7.918, df = 7, p = .340; I2 = 11.6%). The included studies demonstrated a low to moderate risk of bias. CONCLUSIONS This systematic review concluded that the oral function of completely edentate adults significantly improved with implant-supported/retained prostheses, even when only one jaw received implant therapy. Therefore, implant therapy should be promoted for edentulous adults to alleviate the shortcomings of conventional complete removable dental prostheses.
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Affiliation(s)
- Murali Srinivasan
- Clinic of General-, Special Care, and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Porawit Kamnoedboon
- Clinic of General-, Special Care, and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Lea Angst
- Clinic of General-, Special Care, and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
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4
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Abou-Ayash S, Fonseca M, Pieralli S, Reissmann DR. Treatment effect of implant-supported fixed complete dentures and implant overdentures on patient-reported outcomes: A systematic review and meta-analysis. Clin Oral Implants Res 2023; 34 Suppl 26:177-195. [PMID: 37750530 DOI: 10.1111/clr.14065] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 02/22/2023] [Accepted: 03/14/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES To analyze the effect of implant treatment in edentulous patients rehabilitated with implant-supported fixed complete dentures (IFCDs) or implant overdentures (IODs) on dental patient-reported outcomes (dPROs). MATERIALS AND METHODS In January 2022, Medline, Embase, CINAHL, Cochrane Library, PubMed Central, Web of Science, and ClinicalTrials.gov were screened for prospective clinical studies on completely edentulous patients treated with IFCDs and/or IODs, reporting pre-treatment and follow-up dPROs. Hedges' g effect sizes (ES) with corresponding 95% confidence intervals (CI) were calculated. Afterward, meta-analyses were conducted using random effect models. RESULTS A total number of 1608 records was initially identified. Of those, 28 studies reporting dPROs from 1457 patients were finally included. The applied dental patient-reported outcome measures (dPROMs) included several versions of the Oral Health Impact Profile (OHIP) or specific items assessing satisfaction with Visual Analogue Scales (VAS). The overall ES was large for rehabilitation with IFCDs (1.68 [CI: 1.15, 2.20]) and IODs (1.26 [CI: 0.99, 1.52]) with no significant difference (p = .165) between the two. Denture stability was the only factor rated significantly higher for IFCDs (ES difference: 2.37 [CI: 0.21, 4.54]; p = .032). Subgroup analyses revealed moderately higher ES for IODs on two implants relative to one implant (ES difference: 0.73 [CI: 0.34, 1.12]; p < .001). CONCLUSIONS There is a strong positive effect of implant treatment in edentulous patients, independent of the type of prosthetic rehabilitation. In patients seeking high stability, IFCDs may be preferable. In mandibular IODs on a single implant, there was a significantly positive effect of an additional implant on dPROs.
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Affiliation(s)
- Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | - Manrique Fonseca
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | - Stefano Pieralli
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Daniel R Reissmann
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Freiburg, Freiburg im Breisgau, Germany
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de Resende GP, de Menezes EEG, Maniewicz S, Srinivasan M, Leles CR. Prosthodontic outcomes of mandibular overdenture treatment with one or two implants: 4-year results of a randomized clinical trial. Clin Oral Implants Res 2023; 34:233-242. [PMID: 36692124 DOI: 10.1111/clr.14036] [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: 08/01/2022] [Revised: 12/29/2022] [Accepted: 01/12/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To assess the incidence of prosthodontic maintenance events and complications during 4 years of follow-up after mandibular overdenture treatment with one or two implants. METHODS Participants received one or two implants inserted in the midline (1-IOD group) or the lateral incisor-canine area bilaterally (2-IOD group). Implants were loaded with an early loading protocol after 3 weeks. Programmed recall visits were scheduled at the 6-, 12-, 36-, and 48-month follow-ups and nonprogrammed visits in case of prosthodontic complaints. The type of maintenance was registered, and the final treatment outcome was classified as successful, surviving, unknown, dead, repair, or retreatment. RESULTS Forty-seven participants, mean age 65.4 ± 8.6, 74.5% female, were included (1-IOD = 23; 2-IOD = 24) and 44 completed the 4-year follow-up. A total of 159 prosthodontic maintenance events occurred and 89 in unscheduled visits. The most common event was the need for minor modifications of the denture base due to sore spots in the oral mucosa (n = 56 in 31 patients), matrix activation (n = 54 in 34 patients), and overdenture fracture (n = 25 in 18 patients). A "successful" or "surviving" outcome could be attributed to 57.5% of cases, whereas 38.3% needed repair. No significant differences in the incidence of prosthodontic events or treatment outcomes were found between the two groups. CONCLUSIONS Findings show that 1-IODs perform similar to 2-IODs when considering the incidence of fractures and the need for prosthodontic maintenance, including adjustments of the overdenture and the attachment system.
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Affiliation(s)
| | | | - Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Murali Srinivasan
- Clinic of General, Special Care, and Geriatric Dentistry, Centre of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Cláudio Rodrigues Leles
- Department of Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Brazil
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Abd El Rahim NS, Ashour AA. Impact of Platform Switched Implants on Marginal Bone Level in Mandibular Overdentures: A Six-Year Follow-Up Longitudinal Study. Clin Cosmet Investig Dent 2022; 14:307-319. [PMID: 36285194 PMCID: PMC9588294 DOI: 10.2147/ccide.s378636] [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: 07/06/2022] [Accepted: 09/29/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To evaluate the impact of the platform-switched implant on marginal bone loss (MBL) and the probing pocket depth (PPD) in patients wearing mandibular overdenture. PATIENTS AND METHODS This longitudinal study included 40 completely edentulous patients aged 51-64 years. All patients received complete dentures and were distributed into two groups randomly; 20 patients each. The first group GI received two platform switched implants; however, the 2nd group GII received two platform matched implants (3.6 × 11.5 mm) in the canine region of the mandible. The radiographic evaluations were carried out every year for six years, whereas probing pocket depth was evaluated every six months for 72 months for both groups. The data were analyzed by repeated ANOVA, Friedman's, and Student's t-test. RESULTS This study included 36 patients; 56 ± 3.6 years was the mean age; 17 females (47%) and 19 males (53%) completed the study. Statistically significant differences were observed in MBL and PPD in each of GI and GII after 6 years, p ≤ 0.05. Between GI and GII after 6 years, a statistically insignificant difference was detected in MBL or PPD, p ≥ 0.05, except in PPD at loading, 2 and 6 years, p ≤ 0.05. CONCLUSION Time positively affected MBL and PPD in platform switched and matched implants retained mandibular overdentures. Platform switching influences probing pocket depth in implants retained mandibular overdentures.
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Affiliation(s)
- Neveen S Abd El Rahim
- Department of Removable Prosthodontics, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt,Department of Removable Prosthodontics, College of Dentistry, Taibah University, Medina, Saudi Arabia
| | - Asmaa A Ashour
- Department of Removable Prosthodontics, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt,Correspondence: Asmaa A Ashour, Department of Removable Prosthodontics, Faculty of Dental Medicine for Girls, Al-Azhar University, Nasr, Cairo, Egypt, Tel +20 1284048535, Email
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7
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de Araújo SC, Hartmann R, Curado TFF, Schimmel M, Leles CR. A 3‐year prospective cohort on the incidence of prosthodontic complications associated with three implant treatment options for the edentulous mandible. J Oral Rehabil 2022; 49:1155-1162. [DOI: 10.1111/joor.13371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 07/05/2022] [Accepted: 09/06/2022] [Indexed: 12/01/2022]
Affiliation(s)
| | | | | | - Martin Schimmel
- Department of Reconstructive Dentistry, Division of Gerodontology School of Dental Medicine of the University of Bern Switzerland
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine, University of Geneva Geneva Switzerland
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Elsonbaty MA, Alshimy AM, Abdul-Monem MM, Neena AF. Evaluation of retention and wear of a titanium-formed stud overdenture attachment with different interimplant angulations after simulated clinical use: An in vitro study. J Prosthet Dent 2022; 128:205.e1-205.e10. [PMID: 35842280 DOI: 10.1016/j.prosdent.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 06/23/2022] [Accepted: 06/23/2022] [Indexed: 10/17/2022]
Abstract
STATEMENT OF PROBLEM How implant alignment impacts stud attachment retention and wear-induced alterations, notably when the attachment exhibits metal-to-metal frictional interlocking, is unclear. PURPOSE The purpose of this in vitro study was to evaluate the effect of the interimplant angulation on retention forces and wear changes before and after 2 years of simulated clinical use of implant overdentures retained by titanium stud overdenture attachments. MATERIAL AND METHODS The canine regions of 3 identical edentulous mandibular models were used to receive 2 dental implants analogs with TiTach attachments (Dental Evolutions, Inc) at interimplant angulations of 0, 30, and 60 degrees. Six identical overdentures were constructed over each model (n=6). A universal testing machine was used to determine overdenture retention forces at 0, after 1440, and after 2880 insertion and removal cycles to simulate the average insertion and removal cycles in 12 and 24 months. A stereomicroscope, a laser microscope, and a scanning electron microscope were used to evaluate the wear in the attachments. A linear regression model, ANOVA, and the Kruskal-Wallis tests were used to analyze the data (α=.05). RESULTS All groups demonstrated reduced retention over the study duration (P<.001). The retention forces of the 0- and 30-degree groups were not significantly different after 2880 insertion and removal cycles, but both were significantly higher than those of the 60-degree group (P=.002). Within each group, the wear pattern of the matrix cap was more noticeable than that of the patrix abutment, with increased wear changes as interimplant angulation increased (P<.001). CONCLUSIONS TiTach attachments could retain overdentures on parallel and divergent implants with a 30-degree angle of interimplant angulation. However, at a 60-degree angle of interimplant angulation, considerable reduction in retention forces and increased wear changes were observed after 2 years of simulated clinical use.
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Affiliation(s)
- Moustafa A Elsonbaty
- Postgraduate student, Department of Prosthodontics, Faculty of Dentistry, University of Alexandria, Alexandria, Egypt
| | - Ahmed M Alshimy
- Professor of Prosthodontics, Department of Prosthodontics, Faculty of Dentistry, University of Alexandria, Alexandria, Egypt
| | - Mohamed M Abdul-Monem
- Lecturer of Dental Biomaterials, Department of Dental Biomaterials, Faculty of Dentistry, University of Alexandria, Alexandria, Egypt
| | - Akram F Neena
- Lecturer of Prosthodontics, Department of Prosthodontics, Faculty of Dentistry, University of Alexandria, Alexandria, Egypt.
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Hu KF, Lin SW, Lin YC, Jeng JH, Huang YT, Liu PF, Tseng CJ, Chou YH. Using Cone-Beam Computed Tomography to Assess Changes in Alveolar Bone Width around Dental Implants at Native and Reconstructed Bone Sites: A Retrospective Cohort Study. J Pers Med 2021; 11:jpm11101011. [PMID: 34683152 PMCID: PMC8537892 DOI: 10.3390/jpm11101011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 10/03/2021] [Accepted: 10/04/2021] [Indexed: 12/13/2022] Open
Abstract
The aim of this study was to use a cone-beam computed tomography (CBCT) to assess changes in alveolar bone width around dental implants at native and reconstructed bone sites before and after implant surgery. A total of 99 implant sites from 54 patients with at least two CBCT scans before and after implant surgery during 2010–2019 were assessed in this study. Demographic data, dental treatments and CBCT scans were collected. Horizontal alveolar bone widths around implants at three levels (subcrestal width 1 mm (CW1), subcrestal width 4 mm (CW4), and subcrestal width 7 mm (CW7)) were measured. A p-value of < 0.05 indicated statistically significant differences. The initial bone widths (mean ± standard deviation (SD)) at CW1, CW4, and CW7 were 6.98 ± 2.24, 9.97 ± 2.64, and 11.33 ± 3.00 mm, respectively, and the postsurgery widths were 6.83 ± 2.02, 9.58 ± 2.55, and 11.19 ± 2.90 mm, respectively. The change in bone width was 0.15 ± 1.74 mm at CW1, 0.39 ± 1.12 mm at CW4 (p = 0.0008), and 0.14 ± 1.05 mm at CW7. A statistically significant change in bone width was observed at only the CW4 level. Compared with those at the native bone sites, the changes in bone width around implants at reconstructed sites did not differ significantly. A significant alveolar bone width resorption was found only at the middle third on CBCT scans. No significant changes in bone width around implants were detected between native and reconstructed bone sites.
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Affiliation(s)
- Kai-Fang Hu
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan;
- Department of Dentistry, Division of Periodontics, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Szu-Wei Lin
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan; (S.-W.L.); (Y.-C.L.); (J.-H.J.)
| | - Ying-Chu Lin
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan; (S.-W.L.); (Y.-C.L.); (J.-H.J.)
| | - Jiiang-Huei Jeng
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan; (S.-W.L.); (Y.-C.L.); (J.-H.J.)
- Department of Dentistry, National Taiwan University Hospital and School of Dentistry, National Taiwan University Medical College, Taipei 106216, Taiwan
- Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Yu-Ting Huang
- Department of Medical Research, Division of Medical Statistics and Bioinformatics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Pei-Feng Liu
- Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung 807378, Taiwan;
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung 804201, Taiwan
| | - Ching-Jiunn Tseng
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan;
- Department of Medical education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813779, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan
- Correspondence: (C.-J.T.); (Y.-H.C.); Tel.: +886-975-581-557 (C.-J.T.); +886-7-3121101-7004 (Y.-H.C.)
| | - Yu-Hsiang Chou
- Department of Dentistry, Division of Periodontics, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan; (S.-W.L.); (Y.-C.L.); (J.-H.J.)
- Correspondence: (C.-J.T.); (Y.-H.C.); Tel.: +886-975-581-557 (C.-J.T.); +886-7-3121101-7004 (Y.-H.C.)
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10
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Cagna DR, Donovan TE, McKee JR, Eichmiller F, Metz JE, Albouy JP, Marzola R, Murphy KG, 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 2021; 126:276-359. [PMID: 34489050 DOI: 10.1016/j.prosdent.2021.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/22/2021] [Accepted: 06/22/2021] [Indexed: 11/26/2022]
Abstract
The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2020 professional 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 this work to cover this broad topic. Specific subject areas addressed include prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders (TMDs); 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 day-to-day dental treatment decisions with a keen eye on future trends in the profession. With the tremendous volume of dentistry and related literature being published today, this review cannot possibly be comprehensive. The purpose is to update interested readers and provide important resource material for those interested in pursuing greater detail. It remains our intent to assist colleagues in navigating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the dental patients they encounter.
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Affiliation(s)
- David R Cagna
- Professor, Associate Dean, Chair and Residency Director, Department of Prosthodontics, University of Tennessee Health Sciences Center College of Dentistry, Memphis, Tenn.
| | - Terence E Donovan
- Professor, Department of Comprehensive Oral Health, University of North Carolina School of Dentistry, Chapel Hill, NC
| | | | - Frederick Eichmiller
- Vice President and Science Officer, Delta Dental of Wisconsin, Stevens Point, Wis
| | | | - Jean-Pierre Albouy
- Assistant Professor of Prosthodontics, Department of Restorative Sciences, University of North Carolina School of Dentistry, Chapel Hill, NC
| | | | - Kevin G Murphy
- Associate Clinical Professor, Department of Periodontics, University of Maryland College of Dentistry, Baltimore, Md; Private practice, Baltimore, Md
| | - Matthias Troeltzsch
- Associate Professor, Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians University of Munich, Munich, Germany; Private practice, Ansbach, Germany
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de Resende GP, Dias AP, Leles JLR, de Souza JAC, Leles CR. Postsurgical oral symptoms after insertion of one or two implants for mandibular overdentures: short-term results of a randomized clinical trial. Int J Implant Dent 2021; 7:38. [PMID: 33907936 PMCID: PMC8079530 DOI: 10.1186/s40729-021-00321-2] [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: 01/11/2021] [Accepted: 03/17/2021] [Indexed: 11/24/2022] Open
Abstract
Objective This randomized clinical trial aimed to compare the short-term postsurgical symptoms after insertion of one or two implants for retention of a mandibular overdenture. This study investigated whether the less invasive single-implant approach results in lower postoperative symptoms compared to the conventional two-implant overdenture. Materials and methods Patients received new complete dentures and were randomly assigned to groups receiving one or two single-stage, early-loaded hydrophilic implants, inserted in the midline (n = 23), or the lateral incisor-canine area bilaterally (n = 24). Patient-reported postoperative symptoms were measured in a 0–100 visual analogue scale concerning pain in the surgical area, pain when chewing, bleeding, swelling, and unpleasantness. Data collection occurred 24 h and 7 and 21 days after surgery. Demographic and clinical features (smoking habit, classification of the residual ridges, and mucosal width and thickness at the implant sites), osteotomy for alveolar bone reduction, and surgery time were tested as predictors of symptom levels. Results Overall reported symptoms were mild and self-limited, with high rates of complete remission after the early loading period of 3 weeks. Progressive improvement of symptoms occurred from the 24-h to the 7-day and 21-day follow-ups (p < 0.001), similarly in both groups. None of the clinical predictors was significantly associated with the changes in symptoms. Conclusions Findings suggest that the insertion of one or two implants may result in similar postoperative outcomes. Clinical relevance The severity of short-term postoperative symptoms may not be a critical factor for the decision between overdenture treatment with one or two implants.
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Affiliation(s)
- Gabriela Pereira de Resende
- Department of Oral Rehabilitation, School of Dentistry, Federal University of Goias, Praça Universitária, s/n, Setor Universitário, Goiania, Goias, 74605-220, Brazil
| | - Ana Paula Dias
- Department of Oral Rehabilitation, School of Dentistry, Federal University of Goias, Praça Universitária, s/n, Setor Universitário, Goiania, Goias, 74605-220, Brazil
| | - José Luiz Rodrigues Leles
- Private Practice, Goiania, Goias, Brazil.,School of Dentistry, Campus Flamboyant, Paulista University, Rodovia BR 153, Km 503, s/n Fazenda, Marginal Botafogo, Goiania, Goias, 74845-090, Brazil
| | - João Antônio Chaves de Souza
- Department of Stomatology (Periodontology), School of Dentistry, Federal University of Goias, Praça Universitária, s/n, Setor Universitário, Goiania, Goias, 74605-220, Brazil
| | - Cláudio Rodrigues Leles
- Department of Oral Rehabilitation, School of Dentistry, Federal University of Goias, Praça Universitária, s/n, Setor Universitário, Goiania, Goias, 74605-220, Brazil.
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12
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Single-implant mandibular overdentures: Clinical, radiographic, and patient-reported outcomes after a 5-year follow-up. J Prosthet Dent 2021; 128:949-955. [PMID: 33640091 DOI: 10.1016/j.prosdent.2021.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 01/14/2021] [Accepted: 01/14/2021] [Indexed: 11/21/2022]
Abstract
STATEMENT OF PROBLEM Previous studies on single-implant mandibular overdentures have reported favorable results for clinical and patient-reported outcomes. However, information from longer term clinical studies is lacking. PURPOSE The purpose of this clinical study was to assess clinical, radiographic, and patient-reported outcomes of edentulous individuals rehabilitated with single-implant mandibular overdentures after a 5-year follow-up. MATERIAL AND METHODS A prospective clinical study was performed including completely edentulous individuals who received new conventional complete dentures and then an external hexagon implant in the mandibular midline region, followed by the incorporation of a retention system (O-ring/ball attachment; Neodent). Data collection occurred at baseline and 3, 6, 12, 24, and 60 months after implant loading. Assessed outcomes included implant stability, peri-implant soft tissue condition, peri-implant marginal bone level, satisfaction with the prostheses, and oral health-related quality of life (OHRQoL). Clinical maintenance events were also recorded. Descriptive statistics, incidence rates, Wilcoxon Signed Ranks test, and Generalized Estimating Equation regression were used for data analysis (α=.05). RESULTS Thirty of 34 eligible participants attended the 5-year follow-up visit, mean ±standard deviation age was 68.1 ±7.8 years, and 70% were women. The overall implant survival rate was 88.9%. After 5 years, the OHRQoL showed statistically significant improvement for all evaluation periods compared with baseline (P<.001). Regarding satisfaction with the mandibular denture, a significant increase was found between all evaluation periods compared with baseline in terms of comfort, stability, and ability to masticate (P<.001). Implant stability significantly increased (P=.003), and a mean bone loss of 1.46 mm was observed compared with baseline measures. The most frequent maintenance event was replacement of the O-ring matrix (n=80). Twenty-one midline fractures of the overdenture occurred in 14 study participants. No significant changes in peri-implant soft tissue conditions were observed. CONCLUSIONS A single-implant mandibular overdenture effectively maintained the positive effect of the intervention on oral health-related quality of life and patient satisfaction, stable peri-implant condition, and acceptable rates of prosthetic events.
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de Resende GP, Jordão LMR, de Souza JAC, Schimmel M, Leles CR. Single versus two-implant mandibular overdentures using early-loaded titanium-zirconium implants with hydrophilic surface and ball attachments: 1-year randomized clinical trial. Clin Oral Implants Res 2021; 32:359-368. [PMID: 33417279 DOI: 10.1111/clr.13707] [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: 07/22/2020] [Revised: 12/22/2020] [Accepted: 01/03/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This randomized clinical trial aimed to compare the outcomes of the mandibular overdenture retained by one (1-IOD) or two (2-IOD) implants. MATERIALS AND METHODS Participants received new complete dentures, were assessed at baseline and randomly assigned to groups. Early loaded single midline implant (1-IOD) or two implants in the canine regions bilaterally (2-IOD). Ball attachments were used for overdenture retention. Post-treatment outcomes (6- and 12-month follow-ups) included patient satisfaction, oral health-related quality of life measures, and chewing function. Data analysis included within- and between-group comparisons, and Generalized Estimating Equations. Both superiority and non-inferiority hypotheses were tested. RESULTS Forty-seven participants were included (1-IOD = 23; 2-IOD = 24). Significant improvements in OHIP-Edent were observed after insertion of new dentures and at the 1-year follow-up compared with baseline. No differences were found between the 1- and 2-IOD groups for the OHIP-Edent and QoLFAST scores. Patient satisfaction with the mandibular denture improved significantly from baseline to the 6-month follow-up and remained unaltered until 1 year, with no differences between groups. The magnitudes of treatment effect sizes were moderate to large for patient-reported outcomes. Progressive improvement in chewing function occurred in both groups. Non-inferiority testing based on a 15% non-inferiority margin showed inconclusive results for patient-reported outcomes, whilst chewing function in the 1-IOD group was concluded to be not inferior to the 2-IOD group. CONCLUSIONS Results support the use of both 1- and 2-IOD. The 1-IOD was also an acceptable alternative to the 2-IOD as a secondary option for the treatment of the edentulous mandible.
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Affiliation(s)
| | | | | | - 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
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14
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Hartmann R, de Menezes Bandeira ACF, de Araújo SC, McKenna G, Brägger U, Schimmel M, Leles CR. Cost-effectiveness of three different concepts for the rehabilitation of edentulous mandibles: Overdentures with 1 or 2 implant attachments and hybrid prosthesis on four implants. J Oral Rehabil 2020; 47:1394-1402. [PMID: 32885482 DOI: 10.1111/joor.13071] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 06/05/2020] [Accepted: 08/03/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND There are scarce data regarding the combined assessment of the costs and effects of implant treatments for edentulous patients when multiple options are available. AIM This randomised clinical trial aimed to assess the cost-effectiveness of three different concepts for treatment: mandibular overdenture retained by a single (Group I; n = 11) or two implants (Group II; n = 13) and fixed hybrid prosthesis on four implants (Group III; n = 13). METHODS Treatment effectiveness was measured as the 1-year before-after changes in patient satisfaction with the mandibular prosthesis. Costs were prospectively quantified from the perspective of the health provider, including all direct cost items attributed to the delivery of treatments and up to the 1-year follow-up, using a "bottom-up" costing estimation method. RESULTS Patient satisfaction after treatment improved significantly for the three groups. The overall costs were R$ 2370.66, R$ 3185.21 and R$ 5739.52 for Groups I, II and III, respectively (P < .001). Analysis of incremental cost-effectiveness ratios suggested that the overdentures retained by one or two implants were more cost-effective than the fixed implant treatment, considering the mean cost and effectiveness values and the ±20% one-way sensitivity analysis. CONCLUSION This study suggests that the incremental costs for the fixed hybrid prosthesis, compared to the overdenture treatments, is not proportional to the respective gain in effectiveness. Therefore, although all treatment options had satisfactory outcomes, the use of implants to retain a mandibular overdenture, irrespective of the use of one or two implants, is more cost-effective than the fixed implant treatment for the edentulous mandible.
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Affiliation(s)
- Roberto Hartmann
- School of Dentistry, Federal University of Goias, Goiania, Brazil
| | | | | | - Gerald McKenna
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Urs Brägger
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine of the University of Bern, Bern, Switzerland
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine of the University of Bern, Bern, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
| | - Cláudio R Leles
- School of Dentistry, Federal University of Goias, Goiania, Brazil
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