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Nigerian Journal of Clinical Practice Oct 2023Implant-supported overdentures are well-known and widely accepted treatment modality to increase retention which is a crucial factor for determining patient...
Biomechanical behavior of carbon fiber-reinforced polyetheretherketone as a dental implant material in implant-supported overdenture under mandibular trauma: A finite element analysis study.
CONTEXT
Implant-supported overdentures are well-known and widely accepted treatment modality to increase retention which is a crucial factor for determining patient satisfaction. The placement of two implants in the anterior region can be selected as a first-line treatment in patients with the atrophic mandibular ridge.
AIMS
The purpose of this research was to assess the biomechanical effects of carbon fiber-reinforced polyetheretherketone (CFR-PEEK) implant-supported overdenture in the event of 2,000 N forefront trauma to an atrophic edentulous mandible by using the finite element analysis method.
MATERIALS AND METHODS
Three types of mandible models were simulated; the first one was an edentulous atrophic mandible model; in the second model, 3.5 × 11.5 mm CFR-PEEK implants; and in the third model, 4.3 × 11.5 mm CFR-PEEK implants were positioned in the region of the lateral incisor of the identical edentulous atrophic mandible.
RESULTS
Maximum Von Misses stresses 979.261 MPa, 1,454.69 MPa, and 1,940.71 MPa and maximum principal stresses 1,112.74 MPa, 1,249.88 MPa, and 1,251.33 MPa have been detected at the condylar neck area and minimum principal stresses - 1,203.38 MPa, -1,503.21 MPa, and - 1,990.34 MPa have been recorded at the symphysis and corpus regions from M1 to M3, respectively. In addition, the M2 and M3 models showed low-stress distributions around the implant-bone interface, particularly where the implants were in contact with cancellous bone.
CONCLUSIONS
The results showed that the insertion of different diameters of CFR-PEEK implants led to low and homogenous stress distribution all around the implant-bone interface and stresses transferred directly to the condylar neck areas. Therefore, it was observed that CRF-PEEK implants did not change the basic behavior of the mandibula in response to frontal stresses.
Topics: Humans; Carbon Fiber; Denture, Overlay; Dental Implants; Finite Element Analysis; Mandible; Polyethylene Glycols; Ketones; Dental Materials; Dental Stress Analysis; Dental Prosthesis, Implant-Supported
PubMed: 37929532
DOI: 10.4103/njcp.njcp_239_23 -
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 -
Clinical Oral Implants Research Sep 2023The aim of Working Group 4 was to address patient benefits associated with implant dentistry. Focused questions on (a) dental patient-reported outcomes (dPROs), (b)...
OBJECTIVES
The aim of Working Group 4 was to address patient benefits associated with implant dentistry. Focused questions on (a) dental patient-reported outcomes (dPROs), (b) improvement in orofacial function, and (c) preservation of orofacial tissues in partially and fully edentulous patients following provision of implant-retained/supported dental prostheses were addressed.
MATERIALS AND METHODS
Three systematic reviews formed the basis for discussion. Participants developed statements and recommendations determined by group consensus based on the findings of the systematic reviews. These were then presented and accepted following further discussion and modifications as required by the plenary of the 7th ITI Consensus Conference, taking place in 2023 in Lisbon, Portugal.
RESULTS
Edentulous patients wearing complete dentures (CD) experience substantial improvements in overall dPROs and orofacial function following treatment with either complete implant-supported fixed dental prostheses (CIFDP) or implant overdentures (IODs). With respect to dPROs, mandibular IODs retained by two implants are superior to IODs retained by one implant. However, increasing the number of implants beyond two, does not further improve dPROs. In fully edentulous patients, rehabilitation with CIFDP or IOD is recommended to benefit the preservation of alveolar bone and masseter muscle thickness.
CONCLUSIONS
Completely edentulous patients benefit substantially when at least the mandible is restored using an CIFDP or an IOD compared to CD. In fully edentulous patients, implant prostheses are the best option for tooth replacement. The availability of this treatment modality should be actively promoted in all edentulous communities, including those with limited access and means.
Topics: Humans; Dental Implants; Mouth, Edentulous; Denture, Complete; Consensus; Denture, Overlay
PubMed: 37750516
DOI: 10.1111/clr.14145 -
Journal of Applied Oral Science :... 2023Currently, there is no consensus on the indications and clinical performance of implant-supported overdentures (IODs) involving computer-aided design and manufacturing... (Meta-Analysis)
Meta-Analysis
UNLABELLED
Currently, there is no consensus on the indications and clinical performance of implant-supported overdentures (IODs) involving computer-aided design and manufacturing (CAD-CAM) bars.
OBJECTIVE
To evaluate the performance of IODs involving CAD-CAM bars.
METHODOLOGY
A comprehensive search of studies published until May 2023 was conducted in many databases, including PubMed/MEDLINE, Web of Science, Cochrane Library, and SciELO, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The population, intervention, comparison, outcome (PICO) question was: "How do IODs retained by bars fabricated by CAD-CAM technology perform in daily clinical practice?" The meta-analysis included clinical studies based on effect size and a two-tailed null test with a 95% confidence interval (CI).
RESULTS
Ten studies were included in the meta-analysis. Among them, nine reported a 100% implant survival rate for all CAD-CAM milled bars. Complications were reported in two studies with CAD/CAM-milled titanium bars, and one study reported more fractures in soldered gold bars used in maxillary rehabilitation. However, no fractures were observed in IODs retained by PEEK and zirconia bars. According to six studies, biological complications, including peri-implantitis, were minimal in the BioHPP and PEEK bar groups, while no cases were reported in the titanium or zirconia bar groups. CAD-CAM-milled zirconia bars had higher plaque and bleeding indices compared with titanium bars, as evidenced by findings from five studies. All four studies that evaluated Oral Health Impact Profile (OHIP) scores showed a positive effect of IODs retained by CAD-CAM milled titanium bars on quality of life. Patient satisfaction and acceptance by prosthodontists were significantly high, according to the results of five studies.
CONCLUSION
Overdentures retained with CAD-CAM milled titanium bars show great potential for use in daily clinical practice. Moreover, patient and practitioner satisfaction was very high when this method was used.
Topics: Humans; Denture, Overlay; Quality of Life; Titanium; Computer-Aided Design
PubMed: 37646715
DOI: 10.1590/1678-7757-2023-0054 -
Journal of Dentistry Oct 2023To explore the perspectives and experiences of edentate individuals in regard to the immediate-loading protocol of an implant-supported overdenture.
OBJECTIVES
To explore the perspectives and experiences of edentate individuals in regard to the immediate-loading protocol of an implant-supported overdenture.
METHODS
A qualitative approach and interpretive description methodology was used. Seventeen edentate individuals (mean age: 61.9 ± 6.6 years) who received implant-supported overdentures through an immediate-loading protocol participated. Audio-recorded, semi-structured, in-depth interviews, each with a 60-90-minute duration, were conducted by two trained interviewers. The interview guide was developed based on Perneger's Detailed Model. Qualitative data were analyzed using a thematic approach including interview debriefing, transcript coding, data display, inductive thematic analysis, and interpretation.
RESULTS
Three main themes emerged from the interviews: patient awareness and engagement with treatment, experience-shaped expectations, and immediate gratification. All patients expressed satisfaction with the treatment. Providing detailed information, good communication, and accessibility of the dental care provider had a significant impact on patient satisfaction with prosthetic care. Patients highlighted that the high cost of implant therapy was the major barrier to receiving this treatment in the private sector and perceived dental insurance coverage as a facilitator of this process.
CONCLUSIONS
Study findings conclude that patient awareness about immediate-loading protocol improved their treatment engagement, and patient satisfaction with the treatment outcomes was higher than anticipated. The satisfaction was primarily related to prosthesis stability, receiving the prosthesis the same day, and low cost of treatment. Patients' positive experience and satisfaction with the immediate-loading protocol indicate that this treatment modality should be considered in treatment planning for edentate individuals.
CLINICAL SIGNIFICANCE
The perceptions and experiences of edentulous patients gathered in this study highlight their satisfaction with immediate loading for implant-supported overdentures. This therapeutic modality can be considered a viable option in treatment planning for edentulous individuals.
Topics: Humans; Middle Aged; Aged; Dental Implants; Patient Satisfaction; Denture, Overlay; Mandible; Dental Prosthesis, Implant-Supported; Treatment Outcome; Immediate Dental Implant Loading; Jaw, Edentulous; Mouth, Edentulous; Personal Satisfaction
PubMed: 37527728
DOI: 10.1016/j.jdent.2023.104644 -
BMC Oral Health Jul 2023The aim of this study is to evaluate the stresses on the supporting bone, implants, and framework materials under masticatory forces in mandibular overdenture prostheses...
BACKGROUND
The aim of this study is to evaluate the stresses on the supporting bone, implants, and framework materials under masticatory forces in mandibular overdenture prostheses modeled with different framework materials and different implant types, using the Finite Element Analysis (FEA).
METHODS
For the finite element modeling, two identical mandibular jaw models were created; one with two standard (diameter:4.1 mm/12 mm length) and the other with two mini-implants (diameter:2.4 mm/12 mm length) were placed in the canine teeth area. The polymethylmethacrylate (PMMA) denture was modeled upon them, supported by Cobalt Chromium alloy (CoCr), Poly-ether ether ketone (PEEK), and Zantex materials with framework. No framework was added as a control model; only PMMA overdenture prosthesis was modeled.
RESULTS
Regardless of the framework materials of the overdenture prostheses, the stress values on mini-implants in all models yielded approximately two times higher results comparing to standard implants. More stress transmission was observed in the supporting bone and implants in the control prostheses and overdenture prostheses supported with respectively PEEK, Zantex, CoCr alloy frameworks, respectively. In the framework materials, more stress occurred on CoCr, Zantex and PEEK in that order.
CONCLUSION
In the light of this study, the use of mini-implants as an alternative to standard implants is not promising in terms of distribution and transmission of chewing stresses. As a framework material, standard rigid metal alloys were found to be more advantageous than polymer materials in terms of stress distribution.
Topics: Dental Implants; Finite Element Analysis; Denture, Overlay; Polymethyl Methacrylate; Mandible; Ethers; Dental Prosthesis, Implant-Supported; Stress, Mechanical; Dental Stress Analysis
PubMed: 37408011
DOI: 10.1186/s12903-023-03080-1 -
Clinical Oral Implants Research Aug 2023To report the 1-year implant survival/success and peri-implant outcomes of mandibular overdentures retained by four titanium-zirconium mini implants (Straumann® Mini... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To report the 1-year implant survival/success and peri-implant outcomes of mandibular overdentures retained by four titanium-zirconium mini implants (Straumann® Mini Implant System), and to assess how surgery and loading protocols influence these outcomes.
MATERIALS AND METHODS
A 2 × 2 factorial randomized clinical trial (RCT) tested the combined effects of two loading protocols (immediate or delayed) and two surgical approaches (flapless or flapped) on the success/survival of the mini implants, and peri-implant parameters (plaque, bleeding, sulcus depth, gingival position, and marginal bone loss). Outcomes were assessed up to 1-year after loading, and generalized estimating equations (GEEs) were used to analyze longitudinal and within-patient clustered data.
RESULTS
Two hundred and ninety-six implants were placed in 74 patients. The implant survival/success rates after 1 year were 100%, and no major biological complications were observed. After 1-year, descriptive data suggest no noticeable changes in plaque scores, whilst a reduction in bleeding scores at the 6-month and 1-year follow-ups compared to baseline. Good longitudinal stability was observed for the probing depth and gingival margin height measures. Overall mean marginal bone loss was 0.68 (±0.68) mm after 3 months and 0.89 (±0.75) mm after 1-year. The flapless protocol showed better results on soft tissue stability and health but a slightly higher risk for marginal bone loss.
CONCLUSION
The results of this RCT suggest that mandibular overdentures retained by this novel mini implant system represent a safe and predictable treatment option as confirmed by implant survival/success and peri-implant outcomes, even when flapless surgery and immediate loading protocols are adopted.
Topics: Humans; Dental Implants; Titanium; Zirconium; Denture, Overlay; Dental Implantation, Endosseous; Immediate Dental Implant Loading; Mandible; Dental Prosthesis, Implant-Supported; Treatment Outcome; Follow-Up Studies; Alveolar Bone Loss
PubMed: 37254798
DOI: 10.1111/clr.14102 -
BioMed Research International 2023Evaluate the effect of different mini-implant numbers on overdenture retention and evaluate attachment wear following one year of simulated placement/removal. . Nine...
PURPOSE
Evaluate the effect of different mini-implant numbers on overdenture retention and evaluate attachment wear following one year of simulated placement/removal. . Nine models simulating atrophic mandibles held 27 mini dental implants in three groups of 2, 3, and 4 mini-implants. A total of 1080 simulated placement/removal cycles were carried out, and a digital force gauge was used to measure the overdenture dislodgment force. The means of the retention forces were analyzed using SPSS with one-way ANOVA and post hoc ( < 0.05). The inner diameter of attachment inserts was evaluated using a light microscope before and after testing. A paired -test was used to compare the mean of inner ring diameters ( < 0.05).
RESULTS
The retention was significantly reduced regardless of the mini dental implant number, but the number affected overdenture retention. The placement of 4 mini dental implants provided higher retention and less reduction in retentiveness. However, no significant difference was found when 3 mini dental implants were compared to 2 mini dental implants ( = 0.21). Microscopic examination showed abrasion wear in all inserts following testing. However, the inserts of the 4 mini dental implants showed less wear than those used for 2 or 3 mini dental implants with ≤ 0.001 and ≤ 0.001, respectively.
CONCLUSION
Mini dental implant overdenture retention force and attachment wear could improve by increasing the mini dental implants to 4. However, there was no difference in retention force or attachment wear when 2 or 3 mini dental implant overdentures were compared.
Topics: Dental Implants; Denture, Overlay; Denture Retention; Mandible; Microscopy; Dental Stress Analysis
PubMed: 37168235
DOI: 10.1155/2023/7099761 -
Journal of Indian Prosthodontic Society 2023The attachment matrix housing (AMH) of implant overdentures is not chemically bonded with acrylic resins. Therefore, AMH may lose due to insertion and removal forces....
Investigation of the effect of different surface treatments for preventing detachment of polyetheretherketone and titanium attachment matrix housings in overdentures: An study.
AIM
The attachment matrix housing (AMH) of implant overdentures is not chemically bonded with acrylic resins. Therefore, AMH may lose due to insertion and removal forces. This study aims to investigate the effects of different surface treatments to reduce the detachment of AMH and to compare the adhesion of the AMH used in implant-supported overdentures made of different materials with the reline acrylic resin.
MATERIALS AND METHODS
Titanium and polyetheretherketone (PEEK) AMHs were separated into four surface treatment groups; no treatment, airborne-particle abrasion (APA) applied, universal bond (UB) applicated, APA, and UB applicated. Eight millimeters in diameter and ten millimeters tall straws were used to restrain the reline acrylic resin prepared according to the manufacturer's instructions and the resin was injected onto the surface-treated AMH. After the polymerization was completed, the universal testing machine performed the tensile bond strength (TBS) test with a fishing line passed through the acrylic resins.
STATISTICAL ANALYSIS USED
TBS data were analyzed with two and one-way ANOVA and Tukey HSD post hoc tests (α =0.05).
RESULTS
According to the two-way ANOVA results, titanium AMHs (103.78 ± 45.98 N) showed higher TBS than PEEK AMHs (67.81 ± 28.61 N). UB applicated titanium groups showed significantly increased TBS values.
CONCLUSIONS
Using titanium AMHs may be a better choice in situations where clinical aesthetic expectations are unimportant for adhesion to reline acrylic resins. The UB resin significantly increased the bonding of the titanium AMHs with reline resins. The application of UB resin to titanium housings can be easily applied in a clinical situation and can reduce the detachment of the titanium AMHs.
Topics: Dental Bonding; Titanium; Denture, Overlay; Surface Properties; Esthetics, Dental; Acrylic Resins; Polyethylene Glycols; Ketones
PubMed: 37102539
DOI: 10.4103/jips.jips_497_22 -
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