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Journal of Oral Science Oct 2022The purpose of this review is to search for complications of dental implant superstructures and consider the issues involved. This narrative review was performed by... (Review)
Review
The purpose of this review is to search for complications of dental implant superstructures and consider the issues involved. This narrative review was performed by searching through PubMed databases and review articles that were published after 1990. Misfitting of the superstructure can result in loosening of screws, reduced preload, and in some cases, significant stress around the implant. External connection modalities and single implant prostheses have been reported to have more loose or broken abutment screws. In addition, when zirconia abutment was used for platform shifting, the rate of fracture of the abutment was considered to be high. Additionally, it was reported that men were significantly at an increased risk of abutment fracture. As for the retention mechanism of implant overdenture, stud attachment (Locator type) should receive more attention to wear and damage of retention parts than other attachments. The causes of the complications of implant superstructures have not been clarified in some cases, and further verification is required. Verification of complications is considered important to obtain a long-term prognosis for superstructures of implants. It will be necessary to further verify complications of implants in the future.
Topics: Dental Abutments; Dental Implants; Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Denture, Overlay; Humans; Male
PubMed: 35989295
DOI: 10.2334/josnusd.21-0534 -
Australian Dental Journal Jun 2008Implants have changed prosthodontics more than any other innovation in dentistry. Replacement of lost teeth by a fixed or removable prosthesis is considered to be a... (Review)
Review
Implants have changed prosthodontics more than any other innovation in dentistry. Replacement of lost teeth by a fixed or removable prosthesis is considered to be a restitutio ad similem, while implants may provide a feeling of restitutio ad integrum. Implant prosthodontics means restoring function, aesthetics, and providing technology; biology and technology are combined. Placement of implants is a reconstructive, preprosthetic surgical intervention and is therefore different from most goals in oral surgery that consist of tooth extraction, treating infection and removing pathology from soft or hard tissues. Thus, implants are part of the final prosthetic treatment which encompasses functional, aesthetic and social rehabilitation. The patient's needs and functional status determine the goal of prosthetic treatment. Treatment outcomes in implant prosthodontics are survival of implants and prostheses, impact on physiological and psychological status, oral health-related impact on quality of life, and initial and maintenance costs. A variety of prosthetic solutions are available to restore the partially and completely edentulous jaw and more recently specific methods have been developed such as computer guided planning and CAD-CAM technologies. These should allow more uniform quality and passive fit of prostheses, and simultaneously enables processing of biologically well-accepted materials.
Topics: Computer-Aided Design; Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Denture Design; Humans; Needs Assessment; Patient Care Planning; Quality of Life
PubMed: 18498586
DOI: 10.1111/j.1834-7819.2008.00042.x -
Clinical Oral Investigations May 2021To examine the retention force of removable dental prosthesis (RDP) clasps made from polyetheretherketone (PEEK) and cobalt-chrome-molybdenum (CoCrMo, control group)...
OBJECTIVES
To examine the retention force of removable dental prosthesis (RDP) clasps made from polyetheretherketone (PEEK) and cobalt-chrome-molybdenum (CoCrMo, control group) after storage in water and artificial aging.
MATERIALS AND METHODS
For each material, 15 Bonwill clasps with retentive buccal and reciprocal lingual arms situated between the second pre- and first molar were manufactured by milling (Dentokeep [PEEKmilled1], NT digital implant technology; breCAM BioHPP Blank [PEEKmilled2], bredent), pressing (BioHPP Granulat for 2 press [PEEKpressed], bredent), or casting (remanium GM 800+ [CoCrMo], Dentaurum); N = 60, n = 15/subgroup. A total of 50 retention force measurements were performed for each specimen per aging level (initial; after storage [30 days, 37 °C] and 10,000 thermal cycles; after storage [60 days, 37 °C] and 20,000 thermal cycles) in a pull-off test. Data were statistically analyzed using one-way ANOVA, post hoc Scheffé and mixed models (p < 0.05).
RESULTS
Initial, PEEKpressed (80.2 ± 35.2) and PEEKmilled1 (98.9 ± 40.3) presented the lowest results, while PEEKmilled2 (170.2 ± 51.8) showed the highest values. After artificial aging, the highest retention force was observed for the control group (131.4 ± 56.8). The influence of artificial aging was significantly higher for PEEK-based materials. While PEEKmilled2 and PEEKpressed showed an initial decline in retention force, all other groups presented no impact or an increase in retention force over a repetitive insertion and removal of the clasps.
CONCLUSIONS
Within the tested PEEK materials, PEEKmilled2 presented superior results than PEEKpressed. Although CoCrMo showed higher values after artificial aging, all materials exhibited sufficient retention to recommend usage under clinical conditions.
CLINICAL RELEVANCE
As RDPs are still employed for a wide range of indications, esthetic alternatives to conventional CoCrMo clasps are sought.
Topics: Benzophenones; Chromium Alloys; Cobalt; Dental Clasps; Dental Implants; Dental Prosthesis Retention; Dental Stress Analysis; Denture Retention; Denture, Partial, Removable; Esthetics, Dental; Ketones; Materials Testing; Molybdenum; Polyethylene Glycols; Polymers
PubMed: 33064206
DOI: 10.1007/s00784-020-03642-5 -
Revista de Saude Publica Aug 2019To conduct a cost-effectiveness analysis of alternatives for rehabilitation treatment of mandibular edentulism in the context of the Brazilian Unified Health System...
OBJECTIVE
To conduct a cost-effectiveness analysis of alternatives for rehabilitation treatment of mandibular edentulism in the context of the Brazilian Unified Health System (implant-supported total dental prosthesis versus conventional total dental prosthesis).
METHODS
A Markov model was developed to capture long-term clinical and economic outcomes. The model's population was comprised of a hypothetical cohort of 1,000,000 patients, aged 55 years, with total mandibular edentulism and without medical contraindications for performing surgical procedures. The adopted analysis perspective was that of the Brazilian Unified Health System. Based on the proposed model, we calculated cost - in BRL, and effectiveness - measured by quality-adjusted prosthesis year (QAPY). The time horizon of the analysis was 20 years.
RESULTS
Considering a 5% discount in costs and effects, the incremental cost-effectiveness ratio of implant-supported total dental prostheses compared to conventional total dental prosthesis (BRL 464.22/QAPY) was lower than the willingness to pay threshold adopted in the model (BRL 3,050.00/QAPY).
CONCLUSIONS
The results of this economic analysis showed that the rehabilitation of mandibular edentulous patients by implant-supported total prosthesis is very cost-effective when compared to conventional complete prosthesis, considering the cost-effectiveness limits employed.
Topics: Brazil; Cost-Benefit Analysis; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Partial, Fixed; Humans; Middle Aged; Mouth, Edentulous; National Health Programs
PubMed: 31432931
DOI: 10.11606/s1518-8787.2019053001066 -
Journal of Prosthodontics : Official... Aug 2022An obturator with a hollow bulb can decrease the overall weight of the prosthesis, stress on the underlying tissues, and patient discomfort. Although many techniques and...
An obturator with a hollow bulb can decrease the overall weight of the prosthesis, stress on the underlying tissues, and patient discomfort. Although many techniques and materials have been proposed in the literature for hollowing the obturator prosthesis, they are often time consuming and technique sensitive. This proposed technique used an open-source software program to hollow a digital design of a solid obturator base from a commercially available software in one single convenient step. The hollowing process allowed precise control of prosthesis thickness at the hollow space area for desirable hermetic seal and prosthesis strength.
Topics: Computer-Aided Design; Dental Implants; Dental Prosthesis Design; Humans; Palatal Obturators; Software
PubMed: 35343606
DOI: 10.1111/jopr.13513 -
Zirconia dental implants; the relationship between design and clinical outcome: A systematic review.Journal of Dentistry Apr 2024To evaluate the clinical outcome of different designs of zirconia dental implants. (Review)
Review
OBJECTIVE
To evaluate the clinical outcome of different designs of zirconia dental implants.
DATA
This systematic review adhered to the PRISMA checklist and followed the PICO framework. The protocol is registered in PROSPERO (CRD42022337228).
SOURCES
The search was conducted in March 2023 through four databases (PubMed, Web of Science, Cochrane Library, and Google Scholar) along with a search of references in the related reviews. Three authors reviewed on title, and abstract level and analysed the risk of bias, and all authors reviewed on a full-text level.
STUDY SELECTION
Clinical studies excluding case reports for patients treated with different designs of zirconia dental implants were included. From a total of 2728 titles, 71 full-text studies were screened, and 27 studies were included to assess the risk of bias (ROBINS-I tool) and data extraction. After quality assessment, four studies were included, and the remaining 23 excluded studies were narratively described.
RESULT
The included prospective studies with moderate risk of bias reported success and survival rates of one-piece implants that ranged between 95 and 98.4 % with no difference between different lengths and diameters. The acid-etched roughened surface showed higher clinical outcomes compared to other surface roughness designs.
CONCLUSION
Promising 5-year clinical outcomes were found for one-piece zirconia implants with no difference between different diameters and lengths. Concerning surface roughness, better outcomes were found when using the acid-etched implant surface. However, due to the limited available studies, further high-quality clinical studies comparing zirconia one-piece and two-piece implants with different diameters, lengths, and surface roughness are needed.
CLINICAL SIGNIFICANCE
Based on this systematic review, under suitable clinical situations, the one-piece zirconia implants with diameters of 4.0 mm, 4.5 mm, or 5.5 mm and lengths of 8 mm, 10 mm, 12 mm, or 14 mm have similar promising clinical outcomes. Additionally, the acid-etched roughened implant surface may be preferable.
Topics: Humans; Dental Implants; Dental Materials; Prospective Studies; Dental Restoration Failure; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Zirconium
PubMed: 38437977
DOI: 10.1016/j.jdent.2024.104903 -
Clinical Oral Investigations Dec 2022To investigate how different types of dental prosthesis perform in patients with head and neck tumors.
OBJECTIVES
To investigate how different types of dental prosthesis perform in patients with head and neck tumors.
MATERIALS AND METHODS
In this retrospective clinical cohort study, the impact of different patient-related factors was analyzed as influencing factors on the survival probability of dental prosthesis using Kaplan-Meier estimate. For analysis, the dental prosthesis was divided into groups: group 1 (fixed dental prosthesis), group 2 (removable dental prosthesis), group 3 (implant-supported dental prosthesis), and group 4 (prostheses anchored using wrought wire clasps and obturators). The incidental aftercare measures were also evaluated.
RESULTS
Two hundred seventy-nine restorations were observed (mean observation: 2.7 ± 3.0 years, max.14.8 years) out of which 49 (17.6%) had to be replaced during the observation. After 5 years, 100% of group 1 restorations, 79.9% of group 2 restorations, 91.4% of group 3 restorations, and 30% of group 4 restorations were still functional. Four hundred eighty-eight dental implants were observed, of which 77 (15.8%) failed.
CONCLUSIONS
Groups 1, 2, and 3 restorations showed good survival times after 5 years in function, whereas group 4 presented the worst survival times. Group 2 restorations showed the highest amount of necessary aftercare measures.
CLINICAL RELEVANCE
The current investigation shows that groups 1, 2, and 3 restorations should be preferred in the prosthetic treatment planning of patients with head and neck tumors. A treatment with group 4 restorations should only be considered if no other prosthetic treatment is possible or as temporary treatment.
Topics: Humans; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Dental Implants; Retrospective Studies; Cohort Studies; Head and Neck Neoplasms; Dental Prosthesis Design
PubMed: 35976496
DOI: 10.1007/s00784-022-04673-w -
Clinical Oral Implants Research Oct 2021To investigate the impact of timing of implant placement and loading on implant survival and biological outcomes of multiple-unit implant-supported fixed dental... (Meta-Analysis)
Meta-Analysis Review
Does the timing of implant placement and loading influence biological outcomes of implant-supported multiple-unit fixed dental prosthesis-A systematic review with meta-analyses.
OBJECTIVE
To investigate the impact of timing of implant placement and loading on implant survival and biological outcomes of multiple-unit implant-supported fixed dental prosthesis (FDPs).
MATERIAL AND METHODS
A literature search was performed by three independent reviewers for studies reporting on ≥10 patients with FPDs supported by ≥two implants over ≥3 years of follow-up. Data were analyzed on implant survival and biological complications as primary outcomes and biological events, including changes in peri-implant marginal bone level (MBL), probing depth, soft-tissue level, and health condition as secondary outcomes.
RESULTS
7002 titles were identified, 360 full-texts were screened, and 14 studies were included. These comprised 6 randomized controlled studies (RCTs), 5 cohort studies, and 3 case series with identifiable implant placement and loading protocols in five of 09 possible combinations. All groups but one (IPIL) showed implant survival rates >90%. A meta-analysis based on 3 RCTs found no differences in survival rate between DPIL and DPDL (p = .227).
CONCLUSIONS
High survival rates for all studied implant placement and loading combinations were shown for FPDs over ≥3 years of follow-up. When a delayed implant placement protocol is applied, immediate or delayed loading demonstrated similar survival rates. The heterogeneity of the data did not allow to draw any further conclusions on the occurrence of biological complications related to timing of implant placement/loading.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Dental Prosthesis, Implant-Supported; Humans; Immediate Dental Implant Loading
PubMed: 34642990
DOI: 10.1111/clr.13860 -
Clinical Oral Implants Research Oct 2018The aim of Working Group 3 was to focus on three topics that were assessed using patient-reported outcome measures (PROMs). These topics included the following: (a) the...
OBJECTIVES
The aim of Working Group 3 was to focus on three topics that were assessed using patient-reported outcome measures (PROMs). These topics included the following: (a) the aesthetics of tooth and implant-supported fixed dental prostheses focusing on partially edentulous patients, (b) a comparison of fixed and removable implant-retained prostheses for edentulous populations, and (c) immediate versus early/conventional loading of immediately placed implants in partially edentate patients. PROMs include ratings of satisfaction and oral health-related quality of life (QHRQoL), as well as other indicators, that is, pain, general health-related quality of life (e.g., SF-36).
MATERIALS AND METHODS
The Consensus Conference Group 3 participants discussed the findings of the three systematic review manuscripts. Following comprehensive discussions, participants developed consensus statements and recommendations that were then discussed in larger plenary sessions. Following this, any necessary modifications were made and approved.
RESULTS
Patients were very satisfied with the aesthetics of implant-supported fixed dental prostheses and the surrounding mucosa. Implant neck design, restorative material, or use of a provisional restoration did not influence patients' ratings. Edentulous patients highly rate both removable and fixed implant-supported prostheses. However, they rate their ability to maintain their oral hygiene significantly higher with the removable prosthesis. Both immediate provisionalization and conventional loading receive positive patient-reported outcomes.
CONCLUSIONS
Patient-reported outcome measures should be gathered in every clinical study in which the outcomes of oral rehabilitation with dental implants are investigated. PROMs, such as patients' satisfaction and QHRQoL, should supplement other clinical parameters in our clinical definition of success.
Topics: Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture Design; Denture, Partial, Fixed; Denture, Partial, Removable; Esthetics, Dental; Humans; Immediate Dental Implant Loading; Jaw, Edentulous, Partially; Patient Reported Outcome Measures; Patient Satisfaction; Quality of Life; Treatment Outcome
PubMed: 30328187
DOI: 10.1111/clr.13299 -
Journal of Prosthodontic Research Jun 2021The aim of this retrospective cohort study was to investigate the long-term outcome of metal- and all-ceramic resin-bonded fixed dental prosthesis (RBFDP) up to 17...
PURPOSE
The aim of this retrospective cohort study was to investigate the long-term outcome of metal- and all-ceramic resin-bonded fixed dental prosthesis (RBFDP) up to 17 years, and to evaluate potential factors influencing the risk for complications.
METHODS
Patients who were treated with RBFDP to replace teeth in the anterior or first premolar region in an university setting were identified from electronic records. Data collection comprised dental and periodontal parameters, periapical radiographs, and assessment of the RBFDP. Patient-reported satisfaction was evaluated on visual analog scales (VAS), and 5-year cumulative survival and success rates were calculated. Cox regression models were used to compare metal- versus all-ceramic RBFDPs.
RESULTS
Seventy-one patients with RBFDP replacing 65 anterior teeth and 6 premolars were included with a mean observation period of 56.1 (±42.7) months. RBFDP cumulative survival rate was 86.7% and cumulative success rate 71.7% after 5 years, with no significant difference between metal-and all-ceramic RBFDPs. The risk for RBFDP failure was significantly higher with more than one pontic (OR 6.1; p=0.033), or negative pulp vitality testing of abutments (OR 7.3; p=0.042), while complications tended to be increased with two-wings compared to one-wing RBFDP (OR 5.4; p=0.054).
CONCLUSIONS
Metal- and all-ceramic RBFDPs facilitated good long-term results, particularly with one-wing, one-cantilever, and vital abutment teeth.
Topics: Ceramics; Dental Bonding; Dental Restoration Failure; Denture, Partial, Fixed; Denture, Partial, Fixed, Resin-Bonded; Humans; Retrospective Studies
PubMed: 33028798
DOI: 10.2186/jpr.JPR_D_20_00014