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Clinical and Experimental Dental... Apr 2021The World Health Organization (WHO) recognizes edentulism as a physical impairment that results in a negative impact in the daily activities. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The World Health Organization (WHO) recognizes edentulism as a physical impairment that results in a negative impact in the daily activities.
OBJECTIVE
The study aimed to compare the satisfaction and the quality of life, in patients treated with implant retained overdentures with two mandibular implants (IOD) against those with mandibular conventional complete dentures (CCD).
METHODS
Different search strategies were used to screen for articles in Pubmed/Medline, Cochrane Library and Scielo of the last 17 years (2003-2020). The keywords used were: "quality of life OR satisfaction" AND "complete denture OR conventional denture" AND "overdenture OR implant retained."
RESULTS
Six articles and two more were added by manual search. The population was 400 in the CCD and 412 for IOD. The mean age was 64.3 ± 6.41 years. The group was comprised of 283 men and 427 women. The scores obtained in the visual analog scale (VAS) before and after the treatment were statistically significant in favor of the IOD for overall satisfaction, (WMD: 12.329; 95% CI: 4.873 to 19.784, p-value = 0.001), comfort, speech and stability. For esthetics and chewing there was non-significant improvement while hygiene worsened for the IOD. For the comparison after the treatment between both treatment modalities a statistically significant improvement was found in overall satisfaction (WMD: 14.408; 95% CI: 8.589 to 20.226, p-value < 0.001), comfort, speech, chewing and stability in favor of the IOD but not in esthetics or hygiene.
CONCLUSIONS
This systematic review and meta-analysis show the superiority of the IOD, despite is not achieved in all aspects.
Topics: Aged; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Complete; Denture, Complete, Lower; Denture, Overlay; Female; Humans; Male; Middle Aged; Patient Satisfaction; Personal Satisfaction; Quality of Life
PubMed: 33205918
DOI: 10.1002/cre2.347 -
Nutrients Mar 2023Tooth loss may affect food ingestion and, consequently, nutrition intake. The neuroimaging literature using functional magnetic resonance imaging (fMRI) was reviewed to... (Review)
Review
Tooth loss may affect food ingestion and, consequently, nutrition intake. The neuroimaging literature using functional magnetic resonance imaging (fMRI) was reviewed to summarize the changes in brain functions in response to denture rehabilitation in patients with partial or complete edentulous dentition. Overall, this review covered nine fMRI studies on denture rehabilitation. Eight recruited complete edentulous patients, whereas one recruited partially edentulous patients. The risk-of-bias assessment revealed concerns regarding all nine studies. Due to the heterogeneity of the studies and the lack of brain coordinates reported, a meta-analysis could not be conducted, and this review could only summarize the findings without statistical validation. The evidence from jaw-clenching studies suggested that implant-supported fixed dentures could be the best option, as compared to implant-supported overdentures and complete dentures, as it was associated with higher brain activity levels in various brain regions, including those corresponding to the primary sensory (postcentral gyrus) and motor cortices (precentral gyrus). Gum-chewing studies indicated that perhaps the medial and middle frontal gyri were associated with food comminuting and food mixing, which could be improved by the full replacement of the dental arch, instead of only partial replacement. All the fMRI studies described the functional neuroplasticity of the patients undergoing denture rehabilitation and suggested that certain rehabilitation options were more beneficial in restoring masticatory functions, as well as their associated brain activity levels.
Topics: Humans; Adult; Magnetic Resonance Imaging; Denture, Complete; Mouth, Edentulous; Denture, Overlay; Neuronal Plasticity; Mastication
PubMed: 37049418
DOI: 10.3390/nu15071577 -
Journal of Prosthodontic Research Feb 2021To critically review the literature using mini-implants for prosthetic rehabilitation of growing patients and to analyze the survival rates and clinical behavior of... (Review)
Review
PURPOSE
To critically review the literature using mini-implants for prosthetic rehabilitation of growing patients and to analyze the survival rates and clinical behavior of mini-implants.
STUDY SELECTION
Controlled clinical trials and case reports published in English, from January 2006 to October 2018, in a peer-reviewed journal in PubMed, Scopus, LILACS, and Cochrane Library databases. Studies using mini-implants for prosthetic rehabilitation in growing patients were included. Articles reporting mini-implants with a diameter greater than 3 mm, recruitment of adult participants, use of implants with other purposes than prosthodontic rehabilitation, and with a follow-up period shorter than 1 year, were excluded from the analysis. The selection was performed independently by two reviewers.
RESULTS
The selection resulted in the inclusion of eight articles. Although the studies presented heterogeneous protocols and follow-ups (varying from 1 to 8 years), only one case of failure was reported, which corresponded to crown displacement. All rehabilitation procedures were performed in the anterior region using mini-implants with different diameters (1.3-2.9 mm) and lengths (9-14 mm). The prosthetic rehabilitation included individual crowns and/or overdentures.
CONCLUSIONS
Mini-implant prosthetic rehabilitation seems to be a viable and promising option for provisional rehabilitation of growing patients, since it seems to preserve the bone structure while restoring function and esthetics until growth ceases, when then mini-implants can be replaced by standard implants.
Topics: Adult; Crowns; Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture, Overlay; Humans
PubMed: 32938858
DOI: 10.2186/jpr.JPOR_2019_338 -
Clinical Oral Investigations Apr 2022The aim of the study was to determine differences between Locator and CM LOC attachment systems regarding patient satisfaction and wear of the abutments and their... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
The aim of the study was to determine differences between Locator and CM LOC attachment systems regarding patient satisfaction and wear of the abutments and their inserts. Plaque accumulation onto the polyetherketoneketone (PEKK) framework and polymethylmethacrylate (PMMA) was investigated for the implant-supported overdentures.
METHODS
Seventeen edentulous patients were randomised to receive either Locator or CM LOC system for the first year. The total number of implants was 53. After the randomisation, 25 implants received Locator system, and 28 implants received CM LOC system in the first year. After a period of 12 months, the attachment system was exchanged from either Locator to CM LOC or vice versa. Oral Health Impact Profile (OHIP-14) questionnaires were used to evaluate patient satisfaction, chewing comfort, and pressure lesions. Prosthesis hygiene on the PMMA and PEKK surfaces was evaluated by using Stark plaque index. After the exchange of the abutments, they were stored until the end of the 24 months, and the surface wear of the abutments was analysed using a scanning electron microscope.
RESULTS
Three patients (10 implants) died shortly before the end of the first year. Two patients (7 implants) received only Locator system since CM LOC was not indictable for their implant system. Patient's satisfaction was increased when the attachment system was changed from Locator to CM LOC after 12 months of wearing time. Chewing ability and comfort were increased when the attachment system was changed from CM LOC to Locator after 12-month wearing time. There was no influence of the change of the attachment system on pressure lesions. The observed plaque accumulation was higher on the PMMA than on the PEKK surface. For the 8 investigated Locator abutments, the wear was within low and middle level. For the 28 investigated CM LOC abutments, the wear was within middle and high level for the terminal implants and between low and middle for the central implants (for patients who received 4 implants).
CONCLUSIONS
Patient's satisfaction and wearing comfort can be improved with implant-supported overdentures with CM LOC abutments in comparison to Locator. There was no clear difference between both attachment systems concerning the chewing ability of the patients. Plaque accumulation was observed on both attachment systems in different areas. Plaque accumulation on PEKK surface was less than on PMMA surface.
CLINICAL RELEVANCE
The CM LOC attachment system offers stable and comfortable wearing conditions for implant-supported overdentures. The use of PEKK as a framework material could reduce the incidence of pressure lesions.
Topics: Benzophenones; Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Overlay; Humans; Jaw, Edentulous; Mandible; Mucous Membrane; Pilot Projects; Polymers
PubMed: 34935067
DOI: 10.1007/s00784-021-04342-4 -
Journal of Indian Prosthodontic Society 2022Mandibular overdenture is suspected to fracture, especially in the midline and anterior region due to low surface area of coverage and minimum acrylic thickness in...
Mandibular overdenture is suspected to fracture, especially in the midline and anterior region due to low surface area of coverage and minimum acrylic thickness in addition to attachments pickup holes that weakens the denture. Dentures used to be conventionally reinforced with metal meshwork which cannot be done in a digital workflow. This in vitro report introduces a novel approach of digital overdenture reinforcement using computer-aided design, computer-aided manufacturing, and rapid prototyping technologies. This novel approach provided digital reinforced, stable, and well-adapted overdenture with accurate and easy attachment pickup. Digital reinforced denture has fewer clinical steps with fewer laboratory complications. The newly developed overdenture fabrication techniques have the ability to change the conventional clinical and laboratory workflow from analog to digital. Which grantee standardization of the outcome on both research and clinical work.
Topics: Denture Retention; Dental Prosthesis, Implant-Supported; Dental Implants; Denture, Overlay; Mandible
PubMed: 36511033
DOI: 10.4103/jips.jips_514_21 -
Journal of Prosthodontics : Official... Dec 2022To estimate the effects of the thermal cycling (TC) process on the metal surfaces of Locators, as well as retention loss, and the correlation between them.
PURPOSE
To estimate the effects of the thermal cycling (TC) process on the metal surfaces of Locators, as well as retention loss, and the correlation between them.
MATERIALS AND METHODS
Twenty-five new Locator R-Tx were included in the study. Four areas were marked on each Locators' patrix metal surface and scanned using a confocal scanner (μsurf explorer; NanoFocus). Three surface roughness parameters were measured in the scans: Sa (average distance of peaks from the central plain of the area), Vmp (volume of the peaks in the area), and Spc (mean curvature of the peaks describing the degree of their sharpness). Retention test was performed using Instron® 4500 compression tension tensile tester at a speed of 10 mm/min. The retention tests were done using a working model made of two acrylic blocks in which the Locator system parts were inserted. The surface parameters measurements and the retention tests were performed 2 times, once before and once after TC. The Locators were subjected to 15,000 TC cycles by investing them into 2 tubs with different water temperatures, 55°C and 5°C. During each 60-second cycle, the Locators were submerged in each tub for 20 seconds, with a 10 second transition time between the tubs. The post-TC retention and surface parameters measurements were compared with those prior to TC and the prior to TC measurements served as controls. Changes in parameters before and after TC were analyzed by a two-way ANOVA nested model with random intercept and slope by restricted maximum likelihood method. Correlation between retention and surface parameters was quantified and examined using Kendall's correlation test. The findings were considered statistically significant if p < 0.05.
RESULTS
There was a significant decrease in retention of 16.6N at the second retention test (p < 0.001). A significant statistical decrease in surface parameters were measured after TC process, Sa and Vmp (18 ×10 μm, p = 0.041 and 0.94 ×10 1/μm, p = 0.001, respectively). A significant statistical increase in Spc of 6.4 ×10 μm /μm (p = 0.023) was noticed. The correlation between retention decreases and surface changes was not statistically significant.
CONCLUSION
The TC process causes a substantial reduction in retention to the Locator system over time. In addition, TC causes significant but minor changes to the Locator surface area. Most of the changes are in the horizontal dimension.
Topics: Denture Retention; Denture, Overlay; Dental Stress Analysis; Time Factors; Water; Surface Properties; Materials Testing
PubMed: 35061925
DOI: 10.1111/jopr.13481 -
JDR Clinical and Translational Research Jan 2024Single-implant mandibular overdentures (SIMOs) are one of the least invasive implant treatments for edentulism. The new Novaloc attachment system can improve the... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Single-implant mandibular overdentures (SIMOs) are one of the least invasive implant treatments for edentulism. The new Novaloc attachment system can improve the clinical performance of implant-retained overdentures but has not been tested for SIMOs.
OBJECTIVES
To compare Novaloc and a gold standard system (Locator) for SIMOs in an edentate elderly population in terms of patient-reported outcomes and device- and treatment-related complications.
METHODS
In this single-center crossover randomized clinical trial (RCT), 10 edentulous participants received an implant in the lower midline and had their lower complete dentures converted to SIMOs. The participants received each attachment system for 3 mo in a randomized order, followed by measurement of patient satisfaction and oral health-related quality of life via the McGill Denture Satisfaction Questionnaire and the Oral Health Impact Profile for Edentulous People questionnaire, respectively. Complications were registered throughout the RCT. Patients were interviewed for their experiences with SIMOs and preference for one of the attachment systems. Quantitative analysis employed mixed linear models and chi-square tests (α = 0.05), whereas interview data underwent thematic analysis and, in turn, integration into quantitative data (mixed methods explanatory design).
RESULTS
All 10 randomized participants completed the trial. Mean ± SD general satisfaction was 92% ± 8% with Novaloc versus 85% ± 13% with Locator (mean difference, 9%; 95% CI, 1% to 17%). For specific McGill Denture Satisfaction Questionnaire items, only denture stability was significantly increased for Novaloc. Seven participants preferred Novaloc over Locator at the end of the RCT (chi-square, = 0.045). No difference was found between the attachments in terms of oral health-related quality of life based on the Oral Health Impact Profile for Edentulous People and complications. Thematic analysis revealed high patient satisfaction with SIMOs, with denture stability the main criterion for their satisfaction and attachment preference.
CONCLUSION
Among elderly edentulous patients wearing SIMOs, Novaloc led to increased patient satisfaction and preference. Better patient-perceived denture stability may explain this result. The attachment systems exhibited similar short-term maintenance needs.
TRIAL REGISTRATION
ClinicalTrials.gov: NCT03126942 (first registered on April 13, 2017). Secondary identifiers: A03-M07-17A (McGill University, Institutional Review Board) and 2018-3873 (McGill University Health Centre, Research Ethics Board).
KNOWLEDGE TRANSFER STATEMENT
The results of this mixed methods study can be used by clinicians when choosing which attachment system to use for SIMOs. Results suggest that edentulous patients prefer attachments with a better-defined seating position, such as that of the Novaloc system, as opposed to the nylon matrix on metallic abutment of the Locator system.
Topics: Aged; Humans; Denture, Complete; Denture, Overlay; Jaw, Edentulous; Mandible; Patient Satisfaction; Cross-Over Studies
PubMed: 36127832
DOI: 10.1177/23800844221124083 -
Contemporary Clinical Dentistry 2022This clinical report describes the oral rehabilitation with a mandibular overdenture retained by telescopic crowns and ball attachments on semierupted permanent teeth...
This clinical report describes the oral rehabilitation with a mandibular overdenture retained by telescopic crowns and ball attachments on semierupted permanent teeth with a 5-year follow-up. A female patient used an old complete denture in the maxilla and was willing to extract her remaining mandibular teeth to have new dentures. The treatment included preservation of semierupted premolars because of the high surgical risk for mandibular fracture and paresthesia, a new maxillary complete denture, and a mandibular overdenture supported by combined telescopic crowns and ball attachments. The prosthetic rehabilitation restored function and esthetics with high patient satisfaction after 5 years in function.
PubMed: 36213847
DOI: 10.4103/ccd.ccd_240_21 -
International Journal of Environmental... Apr 2021Mini-dental implants (MDIs) have been used to support and retain overdentures, providing patients with a less invasive placement procedure. Although lucrative, the use... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Mini-dental implants (MDIs) have been used to support and retain overdentures, providing patients with a less invasive placement procedure. Although lucrative, the use of MDIs to retain a maxillary overdenture is still not an established treatment modality. This systematic review aims to answer the question: Do mini-implant-retained maxillary overdentures provide a satisfactory treatment outcome for complete edentulism?
METHODS
A systematic search for relevant articles was conducted to include articles published until April 2021 in the following electronic databases: CINAHL, Cochrane, EMBASE, PubMed, and Web of Science. All empirical studies evaluating the biological, survival, or patient-reported outcomes after placing mini-implant-retained overdentures in maxilla were considered for inclusion. The risk of bias was assessed by utilizing the Joanna Briggs Institute critical appraisal checklist. Study screening and data extraction were conducted by three reviewers independently.
RESULTS
The electronic search retrieved 1276 titles after omitting duplicates. Twenty articles were considered for full-text review, of which six studies were included in this systematic review. The included studies evaluated a total of 173 participants with a mean age of 66.3 years. The overall mini-implant survival rate was 77.1% (95% CI: 64.7-89.5%) with a mean follow-up time of 1.79 years (range: 6 months to 3 years). Implant survival differed significantly when comparing complete and partial palatal coverage overdentures. Those with complete palatal coverage exhibited less bone loss overall compared to partial coverage overdentures. Participants of all studies reported an increase in the quality of life and in satisfaction after rehabilitation treatment with MDIs.
CONCLUSIONS
The survival rate of mini-implants retaining an overdenture in the maxilla was observed to be lower than the values reported for traditional implants in the literature. Improvements were observed in all aspects in terms of patient satisfaction, quality of life, oromyofunction, and articulation after the treatment.
Topics: Aged; Denture, Overlay; Humans; Jaw, Edentulous; Maxilla; Mouth, Edentulous; Quality of Life
PubMed: 33924167
DOI: 10.3390/ijerph18084377 -
Clinical Oral Implants Research Nov 2022To compare clinical and patient-reported outcomes when providing maxillary overdentures on four and six splinted implants placed in the posterior region during a 10-year... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To compare clinical and patient-reported outcomes when providing maxillary overdentures on four and six splinted implants placed in the posterior region during a 10-year follow-up period.
MATERIALS AND METHODS
Sixty-six edentulous participants with functional maxillary denture complaints and insufficient bone volume to allow implant placement were scheduled for a bone augmentation procedure. After healing, participants were randomized to receive either four or six implants in the posterior maxilla. After 3 months of osseointegration, a bar overdenture was constructed. Implant survival, overdenture survival, clinical scores, peri-implant bone height changes, and patient satisfaction were assessed.
RESULTS
Forty-six participants completed the 10-year follow-up. Implant survival was 100% in the 4-implant group and 96.7% in the 6-implant group. Seven new overdentures were made in the 4-implant group and 12 new overdentures were made in the 6-implant group due to excessive wear of the denture base and teeth. Clinical parameters did not differ significantly between groups. Mean marginal bone loss compared to baseline was 0.41 ± 0.37 mm in the 4-implant group and 0.70 ± 1.07 mm in the 6-implant group. Overall, patient satisfaction improved significantly, but did not differ between groups.
CONCLUSION
From this 10-year follow-up trial, it was concluded that bar maxillary overdentures on four or six implants in the posterior region of an augmented maxilla resulted in a comparable treatment outcome with high implant survival, limited loss of peri-implant marginal bone, and high patients' satisfaction. (Clinical trial registration number: NTR9729).
Topics: Humans; Denture, Overlay; Maxilla; Jaw, Edentulous; Denture Retention; Dental Prosthesis, Implant-Supported; Dental Implants; Treatment Outcome
PubMed: 36151932
DOI: 10.1111/clr.13997