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Clinical Oral Investigations Jan 2021This study aimed to survey dentists in Germany to identify their favored materials for the fabrication of tooth-supported single crowns (SCs) depending on the location...
OBJECTIVES
This study aimed to survey dentists in Germany to identify their favored materials for the fabrication of tooth-supported single crowns (SCs) depending on the location of the abutment teeth and the preparation margin.
MATERIALS AND METHODS
The survey included questions regarding demographic characteristics of dentists/their dental practice and preferred restorative materials for the fabrication of SCs for abutment teeth 16, 11, 34, and 36 with either supra- or subgingival preparation margins.
RESULTS
Between August 2019 and February 2020, 721 dentists participated in the survey; responses from 33 dentists were excluded from data analysis because the dentists did not work in Germany or provided less than one fixed dental prosthesis/month. Dentists favored ceramic materials independent of the location of the abutment tooth and preparation margin (56.6-92.2%). CAD/CAM resin composites or full metals were preferred by only a few participants. A significantly higher proportion of dentists recommended porcelain fused to metal for subgingival preparation margins than for supragingival margins (p < 0.001). Characteristics of dentists/dental practices influenced a single scenario (11 subgingival) that was dependent on the dentist's time since graduation. When asked to specify the ceramic materials, numerous participants wrote a free response (5.7-7.8%) or did not answer (0.7-4.8%).
CONCLUSIONS
Dentists in Germany selected restorative materials for SCs depending on the clinical scenario. Since numerous dentists did not specify the ceramic materials, postgraduate information and education might help to extend expertise.
CLINICAL RELEVANCE
The results of this survey provide insight into the favored materials of dentists for the fabrication of tooth-supported SCs.
Topics: Crowns; Dental Porcelain; Dental Prosthesis Design; Dentists; Germany; Humans; Surveys and Questionnaires
PubMed: 32556660
DOI: 10.1007/s00784-020-03363-9 -
International Journal of Implant... Feb 2024The aim of this study was to assess implant survival and complications rate of modern subperiosteal implants (CAD designed and additively manufactured). (Review)
Review
PURPOSE
The aim of this study was to assess implant survival and complications rate of modern subperiosteal implants (CAD designed and additively manufactured).
METHODS
A systematic review was conducted using three electronic databases; Medline (Pubmed), Cochrane library, and SCOPUS, following the PRISMA statement recommendations to answer the PICO question: "In patients with bone atrophy (P), do additively manufactured subperiosteal implants (I), compared to subperiosteal implants manufactured following traditional approaches (c), present satisfactory implant survival and complication rates (O)? The study was pre-registered in PROSPERO (CRD42023424211). Included articles quality was assessed using the "NIH quality assessment tools".
RESULTS
Thirteen articles were finally selected (5 cohort studies and 8 case series), including 227 patients (121 female / 106 male; weighted mean age 62.4 years) and 227 implants. After a weighted mean follow-up time of 21.4 months, 97.8% of implants were in function (5 failures reported), 58 implants (25.6%) presented partial exposure, 12 patients (5.3%) suffered soft tissue or persistent infection. Fracture of the interim prosthesis was reported in 8 of the155 patients (5.2%) in which the use of a provisional prosthesis was reported. A great heterogeneity was found in terms of study design and methodological aspects. For this reason, a quantitative analysis followed by meta-analysis was not possible.
CONCLUSIONS
Within the limitations of this study, modern additively manufactured subperiosteal implants presented a good survival in the short-time, but a noticeable number of soft-tissue related complications were reported. Further studies are needed to assess the clinical behavior in the medium- and long-term.
Topics: Humans; Male; Female; Middle Aged; Dental Restoration Failure; Dental Implants; Prosthesis Implantation; Alveolar Bone Loss; Dental Prosthesis, Implant-Supported
PubMed: 38315326
DOI: 10.1186/s40729-024-00521-6 -
BMC Oral Health Jun 2022The aim of the present study was to evaluate the retention and loss of retention after fatigue testing at different time intervals between two types of bar clip...
OBJECTIVES
The aim of the present study was to evaluate the retention and loss of retention after fatigue testing at different time intervals between two types of bar clip materials (digitally designed PEEK bar clip and regular Nylon bar clip).
MATERIALS AND METHODS
An epoxy model was constructed for a completely edentulous mandible. Two implants were placed according to prosthetically driven implant placement by a computer-guided surgical stent. Bar clips were digitally designed, 3D printed, and pressed into Poly Ether Ether Ketone (PEEK). Pick up of PEEK and nylon clips was performed on the dentures fitting surface using self-cured acrylic resin. Each study group was subjected to an insertion and removal fatigue test simulating 3 years of patient usage. Retention values were recorded using the universal testing machine at initial retention and after 1, 2, and 3 years of simulated usage. For proper sample sizing, 24 models and dentures (12 for each group) were used. An independent sample t-test and repeated measures analysis of variance were used to compare the data.
RESULTS
There were statistically significant differences in retention between the PEEK and nylon bar clips at the beginning of the experiment (p = 0.000*). But after 3 years of simulated use, there was no significant difference in retention between the test groups (p = 0.055, NS). After 3 years of simulated use, the retention of PEEK clips decreased by - 58.66% recording 17.37 ± 1.07 N, while the retention of nylon clip increased by + 2.99% recording 16.56 ± 0.88 N.
CONCLUSION
The digitally designed PEEK clip showed comparable retention results to the nylon clip after 3 years of simulated use.
CLINICAL RELEVANCE
Maintenance of bar attachment with PEEK clip offers a clinical solution after the wear of normal plastic clips, which is a cheap solution that is easily fabricated and picked up into the denture. Digital fabricated PEEK bar retentive inserts can be used in cases of bar attachment wear.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Denture Retention; Denture, Overlay; Ethers; Humans; Mandible; Nylons; Surgical Instruments
PubMed: 35681163
DOI: 10.1186/s12903-022-02262-7 -
Journal of Prosthodontic Research Oct 2021Purpose This study aimed to determine the influence of mandibular free-end partial edentulism and use of conventional or implant-supported removable dental prostheses in...
Purpose This study aimed to determine the influence of mandibular free-end partial edentulism and use of conventional or implant-supported removable dental prostheses in the partially edentulous area on the load exerted on the maxillary anterior teeth.Methods A jaw model with mandibular free-end missing teeth was used, and a distal extension, removable partial dental prosthesis was fabricated to replace the missing posterior teeth. Four experimental conditions were set up: 1) without prosthesis, 2) with a conventional removable partial dental prosthesis, 3) with an implant-supported removable partial dental prosthesis, and 4) with a complete dental arch. Strain gauges were attached to the root surface of the maxillary left central incisor, canine, first premolar, and first molar. The load exerted on them was calculated based on the calibration coefficient. An occlusal load of 49 N was applied, and the forces were compared using a Kruskal-Wallis test (P < 0.05). Results The load exerted on the maxillary anterior teeth increased significantly with no prosthesis, decreased significantly with a conventional removable partial dental prosthesis, and decreased even more significantly with an implant-supported removable partial dental prosthesis. Conclusions The burden on the maxillary anterior teeth decreased with the use of a removable partial dental prosthesis and decreased even further with the use of an implant-supported dental prosthesis. The use of an implant to support a distal extension removable partial dental prosthesis is potentially effective in preserving the remaining teeth and tissues by reducing excessive stress in patients with mandibular free-end partial edentulism.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Partial, Removable; Humans; Mandible
PubMed: 33896889
DOI: 10.2186/jpr.JPR_D_20_00077 -
BMC Oral Health Sep 2021The use of intraoral scanners (IOS) has facilitated the use of digital workflows for the fabrication of implant-supported prostheses not only for single missing teeth,...
BACKGROUND
The use of intraoral scanners (IOS) has facilitated the use of digital workflows for the fabrication of implant-supported prostheses not only for single missing teeth, but also for multiple missing teeth. However, the clinical application of IOS and computer-aided design/manufacturing (CAD/CAM) in implant-supported prosthodontics remains unclear. This study aimed to compare the accuracy of digital and silicone impressions for single-tooth implants for bounded edentulous spaces and two-unit and three-unit implant-supported fixed dental prostheses for free-end edentulous spaces.
METHODS
This study enrolled 30 patients (n = 10 for each of the three groups) with an average age of 61.9 years. Conventional silicone-based and digital IOS-based impressions were made for all patients, and the implant superstructures were fabricated. We measured the scan-body misfit and compared the accuracy of the impressions for single-unit, two-unit, and three-unit implant prostheses with a bounded edentulous space by superimposing the standard triangulated language (STL) data obtained from IOS over the STL data of the plaster model used for final prosthesis fabrication. The scan bodies of the superimposed single-molar implant, two-unit implant prosthesis without teeth on the mesial side, two-unit implant prosthesis without teeth on the distal side, three-unit implant prosthesis without teeth on the mesial side, and three-unit implant prosthesis without teeth on the distal side were designated as A, B1, B2, C1, and C2, respectively. The misfit for each scan body was calculated and the accuracies were compared using the Tukey-Kramer method.
RESULTS
The average scan-body misfit for conditions A, B1, B2, C1, and C2 was 40.5 ± 18.9, 45.4 ± 13.4, 56.5 ± 9.6, 50.7 ± 14.9, and 80.3 ± 12.4 μm, respectively. Significant differences were observed between the accuracies of A and B2, A and C2, and C1 and C2 (P < 0.001).
CONCLUSIONS
IOS and CAD/CAM can find clinical applications for implant-supported prostheses of up to three units for a bounded edentulous saddle. The use of IOS could render implant treatment easier, benefiting both the surgeons and patients. Prosthesis maladjustment may lead to peri-implantitis and prosthetic fracture. Therefore, further validation of the accuracy of IOS impressions is required in patients with multiple missing teeth in long-span implant prostheses.
Topics: Computer-Aided Design; Dental Implants; Dental Implants, Single-Tooth; Dental Impression Technique; Dental Prosthesis, Implant-Supported; Humans; Middle Aged; Mouth, Edentulous; Silicones
PubMed: 34556111
DOI: 10.1186/s12903-021-01836-1 -
Journal of Dentistry Nov 2021This observational cross-sectional study aimed to evaluate and compare the oral health-related quality of life (OHRQoL) and clinical performance between dentate subjects... (Observational Study)
Observational Study
Differences in self-perceived OHRQoL between fully dentate subjects and edentulous patients depending on their prosthesis type, socio-demographic profile, and clinical features.
OBJECTIVES
This observational cross-sectional study aimed to evaluate and compare the oral health-related quality of life (OHRQoL) and clinical performance between dentate subjects and edentulous patients restored with conventional dentures or implant overdentures.
METHODS
85 edentulous patients were grouped as follows: Group-1 (CD): conventional denture wearers (n = 42), and Group-2 (IO): implant-retained overdenture wearers (n = 43). For the OHRQoL comparisons, a control group of subjects with a healthy natural dentition (Group-3, ND; n = 50) was included. Participants completed three validated questionnaires (OHIP-14sp, OHIP-20sp, and QoLIP-10). Socio-demographic data, prosthesis-related factors, clinical condition of the mouth, and patient subjective evaluations, were gathered. Descriptive and non-parametric probes were run (α = 0.05).
RESULTS
The ND group was the most unsatisfied (OHIP-14sp; p ≤ 0.001). The OHIP-20sp attributed significantly worse Psychological disability (p = 0.029) and Handicap (p = 0.027) to CD wearers when compared to IO wearers. The CD group showed the significantly highest need for relining (p = 0.041), and the lowest retention (p = 0.011). The OHIP-14sp disclosed a significantly worse OHRQoL for those volunteers who had a job (p = 0.003), a basic education instead of a secondary one (p = 0.022), and no partner (p = 0.006).
CONCLUSIONS
The overall OHRQoL was comparable for both prosthodontic groups, being modulated by socio-demographic and prosthesis-related features. Nonetheless, CD wearers presented prosthetic complications more frequently.
CLINICAL SIGNIFICANCE
While dentate subjects were the most critical about their oral condition and its repercussion in their life, implant overdenture wearers tended to observe a better OHRQoL and clinical performance compared to conventional denture wearers.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Humans; Oral Health; Patient Satisfaction; Quality of Life
PubMed: 34333055
DOI: 10.1016/j.jdent.2021.103756 -
Journal of Dentistry Jun 2024This study aims to explore and discuss recent advancements in tooth reconstruction utilizing deep learning (DL) techniques. A review on new DL methodologies in partial... (Review)
Review
OBJECTIVES
This study aims to explore and discuss recent advancements in tooth reconstruction utilizing deep learning (DL) techniques. A review on new DL methodologies in partial and full tooth reconstruction is conducted.
DATA/SOURCES
PubMed, Google Scholar, and IEEE Xplore databases were searched for articles from 2003 to 2023.
STUDY SELECTION
The review includes 9 articles published from 2018 to 2023. The selected articles showcase novel DL approaches for tooth reconstruction, while those concentrating solely on the application or review of DL methods are excluded. The review shows that data is acquired via intraoral scans or laboratory scans of dental plaster models. Common data representations are depth maps, point clouds, and voxelized point clouds. Reconstructions focus on single teeth, using data from adjacent teeth or the entire jaw. Some articles include antagonist teeth data and features like occlusal grooves and gap distance. Primary network architectures include Generative Adversarial Networks (GANs) and Transformers. Compared to conventional digital methods, DL-based tooth reconstruction reports error rates approximately two times lower.
CONCLUSIONS
Generative DL models analyze dental datasets to reconstruct missing teeth by extracting insights into patterns and structures. Through specialized application, these models reconstruct morphologically and functionally sound dental structures, leveraging information from the existing teeth. The reported advancements facilitate the feasibility of DL-based dental crown reconstruction. Beyond GANs and Transformers with point clouds or voxels, recent studies indicate promising outcomes with diffusion-based architectures and innovative data representations like wavelets for 3D shape completion and inference problems.
CLINICAL SIGNIFICANCE
Generative network architectures employed in the analysis and reconstruction of dental structures demonstrate notable proficiency. The enhanced accuracy and efficiency of DL-based frameworks hold the potential to enhance clinical outcomes and increase patient satisfaction. The reduced reconstruction times and diminished requirement for manual intervention may lead to cost savings and improved accessibility of dental services.
Topics: Humans; Computer-Aided Design; Deep Learning; Dental Prosthesis Design; Dental Restoration, Permanent; Models, Dental; Tooth
PubMed: 38608832
DOI: 10.1016/j.jdent.2024.104988 -
Medical Science Monitor : International... Dec 2017BACKGROUND Implants that can be used in the prosthetic rehabilitation of full and partial edentulous patients are now frequently used due to advances in dentistry....
BACKGROUND Implants that can be used in the prosthetic rehabilitation of full and partial edentulous patients are now frequently used due to advances in dentistry. Despite advanced methods of applications, failures and complications can still be seen. The aim of our study was to evaluate clinical prosthetic values and complications that occurred during 4-year follow-up in implant-supported restorations. MATERIAL AND METHODS This retrospective study included 40 patients who received oral rehabilitation with an implant-supported prosthesis. A total of 162 implants were placed: 99 in the maxilla and 63 in the mandible. The prosthetic and surgical data were recorded. Data including prosthetic complications and implant loss were recorded and statistically analyzed using Cox proportional hazard regression analysis. RESULTS In total, 159 implants (98.14%) survived, 3 implants (1.86%) failed, and 100% of the protheses were successful. There were 62 dental implants used as abutments for removable dentures and 97 for fixed dentures. The most frequent prosthetic complications after placement of an implant-supported prosthesis were loss of retention, mucositis, abutment screw loosening, and fracture. Patient satisfaction after prosthesis use was also evaluated, showing that satisfaction was systematically increased. CONCLUSIONS To minimize the frequency of complications, protocols must be established from diagnosis to the completion of treatment and follow-up of implant-supported prostheses, especially in terms of adequate technical steps and careful radiographic evaluation of the components.
Topics: Adult; Aged; Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dentures; Female; Follow-Up Studies; Humans; Male; Mandible; Maxilla; Middle Aged; Retrospective Studies; Treatment Outcome
PubMed: 29281613
DOI: 10.12659/msm.907840 -
BMC Oral Health Aug 2018This study evaluates the cost-effectiveness of implants (Implant), insurance fixed dental prosthesis (IFDP) and private fixed dental prosthesis (PFDP) for a single...
BACKGROUND
This study evaluates the cost-effectiveness of implants (Implant), insurance fixed dental prosthesis (IFDP) and private fixed dental prosthesis (PFDP) for a single intermediate missing tooth in the molar region to calculate the Incremental Cost Effectiveness Ratio (ICER).
METHODS
The Markov model for cost-effectiveness analysis of the Implant, IFDP and PFDP was carried over maximum 30 years. The starting age for prosthetic treatment was decided to be 50 years. The General Oral Health Assessment Index (GOHAI) was used for the indicator of effectiveness as an oral health QOL value. The GOHAI value was collected from patients who visited the Department of Oral Implantology of Osaka Dental University between September 2014 and March 2016. In addition, the Tornado diagram was drawn and Monte-Carlo simulations made for sensitivity analysis.
RESULTS
From the analysis of survey of QOL of each stage and treatment, the selection of an Implant led to a higher QOL value than FDP. However, the estimated 30-year cost for IFDP was lower than Implant. It also became evident that PFDP had an extended dominated condition compared with IFDP and Implants. The ICER on the Implant versus IFDP was €1423.00.
CONCLUSIONS
These results suggest that a better of QOL value can be obtained from an Implant than from IFDP or PFDP. An evaluation form using an indexed scale for oral health-related aspects needs to be developed that is also consistent as an indicator of effect.
Topics: Adult; Aged; Aged, 80 and over; Cost-Benefit Analysis; Dental Implants; Dental Implants, Single-Tooth; Dental Prosthesis, Implant-Supported; Denture, Partial, Fixed; Female; Humans; Male; Markov Chains; Middle Aged; Molar; Monte Carlo Method; Quality of Life
PubMed: 30126400
DOI: 10.1186/s12903-018-0604-5 -
CoDAS Jul 2019To evaluate the self-perception of the food conditions of elderly users of dental prosthesis, in order to verify the interference that dental prosthesis has in their...
PURPOSE
To evaluate the self-perception of the food conditions of elderly users of dental prosthesis, in order to verify the interference that dental prosthesis has in their feeding.
METHODS
The present study counted with 60 elderly, participants of the Centro de Convivência Nair Ventorin Gurgacz (Community Center), aged between 60 and 88 years old. All participants answered to a questionnaire elaborated by the researchers and the Geriatric Oral Health Assessment Index (GOHAI).
RESULTS
The elderly who participated in this study, mostly women, used a bimaxillary removable prosthesis for over 30 years; although they classified their nutrition as "good" and did not present preference for specific food consistency, they frequently felt pain while chewing. The average score of the GOHAI was 29.73, considered "low", the index dimension with worst score was physical function, that includes eating, speaking and swallowing. No relation was observed between time of use of dental prosthesis, age and the GOHAI scores.
CONCLUSION
The elderly rarely complaint about discomfort or embarrassment on feeding, however, they present an average lower than expected in the GOHAI index, which indicates that, although they do not report it, many deteriorations, that seem to be natural may be happening and may be the cause of worst quality of life.
Topics: Aged; Aged, 80 and over; Brazil; Cross-Sectional Studies; Deglutition; Dental Prosthesis; Eating; Female; Food; Geriatric Assessment; Humans; Male; Mastication; Middle Aged; Oral Health; Quality of Life; Self Concept; Surveys and Questionnaires
PubMed: 31314861
DOI: 10.1590/2317-1782/20182018080