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Afrashtehfar KI, Stawarczyk B, Micovic Soldatovic D, Schmidlin PR. A proof of concept on implant-supported bilateral cantilever bridges: The T-Bridge approach. SWISS DENTAL JOURNAL 2024; 134:1-17. [PMID: 38757922 DOI: 10.61872/sdj-2024-03-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Indexed: 05/18/2024]
Abstract
The concept of bilateral cantilevers on a single central implant (T-design) for three-unit implant-supported fixed dental prostheses (ISFDPs) has not been explored nor tested. This technical hypothesis aimed to explore the feasibility of such an approach as a cost-effective alternative to conventional treatments. Careful considerations regarding implant diameter, length, ideal position, occlusal scheme, and bone remodeling are essential to ensure adequate support, stability, and prevention of complications. In this proof of concept, we present a preliminary case with this novel design to replace missing posterior teeth in a patient with narrow bone conditions. In addition, a series of planned investigations and preliminary results, including preclinical studies, are presented to illustrate our concept and its potential clinical implications. Clinically, after two-year follow-up, healthy and stable peri-implant tissues around the ISFDP exemplarily demonstrated excellent stability, functionality, and comfort, which is supported by acceptable fracture resistance data in vitro, suggesting indeed the practical potential and suitability. Thus, we claim that such a treatment modality has the at least theoretical potential to revolutionize implant dentistry by providing innovative and cost-effective treatment options for patients with partial ISFDPs in very specific cases. Of course, further research and evaluations are necessary to validate the clinical implications of this innovative hypothesis. Implementing the 3-on-1 T-bridge approach in partial ISFDPs could offer a promising alternative to traditional methods. If proven successful, this technique may lead to significant advancements in clinical practice, providing a less invasive cost-effective treatment option.
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Affiliation(s)
- Kelvin I Afrashtehfar
- Evidence Based Practice Unit, College of Dentistry, Ajman University, Ajman City, UAE.
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Berne, Switzerland
- Division of Periodontal and Periimplantitis Sciences, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Private Practice Limited to Implant Dentistry, Richmond, Canada
- Private Practice Limited to Prosthodontics, Abu Dhabi, UAE
| | - Bogna Stawarczyk
- Department of Prosthodontics, Ludwig-Maximilians-University, Munich, Germany.
| | | | - Patrick R Schmidlin
- Division of Periodontal and Periimplantitis Sciences, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
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Bhagawati SB, Jain SR, Debnath P, Riyaz K, Patil R, Ansari J. Patients' Perceptions Regarding Acceptance of Dental Implants as an Option for the Replacement of Missing Teeth: An Observational Study. Cureus 2024; 16:e57232. [PMID: 38686275 PMCID: PMC11056823 DOI: 10.7759/cureus.57232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2024] [Indexed: 05/02/2024] Open
Abstract
INTRODUCTION Dental implants enhance the self-assurance and overall well-being of individuals by providing oral comfort during mastication and a notable degree of contentment. The objectives of the present study were to assess patients' perception of opting or non-opting for dental implants as a replacement for missing teeth and to determine the correlation between various factors and perceived demand for dental implant treatment. MATERIALS AND METHODS A cross-sectional observational study was conducted on 214 partially edentulous individuals aged between 21 and 50 years. These patients sought treatment to replace their missing teeth. The participants were provided with detailed information regarding various options for replacing their missing teeth, including removable prostheses, fixed partial dentures, and dental implants. The researchers recorded and evaluated the reasons behind the patients' decision to opt for or decline dental implant treatment using the chi-squared test. Categorical variables were summarized as percentages (n %). The association between variables and binary data was examined using point biserial correlation, whereas, for continuous data, the Pearson correlation coefficient was employed. RESULTS About 65 (30.4%) patients opted for dental implant treatment and 149 (69.6%) patients did not opt for dental implant treatment. Missing teeth were found in 120 women (56.08%) and 94 men (43.92%). The main reason for seeking dental implant treatment was the need for improvement in functions such as chewing in 65 (100%) patients, followed by the need for improvement in oral health in 57 (88%), aesthetics in 54 (83%), need for bone and adjacent teeth preservation in 52 (80%), and durability of dental implants in 46 (71%) patients. The main reasons for not seeking dental implant treatment and opting for fixed prostheses other than dental implants or removable prostheses cost 149 (100%), fear of surgery 132 (91%), underlying health issues 121 (81%), lack of knowledge about dental implants 120 (80.5%), and time management issues 92 (62%). Gender, age, and number of missing teeth showed a negative correlation, whereas level of education, social status, and oral health awareness showed a positive correlation with the perceived need for dental implant treatment. CONCLUSION Dental implant treatment was preferred by 30.4% of patients, which was influenced by gender, sex, level of education, social status, awareness of oral health, and number of missing teeth. Cost, fear of surgery, underlying medical conditions, lack of knowledge, and time management are some reasons for not opting for dental implant treatment.
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Affiliation(s)
- Sharanamma B Bhagawati
- Department of Periodontics, Hazaribagh College of Dental Sciences and Hospital, Hazaribagh, IND
| | - Saurabh R Jain
- Department of Prosthodontics, Jawahar Medical Foundation's Annasaheb Chudaman Patil Memorial Dental College, Dhule, IND
| | - Puja Debnath
- Department of Periodontics, Agartala Government Dental College & IGM Hospital, Agartala, IND
| | - Khadeer Riyaz
- Department of Orthodontics, The Oxford Dental College and Research Centre, Bengaluru, IND
| | - Rohit Patil
- Department of Prosthodontics, Jawahar Medical Foundation's Annasaheb Chudaman Patil Memorial Dental College, Dhule, IND
| | - Jaweria Ansari
- Department of Prosthodontics, Jawahar Medical Foundation's Annasaheb Chudaman Patil Memorial Dental College, Dhule, IND
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Rooha A, Shetty S, Bajaj G, Jacob NL, George VM, Bhat JS. Development and validation of educational multimedia to promote public health literacy about healthy cognitive aging. Health Expect 2023; 26:2571-2583. [PMID: 37635370 PMCID: PMC10632613 DOI: 10.1111/hex.13857] [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: 05/25/2023] [Revised: 07/31/2023] [Accepted: 08/16/2023] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVES Health literacy (HL) about healthy cognitive aging is essential in preventing cognitive decline and promoting cognitive well-being. It is important that one such HL module should be scientifically designed, delivered in a technically sound manner to the audience, and specific to the context. The present study thus aimed at developing and validating educational multimedia about cognitive health. METHODS The study followed a methodological framework and was carried out across three phases, that is, identification of themes, development and validation of educational script and design, and validation of educational multimedia. The module was scripted based on the Integrated HL framework and the recommendations made during the modified nominal group technique among the research team. Seven speech-language pathologists (SLPs), with expertise in the field of cognitive sciences, and 15 representatives of the general public validated the module using the Educational Content Validation Instrument in Health and the Patient Education Materials Assessment Tool for Audiovisual Materials questionnaire. RESULTS The scientific content of the educational script received satisfactory agreements among the experts (content validity index [CVI]: 0.93) and representatives of the general public (CVI: 0.86). The technical aspects of the educational multimedia were rated to have high understandability (experts: 92.8%; representatives of general public: 98.8%) and actionability (experts and representatives of general public 100%). CONCLUSION Overall, the developed educational multimedia scored optimally with respect to the objective, structure, relevance of the content, actionability and understandability of the multimedia. The developed module holds the potential to be used at community and national level health educational programs or awareness campaigns to enhance public knowledge and beliefs pertaining to cognitive health. PATIENT OR PUBLIC CONTRIBUTION SLPs with expertise in the field of cognitive science and representatives from the general public were included to validate and obtain feedback on the developed educational multimedia.
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Affiliation(s)
- Aysha Rooha
- Department of Audiology and Speech Language PathologyKasturba Medical College, Mangalore, Manipal Academy of Higher EducationManipalKarnatakaIndia
| | - Shreya Shetty
- Department of Audiology and Speech Language PathologyKasturba Medical College, Mangalore, Manipal Academy of Higher EducationManipalKarnatakaIndia
| | - Gagan Bajaj
- Department of Audiology and Speech Language PathologyKasturba Medical College, Mangalore, Manipal Academy of Higher EducationManipalKarnatakaIndia
| | - Nidhi L. Jacob
- Department of Audiology and Speech Language PathologyKasturba Medical College, Mangalore, Manipal Academy of Higher EducationManipalKarnatakaIndia
| | - Vinitha M. George
- Department of Audiology and Speech Language PathologyNational Institute of Speech and HearingTrivandrumKeralaIndia
| | - Jayashree S. Bhat
- Department of Audiology and Speech Language PathologyNitte Institute of Speech and Hearing, DeralakatteMangaloreKarnatakaIndia
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Leles CR, Nascimento LN, Silva JR, de Paula MS, Curado TFF, McKenna G, Schimmel M. Willingness to accept or refuse mandibular implant overdenture treatment: A prospective study on edentulous enrolled in a clinical trial. J Oral Rehabil 2023; 50:392-399. [PMID: 36789570 DOI: 10.1111/joor.13429] [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: 06/13/2022] [Revised: 10/26/2022] [Accepted: 02/06/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Several complete denture wearers have major complaints and may be benefitted from implant treatment. However, the factors that shape the demand for and utilization of implants need further investigation. OBJECTIVE The aim was to evaluate edentulous patient's willingness to accept or refuse the offer and provision of implant-retained treatment. METHODS As part of a clinical trial, edentulous subjects were offered a mandibular overdenture retained by four mini-implants opposing a conventional maxillary denture. Treatment was offered without any financial costs for the patients. Patients' level of interest in receiving treatment was assessed using a 5-point Likert scale, and they were asked to respond to a list of reasons that led to their decision to accept or refuse implants. Those who refused implants received conventional prosthodontic interventions as required, and those who accepted implant treatment underwent surgical planning and implant placement. RESULTS Of 175 eligible subjects, 147 accepted the offer of treatment and were invited to take part in the study (69.4% women, mean age 67.4 ± 10.0 years). Overall, 111 patients (75.5%) expressed a positive intention to undergo implant treatment at the initial contact. Implant treatment was performed for 56.3% (9/16) of those who answered 'probably yes' about their level of interest in implant treatment on the Likert scale, and 69.6% (64/92) of 'certainly yes' (p < .001). Older subjects were less likely to receive implants (OR = 0.93; p = .036), whilst those with a positive intention towards implants (OR = 3.15; p = .001), those previously treated by the dental team (OR = 7.89; p < .001), and who actively demanded implants (OR = 18.1; p < .001) were more likely to accept treatment. Improved chewing was the most common reason for accepting implants, whilst fear of surgery was the most reported reason for refusal. CONCLUSION Refusal of implants was high among edentate patients even when financial costs were removed. Patients' initial attitude towards acceptance is a key factor in the demand for and uptake of implant therapy.
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Affiliation(s)
| | | | | | | | | | - Gerald McKenna
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - 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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Afrashtehfar KI, Yang JW, Al-Sammarraie A, Chen H, Saeed MH. Pre-clinical undergraduate students' perspectives on the adoption of virtual and augmented reality to their dental learning experience: A one-group pre- and post-test design protocol. F1000Res 2023; 10:473. [PMID: 36703700 PMCID: PMC9837452 DOI: 10.12688/f1000research.53059.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 01/07/2023] Open
Abstract
Background: We live in a time where traditional education has rapidly incorporated online modalities due to the recent SARS-CoV-2 (COVID-19) safety measures such as social distancing. Regardless of these challenges, health education constantly strives to implement the best technologies available for an effective student deep learning outcome. Virtual (VR) and augmented reality (AR) in the dental pre-clinical stage may help stimulate students to better understand the foundation material prescribed in the curriculum. Most visual material available for students is still mainly based on 2D graphics. Thus, this study will attempt to evaluate the students' perceptions about implementing VR/AR technologies in the learning setting. Methods: A single-group pretest-posttest design will be implemented where students will be exposed to VR/AR and fill out two questionnaires, one before and one after the exposure. Conclusions: This project is intended to start once the institutional ethical approval is obtained. It is expected that the analysis from the current project will provide recommendations to improve the students' academic curriculum pre-clinical experience. The recommendations will be provided in the form of at least three scientific publications, with one publication for each subject area intended to be evaluated (i.e., head and neck anatomy, dental anatomy, and removable prosthodontics).
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Affiliation(s)
- Kelvin I. Afrashtehfar
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman City, PO Box 346, United Arab Emirates,Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, Faculty of Medicine, Universität Bern, Bern, 3010 Bern, Switzerland,
| | - Jing-Wen Yang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health, Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China
| | - A. Al-Sammarraie
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman City, PO Box 346, United Arab Emirates,
| | - Hui Chen
- Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong SAR, China
| | - Musab H. Saeed
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman City, PO Box 346, United Arab Emirates
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Afrashtehfar KI, Ghanem H, Calvo J. Dental Curriculum's Continuing Improvement in the North American and Gulf Cooperation Council (GCC) Education Systems. Open Dent J 2021. [DOI: 10.2174/1874210602115010601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Dynamic oral health care needs, alongside a diverse demographic of patients, presents a challenge to dental clinicians as they strive to resolve the ever-increasing demand for quality oral care service. Claims have arisen that the most appropriate way of speeding up the slow change in adopting innovations within the dental practice is by updating dentists' knowledge and skills through improving the undergraduate students' curriculum.
Objective:
This review compares the dental curriculum's continuing improvement processes between the North American and Gulf Cooperation Council (GCC) countries.
Methods:
The process of analysis consisted of identifying, examining, and interpreting patterns and themes within textual data, and then determining how each of these help answer the research questions.
Results:
Efforts to implement the dental curriculum's continuous improvement processes in the North American and GCC countries are evident, but the significant barriers for the dental curriculum's continuing improvement among the North American countries include the consequences of a compressed four-year curriculum, reliance on professional regulations, insufficient focus on patient perceptions, and the lack of a more theoretically robust approach to self-reflection. Conversely, amongst the GCC countries, the available literature states that the most significant factors hindering the dental curriculum's continuing improvement include deficient leadership attributes and low research productivity.
Conclusion:
The North American and GCC regions will benefit from the new dental curriculum and result in producing more competent dental practitioners, with improved leadership and patient-centered care. However, it has been observed that the dental curriculum’s continuous improvement processes are adopted slowly, particularly among the GCC countries.
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Canadian Dental Patients with a Single-Unit Implant-Supported Restoration in the Aesthetic Region of the Mouth: Qualitative and Quantitative Patient-Reported Outcome Measures (PROMs). DATA 2021. [DOI: 10.3390/data6080090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
This article contains quantitative and qualitative patient-reported outcome measures (PROMs) collected from nine dental patients, with a single-implant in the maxillary anterior region of the mouth, recruited after obtaining consent documents. The quantitative data were obtained from participants’ demographics, frontal extraoral digital photographs, intraoral scans (IOS) of the maxillary arch, and self-administered questionnaires (where patients judged the overall, appearance, function, and comfort of their single-implant-supported crowns). Objective single-implant aesthetic index mean scores (Pink Esthetic Score/White Esthetic Score [PES/WES]) were obtained after two experienced calibrated clinicians analyzed the photographs and the three-dimensional models generated from the IOS. The self-administered questionnaires used a visual analogue scale (VAS) to obtain the patients’ subjective perceptions. The qualitative data were obtained from in-depth, semi-structured one-to-one interviews. The transcriptions from audio-recorded interview data were managed and coded, with the aid of a Computer-Assisted Qualitative Data Analysis Software (CAQDAS). These data were stored in a public repository that can be easily downloaded from a Mendeley data repository (DOI: 10.17632/sv8t6tkvjv.1).
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Afrashtehfar KI, Bryant SR. Understanding the Lived Experience of North American Dental Patients With a Single-Tooth Implant in the Upper Front Region of the Mouth: Protocol for a Qualitative Study. JMIR Res Protoc 2021; 10:e25767. [PMID: 33886491 PMCID: PMC8277304 DOI: 10.2196/25767] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 03/16/2021] [Accepted: 04/12/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Assessment of the subjective experiences of individuals with maxillary anterior (ie, the upper front region of the mouth) single-tooth implants is limited mainly to quantitative measurements of satisfaction with appearance. Interestingly, there is unexplained variability in the relationship between satisfaction and appearance. OBJECTIVE This qualitative study protocol aims to explore and better understand the satisfaction with appearance and function in a Canadian population with maxillary anterior single-tooth implants treated at a postgraduate university clinic. Thus, we aim to obtain diversity among participants relating to the identification of esthetically pleasing and displeasing cases from a clinician perspective. METHODS A qualitative research design using interpretative phenomenology analysis (IPA) will provide an adaptable inductive research approach. The participants will be recruited, and consent documents, photographs, digital intraoral scans, and self-administered questionnaire responses will be obtained from them. The transcribed verbatim data from audio-recorded, in-depth, semistructured, one-to-one interviews of the participants will be managed, coded, and analyzed thematically with computer-assisted qualitative data analysis software. The IPA will consider the COnsolidated criteria for REporting Qualitative (COREQ) guidelines when applicable. RESULTS For the qualitative interview, we plan to include at least eight patients to conduct up to 1.5 hours of open-ended interviews with each participant aided by an interview guide. Ethical approval was granted by the University of British Columbia Behavioral Research Ethics Board (H19-00107) in May 2019. Two American dental foundations funded this study. CONCLUSIONS The analysis in this study will elucidate the aspects (including their value) that influence participant satisfaction at different dental implant treatment stages. This will be the first qualitative study on this group of the population to explore and obtain a better understanding of their satisfaction with appearance and function, as well as any other patient-reported outcome measures that could be identified. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/25767.
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Affiliation(s)
- Kelvin Ian Afrashtehfar
- Division of Restorative Dental Sciences, Clinical Sciences Department, Ajman University, Ajman City, United Arab Emirates.,Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Berne, Switzerland.,Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Dubai, United Arab Emirates.,Department of Oral Surgery and Stomatology, Faculty of Medicine, University of Bern, Berne, Switzerland
| | - Stephen Ross Bryant
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada.,Division of Prosthodontics and Dental Geriatrics, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
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Afrashtehfar KI, Katsoulis J, Koka S, Igarashi K. Single versus splinted short implants at sinus augmented sites: A systematic review and meta-analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 122:303-310. [PMID: 33002610 DOI: 10.1016/j.jormas.2020.08.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 07/08/2020] [Accepted: 08/26/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This review primarily evaluated the success, survival and failure rates of implants shorter than 10 mm restored with single-unit or splinted fixed dental prostheses in maxillary sinus augmented sites. MATERIAL AND METHODS Two reviewers independently performed the systematic search of electronic databases, including MEDLINE, EMBASE and CENTRAL, up to September 2019 with no language restriction. A supplemental hand search consisted of screening 13 journals. The inclusion criteria were: primary studies reporting implant, prosthetic and patient-reported outcome measures (PROMs) of extra-short and short implants placed in conjunction with sinus floor elevation in partially dentate patients, restored with single- and splinted-crowns for direct comparison, with a minimal 1-year follow-up. Weighted arithmetic mean (WAM) of the implant survival was performed according to the type of prosthesis. This was confirmed by using Review Manager software to perform meta-analysis. RESULTS Two observational studies reporting on 106 tapered, press-fit, sintered porous-surfaced implants with a length ranging from 5 mm to 9 mm were included in this systematic review. Of these, 20 and 86 implants were restored with single and splinted prostheses, respectively. The risk ratio (RR) was 1.16 (95% CI: .31-4.30, p = .58, I² = 0%) for individually restored implants failure when compared to splinted implants, indicating that short dental implants restored with single crowns could have a 16% higher possibility of failure if compared to implants with splinted crowns. The heterogeneity value was not statistically significative (p = .58). No statistical difference in the implant survival rate of the two types of analysed prostheses was observed after WAM (p= .923). The level of evidence for the included studies ranged from low (4) to fair (2B). CONCLUSION Similar clinical outcomes up to a 9-year follow-up were observed in single and splinted porous-surfaced implants shorter than 10 mm located in sites with sinus lift. However, the conclusion shall be interpreted with caution due to the level of evidence and limited number of included studies included in this systematic review.
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Affiliation(s)
- Kelvin I Afrashtehfar
- Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, 3010 Bern, Switzerland; Department of Oral Surgery and Stomatology, School of Dental Medicine, Faculty of Medicine, University of Bern, 3010 Bern, Switzerland; Division of Restorative Dental Sciences, College of Dentistry, Ajman University, 346 Ajman City, UAE; Department of Restorative Dentistry, Edinburgh Dental Institute, University of Edinburgh, College of Medicine and Veterinary, Lauriston Place, Edinburgh, EH3 9HA, UK; Department of Oral Health Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
| | - Joannis Katsoulis
- Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, 3010 Bern, Switzerland; Department of Preventive & Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, PA 19104, USA
| | - Sreenivas Koka
- Division of Advanced Prosthodontics, School of Dentistry, Loma Linda University, Loma Linda, CA 92350, US; Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095, USA; MIT Sloan School of Management, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Kensuke Igarashi
- Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, 3010 Bern, Switzerland; Department of Life Science Dentistry, The Nippon Dental University, Niigata 951-8580, Japan
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Clinical performance of zirconia implants: A meta-review. J Prosthet Dent 2019; 123:419-426. [PMID: 31451193 DOI: 10.1016/j.prosdent.2019.05.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 05/17/2019] [Accepted: 05/17/2019] [Indexed: 12/11/2022]
Abstract
STATEMENT OF PROBLEM The clinical effectiveness of zirconia implants as an alternative to titanium implants is still controversial. PURPOSE The purpose of this analysis was to identify and evaluate systematic reviews reporting on the clinical outcomes of zirconia implants for oral rehabilitation. MATERIAL AND METHODS An electronic search was undertaken on MEDLINE, Embase, and the Cochrane Oral Health Reviews databases up to December 24, 2018, without language restriction. Eligible reviews were screened and assessed. The eligibility criteria were systematic reviews or meta-analyses, implant survival rate, implant success, marginal bone loss, peri-implant soft tissue status, and biologic and functional complications of zirconia implants. Two review authors independently evaluated the quality assessment of the secondary studies by applying the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool. RESULTS Nine reviews fulfilled the inclusion criteria and were evaluated. Seven reviews were classified as moderate and 2 as high quality. The overall AMSTAR's quality of these reports was moderate. In the primary studies contained in these reviews, zirconia implant clinical outcomes were found to be similar or inferior to those for titanium implants. The few primary clinical studies contained in these reviews were not homogeneous among each other, presented poor methodology, and only offered promising short-term outcomes due to the lack of long-term follow-ups. CONCLUSIONS Based on this meta-review, in spite of short-term promising results of zirconia implants, evidence with long term is lacking.
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11
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Afrashtehfar KI, Belser UC. Prevention and Management of Cheek and/or Tongue Biting Related to Posterior Implant-Supported Fixed Dental Prostheses (ISFDPs). J Prosthodont 2018; 28:837-839. [PMID: 29855110 DOI: 10.1111/jopr.12912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2018] [Indexed: 12/19/2022] Open
Abstract
After the loss of several adjacent posterior teeth, bone resorption occurs that can lead to a marked occlusal discrepancy between arches. This discrepancy may originate from the more pronounced resorption at the facial portion of the alveolar bone crest, often resulting in a more palatal implant position. Therefore, establishing normal overbite and cusp-fossa relation may become difficult, namely causing inappropriate crown contours and emergence profiles. This manuscript describes a technique in which a different occlusal configuration is given to solve some problems that edge-to-edge occlusal configuration produces. For instance, patients may suffer from cheek and/or tongue biting after the delivery of a maxillary posterior implant-supported fixed dental prosthesis resulting in an edge-to-edge occlusal configuration. In instances of severe maxillary resorption in the posterior buccal zone, it is recommended to consider a distinct cross-bite occlusion and by this prevent the well-known discomfort and clinical signs associated with both an edge-to-edge interarch relationship or a so-called "stretched" transversal overbite.
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Affiliation(s)
- Kelvin I Afrashtehfar
- Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Oral Surgery & Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Division of Oral Health & Society, McGill University, Montreal, Canada
| | - Urs C Belser
- Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Oral Surgery & Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Division of Fixed Prosthodontics & Biomaterials, School of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Afrashtehfar KI, Eimar H, Yassine R, Abi-Nader S, Tamimi F. Evidence-based dentistry for planning restorative treatments: barriers and potential solutions. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2017; 21:e7-e18. [PMID: 27146788 DOI: 10.1111/eje.12208] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/08/2016] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Evidence-based dentistry (EBD) can help provide the best treatment option for every patient, however, its implementation in restorative dentistry is very limited. OBJECTIVE This study aimed at assessing the barriers preventing the implementation of EBD among dental undergraduate and graduate students in Montreal, and explore possible solutions to overcome these barriers. MATERIALS AND METHODS A cross-sectional survey was conducted by means of a paper format self-administrated questionnaire distributed among dental students. The survey assessed the barriers and potential solutions for implementation of an evidence-based practice. RESULTS Sixty-one students completed the questionnaire. Forty-one percent of respondents found evidence-based literature to be the most reliable source of information for restorative treatment planning, however, only 16% used it. They considered that finding reliable information was difficult and they sometimes encountered conflicting information when consulting different sources. Dental students had positive attitudes towards the need for better access to evidence-based literature to assist learning and decision making in restorative treatment planning and to improve treatment outcomes. Even for dentists trained in EBD, online searching takes too much time, and even though it can provide information of better quality than personal intuition, it might not be enough to identify the best available evidence. CONCLUSIONS Even though dental students are aware of the importance of EBD in restorative dentistry they rarely apply the concept, mainly due to time constraints. For this reason, implementation of EBD would probably require faster access to evidence-based knowledge.
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Affiliation(s)
- K I Afrashtehfar
- Division of Prosthodontics and Restorative Dentistry, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - H Eimar
- Department of Orthodontics, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - R Yassine
- Undergraduate Dental Clinics, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - S Abi-Nader
- Division of Prosthodontics and Restorative Dentistry, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
- Undergraduate Dental Clinics, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - F Tamimi
- Division of Prosthodontics and Restorative Dentistry, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
- Undergraduate Dental Clinics, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
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Igarashi K, Afrashtehfar KI. Clinical assessment of fractured implant abutment screws: The Bernese silicone replica technique. J Prosthet Dent 2017; 119:717-719. [PMID: 28969916 DOI: 10.1016/j.prosdent.2017.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 08/03/2017] [Accepted: 08/03/2017] [Indexed: 11/26/2022]
Abstract
Fractured implant abutment screws can be retrieved with repair or rescue devices. However, whether the screw was completely retrieved or the inner implant body was damaged may be uncertain. A silicone replica technique was recently implemented in Bern and may be the most predictable method available at the moment for clinically assessing the internal implant body. This technique is straightforward and precise and may help dentists determine the internal implant condition when managing a fractured screw.
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Affiliation(s)
- Kensuke Igarashi
- Postdoctoral Fellow, Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; and Assistant Professor, Department of Life Science Dentistry, The Nippon Dental University, Niigata, Japan
| | - Kelvin I Afrashtehfar
- Fellow, Advanced Studies in Oral Implantology, Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
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