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BMC Oral Health Sep 2021When dealing with the replacement of one missing tooth, the patient has the option of choosing between different types of treatment interventions. Several important...
BACKGROUND
When dealing with the replacement of one missing tooth, the patient has the option of choosing between different types of treatment interventions. Several important factors play a role in his decision-making process, including his limited financial means and his efforts to solve the problem of missing teeth as effectively as possible. The main goal of the study is the economic-clinical evaluation of implant treatment, as a surgical-prosthetic method in dentistry, in case of replacement of one missing tooth of the molar area.
METHODS
Cost-utility analysis from the patient's perspective is used for evaluation. The selected comparator is a purely prosthetic solution with the help of a three-unit fixed dental prosthesis. Cost-utility analysis is modelled using Markov models, which consider a 30-year time horizon.
RESULTS
Based on the results of modelling, the intervention evaluated by the patient, i.e. treatment with the help of implant-supported single crown, brings exactly 15.31 quality-adjusted prosthesis years (QAPY) after 30 years. The value of incremental cost-utility ratio amounted to USD - 1434.
CONCLUSION
The results of the cost-utility analysis suggest that implant treatment with an implant-supported single crown is more cost-effective than treatment with the three-unit fixed dental prosthesis.
Topics: Cost-Benefit Analysis; Crowns; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Partial, Fixed; Humans; Molar
PubMed: 34488727
DOI: 10.1186/s12903-021-01790-y -
Journal of Prosthodontics : Official... Mar 2022To investigate the accuracy of additive manufacturing (AM) by means of internal fit of fixed dental prostheses (FDPs) fabricated with two AM technologies using different...
PURPOSE
To investigate the accuracy of additive manufacturing (AM) by means of internal fit of fixed dental prostheses (FDPs) fabricated with two AM technologies using different resins and printing modes (validated vs nonvalidated) compared to milling and direct manual methods.
MATERIAL AND METHODS
Sixty 3-unit interim FDPs replacing the first mandibular molar were divided into 6 groups (n = 10): manual (Protemp 4), milled (Telio-CAD), and AM groups were subdivided based on AM technology (direct light processing (Rapidshape P30 [RS]) and stereolithography (FormLabs 2 [FL])) and the polymer type (P-Pro-C&B [St] and SHERAprint-cb [Sh]) (RS-St, RS-Sh, FL-St, FL-Sh). Validated (RS-Sh and RS-St) or nonvalidated (FL-St and FL-Sh) modes were adopted for AM. The specimens were scanned to 3D align (GOM inspect) according to the triple scan method. The internal space between the FDPs and preparation surfaces in four sites (marginal, axial, occlusal, and total) was measured using equidistant surface points (GOM Inspect). Statistical analysis was done using Kruskal Wallis and Dunn post-hoc tests. (α = 0.05).
RESULTS
One AM group (FL-Sh) and milling exhibited better adaptation compared to manual and RS-St at molar site (p < 0.05). FDPs with St resin (FL-St and RS-St) displayed bigger marginal space than milled, FL-Sh, and RS-Sh. The nonvalidated printing mode showed better mean space results (p < 0.05) with higher predictability and repeatability (p < 0.001).
CONCLUSIONS
The AM interim FDPs tested provided valid alternatives to the milled ones in regard to their accuracy results. The printing mode, resin, and the AM technology used significantly influenced the manufacturing accuracy of interim FDPs, particularly at the marginal area. The nonvalidated printing mode with lower-cost 3D printers is a promising solution for clinical applications.
Topics: Computer-Aided Design; Dental Marginal Adaptation; Dental Prosthesis Design; Denture, Partial, Temporary; Materials Testing; Molar; Printing, Three-Dimensional
PubMed: 34792821
DOI: 10.1111/jopr.13454 -
Health and Quality of Life Outcomes May 2019Oral health-related quality of life (OHRQoL) has important implications for the clinical practice of dentistry and dental research and should contribute to professional...
BACKGROUND
Oral health-related quality of life (OHRQoL) has important implications for the clinical practice of dentistry and dental research and should contribute to professional judgment about restorative treatments and prosthetic replacement in patients who had reduced dentitions. The aim was to compare the OHRQoL among adults (35-44 years) categorized according to different definitions of reduced dentition and considering the use (or non-use) of dental prosthesis.
METHODS
This study used data from a probabilistic sample of adults in Sao Paulo, Brazil, 2015. OHRQoL was based on none items of Oral Impacts on Daily Performance (OIDP) index, as prevalence (at least one impact) and extent (the number of items with non-zero score). We used different criteria to assess dentition status: (1) Shortened Dental Arch (SDA): having 3-5 natural occlusal units (OUs) in posterior teeth and intact anterior region; (2) hierarchical functional classification system: a five-level stepwise classification of dentition; and (3) presence of ≥21 teeth. The use or nonuse of dental prosthesis was recorded. Negative binomial regression models involved the adjustment for social determinants of health.
RESULTS
Nearly half (53.1%) of the 5753 participating adults had at least one oral health issue impacting OHRQoL. OIDP prevalence in adults with SDA did not differ from those with more OUs (PR = 1.02; 95%CI 0.91-1.13). Individuals with non-functional dentition had worse OHRQoL regardless of their use of a dental prosthesis. Adults with fewer than 21 remaining teeth, ranked significantly higher in OIDP extent, regardless of dental prosthesis use (PR = 1.38; 95%CI 1.16-1.63 with prosthesis; PR = 1.62; 95%CI 1.19-2.20 without dental prosthesis).
CONCLUSIONS
Individuals with more missing teeth reported worse OHRQoL regardless of using a dental prosthesis. Preserving a functional dentition, even with missing teeth, is compatible with OHRQoL.
Topics: Adult; Brazil; Cross-Sectional Studies; Dental Prosthesis; Dentition, Permanent; Female; Humans; Male; Oral Health; Quality of Life; Tooth Loss
PubMed: 31053080
DOI: 10.1186/s12955-019-1149-2 -
Clinical Oral Implants Research Oct 2018The aim of the present publication was to report on the EAO Workshop group-4 discussions and consensus statements on the five reviews previously prepared. These reviews...
OBJECTIVES
The aim of the present publication was to report on the EAO Workshop group-4 discussions and consensus statements on the five reviews previously prepared. These reviews provided the scientific evidence on the effect of crown-to-implant ratio, on reconstructions with cantilevers in fully and partially edentulous patients, on biological and technical complications of tilted in comparison with straight implants, and on the effects of osseointegrated implants functioning in a residual dentition.
MATERIAL AND METHODS
The group discussed, evaluated, corrected where deemed appropriate, and made recommendations to the authors regarding the following five reviews submitted: (a) Is there an effect of crown-to-implant ratio on implant treatment outcomes?; (b) Implant-supported cantilevered fixed dental rehabilitations in fully edentulous patients; (c) and in partially edentulous patients; (d) Biological and technical complications of tilted implants in comparison with straight implants supporting fixed dental prostheses; (e) What are the adverse effects of osseointegrated implants functioning among natural teeth of a residual dentition? Based on the five manuscripts and the discussion among the group as well as the plenum members, the major findings were summarized, consensus statements were formulated, clinical recommendations were proposed, and areas of future research were identified.
RESULTS
Crown-to-implant ratios ranging from 0.9 to 2.2 did not influence the occurrence of biological or technical complications also in single-tooth restorations. Reconstructions with cantilevers for the rehabilitation of fully and partially edentulous jaws showed high implant and reconstruction survival rates. In contrast, the rate of complications-in particular associated with veneering material-was high during the observation period of 5-10 years. The data reported were primarily derived from studies with high risk of bias. The data for single-implant reconstructions were small. There was no evidence that distally tilted implants were associated with higher failure rates and increased amounts of marginal bone loss. The data supporting these findings, however, were at high risk of bias and frequently incompletely reported. Frequent positional changes occurred between the natural teeth and the implant-supported restorations. These changes were more pronounced in younger individuals, and even though they were reduced with age, they still occurred in adult patients. Even though these changes were frequent, potential implications for the patient are unclear.
CONCLUSIONS
The use of single-tooth restorations with crown-to-implant ratio in between 0.9 and 2.2 may be considered a viable treatment option. Multiunit reconstructions with cantilevers are a viable treatment option in fully and partially edentulous patients. Clinicians and patients should be aware, however, that complications are frequent and primarily related to resin material used for veneering. There is some evidence that tilting an implant does affect stability of the implant and the surrounding bone. Treatment options to tilted implants should carefully be considered, as the effect on soft tissues and on prosthesis behavior is poorly reported for tilted implants. Positional changes in the dentition in relation to implant-supported restorations occur frequently. The patient should be informed about the possible need for a treatment related to these changes in the long term.
Topics: Biomechanical Phenomena; Crowns; Dental Implantation, Endosseous; Dental Prosthesis, Implant-Supported; Dental Restoration, Permanent; Denture, Complete; Denture, Partial, Fixed; Humans; Jaw, Edentulous, Partially; Mouth, Edentulous; Treatment Outcome
PubMed: 30306690
DOI: 10.1111/clr.13284 -
Clinical Oral Implants Research Oct 2021To study the time and costs involved with computer-assisted versus non-computer-assisted implant planning and placement. (Review)
Review
AIM
To study the time and costs involved with computer-assisted versus non-computer-assisted implant planning and placement.
MATERIAL AND METHODS
Based on the PICO question, "In patients receiving dental implants, is computer-assisted implant planning and surgery (CAIPS) compared to non-computer-assisted implant planning and surgery (non-CAIPS) beneficial in terms of treatment related costs and time involved?", a search path was created to perform an electronic search in the databases PubMed, PubMed Central, EMBASE, and Cochrane. The publication period of eligible publications extended from 01.01.2005 to 04.05.2020. Four independent reviewers reviewed the literature to identify studies that met the eligibility inclusion criteria. A further manual search of articles was performed, and gray literature was excluded. Corresponding authors of potentially eligible manuscripts were contacted for further information.
RESULTS
Of the 1354 retrieved titles after the search were screened. Thirty-one articles have been identified to read the full text, resulting in four articles to be analyzed for the present review all of which were RCTs. In total, 182 partially and completely edentulous patients were treated with 416 implants following either non-computer-assisted or computer-assisted implant planning and surgery to determine the duration of the single working steps and the financial aspects of the different procedures.
CONCLUSIONS
When evaluating the time and costs involved with the diagnostic and planning procedures in computer-assisted implant planning and surgery workflow protocols, one can summarize that these are higher than in the non-computer-assisted workflow protocols. The time involved with the procedures appears to be the driving factor when it comes to economic considerations. On the basis of the conclusions, also the time for the prosthetic restoration should be taken into account.
Topics: Computers; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis, Implant-Supported; Humans; Surgery, Computer-Assisted
PubMed: 34642994
DOI: 10.1111/clr.13862 -
Australian Dental Journal Mar 2015Dental implant treatment has established benefits over traditional alternatives. Age-related changes in systemic and oral health in conjunction with social, economic and... (Review)
Review
Dental implant treatment has established benefits over traditional alternatives. Age-related changes in systemic and oral health in conjunction with social, economic and resource considerations often introduce complexities into dental implant treatment of ageing patients. When time, opportunity, discomfort and maintenance costs are coupled with cost-benefit and quality of life predictions, otherwise simple treatment decisions can become more difficult. Implants for different types of prostheses in both arches and the different types of prostheses themselves present a variety of treatment challenges, risks, benefits and maintenance requirements. This narrative review discusses selective literature pertinent to the provision of dental implant treatment in the ageing population.
Topics: Aged; Aged, 80 and over; Cost-Benefit Analysis; Dental Prosthesis; Dental Prosthesis, Implant-Supported; Denture, Overlay; Humans; Mouth, Edentulous; Oral Health; Patient Selection; Prosthesis Failure; Quality of Life; Risk Factors
PubMed: 25762040
DOI: 10.1111/adj.12282 -
Journal of Indian Prosthodontic Society 2023To evaluate and compare the strain development and distribution of maxillary implant-supported complete fixed dental prosthesis (ISCFDP) with computer-aided...
Comparative evaluation to study the effect of implant support on complete fixed dental prosthesis fabricated with peek framework when implants placed in all-on-4 and all-on-6 situation, by strain gauge analysis and finite element analysis - An study.
AIM
To evaluate and compare the strain development and distribution of maxillary implant-supported complete fixed dental prosthesis (ISCFDP) with computer-aided design-computer-aided manufacturing milled PEEK BIO-HPP superstructure when placed using All-on-4 and All-on-6 situation using a strain gauge and finite element analysis (FEA).
SETTING AND DESIGN
This is an in vitro study to evaluate and compare the stress minimization and strain developed at implant in premolar and in two clinically simulated situation of All-on-4 and All-on -6 ISCFDP.
MATERIALS AND METHODS
The study involved converting a human skull into. stl format to create 3D-printed stereolithography models with a modulus of elasticity closer to bone. Implants were placed in two models (M1 nad M2) in incisor, premolar, and pterygoid regions. A fixed dental prosthesis framework was fabricated on both models, and strain gauge sensors were attached.
STATISTICAL ANALYSIS USED
Descriptive and analytical statistics were done. The normality of data was analyzed by the Shapiro-Wilk test.
RESULTS
The results obtained were tabulated and it showed strain around the neck of ISCFDP under 100N configuration in strain gauge analysis. Stress was found more in the molar region when compared to the premolar region. This design showed that the largest stress around the neck of ISFDP under 100 N load was found more in the premolar region when compared to the molar region due to the reduction of stresses in the pterygoid region in FEA.
CONCLUSION
In the present study, strain gauge analysis at 100 N for loading at the premolar and molar region shows the reduced strain on tilted implants in All-on-6 situation due to stress dissipation to the terminal pterygoid implant using strain gauge.
Topics: Humans; Dental Implants; Finite Element Analysis; Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Stress, Mechanical
PubMed: 37861614
DOI: 10.4103/jips.jips_196_23 -
International Journal of Environmental... Dec 2020This study examined the prevalence of self-perceived chewing discomfort depending on the type of dental prosthesis used in South Korean adults. The subjects were 12,802...
This study examined the prevalence of self-perceived chewing discomfort depending on the type of dental prosthesis used in South Korean adults. The subjects were 12,802 people over 20 years of age who participated in a health interview and dental examination. Chewing discomfort was examined using a self-assessed report with a structured questionnaire. Using multivariable logistic regression analysis, adjusted odds ratios were evaluated along with their 95% confidence intervals (α = 0.05). After adjusting for covariates, including age, gender, smoking, drinking, hypertension, diabetes, body mass index, education, income, and toothbrushing frequency, the odds ratios (95% confidence intervals) for chewing discomfort in groups without a dental prosthesis, with fixed dental prostheses, with removable partial dentures, and with removable complete dentures were 1 (reference), 1.363 (1.213-1.532), 2.275 (1.879-2.753), and 2.483 (1.929-3.197), respectively. The association between the prevalence of chewing discomfort and the type of dental prosthesis used was statistically significant even after adjusting for various confounders ( < 0.0001). The type of dental prosthesis was related to chewing discomfort among South Korean adults.
Topics: Adult; Cross-Sectional Studies; Denture, Complete; Denture, Partial, Removable; Female; Humans; Male; Mastication; Middle Aged; Oral Health; Pain; Republic of Korea
PubMed: 33374152
DOI: 10.3390/ijerph18010071 -
Journal of Prosthodontic Research Apr 2024The present study aimed to identify, through a critical review of the literature, the success factors associated with the splinting of fixed prostheses on adjacent... (Review)
Review
PURPOSE
The present study aimed to identify, through a critical review of the literature, the success factors associated with the splinting of fixed prostheses on adjacent implants of the posterior sectors in partially edentulous patients compared with those not splinted.
STUDY SELECTION
A MEDLINE strategy was implemented based on a research question to systematically search and extract information from databases (PubMed and Scopus) using MeSH terms/keywords identified for each domain. Systematic reviews, clinical and in vitro studies were selected and classified according to eligibility criteria based on the research question and level of evidence using the PRISMA flowchart.
RESULTS
A total of 32 studies were selected for data extraction and analysis according to study design (three systematic reviews, 14 clinical studies, and 15 in vitro studies). Overall, the studies found no significant difference in the association between the survival rate and prosthesis type. In clinical studies, there have been no differences in marginal bone loss between splinted and non-splinted prostheses, and the influence of peri-implant status and restorative materials has been poorly evaluated. The distribution of stress and loads determined in the in vitro studies showed results that could favor splinted prostheses; however, are generally associated with implant design.
CONCLUSIONS
The need for splinted or non-splinted adjacent implant-supported prostheses remains controversial. The reviewed evidence indicates that factors such as implant size and its relationship with coronal height could be important in decision-making.
Topics: Humans; Dental Implants; Dental Materials; Mouth, Edentulous; Dental Prosthesis, Implant-Supported; Dental Prosthesis Design
PubMed: 37648482
DOI: 10.2186/jpr.JPR_D_22_00220 -
European Journal of Oral Sciences Aug 2022The purpose of the study was to investigate the influence of multiple factors on the survival of tooth-supported single crowns and assess the biological and technical...
The purpose of the study was to investigate the influence of multiple factors on the survival of tooth-supported single crowns and assess the biological and technical complications. This retrospective study included patients rehabilitated with single crowns with a minimum follow-up time of 6 months after delivery. The cumulative survival rate was calculated over the maximum period of follow-up time and reported in a life-table survival analysis. Univariate and multivariate Cox regression was used to evaluate the associations between clinical covariates and crown failure. The included cohort group consisted of 1037 single crowns delivered in 401 patients and followed for a mean of 134.8 ± 80.2 months. Cumulative survival rate was 89.9% and 80.9% after 5 and 10 years and 70.5% and 61.8% after 15 and 20 years, respectively. The main reasons for single crown failure were loss of retention, tooth loss, and fracture. Anterior placement, non-vital abutments, and bruxism significantly influenced the survival of single crowns. The survival of single crowns was not influenced by patient's age and sex, location of the crowns in relation to the jaws, type of tooth, presence of post and core, and type of crown material, treatment providers, or smoking. Anterior placement, non-vital abutments, and bruxism are factors suggested to increase the risk of single crown failure and the prevalence of technical and biological complications.
Topics: Bruxism; Cohort Studies; Crowns; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Follow-Up Studies; Humans; Retrospective Studies
PubMed: 35613306
DOI: 10.1111/eos.12871