Is there a relationship between general and oral health‐related quality of life in partially edentulous patients before and after implant treatment? A quasi‐experimental study

THE CORRELATION BETWEEN ORAL AND GENERAL HEALTH-RELATED QUALITY OF LIFE IN ADULTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

OBJECTIVE

The relationship between general health and oral health is critical for understanding the broader implications of oral health on overall well-being and vice versa. The impact of oral and general health on individuals can be comprehensively captured by the concepts oral and general health-related quality of life (OHRQoL and HRQoL), respectively. This systematic review and meta-analysis aimed to synthesize existing evidence on the correlation between OHRQoL and HRQoL across different adult populations.

METHODS

A comprehensive search strategy was executed across 6 databases (Ovid MEDLINE(R), Embase, CINAHL, APA PsycINFO, Web of Science Core Collection, and Scopus). The search included studies measuring OHRQoL with the Oral Health Impact Profile (OHIP) and HRQoL with a variety of generic patient-reported outcome measures (PROMs). Studies were included if they reported correlations between OHRQoL and HRQoL summary scores in adult populations across dental, medical, or nonpatient settings. If a study examined more than one population, each correlation was included for independent analysis. Data extraction and quality assessment were conducted by independent reviewers, with disagreements resolved by a third reviewer. Random effects meta-analysis was used to summarize the OHRQoL-HRQoL correlations.

RESULTS

From 10 studies, 13 populations (N=6,053 participants) were included in the analysis. The correlation between general health and oral health-related quality of life was of medium size (r=0.41, 95% CI: 0.32-0.50) with high heterogeneity across populations (I2=95%). Results were not unduly influenced by individual populations, study quality, or publication bias.

CONCLUSIONS

The correlation between oral health and general health is of medium size, highlighting the potential for medical-dental integration to enhance patient and community health outcomes.

Somatosensory alterations after single-unit dental implant immediate loading: A 1-year follow-up study

OBJECTIVE

This cohort study aimed to assess the incidence of somatosensory alterations after implant surgery using standardized quantitative and qualitative sensory testing.

METHODS

33 participants with single-tooth loss, undergoing immediate implant loading were included. Quantitative Sensory Testing (QST) and Qualitative Sensory Testing (QualST) were conducted at eight time points over a year (baseline to 1 year). Two-Way Repeated Measures ANOVA and post hoc Tukey test were used on QST values and Cochran Q test on QualST.

RESULTS

The study revealed significant increase in thermal thresholds overtime. At the operated side, overall Cold Pain Threshold (extraoral: p = 0.030; intraoral: p < 0.001), and Cold Detection Threshold (intraoral: p < 0.001) increased overtime. In contralateral region, maxilla Cold Detection Threshold (extraoral: p = 0.024; intraoral: p = 0.031), Warm Detection Threshold (extraoral: p = 0.026; intraoral: p = 0.047) and overall Cold Pain Threshold (extraoral and intraoral: p < 0.001) also increased. QualST showed extraoral pinprick (p = 0.032) and intraoral pinprick (p = 0.000), cold (p = 0.000) and touch (p = 0.002) stimuli abnormalities overtime.

CONCLUSIONS

Somatosensory alterations after implant surgery were detected in both quantitative and qualitative sensory assessments, but rapidly decreased during the first follow-ups, and then continuously until 1-year.

CLINICAL SIGNIFICANCE

This study provides clinical and controlled evidence on the real effect of the somatosensory alterations overtime, leading to a better understanding of neurosensory behaviour after single-tooth dental implant rehabilitation.

Assessment of Patient Satisfaction and Oral Health-Related Quality of Life Following Full Mouth Rehabilitation with Implant-Supported Prostheses

Background

The concept of success is typically established by the researcher or the practitioner rather than the patient, who has the greatest stake in the outcome of the prosthodontics therapy.

Aim

To assess patient satisfaction and oral health-related quality of life (OHRQoL) in following full mouth rehabilitation with implant-supported prostheses (ISP).

Methods and Materials

Thirty-two patients who underwent full mouth rehabilitation with ISP were included in this study. The Oral Health Impact Profile-14 (OHIP-14) questionnaire was used for the assessment of patient satisfaction and OHRQoL following full mouth rehabilitation with ISP.

Results

The functional limitation among study participants before, 1 month, and 3 months after ISP was 2.1 ± 1.3, 1.5 ± 0.8, and 1.4 ± 0.9, respectively. There was a significant reduction in functional limitation, psychological disability, and social disability before and 3 months after ISP.

Conclusion

There is a significant improvement in patient satisfaction and OHRQoL in following full mouth rehabilitation with ISP.

Immediately loaded full arch implant rehabilitation and oral health-related quality of life: A retrospective cohort study from primary dental care

AIMS

This study evaluates patient-centered outcomes in patients undergoing full-arch rehabilitation, with immediate loading of implants. Using the Oral Health Impact Profile questionnaire pre-and post-treatment, it assesses the hypothesis that immediate full arch loading significantly improves quality of life.

METHODOLOGY

A dataset was defined as: 20 consecutive patients from a research database who had undergone IFAL surgery (maxilla, mandible, or both) and definitive restoration by a single clinician, and completed the OHIP-14 questionnaire prior to treatment and after restoration.

RESULTS

Pre (T0 ) and post (T1 ) treatment questionnaires were analyzed from 20 consecutive patients in whom a total of 160 implants were placed. The mean T0 score was 26.7, and mean T1 score 4.6. Differences were statistically significant (p = 0.00008). Greatest improvements were seen in psychological discomfort and disability, and pain. Worsening quality of life was shown by questions relating to speech in six patients and taste in three patients.

CONCLUSION

This study demonstrates that overall IFAL significantly improves tooth-related quality of life. It suggests reasons for patients to seek treatment while providing evidence to manage expectations, such as possible implications on speech, thus supporting informed consent of future patients in a primary care setting.

Changes of dental anxiety, aesthetic perception and oral health-related quality of life related to influencing factors of patients' demographics after anterior implant treatment: a prospective study

BACKGROUND

Accumulating evidence has revealed the effects of anterior implant procedures on dental anxiety (DA), aesthetic perception and oral health-related quality of life (OHRQoL). However, few reported the changes and influencing factors of the above outcomes before and after anterior implant treatment. This study was to evaluate the changes of DA, aesthetic perception and OHRQoL related to influencing factors of patients' demographics after anterior implant treatment.

METHODS

Thirty-nine patients satisfying the inclusion criteria were prospectively recruited before surgery. The subjects completed the Modified Dental Anxiety Scale (MDAS), the Orofacial Esthetic Scale (OSE) and the Oral Health Impact Profile-14 (OHIP-14), before implant surgery and after definitive prosthesis placement. Mann-Whitney U test and Kruskal-Wallis test by Bonferroni correction were applied for the data analysis and the influencing factors evaluation (p < 0.05).

RESULTS

Overall, 39 patients (mean age of 44.9 ± 12.0) completed the three scales. After anterior implant treatment, MDAS was not significantly changed (p > 0.05). The overall OSE (p < 0.001) and OHIP-14 (p < 0.05) were significantly improved. Females showed more improvement of overall OHIP score than males after anterior implant treatment (p < 0.05).

CONCLUSIONS

Anterior implant procedures did not change the level of patient's DA, while aesthetic perception and OHRQoL were enhanced. Only gender difference of overall OHIP change was found in our study. Thus, more related influencing factors with larger sample and long-term effective follow-up are needed.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT05424458. Registered 13 June 2022-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT05424458 .

Oral health-related quality of life of patients rehabilitated with fixed and removable implant-supported dental prostheses

Dental implants have become a mainstream treatment approach in daily practice, and because of their high survival rates over time, they have become the preferred treatment option for prosthetic rehabilitation in many situations. Despite the relatively high predictability of implant therapy and high costs to patients, patient perceptions of success and patient-reported outcome measures have become increasingly significant in implant dentistry. Increasing numbers of publications deal with oral health-related quality of life and/or patient-reported outcome measures. The aim of this paper was to provide an overview of the available evidence on oral health-related quality of life of fully and partially dentate patients rehabilitated with fixed and removable implant-supported dental prostheses. A comprehensive electronic search was performed on publications in English up to 2021. A selection of standardized questionnaires and scales used for the evaluation of oral health-related quality of life were analyzed and explained. The analysis encompassed three aspects: a functional evaluation of oral health-related quality of life, an esthetic assessment of oral health-related quality of life, and a cost-related evaluation of oral health-related quality of life for rehabilitation with dental implants. The data demonstrated that the preoperative expectations of patients markedly affected the outcomes perceived by the patients. As expected, reconstructions supported by implants substantially improved the stability of conventional dentures and allowed improved function and patient satisfaction. However, from a patient's perspective, oral health-related quality of life was not significantly greater for dental implants compared with conventional tooth-supported prostheses. The connection of the implants to the prostheses with locators or balls indicated high oral health-related quality of life. The data also suggest that patient expectation is not a good predictor of treatment outcome. In terms of esthetic outcomes, the data clearly indicate that patients' perceptions and clinicians' assessments differed, with those of clinicians yielding higher standards. There were no significant differences found between the esthetic oral health-related quality of life ratings for soft tissue-level implants compared with those for bone-level implants. Comparison of all-ceramic and metal-ceramic restorations showed no significant differences in patients' perceptions in terms of esthetic outcomes. Depending on the choice of outcome measure and financial marginal value, supporting a conventional removable partial denture with implants is cost-effective when the patient is willing to invest more to achieve a higher oral health-related quality of life. In conclusion, the oral health-related quality of life of patients rehabilitated with implant-supported dental prostheses did not show overall superiority over conventional prosthetics. Clinicians' and patients' evaluations, especially of esthetic outcomes, are, in the majority of cases, incongruent. Nevertheless, patient-reported outcomes are important in the evaluation of function, esthetics, and the cost-effectiveness of treatment with implant-supported dental prostheses, and should be taken into consideration in daily practice.

Implant-supported rehabilitation following transcrestal and lateral sinus floor elevation: analysis of costs and quality of life from a bi-center, parallel-arm randomized trial

AIM

to comparatively evaluate costs and specific aspects of oral-health related quality of life (OhRQoL) related to the period between the surgery phase of transcrestal and lateral sinus floor elevation (tSFE and lSFE, respectively) and 6 months after delivery of implant-supported prosthesis.

METHODS

A bi-center, parallel-arm, randomized trial comparatively evaluating tSFE and lSFE when applied concomitantly with implant placement was conducted. At 6 months after prosthesis delivery, data on cost-associated items related to the post-surgery period and selected aspects of OhRQoL were collected.

RESULTS

Analyses of costs and quality of life was conducted on 56 patients (tSFE: 28; lSFE: 28) and 54 patients (tSFE: 26; lSFE: 28), respectively. Significantly lower dose of anesthetic (2 vs 3 vials), amount of xenograft (420 mg vs 1975 mg), and duration of surgery (54' vs 86') were observed for tSFE compared to lSFE. No significant differences in the number of additional surgical sessions, postoperative exams, specialist consultations and drug consumption were found between groups. In a limited fraction of patients in both groups, improvements were observed for pain (tSFE: 3.8%; lSFE: 7.4%), comfort in eating any food (tSFE: 11.5%; lSFE: 3.6%), self-consciousness (tSFE: 19.2%; lSFE: 14.3%), and satisfaction about life (tSFE: 19.2%; lSFE: 10.7%).

CONCLUSIONS

The surgery phase of maxillary sinus floor elevation is characterized by more favorable cost-associated items for tSFE compared to lSFE. Differently, tSFE and lSFE do not differ for either costs related to the post-surgery phases or impact of the implant-supported rehabilitation on specific aspects of OhRQoL.

Maxillary sinus augmentation with three different biomaterials: Histological, histomorphometric, clinical, and patient-reported outcomes from a randomized controlled trial

BACKGROUND

Lateral maxillary sinus augmentation (MSA) is a predictable bone regeneration technique in case of atrophy of the posterior-upper maxilla. Aimed at obtaining quantity and quality of bone suitable for receiving osseointegrated implants, its success is largely due to the skill of the surgeon, but also to the characteristics of the biomaterial used.

METHODS

Twenty-four patients needing MSA were included in the study. The patients were randomly allocated to three different groups: anorganic bovine bone mineral as control, tricalcium phosphate with or without hyaluronic acid (HA) as test groups. Nine months after MSA, bone biopsies were harvested for the histomorphometric analysis. Secondary outcomes were mean bone gain, intraoperative and postoperative complications, implant insertion torque, implant failure, and patient-reported outcome measures.

RESULTS

Although the percentage of new bone was not statistically different between the three groups (P = .191), the percentages of residual biomaterial was significantly higher (P < .000) and nonmineralized tissue significantly lower (P < .000) in the control than in the test groups. Test groups did not differ significantly from each other for all histomorphometric parameters. The implant insertion torque was significantly higher in the control group (P < .0005). The rest of the secondary outcomes were not significantly different between the groups.

CONCLUSION

MSA is a safe and predictable procedure in terms of histological, clinical, and PROAMs, regardless of the biomaterial used. The addition of HA did not influence the outcomes.