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General Dentistry 2024
Topics: Humans; Denture, Overlay; Patient Satisfaction; Dental Implants; Dental Prosthesis, Implant-Supported; Mandible; Denture Retention; Jaw, Edentulous
PubMed: 38640001
DOI: No ID Found -
Trials Apr 2024Complete tooth loss is a significant global oral health issue, particularly impacting older individuals with lower socioeconomic status. Computer-assisted technologies...
BACKGROUND
Complete tooth loss is a significant global oral health issue, particularly impacting older individuals with lower socioeconomic status. Computer-assisted technologies enhance oral healthcare access by the elderly. Despite promising in vitro reports on digital denture materials, evidence from randomized clinical trials (RCTs) is lacking to verify their performance. This cross-over RCT will investigate whether 3D-printed implant-retained mandibular overdentures (IMO) are more satisfactory for edentulous seniors than those made through traditional methods.
METHODS/DESIGN
We will recruit 26 completely edentulous participants (any sex/gender) based on the following eligibility criteria: age ≥ 60 years, no tooth extraction in the past 12 months, two implants in the lower jaw, and need for new dentures in both jaws. Each participant will receive two denture pairs, either manufactured by 3D printing or traditionally, to be worn in a random order. A timeline of 3 months with each denture pair will be considered for outcome assessment (total: 6 months). Patient satisfaction with dentures will be measured by the McGill Denture Satisfaction Questionnaire. We will evaluate other patient-reported outcomes (including oral health-related quality of life) as well as clinician-assessed quality and cost. At the end of the trial, participants will choose which denture pair they wish to keep and interviewed about their experiences with the 3D-printed IMO. The quantitative and qualitative data will be incorporated through an explanatory mixed-methods strategy. A final quantitative assessment will happen after 12 months with the preferred IMO to assess the long-term performance and maintenance needs.
DISCUSSION
This mixed-methods RCT will explore patient experiences with 3D-printed IMOs, aiming to assess the potential for altering clinical practice and dental public health policies. Our results will inform policies by showing whether 3D printing offers comparable outcomes at lower costs, facilitating greater access to oral care for the elderly.
TRIAL REGISTRATION
ClinicalTrials.gov, NCT06155630, Registered on 04 December 2023. https://classic.
CLINICALTRIALS
gov/ct2/show/NCT06155630.
Topics: Humans; Aged; Middle Aged; Denture, Overlay; Workflow; Jaw, Edentulous; Mandible; Patient Satisfaction; Printing, Three-Dimensional; Dental Prosthesis, Implant-Supported; Dental Implants; Randomized Controlled Trials as Topic
PubMed: 38627819
DOI: 10.1186/s13063-024-08097-7 -
Quintessence International (Berlin,... Jun 2024This systematic review compares the impact of ball and locator attachments on marginal bone loss in implant-retained overdentures in completely edentulous patients. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
This systematic review compares the impact of ball and locator attachments on marginal bone loss in implant-retained overdentures in completely edentulous patients.
METHOD AND MATERIALS
Following PRISMA guidelines, health science librarians completed literature searches from inception to 17 March 2023 in seven databases. There were 15,686 items exported to EndNote from Embase.com, CINAHL (EBSCO), Cochrane Library, Ovid MEDLINE-ALL, PubMed, Scopus, and Web of Science. Hand-searching added four more articles. After deduplication, 6,756 items were screened for eligibility. Twenty-nine studies were assessed by full text, of which ten studies, involving 424 subjects, were included in the review. Risk of bias assessment was conducted using the Cochrane risk-of-bias tool and the Newcastle-Ottawa scale. A meta-analysis was performed to synthesize and analyze the collective data from the selected studies.
RESULTS
The included studies used diverse methodologies, implant systems, and loading protocols. Most studies reported no significant difference in marginal bone loss between ball and locator attachments. The meta-analysis revealed high heterogeneity.
CONCLUSION
The results of this systematic review suggest that ball and locator attachments exhibit similar performance in terms of marginal bone loss in implant-retained overdentures. However, the limited number, risk of bias, and heterogeneity of studies highlight the need for standardized research designs and larger sample sizes in future investigations to draw more definitive conclusions.
Topics: Humans; Denture, Overlay; Dental Prosthesis, Implant-Supported; Alveolar Bone Loss; Denture Retention
PubMed: 38619260
DOI: 10.3290/j.qi.b5213685 -
Journal of Dentistry Jun 2024To report the implant survival rates, clinical, and radiographic status after a period of more than 5 years in the function of 4 inter-foraminal implants retaining...
OBJECTIVES
To report the implant survival rates, clinical, and radiographic status after a period of more than 5 years in the function of 4 inter-foraminal implants retaining mandibular overdentures (OVDs) in individuals with T2DM.
METHODS
78 completely edentulous participants with type 2 diabetic mellitus (T2DM) who had worn mandibular OVDs retained by 4 inter-foraminal implants for long-term functional life were selected for this study. The participants were divided into 2 groups according to glycosylated haemoglobin A1c (HbA1c) levels before implant placement: group I with an HbA1c value > 6.5 % (inadequately controlled T2DM), and group II with an HbA1c value ≤6.5 % (well-controlled T2DM). The inadequately controlled T2DM was further subdivided into 2 groups: Group IA with an HbA1c value > 6.5 % and ≤8 % (moderately controlled), and Group IB has an HbA1c value > 8 % (poorly controlled). Implant survival rate, plaque index (PI), bleeding on probing (BOP), probing depth (PD), and radiographic crestal bone level (CBL) around implants were measured.
RESULTS
Among 312 implants, 6 failed, 4 in well-controlled diabetics, and 2 in inadequately controlled diabetics. The overall survival rate was 98.07 %. The mean PI in group Ι was 36.4 (group IA =37.76, group IB = 34.27), and in group ΙΙ it was 19. The mean BOP in group Ι was 45.5 (group IA =47.84, group IB = 41.76), and in group ΙΙ it was 22. The mean PD in group Ι was 4.1 (group IA =4.3, group IB = 3.85) and in group ΙΙ was 2.2. The mean radiographic CBL in group Ι was 3.4 (group IA =3.7, group IB = 2.9), and in group ΙΙ was 1.5. Group IA exhibited a significantly greater level of PI, BOP, PD, and CBL compared to group IB and group IΙ (P1=0.017, P2=0.001).
CONCLUSIONS
Individuals with T2DM can benefit from 4 inter-foraminal implants retained mandibular OVDs, and their inability to maintain proper glucose control may not exclude implant success.
CLINICAL SIGNIFICANCE
This study is a significant step toward improving knowledge of options available for treatment and anticipated outcomes for T2DM completely edentulous populations undergoing implant therapy.
Topics: Humans; Diabetes Mellitus, Type 2; Denture, Overlay; Male; Dental Prosthesis, Implant-Supported; Glycated Hemoglobin; Female; Retrospective Studies; Middle Aged; Mandible; Aged; Dental Implants; Treatment Outcome; Dental Plaque Index; Periodontal Index; Alveolar Bone Loss; Denture, Complete, Lower; Denture Retention; Dental Restoration Failure; Jaw, Edentulous
PubMed: 38583644
DOI: 10.1016/j.jdent.2024.104982 -
Shanghai Kou Qiang Yi Xue = Shanghai... Feb 2024To observe the long-term clinical effect of implants retained complete overdentures with Locator attachments.
PURPOSE
To observe the long-term clinical effect of implants retained complete overdentures with Locator attachments.
METHODS
A total of 48 patients with edentulous jaws treated with implants retained complete overdentures with Locator attachments were selected from the Outpatient Department of Peking University School and Hospital of Stomatology from 2016 to 2017. Among them, 21 patients underwent double-maxillary complete overdentures restoration and 27 patients underwent single-maxillary restoration. A total of 230 implants were implanted. The clinical observation indicators included the implant survival rate, peri-implant mucosal bleeding on probing(BOP), the change in the vertical height of alveolar bone absorption around the implants, overdenture base fracture rate, artificial tooth fall off and fracture rate and other complications. The change of the locator attachment retention force of the implant-supported overdentures was evaluated. SPSS 13.0 software package was used for data analysis.
RESULTS
During the five-years clinical observation period, 5 implants fell off, 1 narrow dimeter implant in the anterior zone was broken, and 12 implants were lost to follow-up. The implant survival rate was 97.25%. One year after the restoration therapy finished, peri-implant mucosal bleeding on probing (BOP+) was detected in 48 (21.4%) implants. The average BI was 0.21±0.42, which was higher in the anterior zone than that in the posterior zone. The vertical alveolar bone absorption height around the implants was (0.21±0.35) mm, 2 implants-supported complete overdenture bases were broken. After 5 years of restoration, 163(76.89%) implants had peri-implant mucosal bleeding on probing(BOP+). The average BI was 1.00±0.70, and the vertical alveolar bone absorption height around the implants was (0.58±0.85) mm. There was no significant difference between males and females. There was no significant difference in the peri-implant mucosal bleeding index and the alveolar bone vertical absorption height between the anterior zone and the posterior zone(P>0.05). The mean BI of peri-implant mucosa and the vertical absorption height of peri-implant alveolar bone were significantly different between the 1-year observation period and the 5-year observation period respectively(P<0.01). There were 17(26.15%) cases with overdenture bases fracture, and the fracture rate of artificial teeth was 16.92%. Most of them occurred in the midline area of the anterior zone and the location of the overdenture base on the locator attachments. The average first replacement time of the locator attachment nylon retainer washer was 34.2±10.3 months.
CONCLUSIONS
Implants retained complete overdentures with Locator attachments are effective in long term clinical observation. Complications are mainly found in peri-implant mucosal bleeding on probing and vertical alveolar bone absorption, and tended to increase gradually over time. The fracture of the implant retains complete overdenture bases and the fall off or fracture of the artificial teeth are the second serious complications. Overdenture base with metal frame at the location of the Locator abutment and the midline of the anterior area should be strengthened, and narrow diameter implants should be avoided as far as possible in the anterior zone.
Topics: Male; Female; Humans; Denture, Overlay; Dental Prosthesis, Implant-Supported; Denture Retention; Jaw, Edentulous; Mandible; Dental Implants
PubMed: 38583032
DOI: No ID Found -
Evidence-based Dentistry Jun 2024This study was an extension of a randomized crossover clinical trial approved by the institutional ethics committee (approval number: D2014-148) and adhered to the... (Randomized Controlled Trial)
Randomized Controlled Trial
DESIGN
This study was an extension of a randomized crossover clinical trial approved by the institutional ethics committee (approval number: D2014-148) and adhered to the CONSORT guidelines. The original study juxtaposed patient contentment with single-implant overdentures (1-IODs) against conventional complete dentures (CCDs), with patient satisfaction being the primary focus. In this follow-up study, the cognitive function of edentulous patients receiving 1-IODs was assessed, specifically monitoring for the emergence of mild cognitive impairment (MCI) throughout a three-year period. Patient outcomes were systematically recorded at predetermined intervals: initially, two months post-1-IOD placement, after one year (with groups alternated between denture types at eight-month marks), then after two and three years. A prosthodontist with a decade of expertise performed all denture-related procedures. This follow-up emphasized the cognitive outcomes using the Montreal Cognitive Assessment (MoCA-J), considering it alongside previously documented results on masticatory function, bone resorption, survival rates, and patient-reported outcomes.
CASE SELECTION
Between 2015 and 2016, a follow-up study enrolled edentulous patients over 50 years of age who were proficient in Japanese, had sufficient mandibular bone for implants, and were free of systemic health issues and habits that could impact oral health. The participants were randomly divided into two groups after receiving a central mandibular implant. Group 1 initially used 1-IODs, and Group 2 used unloaded CCDs. After two months and subsequent periods, they swapped denture types. Eventually, all patients chose 1-IODs for continued use. Implant success was monitored over three years. The design featured block randomization and accounted for a sample size of 22, determined to be sufficient for evaluating the primary outcome of patient satisfaction. All patients underwent careful allocation and received customized dental interventions, with detailed radiographic planning and surgical precision guiding the implantation process.
DATA ANALYSIS
Multivariable linear mixed models were used to assess within-group changes in both overall and specific cognitive function scores across five timepoints. Age, assessment interval, and upper jaw denture status were incorporated as consistent variables, while individual participants were considered variable elements in the analysis. SPSS software version 22.0 was utilized to conduct the statistical tests, and a p value threshold of 0.05 was predetermined to establish statistical significance.
RESULTS
Twenty-two patients with edentulous mandibles received 1-IODs. Memory and executive functions saw significant score increases at multiple timepoints over the three-year period, with statistical significance. Though one participant dropped out and another passed away, and two did not complete the 3-year follow-up, the remaining 18 participants provided comprehensive data. Age and type of maxillary denture were significant factors, influencing MoCA-J scores with older participants and those with fixed dentures showing lower scores in certain domains. Overall, the findings illustrated the positive correlation between 1-IODs and cognitive function in older adults.
CONCLUSIONS
Older adults with no natural teeth left in their mandible showed improved cognitive function after one and three years of using 1-IODs, as reflected by their total and specific cognitive domain scores. The study suggests that such implant therapy may offer protective benefits against cognitive decline, demonstrating clinical relevance for patient care, regardless of the maxillary arch (antagonist) condition.
Topics: Humans; Denture, Overlay; Aged; Female; Male; Cognition; Dental Prosthesis, Implant-Supported; Cross-Over Studies; Cognitive Dysfunction; Aged, 80 and over; Patient Satisfaction; Middle Aged; Follow-Up Studies; Mouth, Edentulous
PubMed: 38570647
DOI: 10.1038/s41432-024-00999-4 -
BMC Oral Health Mar 2024To assess stress distribution in peri-implant bone and attachments of mandibular overdentures retained by small diameter implants, and to explore the impact of implant...
OBJECTIVE
To assess stress distribution in peri-implant bone and attachments of mandibular overdentures retained by small diameter implants, and to explore the impact of implant distribution on denture stability.
METHODS
Through three-dimensional Finite Element Analysis (3D FEA), four models were established: three models of a two mandibular implants retained overdenture (IOD) and one model of a conventional complete denture (CD). The three IOD models consisted of one with two implants in the bilateral canine area, another with implants in the bilateral lateral incisor area, and the third with one implant in the canine area, and another in the lateral incisor area. Three types of loads were applied on the overdenture for each model: a 100 N vertical load and a inclined load on the left first molar, and a100N vertical load on the lower incisors. The stress distribution in the peri-implant bone, attachments, and the biomechanical behaviors of the overdentures were analyzed.
RESULTS
Despite different distribution of implants, the maximum stress values in peri-implant bone remained within the physiological threshold for all models across three loading conditions. The dispersed implant distribution design (implant in the canine area) exhibited the highest maximum stress in peri-implant bone (822.8 µe) and the attachments (275 MPa) among the three IOD models. The CD model demonstrated highest peak pressure on mucosa under three loading conditions (0.8188 Mpa). The contact area between the denture and mucosa of the CD model was smaller than that in the IOD models under molar loading, yet it was larger in the CD model compared to the IOD model under anterior loading. However, the contact area between the denture and mucosa under anterior loading in all models was significantly smaller than those under molar loading. The IOD in all three models exhibited significantly less rotational movement than the complete denture. Different implant positions had minimal impact on the rotational movement of the IOD.
CONCLUSION
IOD with implants in canine area exhibited the highest maximum stress in the peri-implant bone and attachments, and demonstrated increased rotational movement. The maximum principal stress was concentrated around the neck of the small diameter one-piece implant, rather than in the abutment. An overdenture retained by two implants showed better stability than a complete denture.
Topics: Humans; Dental Implants; Denture, Overlay; Finite Element Analysis; Denture, Complete; Mandible; Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Denture Retention
PubMed: 38555452
DOI: 10.1186/s12903-024-04146-4 -
Photodiagnosis and Photodynamic Therapy Apr 2024The aim was to systematically review clinical studies that investigated the efficacy of antimicrobial photodynamic therapy (aPDT) in reducing oral yeasts growth (OYG) in... (Review)
Review
OBJECTIVE
The aim was to systematically review clinical studies that investigated the efficacy of antimicrobial photodynamic therapy (aPDT) in reducing oral yeasts growth (OYG) in individuals wearing implant overdentures (IO).
METHODS
The focused question was "Is aPDT effective in reducing OYG in patients wearing IO?" Literature search was performed in accordance with PRISMA guidelines. Indexed databases were searched without time and language restrictions up to and including January 2024. Clinical studies were included; and letters to the Editor, case-reports/case-series, perspectives/commentaries, in-vitro/ex-vivo studies, studies on animal models and expert opinions were excluded. The risk of bias was also assessed.
RESULTS
Two clinical studies were included and processed for data extraction. The study population comprised of 100 (mean age: 58.5 years) and 53 (mean age: 58.5 years) individuals. The numbers of males and females included in these studies ranged between 33 and 35 males and 18-67 females, respectively. In both studies, follow-up evaluations were performed after 60 days. In both studies, aPDT was performed using a 660 nm diode laser at a power of 100 mW and using methylene-blue as photosensitizer. Results from both studies showed that aPDT is effective in significantly reducing oral yeasts CFU/ml and improvement of OHRQoL of individuals using IO.
CONCLUSION
The aPDT is useful in reducing OYG on IO; however, further well-designed and power-adjusted studies are needed in this area of research.
Topics: Photochemotherapy; Humans; Photosensitizing Agents; Denture, Overlay; Methylene Blue; Lasers, Semiconductor; Yeasts; Clinical Trials as Topic
PubMed: 38548040
DOI: 10.1016/j.pdpdt.2024.104050 -
International Journal of Implant... Mar 2024The aim of this article is to evaluate to the masticatory function performance and Oral Health-related Quality of Life (OHRQoL) in implant-retained overdenture compared...
Evaluation of masticatory efficiency and OHRQoL in implant-retained overdenture with different numbers of implant in the edentulous mandible: a one-year follow-up prospective study.
PURPOSE
The aim of this article is to evaluate to the masticatory function performance and Oral Health-related Quality of Life (OHRQoL) in implant-retained overdenture compared with different implant number placements in the edentulous mandible.
METHODS
From 2013 to 2015, each patients received 3 implants (iSy-Implant, Camlog, Wimsheim, Germany) in intraforaminal mandible (34, 41/31, 44). After operation, inserted implants were gradually loaded and incorporated into an overdenture with a self-aligning attachment system (Locator abutments) in 3 + 3 + 3 months. Five checked points were performed chewing cycle test with multicolored chewing gum and OHIP-G14 questionnaire and a sum score questionnaire as following: pre-operation, one implant load (41/31), two implants loaded (33,43), three implants loaded and 1-year follow up.
RESULT
A total of 10 patients with 30 implants were placed, the survival rate of the implants was 100% within 1-year follow-up. Regarding the masticatory function analysis, for the higher number of chewing cycles, the higher mixing rate was observed. After 1 year, the inter-mixing rate without significant changes was found compared to the time after three implants were loaded with attachment system. The mean value of OHIP-G14 was 30.4 preoperatively, 21.1 after loading the first locator, 10.7 after loading two locator abutments, and 3.2 after loading all three locator abutments. After 1 year, OHIP-G14 was 2.6 without significantly changed. The mean of the sum score was 15.5 preoperatively, 27.8 after activation of the first locator, 39.4 after activation of two locators, 46.2 after activation of all three locators, and 47.3 after 1 year. An increase of 0.7 sum score units per time point was observed. No significance was detectable, analogous to OHIP-G14, compared to the time of activation of all three locator setups (p-value = 0.22).
CONCLUSIONS
A significant improvement in masticatory function performance and OHRQoL was evaluated with the increasing number of implants with locator attachment in edentulous mandible. With the investigation of the OHIP-G14 and sum score, the results of patient report outcome might be associated with the increase in the number of implants.
Topics: Humans; Follow-Up Studies; Dental Implants; Prospective Studies; Denture, Overlay; Quality of Life; Jaw, Edentulous; Mandible
PubMed: 38480586
DOI: 10.1186/s40729-024-00519-0 -
Journal of Oral Rehabilitation Jun 2024Graftless sinus floor augmentation shows good results in bone gain, radiology and implant survival. Clinically, this technique can be recommended as an alternative to...
BACKGROUND
Graftless sinus floor augmentation shows good results in bone gain, radiology and implant survival. Clinically, this technique can be recommended as an alternative to conventional procedures using augmentation materials.
OBJECTIVES
This study aims to assess masticatory performance, masticatory ability and patient satisfaction after graftless sinus floor augmentation.
METHODS
The study group consisted of patients who had received a graftless sinus lift procedure in a split-mouth design and was compared to patients with maxillary implant-supported overdentures without augmentation and a natural dentition group. To assess objective masticatory performance, the mixing ability test was performed. Three questionnaires were used to assess patient reported outcomes related to mastication and patient satisfaction.
RESULTS
Each group included ten patients. Both the graftless sinus lift group and the edentulous control group had a worse masticatory performance compared to the natural dentition group. Masticatory ability, measured by patient reported outcomes, was not different between the graftless sinus floor augmentation group and implant-retained overdentures group without augmentation, but the natural dentition group showed better results. Thereby, the better the masticatory performance in patients with a graftless sinus membrane elevation the better the patient satisfaction for 'prosthesis', 'appearance of prostheses', 'speech' and 'mastication and eating'.
CONCLUSIONS
Patients with implant-supported overdentures show inferior masticatory function compared to those with natural dentition. There were no significant differences in masticatory performance between patients with implant-retained overdentures, with or without graftless augmentation. The decision on the preferred procedure should consider additional factors such as anatomical, surgical-technical aspects and patient's preferences.
Topics: Humans; Mastication; Female; Male; Denture, Overlay; Patient Satisfaction; Middle Aged; Dental Prosthesis, Implant-Supported; Sinus Floor Augmentation; Aged; Mouth, Edentulous; Treatment Outcome
PubMed: 38475939
DOI: 10.1111/joor.13675