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Clinical Implant Dentistry and Related... Dec 2023Hypohidrotic ectodermal dysplasia (HED) patients suffering of oligo-anodontia require early dental treatment to improve oral functions and reduce social impairment. The...
INTRODUCTION
Hypohidrotic ectodermal dysplasia (HED) patients suffering of oligo-anodontia require early dental treatment to improve oral functions and reduce social impairment. The aim of this study was to evaluate the skeletal growth, implant and prosthetic survival rate, success, and complications after the rehabilitation with a maxillary denture and an implant-supported overdenture provided by a sliding bar in case of severe hypodontia/anodontia related to HED.
MATERIALS AND METHODS
This retrospective cohort study began in 2009. Nine patients over 7 years old with HED and associated oligo-anodontia who presented at the University of Bologna for dental treatment were included in the study. They were first treated with conventional dentures and then with a maxillary denture and an implant-supported overdenture with a sliding bar connected to two implants placed in the anterior mandible. The subjects treated were followed for 3-12 years. In each case, orthopanoramic and lateral cephalometric radiographic exam were taken before implant placement and annually after prosthetic load. Vertical and transverse dimensions of the mandible in the symphysis area at implant sites were taken on the lateral cephalometric radiography at the time of implant placement and after 5 years from the prosthetic loading to assess the presence or absence of an anterior mandibular growth. Biologic and mechanical complications were also recorded at every visit.
RESULTS
A mandibular vertical growth under the implant apex, at the implant neck, and a sagittal growth of the symphysis after 5 years from the prosthetic loading were observed and measured. Implant and prosthetic success and survival rates were 100% after 8.1 years (mean) follow-up period. No complications were reported except in one patient, where the repositioning of a retentive cap on the counter bar in the superstructure was necessary after 3 years from the prosthetic loading.
CONCLUSIONS
The present study suggests that the growth of the mandible near implant sites continues even after their positioning. Implants can be successfully placed and provide support for prosthetic rehabilitation in preteens patients with HED.
Topics: Humans; Child; Dental Implants; Cohort Studies; Denture, Overlay; Retrospective Studies; Anodontia; Ectodermal Dysplasia; Mandible; Dental Prosthesis, Implant-Supported; Treatment Outcome; Denture Retention
PubMed: 37608501
DOI: 10.1111/cid.13258 -
Clinical Oral Implants Research Sep 2023To analyze the effect of implant treatment in edentulous patients rehabilitated with implant-supported fixed complete dentures (IFCDs) or implant overdentures (IODs) on... (Meta-Analysis)
Meta-Analysis Review
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.
Topics: Humans; Denture, Overlay; Prospective Studies; Dental Implants; Denture, Complete; Mouth, Edentulous; Patient Reported Outcome Measures
PubMed: 37750530
DOI: 10.1111/clr.14065 -
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 -
Clinical Oral Investigations Feb 2022The aim of this study was to evaluate the factors influencing edentulous patients' willingness about mandibular implant-supported complete denture.
OBJECTIVE
The aim of this study was to evaluate the factors influencing edentulous patients' willingness about mandibular implant-supported complete denture.
MATERIALS AND METHODS
A cross-sectional study was carried out with 117 bimaxillary edentulous patients wearing removable complete dentures (CDs). Patients were assessed concerning denture-related items (number of previous mandibular CDs, previous denture wearing period, dentures maker professional, and regular wearing of previous mandibular dentures) and individual-related aspects, such as mandibular edentulousness period, mandibular bone height, and willingness to the use of mandibular implant-supported complete denture. Masticatory performance was evaluated by the median particle diameter. Mandibular bone height and satisfaction were assessed using a validated method. The Chi-square test was used for data analysis and prevalence ratios were adjusted by using multivariate Poisson regression, both with 95% confidence interval.
RESULTS
A total of 78 participants (66.7%) were interested in mandibular implant-supported overdenture (mean age 65.33 ± 9.49). Masticatory performance was not influenced by choosing mandibular implant-supported complete denture. The preference about mandibular implant-supported complete denture was correlated with longer mandibular complete denture experience (p = 0.021) and it was significantly associated with dissatisfaction about retention (p = 0.005).
CONCLUSION
Previous experience with mandibular complete dentures and dissatisfaction about retention influence the willingness about mandibular implant-supported overdenture.
CLINICAL RELEVANCE
Many factors are associated with rehabilitation preferences for edentulous patients and mandibular implant-supported complete denture is one of the available alternatives. Therefore, this study has demonstrated the factors influencing the decision to replace a mandibular conventional complete denture by dental implant treatment based on patient's outcomes. Such finding may be considered as a relevant aspect towards shared decision-making for prosthodontic rehabilitation of edentulous patients.
Topics: Aged; Cross-Sectional Studies; Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Complete; Denture, Overlay; Humans; Jaw, Edentulous; Mandible; Mastication; Middle Aged; Multivariate Analysis; Patient Satisfaction
PubMed: 34491447
DOI: 10.1007/s00784-021-04158-2 -
The International Journal of Oral &... 2022To compare the axial and nonaxial retention forces of different milled bar attachment designs for maxillary implant overdentures.
PURPOSE
To compare the axial and nonaxial retention forces of different milled bar attachment designs for maxillary implant overdentures.
MATERIALS AND METHODS
Four implants were placed in the canine and second premolar areas of an edentulous maxillary ridge model and connected to a cobalt-chromium milled bar either with or without Locator attachments. According to the type of bar and overlying housing, the following groups (n = 10 each) were investigated: group 1 (MWM) = milled bar without attachments and metal housing; group 2 (MWP) = milled bar without attachments and PEEK housing; group 3 (MAM) = milled bar with Locator attachments and metal housing; and group 4 (MAP) = milled bar with Locator attachments and PEEK housing. Axial and nonaxial (anterior, posterior, and lateral) retention forces were measured both at baseline and after wear simulation, then compared between groups and dislodging directions.
RESULTS
MAM showed the highest axial (53.20 ± 2.28 N) and nonaxial (anterior [33.80 ± 1.48 N], posterior [37.60 ± 2.07 N], and lateral [34.40 ± 1.67 N]) retention forces at baseline, followed by MAP, then MWM, and MWP (P < .001). MAP showed the highest axial (42.80 ± 2.28 N) and nonaxial (anterior [24.00 ± 1.58 N], posterior [29.40 ± 2.07 N], and lateral [27.80 ± 1.64 N]) retention forces after wear simulation, followed by MAM, then MWP, and finally MWM (P < .001). MAM showed the highest axial (25.25 ± 2.45 N) and nonaxial (anterior [28.29 ± 4.03 N], posterior [24.40 ± 3.25 N], and lateral [25.55 ± 1.65 N]) retention loss, followed by MWM, then MAP, and finally MWP (P < .001). For all groups, the highest retention forces were noted with axial dislodging, followed by posterior dislodging, then lateral dislodging, and finally vertical dislodging (P < .001).
CONCLUSION
Milled bars with PEEK housings and Locator attachments for maxillary implant overdentures were associated with the highest axial and nonaxial retention forces after wear simulation, while milled bars with metal housing and no attachments showed the lowest forces. Milled bars with metal housing and attachments showed the highest retention loss, while milled bars with PEEK housing with no attachments showed retention gain.
Topics: Humans; Denture, Overlay; Dental Implants; Research Design; Mouth, Edentulous
PubMed: 36450025
DOI: 10.11607/jomi.9684 -
The Journal of Prosthetic Dentistry Oct 2023Implant overdentures have been widely used as a treatment option for edentulous patients. However, the development of implants, aside from commercial growth, requires...
STATEMENT OF PROBLEM
Implant overdentures have been widely used as a treatment option for edentulous patients. However, the development of implants, aside from commercial growth, requires funding assistance to determine scientific reliability and clinical applications. Nonetheless, bibliometric studies in the implant overdenture field are lacking.
PURPOSE
The purpose of this bibliometric analysis was to evaluate the prevalence of funding and its bibliometric associated parameters according to the financial assistance granted and the implant overdenture documentation over time.
MATERIAL AND METHODS
Six databases were assessed, and 12 bibliometric parameters related to the economy, geographical origin, publication details, and corresponding author metrics were recorded. An incidence rate ratio was applied by using a multiple Poisson regression model (α=.05) to assess the association between funding and each bibliometric parameter.
RESULTS
In total, 1369 studies published between 1986 and 2021 were assessed bibliometrically. The prevalence of funded studies was 34.8% (n=477). The parameter associated with the presence of funding was country income (P<.01), with those having a high and upper-middle income being more funded than those with a lower-middle and low income. Oceania and South America were the continents more frequently funded (P<.05), with Africa being the least frequent. Randomized and nonrandomized controlled trials, in vitro studies, and in silico studies were more funded (P<.001) than case reports and series. Stud and ball attachment systems were more funded (P<.01) than studies with more than 1 retention system. Funding increased over time (P<.01), and corresponding authors with a higher h-index had more studies funded (P<.05).
CONCLUSIONS
The number of funded studies on implant overdentures increased over the years. Other bibliometric parameters such as country income, continent, study design, retention system, and corresponding author h-index were associated with the frequency of funded studies published.
Topics: Humans; Dental Implants; Denture, Overlay; Reproducibility of Results; Mouth, Edentulous; Bibliometrics; Dental Prosthesis, Implant-Supported; Denture Retention; Jaw, Edentulous
PubMed: 34916064
DOI: 10.1016/j.prosdent.2021.11.002 -
Evidence-based Dentistry Dec 2021Design A randomised crossover clinical trial was designed to determine survival and success of four-implant overdentures in the edentulous maxilla, in participants with... (Review)
Review
Design A randomised crossover clinical trial was designed to determine survival and success of four-implant overdentures in the edentulous maxilla, in participants with mandibular two-implant overdentures. Participants received four implants in the maxilla, two anteriorly and two posteriorly, then were randomly allocated into two treatment groups. The prosthetic phase included alternate loading of anterior and posterior implants for three months each, followed by loading of all four implants for another three months. Participants were then followed up in the recall phase for a mean period of 2.2 years.Case selection Four participants were taken from the authors' previous clinical study, meeting the inclusion criteria for a two-implant overdenture in the mandible. Another 21 participants were recruited from study calls after a widening of inclusion criteria. These patients were all pre-treated in accordance with the previous study protocol, so there was standardisation before maxillary implant placement.Data analysis A sample size calculation was performed and a Kaplan-Meier curve was used to demonstrate implant survival over time.Results Twenty-four patients were included in the study. Three implants were lost during the prosthetic phase and two during the recall phase; all were anterior implants. Implant survival after loading was 93.8% after a mean period of 3.1 years. There were 27 maxillary prosthetic complications overall. Denture success was 95.8% after a mean period of 2.2 years.Conclusions Implant survival of four asynchronously loaded implants in implant-supported overdentures in the edentulous maxilla was good and is a recommendable treatment option for patients with two-implant mandibular overdentures. Implant and prosthetic complications are common but mostly straightforward to manage. Two posterior implants are not superior to two anterior implants, but the majority of patients prefer the four-implant maxillary overdenture.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Humans; Mandible; Maxilla
PubMed: 34916643
DOI: 10.1038/s41432-021-0221-z -
Journal of Dentistry Dec 2021This cohort study investigated clinical, functional, and quality of life outcomes, along with prosthetic maintenance events in mandibular overdenture (MO) wearers for 3...
OBJECTIVES
This cohort study investigated clinical, functional, and quality of life outcomes, along with prosthetic maintenance events in mandibular overdenture (MO) wearers for 3 years.
METHODS
Thirty MO wearers with narrow diameter implants (NDIs) and locking taper stud abutments (Facility-Equator system) were annually monitored by registering the visible plaque index (VPI), peri‑implant inflammation (PI), calculus presence (CP), probing depth (PD), bleeding on probing (BOP), secondary implant stability (ISQ), marginal bone loss (MBL), masticatory performance and dental impact in daily life (DIDL) questionnaire domains. Multilevel mixed-effects linear regression was performed to analyse changes over time. Chi-square tests were performed to analyse the relationship between the appearance of prosthetic complications and maintenance occurrences. The survival rate of patients with NDIs was calculated using the Kaplan-Meier test.
RESULTS
Twenty-six individuals attended all follow-ups, the survival rate of 83.3% in the first year was maintained, and no one implant was lost over the 3-year period. There were significant differences for PD between 1 and 3 years (p ≤ 0.01) and between 2 and 3 years for PI (p ≤ 0.01), GI (p ≤ 0.01), ISQ (p = 0.02), and MBL (p ≤ 0.01). All masticatory performance outcomes showed significant differences (p ≤.01). Prosthetic maintenance events decreased significantly over time. Appearance, general performance, and eating and chewing domains presented high effect sizes.
CONCLUSION
Continued changes were observed in the clinical parameters of MO users over the 3-year period. In addition, most functional parameters, except for particle homogenization, improved significantly over time. The positive impact on quality of life is likely related to the significant reduction in prosthetic maintenance events.
CLINICAL SIGNIFICANCE
Periodic returns to assess peri‑implant tissues and MO maintenance should be performed to ensure the success of rehabilitation to assure improvements in masticatory function and oral health-related quality of life.
Topics: Aftercare; Cohort Studies; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Humans; Mandible; Mastication; Quality of Life
PubMed: 34740638
DOI: 10.1016/j.jdent.2021.103880 -
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