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BMC Oral Health Jun 2024This crossover clinical study aimed to evaluate and compare masticatory performance and patient satisfaction for patients rehabilitated with conventional heat-cured... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
BACKGROUND
This crossover clinical study aimed to evaluate and compare masticatory performance and patient satisfaction for patients rehabilitated with conventional heat-cured acrylic resin and 3D-printed mandibular implant overdentures retained with bar attachment.
MATERIALS AND METHODS
Sixteen completely edentulous healthy participants received new conventional dentures. In the mandible, four interforaminal implants were inserted. Following the stage of osseointegration, the bar was constructed in a trapezoidal configuration. Each patient randomly received the following overdentures using a crossover design: (1) conventional heat-cured acrylic resin overdenture and (2) 3D-printed overdenture (developed by scanning of mandibular conventional overdenture). The masticatory performance was assessed by conducting a two-colour mixing ability test at 5, 10, 20, 30, and 50 masticatory cycles. Moreover, the McGill Denture Satisfaction Questionnaire (MDSQ) was employed to assess patient satisfaction. Evaluation was performed after 3 months of using each overdenture. Paired sample t tests were used to compare the masticatory performance and MDSQ scores of patients for both prostheses.
RESULTS
No significant difference in masticatory performance was reported between the two types of overdentures. Regarding patient satisfaction, only the esthetic aspect was significantly better for conventionally processed overdentures than for printed overdentures. Insignificant differences were observed regarding other MDSQ items between the two overdentures.
CONCLUSION
Within this clinical study, 3D-printed implant overdentures showed promising results in terms of chewing efficiency and patient satisfaction compared to conventionally fabricated implant overdentures.
TRIAL REGISTRATION
Retrospectively registered at www.
CLINICALTRIALS
gov : NCT06148727.(28/11/2023).
Topics: Humans; Cross-Over Studies; Denture, Overlay; Patient Satisfaction; Mastication; Printing, Three-Dimensional; Male; Female; Dental Prosthesis, Implant-Supported; Middle Aged; Aged; Mandible; Acrylic Resins
PubMed: 38851676
DOI: 10.1186/s12903-024-04389-1 -
Clinical Oral Investigations May 2024The aim of this multi-center pilot study was to assess the viability and feasibility of a novel treatment concept - the canine-positioned single implant mandibular...
OBJECTIVES
The aim of this multi-center pilot study was to assess the viability and feasibility of a novel treatment concept - the canine-positioned single implant mandibular overdenture (c-SIMO), with the single implant placed on the patient's preferred chewing side instead of the midline.
MATERIALS AND METHODS
Participants received a single implant in the canine region of their preferred chewing side, based on an Asymmetry Index observed during mastication. The pre-existing mandibular denture was transformed into a c-SIMO on a spherical attachment. The primary outcome was oral health-related quality of life (OHRQoL), measured with GOHAI and OHIP-EDENT. Secondary outcomes included denture satisfaction index (DSI), chewing efficiency (CE), maximum bite force (MBF), implant survival and success, and prosthetic maintenance. Data analysis included descriptive statistics and bivariate comparison tests.
RESULTS
Fifteen participants received the c-SIMO treatment (mean age: 69.9 ± 7.0). Implant success and survival rates were 100% at 1 year. Patient-reported outcome measures improved significantly compared to pre-treatment values (OHIP-EDENT: p = 0.001; DSI: p = 0.001; GOHAI: p = 0.002). Masticatory outcomes also improved significantly (CE: p = 0.001; overall MBF: p = 0.005). Post-implant, MBF was significantly higher in the ipsilateral side compared to the contralateral side at 2 weeks (p = 0.019) and 3 months (p = 0.015), but no longer at T3 (p = 0.730). Common prosthodontic events included denture base adjustments (n = 17) and matrix activation (n = 9).
CONCLUSIONS
This pilot study concludes that c-SIMO is a promising treatment option, and a potential alternative to the single midline implant overdenture.
CLINICAL RELEVANCE
The novel treatment concept of a canine-positioned single implant mandibular overdenture could be a viable treatment alternative to the midline positioning.
Topics: Humans; Denture, Overlay; Pilot Projects; Aged; Male; Female; Feasibility Studies; Dental Prosthesis, Implant-Supported; Quality of Life; Mastication; Cuspid; Dental Implants, Single-Tooth; Patient Satisfaction; Middle Aged; Mandible; Denture Design
PubMed: 38772987
DOI: 10.1007/s00784-024-05723-1 -
Polymers Apr 2024The object of the study was to evaluate the suitability and trueness of the removable partial denture (RPD) framework fabricated by polyether ether ketone (PEEK) with...
The object of the study was to evaluate the suitability and trueness of the removable partial denture (RPD) framework fabricated by polyether ether ketone (PEEK) with the CAD-CAM technology in vitro. Four different types of dentition defects were selected. In each type, five PEEK RPD frameworks were fabricated by the CAD-CAM technology, while five Co-Cr RPD frameworks were made by traditional casting. The suitability of the framework was evaluated by silicone rubber film slice measurement and the three-dimensional image overlay method. The trueness of the PEEK framework was detected by the three-dimensional image overlay method. Data were statistically analyzed with the use of an independent samples -test (α = 0.05). The suitability values by silicone rubber film slice measurement of the PEEK group were lower than those of the Co-Cr group in four types, with the differences indicating statistical significance ( < 0.05) in type one, type two, and type four. The suitability values using the three-dimensional image overlay method showed no statistical differences ( > 0.05) between the two groups in four types. The trueness values of the PEEK group were within the allowable range of clinical error. The suitability and trueness of the PEEK RPD framework fabricated by CAD-CAM technology met the requirements of the clinical prosthesis.
PubMed: 38675038
DOI: 10.3390/polym16081119 -
Medicina (Kaunas, Lithuania) Mar 2024: Despite the identified benefits of early implant loading, studies have questioned its advantages compared to delayed loading in edentulous patients. This study aimed...
: Despite the identified benefits of early implant loading, studies have questioned its advantages compared to delayed loading in edentulous patients. This study aimed to evaluate clinical peri-implant parameters and marginal bone loss around early placed and loaded mandibular implant overdentures with a 60-month follow-up. : In this prospective cohort study, 43 patients were enrolled to receive 86 early loading sub-crestal dental implants through prosthetic guides. Implant overdentures were supported by two isolated implant locator attachments between two mental foramens. Clinical peri-implant parameters, including plaque index (PI), bleeding index (BI), peri-implant pocket depth (PIPD), and marginal bone loss (MBL) were evaluated using standardized techniques at 1, 12, 24, 36, 48, and 60 months follow-up. At 60 months, complications associated with implant overdentures (IOD's) were noted. The mean comparison of peri-implant clinical parameters was performed through ANOVA test. A -value of ≤0.05 was taken as significant. : Out of the total 43 enrolled patients, 8 patients were lost during follow-up; as a result, 35 patients completed the 5 years follow-up. The mean values of PI, BI, and PIPD increased with no statistical difference ( > 0.05). For marginal bone loss, an increase in the mean values was noted at different time intervals with statistical differences ( < 0.001). The most common complications noted were loosening of the abutment, occlusal adjustment, retentive locator loosening and replacement, and relining of the denture. : Early placement of IODs failed to prevent bone loss over time and was associated with complications, predominantly consisting of abutment loosening, occlusal adjustments, broken retentive locator components, relining, and rebasing.
Topics: Humans; Female; Denture, Overlay; Male; Prospective Studies; Alveolar Bone Loss; Middle Aged; Follow-Up Studies; Mandible; Aged; Dental Prosthesis, Implant-Supported; Dental Implants; Cohort Studies; Adult
PubMed: 38674234
DOI: 10.3390/medicina60040588 -
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 -
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 the West African College of... 2023Dental agenesis is the most common developmental aberration in humans, and it is typically linked with a variety of other oral anomalies. Oligodontia, anodontia, and...
Dental agenesis is the most common developmental aberration in humans, and it is typically linked with a variety of other oral anomalies. Oligodontia, anodontia, and hypodontia are the words used in the literature to denote missing teeth. Although tooth agenesis is not a serious public health problem, it can cause speech, masticatory, aesthetic, and functional problems. A multidisciplinary approach is necessary to establish comprehensive treatment planning, counselling sessions, and frequent follow-ups, to obtain stable, functional, and psychological rehabilitation, which will eventually improves the patient's quality of life. In this case study, after considering the young age and growth of the patient and also his financial status, a conservative approach to rehabilitate the non-syndromic oligodontia patient with a 12-year follow-up and fabrication of maxillary overlay denture and mandibular conventional complete denture has been discussed.
PubMed: 38449548
DOI: 10.4103/jwas.jwas_294_22 -
Dentistry Journal Feb 2024Digital technology has been introduced in prosthodontics, and it has been widely used in denture duplication instead of a conventional denture duplication technique....
BACKGROUND
Digital technology has been introduced in prosthodontics, and it has been widely used in denture duplication instead of a conventional denture duplication technique. However, research comparing different denture duplication techniques and how they affect the fitting accuracy of the denture base is scarce.
OBJECTIVES
The aim was to assess the impact of duplication techniques on the accuracy of the fitting surface of computer-aided design and manufacturing (CAD-CAM) milled, 3D-printed, and injection-molded complete denture bases (CDBs).
METHODOLOGY
This study involved fabricating a mandibular complete denture base with three marked dimples as reference marks (A, B, and C at the incisive papilla, right molar, and left molar areas) using a conventional compression molded technique. This denture was then scanned to generate a standard tessellation language (STL) file; after that, it was duplicated using three different techniques (milling, 3D printing, and injection molding) and five denture base resin materials-two milled CAD-CAM materials (AvaDent and IvoBase), two 3D-printed materials (NextDent and HARZ Labs), and one injection-molded material (iFlextm). Based on the denture base type, the study divided them into five groups (each with = 10). An evaluation of duplication accuracy was conducted on the fitting surface of each complete denture base (CDB) using two assessment methods. The first method was a two-dimensional evaluation, which entailed linear measurements of the distances (A-B, A-C, and B-C) between reference points on both the scanned reference mandibular denture and the duplicated dentures. Additionally, a three-dimensional superimposition technique was employed, involving the overlay of the STL files of the dentures onto the reference denture's STL file. The collected data underwent statistical analysis using a one-way analysis of variance and Tukey's pairwise post hoc tests.
RESULTS
Both evaluation techniques showed significant differences in fitting surface accuracy between the tested CDBs ( ˂ 0.001), as indicated by one-way ANOVA. In addition, the milled CDBs (AvaDent and IvoBase) had significantly higher fitting surface accuracy than the other groups ( ˂ 0.001) and were followed by 3D-printed CDBs (NextDent and HARZ Labs), while the injection-molded (iFlextm) CDBs had the lowest accuracy ( ˂ 0.001).
CONCLUSIONS
The duplication technique of complete dentures using a CAD-CAM milling system produced superior fitting surface accuracy compared to the 3D-printing and injection-molded techniques.
PubMed: 38392236
DOI: 10.3390/dj12020032