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The International Journal of... 2022To compare the speaking space, perceived rotational movement during chewing, and oral health-related quality of life (OHRQoL) of elderly people rehabilitated with new...
PURPOSE
To compare the speaking space, perceived rotational movement during chewing, and oral health-related quality of life (OHRQoL) of elderly people rehabilitated with new conventional complete dentures (CDs) and single-implant mandibular overdentures (SIMOs) using a paired design. Patient expectations for SIMO use were also evaluated.
MATERIALS AND METHODS
The participants were 22 elderly users of unsatisfactory CDs. They received new sets of conventional CDs, and assessment was performed after 2 months of use. Speaking space was recorded with a kinesiograph while participants read a list of words. Participants were asked two questions about perceived posterior rotational denture movement during chewing. The Dental Impact on Daily Living (DIDL) questionnaire was used to examine OHRQoL, and a visual analog scale was used to quantify participants' SIMO expectations. Subsequently, the mandibular CDs were converted to SIMOs, and the assessment was repeated after 2 months of use. Speaking space and OHRQoL data were submitted to ANOVA and Student t test, and perceived mandibular movement and expectation data were examined using likelihood-ratio chi-square test.
RESULTS
The speaking space and perceived rotational movement did not differ between CD and SIMO use. General performance and eating restriction DIDL scores increased after SIMO insertion. Participants' SIMO expectations regarding speaking, cleaning, esthetics, and general aspects were met.
CONCLUSION
Relative to CD use, SIMO use did not change the speaking space or perceived rotational movement when chewing among elderly patients. It improved OHRQoL via enhancement of two DIDL dimensions and met most elderly patients' expectations.
Topics: Humans; Aged; Mastication; Motivation; Denture, Overlay; Quality of Life; Patient Satisfaction; Dental Prosthesis, Implant-Supported; Esthetics, Dental; Denture, Complete; Mandible; Denture Retention
PubMed: 36645860
DOI: 10.11607/ijp.7901 -
Journal of Esthetic and Restorative... Jan 2021Overdenture therapy is an important option for implant rehabilitation. However, numerous reports suggest that mechanical/technical complications and failures can limit...
OBJECTIVE
Overdenture therapy is an important option for implant rehabilitation. However, numerous reports suggest that mechanical/technical complications and failures can limit therapeutic success. The goal of this report is to illustrate a digital approach to design and construction of a robust overdenture with high-esthetic value.
MATERIALS AND METHODS
Beginning with new denture design to establish esthetic parameters, 3D modeling of a metal framework and the denture teeth are completed in a connected manner. This enables connection of rapidly printed, prototype dentition that is attached directly to the framework without intervening wax or acrylic components. Following evaluation of the dentition and required adjustments, the final dentition is milled from resin and processed to the selective laser sintered framework.
RESULTS
The advantages of the digital workflow include the control of dimensions and strength of the framework, the esthetic relationship of the framework to the dentition and the facilitation of esthetic try-in of the dentition.
CONCLUSION
Enhancing a robust overdenture can be readily achieved using a digital workflow.
CLINICAL SIGNIFICANCE
The use of digital technology enables the clinical team to plan and produce prostheses with dimensions and contours that support long-term function and esthetics. The clinical chair time can be potentially reduced by use of digital design that facilitates try-in and reduces major errors by improved communication between the patient, dentist, and technician.
Topics: Computer-Aided Design; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Esthetics, Dental; Humans; Workflow
PubMed: 33484047
DOI: 10.1111/jerd.12711 -
Clinical Implant Dentistry and Related... Apr 2018Implant-supported overdenture is one of the most predictable treatment options used in complete edentulism. However, differences have been reported between bar and ball... (Review)
Review
BACKGROUND
Implant-supported overdenture is one of the most predictable treatment options used in complete edentulism. However, differences have been reported between bar and ball attachments used to retain overdentures in terms of patient satisfaction and prosthesis retention.
PURPOSE
The purpose of this study is to compare the effectiveness of bar and ball attachments for conventionally loaded implant-supported overdentures in completely edentulous patients to improve patient satisfaction and prosthesis retention.
MATERIALS AND METHODS
We conducted the review according to the Cochrane methods and following MECIR standards. We searched Cochrane Oral Health Group Trial register, Cochrane Central Register of Controlled Trials, MEDLINE, and the WHO ICTRP (March 31, 2017). Two review authors assessed trials for inclusion and risk of bias, extracted data, and checked for accuracy. We have expressed results as risk ratio or mean differences, together with their 95% confidence intervals.
RESULTS
We included 10 trials (465 participants). After 5 y, one trial reported higher patient satisfaction when bar attachment was used (MD 1.30, 95% CI 0.20-2.40), and reported no difference between both systems in prosthesis retention (MD -0.90, 95% CI -1.90 to 0.10). Two trials reported no implant failures after 1 and 5 y in both attachments. Downgrading of evidence was based on the unclear risk of bias of included studies and the wide CI crossing the line of no effect.
CONCLUSIONS
There is insufficient evidence to support bar or ball attachment to be used with implant-supported overdentures in completely edentulous patients to improve patient satisfaction and prosthesis retention (PROSPERO 2014:CRD42014014594).
Topics: Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Overlay; Female; Humans; Male; Mouth, Edentulous
PubMed: 29071777
DOI: 10.1111/cid.12551 -
The Journal of Prosthetic Dentistry Oct 2018Acrylic resin overdenture bases usually fracture because of stress concentrations at the area of the abutments.
STATEMENT OF PROBLEM
Acrylic resin overdenture bases usually fracture because of stress concentrations at the area of the abutments.
PURPOSE
The purpose of this study was to evaluate the reinforcing effect of bidirectional woven electrical glass (E-glass) fiber weaves with a different number of layers and different locations on the load-bearing capacity of simulated Locator-retained overdenture specimens.
MATERIAL AND METHODS
Test specimens with a centrally located metal housing for a Locator stud attachment were fabricated from autopolymerizing acrylic resin (polymethylmethacrylate based) and reinforced with bidirectional woven E-glass fiber layers. The control group specimens were fabricated without fiber reinforcement. The 2L group had 2 layers of E-glass fiber weaves and was divided according to the fiber location within the specimens as follows: 2L-A subgroup with 2 fiber layers above the metal housing; 2L-N subgroup with 2 fiber layers adjacent to the housing; and 2L-A+2L-N subgroup with 2 fiber layers above and 2 fiber layers adjacent to the housing. The 4L group had 4 layers of E-glass fiber weaves and was divided according to the fiber location as follows: 4L-A subgroup with 4 fiber layers above the housing; 4L-N subgroup with 4 fiber layers adjacent to the housing; and 4L-A+4L-N subgroup with 4 fiber layers above and 4 fiber layers adjacent to the housing. Dry specimens were submitted to a 3-point static loading test, and the mean flexural strength, flexural modulus, and strain values were analyzed with 1-way ANOVA and Tukey post hoc tests (α=.05). Two-way ANOVA was conducted to detect the influence of the number and location of the reinforcing layers (α=.05).
RESULTS
The results revealed a significant difference (P<.001) in flexural strength values between the control group (92.4 ±14 MPa) and the 2 subgroups, 4L-A (116 ±7.3 MPa) and 4L-A+4L-N (117.1 ±6 MPa), with a significant effect only from the number of the reinforcing layers (P<.001) and not the location (P=.153). No significant differences were found with flexural modulus (P=.195) and strain values (P=.174) among the tested groups.
CONCLUSIONS
The load-bearing capacity of a Locator-retained overdenture can be significantly increased by placing 4 layers of bidirectional woven E-glass fiber weaves either only above the metal housing or in both locations above and adjacent to the metal.
Topics: Dental Implant-Abutment Design; Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Denture, Complete; Denture, Overlay; Glass; Humans; In Vitro Techniques; Weight-Bearing
PubMed: 29961629
DOI: 10.1016/j.prosdent.2018.04.009 -
Dental and Medical Problems 2023The ball attachments and their O-rings used for the retention and stabilization of overdentures showed a decrease in retention as the number of cycles increased. This... (Review)
Review
The ball attachments and their O-rings used for the retention and stabilization of overdentures showed a decrease in retention as the number of cycles increased. This fact resulted in a decrease in the retention of the prosthesis. The purpose of this study was to evaluate the fatigue resistance of ball attachments through a systematic review. An electronic search was performed using the Cochrane Library, LILACS, PubMed, ScienceDirect, and Web of Science databases. The search was conducted based on the PICOS framework. The inclusion criteria involved in the search comprised research articles written in English and published between the years 2000 and 2020. In the final selection, 18 articles were included in the review. Most of these studies performed the fatigue retention tests using parallel implants without angles. However, some studies used different angles to analyze the fatigue retention values. With the passage of time, the wear results in deformation and, as a consequence, a decrease in the retention of most attachments, leading to treatment failure. The main factor to be considered is the loss of retention of these components and their low durability. The loss of retention is due to large extent to the materials used to manufacture the attachments and O-rings, the size and angulation of the implants, and the length of the prosthesis. Future research is needed to further elucidate the reasons for the failure of the attachments.
Topics: Humans; Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Overlay
PubMed: 37023344
DOI: 10.17219/dmp/146719 -
Brazilian Dental Journal Sep 2020This cross-sectional observational study with 24 patients evaluated differences in bite force (BF) and masticatory performance (MP) between conventional complete denture...
This cross-sectional observational study with 24 patients evaluated differences in bite force (BF) and masticatory performance (MP) between conventional complete denture (CCD) and implant mandibular overdenture (IMO) users and the correlation between these variables. The BF test was performed bilaterally with an occlusal force device. During the MP test, patients were asked to chew Optocal particles for 40 cycles. The Shapiro Wilk test was employed to verify the normality of the data, the student t test to identify differences between groups, and Pearson's correlation to investigate interrelationships between variables. A multiple linear regression was subsequently performed via the stepwise method. P values ≤0.05 were considered statistically significant. Unlike IMO users, CCD users presented a significant difference (25.6%) in BF between the dominant and non-dominant chewing side (p=0.04). IMO users presented significantly higher BF (p=0.01) without presenting a dominant side (p=0.38), and also performed significantly better for the following MP parameters: MPX50 values decreased by 27.25% in IMO users (p=0.01), MPB decreased by 48.38% (p=0.01), and ME 5.6 decreased by 53.25% (p=0.02), while ME2.8 increased by 151.57% (p=0.01). The BF and MPX50 in the IMO wearers group were negatively correlated (-0.57; p=0.05); this correlation coefficient was the only parameter included in the multivariate regression model. IMO users have higher BF and better masticatory performance than CCD users, especially in terms of chewed particles size reduction. MP is correlated with a higher BF in IMO users through better particle trituration.
Topics: Bite Force; Cross-Sectional Studies; Denture, Complete; Denture, Overlay; Humans; Mandible
PubMed: 32901716
DOI: 10.1590/0103-6440202003525 -
Clinical Oral Implants Research Jul 2017The goal of this meta-analysis was to evaluate how muscular activity, measured by electromyography (EMG), differs among edentulous patients treated with a complete... (Meta-Analysis)
Meta-Analysis Review
EMG correlations of edentulous patients with implant overdentures and fixed dental prostheses compared to conventional complete dentures and dentates: a systematic review and meta-analysis.
OBJECTIVES
The goal of this meta-analysis was to evaluate how muscular activity, measured by electromyography (EMG), differs among edentulous patients treated with a complete denture (CD), removable implant overdentures (IO), implant-retained fixed dental prostheses (IFDP), and dentates. The differences during clenching and chewing were of particular interest.
MATERIALS AND METHODS
An electronic literature review was carried out on MEDLINE (Pubmed) and the Cochrane Library covering the period January 1980 through September 2013. This was accomplished independently by three different reviewers and supplemented by a manual search. The review included randomized controlled trials, controlled clinical trials, and clinical trials which evaluated surface electromyography, bite force, chewing, and implants or complete dentures. In addition, the research was adjusted using MeSH terms.
RESULTS
The search garnered 646 titles and abstracts. Sixteen articles which met the inclusion criteria were analyzed. The effect size for muscular activity after implant support increased after therapy during clenching 2.18 (95% CI: 1.14, 3.23) and during chewing 1.45 (95%CI: 1.21, 1.69). Moreover, the EMG data of IO and IFDP groups (pooled) were lower than that of dentate control subjects during clenching (effect size: -1.01 [95%CI: -1.37, -0.65]). In contrast, the IFDP-wearers showed higher values than dentates during chewing. Among the edentulous control patients, the IO and IFDP groups (pooled) displayed higher values during clenching (effect size: 1.12 [95%CI: 0.7, 1.55]) and chewing (effect size: 1.33 [95%CI: -0.57, 2.10]). Furthermore, the muscular activity during chewing correlated with the hardness of the food.
CONCLUSION
In general, edentulous patients with CDs can achieve a greater degree of muscular activity after rehabilitation with IOs during clenching and chewing. During clenching, patients with IFDPs achieved higher values than those with dentates. The muscular activity increases with the hardness of the food.
Topics: Dental Prosthesis, Implant-Supported; Denture, Complete; Denture, Overlay; Electromyography; Humans; Masticatory Muscles; Mouth, Edentulous
PubMed: 27302014
DOI: 10.1111/clr.12874 -
Journal of Oral Rehabilitation Dec 2023Adequate muscle activity is important for the success of oral rehabilitation: it maintains the integrity of the stomatognathic system and is responsible for chewing... (Review)
Review
BACKGROUND
Adequate muscle activity is important for the success of oral rehabilitation: it maintains the integrity of the stomatognathic system and is responsible for chewing movements needed to break, crush and grind food.
OBJECTIVE
To compare muscle activity using electromyography (EMG) while clenching or chewing soft and/or hard foods among individuals with natural dentition (ND) and edentulous patients rehabilitated with dental prostheses.
METHODS
This review was conducted until March, 2023, and the research question was "Is the muscle activity of edentulous patients rehabilitated with dental prostheses similar to that of dentate individuals?" A search strategy was conducted in PubMed/MEDLINE, The Cochrane Library, Web of Science, Lilacs, Embase and manual journal searches.
RESULTS
Ten studies were included in the analysis. Most of them reported that individuals with ND had significant higher muscle activity (clenching or chewing) than complete dentures (CD) users. However, no difference was observed between patients with full mouth implant-supported fixed dental prosthesis (ISFDP) and ND. Additionally, two studies compared patients with mandibular ISFDP with maxillary CD and individuals with ND and found no differences; however, one study concluded that patients with ISFDP with CD (maxillary or mandibular) had lower muscle activity than individuals with ND. Only one study reported a higher muscle activity in patients with full-mouth ISFDP than in individuals with ND.
CONCLUSIONS
Bimaxillary CD users had lower muscle activity than individuals with ND. During rehabilitation, the muscle activity of patients with full-mouth ISFDP and mandibular ISFDP with maxillary CD is similar to individuals with ND.
Topics: Humans; Dental Prosthesis, Implant-Supported; Mouth, Edentulous; Denture, Complete; Mastication; Muscles; Dental Implants; Denture, Overlay
PubMed: 37605296
DOI: 10.1111/joor.13564 -
The International Journal of Oral &... 2021To examine the effect of the attachment features (abutment height, retention, and freedom of rotation) of implant overdentures on the bending strain around implants...
PURPOSE
To examine the effect of the attachment features (abutment height, retention, and freedom of rotation) of implant overdentures on the bending strain around implants under an overdenture.
MATERIALS AND METHODS
Mandibular and maxillary edentulous models were fabricated and covered with silicone rubber. Strain gauges were attached to the four sides of each implant. Two implants (tissue-level implant, 4.1-mm diameter, 10-mm length) were placed bilaterally in the area between the mandibular canines and lateral incisors. A maxillary conventional denture and a mandibular overdenture were made to fit the edentulous models. Three levels of peri-implant bone resorption were created sequentially: no bone resorption, 0.8 mm, and 1.5 mm. Three kinds of attachments (magnetic, stud, and ball attachments) were used. Bending strains generated from a 98-N occlusal load through the maxillary denture were measured using a sensor interface, and the data were analyzed using the Kruskal-Wallis and Bonferroni tests. Multiple regression analysis was used to find the relationship between independent variables (peri-implant bone resorption level, abutment height, retention, and freedom of rotation) and the dependent variable (bending strain).
RESULTS
For all attachment types, the bending strains were smallest with no bone resorption and largest with 1.5-mm bone resorption (P < .05). Multiple regression analysis showed that abutment height had the greatest impact on the reduction of bending strain (beta = .413), followed by freedom of rotation (beta = -.349), and retention (beta = .107).
CONCLUSION
Low abutment height, large freedom of rotation, and low retention can minimize bending strain around implants.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Overlay; Mandible
PubMed: 33600528
DOI: 10.11607/jomi.8420 -
The Journal of Prosthetic Dentistry Feb 2020The performance of a recently introduced overdenture attachment system after cyclic dislodgement is not known.
STATEMENT OF PROBLEM
The performance of a recently introduced overdenture attachment system after cyclic dislodgement is not known.
PURPOSE
The purpose of this in vitro study was to compare a conventional attachment system and a recently introduced attachment system for their dislodgement forces before and after cyclic dislodgement.
MATERIAL AND METHODS
Three acrylic resin models were fabricated with 2 implant analogs (4.1 mm; Zimmer Dental) in different angulations; parallel in the first, divergent by 30 degrees in the second, and divergent by 60 degrees in the third model. Six acrylic resin blocks containing 2 metal housings of 2 different LOCATOR attachments (LOCATOR Legacy [LL], R-Tx, n=3; Zest Dental Solutions) were also fabricated. LOCATOR abutment pairs (LL and R-Tx) were placed onto the analogs. Seven specimens for LL and R-Tx with pink attachments were tested for dislodgement forces, and the values were recorded before and after 1440 times (simulated 1-year use) of cyclic dislodgement using an occlusal loading simulator machine. A 3-way ANOVA was used for dislodgement force comparison before and after cyclic dislodgement for different angulations and for 2 different LOCATOR attachments. Any significant differences were identified with the Tukey HSD test (α=.05). The percentage decrease in the dislodgement force was also calculated.
RESULTS
A significant 3-way interaction was found for the LOCATOR type, implant angle, and time (P<.001). LOCATOR type made a difference for only parallel and 60 degree-divergent implants before cyclic dislodgement (P≤.022). After cyclic dislodgement, a significant effect of the LOCATOR type on dislodgement force was found for only parallel implants (P=.034). In both LOCATOR systems, the dislodgement force was different (P<.001) among different implant angulations, except for parallel to 30-degree comparison, before and after cyclic dislodgement. For both LL and R-Tx, significant differences (P≤.022) were found between before and after cyclic dislodgement for all angulations except LL in parallel (P=.214).
CONCLUSIONS
When implants were parallel, initially, the dislodgement force of R-Tx was higher than that of LL; however, the forces were similar after cyclic dislodgement. When implants were divergent by 30 degrees, there were no differences between the dislodgement forces of the LOCATOR systems before and after cyclic dislodgement. When implants were divergent by 60 degrees, initially, the dislodgement force of LL was higher than that of R-Tx; however, the forces were similar after cyclic dislodgement. Before and after cyclic dislodgement, in each system, dislodgement forces were greater when implants were divergent by 60 degrees than when parallel and 30 degrees. After cyclic dislodgement, dislodgement forces decreased for both systems, except for LL when the implants were parallel.
Topics: Acrylic Resins; Dental Implants; Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Denture Retention; Denture, Overlay
PubMed: 31202554
DOI: 10.1016/j.prosdent.2018.11.009