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Clinical Oral Implants Research Feb 2005Due to lack of the periodontal ligament, osseointegrated implants, unlike natural teeth, react biomechanically in a different fashion to occlusal force. It is therefore... (Review)
Review
Due to lack of the periodontal ligament, osseointegrated implants, unlike natural teeth, react biomechanically in a different fashion to occlusal force. It is therefore believed that dental implants may be more prone to occlusal overloading, which is often regarded as one of the potential causes for peri-implant bone loss and failure of the implant/implant prosthesis. Overloading factors that may negatively influence on implant longevity include large cantilevers, parafunctions, improper occlusal designs, and premature contacts. Hence, it is important to control implant occlusion within physiologic limit and thus provide optimal implant load to ensure a long-term implant success. The purposes of this paper are to discuss the importance of implant occlusion for implant longevity and to provide clinical guidelines of optimal implant occlusion and possible solutions managing complications related to implant occlusion. It must be emphasized that currently there is no evidence-based, implant-specific concept of occlusion. Future studies in this area are needed to clarify the relationship between occlusion and implant success.
Topics: Biomechanical Phenomena; Bite Force; Dental Implantation, Endosseous; Dental Occlusion; Dental Occlusion, Traumatic; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Dental Stress Analysis; Denture, Complete; Denture, Overlay; Denture, Partial, Fixed; Humans; Occlusal Adjustment; Practice Guidelines as Topic
PubMed: 15642028
DOI: 10.1111/j.1600-0501.2004.01067.x -
Journal of Oral Science Oct 2021The recent literature on maxillary implant overdenture (IOD) was reviewed in order to clarify its predictability and establish treatment guidelines. Electronic searches... (Review)
Review
The recent literature on maxillary implant overdenture (IOD) was reviewed in order to clarify its predictability and establish treatment guidelines. Electronic searches were performed using PubMed, and articles about maxillary IOD written after 1990 were reviewed, focusing on the following items: I. implant survival rate, II. maxillary IOD survival rate, III. number of implants, IV. attachment type, V. follow-up period, VI. implant system, and VII. opposing dentition. The review revealed an implant survival rate of 61-100% and an overdenture survival rate of 72.4-100%. The attachments used included bars, balls, locators, and telescope crowns. The minimum and maximum observation periods were 12 months and 120 months, respectively, and the number of implants used for supporting IOD ranged from 2 to 8. At present, there is no strong evidence to indicate that maxillary IOD is clearly superior for all the items examined. However, the existing data indicate that maxillary IOD has almost the same therapeutic effect as fixed implant superstructures, and is a treatment option that can be actively adopted for patients in whom fixed superstructures cannot be applied for various reasons.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Overlay; Humans; Maxilla
PubMed: 34408111
DOI: 10.2334/josnusd.21-0087 -
The Open Dentistry Journal 2018This article explains the concept of telescopic denture. (Review)
Review
AIM
This article explains the concept of telescopic denture.
PROCEDURE
It describes the different types of telescopic attachment (or double crown), and provides an overview of the advantages and the disadvantages of this type of prosthodontic treatment.
CONCLUSION
The indications and the clinical applications of telescopic denture are discussed.
PubMed: 29760817
DOI: 10.2174/1874210601812010246 -
Clinical Oral Implants Research Feb 2016The aim of this systematic review was to analyze post-loading implant loss for implant-supported prostheses in edentulous jaws, regarding a potential impact of implant... (Review)
Review
OBJECTIVES
The aim of this systematic review was to analyze post-loading implant loss for implant-supported prostheses in edentulous jaws, regarding a potential impact of implant location (maxilla vs. mandible), implant number per patient, type of prosthesis (removable vs. fixed), and type of attachment system (screw-retained, ball vs. bar vs. telescopic crown).
MATERIAL AND METHODS
A systematic literature search for randomized-controlled trials (RCTs) or prospective studies was conducted within PubMed, Cochrane Library, and Embase. Quality assessment of the included studies was carried out, and the review was structured according to PRISMA. Implant loss and corresponding 3- and 5-year survival rates were estimated by means of a Poisson regression model with total exposure time as offset.
RESULTS
After title, abstract, and full-text screening, 54 studies were included for qualitative analyses. Estimated 5-year survival rates of implants were 97.9% [95% CI 97.4; 98.4] in the maxilla and 98.9% [95% CI 98.7; 99.1] in the mandible. Corresponding implant loss rates per 100 implant years were significantly higher in the maxilla (0.42 [95% CI 0.33; 0.53] vs. 0.22 [95% CI 0.17; 0.27]; P = 0.0001). Implant loss rates for fixed restorations were significantly lower compared to removable restorations (0.23 [95% CI 0.18; 0.29] vs. 0.35 [95% CI 0.28; 0.44]; P = 0.0148). Four implants and a fixed restoration in the mandible resulted in significantly higher implant loss rates compared to five or more implants with a fixed restoration. The analysis of one implant and a mandibular overdenture also revealed higher implant loss rates than an overdenture on two implants. The same (lower implant number = higher implant loss rate) applied when comparing 2 vs. 4 implants and a mandibular overdenture. Implant loss rates for maxillary overdentures on <4 implants were significantly higher than for four implants (7.22 [95% CI 5.41; 9.64] vs. 2.31 [1.56; 3.42]; P < 0.0001).
CONCLUSIONS
Implant location, type of restoration, and implant number do have an influence on the estimated implant loss rate. Consistent reporting of clinical studies is necessary and high-quality studies are needed to confirm the present results.
Topics: Dental Implantation, Endosseous; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture, Overlay; Denture, Partial, Fixed; Humans; Jaw, Edentulous
PubMed: 25664612
DOI: 10.1111/clr.12531 -
Journal of Indian Prosthodontic Society 2021This systematic review aimed to compare different attachment systems used in mandibular implant supported overdentures by assessing outcomes such as prosthodontic... (Meta-Analysis)
Meta-Analysis Review
AIM
This systematic review aimed to compare different attachment systems used in mandibular implant supported overdentures by assessing outcomes such as prosthodontic maintenance and complication, peri implant tissue changes, retention, and patient satisfaction for optimum selection of attachment system.
SETTINGS AND DESIGN
This systematic review conducted following Preferred Reporting Items for the Systematic Review and Meta Analysis (PRISMA) guidelines.
MATERIALS AND METHODS
A systematic electronic literature search was conducted through PubMed, The Cochrane Central Register of Controlled Trials (Central), and Science direct. A hand search was also performed for individual journals and reference lists of selected studies. Randomized controlled clinical trials and crossover clinical trials from 2010 to 2020 with follow up of more than 1 year were included. The Cochrane Collaboration's tool was used for assessing the risk of bias of included studies.
STATISTICAL ANALYSIS USED
The statistical meta analysis was performed using Review Manager (RevMan) [computer program]. Version 5.4. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboation, 2020.
RESULTS
Six studies that met the inclusion criteria possess the low risk of bias with follow up of more than 1 year were included in this systematic review. Out of four outcomes, meta analysis was performed for prosthodontic maintenance and peri implant tissue changes. Due to the limited availability of data, retention and patient satisfaction were reviewed systematically without meta analysis. The result of meta analysis for ball versus magnet attachment showed statistically significant differences in prosthodontic complications and maintenance, and ball attachment reported fewer complications than the locator attachment (risk ratio [RR] =0.55, confidence interval [CI] =95%, P = 0.03). Peri implant tissue changes were analyzed in the included studies as probing depth and marginal bone loss. The result of meta analysis for probing depth showed no statistically significant difference between bar versus telescopic type of attachment (RR = 0.20, CI = 95%, P = 0.74). The meta analysis results for marginal bone loss showed no statistically significant difference between bar versus telescopic type of attachment (mean difference = 0.35, CI = 95%, P = 0.10).
CONCLUSION
It can be concluded from the current review that bar attachment provided the most superior retention. The telescopic attachment system not only showed the most favorable patient's satisfaction but also reported the least peri implant mucosal changes. The ball attachment system is a favorable choice for limited inter arch space and parallel implant placement.
Topics: Cross-Over Studies; Denture, Overlay; Humans; Jaw, Edentulous; Mandible; Patient Satisfaction
PubMed: 34810359
DOI: 10.4103/jips.jips_158_21 -
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 -
International Journal of Biomedical... Mar 2017This report describes the case of a 68 year old female patient who presented with the chief complaint of difficulty in chewing and poor aesthetics due to missing teeth....
PATIENT
This report describes the case of a 68 year old female patient who presented with the chief complaint of difficulty in chewing and poor aesthetics due to missing teeth. The patient was interested in saving the remaining natural teeth and desired minimal tissue coverage from the prosthesis. After consideration of all the factors involved, it was deemed advisable to resort to a palate free maxillary telescopic complete denture and a mandibular removable partial denture.
DISCUSSION
Considering the age of the patient and the cost involved, implant supported prosthesis was ruled out as a treatment option for the patient. A telescopic denture was chosen as a favourable treatment option since it overcomes many of the problems posed by conventional complete dentures like progressive bone loss, lower stability and retention, loss of periodontal proprioception and low masticatory efficiency. It also provides minimal tissue coverage and better distribution of forces. Evaluation of occlusion, esthetics, phonetics and comfort after 24 hours, 1 week and 1 month of treatment showed that the patient was happy with the prosthesis and was able to speak and chew well.
CONCLUSION
Telescopic overdentures have better retention and stability as compared to conventional complete dentures. They improve the chewing efficiency, patient comfort and also decrease the alveolar bone resorption. As such they are an excellent alternative to conventional complete denture treatment.
PubMed: 28533736
DOI: No ID Found -
BMJ Open Aug 2016The need for denture treatment in public health will increase as the population ages. However, the impact of dentures on nutrition, particularly overdenture treatment,... (Comparative Study)
Comparative Study Meta-Analysis Review
OBJECTIVES
The need for denture treatment in public health will increase as the population ages. However, the impact of dentures on nutrition, particularly overdenture treatment, remains unclear although the physical and psychological effects are known. We investigated whether treatment with a mandibular implant supported overdenture improves nutrient intake and markers of nutritional status better than a conventional complete denture in edentulous patients.
DESIGN
Systematic review and meta-analysis.
METHODS
Medline, EMBASE and the Cochrane Central Register of Controlled Trials were searched for eligible studies published up to April 2016. We included studies which compared the treatment effect of an overdenture to conventional denture on nutrition, in which primary outcomes included changes in intake of macronutrients and/or micronutrients and/or indicators of nutritional status. Two reviewers independently evaluated eligible studies and assessed the risk of bias. We used a fixed effects model to estimate the weighted mean difference (WMD) and 95% CI for change in body mass index (BMI), albumin and serum vitamin B12 between overdenture and conventional denture 6 months after treatment.
RESULTS
Of 108 eligible studies, 8 studies involving 901 participants were included in the narrative appraisal. Four studies reported changes in markers of nutritional status and nutrient intake after treatment with a prosthetic, regardless of type. In a meta-analysis of 322 participants aged 65 years or older from three studies, pooled analysis suggested no significant difference in change in BMI between an overdenture and conventional denture 6 months after treatment (WMD=-0.18 kg/m(2) (95% CI -0.52 to 0.16)), and no significant difference in change in albumin or vitamin B12 between the two treatments.
CONCLUSIONS
The modifying effect of overdenture treatment on nutritional status might be limited. Further studies are needed to evaluate the effectiveness and efficacy of denture treatments.
Topics: Dental Prosthesis, Implant-Supported; Denture, Complete; Denture, Overlay; Diet; Humans; Mouth, Edentulous; Nutritional Status; Patient Satisfaction; Randomized Controlled Trials as Topic; Serum Albumin, Human; Vitamin B 12
PubMed: 27489156
DOI: 10.1136/bmjopen-2016-011799 -
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 -
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