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Clinical Implant Dentistry and Related... Aug 2021Implant-supported overdentures (IODs) have been reported to increase patients' oral health-related quality of life (OHRQoL) in comparison with conventional dentures... (Review)
Review
BACKGROUND
Implant-supported overdentures (IODs) have been reported to increase patients' oral health-related quality of life (OHRQoL) in comparison with conventional dentures (CDs); however, the conclusiveness of evidence on the clinical effectiveness and value for money of IODs versus CDs remains unclear.
PURPOSE
To review how the added value of IODs is demonstrated in the literature.
MATERIALS AND METHODS
MEDLINE, EMBASE, and the Cochrane Database were searched for randomized control trials, controlled clinical trials, and prospective cohort studies containing evaluations of the economic and health benefits and costs of IODs. Information about the clinical effectiveness, such as magnitude of bite forces or chewing efficacy, OHRQoL, costs, and cost-effectiveness of IODs, was extracted.
RESULTS
A total of 17 articles were included, reporting 15 economic evaluations: 11 cost-utility analyses (CUAs), 2 of which were combined with a cost-effectiveness analysis (CEA), and 2 cost-benefit analyses (CBAs). Seven CUAs used the Oral Health Impact Profile (OHIP) questionnaire while four used satisfaction questionnaires to assess the OHRQoL. One study applied quality-adjusted prosthesis years (QAPYs) for this purpose. The CBAs expressed both the beneficial outcome and the costs of the IOD in monetary terms. The included studies employed a large variety of economic evaluation methods, which limited cross-study comparability.
CONCLUSIONS
On the basis of existing economic evaluations, IODs have frequently been suggested to be a cost-efficient treatment alternative to CDs; however, the comparability between the various economic evaluation studies was limited due to the different outcome measures used. In addition, it remains unclear whether the additional health benefits of IODs outweigh the higher costs. This is largely dependent on the decision maker's valuation of oral health outcomes. Future research is encouraged to further elucidate patient willingness to pay for IODs and the societal return on investing in IODs more generally.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Humans; Patient Satisfaction; Prospective Studies; Quality of Life
PubMed: 34268866
DOI: 10.1111/cid.13027 -
International Journal of Implant... Jul 2021Evaluation of dental implant treatment is mostly based on studies with well-controlled study groups treated within a university-based setting. There are no long-term...
BACKGROUND
Evaluation of dental implant treatment is mostly based on studies with well-controlled study groups treated within a university-based setting. There are no long-term observational practice-based studies known on implant-supported overdentures. The present retrospective study deals with implant survival, peri-implant hard and soft tissue health, surgical and prosthetic aftercare, and satisfaction of patients treated with an implant-supported mandibular overdenture in a daily dental practice.
MATERIALS AND METHODS
Within the years 2006 till 2015, 295 patients were treated with two, three, or four implants for mandibular overdenture treatment in a daily dental practice in Zaandam, The Netherlands. Outcome parameters were scored at a routine yearly inspection including implant loss, plaque index, gingival index, bleeding index, presence of calculus, probing depth, and satisfaction with implant-supported overdenture. Radiographic analysis was performed to assess peri-implant bone changes. Surgical and prosthetic aftercare was obtained from the medical record.
RESULTS
A total of 133 patients were seen for an evaluation visit (mean follow-up 51.2 months). Cumulative implant survival rate in the 2-implant group, 3-implant group, and 4-implant group was 100%, 99.1%, and 97.8% respectively, with a mean peri-implant bone loss of 0.53 mm, 0.61 mm, and 0.40 mm. Patients' satisfaction was high in all groups.
CONCLUSION
It was demonstrated, within the limitations of this study, that patients, who were treated with an implant-supported mandibular overdenture in a daily dental practice, experienced a high cumulative implant survival rate and a good peri-implant health, and were very satisfied.
TRIAL REGISTRATION
Netherlands Trial Register, NL8867 . Registered 15 September 2020-retrospectively registered.
Topics: Dental Prosthesis, Implant-Supported; Denture, Overlay; Follow-Up Studies; Humans; Jaw, Edentulous; Mandible; Retrospective Studies
PubMed: 34235585
DOI: 10.1186/s40729-021-00345-8 -
International Journal of Implant... Jun 2021The appropriate loading protocol to improve masticatory performance (MP) is still unclear in elderly patients and two-implant overdentures (2-IODs) wearers. This study... (Randomized Controlled Trial)
Randomized Controlled Trial
Masticatory performances and maximum occlusal forces of immediate and conventional loaded two-implant supported overdentures retained by magnetic attachments: preliminary study of randomized controlled clinical trial.
BACKGROUND
The appropriate loading protocol to improve masticatory performance (MP) is still unclear in elderly patients and two-implant overdentures (2-IODs) wearers. This study aimed to compare the long-term MP and maximum occlusal force of immediate loading (IL) and conventional loading (CL) of 2-IODs retained by magnetic attachments. Nineteen edentulous patients were randomly assigned to either an IL (n=10) or CL group (n = 9). In the IL group, the implant was loaded on the same day as insertion, whereas it was loaded 3 months after insertion in the CL group. Magnetic attachments were used to retain all overdentures to the implants. MP, measured by a piece of color-changeable chewing gum and a gummy jelly test, and maximum occlusal force, measured using an occlusal force measuring device, were assessed in both groups at baseline and at 3-, 4-, and 5-year follow-ups.
RESULTS
No significant differences were observed in the MP and the maximum occlusal force between the IL and CL groups at any time point. However, a significantly higher MP was observed at the 3-year time point in the IL group (P = 0.036). The maximum occlusal force revealed a significant correlation with MP, both with the color-changeable chewing gum and gummy jelly at 5 years.
CONCLUSION
After long-term observation, no significant differences in MP and maximum occlusal force were observed between the IL and CL groups. However, compared to pre-implant insertion of the complete denture, the MP in the IL group significantly improved at 3 years. Furthermore, the maximum occlusal force was significantly correlated with MP at 5 years.
TRIAL REGISTRATION
UMIN, UMIN000009889 . Registered on 28 January 2013.
Topics: Aged; Bite Force; Denture, Overlay; Humans; Immediate Dental Implant Loading; Magnetic Phenomena; Mandible
PubMed: 34184165
DOI: 10.1186/s40729-021-00342-x -
Neurology India 2021Dental implantation is thought to be associated with enhancement of neuro-cortical sensorimotor activity which has been lost due to an edentulous state. Such changes are...
BACKGROUND AND PURPOSE
Dental implantation is thought to be associated with enhancement of neuro-cortical sensorimotor activity which has been lost due to an edentulous state. Such changes are either feeble or absent after the placement of a conventional denture. In the present study, we test this hypothesis using blood oxygen level-dependent (BOLD) activity on functional MRI (fMRI) as a bio-surrogate.
MATERIALS AND METHODS
fMRI was performed in 12 consecutive edentulous subjects (mean age = 59.2 years) after the placement of a conventional complete denture (CD) and subsequently after intraoral dental implantation (IOD). The semi-quantitative data of the BOLD activity was compiled to depict the activation seen in both scenarios in six anatomical regions. Statistical analysis was done to evaluate the significance of enhancement in BOLD activity in these regions in patients having an IOD as compared to those having a CD.
RESULTS
The enhancement of BOLD activity on fMRI after placement of an IOD was much more significant as compared to that noted with CD. Using Wilcoxon's signed-rank test the nonparametric data showed a significant positive elevation in global and regional assigned mean ranks of BOLD activity.
CONCLUSION
Intraoral implantation leads to a significant elevation in the BOLD activity of the sensorimotor cortex as compared to the placement of a conventional CD.
Topics: Dental Implantation; Denture, Overlay; Humans; Magnetic Resonance Imaging; Middle Aged; Oxygen; Sensorimotor Cortex
PubMed: 34169865
DOI: 10.4103/0028-3886.317239 -
Journal of the Mechanical Behavior of... Sep 2021Contemporary prosthetic materials are characterized by highly specific preparation for a given application. This means that at the stage of their creation, not only...
Adhesion as a component of retention force of overdenture prostheses-study on selected Au based dental materials used for telescopic crowns using atomic force microscopy and contact angle techniques.
Contemporary prosthetic materials are characterized by highly specific preparation for a given application. This means that at the stage of their creation, not only their function is taken into account, but also the long-term behavior of this material during use. In the case of telescopic crowns, an important factor not yet appearing in the research is the aspect of adhesion force and its dependence on the type of biomaterial, but also the properties of human saliva. The use of artificial saliva, which creates a lubricating layer, reduces the wear on the surface of the telescopic crowns by reducing friction. The impact of artificial saliva on the formation of chemical bonds between prosthetic elements, thus contributing to the so-called retention force has not yet been studied. In this work, two types of measurements of gold telescopic crown materials in the aspect of the adhesion process are presented. Obtained results allowed to fully characterize this phenomenon. We modeled the load force between the microcircuit and the surface under study to suit the conditions between the primary and secondary crowns in the patient's mouth.
Topics: Crowns; Dental Materials; Dental Prosthesis Design; Denture, Overlay; Friction; Humans; Microscopy, Atomic Force
PubMed: 34153624
DOI: 10.1016/j.jmbbm.2021.104648 -
Biomedizinische Technik. Biomedical... Jun 2021The aim of this study was to investigate experimentally the fatigue and stability of three bar materials with distal extension at the molar region and to numerically...
The aim of this study was to investigate experimentally the fatigue and stability of three bar materials with distal extension at the molar region and to numerically analyse the biomechanical properties of the bar materials connected to overdentures in a patient individual model. A milled bar was designed for the mandible on four implants in the canine and second premolar region. Three bar materials were investigated: titanium (Ti), cobalt chromium (CoCr), and polyetherketonketon (PEKK). Firstly, static and fatigue tests were performed based on EN ISO 14801 in a commercial permanent loading set-up. Unilateral axial force was applied on the distal extension of the bars. Secondly, numerical models were created. Different bar materials and loading scenarios were analysed. The static fracture limit of the three materials was 1,750 N, 780 N, 310 N for Ti, CoCr, and PEKK, respectively. The Wöhler curves showed comparable fatigue limits of 200 N, 160 N, and 150 N for titanium, CoCr, and PEKK, respectively. The stress at the distal extension was 2,600 MPa (Ti), 1,000 MPa (CoCr), and 270 MPa (PEKK). All loading simulations with the PEKK bar showed higher stresses in the implants and in the bone bed as well as higher displacements of the over denture in comparison to metal bars. PEKK showed different mechanical behaviour compared to Ti and CoCr. The distribution of stresses within the PEKK bar was wider than the area of loading which probably leads to fatigue of the whole bar and not only the part under load.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Denture, Overlay; Finite Element Analysis; Humans; Mandible; Materials Testing; Prostheses and Implants; Stress, Mechanical; Titanium
PubMed: 34062636
DOI: 10.1515/bmt-2020-0157 -
The Journal of Prosthetic Dentistry Dec 2022This clinical report describes the treatment of a complex intraoral situation by fabricating a maxillary implant-retained overdenture with a high-performance polymer...
This clinical report describes the treatment of a complex intraoral situation by fabricating a maxillary implant-retained overdenture with a high-performance polymer (polyetherketoneketone) framework and lithium disilicate crowns and mandibular tooth- and implant-supported ceramic restorations. No complications were noted in 2 years, and the patient was satisfied with function and esthetics.
Topics: Humans; Denture, Overlay; Zirconium; Dental Implants; Esthetics, Dental; Dental Porcelain; Crowns; Polymers; Ceramics; Dental Restoration Failure; Dental Prosthesis, Implant-Supported
PubMed: 33994192
DOI: 10.1016/j.prosdent.2021.04.001 -
Journal of Prosthodontic Research Oct 2021Purpose The aim of this study was to evaluate patients' economic preferences for two different tooth replacement strategies for the edentulous mandible namely...
Purpose The aim of this study was to evaluate patients' economic preferences for two different tooth replacement strategies for the edentulous mandible namely conventional complete dentures (CCDs) and implant overdentures supported by two implants (IODs), using a willingness-to-pay (WTP) analysis.Methods Twenty-six elderly patients who had been rehabilitated with either a mandibular CCD or IOD were invited to participate in this study. All participants were provided with the details of the two treatment protocols, including advantages, disadvantages, and treatment costs. The patients were then asked to indicate their maximum WTP values for each protocol using a payment card method for contingency evaluation.Results Fifteen patients with mandibular CCD (CCD-Group) and 12 patients with IOD (IOD-Group) participated in the study. Overall, the median and maximum WTP values recorded for IOD therapy were significantly higher than those for CCD therapy (p<0.05). Both treatment groups recorded maximum WTP values for CCD therapy, which exceeded the market cost (¥30,000 [US$280]), CCD-Group: ¥50,000 (interquartile range [IQR]: 40,000 - 65,000), and IOD-Group: ¥45,000 (IQR: 30,000-85,000)]. However, both groups registered a median and maximum WTP values for IOD therapy lower than the market cost (¥780,000 [US$7,300]), (CCD-Group: ¥500,000 [IQR: 300,000 - 750,000], IOD-Group: ¥700,000 [IQR: 500,000-800,000]).Conclusion The maximum WTP values recorded for IOD therapy were significantly higher than CCD therapy in both treatment groups. While patients were willing to pay more than the current market costs for CCDs, they were not willing to meet the market value for IODs.
Topics: Aged; Denture, Complete; Denture, Overlay; Humans; Mandible; Patient Preference
PubMed: 33980785
DOI: 10.2186/jpr.JPR_D_20_00170 -
BMC Oral Health May 2021Implant-supported overdentures offer enhanced mechanical properties, which lead to better patient satisfaction and survival rates than conventional dentures. However, it... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Implant-supported overdentures offer enhanced mechanical properties, which lead to better patient satisfaction and survival rates than conventional dentures. However, it is unclear whether these satisfaction levels and survival rates depend on the number of implants supporting the overdenture. Therefore, this systematic review aimed to compare maxillary overdentures supported by four or six splinted implants in terms of patient satisfaction, implant survival, overdenture survival, and prosthodontic complications.
METHODS
Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (PubMed), and EMBASE databases were systematically searched and complemented by hand searching from 2000 to 2019, employing a combination of specific keywords. Studies comparing the use of four versus six implants for supporting overdentures with at least one-year of follow-up after prosthesis installation and including ten fully edentulous patients were included. The risk of bias (RoB) was analyzed with Cochrane's RoB 2 and Newcastle-Ottawa tools. Implants and prosthesis survival rates were analyzed by random-effects meta-analysis and expressed as risk ratios or risk differences, respectively, and by the non-parametric unpaired Fisher's test.
RESULTS
A total of 15 from 1865 articles were included, and reported follow-up times after implant placement ranged from 1 to 10 years. Irrespective of the number of implants used, high scores were reported by all studies investigating patient satisfaction. Meta-analysis and non-parametric Fisher's test showed no statistical differences regarding the survival rate of implants (P = 0.34, P = 0.3) or overdentures (P = 0.74, P = 0.9) when using 4 versus 6 splinted implants to support overdentures, and no significant differences regarding prosthodontic complications were found between groups. Randomized studies presented high RoB and non-randomized studies presented acceptable quality.
CONCLUSIONS
Within the limits of this systematic review, we can conclude that the bar-supported overdenture on four implants is not inferior to the overdenture supported by six implants for rehabilitating the edentulous maxilla, in terms of patient satisfaction, survival rates of implants and overdentures, and prosthodontic complications.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Overlay; Humans; Jaw, Edentulous; Maxilla; Patient Satisfaction
PubMed: 33962612
DOI: 10.1186/s12903-021-01572-6 -
Journal of Indian Prosthodontic Society 2021Kenny-Caffey syndrome (KCS) is a rarely reported autosomal disorder characterized by skeletal, ocular, and oral manifestations. Oral features such as microdontia,...
Kenny-Caffey syndrome (KCS) is a rarely reported autosomal disorder characterized by skeletal, ocular, and oral manifestations. Oral features such as microdontia, hypodontia, malalignment of teeth, bone loss, and difficulty in mastication results in serious esthetic and functional handicap. The prosthetic rehabilitation of such patients is challenging, especially when implant placement is not a good choice due to poor Vitamin D levels. The existing literature is scarce in describing the treatment options. This case report describes the oral rehabilitation of a patient affected with KCS using telescopic overdenture.
Topics: Anodontia; Denture, Overlay; Humans; Hyperostosis, Cortical, Congenital; Hypocalcemia; Tooth Abnormalities
PubMed: 33938872
DOI: 10.4103/jips.jips_31_21