Patient-reported outcome measures of edentulous patients restored with single-implant mandibular overdentures: A systematic review

Effect of implant angulation and patrice on the retention of overdenture attachment systems: An in vitro study

PURPOSE

To test the retention of two different overdenture attachment matrices and straight abutments when implants are placed at 0-, 15-, and 30-degree diverging angulations as well as the retention of 15-degree-angled abutments to correct the overall angulation to 0-degrees.

MATERIALS AND METHODS

Matching aluminum blocks were machined to incorporate two dental implants at 0-degree, 15-degree, and 30-degree relative angulations and overdenture attachments to simulate a two-implant overdenture. At 0-degree, 15-degree, and 30-degree implant angulation, straight abutments were studied. At 30-degree implant angulation, an additional group was compared utilizing 15-degree angulated abutments that corrected the overall implant angulation to 0-degrees. A custom-designed testing apparatus that allowed automated insertion and removal of the simulated overdenture was designed, with three independent testing stations, each consisting of one simulated arch and one simulated overdenture base. The baseline and residual retention forces after 30,000 dislodging cycles of the simulated overdenture were measured. One-way ANOVA was used to compare retention differences among different color patrices within the 0-, 15-, and 30-degree implant angulation groups followed by Tukey's multiple comparison test. Two sample t-tests were used to compare 0-degree versus 15-degree implant groups with straight abutments and 30-degree implant groups with straight abutments versus 30-degree implant groups with angulated abutments.

RESULTS

Regardless of implant angulation or abutment correction, the change in retention exhibited by the Novaloc system after testing was not statistically significant for all patrice types (p > 0.05); however, the change in retention exhibited by the Locator system was statistically significant for the tested group (p = 0.0272). In both the Novaloc and Locator systems, the baseline and final retention values provided by the different patrices were significantly different except for the white and green Novaloc patrices in the 15-degree divergent implant group which did not meet the specified level of significance (p = 0.0776).

CONCLUSION

Within the limitations of this study, implant angulations upto 15 degrees do not affect differential change in retention of Novaloc patrices. There is no difference between Novaloc white inserts (light retention value) and green inserts (strong retention values) when implants diverge upto 15 degrees. When Novaloc straight abutments were placed on implants diverging by 30 degrees, blue extra-strong retention inserts outperformed yellow medium retention inserts by maintaining a higher retention value after 30,000 cycles. When utilizing Novaloc 15-degree angulated abutments that correct the overall implant angulation to zero degrees, the red light retentive patrice provides steady retention. Finally, the Locator-green patrice system provides greater retention than the comparable Novaloc-blue patrice combination; however, it also loses more retention after 30,000 cycles.

The Single Midline Implant in the Edentulous Mandible-Current Status of Clinical Trials

The single midline implant in the edentulous mandible is a treatment concept that has often been controversially discussed. Nearly 30 years ago, the first available clinical results revealed high implant survival rates and remarkable improvements in oral comfort, function, patient satisfaction and oral health-related quality of life for edentulous patients compared to the situation with no implant. However, the clinical trials were predominantly conducted with a small number of patients over a short to medium follow-up period. Today, numerous clinical investigations on the single midline implant in the edentulous mandible, which increasingly include longer-term observation periods, are available. It is the aim of this overview to present the current literature and to highlight the clinical problems. This article is a 2023 update of a review published by the authors in the German language in 2021 in the German journal Implantologie. In total, 19 prospective clinical trials with a follow-up period of 0.5-10 years were analyzed. Over this observation period, single implants with modern rough implant surfaces in the edentulous mandible reveal high implant survival rates of between 90.9 and 100% when a conventional delayed loading protocol was applied.

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

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.

Patient-reported outcomes in patients with severe maxillary bone atrophy restored with zygomatic implant-supported complete dental prostheses: a systematic review

Introduction and Objective: Zygomatic implants (ZI) offer a good and predictable alternative to reconstructive procedures of atrophic maxillae. The main objetive of this systematic review was to assess the effect of rehabilitation with zygomatic implants on patient's quality of life (QLP) using Patient Reported Outcomes Measures (PROMs).Materials and Methods: This review followed PRISMA guidelines. An automated electronic search was conducted in four databases supplemented by a manual search for relevant articles published until the end of January 2021. The Cochrane Collaboration Risk of Bias tool and the Newcastle-Ottawa Quality Assessment Scale were used to assess the quality of evidence in the studies reviewed.Results: General findings of this systematic review showed substantial increases in Oral health-related quality of life (OHRQoL) among patients restored with ZI and high scores in terms of general satisfaction, especially in chewing ability and esthetics. An overall survival rate of ZI was 98.3% after a mean follow-up time of 46.5 months was observed. Occurrence of 13.1% biological complications and 1.8% technical complications were reported.Conclusions: Patients rehabilitated with zygomatic implant-supported complete dental prostheses showed substantial improvements in OHRQoL and general satisfaction with the treatment received.

Oral health-related quality of life of patients using single or two-implant mandibular overdentures with immediate loading protocols: A randomized controlled trial

Aim:

Single implant-retained mandibular overdentures (1IMO) is a viable alternative to 2 implant-retained overdentures (2IMO) in edentulous patients. However, literature lacks in the quality of life (QoL) of these patients when treated with immediate loading protocols. The purpose of this study was to compare oral health-related QoL (OHRQoL) of patients using 1IMO or 2 IMO with immediate loading protocols at 1 month and 1 year.

Settings and Design:

Randomized Controlled Trial.

Materials and Methods:

Fifty-two edentulous participants treated with mandibular overdentures using either single implant (n = 26) or two implants (n = 26) with immediate loading protocol by a single operator. The low-profile stud-attachments (LOCATOR; Zest Anchors) were attached to the implants and female attachments were picked up within 0–7 days of implant placement. The OHRQoL was recorded using Oral Health Impact Profile-14 (OHIP-14) questionnaire either in English or in the Malay language before treatment and 1 month and 1 year after treatment.

Statistical Analysis Used:

Kruskal Wallis test was used to find out significant difference amongst 3 timepoints and 7 OHIP-14 domains and Mann-Whitney-U test to compare 1IMO or 2IMO groups.

Results:

Compared to baseline OHIP-14 scores, participants had a statistically significant decrease in total OHIP-14 at 1 month and 1 year after-treatment time points in both 1IMO and 2IMO groups (P < 0.05). The difference between 1 month and 1 year after-treatment total and subscale scores were also found to be statistically significant (P < 0.05). The overall QoL improvement was comparatively higher in 2IMO group than 1IMO group. The OHIP-14 scores were statistically different within seven domains (P < 0.05). Overall total scores between 1IMO and 2IMO groups were also found to be statistically significant (P < 0.05) at baseline and insignificant (P > 0.05) at 1 month and 1 year.

Conclusions:

Mandibular single and 2IMO improve the QoL of elderly edentulous Malaysian participants at 1 month of immediate loading and 1 year of recall. 1IMO may provide comparable QoL with the elderly patients using 2 implants.

Patient-reported outcome measures for masticatory function in adults: a systematic review

Objective

The aim of this systematic review was to critically evaluate the Patient-Reported Outcome Measures (PROMs) for masticatory function in adults.

Methods

Five electronic databases (Medline, Embase, Web of Science Core Collection, CINAHL Plus and APA PsycINFO) were searched up to March 2021. Studies reporting development or validation of PROMs for masticatory function on adults were identified. Methodological quality of the included studies was evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) risk of bias checklist. Psychometric properties of the PROM in each included study were rated against the criteria for good measurement properties based on the COSMIN guideline.

Results

Twenty-three studies investigating 19 PROMs were included. Methodological qualities of these studies were diverse. Four types of PROMs were identified: questions using food items to assess masticatory function (13 PROMs), questions on chewing problems (3 PROMs), questions using both food items and chewing problems (2 PROMs) and a global question (1 PROM). Only a few of these PROMs, namely chewing function questionnaire-Chinese, Croatian or Albanian, food intake questionnaire-Japanese, new food intake questionnaire-Japanese, screening for masticatory disorders in older adults and perceived difficulty of chewing-Tanzania demonstrated high or moderate level of evidence in several psychometric properties.

Conclusions

Currently, there is no PROM for masticatory function in adults with high-level evidence for all psychometric properties. There are variations in the psychometric properties among the different reported PROMs.

Trial Registration PROSPERO (CRD42020171591).

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-021-01949-7.