-
Journal of the American Dental... Aug 2019Management of the full and partially edentulous arch requires an understanding regarding the amount of vertical and horizontal restorative space that is needed for...
BACKGROUND
Management of the full and partially edentulous arch requires an understanding regarding the amount of vertical and horizontal restorative space that is needed for different types of dental implant prostheses. Failure to design a prosthetic construct without considering space issues can result in a rehabilitation with diminished stability, poor esthetics, and inadequate contours. Therefore, available restorative volume must be computed before initiating therapy to ensure proper prosthesis design.
TYPES OF STUDIES REVIEWED
The authors searched the dental literature for articles that addressed space requirements for different types of dental implant prostheses and found a few on this subject.
RESULTS
The dental literature indicates there is a 3-dimensional hierarchy of restorative space necessary for different types of implant constructs. The minimum amount of vertical space required for implant prostheses is as follows: fixed screw-retained (implant level): 4 through 5 millimeters; fixed screw-retained (abutment level): 7.5 mm; fixed cement-retained: 7 through 8 mm; unsplinted overdenture: 7mm; bar overdenture: 11 mm; and fixed screw-retained hybrid: 15mm. These dimensions represent the minimal amount of vertical rehabilitative space that can accommodate the above implant prostheses. With respect to horizontal space, computations are needed to account for the discrepancy between an implant and tooth position.
CONCLUSIONS AND PRACTICAL IMPLICATIONS
Restorative spaces for each type of prostheses are restoration specific and should be considered during treatment planning to facilitate proper case selection and enhance patient satisfaction.
Topics: Dental Implantation; Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture, Overlay; Humans
PubMed: 31352966
DOI: 10.1016/j.adaj.2019.04.015 -
Journal of Oral Science Oct 2021The recent literature on maxillary implant overdenture (IOD) was reviewed in order to clarify its predictability and establish treatment guidelines. Electronic searches... (Review)
Review
The recent literature on maxillary implant overdenture (IOD) was reviewed in order to clarify its predictability and establish treatment guidelines. Electronic searches were performed using PubMed, and articles about maxillary IOD written after 1990 were reviewed, focusing on the following items: I. implant survival rate, II. maxillary IOD survival rate, III. number of implants, IV. attachment type, V. follow-up period, VI. implant system, and VII. opposing dentition. The review revealed an implant survival rate of 61-100% and an overdenture survival rate of 72.4-100%. The attachments used included bars, balls, locators, and telescope crowns. The minimum and maximum observation periods were 12 months and 120 months, respectively, and the number of implants used for supporting IOD ranged from 2 to 8. At present, there is no strong evidence to indicate that maxillary IOD is clearly superior for all the items examined. However, the existing data indicate that maxillary IOD has almost the same therapeutic effect as fixed implant superstructures, and is a treatment option that can be actively adopted for patients in whom fixed superstructures cannot be applied for various reasons.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Overlay; Humans; Maxilla
PubMed: 34408111
DOI: 10.2334/josnusd.21-0087 -
Journal of Dental Research Aug 2016This systematic review and meta-analysis aimed to evaluate the survival rate of ceramic and resin inlays, onlays, and overlays and to identify the complication types... (Meta-Analysis)
Meta-Analysis Review
This systematic review and meta-analysis aimed to evaluate the survival rate of ceramic and resin inlays, onlays, and overlays and to identify the complication types associated with the main clinical outcomes. Two reviewers searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials for articles published between 1983 through April 2015, conforming to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews. Clinical studies meeting the following criteria were included: 1) studies related to resin and ceramic inlays, onlays, and overlays; 2) prospective, retrospective, or randomized controlled trials conducted in humans; 3) studies with a dropout rate of less than 30%; and 4) studies with a follow-up longer than 5 y. Of 1,389 articles, 14 met the inclusion criteria. The meta-regression indicated that the type of ceramic material (feldspathic porcelain vs. glass-ceramic), study design (retrospective vs. prospective), follow-up time (5 vs. 10 y), and study setting (university vs. private clinic) did not affect the survival rate. Estimated survival rates for glass-ceramics and feldspathic porcelain were between 92% and 95% at 5 y (n = 5,811 restorations) and were 91% at 10 y (n = 2,154 restorations). Failures were related to fractures/chipping (4%), followed by endodontic complications (3%), secondary caries (1%), debonding (1%), and severe marginal staining (0%). Odds ratios (95% confidence intervals) were 0.19 (0.04 to 0.96) and 0.54 (0.17 to 1.69) for pulp vitality and type of tooth involved (premolars vs. molars), respectively. Ceramic inlays, onlays, and overlays showed high survival rates at 5 y and 10 y, and fractures were the most frequent cause of failure.
Topics: Ceramics; Composite Resins; Dental Materials; Dental Restoration Failure; Denture, Overlay; Humans; Inlays
PubMed: 27287305
DOI: 10.1177/0022034516652848 -
Journal of Prosthodontic Research Jan 2018Several studies reported better outcomes when restoring edentulous mandible with unsplinted IODs compared to CCDs; however, it is not clear if these outcomes remain when... (Comparative Study)
Comparative Study Meta-Analysis
PURPOSE
Several studies reported better outcomes when restoring edentulous mandible with unsplinted IODs compared to CCDs; however, it is not clear if these outcomes remain when the full literature is considered. The aim of this systematic review is to compare conventional complete dentures (CCDs) to unsplinted implant-retained overdentures (IODs) with regard to efficacy, satisfaction and quality of life.
STUDY SELECTION
The main question addressed was: How do CCDs compare to unsplinted IODs with regard to efficacy, satisfaction and quality of life? Three databases were electronically searched to identify articles comparing CCD to unsplinted IOD. Twenty-six articles were selected and reviewed in full. Of these selected articles, twenty-five compared CCDs restoring function in both arches to a maxillary CCD opposing a mandibular IOD retained by two unsplinted implants. Only one articles compared a maxillary CCDs to a maxillary IOD.
RESULTS
Outcome measures varied among the studies, including the Oral Health Impact Profile (OHIP), visual analogue scales (VAS), and masticatory performance tests. Overall, IODs were associated with significantly better patient's masticatory performance and quality of life as indicated by Oral Health as Related to Quality of Life (OHRQoL). Mandibular unsplinted IODs were more likely than CCDs to be associated with improved OHRQoL for edentulous patients and were associated with significantly higher ratings of overall satisfaction, comfort, stability, ability to speak and ability to chew.
CONCLUSIONS
Results of this systematic review indicate the superiority of IODs retained by two unsplinted mandibular implants when compared to CCDs with regards to efficacy, satisfaction and quality of life.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Complete; Denture, Overlay; Humans; Jaw, Edentulous; Mandible; Mastication; Patient Satisfaction; Quality of Life
PubMed: 28666845
DOI: 10.1016/j.jpor.2017.06.004 -
Periodontology 2000 Oct 2014The current review was undertaken to obtain a better understanding of the knowledge base of implant-assisted complete dental prostheses (fixed and removable) in the... (Review)
Review
The current review was undertaken to obtain a better understanding of the knowledge base of implant-assisted complete dental prostheses (fixed and removable) in the treatment of the completely edentulous maxilla or mandible. Indications, advantages and disadvantages, complications and maintenance issues, as well as the cost-effectiveness of both treatments, are discussed to help clinicians in their therapeutic decision-making. In summary, when indicated and depending on the patients' needs, both removable and fixed implant-assisted prostheses are highly safe, reliable and satisfactory treatment modalities for the rehabilitation of edentulous jaws. Careful and precise treatment planning is highly recommended to assist the clinician in preventing potential prosthetic failures. The review also reveals that there is still a need for data, generated using robust research methods, on some patient-based and clinical outcomes.
Topics: Decision Making; Dental Implants; Dental Prosthesis, Implant-Supported; Denture Design; Denture, Complete; Denture, Overlay; Humans; Jaw, Edentulous; Patient Care Planning; Patient Satisfaction; Treatment Outcome
PubMed: 25123765
DOI: 10.1111/prd.12041 -
Primary Dental Journal Sep 2020Whilst increasing numbers of older people retain natural teeth, a sizable proportion of older people are still edentate. Replacement of missing teeth is important for...
Whilst increasing numbers of older people retain natural teeth, a sizable proportion of older people are still edentate. Replacement of missing teeth is important for function, aesthetics and to facilitate social interactions. The process of providing oral rehabilitation for edentate older adults can be challenging, but clinicians can utilise a number of treatment options including removable or implant retained prostheses. In this article, complete denture construction will be described using both conventional and copy denture techniques. Recent innovations in the process for constructing complete dentures using computer aided design and manufacturing (CAD-CAM) techniques will also be discussed. Dental implants can be used to help retain removable complete prostheses for edentate patients and the use of implant-retained overdentures is presented as a treatment alternative.
Topics: Aged; Aged, 80 and over; Computer-Aided Design; Dental Prosthesis, Implant-Supported; Denture, Complete; Denture, Overlay; Humans
PubMed: 32940588
DOI: 10.1177/2050168420943410 -
Dental Clinics of North America Jan 2015Implant-supported removable prostheses improve patients' satisfaction with treatment and quality of life. Improvements in the implant's surface and in attachment... (Review)
Review
Implant-supported removable prostheses improve patients' satisfaction with treatment and quality of life. Improvements in the implant's surface and in attachment elements have made this treatment method very successful. However, some biological and mechanical complications remain. Mechanical complications associated with implant-supported overdentures and implant-supported removable partial dentures are loss of retention of attachment systems, the need to replace retention elements and to reline or repair the resin portion of the denture, and implant fracture. Despite their success, implant-supported removable prostheses require periodic maintenance.
Topics: Biomechanical Phenomena; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture Bases; Denture Rebasing; Denture Repair; Denture Retention; Denture, Overlay; Denture, Partial, Removable; Humans
PubMed: 25434567
DOI: 10.1016/j.cden.2014.08.001 -
Dentistry Today Mar 2016
Topics: Dental Implants; Dental Materials; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Wear; Denture Design; Denture Retention; Denture, Overlay; Humans; Patient Care Planning; Zirconium
PubMed: 27039539
DOI: No ID Found -
Minerva Stomatologica Feb 2017When the patient cannot be rehabilitated with a fixed denture, or when he does not succeed in adapting to a traditional removable denture, a possible alternative... (Review)
Review
When the patient cannot be rehabilitated with a fixed denture, or when he does not succeed in adapting to a traditional removable denture, a possible alternative solution consists in the use of a limited number of implants, placed in strategic positions in the arches of the patient, and subsequently connected to their residual teeth. The aim of this review is to evaluate the progress made on connections between teeth and implants in removable denture, to analyze their advantages and disadvantages and to compare the survival rate, both of the teeth and of the implants used as abutments, present in the various studies taken into examination, with the aim of being able to evaluate the effectiveness of this rehabilitative option. The concept of preserving residual teeth, even if these are unfavorably distributed, and inserting a minimum number of implants in strategic positions, thanks to which an area of favorable support for the denture can be created, seems reasonable; this will guarantee a better adaptation of the patient to the denture, as well as an improvement in the quality of life. The study of articles present in literature suggests that the survival rate of the implants in removable dentures, supported by teeth and implants through traditional systems of anchorage, appears to be quite high. However, further studies with a higher level of evidence, more representative test subjects and a longer follow-up period are necessary, in order to confirm the validity of this rehabilitative solution.
Topics: Crowns; Dental Abutments; Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Denture Design; Denture, Overlay; Denture, Partial, Removable; Equipment Failure; Humans; Jaw, Edentulous, Partially; Quality of Life; Stress, Mechanical
PubMed: 27583529
DOI: 10.23736/S0926-4970.16.03953-9 -
British Dental Journal Aug 2021The ability to provide high-quality complete dentures is a key skill for the general dental practitioner. The introduction of new implant attachments and dental...
The ability to provide high-quality complete dentures is a key skill for the general dental practitioner. The introduction of new implant attachments and dental technologies has opened the possibility of a wide variety of treatment options when considering implant-supported overdentures (ISODs).A thorough understanding of the advantages and disadvantages of ISODs is essential to ensuring appropriate treatment planning, consent and maintenance. Part one of this paper discussed the role of ISODs and the different attachment systems available. This second part will explore the relevant treatment planning considerations and maintenance requirements.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Dentists; Denture Retention; Denture, Overlay; Humans; Mandible; Professional Role
PubMed: 34385644
DOI: 10.1038/s41415-021-3278-3