Quality of Life of Patients Treated With Implant-Supported Mandibular Overdentures Evaluated With the Oral Health Impact Profile (OHIP-14): a Survey of 58 Patients

A Post-Implanto-Prosthetic Rehabilitation Study Regarding the Degree of Improvement in Patients' Quality of Life: A Before-After Study

BACKGROUND

Implant-prosthetic rehabilitation has the ability to improve the quality of life of patients, because, in addition to the role of restoring masticatory function, they also have many other benefits, such as restoring aesthetics or improving speech. This study aimed to analyze whether patients' quality of life was improved by implanto-prosthetic rehabilitation and which were the most important aspects.

MATERIALS AND METHODS

In this before-after study, we applied the Oral Health Impact Profile (OHIP-14) questionnaire to analyze the degree to which complex implanto-prosthetic rehabilitation led or not to an increase in patients' quality of life. The present study was carried out at the level of a private medical center in a city in the central region of Romania and included patients who visited this medical center between January and June 2022 and who benefited from a complex implanto-prosthetic rehabilitation, with the total number of patients eligible for inclusion in the study being 116.

RESULTS

Overall, an improvement in quality of life after implant-prosthetic rehabilitation was found. Patients' gender, age, or educational level did not significantly influence their responses. The network analysis offered an overview (intuitive visual representation) of the similarities but also the differences in the OHIP-14 item relationships in both situations: before and after oral rehabilitation.

CONCLUSIONS

A better understanding of how patients perceive implanto-prosthetic rehabilitation and the aspects that influence this perception can lead to an improvement in their quality of life, increasing the addressability of this type of medical procedure.

Orofacial esthetics, chewing function, and oral health-related quality of life in Kennedy class I patients with mini-implant-retained removable partial dentures: A 3-year clinical prospective study

This prospective clinical study aimed to assess self-reported orofacial esthetics, chewing function, and oral health-related quality of life (OHRQoL) over three years in the Kennedy Class I patients without posterior dentition who received free-end saddle removable partial dentures (RPDs) retained by two mini dental implants (MDIs) inserted in the canine/first premolar region. The study's robust findings reaffirm the viability of MDI-retained RPDs as a treatment modality in contemporary prosthodontics, instilling confidence in the dental community.

MATERIALS AND METHODS

92 participants with posterior edentulism in the maxilla or mandible received 184 MDIs and 92 RPDs. After one year, three participants were excluded, and another seven were excluded after three years. The final sample was 82 participants. Self-perceived orofacial esthetics was assessed by the Orofacial Esthetic Scale (OES), chewing function by the Chewing Function Questionnaire (CFQ), and the OHRQoL by the OHIP-14. Statistical analysis utilized multivariate regression analysis, standardized effect size calculation, Wilcoxon Signed Rank test, and Friedman's test.

RESULTS

OHRQoL and chewing function significantly improved (p < 0.001) one month after MDI loading by the new RPDs and continued to improve over the observation period (p < 0.05). The OES also significantly improved (p < 0.001) and remained almost unchanged over the next three years (p = 0.440).

CONCLUSION

Despite the limitations of this study, the MDI-retained RPD appears to be a viable treatment modality in contemporary prosthodontics from the patients' perspective.

Five years clinical outcome of maxillary mini dental implant overdenture treatment: A prospective multicenter clinical cohort study

BACKGROUND

The long-term clinical outcome of mini dental implants (MDIs) to support an overdenture is underreported especially in severely atrophic maxillae and when installed flaplessly.

PURPOSE

The current report is a 5-years follow-up of the previously published 2- and 3-years clinical outcome of MDIs supporting a maxillary overdenture in narrow alveolar ridges. MDI survival, marginal bone level, peri-implant health, technical complications, and oral health related quality of life (OHIP) and respective changes over time are reported.

MATERIALS AND METHODS

Subjects aged 50 years or older, in need of improvement of maxillary denture retention, were included. The MDIs were 2.4 mm diameter one-piece tapered implants, Class 4 pure Titanium, and lengths 10 or 11.5 mm. Under local anesthesia, 5-6 MDIs were placed in atrophic maxillae with a free-handed flapless approach. One week postoperative the denture was adapted with a retentive soft reliner. The final prosthetic connection was established after 6 months with a metal-reinforced horse-shoe denture. Clinical outcome after 5 years was assessed with probing pocket depts (PPD), bleeding on probing (BoP), and additional cone beam computed tomography (CBCT) MDI bone level measurements were performed. Oral Health-Related Quality of Life (OHRQoL) investigated with OHIP-14 was assessed preoperative, during provisional loading, and after final prosthetic connection up to 5 years.

RESULTS

Initially, 31 patients (14 females and 17 males) with mean age 62.30 underwent treatment. In the provisional loading interval, 16 patients encountered 32/185 MDIs failures, resulting in a failure of 17.3%; 170 MDIs were functionally loaded in 29 patients. Additionally, 14 implants were lost in three patients, all of whom had had already previous failures. Reimplantation of 17 MDIs were performed during the provisional loading and 2 MDI after functional loading. After 5 years, the absolute implant failure rate was 46/204 (22.5%), corresponding to a cumulative failure rate of 23.2%. Prosthetic failure was observed in four patients due to implant loss and in two patients related to excessive one-piece implant ball attachment wear, making the 5-years prosthetic success 80.0%. The mean PPD and absence/presence of BoP for 149 implants at 5 years was 4.3 and 0.2 mm, respectively. Average mesial-distal-vestibular-palatal bone loss in the interval 2-5 years was 0.08 mm. No statistically significant difference in marginal MDI bone loss between male or female (p = 0.835), smoking and nonsmoking (p = 0.666) was observed. The five-years total measured CBCT interdental bone level (mesial and distal) correlates with the 5-years PPD (Pearson 0.434; p = 0.01). After 5 years, OHRQoL with the treatment procedure was assessed in 27/31 participants. Decreasing mean total OHIP-14 scores with improved OHRQoL, was observed in 27/31 participants, with values of 21.3 at baseline to 15.6 at the time of provisional loading which significantly (p = 0.006) decrease to 7.3 at the final prosthetic connection. The next 3-5 years further decrease was observed with 6.5 and 4.96, respectively.

CONCLUSIONS

Maxillary MDIs for overdentures are an accessible and acceptable treatment option. Although after 5 years between one fifth and one fourth of the MDIs were lost, prosthetic success remains 80.0% and high OHRQoL could be achieved.

Treatment effect of implant-supported fixed complete dentures and implant overdentures on patient-reported outcomes: A systematic review and meta-analysis

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.

Fracture strength test of digitally produced ceramic-filled and unfilled dental resin restorations via 3d printing: An in vitro study

Background

Purpose of this study was to investigate the mechanical efficiency of 3D-printed permanent and provisional implant cemented fixed bridges produced via CAD/CAM technology using an interim and a permanent ceramic filled hybrid material.

Material and Methods

Two groups with twenty specimens each were designed and 3D-printed via digital light processing technology (DLP). A fracture strength test was performed. Statistical analysis was performed (p>0.05) for impression distance and force.

Results

For the fracture resistance and impression distance no significant difference (p = 0.643) were detected. The specimens of interim resin showed a mean value of 365.90 ± 86.67 N. Whereas specimens of permanent ceramic filled hybrid material showed a mean value of 363.45 ± 87.57 N.

Conclusions

In this in vitro study 3D-printed ceramic filled hybrid material and interim resin based on methacrylic acid esters showed an acceptable resistance to bite forces with no differences in fracture mechanism. Key words:CAD-CAM, dental resin, 3D printing.

Sociodemographic Factors and Implant Consideration by Patients Attending Removable Prosthodontics Clinics

Objective. This study is aimed at investigating the treatment options offered to and chosen by patients attending a student prosthodontics clinic and to investigate the effect of the sociodemographic background of participants on implant consideration. Material and Methods. A cross-sectional descriptive study was conducted on 200 participants including their socioeconomic background, treatment options presented, treatment preferences, and implant consideration. Bivariate tests (unpaired $t$ -test, chi-square, and Mann–Whitney test) and Spearman correlation were used for comparison of different socioeconomic groups according to treatment preferences (implant consideration versus conventional removable prosthesis). Results. Treatment options presented by dental students include 63.5% complete denture, 32% implants/removable dentures, and partial denture 4.5%. Conventional removable prostheses were mostly chosen due to low income. Implants were only considered by 26% of participants. Age and implant consideration had a significant negative correlation. No significant difference in gender and residency area on implant consideration was found. The chi-square test showed a significant difference between implant consideration and conventional removable prostheses in the various occupation groups. Conclusions. Low income is the main factor prohibiting patients from considering dental implants. Age and educational level may play a considerable role in considering dental implants. There should be more emphasis on dental students’ treatment planning education to include and explain dental implants as a treatment option for their patients in the prosthodontics clinic.

Assessment of quality of life in total edentulous patients rehabilitated with implants and fixed prosthesis

Aim: Tooth loss is very prevalent in Brazil, reflecting high demand for dental services, especially those related to oral rehabilitation. This study aimed to assess the quality of life in total edentulous patients rehabilitated with implants and fixed prosthesis. Methods: Thirty-two patients were evaluated before and after rehabilitation with dental implants and fixed prosthesis using the OHIP-14 questionnaire and the Visual Analogue Scale (VAS) after 6 months follow-up. Results: OHIP-14 revealed a significant improvement after treatment in all seven parameters and in the global score (P < 0.001). VAS presented positive results related to patient satisfaction regarding oral rehabilitation, except for the hygiene of the fixed dentures. Conclusion: At the end of this study, OHIP-14 scores decreased by 50% in most of the questions raised, and VAS presented positive results, except for hygiene of the fixed dentures, presenting an improvement in the quality of life of total edentulous patients after rehabilitation with implants and fixed prosthesis.

Comparing Masticatory Performance of Maxillary Mini Dental Implant Overdentures, Complete Removable Dentures and Dentate Subjects

Background: Mini dental implant (MDI) overdenture rehabilitation for the edentulous maxilla is a valuable, less invasive and affordable treatment alternative for complete removable dentures (CRD). However, comparative quantification of masticatory performance in different oral conditions are scarce. Purpose: This study compares objective masticatory performance of dentate groups, maxillary CRD and MDI overdentures and subjective masticatory performance in maxillary CRD and MDI overdentures. Materials and Methods: Four groups were defined, age 20+ dentate dental students (DS), age 50+ complete dentate subjects (DP), age 50+ maxillary CRD or MDI overdentures/dentate mandible. Objective masticatory performance was evaluated by measuring circular Variance of Hue (VOH) or the mixture degree of two-color chewing gum (Hue-check View Gum^® Test). Additionally, subjective masticatory comparison was investigated in the CRD and MDI groups, with a visual analogue scale (VAS) for different food consistencies and the Oral Health Related Quality of Life (OHRQL) OHIP-14 questionnaire. Results: The mean VOH was 0.11 (SD 0.50, range 0.05–0.27) for the dentate dental 20+ students, 0.13 (SD 0.08, range 0.03–0.31) for the 50+ dentate group (p = 0.774), 0.41 (SD 0.41, range 0.14–0.76) for the CRD group and 0.39 (SD 0.18, range 0.07–0.76) for the MDI group (p = 0.725). Based on the VAS scores, no improvement was found between the CRD and the MDI overdenture group (p > 0.050). The mean OHIP-14 total score was 12.10 (SD 15.87, range 0–56) for CRD, while the MDI group (p = 0.039) saw a significant improvement to 2.85 (SD 2.85, range 0–15). Conclusion: Comparable results in objective masticatory performance were registered in dentate 20+ and 50+ subjects with a remarkable inferior outcome for the CRD and MDI group. Compared to CRD, MDI overdentures revealed no substantial improvement in subjective and objective masticatory performance. However, for MDI a significant increase in OHRQL was apparent.

Comparison between CBCT superimposition protocol and S.T.A.P. method to evaluate the accuracy in implant insertion in guided surgery

BACKGROUND

The aim of this study is to evaluate the accuracy of implant placement using static guided surgery. Two methods of measuring accuracy were compared, the superimposition of CBCT and the non-radiological S.T.A.P. method.

METHODS

In this prospective clinical study 23 implants were placed with static surgical template using a flapless technique and post-extractive procedure. Six months after surgery, a post-operative CBCT was performed to assess the position of the implants and at the same time dental impressions were taken for the final prosthesis. The plaster models made at this stage have made it possible to obtain the position of the implants inserted using the probe technology. Pre-operative and post-operative data were superimposed, deviations in the three dimensions of the space were calculated. The differences between the two measurement methods were assessed.

RESULTS

The study showed no statistically significant differences between the two methods of measuring accuracy at the implant platform level, apex or angles. The average real deviation detected at the implant platform level is 1.16±0.58 mm with CBCT, 1.22±0.55 mm with the S.T.A.P. method; at the apex level is 1.48±0.98 mm with CBCT, 1.47±0.72 mm with the S.T.A.P. method. The average difference between CBCT and S.T.A.P. method for real deviation is 0.06±0.75 mm at the platform level and 0.007±1.24 mm at the apex level.

CONCLUSIONS

The study shows that measuring accuracy by S.T.A.P. method is comparable to that obtained by CBCT superimposition.

Ball versus Locator® Attachments: A Retrospective Study on Prosthetic Maintenance and Effect on Oral-Health-Related Quality of Life

Locator^® and ball attachments are well-established systems to attach overdentures to two inter-foraminal implants. This study aimed to evaluate differences between the two systems regarding prosthetic maintenance and patients’ oral-health-related quality of life (OHRQoL). Dental records of patients with a mandibular implant-retained overdenture were retrospectively analyzed. Prosthetic maintenance measures involving the denture suprastructure and attachment matrix and patrix were analyzed. Furthermore, the Oral Health Impact Profile-G14 (OHIP-G14) was used to evaluate OHRQoL. Results were analyzed by means of Kaplan–Meier analysis and Student’s t- and log-rank tests. The records of 122 patients were evaluated. Kaplan–Meier survival analysis revealed a significant difference between ball attachments (Group B; n patients = 47) and Locator^® attachments (Group L; n patients = 75) regarding the occurrence of denture fractures (p < 0.001) and events affecting the matrix (p = 0.028) and patrix (p = 0.030). Group L had a significantly lower total OHIP-G14 score than Group B (p = 0.002). The most common maintenance events were matrix-related and denture relining for both attachment systems. Group B required more maintenance measures than Group L. Moreover, patients in Group L had better OHRQoL than patients in Group B.

Oral Health Related Quality of Life of Patients Using Conventional Dentures versus Implant-Supported Overdentures

Objectives:

This study aimed to compare the oral health related quality of life (OHRQoL) of patients using conventional dentures versus implant-supported overdentures.

Materials and Methods:

This study evaluated the OHRQoL of 90 patients between 35 to 75 years who were selected from several public and private dental clinics in Tehran in 2018. Of all, 45 had conventional dentures of both jaws, and 45 had a mandibular overdenture supported by two implants at the site of mandibular canine teeth and a conventional maxillary denture. The OHRQoL of patients was determined using the Oral Health Impact Prfile-20 (OHIP-20). The questionnaire was translated to Persian, and its content validity and internal consistency were confirmed. Data were analyzed by one-way ANOVA, Mann-Whitney test, and independent t-test.

Results:

In the conventional denture group, 46.7% had good, 46.7% had moderate, and 6.6% had poor OHRQoL. These values were 55.6%, 37.8% and 6.6% in the overdenture group, respectively. Level of education had a significant correlation with the total score of OHIP-20 in both groups (P<0.05). But no significant association was noted between the residential status and gender of patients with different domains of OHRQoL (P>0.05) except for the psychological disability domain, which had a higher mean value in males with conventional dentures (P<0.05).

Conclusion:

Patients with a mandibular overdenture supported by two implants at the site of canine teeth and a conventional maxillary denture had higher OHRQoL than patients with conventional dentures of both jaws.

An Innovative Meta-Systematic Review into the Landscape of Literature and the Concluding Evidence on the Quality of Life of Patients Using Two Implant Supported Mandibular Complete Denture Prosthesis

Aim:

The aim of this systematic review is to analyze the existing evidence on the quality of life of patients completely edentulous in the mandible.

Materials and Methods:

A search questionnaire was formulated using population intervention comparison outcome (PICO) analysis, and a comprehensive search was initiated in PubMed Central, Medline, Cochrane, and Google Scholar databases for the related topics. Manuscripts published till December 2019 were included in this review. Out of the 63 articles obtained from searching all databases, 27 studies were excluded based on the title and abstract. Out of the remaining 36 studies, 12 were excluded based on the inclusion and exclusion criteria of our interest and 24 were included on the basis of core data.

Results:

One review author identified randomized trials meeting inclusion criteria for this review. Two review authors extracted data and assessed study quality. The oral health-related quality of life in completely edentulous mandibular patients wearing implant-supported overdentures was better when compared to conventional tissue-supported complete denture, and a minimum two implant-supported mandibular complete denture has sufficient improvement in oral health-related quality of life.

Conclusion:

There are about more than 170 reviews and clinical trials that have been published in support of the same for the past two decades. Thus, the clinicians may not be tempted in placing additional implants in well-formed mandibular edentulous ridges. To enhance the understanding of mandibular implant overdenture treatment, clinicians must scrutinize the existing evidence and formulate a protocol by striking a balance between efficient and evidence based treatment.

"Longitudinal Oral Health-Related Quality of Life in maxillary mini dental implant overdentures after 3 years in function"

OBJECTIVES

Longitudinal evaluation of Oral Health-Related Quality of Life (OHRQoL) during treatment of flaplessly placed, one-piece mini-dental-implants (MDIs) for maxillary overdentures is rarely investigated, nor is the impact of MDI failures.

MATERIAL AND METHODS

This multicenter prospective cohort study evaluated the 3-year outcome of 5-6 MDIs in the edentulous maxilla in patients above 50 years with dentate mandible. Provisional dentures were provided before final prosthetic connection was established at 6 months. Postoperative discomfort was assessed using a visual analogue score (VAS). OHRQoL was investigated using the Oral Health Impact Profile (OHIP)-14 at baseline (preoperatively), postoperatively, post-prosthetic connection and after 3 years in function.

RESULTS

164 (78.4%) of the 204 placed MDIs were still in situ after 3 years, in 29/31 patients. Two patients lost 5/6 MDIs resulting in two prosthetic failures (6.45%). With regard to pain, a score of 4.1/10 (SD 2.8) was recorded on day 1, and 1.1/10 (SD 1.7) on day 7. A decrease in total OHIP-14 scores was observed postoperatively (15.6; SD 12.8) as compared to baseline (21.3; SD 13.1), with improvement of OHRQoL. Furthermore, this was statistically significant at connection of the final prosthesis (7.3; SD 6.7) (p = .006). The OHIP-14 improved less (p = .011) when experiencing one or more implant losses (9.5; SD: 9.85), in comparison with no implant loss (20.7; SD: 13.97). A failure of one MDI did not affect OHIP-14 score (p = .658); however, multiple failures did (p = .007).

CONCLUSION

Maxillary MDI overdenture treatment yields significant OHRQoL improvement when at least 5 MDIs survive, preserving functional comfort.

Marginal Bone Level Changes and Oral Health Impact Profile (14) Score of Smokers Treated by Mandibular Mini Implant Overdentures: A 5-Year Follow-up Study

Objectives  Studies considered edentulous patients having smoking habit as a compromised oral condition. This research examined the value of using mini implant mandibular overdenture to maintain long-term satisfactory levels of oral health quality of life and marginal vertical bone loss.

Materials and Methods  Twenty-nine edentulous patients with smoking habit received four mini implants in the mandible loaded by overdentures. The present study monitored patients radiographically for vertical bone loss after (1 month, 1, 3, and 5 years) of treatment. Patients were also evaluated by oral health impact profile 14 (OHIP-14) pretreatment and at 1 and 5 years of treatment.

Statistical Analysis  Repeated measure analysis of variance with Bonferroni’s test as a post-hoc test was used to see the difference among time points. Independent sample t -tests were used to compare between anterior and posterior mini implant positions after 5 years of follow-up. OHIP-14 questionnaire was analyzed by Wilcoxon signed ranks for pairwise comparisons at different evaluation times. A Holm-Bonferroni correction method was used to control the familywise error rate.

Results  The mean of the bone height changes showed a significant difference between 1-month data and all other evaluation intervals while no significance was calculated among other evaluation intervals. Bone loss of the mini implants placed anteriorly was less than those placed posteriorly with a statistically significant difference. A significant reduction in the OHIP-14 score levels was observed between pretreatment and both 1 and 5 years of treatment. No significance was seen between the first and fifth year after treatment.

Conclusion  Mini implant overdenture could maintain satisfactory marginal bone level changes and oral health quality of life for patients with smoking habit after 5-year follow-up period.

Development and Validation of a Questionnaire Evaluating the Impact of Prosthetic Dental Treatments on Patients' Oral Health Quality of Life: A Prospective Pilot Study

Objectives: the aims of this study were the development of a novel questionnaire to assess the impact of prosthetic treatments on oral health-related quality of life (OHRQoL) and the performance of a prospective pilot study. Background: the currently preferred OHRQoL measurement tool is the oral health impact profile-49 (OHIP-49), a self-report questionnaire which mainly focuses on general effects related to oral health. Materials and methods: A total of 24 adult participants (9 females and 15 males) were recruited and asked to complete the novel questionnaire twice: once before the prosthetic treatment began and 4–6 weeks post-treatment. The assessment of the change in OHRQoL was based on the differences in participants’ answers before and after treatment. Data were analyzed using ANOVA with a repeated-measures method and t-tests. The reliability of the questionnaire was tested using Cronbach’s alpha and intraclass coefficient (ICC). Results: The questionnaire was found to be reliable (α ≥ 0.6), with “social disability” having the highest score (α = 0.868). All domains showed an improvement (α < 0.005) in OHRQoL scores after treatment. Conclusions: the novel questionnaire tested in this study was found to be reliable and convenient to use, and demonstrated that prosthetic treatments have a significant positive effect on OHRQoL post-treatment scores.

The Correlation of Clinical Outcomes (Marginal Bone Loss, Probing Depth, and Patient Satisfaction) With Different Prosthetic Aspects of Implant Overdentures: A Five-Year Retrospective Cohort Study

Implant overdentures increase retention, stability, support, and subsequently comfort and patient satisfaction with removable dentures. This study aimed to investigate the correlation of clinical outcomes (marginal bone loss, probing depth, and patient satisfaction) with different prosthetic aspects of mandibular implant overdentures. Seventy-four implant overdenture wearers who had received their overdentures between 1 to 5 years ago were selected using simple cluster sampling. The data investigated included mucosal health of the mouth, condition of peri-implant tissues, marginal bone loss (MBL), and patient satisfaction. The relationship of MBL and probing depth (PD) with independent variables was assessed by Pearson and Spearman's rho correlation coefficients. The comparisons of MBL, PD, patient satisfaction, and tissue irritation among different states of independent variables were done by analysis of covariance, Tukey and Tamhane post-tests, and chi-square tests (α = 0.05). A total of 186 implants were evaluated. The mean ages of participants and overdentures were 61.62 ± 9.28 (year) and 38.45 ± 16.64 (month), respectively. The survival rate and success rate were calculated to be 100% and 97.8%, respectively. Higher width of attached gingiva was correlated with less PD significantly (P = .006). Gingival index (P &lt; .001) and plaque index (P = .006) were correlated with PD positively. Mean MBL for those who needed matrix/patrix adjustment was significantly higher than that of those who did not need it (P = .025). Taking into account our small sample size, the results of this study suggest that healthy peri-implant mucosa is significantly correlated with the presence of attached gingiva and appropriate oral health care. Furthermore, patients receiving implant overdentures should be informed about the importance of regular recalls.

Maxillary implant overdentures retained by use of bars or locator attachments: 1-year findings from a randomized controlled trial

PURPOSE

Comparison of outcomes of maxillary implant overdentures retained by use of either locator attachments or bars in a 1-year randomized controlled trial.

METHODS

Fifty edentulous participants received four maxillary implants. They were allocated to two groups (n = 25) differing in type of prosthetic attachment used to retain the maxillary prosthesis: either locator attachments or bars were applied. After one year, implant and overdenture survival was assessed. Peri-implant hygiene (Plaque-index, presence of calculus), soft tissue conditions (Gingiva-index, Sulcus Bleeding-index and pocket probing depth) and patient satisfaction (oral health impact profile (OHIP-49), denture complaints questionnaire and general satisfaction score (GSS)) were compared. The peri-implant bone level was estimated using intra-oral radiographs (student T-test).

RESULTS

Implant survival was 96.7% in the locator group and 97.9% in the bar group. No overdentures had to be remade. Patient satisfaction was significantly greater in the bar group when rated by OHIP-49 sum score and by GSS. When comparing the denture complaints questionnaire and the separate OHIP-49 item scores, no significant difference was found. There was not a significant difference in hygiene and soft tissue conditions. Marginal bone loss was estimated 0.58 ± 0.71 mm for locators and 0.31 ± 0.47 mm for bars.

CONCLUSIONS

Maxillary overdentures on four implants retained by bars or locators were compared. Bone loss was within an acceptable range for both groups after 1 year. However, less bone was lost in the bar group. Even though both treatment options improved patient satisfaction, bars seem to be particularly beneficial with regard to OHIP-49 sum score.

Comparison of immediate and conventional loading protocols with respect to marginal bone loss around implants supporting mandibular overdentures: A systematic review and meta-analysis

Purpose

To compare marginal bone level changes (MBLCs) of immediately- and conventionally-loaded implants supporting a mandibular implant overdenture (IOD).

Materials and methods

Both electronic (MEDLINE, PubMed, and The Cochrane Library) and manual searches were conducted for all relevant studies published from 1 January 2000 to 1 November, 2017. Randomized controlled trials (RCTs) and prospective studies with a minimum follow-up of 12 months were selected. Studies which utilized implants narrower than 3 mm were excluded from analysis.

Results

Four studies met the criteria, with two evaluating horizontal bone loss. There were 70 patients in the test group (immediate loading) and 60 in the control group (conventional loading). Follow-up lasted 6–36 months, with MBLCs being interpreted from standardized periapical x-rays, panoramics or cone beam computed tomography. Each patient was given 2–3 implants.

After 6 and 12 months, the differences in MBLCs were 0.04 mm (95% CI: −0.21, 0.29) and 0. 00 mm (95% CI: −0.35, 0.36) respectively. Subgroup analysis of RCTs with 2 implants revealed group differences in MBLCs as 0.13 mm (95% CI: −0.22, 0.48) and that in horizontal bone loss as 0.04 mm (95% CI: −0.02, 0.10). No statistically significant differences were identified (p > 0.05).

Conclusion

The MBLCs of immediately-loaded implants for mandibular IODs seems comparable to those of conventional loading.

A retrospective study of the accuracy of template-guided versus freehand implant placement: A nonradiologic method

OBJECTIVE

The aim of this retrospective case study was to evaluate implant placement accuracy in inexperienced clinicians with use of a surgical guide template vs the freehand method for preoperatively planned implant position.

STUDY DESIGN

Oral implant therapy was performed by inexperienced dental practitioners (<20 implants placed) on eligible patients after cone beam computer tomography (CBCT)-based software planning. Two patients' groups were formed according to the surgical technique: guided and freehand implant placement. The casts used for the fabrication of reconstructions were scanned by using a 3-dimensional (3D) laser scanner, the implant positions were superimposed with preoperative planning data, and the 3D deviations were calculated.

RESULTS

Twenty adult patients were included in this retrospective study (20 guided and 21 freehand implant placements). Mean calculated deviations with use of a surgical guide template were significantly lower compared with those of the freehand method with regard to angulation (P = .002), apical position (P = .002), and basal position (P = .012). No significant differences in implant placement accuracy were detected between the groups according to the implant position (premolars/molars; upper jaw/lower jaw) (P > .05).

CONCLUSIONS

Computer-aided planning and the use of surgical guides in accordance with CBCT images may help inexperienced clinicians to place implants with high accuracy.

Effect of implant- and occlusal load location on stress distribution in Locator attachments of mandibular overdenture. A finite element study

PURPOSE

The aim of this study is to evaluate and compare the stress distribution in Locator attachments in mandibular two-implant overdentures according to implant locations and different loading conditions.

MATERIALS AND METHODS

Four three-dimensional finite element models were created, simulating two osseointegrated implants in the mandible to support two Locator attachments and an overdenture. The models simulated an overdenture with implants located in the position of the level of lateral incisors, canines, second premolars, and crossed implant. A 150 N vertical unilateral and bilateral load was applied at different locations and 40 N was also applied when combined with anterior load at the midline. Data for von Mises stresses in the abutment (matrix) of the attachment and the plastic insert (patrix) of the attachment were produced numerically, color-coded, and compared between the models for attachments and loading conditions.

RESULTS

Regardless of the load, the greatest stress values were recorded in the overdenture attachments with implants at lateral incisor locations. In all models and load conditions, the attachment abutment (matrix) withstood a much greater stress than the insert plastic (patrix). Regardless of the model, when a unilateral load was applied, the load side Locator attachments recorded a much higher stress compared to the contralateral side. However, with load bilateral posterior alone or combined at midline load, the stress distribution was more symmetrical. The stress is distributed primarily in the occlusal and lateral surface of the insert plastic patrix and threadless area of the abutment (matrix).

CONCLUSION

The overdenture model with lateral incisor level implants is the worst design in terms of biomechanical environment for the attachment components. The bilateral load in general favors a more uniform stress distribution in both attachments compared to a much greater stress registered with unilateral load in the load side attachments. Regardless of the implant positions and the occlusal load application site, the stress transferred to the insert plastic is much lower than that registered in the abutment.

Comparing the Quality of Life of Patients Requesting Dental Implants Before and After Implant

Background and Objectives:

Tooth loss is a serious life event that impairs two important functions, namely, eating and speaking, and has significant side effects on different aspects of quality of life. These effects are internalized by the individual. The present study aimed to compare the quality of life (QOL) of patients requesting dental implants before and after implant.

Materials and Methods:

This analytical cross-sectional study was conducted on patients referred to the Mashhad faculty of Dentistry and private clinics with dental implants in 2015. Patient Quality Of Life (QOL) was assessed using the Oral Impact on Daily Practice (OIDP) questionnaire. Data were analyzed using SPSS software.

Results:

In this study, the most common problems reported by patients were eating (78%), smiling, laughing, and embarrassment (53%) before surgery. The quality of life associated with eating; speaking clearly; clean teeth or dentures; light physical activities, such as working at home, going out to work or meeting others; smiling; laughing; showing teeth without discomfort and embarrassment; emotional conditions, such as becoming upset quicker than usual, enjoying communication with others (i.e., friends, relatives and neighbors); and job-related activities significantly increased after surgery, but QOL associated with the amount of sleep and resting did not improve. No significant association was noted between quality of life after implantation and place of residence, education and gender.

Conclusion:

In this study, implants had a favorable impact on a patient’s quality of life.

Effect of UV Photofunctionalization on Osseointegration in Aged Rats

OBJECTIVES

This study evaluated the effect of photofunctionalization on osseointegration under the biologically adverse conditions of aging.

MATERIALS

First of all, bone marrow-derived osteoblastic cells from young (8 weeks old) and aged (15 months old) rats were biologically characterized. Then, the osteoblasts from aged rats were seeded on titanium discs with and without photofunctionalization, and assessed for initial cell attachment and osteoblastic functions. Titanium mini-implants, with and without photofunctionalization, were placed in the femur of aged rats, and the strength of osseointegration was measured at week 2 of healing. Periimplant tissue was examined morphologically and chemically using scanning electron microscopy and energy dispersive x-ray spectroscopy, respectively.

RESULTS

Cells from the aged rats showed substantially reduced biological capabilities compared with those derived from young rats. The cells from aged rats showed significantly increased cell attachment and the expression of osteoblastic function on photofunctionalized titanium than on untreated titanium. In addition, the strength of osseointegration was increased by 40% in aged rats carrying the photofunctionalized implants. Robust bone formation was observed around the photofunctionalized implants with strong elemental peaks of calcium and phosphorus, whereas the tissue around untreated implants showed weaker calcium and phosphate signals than titanium ones.

CONCLUSION

These in vivo and in vitro results corroboratively demonstrate that photofunctionalization is effective for enhancing osseointegration in aged rats.

Oral health related quality-of-life outcomes of partially edentulous patients treated with implant-supported single crowns or fixed partial dentures

BACKGROUND

Oral health-related quality of life (OHRQoL) is afflicted by different variables. Limited information is available regarding the impact of different phases of implant therapy on OHRQoL of edentulous patients. This study was carried out to assess the OHRQoL of patients treated with implant-supported single crowns or fixed partial dentures.

MATERIAL AND METHODS

A total of 79 healthy partially edentulous subjects needing implant therapy were incorporated in this study. Before placement of the implants, the subjects were instructed to fill the original version of OHIP questionnaire. Subsequently patients received titanium oral implants of the ITI® Dental Implant System. After 1st, 2nd and 3rd year of implant placement, patients filled the same OHIP-49 questionnaire. In this manner the impact of implant therapy on OHRQoL by putting in comparison pre- and post-treatment OHIP-49 scores was assessed. Statistical analyses were performed using Statistical Package for the Social Science software (SPSS, version 22, Chicago, IL, USA). Paired t test and Unpaired t test were performed and a statistical significance was set at 5% level of significance (p<0.05).

RESULTS

Functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability were significantly decreased from baseline to 1st year (p<0.05) except handicap (p>0.05). All variables were also significantly decreased from baseline to 2nd year and 3rd year (p<0.05). There were no significant differences dependent on gender with respect to OHIP (p>0.05). Patients aged less than 60 years and more than 60 years of age groups differed significantly with respect to OHIP scores measured at 1st year, 2nd year and at 3rd year of implant placement (p<0.05).

CONCLUSIONS

Decrease in pre- and post-treatment OHIP scores OHIP demonstrated the significant increase in the OHRQoL after the therapy, which suggested increased levels of patient satisfaction. Key words:Edentulism, dental implants, Oral health-related quality-of-life.

Assessment and Evaluation of Quality of Life (OHRQoL) of Patients with Dental Implants Using the Oral Health Impact Profile (OHIP-14) - A Clinical Study

INTRODUCTION

Peri-implant tissue health is a requisite for success of dental implant therapy. Plaque accumulation leads to initiation of gingivitis around natural teeth and peri-implantitis around dental implants. Peri-implantitis around dental implants may result in implant placement failure. For obtaining long-term success, timely assessment of dental implant site is mandatory.

AIM

To assess and evaluate Quality of Life (OHRQoL) of individuals with dental implants using the Oral Health Impact Profile (OHIP-14).

MATERIALS AND METHODS

Total 92 patients were evaluated for assessment of the health of peri-implant tissues by recording, Plaque Index (PI), Probing Pocket Depth (PD), Bleeding On Probing (BOP) and Probing Attachment Level (PAL) as compared to contra-lateral natural teeth (control). In the same patients Quality of Life Assessment was done by utilizing Oral Health Impact Profile Index (OHIP-14).

RESULTS

The mean plaque index around natural teeth was more compared to implants and it was statistically significant. Other three dimensions mean bleeding on probing; mean probing attachment level and mean pocket depth around both natural teeth and implant surfaces was found to be not statistically significant. OHIP-14 revealed that patients with dental implants were satisfied with their Oral Health-Related Quality of Life (OHRQoL).

CONCLUSION

Similar inflammatory conditions are present around both natural teeth and implant prostheses as suggested by results of mean plaque index, mean bleeding on probing, mean pocket depth and mean probing attachment level, hence reinforcing the periodontal health maintenance both prior to and after incorporation of dental implants. Influence of implant prostheses on patient's oral health related quality of life (as depicted by OHIP-14) and patients' perceptions and expectations may guide the clinician in providing the best implant services.

Comparison of masticatory efficiency, patient satisfaction for single, two, and three implants supported overdenture in the same patient: A pilot study

STATEMENT OF PROBLEM

Over 30% of the world population suffers from edentulism. Implant supported overdenture have been a relatively successful treatment option for edentulism and have shown to slowed the rate of residual resorption and maintain the vertical height of the residual.

PURPOSE

The purpose of this study was to measure patient masticatary efficiency and satisfaction with the mandibular one-, two-, and three-implant-retained overdenture therapy when compared with conventional denture in a the same patients.

MATERIALS AND METHODS

Ten complete edentulous patients, who were wearing conventional complete dentures, were involved in this study. Three single piece endosseous implant of 3.0 mm in diameter and 13 mm in length were surgically placed in the mandible in the region of B, C, and D. Mandibular denture was connected for single, two, and three implant supported overdenture periodically and checked for masticatory efficiency using a bite gauge and patient satisfaction using a questionnaire.

RESULTS

Statistical analysis was done using Wilcoxon signed rank test. Four groups of bite forces when compared to each other. Group 1 was compared with Group 2, with the statistical value showing significance. Signed rank test showed no significance (0.268) when Group 2 was compared with Group 3. When Group 3 was compared with Group 4, and Group 1 compared with Group 4, rank test showed significant values. Four groups were compared with each other for patient satisfaction, Group 1 was compared with Group 2, with the statistical value showing no significance.

CONCLUSIONS

A single midline implant supported overdenture can be considered as a suitable and cost-effective treatment option over conventional denture. The study concludes that masticatory efficiency of this single midline implant supported overdenture is better than the conventional complete denture.

Evaluation of retention forces and resistance to fatigue of attachment systems for overdentures: plastic and metal components

PURPOSE

To compare retention forces of 3 overdenture attachment systems with metal and plastic components.

MATERIALS AND METHODS

Four samples of each system evaluated (Ball-Attachment [metal]; O-Ring, and ERA [plastic]) were prepared and underwent fatigue and retention force in a universal testing machine. Maximum retention force (N) was measured at 6 time points (from 0 to 36 months-0.5 mm/min). Two-way analysis of variance and the Tukey test were used (α = 0.05).

RESULTS

The Ball-Attachment group showed the highest retention values, statistically greater than the other systems, without differences during the trial (42.75-44.75). The ERA group had intermediate values and a statistically significant decrease during the trial (20.75-14). The lowest retention forces were found for the O-Ring group (13.75-11.75), with no statistical differences during the trial.

CONCLUSION

Retention forces are significantly affected by abutment type because the metal retainer was more retentive than plastics, possibly providing better fixation of the prosthesis in position, and more difficult to remove. After 6 months of simulation, retentiveness of both plastic components was similar. There was no fracture of any component.

Masticatory efficiency and oral health-related quality of life with implant-retained mandibular overdentures

OBJECTIVES

To evaluate masticatory efficiency (ME) and oral health-related quality of life (OHRQoL) in patients rehabilitated with implant-retained mandibular overdentures.

METHODS

In this randomized controlled clinical trial, 50 edentulous patients visiting the Implant Center and Department of Prosthodontics, West China College of Stomatology, Sichuan University, Chengdu, China between June 2010 and June 2012 were selected and received 2 implant-retained mandibular overdenture treatments. All patients were rehabilitated with maxillary complete dentures. The ME and OHRQoL were determined both one month before the mandibular complete denture was anchored to the osseointegrated implants, and 6 months after anchoring. Paired t-tests were used to compare means of ME, and oral health impact profile-49 (OHIP-49)  domains scores between pre- and post-implant. Linear regression models were utilized to seek correlations between ME and OHIP domains scores.

RESULTS

The ME increased from pre- to post-implant retained mandibular overdentures significantly (p&lt;0.001). The total OHIP score and 4 subscales scores were changed significantly from pre- to post-implant; namely, functional limitation, psychological discomfort, physical disability, and physical pain. The total OHIP score, functional limitation, physical disability, and physical pain subscale scores were related to ME.

CONCLUSION

Implant-retained mandibular over dentures can significantly improve patients' ME and OHRQoL. The improvement in OHRQoL is mainly because of the improved ME. An improved chewing experience, and pain relief also contributes to improvement of OHRQoL.