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Brazilian Oral Research 2022This longitudinal study aimed to assess the performance of the Facility-Equator system as mandibular overdenture (MO) retainers from a prosthetic perspective during 2...
This longitudinal study aimed to assess the performance of the Facility-Equator system as mandibular overdenture (MO) retainers from a prosthetic perspective during 2 years of loading and to investigate the oral health-related quality of life (OHRQoL) and whether prosthetic events can affect the OHRQoL. Twenty-four patients (68.1 ± 7.51 years) reported their OHRQoL through the Geriatric Oral Health Assessment Index (GOHAI) and Oral Health Impact Profile (OHIP-EDENT) questionnaires before MO loading and after 1 and 2 years of usage. Prosthetic occurrences were recorded during this period. Data were analyzed using the Wilcoxon test, Mann-Whitney test, and Spearman correlation coefficients. Of the 127 prosthetic events that occurred in the first year, the most frequent events were prosthesis adjustments (16.5%), dislodgement of the Equator attachment (14.17%), and O-ring replacement (11.8%). Eighty-seven prosthetic events were recorded in the second year, the most frequent events being prosthesis adjustments (27.6%), O-ring replacement (20.7%), and recapturing the female matrix (11.5%). All domains of the GOHAI and OHIP-EDENT questionnaires exhibited a significant difference (p < 0.05) between the baseline and 1- and 2-year evaluations, except in the Social Disability and Psychological Discomfort domains (p > 0.05) of OHIP-EDENT after 1 year. Complications related to prosthetic maintenance, such as fracturing of the prosthesis, Equator dislodgement, prosthesis rebasing, and new overdenture confection, affect the OHRQoL (p < 0.05), primarily the Physical Pain and Discomfort domains, especially in the first year of MO loading.
Topics: Aged; Dental Prosthesis, Implant-Supported; Denture, Overlay; Female; Humans; Longitudinal Studies; Mandible; Oral Health; Patient Satisfaction; Quality of Life; Surveys and Questionnaires
PubMed: 35946733
DOI: 10.1590/1807-3107bor-2022.vol36.0081 -
Clinical Oral Implants Research Sep 2022This factorial randomized clinical trial (RCT) tested the effects of the surgical approach (flapped-FPS vs. flapless-FLS surgery) and loading protocol (delayed-DL vs.... (Randomized Controlled Trial)
Randomized Controlled Trial
Flapped versus flapless surgery and delayed versus immediate loading for a four mini implant mandibular overdenture: A RCT on post-surgical symptoms and short-term clinical outcomes.
OBJECTIVE
This factorial randomized clinical trial (RCT) tested the effects of the surgical approach (flapped-FPS vs. flapless-FLS surgery) and loading protocol (delayed-DL vs. immediate-IL) for treatment with a four mini implant mandibular overdenture.
MATERIAL AND METHODS
A total of 296 one-piece titanium-zirconium mini-implants were inserted in 74 patients (IL/FLS = 17; IL/FPS = 18; DL/FLS = 20; and DL/FPS = 19). Outcomes included patient's perceived surgical burdens, clinical time, implant survival, and post-surgical symptoms and complications, assessed immediately after surgery, in the 7-day and 6-week follow-ups.
RESULTS
Perceived surgical burdens were relatively low, higher for females, and no difference was found between FPS and FLS surgery. Surgical time was lower for FLS surgery. Overall symptoms were mild after 24 h, and higher for females. Less symptoms were recorded for the FLS surgery compared to the FPS for the delayed loading patients, and FLS surgery was associated with a lower risk of bleeding. No early implant failure was observed until the 6-week follow-up. Delayed was associated with discontinuous use of the prosthesis and poor function. Lower complaint rates were observed for immediate loading regardless of the surgery protocol.
CONCLUSIONS
Mini implants for mandibular overdenture are a feasible option regardless of surgical access and loading protocol, with high safety and predictable survival rates, and low incidence of post-insertion complications. FLS surgery requires less clinical time and results in easier intraoral prosthetic incorporation of attachments compared to FPS surgeries. Immediate loading did not increase the risk of early implant failure when satisfactory primary stability was achieved.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture, Overlay; Female; Follow-Up Studies; Humans; Immediate Dental Implant Loading; Mandible; Treatment Outcome
PubMed: 35818640
DOI: 10.1111/clr.13974 -
Journal of Prosthodontic Research Apr 2023This study aimed to assess patients' expected burdens before treatment and their perceived burdens after the surgical and prosthodontic procedures of mandibular... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
This study aimed to assess patients' expected burdens before treatment and their perceived burdens after the surgical and prosthodontic procedures of mandibular overdenture treatment and to evaluate factors influencing patients' perceptions.
METHODS
Data were collected from 47 participants enrolled in a randomized clinical trial comparing mandibular overdentures retained by one or two implants. A 20-item questionnaire measured on a four-point Likert scale covering the surgical and prosthetic treatment procedures was used to assess the patients' perception of the procedural burdens before (expected burdens) and immediately after (experienced burdens) each procedure. Operators' perceptions of intercurrences associated with the procedures were also assessed as an independent variable.
RESULTS
Low levels of perceived burdens were observed both before and after treatment. The mean overall scores of 1.65 ± 0.46 and 1.53 ± 0.33 for expected and experienced burdens, respectively, indicated that most items ranged between "not burdensome at all" and "somewhat burdensome." Significant differences between expected and experienced burdens were found for eight items (P < 0.001). Considering the treatment stages, expected burdens scored higher in the pre-surgical, surgical, and prosthetic stages and lower in the post-surgical phase than experienced burdens. Overall, the experienced burdens were significantly affected by the expected burdens (P < 0.001) and operator's perceived burdens(P = 0.045).
CONCLUSIONS
Treatments were associated with low levels of perceived burdens related to surgical and prosthodontic procedures and were highly correlated with the expected burdens before treatment. However, patients tend to overestimate the expected burdens before treatment, especially for surgical procedures.
Topics: Humans; Denture, Overlay; Dental Implants; Patient Satisfaction; Denture, Complete, Lower; Jaw, Edentulous; Mandible; Dental Prosthesis, Implant-Supported; Denture Retention; Treatment Outcome
PubMed: 35786572
DOI: 10.2186/jpr.JPR_D_21_00343 -
Molecules (Basel, Switzerland) Jun 2022This study aimed to examine the retentive characteristics of each retentive element material and the effects from thermocycling using the two implant-retained mandibular...
This study aimed to examine the retentive characteristics of each retentive element material and the effects from thermocycling using the two implant-retained mandibular overdenture model. Two stud abutments and three retentive element materials; nylon, polyetheretherketone (PEEK) and polyvinylsiloxane (PVS) were used in this study. Four tested groups, with a total of 40 overdentures, were fabricated, including a Locator® abutment with nylon retention insert (NY), Novaloc® abutment with PEEK retention insert (PK), Locator® abutment with PVS retention insert (RL), and Novaloc® abutment with PVS retention insert (RN). The retentive force (N) was measured before thermocycling, and at 2500, 5000, and 10,000 cycles after thermocycling. Significant changes in the percentage of retention loss were found in the NY and PK groups (p < 0.05) at 6 and 12 months for the RL group (p < 0.05) after artificial aging. The RN group exhibited a constant retentive force (p > 0.05). The tendency of the percentage of retention loss significantly increased for PEEK, nylon, and PVS silicone over time. The results of the present study implied that retentive element materials tend to lose their retentive capability as a result of thermal undulation and water dispersion. Nylon and PEEK, comprising strong polar groups in polymer chains, showed a higher rate of retention loss than polyvinylsiloxane.
Topics: Denture Retention; Denture, Overlay; Ketones; Mandible; Nylons; Polyethylene Glycols
PubMed: 35745048
DOI: 10.3390/molecules27123925 -
BMC Oral Health Jun 2022The aim of the present study was to evaluate the retention and loss of retention after fatigue testing at different time intervals between two types of bar clip...
OBJECTIVES
The aim of the present study was to evaluate the retention and loss of retention after fatigue testing at different time intervals between two types of bar clip materials (digitally designed PEEK bar clip and regular Nylon bar clip).
MATERIALS AND METHODS
An epoxy model was constructed for a completely edentulous mandible. Two implants were placed according to prosthetically driven implant placement by a computer-guided surgical stent. Bar clips were digitally designed, 3D printed, and pressed into Poly Ether Ether Ketone (PEEK). Pick up of PEEK and nylon clips was performed on the dentures fitting surface using self-cured acrylic resin. Each study group was subjected to an insertion and removal fatigue test simulating 3 years of patient usage. Retention values were recorded using the universal testing machine at initial retention and after 1, 2, and 3 years of simulated usage. For proper sample sizing, 24 models and dentures (12 for each group) were used. An independent sample t-test and repeated measures analysis of variance were used to compare the data.
RESULTS
There were statistically significant differences in retention between the PEEK and nylon bar clips at the beginning of the experiment (p = 0.000*). But after 3 years of simulated use, there was no significant difference in retention between the test groups (p = 0.055, NS). After 3 years of simulated use, the retention of PEEK clips decreased by - 58.66% recording 17.37 ± 1.07 N, while the retention of nylon clip increased by + 2.99% recording 16.56 ± 0.88 N.
CONCLUSION
The digitally designed PEEK clip showed comparable retention results to the nylon clip after 3 years of simulated use.
CLINICAL RELEVANCE
Maintenance of bar attachment with PEEK clip offers a clinical solution after the wear of normal plastic clips, which is a cheap solution that is easily fabricated and picked up into the denture. Digital fabricated PEEK bar retentive inserts can be used in cases of bar attachment wear.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Denture Retention; Denture, Overlay; Ethers; Humans; Mandible; Nylons; Surgical Instruments
PubMed: 35681163
DOI: 10.1186/s12903-022-02262-7 -
Journal of Prosthodontic Research Jan 2023The present study was done to assess patient satisfaction and crestal bone changes with one-piece and two-piece single implant-retained mandibular overdentures (SIMOs). (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
The present study was done to assess patient satisfaction and crestal bone changes with one-piece and two-piece single implant-retained mandibular overdentures (SIMOs).
METHODS
The participants included in Group 1 (n=12) received one-piece SIMOs; the participants in Group 2 (n=12) received two-piece SIMOs.Scheduled follow-ups were done at 1 month and 1 year after implant placement. Patient satisfaction and crestal bone changes were evaluated. The data obtained were analyzed statistically with independent Student t-test.
RESULTS
Visual analogue scale (VAS) score for patient satisfaction with one-piece and two-piece SIMOs were statistically significant at 1-year of follow-up. The patient satisfaction level on the VAS score increased (38.1 to 51.1) with group one-piece SIMOs and two-piece SIMOs (36.6 to 46.8) at baseline to 1 month (P=0.13). The patient satisfaction level increased (38.1 to 56.6) with group one-piece SIMOs and two-piece SIMOs (36.6 to 52.2) at baseline to 1 year (P=0.03). At the 1 year follow-ups, group 1 had mean crestal bone loss of 0.80 ± 0.49 mm and group 2 had 1.24 ± 0.90 mm (P=0.16). Crestal bone loss was greater in the two-piece SIMOs group at 1 month and 1 year follow-ups, but statistically it was insignificant.
CONCLUSIONS
One-piece SIMOs seemed to be a viable treatment option with increased patient satisfaction on a VAS. Crestal bone loss was greater in the patients with two-piece SIMOs during follow-up. One-piece SIMOs was comparatively simple with less invasive procedures and needed fewer components,so considerable number of patients requiring implant retained dentures could be benefited.
Topics: Humans; Patient Satisfaction; Dental Implants; Denture, Overlay; Mandible; Dental Prosthesis, Implant-Supported; Follow-Up Studies; Denture Retention; Treatment Outcome
PubMed: 35321961
DOI: 10.2186/jpr.JPR_D_20_00315 -
Clinical Case Reports Feb 2022Shallow lingual vestibule and lack of keratinized attached mucosa are considered risk factors for the long-term success of dental implants. This article describes a...
Shallow lingual vestibule and lack of keratinized attached mucosa are considered risk factors for the long-term success of dental implants. This article describes a modified surgical approach accompanied by a free gingival graft to correct the shallow lingual/buccal vestibule and to increase the keratinized tissue around dental implants.
PubMed: 35228888
DOI: 10.1002/ccr3.5500 -
Journal of Prosthodontic Research Oct 2022
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Immediate Dental Implant Loading; Mandible; Mastication; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 35197416
DOI: 10.2186/jpr.JPR_D_21_00216 -
International Journal of Environmental... Feb 2022Few studies have compared marginal bone loss (MBL) around implant-retaining overdentures (IODs) vs. implant-supported fixed prostheses (FPs). This study evaluated the...
Few studies have compared marginal bone loss (MBL) around implant-retaining overdentures (IODs) vs. implant-supported fixed prostheses (FPs). This study evaluated the mean MBL and radiographic bone-implant interface contact (r-BIIC) around IODs and implant-supported FPs. We also investigated osseointegration and MBL around non-submerged dental implants. We measured the changes between the MBL in the mesial and distal sites immediately after prosthetic delivery and after one year. The mean MBL and its changes in the IOD group were significantly higher. The mean percentage of r-BIIC was significantly higher in the FP group. MBL and its changes in males were significantly higher in the IOD group. The percentage of r-BIIC was significantly higher in the FP group. MBL in the lower site in the IOD group was significantly higher. Regarding MBL, the location of the implant was the only significant factor in the IOD group, while gender was the only significant predictor in the FP group. Regarding the r-BIIC percentage, gender was a significant factor in the FP group. We concluded that non-submerged dental implants restored with FPs and IODs maintained stable bone remodeling one year after prosthetic delivery.
Topics: Bone Remodeling; Bone-Implant Interface; Denture, Overlay; Follow-Up Studies; Humans; Male; Osseointegration; Retrospective Studies
PubMed: 35162773
DOI: 10.3390/ijerph19031750 -
Clinical Implant Dentistry and Related... Apr 2022Though studies on maxillary overdentures show satisfying results on implant survival, patient-related outcomes and prosthetic complications, the epidemiology of...
Incidence of peri-implant mucositis and peri-implantitis in patients with a maxillary overdenture: A sub-analysis of two prospective studies with a 10-year follow-up period.
BACKGROUND
Though studies on maxillary overdentures show satisfying results on implant survival, patient-related outcomes and prosthetic complications, the epidemiology of peri-implant diseases in this specific group of patients has hardly been reported. While the general patient-level prevalence of peri-implant mucositis and peri-implantitis are estimated at ~45% and ~20%, respectively, the risk of developing these diseases within a specific period is less clear. To fully appreciate the epidemiology of peri-implant diseases, more long-term data on incidence of peri-implant diseases are needed.
PURPOSE
The purpose of this sub-analysis of two prospective studies was to assess the incidence of peri-implant mucositis and peri-implantitis in fully edentulous patients with implant-retained maxillary overdentures during a 10-year follow-up period.
MATERIALS AND METHODS
One hundred and sixteen patients treated with implant-supported maxillary overdentures were available from two clinical trials. Data on biological complications, clinical and radiographical parameters were collected for 106 patients at 5-year, for 82 patients at 10-year follow-up. The incidence was calculated following the consensus of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Extent and severity then were calculated to enable an appropriate epidemiological description of peri-implantitis.
RESULTS
The patient-level incidence of peri-implant mucositis was 37.7% after 5 years and 64.6% after 10 years whereas the patient-level incidence of peri-implantitis was 10.4% after 5 years and 19.5% after 10 years. After 10 years, the extent of peri-implant mucositis and peri-implantitis is 52.8% and 43.8%, respectively. In terms of severity, 26.5% of all affected implants suffered from >3 mm bone loss and 17.6% of all affected implants was lost.
CONCLUSION
Three of five fully edentulous patients with implant-supported maxillary overdentures experience peri-implant mucositis after 10 years. Peri-implantitis occurs in one of five patients after 10 years. In spite of these incidence rates, implant survival remains high.
Topics: Dental Implants; Denture, Overlay; Follow-Up Studies; Humans; Incidence; Mouth, Edentulous; Mucositis; Peri-Implantitis; Prospective Studies
PubMed: 35137509
DOI: 10.1111/cid.13071