A Retrospective 3- to 5-Year Study of the Reconstruction of Oral Function Using Implant-Supported Prostheses in Patients With Hypohidrotic Ectodermal Dysplasia

Surgical and prosthetic rehabilitation of siblings with Witkop tooth and nail syndrome using zygomatic implants: a familial case series of 3 patients with up to 15-year follow-up

Witkop tooth and nail syndrome is a rare, autosomal dominant type of ectodermal dysplasia that can have significant effects on dentition, including hypoplastic and malformed dentition and significantly atrophic maxillas. Endosseous implants have become one possible solution to replace missing teeth, although their use in areas where bone is sparse becomes challenging. Due to the severe atrophy of the maxillary alveolus, extensive preprosthetic surgeries including orthognathic surgery, extensive bone grafting, and sinus floor augmentations have been recommended prior to placement of endosseous dental implants. Although this treatment has shown favorable outcomes, it requires multiple surgical procedures, contributing to a prolonged treatment course and increased morbidity. An alternative treatment of atrophic maxillas in patients with ectodermal dysplasia includes the use of zygomatic implants. This familial case series discusses 3 siblings, all previously diagnosed with Witkop Syndrome, who underwent comprehensive preprosthetic surgery and prosthetic rehabilitation using zygomatic implants with a follow-up period up to 15 years.

Pre-implant and implant management of oligodontia patients: A 10-year retrospective study

INTRODUCTION

the aim of this study was to report and assess the management and implant rehabilitation of oligodontia patients since its recognition in 2012 by french authorities in the nomenclature.

MATERIAL AND METHODS

we conducted a retrospective study in the Maxillofacial Surgery and Stomatology Department of the Lille University Hospital between January 2012 and May 2022. Patients had to present an oligodontia recognized under the ALD31 in adulthood, and to have benefited from a pre-implant/implant surgical treatment in the unit.

RESULTS

a total of 106 patients were included in the study. The mean number of agenesis was 12 per patient. The most missing teeth are the ones at the end of the series. After a pre-implant surgery phase including orthognathic surgery and/or bone grafting, 97 patients benefited from implant placements. The mean age for this phase was 19.38. A total of 688 implants were placed. The median number of implants placed was 6 per patient and 5 patients presented implant failures after or during the osseointegration phase (16 implants lost). The implant success rate was 97.6%. 78 patients benefited from rehabilitations by fixed implant-supported prostheses and 3 by implant-supported mandibular removable prostheses.

DISCUSSION

The described care pathway seems to us adapted to the patients followed in our department, with good functional and esthetic results. It would be necessary to evaluate on a national scale to adapt the management process.

Osseointegration of Dental Implants in Patients with Congenital and Degenerative Bone Disorders: A Literature Review

Aims and Objectives

The aim of this study was to describe the mechanism of dental implants osseointegration in patients with congenital and degenerative genetic bone disorders.

Materials and Methods

A PubMed and Scopus documents search was carried out between November 2021 in the, using words such as "osseointegration," "degenerative disease," "congenital disease," and "dental implants."

Results

The thirteen articles selected dealt with dental implants osseointegration in patients with congenital and degenerative bone disorders. The influence and repercussion of these diseases on the bone system, as well as the osseointegration process were described from healing to bone remodeling. In addition, certain articles described some considerations to improve the osseointegration process in patients suffering from these types of conditions.

Conclusions

Within the limitations of this literature review we can conclude that osseointegration in patients with ectodermal dysplasia and osteoporosis could be achieved. However, the planning process for dental implant placement in these patients should be more meticulous and individualized considering the degree of tissue involvement as well as the patient's age and skeletal development compared to systemically healthy patients.

Surgical bone augmentation procedures for oral rehabilitation of patients with oligodontia: A review with a systematic approach

Oligodontia is a developmental dental anomaly defined by the absence of 6 or more permanent teeth, excluding the third molars. We performed a review with a systematic approach and proposed a guideline for the choice of the bone augmentation surgery. The different bone augmentation technique terms were searched in the PubMed and Science Direct database. Clinical studies were eligible if they reported on pre-implant surgery in patients with oligodontia. The database search yielded 400 studies after duplicates removed. Thirty studies were finally included, involving 410 patients. Sixty-three sinus lifts were performed in 37 patients with no failure. Thirteen out of 33 patients with iliac bone transplantation and two out of 24 with parietal bone transplantation had resorption, one out of 4 patients who received allogeneic bone block had complete failure. Seventy-eight patients underwent guided bone regeneration, none had bone loss. No failure was found with the alveolar distraction osteogenesis technique. Four out of thirteen patients developed permanent hypoesthesia after inferior alveolar nerve transposition. The cumulative implant survival rate was 94.4% after bone augmentation procedures. Extensive edentulous areas should be grafted with parietal bone, as iliac grafts present a greater risk of resorption. Smaller edentulous areas should be treated by endobuccal harvesting or guided bone regeneration. Osteogenesis distraction and nerve transposition are effective surgeries for medium-to-large mandibular edentulous spaces. The implant survival rate is not significantly different between implants placed in grafted and nongrafted bone, the appropriate choice of bone augmentation technique can reduce the risk of peri‑implant bone resorption.

Survival and complications of zygomatic implants compared to conventional implants reported in longitudinal studies with a follow-up period of at least 5 years: A systematic review and meta-analysis

BACKGROUND

Zygomatic implants (ZI) have been frequently indicated to rehabilitate patients with extensive atrophies in alternatives to major bone reconstructions. It can be installed inside the maxillary sinus, called instrasinus zygomatic implant (IZI) or outside the maxillary sinus (EZI), depending on the surgery technique.

OBJECTIVE

To evaluate the survival and complication rates of ZI in longitudinal studies when compared with conventional implants (CI).

METHODS

An electronic search was performed in five databases and in Gray literature for articles published until April, 2022. The eligibility criteria comprised observational cohort studies (prospective or retrospective) and randomized clinical trials (RCTs) with at least 5 years of follow-up, reporting survival rate of ZI versus CI. A meta-analysis was conduct with 18 studies.

RESULTS

A total of 5434 implants (2972 ZI and 2462 CI) were analyzed in 1709 patients. The mean survival rate was 96.5% ± 5.02 and 95.8% ± 6.36 for ZI and CI, respectively (mean follow-up time of 78 months). There were observed no statistically significant between ZI and CI in prospective studies (risk ratio [RR] of 1.21; 95% confidence intervals [CIs]: 0.28 to 5.28; chi-squared [Chi² ] = 11.37; I²  = 56%; degrees of freedom [df] = 5; z-score = 0.25; P = 0.80), retrospective studies IZI (RR of 1.29; 95% CIs: 0.52 to 3.23; Chi²  = 4.07; I²  = 2%; df = 4; z-score = 0.55; P = 0.58) and retrospective studies EZI (RR of 0.72; 95% CIs: 0.31 to 1.66; Chi²  = 1.99; I²  = 0%; df = 3; z-score = 0.78; P = 0.44). The biological complications most related to ZI was sinusitis, followed by infection and oroantral communication.

CONCLUSION

ZI have a high long-term survival rate (96.5% with a mean of 91.5 months of follow-up), showing no significant difference when compared with CI. The most prevalent biological complication is sinusitis, being most commonly to the IZI technique. This systematic review (SR) was registered in INPLASY under number INPLASY202280025.

Staged autogenous calvarial bone grafting and dental implants placement in the management of oligodontia: a retrospective study of 20 patients over a 12-year period

Oligodontia demands multidisciplinary management due to its repercussions on dentofacial growth. To place implants to realize implant-borne fixed denture, preimplant surgery may be necessary if bone volumes are insufficient. Our aim was to assess bone increase following autogenic bone grafting and to discuss prosthetic options. Twenty patients followed for oligodontia, who underwent bone grafting, were treated from 2008 to 2019. Transversal and vertical bone levels were measured pre- and postoperatively to assess alveolar ridge augmentation. Mean horizontal grafting increase was 4.60 mm [standard deviation (SD) 0.79 mm], mean sinus lift increase was 9.95 mm (SD 2.35 mm). Mean implants placed per patient was 9, mean implants placed on grafted site was 5 per patient. Overall implant survival rate was 100%. All patients benefited from prosthetic procedures when it was planned to perform implant-borne fixed dentures. Within the framework of a complete treatment plan (involving paediatric dentistry, dentofacial orthopaedics, oral and maxillofacial surgery, and prosthodontics), autologous bone grafting combined or not with orthognathic surgery is fully adapted to patients with oligodontia. It allows reconstruction of favourable bone volumes for placement of implants to realize implant-borne fixed dentures, with high implant survival rates and great improvements to quality of life.

Complex Rehabilitation for an Adolescent with Ectodermal Dysplasia-A 10-Year Follow-Up

Maxillofacial rehabilitation of patients with ectodermal dysplasia (ED) often presents clinical challenges due to hypodontia and hypoplastic alveolar bone. This clinical report describes a 16-year-old patient suffering from ED who displayed severe hypodontia, maxillary retrusion and thin knife-edge alveolar crest. This patient was treated with distraction osteogenesis and a bone graft harvested from the iliac crest to correct maxillary retrusion and bone insufficiency. Six months later, implants were inserted. Then, implant-supported overdentures were completed. Although a new implant was reinserted during the 10-year follow-up, the results showed that combination surgical treatment achieved a predictable, functional and esthetic outcome in a patient suffering from ED.

Long-Term Influence of Platelet-Rich Plasma (PRP) on Dental Implants after Maxillary Augmentation: Implant Survival and Success Rates

The atrophic maxilla often requires bone augmentation before implant placement to ensure long-term implant success. A previous prospective clinical trial examined the use of platelet-rich plasma (PRP) during maxillary augmentation. The short-term results showed no positive effect of PRP. The aim of this study was to evaluate the same patient collective of the previous study regarding the PRP long-term impact on the survival and success of dental implants. Fifty-three patients from the previous study diagnosed with maxillary atrophy and augmented with autologous bone grafts from the iliac crest and dental implants, were included in this study. Treatment was carried out on both sides in 34 patients with a split-mouth-design in which one randomly chosen side was treated additionally with PRP, the other side was the control-side. Nineteen patients were treated only on one side and were assigned to the PRP-or the control group randomly. Implant follow-up of the patients from the previous study was performed after an average time of 13 years. Implant success was evaluated using two different success criteria. Thitry-seven patients (25 women and 12 men) were investigated in this study. Seventeen patients (12 female, 5 male) were included in the PRP group, while 20 patients (13 female, 7 male) participated in the control group. A total of 210 implants were inserted. Of these, 102 implants (48.57%) were placed in the PRP group and 108 implants (51.42%) in the control group. Out of 102 investigated implants in the PRP group, 6 were removed (survival rate 94.1%). While two of the 108 implants in the control group were loss (survival rate 98.1%). In the PRP group, the cumulative probability of survival after 15.1 years was 94.1% and in the control group, was 98.1%, with no significant difference between the two groups. Higher significant difference for the control group was found in the cumulative success probability using Albrektson criteria (p = 0.05). Positive impact of PRP on long-term implant survival and success could not be found.

Oral Rehabilitation of Hypodontia Patients Using an Endosseous Dental Implant: Functional and Aesthetic Results

Hypodontia often leads to limited bone availability of the alveolar ridges. Oral rehabilitation of severe hypodontia patients is challenging. In this retrospective study, we evaluated the functional and aesthetic results after dental implants in hypodontia patients, corroborated by Albrektsson implant success criteria. Over a period of 15 years (2000–2015), a total of 43 patients were diagnosed with hypodontia and 165 dental implants were inserted. Six patients who received 10 implants were lost in the follow-up. We examined 155 implants in 37 patients between December 2015 and May 2017. Besides family history, patients evaluated the general satisfaction, functionality, and aesthetics of the implants. Study subjects were between 17 and 44 years old (mean ± SD: 21.4 ± 5.6). Hypodontia patients were missing one to five teeth (n = 28), whereas patients diagnosed with oligodontia (≥6 missing teeth, n = 9). In this study, 24 patients (64.9%) with hypodontia had a positive family history; the remaining 13 patients had no family member with hypodontia. The final follow-up time ranged between 5 and 189 months after implant placement. Orthodontic treatment was performed in 32 patients (86%) before implant placement. Rehabilitation resulted in 62% of the cases being treated with 1–2 implants and 38% treated with 3–15 implants. However, out of 155 inserted dental implants, 18 implants failed to meet Albrektsson criteria, under which two implants were removed. Only autografts were used for bone augmentation with 97 implants. More than two-thirds of the patients showed high general satisfaction and masticatory function (69.4%) as well as phonetic ability (80.6%). The aesthetic outcome was rated as excellent by 17 patients (47.2%). The findings emphasize the importance of interdisciplinary treatment of hypodontia, leading to a satisfactory, functional, and long-term fixed prosthodontics using dental implants.

Evaluation of Implant Success in Patients with Dental Aplasia

Introduction

Dental aplasia is an anomaly in which the number of teeth is reduced. It is the most commonly occurring dental anomaly during tooth development. Treatment management of patients with dental aplasia is challenging.

Objectives

The aim of this retrospective clinical study was to analyze the survival and success rates of dental implants placed in hypodontic patients, rated with different criteria.

Methods

Forty-three patients were diagnosed with dental aplasia and treated with dental implants between November 2000 and February 2016. The variables assessed included the plaque level, bleeding on probing, probing depth, implant mobility, implant stability, and implant loss. To analyze the peri-implant bone level, a panoramic X-ray of each patient was taken. The results were compared with X-rays taken immediately after implantation.

Results

Thirty-seven patients (16 males; 21 females) participated in this study. In total, 155 implants (86 maxillary; 69 mandibular) were inserted. Two of the 155 implants failed; the in situ survival rate was 98.7%. The success rate according to the criteria of Buser et al. was 96.8%, and that according to the criteria of Albrektsson et al. was 88.4%.

Conclusion

The survival and success rates of dental implants in patients with congenitally absent teeth were very high and did not differ significantly from results achieved in an unaffected population. Dental implants are a reliable therapy for patients with dental aplasia.

Prosthetic rehabilitation of patients with hypohidrotic ectodermal dysplasia: A systematic review

Hypohidrotic ectodermal dysplasia (HED) comprises a large group of inherited disorders of ectodermal structures, characterised by hypo- or anhidrosis, hypotrichosis and hypo- or oligo- or anodontia. We aimed to systematically assess the spectrum of prosthodontic approaches with regard to the patients' age and to provide clinical implications for practicing dentists. An electronic and manual search was conducted in four databases (Medline, LIVIVO, Cochrane Library, Web of Science Core Collection). Publications of multiple study designs written in English or German without data restrictions, reporting on prosthodontic treatment of patients diagnosed with HED and afflicted with oligo- or anodontia, were included. In total, 75 articles on 146 patients were analysed according to the patients' age. In children aged 2-17 years, removable full or partial (over)dentures represented standard treatment. In the mandible, implant-supported removable dentures on two interforaminal implants presented an alternative, already in young childhood. In cases with more than six teeth per jaw, also fixed (resin) bridges were used, frequently after orthodontic treatment. In adults, fixed or removable reconstructions with the help of up to eight implants per jaw, usually placed after bone augmentation procedures, were standard. Ten case reports/series with long-term follow-up illustrated the need for consistent maintenance including denture renewals. Prosthodontic rehabilitation should start in early childhood and needs to be revised in accordance with the patients' growth. Treatment should be carried out by a multidisciplinary team addressing variable demands in different age groups.

Early implant placement for a patient with ectodermal dysplasia: Thirteen years of clinical care

Patients with ectodermal dysplasia have abnormalities of 2 or more structures that originate from the ectoderm. The oral manifestations often include the congenital absence of teeth and malformed teeth. This clinical report describes the interdisciplinary care from childhood through the definitive dental rehabilitation completed at skeletal maturation to replace the missing teeth in a patient with ectodermal dysplasia. Treatment began at 9 years of age with an implant-assisted mandibular overdenture to improve function and replace the missing mandibular teeth. Orthodontic treatment for the consolidation of space, composite resin restorations, and interim removable dental prostheses were provided to improve esthetics and replace the missing maxillary teeth. Skeletal growth was monitored, and orthognathic surgery was performed at the cessation of growth. The definitive rehabilitation consisted of a mandibular fixed dental prosthesis supported by dental implants and a maxillary removable dental prosthesis to restore the patient to esthetics and function.

Oral Rehabilitation of a Patient With Ectodermal Dysplasia Treated With Fresh-Frozen Bone Allografts and Computer-Guided Implant Placement: A Clinical Case Report

Ectodermal dysplasia (ED) is an inherited disorder characterized by abnormality of ectodermally derived structures. A recurrent oral finding is oligodontia, which in turn leads to a severely hypotrophic alveolar process with typical knife-edge morphology and adverse ridge contours. This unfavorable anatomy can seriously hamper proper implant placement. Fresh-frozen bone (FFB) allografts recently have been proposed to augment the residual bone volume for implant placement purposes; however, scientific evidence concerning the use of FFB to treat ED patients is absent. Similarly, data reporting computer-aided template-guided implant placement in medically compromised patients are limited. Thus the purpose of this report is to illustrate the oral rehabilitation of a female patient affected by ED and treated with appositional FFB block grafts and consecutive computer-guided flapless implant placement in a 2-stage procedure. Fixed implant-supported dental prostheses were finally delivered to the patient, which improved her self-esteem and quality of life. During the follow-up recall 1 year after the prosthetic loading, the clinical examination showed healthy peri-implant soft tissues with no signs of bleeding on probing or pathologic probing depths. The panoramic radiograph confirmed the clinical stability of the result. Peri-implant marginal bone levels were radiographically stable with neither pathologic bone loss at the mesial and distal aspects of each implant nor peri-implant radiolucency. Within the limitations of this report, the use of FFB allografts in association with computer-aided flapless implant surgery might be considered a useful technique in patients affected by ED.

Occlusal rehabilitation in patients with congenitally missing teeth-dental implants, conventional prosthetics, tooth autotransplants, and preservation of deciduous teeth-a systematic review

Background

Implant patients with congenitally missing teeth share some common charateristics and deserve special attention.

Methods

The PICO question was “In patients with congenitally missing teeth, does an early occlusal rehabilitation with dental implants in comparison to tooth autotransplants, conventional prosthetics on teeth or preservation of deciduous teeth have better general outcomes in terms of survival, success and better patient centered outcomes in terms of quality of life, self-esteem, satisfaction, chewing function?”

After electronic database search, a total of 63 relevant studies were eligible, of which 42 qualified for numerical data synthesis, 26 being retrospective studies. A data synthesis was performed by weighted means for survival/success/annual failure rates.

Results

The mean survival of implants was 95.3 % (prosthesis survival 97.8 %), autotransplants 94.4 %, deciduous teeth 89.6 %, and conventional prostheses 60.2 %. The implant survival in children, adolescents, and adults was 72.4, 93.0, and 97.4 %. Annual failure rates of implants 3.317 %, autotransplants 1.061 %, deciduous teeth 0.908 %, and conventional prostheses 5.144 % indicated better results for natural teeth and more maintenance needs for the both prosthetic treatments. The mean OHIP score was 27.8 at baseline and a mean improvement of 14.9 score points was reported after implant prosthetics. The mean satisfaction rates were 93.4 (implants), 76.6 (conventional prostheses), 72.0 (autotransplants), and 65.5 % (orthodontic space closure).

Conclusions

In synopsis of general and patient-centered outcomes, implants yielded the best results, however, not in children <13 years. Autotransplants and deciduous teeth had low annual failure rates and are appropriate treatments in children and adolescents at low costs. Conventional prosthetics had lower survival/success rates than the other options. Due to heterogeneity and low number of studies, patient-reported outcomes in this review have to be interpreted with caution.

Survival and Complications of Zygomatic Implants: An Updated Systematic Review

PURPOSE

To assess the survival rate of zygomatic implants (ZIs) and the prevalence of complications based on previously published studies.

MATERIALS AND METHODS

An electronic search of 3 databases was performed in December 2015 and was supplemented by manual searching. Clinical series of ZIs were included. Interval survival rate and cumulative survival rate (CSR) were calculated. The untransformed proportion of complications (sinusitis, soft tissue infection, paresthesia, oroantral fistulas) was calculated by considering the prevalence reported in the studies.

RESULTS

Sixty-eight studies were included, comprising 4,556 ZIs in 2,161 patients with 103 failures. The 12-year CSR was 95.21%. Most failures were detected within the 6-month postsurgical period. Studies (n = 26) that exclusively evaluated immediate loading showed a statistically lower ZI failure rate than studies (n = 34) evaluating delayed loading protocols (P = .003). Studies (n = 5) evaluating ZIs for the rehabilitation of patients after maxillary resections presented lower survival rates. The probability of presenting postoperative complications with ZIs was as follows: sinusitis, 2.4% (95% confidence interval [CI], 1.8-3.0); soft tissue infection, 2.0% (95% CI, 1.2-2.8); paresthesia, 1.0% (95% CI, 0.5-1.4); and oroantral fistulas, 0.4% (95% CI, 0.1-0.6). However, these numbers might be underestimated, because many studies failed to mention the prevalence of these complications.

CONCLUSION

ZIs present a high 12-year CSR, with most failures occurring at the early stages postoperatively. The main observed complication related to ZIs was sinusitis, which can appear several years after ZI installation surgery.

Prosthetic treatment outcome in patients with severe hypodontia: a systematic review

Severe hypodontia (≥6 missing teeth) is associated with aesthetic and functional problems. Its presentation is heterogenic, and a variety of treatment modalities are used resulting in different treatment outcomes. As there is currently no standard treatment approach for patients with severe hypodontia, the literature was systematically reviewed with the focus on treatment outcomes. Medline, Embase and The Cochrane Central Register of Controlled Trials were searched (last search 24 August 2015). This was completed with a manual search of the reference lists of the selected studies. To be included, studies had to describe dental treatment outcome measure(s) in patients with severe hypodontia; there were no language restrictions. The methodological quality was assessed using MINORS criteria. Twenty-one studies were eligible, but the diversity in type and quality did not allow for a meta-analysis; seventeen studies had a retrospective design; sixteen studies described the results of implant treatment. Treatment with (partial) dentures, orthodontics, fixed crowns or bridges was sparsely presented in the eligible studies. Implant survival, the most frequently reported treatment outcome, ranging from 35·7% to 98·7%, was influenced by 'location' and 'bone volume'. The results of implant treatment in severe hypodontia patients are promising, but due to its heterogenic presentation, its low prevalence and the poor quality of the studies, evidence-based decision-making in the treatment of severe hypodontia is not yet feasible, thus prompting further research.

Oral Rehabilitation of Adult Edentulous Siblings Severely Lacking Alveolar Bone Due to Ectodermal Dysplasia: A Report of 2 Clinical Cases and a Literature Review

The oral conditions of adult edentulous patients with ectodermal dysplasia (ED) often lead to decreased physical and psychological health, and the negative effects can become as extreme as social and psychological isolation. However, restoring oral function of adult edentulous patients with ED using zygomatic implants (ZIs) or conventional implants (CIs) remains challenging for dentists because of the severe atrophy of these patients' alveolar ridges. This report describes 2 cases of adult edentulous siblings with ED; they exhibited severe alveolar bone atrophy and were treated with ZIs and CIs as bases to augment the bone in their anterior jaws. For these patients, bone augmentation was completed with an autogenous fibular graft. Although there was mild evidence of bone graft resorption in the maxilla, the bone augmentation procedures were successful in the 2 patients. Effective osseointegration of the implants was obtained. After placement, the functional and esthetic results of the oral rehabilitation were acceptable. More importantly, restoration of the patients' oral function enhanced their self-confidence and self-esteem. Therefore, restoring oral function in adult patients with ED and edentulous jaws using ZIs and CIs as the bases for bone augmentation is an effective approach.

Restoration of Oral Function for Adult Edentulous Patients with Ectodermal Dysplasia: A Prospective Preliminary Clinical Study

BACKGROUND

Therapy with zygomatic implants (ZIs) or conventional implants (CIs) has proven to be an effective method to restore oral function for systemically healthy patients. However, it is still a major challenge to fully restore oral function to edentulous adult patients with ectodermal dysplasia (ED).

PURPOSE

The aim of this study was to determine an effective treatment protocol for restoring oral function using ZIs and CIs to edentulous adult ED patients.

MATERIALS AND METHODS

Ten edentulous adult ED patients were treated in this study. The treatment protocol involved the following: (1) bone augmentation in the region of the anterior teeth; (2) placement of two ZIs and four CIs in the maxilla, and four CIs in the mandible; (3) fabrication of dental prosthesis; and (4) psychological and oral education. Following treatment of these patients, implant success rates, biological complications, patient satisfaction, and psychological changes were recorded.

RESULTS

Although there was evidence of bone graft resorption in the maxilla, bone augmentation of the mandible was successful in all patients. Nine CIs in the maxilla failed and were removed. All ZIs were successful, and the CIs success rates were 77.50% in the maxilla and 100% in the mandible, with a mean of 88.75%. The mean peri-implant bone resorption for the CIs ranged from 1.3 ± 0.4 mm to 1.8 ± 0.6 mm, and four cases exhibited gingival hyperplasia in the maxilla and mandible. One hundred percent of the patients were satisfied with the restoration of their oral function, and >50% of the patients exhibited enhanced self-confidence and self-esteem.

CONCLUSIONS

This study demonstrates that oral function can be restored in edentulous adult ED patients using a comprehensive and systematic treatment protocol involving psychological and oral education, bone augmentation, implant placement, and denture fabrication. Despite these positive outcomes, bone augmentation remains challenging in the anterior region of the maxilla for edentulous adult ED patients.