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Amin NAM. Perception, sentiments, and the level of awareness toward the dental implant among general population in Sulaimaniyah City, Iraq. BMC Oral Health 2024; 24:255. [PMID: 38378507 PMCID: PMC10877875 DOI: 10.1186/s12903-024-03964-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 02/01/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Edentulism is one of the most commonly encountered conditions affecting the oral cavity. Dental implants have emerged as a widely accepted treatment option prosthodontically. However, lack of public awareness and the cost of the treatment act as barriers to limit their applicability. OBJECTIVES To investigate the perception, sentiments, and level of awareness toward dental implants among the general population in Sulaimaniyah City, Iraq. MATERIALS AND METHODS A questionnaire-based survey was conducted on 1132 participants in Sulaimaniyah City, Iraq, from February 15, 2023, till August 15, 2023, to collect their sociodemographic data, knowledge and attitudes toward dental implants for their missing tooth/teeth. RESULTS The mean age of participants was 41.3 ± 14.6 years, and most (30.7%) belong to the age group 31-44 years. Also, most of them were males (63.6%), married (75.3%), educated (91.3%), from rural areas (82.3%), and had > 1 missing tooth (75%). Regarding the participants' knowledge of dental implants, most had information (78.4%)/heard about it (83.3%), mainly from dentists (43.6%); however, least of them (21.5%) /their family members (43%) had replaced missing teeth by dental implants. Additionally, the participant's attitudes toward the dental implant indicated that most of them were interested in replacing their missing teeth (88.8%) but did not do it due to financial reasons (87%) and considered replacement as a significant (92.5%) and safe process (79.2%). Also, most of them thought there was no substantial difference between artificial and natural tooth appearance/function (47.9%), preferred the delayed implant for dental implant (47.7%), and would like to do an implant due to problems in dental appearance, speech, or dental function (81.5%). Finally, significant/highly significant differences were seen between each participant's factor (age, gender, marital status, education level, and residency) with most items of attitude/awareness toward dental implants. CONCLUSIONS Most participants were aware of the knowledge and attitude of dental implants for replacing missing tooth/teeth, especially males, married ones, educated individuals, and those from urban areas; however, financial problems are the main obstacle. Additionally, the delayed implant is preferable for replacing missing tooth/teeth using dental implants among studied individuals.
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Affiliation(s)
- Nzar Abdulqadr Muhammed Amin
- Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Sulaimani, Sulaimaniyah, 0046, Iraq.
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Esteve-Pardo G, De-Larriva E, Sanchez-Suarez LM, Sanchez-Nicolas JA, Bernabeu-Esclapez A, Esteve-Colomina L. How do implant patients experience complications? A cross-sectional multicentre pilot study. Clin Oral Implants Res 2023; 34:987-998. [PMID: 37416986 DOI: 10.1111/clr.14125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 05/29/2023] [Accepted: 06/20/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND This cross-sectional study aimed to quantify the impact of implant-related complications on perceived pain, functional impairment, concern, quality of life (QoL) and confidence which were the study's primary outcomes. MATERIALS AND METHODS Patients were recruited in five centres over 19 months. They completed a structured ad hoc questionnaire scoring pain, chewing ability, concern, QoL and confidence in future implant treatment. Some potential independent variables were also recorded. The data were analysed descriptively and with a multiple-stepwise regression model for correlations of the five primary variables with the other data. RESULTS The sample consisted of 408 patients, with prosthesis mobility being the most common complication (40.7%). Most patients (79.2%) consulted because of a complication, while 20.8% were asymptomatic and consulted regularly. Pain was correlated with symptoms at consultation and in biological/mixed complications (p < .001; R2 = 44.8%). Chewing impairment with implant loss, prosthesis fracture and removable implant-supported or total prostheses (p < .001; R2 = 42.8%); patient concern was correlated with the clinical symptoms and removable implant-supported prostheses (p < .001; R2 = 36.1%); impact on QoL was correlated with implant loss, prosthesis fracture and removable implant-supported prostheses (p < .001; R2 = 41.1%). Patient confidence was relatively independent and only impact on quality of life significantly influenced it (r = 0.73). CONCLUSIONS Implant-related complications moderately impaired patients' perceptions of pain, chewing ability, concern and QoL. Nevertheless, complications only slightly reduced their confidence in future implant treatment.
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Sáez-Alcaide LM, Cortés-Bretón-Brinkmann J, Sánchez-Labrador L, Pérez-González F, Forteza-López A, Molinero-Mourelle P, López-Quiles J. Patient-reported outcomes in patients with severe maxillary bone atrophy restored with zygomatic implant-supported complete dental prostheses: a systematic review. Acta Odontol Scand 2022; 80:363-373. [PMID: 35044889 DOI: 10.1080/00016357.2021.2018494] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Introduction and Objective: Zygomatic implants (ZI) offer a good and predictable alternative to reconstructive procedures of atrophic maxillae. The main objetive of this systematic review was to assess the effect of rehabilitation with zygomatic implants on patient's quality of life (QLP) using Patient Reported Outcomes Measures (PROMs).Materials and Methods: This review followed PRISMA guidelines. An automated electronic search was conducted in four databases supplemented by a manual search for relevant articles published until the end of January 2021. The Cochrane Collaboration Risk of Bias tool and the Newcastle-Ottawa Quality Assessment Scale were used to assess the quality of evidence in the studies reviewed.Results: General findings of this systematic review showed substantial increases in Oral health-related quality of life (OHRQoL) among patients restored with ZI and high scores in terms of general satisfaction, especially in chewing ability and esthetics. An overall survival rate of ZI was 98.3% after a mean follow-up time of 46.5 months was observed. Occurrence of 13.1% biological complications and 1.8% technical complications were reported.Conclusions: Patients rehabilitated with zygomatic implant-supported complete dental prostheses showed substantial improvements in OHRQoL and general satisfaction with the treatment received.
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Affiliation(s)
- Luis Miguel Sáez-Alcaide
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | | | - Luis Sánchez-Labrador
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Fabián Pérez-González
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Alba Forteza-López
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Pedro Molinero-Mourelle
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Juan López-Quiles
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
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Wu X, Ye M, Sun J, Yan Q, Shi B, Xia H. Patient-reported outcome measures following surgeries in implant dentistry and associated factors: a cross-sectional study. BMJ Open 2022; 12:e059730. [PMID: 35710257 PMCID: PMC9207936 DOI: 10.1136/bmjopen-2021-059730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES We aimed to evaluate the patient-reported outcome measures (PROMs) of dental implant surgeries and analyse the associated indicators. DESIGN A cross-sectional study design was used. SETTING Department of Oral Implantology, Hospital of Stomatology, Wuhan University (May 2020-April 2021). PARTICIPANTS Participants with missing teeth in need of implant-supported rehabilitation. INTERVENTIONS Dental implant placement and/or bone augmentation procedures. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was discomfort on postoperative day 1, measured using a numerical rating scale (NRS). Secondary outcomes included pain and anxiety during surgery; discomfort on postoperative days 3, 7 and 14; and post-surgical complications. RESULTS A total of 366 participants were included, of which 288 (78.7%) and 328 (89.7%) reported no to mild pain and anxiety (NRS 0-3) during surgery, respectively. The proportion of patients reporting discomfort decreased from postoperative day 1 (57.7%) to day 3 (36.1%) and day 7 (17.5%). The most frequent postoperative adverse events were pain and swelling. Patient-related factors (age, sex, smoking, alcohol consumption, history of periodontitis, and pain and anxiety during surgery) and surgery-related factors (type and extent of surgical procedure) were analysed. The factors associated with the severity of discomfort after surgery included alcohol consumption, pain perception during surgery, bone augmentation procedures and age (p<0.05). Similarly, the factors associated with the duration of discomfort included alcohol consumption, pain perception during surgery and age (p<0.05). CONCLUSIONS PROMs related to dental implant surgeries can be predicted using certain risk indicators. Alcohol consumption, pain during surgery and age were associated with discomfort following dental implant surgery.
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Affiliation(s)
- Xinyu Wu
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Mengjie Ye
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jiahui Sun
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qi Yan
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bin Shi
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Haibin Xia
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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Rudeejaraswan A, Pisarnturakit PP, Mattheos N, Pimkhaokham A, Subbalekha K. Dentists' Attitudes Toward Dental Implant Maintenance in Thailand. JDR Clin Trans Res 2021; 8:23800844211049405. [PMID: 34719981 DOI: 10.1177/23800844211049405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION As implant therapy is a widely applied treatment modality, general dentists are in the frontline of maintaining health in patients with implants. It is however unknown to what extent general dentists are competent and feel prepared to deliver maintenance of implants to patients. OBJECTIVES The aim of this study was to investigate the attitudes and self-reported and objectively assessed competences of general dentists with maintenance of dental implants in patients. METHODS A questionnaire designed and validated for the purpose of the study, including attitudes and self-reported and objectively assessed competences, was distributed by means of an online platform. RESULTS Data from 429 questionnaires were included in the study. Half of the participants were 28 to 33 y old and 78% had been working <10 y. Seventy-eight percent believed that dental implant maintenance should be performed by general dentists, but only 51% were prepared to do this, citing obstacles such as insufficient knowledge and limitations of their working environment. The mean ± SD objectively assessed competence score was 8.97 ± 2.74 of 17. There were significant differences (P < 0.001, 1-way analysis of variance) in the scores among dentists who offered the full range of maintenance and management of complications (10.83 ± 2.45) with those willing to provide comprehensive oral examination and implant maintenance only (9.31 ± 2.73), those offering comprehensive examination but unwilling to conduct maintenance (8.22 ± 2.28), and those who refer all dental implant patients elsewhere (7.2 ± 2.66). Around half of the dentists believed that implants last for life. CONCLUSIONS While general dentists appeared to largely acknowledge the importance of providing implant maintenance care and present with positive attitudes, a large portion was unwilling to engage with maintenance of implants in patients and appeared to lack essential competences to this end. The main obstacles for providing implant maintenance care included insufficient knowledge and lack of a properly equipped clinical environment. KNOWLEDGE TRANSFER STATEMENT The results of this study can identify deficiencies in the currently available maintenance competences and schemes for patients with implants. These results can also help dental professionals, scientific bodies, and associations to design appropriate education and professional development strategies that can strengthen the confidence and competences of general dentists, thus offering better service to the public.
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Affiliation(s)
- A Rudeejaraswan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry Chulalongkorn University, Bangkok, Thailand
| | - P P Pisarnturakit
- Department of Community Dentistry, Faculty of Dentistry Chulalongkorn University, Bangkok, Thailand
| | - N Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry Chulalongkorn University, Bangkok, Thailand
- Department of Dental Medicine, Karolinska Institute, Solna, Sweden
| | - A Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry Chulalongkorn University, Bangkok, Thailand
| | - K Subbalekha
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry Chulalongkorn University, Bangkok, Thailand
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Sermsiripoca K, Pisarnturakit PP, Mattheos N, Pimkhaokham A, Subbalekha K. Comparing pre- and post-treatment patients' perceptions on dental implant therapy. Clin Implant Dent Relat Res 2021; 23:769-778. [PMID: 34346146 DOI: 10.1111/cid.13036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/01/2021] [Accepted: 07/26/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Appropriate patients' perceptions as one of Patient Reported Outcome Measures (PROMs), are shown to be critical for the sustainable success of implant therapy, little is known however of how they prospectively evolve throughout the treatment process. OBJECTIVE This study aimed to prospectively assess patients' perceptions before and after treatment with dental implants and to identify the impact of patients' characteristics on their perceptions. MATERIALS AND METHODS Patients' perceptions on implant therapy were prospectively assessed by means of purpose-made questionnaire, rating the extent of agreement/disagreement with a set of statements on a visual analog scale. The questionnaire was collected before initial consultation with the implant dentist and post-treatment at least 1 month after prosthetic loading of the implant. Changes in patients' perceptions were analyzed with the Wilcoxon signed-rank test. RESULTS Pretreatment questionnaire was collected from 359 patients. While 245 of them proceeded with implant therapy, 145 received final restoration within the timeframe of the study and completed the post-treatment questionnaires between 1 and 6 months after prosthesis delivery. The most common source of information was dental professions (72.4%). Although patients' perceptions were more realistic at post-treatment, few improper perceptions persisted as only 51% of patients agreed with the statement "There is a chance of dental implant failure," 28% agreed with the statement "Dental implants last longer than natural teeth," and higher percentage of patients agreed with "Dental implant therapy is appropriate for all patients." CONCLUSIONS Although patients appear to harbor more realistic perceptions of implant therapy, certain improper perceptions still persist at post-treatment. The design of appropriate patient educational program might be essential to correct misperceptions that might affect long term success of implant therapy. This study had been registered on Thai Clinical Trials Registry (TCTR) with the TCTR identification number: TCTR20181101001.
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Affiliation(s)
- Khunsiri Sermsiripoca
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | | | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Keskanya Subbalekha
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Engkawong S, Mattheos N, Pisarnturakit PP, Pimkhaokham A, Subbalekha K. Comparing patient-reported outcomes and experiences among static, dynamic computer-aided, and conventional freehand dental implant placement: A randomized clinical trial. Clin Implant Dent Relat Res 2021; 23:660-670. [PMID: 34231956 DOI: 10.1111/cid.13030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/10/2021] [Accepted: 06/22/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of this study was to compare patient-reported outcomes and experiences (PROs and PREs) among three techniques of dental implant placement, including (a) conventional freehand, (b) dynamic, and (c) static computer-aided implant surgery (CAIS). MATERIAL AND METHODS Ninety patients were randomly assigned to have dental implant placed with one of the three protocols. Participants were asked to fill in a series of self-administered questionnaires assessing (1) preoperative expectations, (2) postoperative healing events during the first week after surgery, and (3) experiences and overall satisfaction with the procedures at 2 weeks. Differences within the groups were analyzed by Wilcoxson signed-rank test. Kruskal-Wallis test was used for comparisons among the three groups. RESULTS Eighty-eight patients completed the study. Patients' expectations on chewing difficulty, the postoperative experience of duration of pain, speaking limitations, and impact on routine activities were significantly different among groups (p = 0.04, 0.01, 0.038, and 0.046, respectively). Overall, patients appeared to significantly underestimate the duration of postoperative pain (p = 0.035) and swelling (p = 0.001). No significant difference in magnitude of postoperative pain, swelling, and painkiller consumption was found among the groups. The short-term functional limitations after surgery were deemed acceptable by most participants and 89% were satisfied by the overall procedure. CONCLUSIONS Surgical placement of dental implant with conventional freehand, static, and dynamic CAIS techniques did not result in any difference in the level of postoperative pain and swelling, and appeared to lead to equal levels of satisfaction as expressed by the patients postoperatively.
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Affiliation(s)
- Sunida Engkawong
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Department of Dental Medicine, Karolinska Institute, Solna, Sweden
| | | | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Keskanya Subbalekha
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Monje A, Pérez A, Vera-Rodriguez M, Nart J, Catena A, Petrova D. Comprehension and recall of information about factors associated with peri-implantitis: A randomized controlled trial. J Periodontol 2021; 93:89-99. [PMID: 33949680 DOI: 10.1002/jper.21-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/17/2021] [Accepted: 04/23/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND To evaluate the effect of different communication strategies on comprehension and recall of information about factors associated to peri-implantitis. MATERIALS A prospective, randomized controlled trial was conducted in consecutive patients diagnosed with peri-implantitis. The sample was divided into three groups according to the communication strategy used: Test group 1-Written communication via leaflet with visual aids (L-VA); Test group 2-Written communication via leaflet with no visual aids (L-NVA); and control group-only verbal communication with no leaflet (NL). A questionnaire assessing comprehension at baseline (T0) and recall at 3 months (T1) and 6 months (T2) was administered following the fuzzy trace theory with a combination of 11 "gist" and seven "verbatim" items. The "health belief model" dimensions were further examined to test the influence of the communication strategy upon perceived severity, susceptibility, benefits, barriers, self-efficacy, and behavioral intentions. RESULTS Ninety-nine patients that fulfilled the eligibility criteria were included. Gist and verbatim comprehension of the control, risk factors, and preventive measures for peri-implantitis overall was significantly greater in the test groups, in particular in L-VA at T0 (n = 99). Nevertheless, recall was not influenced by the communication strategy at T1 (n = 85) or T2 (n = 78). No significant differences were noted between groups or as a function of time for any of the "health belief model" constructs with the sole exception of perceived barriers (P = 0.045), which proved lower in the test groups. CONCLUSION The comprehension of information about factors associated to peri-implantitis can be efficiently improved by using written communicative strategies, in particular when supplemented with visual aids. Nevertheless, this approach failed to show effectiveness in modulating recall or in changing behavioral intentions over follow-up (NCT04543604).
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Affiliation(s)
- Alberto Monje
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain.,Department of Periodontology, School of Dental Medicine, University of Michigan, Ann Arbor, USA.,Private practice, CICOM, Badajoz, Spain
| | | | - Maria Vera-Rodriguez
- Department of Periodontology, School of Dental Medicine, University of Michigan, Ann Arbor, USA
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Andrés Catena
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Dafina Petrova
- CIBER of Epidemiology and Public Health (CIBERSP), Madrid, Spain.,Escuela Andaluza de Salud Pública (EASP), Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
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Fu L, Liu G, Wu X, Zhu Z, Sun H, Xia H. Patient-reported outcome measures of edentulous patients restored with single-implant mandibular overdentures: A systematic review. J Oral Rehabil 2020; 48:81-94. [PMID: 32989781 DOI: 10.1111/joor.13103] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 11/29/2022]
Abstract
AIM To review the literatures concerning the effect of the single-implant mandibular overdenture (SIMO) on patient-reported outcome measures (PROMs) and masticatory function in the fully edentulous patients. MATERIALS AND METHODS Electronic databases (PubMed, Cochrane Library, EMBASE and Web of Science) were searched, complemented with manual resources. Prospective studies published in English up to February 2020 reporting the effect of SIMO on PROMs and masticatory function in the edentulous patients were included. This review focused on oral health-related quality of life (OHRQoL), satisfaction and masticatory function outcomes. RESULTS Of 1157 initially screened articles, 9 randomised controlled trials (RCTs) and 8 prospective studies involving 551 subjects fulfilled the inclusion criteria. Two RCTs were graded as high risk of bias or some concern, while others were low risk. All prospective studies had adequate representativeness and assessment, but only one study had a controlled cohort. In general, the edentulous patients restored with SIMOs had improved OHRQoL and general satisfaction compared to those with conventional complete dentures (CCDs), but the outcome of masticatory function was controversial. Compared with two-implant mandibular overdenture (TIMO), SIMO showed no significant differences regarding general satisfaction and satisfaction with speech, comfort, chewing ability, aesthetics and social life. Conflicting results were observed in OHRQoL and satisfaction with retention and stability. Better masticatory performance was observed in TIMO group than SIMO group. CONCLUSION Within the limitation of this review, SIMO is featured with better OHRQoL and satisfaction than CCD. SIMO and TIMO rendered similar patient satisfaction, but TIMO had better masticatory performance.
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Affiliation(s)
- Liangliang Fu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Oral Implantology, Hospital and School of Stomatology, Wuhan University, Wuhan, China
| | - Gufeng Liu
- School of Stomatology, Wuhan University, Wuhan, China
| | - Xiaoyi Wu
- School of Stomatology, Wuhan University, Wuhan, China
| | - Zhenzhen Zhu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Oral Implantology, Hospital and School of Stomatology, Wuhan University, Wuhan, China
| | - Huifang Sun
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Haibin Xia
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Oral Implantology, Hospital and School of Stomatology, Wuhan University, Wuhan, China
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10
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Wu X, Hu Q, Yan Q, Zhang T, Riley P, Hua F, Shi B, Tu YK. Trends in the level of evidence and impact of clinical studies published in leading oral implantology journals: 2008-2018. Clin Oral Implants Res 2020; 31:980-991. [PMID: 32734630 DOI: 10.1111/clr.13641] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/18/2020] [Accepted: 07/20/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To present the characteristics and level of evidence (LOE) of clinical studies published in leading oral implantology journals during 2008-2018 and to explore whether the LOE of a study is associated with its scientific and social impact. MATERIALS AND METHODS Clinical studies with direct relevance to the evaluation of healthcare interventions published in 2008, 2013, and 2018 in six oral implantology journals were identified via hand searches. A modified 4-level Oxford 2011 LOE tool was used to assess the LOE of all eligible studies. The citation count and Altmetric Attention Score (AAS) of each study were extracted from Web of Science and Altmetric Explorer, respectively. Thereafter, multivariable generalized estimation equation analyses were used to investigate the association between LOE, citation counts, and AAS, adjusting for potential confounding factors and clustering effects. RESULTS A total of 763 clinical studies were included, among which the proportion of level-1, level-2, level-3, and level-4 studies was 2.4%, 30.4%, 40.2%, and 27.0%, respectively. During 2008-2018, the proportion of high LOE studies (level-1 and level-2) increased substantially from 24.6% to 43.1%, although the number of systematic reviews that only include randomized controlled trials has remained limited. According to multivariable analyses, the citation count (p = .002) and AAS (p = .005) of high LOE studies were both significantly greater than those of low LOE studies. CONCLUSIONS During the past decade, the proportion of high LOE studies has increased substantially in the field of oral implantology. Clinical studies with higher LOE tend to have greater scientific and social impact.
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Affiliation(s)
- Xinyu Wu
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qing Hu
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qi Yan
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Tingting Zhang
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Philip Riley
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Fang Hua
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.,Centre for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bin Shi
- Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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11
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Brunello G, Gervasi M, Ricci S, Tomasi C, Bressan E. Patients' perceptions of implant therapy and maintenance: A questionnaire‐based survey. Clin Oral Implants Res 2020; 31:917-927. [DOI: 10.1111/clr.13634] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 06/19/2020] [Accepted: 06/21/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Giulia Brunello
- Department of Neurosciences School of Dentistry University of Padova Padova Italy
- Department of Management and Engineering University of Padova Vicenza Italy
| | - Marika Gervasi
- Department of Neurosciences School of Dentistry University of Padova Padova Italy
| | - Sara Ricci
- Department of Neurosciences School of Dentistry University of Padova Padova Italy
| | - Cristiano Tomasi
- Department of Periodontology Institute of Odontology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Eriberto Bressan
- Department of Neurosciences School of Dentistry University of Padova Padova Italy
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12
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Camacho-Alonso F, Vilaplana-Vivo J, Caballero-Guerrero PM, Pato-Mourelo J, Sánchez-Siles M. Impact of audiovisual information on anxiety and fear in patients undergoing dental implant treatment. Clin Implant Dent Relat Res 2019; 21:1189-1198. [PMID: 31639265 DOI: 10.1111/cid.12851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 09/12/2019] [Accepted: 09/16/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Few studies have reported the impact of audiovisual implant surgery information on anxiety and fear. PURPOSE To investigate the impact of audiovisual information on anxiety and fear in patients undergoing dental implant treatment. MATERIALS AND METHODS This study included 300 patients due to undergo surgery to place a single implant. An interview topic guide and the Krantz Health Opinion Survey (KHOS) survey were used to assess the information patients already had about treatment and how much information they were seeking. Afterwards were randomized into two groups (n = 150): group 1 (verbal information) and group 2 (audiovisual information). Before surgery, anxiety and fear were assessed using State-Trait Anxiety Inventory (STAI), Modified Corah Dental Anxiety Scale (MDAS), and Dental Fear Scale (DFS) scales. After treatment, all patients described their satisfaction with the information received with a VAS. RESULTS Before receiving information, both groups were homogenous in their knowledge of the implant procedure (P = .825) and the quantity of information sought (KHOS; P = .080). After receiving information, group 2 patients presented more anxiety and fear than group 1 (STAI-State, STAI-Treat, MDAS, DFS; P < .001). After surgery, both groups were equally satisfied with the information received and the need for additional information (P = .689; P = .199, respectively). CONCLUSIONS Audiovisual information generated greater anxiety and fear than conventional verbal information in patients undergoing implant surgery.
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13
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Vipattanaporn P, Mattheos N, Pisarnturakit P, Pimkhaokham A, Subbalekha K. Post‐treatment patient‐reported outcome measures in a group of Thai dental implant patients. Clin Oral Implants Res 2019; 30:928-939. [DOI: 10.1111/clr.13500] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 05/22/2019] [Accepted: 06/18/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Pat Vipattanaporn
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry Chulalongkorn University Bangkok Thailand
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry Chulalongkorn University Bangkok Thailand
- Faculty of Dentistry The University of Hong Kong Hong Kong China
| | - Pagaporn Pisarnturakit
- Department of Community Dentistry, Faculty of Dentistry Chulalongkorn University Bangkok Thailand
| | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry Chulalongkorn University Bangkok Thailand
| | - Keskanya Subbalekha
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry Chulalongkorn University Bangkok Thailand
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14
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Curtis DA, Sadowsky SJ. How should we communicate implant treatment risk to a patient? J Am Dent Assoc 2019; 150:481-483. [DOI: 10.1016/j.adaj.2019.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 04/03/2019] [Accepted: 04/03/2019] [Indexed: 11/16/2022]
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15
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Yin D, Komasa S, Yoshimine S, Sekino T, Okazaki J. Effect of mussel adhesive protein coating on osteogenesis in vitro and osteointegration in vivo to alkali-treated titanium with nanonetwork structures. Int J Nanomedicine 2019; 14:3831-3843. [PMID: 31213804 PMCID: PMC6536716 DOI: 10.2147/ijn.s206313] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 04/17/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose: On the basis of reasonable superposition of various surface treatment methods, alkali-treated titanium with nanonetwork structures (TNS) was coated with mussel adhesive protein (MAP) and named TNS-MAP. The aims were to optimize the biological properties of TNS, endue it with new properties, and enhance its utility in clinical dental applications. Methods: TNS disks were coated with MAP and the product surface was characterized. Its osteogenic properties were determined by evaluating its effects on cell adhesion, cell proliferation, the expression of osteogenesis-related genes, and in vivo experiments. Results: The treated materials showed excellent hydrophilicity, good surface roughness, and advantages of both TNS and MAP. TNS-MAP significantly promoted initial cell attachment especially after 15 mins and 30 mins. At every time point, cell adhesion and proliferation, the detection rate of osteogenesis-related markers in the extracellular matrix, and the expression of osteogenesis-related genes were markedly superior on TNS-MAP than the control. The in vivo experiments revealed that TNS-MAP promoted new bone growth around the implants and the bone-implant interface. Conclusion: We verified through in vitro and in vivo experiments that we successfully created an effective TNS-MAP composite implant with excellent biocompatibility and advantages of both its TNS and MAP parent materials. Therefore, the new biocomposite implant material TNS-MAP may potentially serve in practical dentistry and orthopedics.
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Affiliation(s)
- Derong Yin
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, Hirakata, Osaka, Japan
| | - Satoshi Komasa
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, Hirakata, Osaka, Japan
| | - Shigeki Yoshimine
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, Hirakata, Osaka, Japan
| | - Tohru Sekino
- Advanced Hard Materials, The Institute of Scientific and Industrial Research, Osaka University, Suita, Osaka, Japan
| | - Joji Okazaki
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, Hirakata, Osaka, Japan
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16
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Dong H, Zhou N, Liu H, Huang H, Yang G, Chen L, Ding M, Mou Y. Satisfaction analysis of patients with single implant treatments based on a questionnaire survey. Patient Prefer Adherence 2019; 13:695-704. [PMID: 31190753 PMCID: PMC6519022 DOI: 10.2147/ppa.s201088] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 04/04/2019] [Indexed: 12/03/2022] Open
Abstract
Background: The factors influencing satisfaction of the patients with implant treatments are still unclear. This study aims to evaluate the patients' satisfaction and to identify influencing factors, which will improve the medical quality of oral implantology. Materials and methods: Patients who lost single teeth and received implant treatments were enrolled in Nanjing Stomatological Hospital between February 2016 and March 2018. A questionnaire survey was performed to assess patient satisfaction and data were collected at four time points. Information included gender, age, educational level, application of bone augmentation, type of prosthetic restoration, period of teeth loss, dentist qualification, and tooth position. Meanwhile, the satisfaction of the patients was evaluated by visual analog scale. Results: A total of 373 patients completed the questionnaires. The mean of overall satisfaction score was 69.05±7.10. Lower overall satisfaction score was found in patients who received bone augmentation (P<0.001) and those with a longer period of teeth loss (P<0.05). In the bone augmentation group, the elements of pain and complication were significantly associated with a decrease in the median satisfaction score (P<0.001), and a similar result was obtained form the duration of operative time and healing response (P<0.001). On the other hand, the satisfaction scores for elements including the duration of operative time and healing response (P<0.05), aesthetics and psychology (P<0.05), and chewing function (P<0.05) decreased with an extended period of teeth loss. Meanwhile, over half of respondents were more concerned about the survival time (40.70%) and success rate (20.49%) of implants. Conclusion: Bone augmentation and the period of teeth loss are negative factors affecting patient satisfaction, and the success rate and survival time of implants are considerable aspects for patients. It is essential to raise general awareness of oral hygiene and optimize the dental implant therapeutic process.
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Affiliation(s)
- Heng Dong
- Department of Oral Implantology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing,Jiangsu, People’s Republic of China
| | - Na Zhou
- Department of Oral Implantology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing,Jiangsu, People’s Republic of China
| | - Hui Liu
- Department of Oral Implantology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing,Jiangsu, People’s Republic of China
| | - Haohao Huang
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, People’s Republic of China
| | - Guangwen Yang
- Department of Oral Implantology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing,Jiangsu, People’s Republic of China
| | - Li Chen
- Department of Oral Implantology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing,Jiangsu, People’s Republic of China
| | - Meng Ding
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, People’s Republic of China
- Correspondence: Yongbin Mou; Meng Ding Department of Research Service, Nanjing Stomatological Hospital, Medical School of Nanjing University, #30 Zhongyang Road, Nanjing 210008, People’s Republic of ChinaTel +86 258 362 0236Fax +86 258 362 0202 Email ;
| | - Yongbin Mou
- Department of Oral Implantology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing,Jiangsu, People’s Republic of China
- Correspondence: Yongbin Mou; Meng Ding Department of Research Service, Nanjing Stomatological Hospital, Medical School of Nanjing University, #30 Zhongyang Road, Nanjing 210008, People’s Republic of ChinaTel +86 258 362 0236Fax +86 258 362 0202 Email ;
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Yao CJ, Cao C, Bornstein MM, Mattheos N. Patient‐reported outcome measures of edentulous patients restored with implant‐supported removable and fixed prostheses: A systematic review. Clin Oral Implants Res 2018; 29 Suppl 16:241-254. [DOI: 10.1111/clr.13286] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 03/01/2018] [Accepted: 03/01/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Coral J Yao
- Implant Dentistry, ProsthodonticsFaculty of DentistryUniversity of Hong Kong Hong Kong China
| | - Cong Cao
- Center of StomatologyChina Japan Friendship Hospital Beijing China
- ITI Scholar 2016‐2017Implant DentistryProsthodonticsFaculty of DentistryUniversity of Hong Kong China
| | - Michael M. Bornstein
- Oral and Maxillofacial RadiologyFaculty of DentistryUniversity of Hong Kong Hong Kong China
| | - Nikos Mattheos
- Implant Dentistry, ProsthodonticsFaculty of DentistryUniversity of Hong Kong Hong Kong China
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18
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Provision of information to patients on dental implant treatment: Clinicians’ perspectives on the current approaches and future strategies. J Dent 2018; 76:117-124. [DOI: 10.1016/j.jdent.2018.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 07/03/2018] [Accepted: 07/04/2018] [Indexed: 11/20/2022] Open
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19
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Kashbour WA, Rousseau NS, Thomason JM, Ellis JS. Provision of information on dental implant treatment: Patients' thoughts and experiences. Clin Oral Implants Res 2018; 29:309-319. [PMID: 29337393 DOI: 10.1111/clr.13118] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To explore patients' thoughts and perceptions of information provision regarding dental implant treatment. METHODS This generic qualitative study involved 38 semi-structured face-to-face and telephone interviews with 34 participants, who were at different stages of dental implant treatment. The interviews were transcribed verbatim. The data collection and coding process followed the principles of qualitative thematic analysis. RESULTS Clinical sources of information were generally trusted by patients; however, patients clearly lacked information relative to their own specific situation, concerns and preferences, and this may lead to patients' reliance on other general sources of information. Crucial information on the long-term prosthesis needs was requested by patients at all treatment stages. Issues concerning the longevity and functional capability of the implant restoration and the long-term maintenance including optimisation of hygiene practice were questioned by patients and required greater explanation. CONCLUSION With growing patient interest in implants for replacement of missing teeth, complete and accurate knowledge and understanding of implants should be established with patients. This should be undertaken with more reliance on reliable clinically based sources of implant information.
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Affiliation(s)
| | - Nikki S Rousseau
- Institute of Health and Society, Newcastle University, Newcastle Upon Tyne, UK
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20
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Insua A, Monje A, Wang HL, Inglehart M. Patient-Centered Perspectives and Understanding of Peri-Implantitis. J Periodontol 2017; 88:1153-1162. [DOI: 10.1902/jop.2017.160796] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Angel Insua
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI
| | - Alberto Monje
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI
- Department of Oral Surgery and Stomatology, ZMK Bern, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI
| | - Marita Inglehart
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI
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21
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Merz MA, Terheyden H, Huber CG, Seixas AA, Schoetzau A, Schneeberger AR. Facilitators and barriers influencing the readiness to receive dental implants in a geriatric institutionalised population-A randomized non-invasive interventional study. Gerodontology 2017; 34:306-312. [PMID: 28370397 DOI: 10.1111/ger.12264] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Although elderly people have many serious dental issues and are in need of prosthesis, few opt for dental implants. The aim of this study was to investigate barriers that prevent elderly people from receiving dental implants. Specifically, we examined (i) whether the message was delivered before or after the interview had an impact, and (ii) whether it did matter who delivered the message. MATERIALS AND METHODS Sixty-six residents from seven residential homes in the Canton of Grisons, Switzerland were included. The sample was randomized to a treatment group that received comprehensive education about dental implants before the interview and a control group that received education after completing the questionnaire. RESULTS The sample consisted of 54 women (81.8%) and 12 males (18.2%) with an average age of 86.2 years. Education before the interview did not show any impact on the attitude towards dental implants. Main reasons for a negative attitude towards implants were old age and high costs. Participants who received information about implants from their relatives and their own dentist and not from the study dentist were significantly more willing to receive implants. CONCLUSION Providing an adequate education about benefits and risks of receiving dental implants does not change the attitude towards dental implants. The source of information/messenger does influence attitudes towards implants. If the person delivering the education and information is a relative or a known medical person, the person's attitude is more likely to change as compared to people receiving the information from an unrelated person.
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Affiliation(s)
- Miriam A Merz
- Implantatzentrum Professor Terheyden Kassel, Kassel, Germany
| | | | - Christian G Huber
- Universitaere Psychiatrische Kliniken, Universitaet Basel, Basel, Switzerland
| | - Azizi A Seixas
- Department of Population Health, Center for Healthful Behavior Change, New York University School of Medicine, New York, NY, USA
| | | | - Andres R Schneeberger
- Universitaere Psychiatrische Kliniken, Universitaet Basel, Basel, Switzerland.,Psychiatrische Dienste Graubuenden, St. Moritz, Switzerland.,Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
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