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Kuroshima S, Ohta Y, Uto Y, Al-Omari FA, Sasaki M, Sawase T. Implant-assisted removable partial dentures: Part I. a scoping review of clinical applications. J Prosthodont Res 2024; 68:20-39. [PMID: 37164658 DOI: 10.2186/jpr.jpr_d_22_00252] [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] [Indexed: 05/12/2023]
Abstract
PURPOSE This scoping review aimed to systematically map research regarding implant-assisted removable partial dentures (IARPDs), and identify existing gaps in knowledge. STUDY SELECTION Two reviewers independently conducted a search of the MEDLINE-PubMed and Scopus databases according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) extension for Scoping Review and included articles published in English up to August 31, 2022, including human studies, reviews, and in vitro studies. Expert opinions, animal studies, and clinical studies involving complete overdentures were excluded, and ten aspects for establishing the treatment strategy for IARPDs were examined. RESULTS One hundred and twelve articles were chosen. There were two treatment modalities: IARPDs retained by implant- and tooth-supported surveyed single crowns (SCs) or fixed partial dentures (FPDs). In IARPDs retained by tooth-supported surveyed SCs or FPDs, the survival rate of dental implants for IARPDs was relatively higher with a wide range of marginal bone loss and many complications, but with improved functional performance, oral health-related quality of life, and patient satisfaction. There were limited data on survival or success rates and designs of IARPDs, attachment selections, length and diameter, inclination, placement sites, and loading protocols of implants, regardless of prosthetic types. There was limited information on maxillary IARPDs except for survival rates of implants. CONCLUSIONS Although IARPDs could become a useful treatment strategy, there is limited scientific consensus with gaps in knowledge about their use. Additional well-designed clinical and in vitro studies are necessary to scientifically establish IARPDs as definitive prostheses in implant dentistry.
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Affiliation(s)
- Shinichiro Kuroshima
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yoshikazu Ohta
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yusuke Uto
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Farah A Al-Omari
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Muneteru Sasaki
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Takashi Sawase
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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Seoane M, Lorenzo-Erro SM, Massa F, Hilgert JB, Hugo FN, De Marchi RJ, Celeste RK. Residual dentition, prosthesis type and oral health-related quality of life in Uruguayan adults. Gerodontology 2023; 40:317-325. [PMID: 36214197 DOI: 10.1111/ger.12656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 09/19/2022] [Accepted: 09/24/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To investigate the association between different types of dental prostheses (and residual dentition) and oral health-related quality of life (OHRQoL). METHODS A population-based study with a representative sample of adults and older adults in Uruguay (2010-2011). The dependent variable was the score on the oral impact on daily performance (OIDP), and the main predictor was the pattern of tooth loss and prosthesis use. Covariates included sex, age, socioeconomic status, education, missing teeth, pain and decayed teeth. Negative binomial regression was used. RESULTS The sample comprised 762 participants. Those participants not wearing a prosthesis and with extensive tooth loss had a mean OIDP of 3.1 (95% CI = 1.6-6.2), while those wearing removable partial dentures (RPD) and having <12 missing teeth had a mean OIDP of 3.6 (95% CI = 1.3-10.0). Participants with a free-end saddle had the highest mean OIDP, at 4.9 (95% CI = 2.0-12.1). For participants with ≤12 missing teeth, any additional missing tooth was associated with an 11% higher OIDP score. Participants who wore RDPs reported fewer impacts on OHRQoL if they had extensive tooth loss or anterior tooth loss than those with a free-end saddle, or who had lost fewer teeth. CONCLUSIONS The use of RPDs is associated with better OHRQoL. These findings may be valuable in clinical practice and prosthetic planning.
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Affiliation(s)
- Mariana Seoane
- Chair of Removable Partial Prosthesis, Faculty of Dentistry, University of the Republic, Montevideo, Uruguay
| | - Susana Margarita Lorenzo-Erro
- Chair of Social Dentistry, Epidemiology and Statistics Service, Faculty of Dentistry, University of the Republic, Montevideo, Uruguay
| | - Fernando Massa
- Chair of Social Dentistry, Epidemiology and Statistics Service, Faculty of Dentistry, University of the Republic, Montevideo, Uruguay
| | - Juliana Balbinot Hilgert
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando Neves Hugo
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Renato Jose De Marchi
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Roger Keller Celeste
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Abou-Ayash S, Rudaz AC, Janner S, Kraus D, Schimmel M, Enkling N. Converting Bilateral Free-End Removable Partial Dentures to Implant-Assisted Removable Partial Dentures Using 6 mm Short Implants: Patient-Reported Outcomes of a Prospective Clinical Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158998. [PMID: 35897369 PMCID: PMC9332696 DOI: 10.3390/ijerph19158998] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 11/27/2022]
Abstract
The study assessed oral health-related quality of life (OHRQoL) of patients who received two 6 mm short implants in mandibular molar sites, converting existing bilateral free-end removable partial dentures (RPDs) to implant-assisted RPDs (IARPDs). After a postsurgical healing period of 4 months, the participants received a non-retentive dome abutment for 8 weeks, and then a retentive ball abutment for another 8 weeks. Afterwards, the participants made their final choice on which abutment to keep. The final follow-up was 1 year after implant placement. OHRQoL was evaluated with the 49-items version of the Oral Health Impact Profile (OHIP-49) at the abutment exchanges and the final follow-up. Furthermore, numerical rating scales were used to analyze patient satisfaction after 1 year. Questionnaire data of 13 participants were evaluated. Overall, OHRQoL increased with both the dome (p = 0.02) and the ball abutments (p < 0.001), without a significant difference between the abutments (p = 0.953). The questionnaires revealed an improvement in terms of oral situation, quality of life, and masticatory capacity (all p < 0.01). Patients showed a significant preference for the ball abutments (p < 0.001). Converting RPDs to IARPDs resulted in significant improvement of OHRQoL. Patients seem to prefer retentive over non-retentive abutments, although no differences in terms of OHRQoL were observed.
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Affiliation(s)
- Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (A.-C.R.); or (S.J.); (M.S.); or (N.E.)
- Correspondence:
| | - Anne-Carole Rudaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (A.-C.R.); or (S.J.); (M.S.); or (N.E.)
| | - Simone Janner
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (A.-C.R.); or (S.J.); (M.S.); or (N.E.)
- Surgery Center ZIKO, 3008 Bern, Switzerland
- Department of Oral Surgery, University Center for Dental Medicine Basel, University of Basel, 4058 Basel, Switzerland
| | - Dominik Kraus
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, University of Bonn, 5311 Bonn, Germany;
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (A.-C.R.); or (S.J.); (M.S.); or (N.E.)
- Division of Gerodontology and Removable Prosthodontics, University of Geneva, 1205 Geneva, Switzerland
| | - Norbert Enkling
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (A.-C.R.); or (S.J.); (M.S.); or (N.E.)
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, University of Bonn, 5311 Bonn, Germany;
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Bandiaky ON, Lokossou DL, Soueidan A, Le Bars P, Gueye M, Mbodj EB, Le Guéhennec L. Implant-supported removable partial dentures compared to conventional dentures: A systematic review and meta-analysis of quality of life, patient satisfaction, and biomechanical complications. Clin Exp Dent Res 2022; 8:294-312. [PMID: 35014207 PMCID: PMC8874059 DOI: 10.1002/cre2.521] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/24/2021] [Accepted: 12/01/2021] [Indexed: 12/28/2022] Open
Abstract
Objectives The purpose of this systematic review and meta‐analysis was to compare implant‐supported removable partial dentures (ISRPDs) with distal extension removable partial dentures (DERPDs) in terms of patient‐reported outcome measures (PROMs: patients' quality of life and satisfaction) and to determine mechanical and biological complications associated with ISRPDs. Material and Methods An electronic search was performed on four databases to identify studies treating Kennedy class I or II edentulous patients and which compared ISRPDs with DERPDs in terms of PROMS and studies, which evaluated mechanical and biological complications associated ISRPDs. Two authors independently extracted data on quality of life, patient satisfaction, and biomechanical complications from these studies. The risk of bias was assessed for each study, and for PROMs, the authors performed a meta‐analysis by using a random‐effects model. Results Thirteen articles were included based on the selection criteria. The difference in mean scores for quality of life (30.5 ± 1.8; 95% confidence interval [CI], 24.9–36.1) and patient satisfaction (−20.8 ± 0.2; 95% CI, −23.7 to −17.8) between treatments with conventional and implant‐supported removable dentures was statistically significant (p < .05). Implant‐supported removable dentures improved patients' overall quality of life and satisfaction. Some mechanical and biological complications, such as clasp adjustment, abutment or implant loosening, marginal bone resorption, and peri‐implant mucositis, were noted in ISRPDs during patient follow‐up. Studies assessing PROMs were very heterogeneous (I2 = 65%, p = .85; I2 = 75%, p = .88). Conclusions ISRPDs significantly improved quality of life and patient satisfaction. Some mechanical and biological complications have been associated with ISRPDs treatment, requiring regular monitoring of patients to avoid the occurrence of these complications.
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Affiliation(s)
- Octave N Bandiaky
- Division of Fixed Prosthodontics, University of Nantes, Nantes, France
| | - Dohoue L Lokossou
- School of Dentistry, University of El Hadji Ibrahima Niasse, Dakar, Sénégal
| | - Assem Soueidan
- Department of Periodontology, Rmes U1229, University of Nantes, Nantes, France
| | - Pierre Le Bars
- Division of Fixed Prosthodontics, CHU Nantes, Nantes, France
| | - Moctar Gueye
- Department of Odontology, Clinic of Fixed and Removable Prosthodontics, University of Dakar, Dakar, Senegal
| | - Elhadj B Mbodj
- Department of Odontology, Clinic of Fixed and Removable Prosthodontics, University of Dakar, Dakar, Senegal
| | - Laurent Le Guéhennec
- Department of Prosthetic Dentistry, Faculty of Dentistry, University of Nantes, Nantes, France
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Putra Wigianto AY, Goto T, Iwawaki Y, Ishida Y, Watanabe M, Ichikawa T. Treatment outcomes of implant-assisted removable partial denture with distal extension based on the Kennedy classification and attachment type: a systematic review. Int J Implant Dent 2021; 7:111. [PMID: 34773513 PMCID: PMC8590637 DOI: 10.1186/s40729-021-00394-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 11/07/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Implant-assisted removable partial dentures (IARPDs) have recently become popular, but little information is available on the treatment outcomes based on the Kennedy classification and attachment types. OBJECTIVE The objective of this review was to evaluate the treatment outcomes of IARPD delivered for distal extension edentulous areas based on the differences in the Kennedy classification and attachment type. MATERIALS AND METHODS English-language clinical studies on IARPD published between January 1980 and February 2020 were collected from MEDLINE (via PubMed), the Cochrane Library (via the Cochrane Central Register of Controlled Trials), Scopus online database, and manual searching. Two reviewers selected the articles based on pre-determined inclusion and exclusion criteria, followed by data extraction and analysis. RESULTS Eighty-one studies were selected after evaluating the titles and abstracts of 2410 papers. Nineteen studies were finally included after the perusal of the full text. Fourteen studies focused on Class I, 4 studies investigated both Class I and II, and only 1 study was conducted on Kennedy's class II. Eight types of attachments were reported. The ball attachment was the most frequently used attachment, which was employed in 8 of the included studies. The implant survival rate ranged from 91 to 100%. The reported marginal bone loss ranged from 0.3 mm to 2.30 mm. The patient satisfaction was higher with IARPD than with conventional RPDs or that before treatment. The results of prosthetic complications were heterogeneous and inconclusive. CONCLUSION IARPD exhibited favorable clinical outcomes when used as a replacement for distal extension edentulous areas. The comparison between the clinical outcomes of Kennedy's class I and II was inconclusive owing to the lack of studies focusing on Kennedy Class II alone. The stud attachment was the most commonly used type in IARPDs. Overall, the different attachment systems did not influence the implant survival rate and patient satisfaction. Further high-quality studies are needed to investigate the attachment systems used in IARPD.
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Affiliation(s)
- Adityakrisna Yoshi Putra Wigianto
- Department of Prosthodontics & Oral Rehabilitation, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima, 770-8504, Japan
| | - Takaharu Goto
- Department of Prosthodontics & Oral Rehabilitation, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima, 770-8504, Japan.
| | - Yuki Iwawaki
- Department of Prosthodontics & Oral Rehabilitation, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima, 770-8504, Japan
| | - Yuichi Ishida
- Department of Prosthodontics & Oral Rehabilitation, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima, 770-8504, Japan
| | - Megumi Watanabe
- Department of Prosthodontics & Oral Rehabilitation, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima, 770-8504, Japan
| | - Tetsuo Ichikawa
- Department of Prosthodontics & Oral Rehabilitation, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima, 770-8504, Japan
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Lemos CAA, Nunes RG, Santiago-Júnior JF, Marcela de Luna Gomes J, Oliveira Limirio JPJ, Rosa CDDRD, Verri FR, Pellizzer EP. Are implant-supported removable partial dentures a suitable treatment for partially edentulous patients? A systematic review and meta-analysis. J Prosthet Dent 2021; 129:538-546. [PMID: 34330529 DOI: 10.1016/j.prosdent.2021.06.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 06/12/2021] [Accepted: 06/14/2021] [Indexed: 12/30/2022]
Abstract
STATEMENT OF PROBLEM A consensus on the clinical performance of implant-supported removable partial dentures (ISRPDs) is lacking. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate the clinical performance of ISRPDs in terms of the implant survival rates, marginal bone loss, and patient-reported outcome measures (PROMs). MATERIAL AND METHODS Four electronic databases (MEDLINE/PubMed, EMBASE, Web of Science, and Cochrane Library) were independently searched by 2 reviewers for articles published up to December 2020. A single-arm meta-analysis was performed to evaluate the implant survival rates and marginal bone loss by using the R program. The Cochrane collaboration tool was used to evaluate the risk of bias of randomized controlled trials (RCTs), and the Newcastle-Ottawa scale for non-RCT studies. RESULTS Sixteen studies were included, with a total of 334 participants and a mean age of 58 years. The participants received a total of 581 dental implants, 475 conventional and 106 mini-implants. All included studies reported implant survival rate above 90% (range: 92% to 100%). Meta-analysis indicated a high proportion of implant survival rates of 3% (95% confidence interval [CI]: 2% to 5%) and a low mean raw score of marginal bone loss 0.98 mm (CI: 0.61 to 1.36 mm). Compared with conventional RPDs, improved patient quality of life and satisfaction were reported by studies that evaluated ISRPDs. RCT studies exhibited a low risk of bias for most domains, while most non-RCT studies were classified as good quality. CONCLUSIONS ISRPDs exhibited high implant survival rates and acceptable bone loss with improvement in the quality of life and satisfaction of patients when compared with conventional RPDs. Therefore, they can be considered suitable for the rehabilitation of partially edentulous patients.
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Affiliation(s)
- Cleidiel Aparecido Araujo Lemos
- Adjunct Professor, Department of Dentistry (Division of Prosthodontics), Federal University of Juiz de Fora (UFJF), Campus Avançado de Governador Valadares, School of Dentistry, Governador Valadares, State of Minas Gerais, Brazil.
| | - Rafaela Gaião Nunes
- Graduate, Departament of Dental Materials and Prosthodontics, São Paulo State Univeristy (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | | | - Jéssica Marcela de Luna Gomes
- Postgraduate Student, Departament of Dental Materials and Prosthodontics, São Paulo State Univeristy (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | - João Pedro Justino Oliveira Limirio
- Postgraduate Student, Departament of Dental Materials and Prosthodontics, São Paulo State Univeristy (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | - Cléber Davi Del Rei Daltro Rosa
- Postgraduate Student, Departament of Dental Materials and Prosthodontics, São Paulo State Univeristy (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | - Fellippo Ramos Verri
- Adjunct Professor, Departament of Dental Materials and Prosthodontics, São Paulo State Univeristy (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | - Eduardo Piza Pellizzer
- Full Professor, Departament of Dental Materials and Prosthodontics, São Paulo State Univeristy (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
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Zhang H, Ramos V, Bratos M, Liu PP, He W. Effect of the attachments on clinical outcomes of mandibular distal extension implant-supported removable partial dentures: A systematic review. J Prosthet Dent 2021; 128:1211-1220. [PMID: 34301416 DOI: 10.1016/j.prosdent.2021.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 04/10/2021] [Accepted: 04/12/2021] [Indexed: 02/08/2023]
Abstract
STATEMENT OF PROBLEM Healing abutments and attachments have been used for implant-supported removable partial dentures (ISRPDs). However, the effects of these abutments and attachments on the clinical outcomes of the implants and prostheses are elusive because of the lack of standardized research protocols. PURPOSE The purpose of this systematic review was to determine the clinical outcomes of mandibular distal extension ISRPDs with healing abutments and attachments by analyzing qualified studies. MATERIAL AND METHODS An electronic and manual literature search was conducted on PubMed, Web of Science, Scopus, Embase, and Cochrane Library databases including articles published in English from 1980 to 2020. Publications of clinical outcome studies on the mandibular distal extension ISRPDs with healing abutments or attachments were screened by inclusion and exclusion criteria. Clinical outcomes of removable partial dentures (RPDs) and ISRPDs with different types of abutments or attachments were compared by using patient-reported outcome measures, implant survival rate, masticatory performance, and implant- or prosthesis-related complications. Study designs and clinical outcome data were extracted and analyzed. The evidence of the selected studies and degree of recommendation were made according to the Oxford Centre for Evidence-based Medicine, and the risk of bias of the studies was assessed based on Newcastle-Ottawa criteria. RESULTS Of 541 articles initially identified after removing duplicate records, 11 articles were selected by applying the inclusion and exclusion criteria, by inter-viewer agreement, and by hand searching. Nine prospective cohort studies, 1 retrospective cohort study, and 1 randomized controlled trial were included with evidence levels assessed at 1b, 2b, and 2c. The risk of bias varied from 5 to 8 out of 9. Patient overall satisfaction, oral health-related quality of life (OHRQoL) scores, and masticatory ability were significantly improved for ISRPDs with either healing abutments, ball, or LOCATOR attachments when compared with RPDs. The implant survival rate varied from 92% to 97% at 2 to 10 years for ball attachment and was 100% at 1 year for LOCATOR attachment-supported ISRPDs. Marginal bone loss (MBL) varied from 0 to 1 mm in all studies, although LOCATOR attachments had significantly less MBL compared with ball attachments. The maximal pocket depth and bleeding on probing index around implants at 1 year were 1.7 to 1.8 mm and 0.1 to 0.3. Loose healing caps were the main mechanical complication of implants. There were more prosthetic complications in ISRPDs with ball attachments than RPDs at 10-year follow-up, including gold matrix loosening, loss of retention, and denture base fractures. No direct comparisons were made of patient-reported outcomes or prosthetic complications between ball and LOCATOR attachment-supported ISRPDs. CONCLUSIONS Healing abutments and attachments (ball or LOCATOR) improved patient-reported outcomes and the masticatory function of mandibular distal extension ISRPDs. However, insufficient evidence was found to determine the relative effectiveness of different attachment systems on the clinical outcomes of mandibular distal extension ISRPDs. Abutment loosening was the most frequent mechanical complication for healing abutments. More prosthetic complications were associated with ball attachment-supported ISRPDs than RPDs. The major weaknesses of this systematic review were the relatively moderate level of evidence and the publication language, since implant attachments are used in many non-English speaking countries.
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Affiliation(s)
- Hai Zhang
- Associate Professor, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash.
| | - Van Ramos
- Clinical Associate Professor, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash
| | - Manuel Bratos
- Private practice, Madrid, Spain; Affiliate Assistant Professor, Department of Restorative Dentistry, University of Washington, Seattle, Wash
| | - Pearl Pei Liu
- Post-doctoral Fellow, Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, PR China
| | - Wei He
- Lecturer, The First Affiliated Hospital of Nanchang University, Nanchang, PR China; Visiting Scholar, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash
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Negoro M, Kanazawa M, Sato D, Shimada R, Miyayasu A, Asami M, Katheng A, Kusumoto Y, Abe Y, Baba K, Minakuchi S. Patient-reported outcomes of implant-assisted removable partial dentures with magnetic attachments using short implants: A prospective study. J Prosthodont Res 2021; 65:554-558. [PMID: 34193745 DOI: 10.2186/jpr.jpr_d_20_00221] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE Implant-assisted removable partial dentures (IARPDs) with short implants improve the oral functions of removable partial dentures (RPDs). This study aimed to compare the patient-reported outcomes of RPDs and IARPDs with short implants retained by magnetic attachments. METHODS We recruited 30 participants with mandibular Kennedy Class I or II and distal extension defects of three or more teeth. RPDs, IARPDs with a healing cap, and IARPDs with a magnetic attachment were evaluated across stages using patient-reported outcomes. All participants completed questionnaires (oral health-related quality of life [OHRQoL], patient general satisfaction, and patient's denture assessment [PDA]) at each stage. The OHRQoL was evaluated using the Oral Health Impact Profile-J 54 (OHIP-J 54) score. The general patient satisfaction was evaluated using a 100 mm visual analog scale. The Wilcoxon signed-rank test and Bonferroni correction were used to evaluate differences between the groups (α=0.05). RESULTS The OHRQoL of IARPDs was significantly higher than that of RPDs. IARPDs with a magnetic attachment had significantly better patient general satisfaction and PDA than IARPDs with a healing cap. CONCLUSIONS The OHRQoL, patient general satisfaction, and PDA were improved by IARPD with a short implant using a magnetic attachment.
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Affiliation(s)
- Masatoshi Negoro
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
| | - Manabu Kanazawa
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
| | - Daisuke Sato
- Department of Implant Dentistry, School of Dentistry, Showa University, Tokyo
| | - Ryo Shimada
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
| | - Anna Miyayasu
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
| | - Mari Asami
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
| | - Awutsadaporn Katheng
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
| | - Yuriko Kusumoto
- Department of Prosthodontics, School of Dentistry, Showa University, Tokyo
| | - Yuka Abe
- Department of Prosthodontics, School of Dentistry, Showa University, Tokyo
| | - Kazuyoshi Baba
- Department of Prosthodontics, School of Dentistry, Showa University, Tokyo
| | - Shunsuke Minakuchi
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
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9
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Swelem AA, Abdelnabi MH. Attachment-retained removable prostheses: Patient satisfaction and quality of life assessment. J Prosthet Dent 2020; 125:636-644. [PMID: 32893014 DOI: 10.1016/j.prosdent.2020.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 07/16/2020] [Accepted: 07/16/2020] [Indexed: 11/24/2022]
Abstract
STATEMENT OF PROBLEM Studies on the impact of incorporating attachments in removable prostheses on patient-based outcomes are scarce. PURPOSE The purpose of this clinical study was to investigate oral health-related quality of life (OHRQoL) and patient satisfaction in partially edentulous participants before and after rehabilitation with mandibular attachment-retained removable prostheses as compared with conventional removable prostheses. MATERIAL AND METHODS This crossover study included 74 participants (aged 36 to 57). Initially, 56 received conventional clasp-retained removable dental prostheses (RDPs), and 18 received conventional overdentures (ODs) based on their mandibular partially edentulous state. Two months later, of the 56 RDP participants, 24 had received extracoronal attachment-retained RDPs, 17 received telescope-retained RDPs, and 15 received bar-attachment retained RDPs. The 18 OD participants received ball attachment-retained ODs. Assessments included Oral Health Impact Profile-short version-14 for OHRQoL and a visual analog scale (VAS) for patient satisfaction. Assessments were done before treatment and 2 months after wearing each prosthesis with a 1-month washout period. Statistical analysis included the Friedman then the Wilcoxon signed rank test for Oral Health Impact Profile-short version-14 scores and repeated measures ANOVA then the Bonferroni or paired t test for VAS scores (α=.05). RESULTS There were no dropouts. Rehabilitation, irrespective of prosthesis type, significantly improved OHRQoL in all domains and significantly increased overall patient satisfaction (P<.05). When compared with the conventional prostheses, attachment-retained prostheses significantly improved functional limitation, psychological discomfort, and physical limitation domains in all groups (P<.05), as well as the physical pain domain in the OD group (P=.041). General satisfaction, stability, comfort, ability to speak, and ability to masticate significantly increased (P<.05) with attachment-retained prostheses. Conventional prostheses were significantly easier to clean (P<.05) in all groups, except for the telescope-attachment group. CONCLUSIONS Both conventional and attachment-retained prostheses significantly increased patient satisfaction and improved OHRQoL in all domains as compared with before treatment. However, incorporation of attachments further improved functional limitation, psychological discomfort, and physical limitation domains in all groups, as well as the physical pain domain in the OD group. Participants were more satisfied with their attachment-retained prostheses in most aspects.
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Affiliation(s)
- Amal A Swelem
- Professor, Oral and Maxillofacial Prosthodontic Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; Removable Prosthodontic Department, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt.
| | - Mohamed H Abdelnabi
- Professor, Oral and Maxillofacial Prosthodontic Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; Removable Prosthodontic Department, Faculty of Oral and Dental Medicine, Minia University, Minia, Egypt
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10
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Schierz O, Baba K, Fueki K. Functional oral health-related quality of life impact: A systematic review in populations with tooth loss. J Oral Rehabil 2020; 48:256-270. [PMID: 32333415 DOI: 10.1111/joor.12984] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 04/03/2020] [Accepted: 04/12/2020] [Indexed: 12/11/2022]
Abstract
Patients perceive the impact of oral disorder in four major areas, the dimensions of oral health-related quality life (OHRQoL) Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact. The functional aspect is essential given the need of chewing, biting, speech and swallowing. The objective of this study was to identify OHRQoL information for dental subjects with functional oral health problems. In a systematic review, distinct and clinically relevant groups of dental subject samples, in this study called "population groups," with such functional OHRQoL information based on the Oral Health Impact Profile (OHIP) were identified (PROSPERO registration: CRD42017064033). The search strategy was "Oral Health Impact Profile" or OHIP. Searches were conducted in the PubMed interface of the Medline database, EMBASE, Cochrane, CINAHL and PsyINFO on 8 June 2017 and updated on 14 January 2019. Published OHIP domain data of different versions were recalculated into OHIP-14`s Physical Disability domain score, characterising the subject's Oral Function impact. 3,653 potentially abstracts were screened. We identified 78 publications reporting dimensional information on 154 subject samples with 52 populations. A typical mean functional impact for partially dentate subjects was 1.6 units on a 0 to 8 unit metric, while for edentate subjects, the mean functional impact was 2.6 units. The functional impact score ranged from 0 to 7.9 units with 50% of the patient samples located between 0.8 and 2.6 units. For the first time, we provide normalised and therefore comparable metric information about the functional OHRQoL impact for a substantial number of functional oral conditions.
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Affiliation(s)
- Oliver Schierz
- Department of Prosthodontics and Materials Science, University of Leipzig, Leipzig, Germany
| | - Kazuyoshi Baba
- Department of Prosthodontics, Showa University, Tokyo, Japan
| | - Kenji Fueki
- Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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11
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Park J, Lee J, Shin S, Kim H. Effect of conversion to implant‐assisted removable partial denture in patients with mandibular Kennedy classification Ⅰ: A systematic review and meta‐analysis. Clin Oral Implants Res 2020; 31:360-373. [DOI: 10.1111/clr.13574] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/14/2019] [Accepted: 01/04/2020] [Indexed: 01/23/2023]
Affiliation(s)
- Jin‐Hong Park
- Department of Prosthodontics Institute for Clinical Dental Research Korea University Medicine Korea University Seoul Korea
| | - Jeong‐Yol Lee
- Department of Prosthodontics Institute for Clinical Dental Research Korea University Medicine Korea University Seoul Korea
| | - Sang‐Wan Shin
- Department of Prosthodontics Institute for Clinical Dental Research Korea University Medicine Korea University Seoul Korea
| | - Hyun‐Jung Kim
- Department of Preventive Medicine College of Medicine Korea University Seoul Korea
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12
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Tribst JPM, de Araújo RM, Ramanzine NP, Santos NR, Dal Piva AMDO, Borges ALS, da Silva JMF. Mechanical behavior of implant assisted removable partial denture for Kennedy class II. J Clin Exp Dent 2020; 12:e38-e45. [PMID: 31976042 DOI: 10.4317/medoral.56533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 11/25/2019] [Indexed: 11/05/2022] Open
Abstract
Background This study evaluated the mechanical response of a removable partial denture (RPD) in Kennedy Class II according to being associated or not with implants. Material and Methods Four RPDs were manufactured for a Kennedy Class II: CRPD - Conventional RPD, RPD+1M, RPD+2M and RPD+12M, respectively, signifying implant assisted RPDs with the implant installed in the first molar, second molar, and in the first and second molars. The finite element method was used to determine the most damaged support tooth under compressive load (300N, 10s) and strain gauge analysis was used to evaluate the microstrain. All groups were submitted to a retentive force analysis (0.5 mm/mm, 100kgf). Microstrain and retentive force data were submitted to One-way ANOVA and the Tukey test, all with α=5%. Results High microstrain was observed in the second premolar adjacent to the edentulous space under compression load (p< 0.01). RPD+12M presented lower microstrain, however being similar to RPD+2M. RPD+1M presented a higher mean value of retentive force, but similar to RPD+12M. FEM showed RPD assisted by implants concentrates less stress in the periodontal ligament. The association of two implants was sufficient to decrease the stress generated in the implants. The most stressed region for the o-ring abutment was the threads, and the group with two implants showed the lowest stress concentration. Conclusions In cases of Kennedy Class II, the association of RPD with implants in the molar region is a favorable option for patient rehabilitation, reducing the movement of the direct retainer adjacent to the edentulous space, increasing the removal force and decreasing the stress magnitude in the periodontal ligament. Key words:Removable partial denture, Finite element analysis, Prosthetic dentistry, Implant-assisted RPD, Distal extension RPD considerations.
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Affiliation(s)
- João-Paulo-Mendes Tribst
- DDs, MSc, PhD Student, Department of Dental Materials and Proshodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos / SP, Brazil
| | - Rodrigo-Máximo de Araújo
- DDs, MSc, Professor, Department of Dental Materials and Proshodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos / SP, Brazil
| | - Naiara-Pires Ramanzine
- DDs, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos / SP, Brazil
| | - Natália-Ribeiro Santos
- DDs, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos / SP, Brazil
| | - Amanda-Maria-de Oliveira Dal Piva
- DDs, MSc, PhD Student, Department of Dental Materials and Proshodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos / SP, Brazil
| | - Alexandre-Luiz-Souto Borges
- DDs, MSc, Professor, Department of Dental Materials and Proshodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos / SP, Brazil
| | - João-Mauricio-Ferraz da Silva
- DDs, MSc, Professor, Department of Dental Materials and Proshodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos / SP, Brazil
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13
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Minimal clinically important differences of oral health-related quality of life after removable partial denture treatments. J Dent 2020; 92:103246. [DOI: 10.1016/j.jdent.2019.103246] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 10/28/2019] [Accepted: 11/14/2019] [Indexed: 01/03/2023] Open
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14
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Fueki K, Baba K. Shortened dental arch and prosthetic effect on oral health-related quality of life: a systematic review and meta-analysis. J Oral Rehabil 2017; 44:563-572. [DOI: 10.1111/joor.12511] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2017] [Indexed: 11/28/2022]
Affiliation(s)
- K. Fueki
- Removable Partial Prosthodontics; Graduate School of Medical and Dental Sciences; Tokyo Medical and Dental University (TMDU); Tokyo Japan
| | - K. Baba
- Department of Prosthodontics; Showa University; Tokyo Japan
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15
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Andrade KMD, Alfenas BFM, Campos CH, Rodrigues Garcia RCM. Mandibular movements in older people with rheumatoid arthritis. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:e153-e159. [PMID: 28407990 DOI: 10.1016/j.oooo.2017.01.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 01/24/2017] [Accepted: 01/31/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study was to compare the mandibular movements in older people with and without temporomandibular disorder (TMD) associated with rheumatoid arthritis (RA). STUDY DESIGN Thirty partially or completely edentulous older adults (65.33 ± 4.7 years) were assigned to 2 groups: (1) with RA and TMD and (2) without RA and TMD. Chewing movements of the jaws during mastication of the test material (Optocal) and the range of mandibular movements were evaluated by using the JT-3-D kinesiographic device before and after new removable prosthesis insertion. Multiple comparisons were made with analysis of variance (ANOVA) and the Tukey-Kramer test. RESULTS Comparisons between the 2 groups before and after new prosthesis insertion revealed that the RA and TMD group had reduced opening angles (P < .05) during chewing. After insertion of new prostheses, both groups showed increased opening and closing angles during chewing (P < .05). The mandibular range of motion results showed that patients with RA and TMD exhibited lower aperture and laterality movements (P < .05) compared with controls before and after new prosthesis insertion. However, there was an increase in aperture, lefty laterality, and protrusion values after new prosthesis insertion in both groups. CONCLUSIONS TMD associated with RA may impair mandibular movements. Well-fitted prostheses may improve mandibular movements in older adults, especially those with RA.
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Affiliation(s)
- Kelly Machado de Andrade
- Graduate Student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Bruna Fernandes Moreira Alfenas
- Graduate Student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Camila Heitor Campos
- Assistant Professor, Department of Specific Formation, Nova Friburgo Health Institute, Fluminense Federal University, Rio de Janeiro, Brazil
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16
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Ribeiro GR, Campos CH, Rodrigues Garcia RCM. Influence of a removable prosthesis on oral health-related quality of life and mastication in elders with Parkinson disease. J Prosthet Dent 2017; 118:637-642. [PMID: 28385436 DOI: 10.1016/j.prosdent.2016.12.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 12/22/2016] [Accepted: 12/22/2016] [Indexed: 01/26/2023]
Abstract
STATEMENT OF PROBLEM Parkinson disease (PD) symptoms, such as muscle rigidity, tremors in the lips and tongue, and involuntary mandibular movements, may cause oral health-related problems, mastication difficulties, and denture discomfort because of the difficulty in controlling a prosthesis with the oral musculature. PURPOSE The purpose of this observational clinical study was to evaluate the influence of oral rehabilitation with a removable prosthesis on oral health-related quality of life (OHRQoL) and masticatory efficiency (ME) in elders with PD. MATERIAL AND METHODS Thirty-four elders with PD (n=17, mean age 69.4 ±4.7 years) or without PD (n=17, mean age 70.7 ±4.7 years) were recruited. All participants first underwent OHRQoL and ME evaluations. Two months after the insertion of new removable prostheses, the participants were reassessed. The OHRQoL was measured with the Oral Health Impact Profile (OHIP-49). ME was evaluated by determining the percentage weight of the comminuted silicone-based artificial material that passed through a 2.8 mm sieve. For each group, data were compared between baseline and after insertion of new removable prostheses by paired t test or Wilcoxon sign test/signed-rank test. Group differences were assessed at each time point by t test (α=.05). RESULTS After the insertion of removable prostheses, elders with PD showed improved OHRQoL and ME. Controls also showed improvements on both measures after insertion of removable prostheses. At baseline, elders with PD had lower OHRQoL and ME compared with the controls (P<.05). After removable prosthesis insertion, the elders with PD continued to show lower ME values than the controls, but their OHRQoL was similar. CONCLUSIONS Oral rehabilitation with new removable dental prostheses improved the OHRQoL and ME in elders with and without PD, although ME did not reach control levels in elders with PD.
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Affiliation(s)
- Giselle R Ribeiro
- Predoctoral student, Department of Prosthodontics and Periodontology, University of Campinas (UNICAMP), Piracicaba Dental School, São Paulo, Brazil
| | - Camila H Campos
- Predoctoral student, Department of Prosthodontics and Periodontology, University of Campinas (UNICAMP), Piracicaba Dental School, São Paulo, Brazil
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17
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Sampaio Fernandes M, Vaz P, Braga AC, Sampaio Fernandes JC, Figueiral MH. The role of IL-1 gene polymorphisms (IL1A, IL1B, and IL1RN) as a risk factor in unsuccessful implants retaining overdentures. J Prosthodont Res 2017; 61:439-449. [PMID: 28223139 DOI: 10.1016/j.jpor.2017.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 10/19/2016] [Accepted: 01/17/2017] [Indexed: 11/18/2022]
Abstract
PURPOSE Implant-supported overdentures are an alternative predictable rehabilitation method that has a high impact on improving the patient's quality of life. However, some biological complications may interfere with the maintenance and survival of these overdenture implants. The goal of this article was to assess the factors that affect peri-implant success, through a hypothetical prediction model for biological complications of implant overdentures. METHODS A retrospective observational, prevalence study was conducted in 58 edentulous Caucasian patients rehabilitated with implant overdentures. A total of 229 implants were included in the study. Anamnestic, clinical, and implant-related parameters were collected and recorded in a single database. "Patient" was chosen as the unit of analysis, and a complete screening protocol was established. The data analytical study included assessing the odds ratio, concerning the presence or absence of a particular risk factor, by using binary logistic regression modeling. Probability values (p values) inferior to 0.05 were considered as representing statistically significant evidence. RESULTS The performed prediction model included the following variables: mean probing depth, metal exposure, IL1B_allele2, maxillary edentulousness, and Fusobacterium nucleatum. The F. nucleatum showed significant association with the outcome. Introducing a negative coefficient appeared to prevent complications or even boost the biological defense when associated with other factors. CONCLUSIONS The prediction model developed in this study could serve as a basis for further improved models that would assist clinicians in the daily diagnosis and treatment planning practice of oral rehabilitation with implant overdentures.
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Affiliation(s)
| | - Paula Vaz
- Department of Orofacial Genetics, Faculty of Dental Medicine of the University of Porto, Portugal.
| | - Ana Cristina Braga
- Department of Production and Systems Engineering-Algoritmi Centre, University of Minho, Braga, Portugal.
| | | | - Maria Helena Figueiral
- Department of Removable Prosthesis, Faculty of Dental Medicine of the University of Porto, Portugal.
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18
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Jensen C, Ross J, Feenstra TL, Raghoebar GM, Speksnijder C, Meijer HJA, Cune MS. Cost-effectiveness of implant-supported mandibular removable partial dentures. Clin Oral Implants Res 2016; 28:594-601. [PMID: 27080041 DOI: 10.1111/clr.12840] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to conduct a cost-effectiveness analysis comparing conventional removable partial dentures (RPDs) and implant-supported RPDs (ISRPDs) treatment in patients with an edentulous maxilla and a bilateral free-ending situation in the mandible. MATERIAL AND METHODS Thirty subjects were included. A new RPD was made and implant support was provided 3 months later. Treatment costs (opportunity costs and costs based on tariffs) were calculated. Treatment effect was expressed by means of the Dutch Oral Health Impact Profile questionnaire (OHIP-NL49), a chewing ability test (Mixing Ability Index, MAI) and a short-form health survey measuring perceived general health (SF-36), which was subsequently converted into quality-adjusted-life-years (QALYs). The incremental cost-effectiveness ratio (ICER) was the primary outcome measure of cost-effectiveness, comparing both treatment strategies. RESULTS The mean total opportunity costs were €981 (95% CI €971-€991) for the RPD treatment and €2.480 (95% CI €2.461-€2.500) for the ISRPD treatment. The total costs derived from the national tariff structure were €850 for the RPD treatment and €2.610 for the ISRPD treatment. The ICER for OHIP-NL49 and MAI using the opportunity costs was €80 and €786, respectively. When using the tariff structure, corresponding ICERs were €94 and €921. The effect of supporting an RPD with implants when expressed in QALYs was negligible; hence an ICER was not determined. CONCLUSIONS It is concluded that depending on the choice of outcome measure and monetary threshold, supporting an RPD with implants is cost-effective when payers are willing to pay more than €80 per OHIP point gained. Per MAI point gained, an additional €786 has to be invested.
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Affiliation(s)
- Charlotte Jensen
- Department of Fixed and Removable Prosthodontics and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Jamila Ross
- Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, University of Utrecht, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Talitha L Feenstra
- Department of Epidemiology, Health Technology Assessment Unit, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Caroline Speksnijder
- Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, University of Utrecht, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Henny J A Meijer
- Department of Fixed and Removable Prosthodontics and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.,Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Marco S Cune
- Department of Fixed and Removable Prosthodontics and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.,Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, St. Antonius Hospital Nieuwegein, Nieuwegein, the Netherlands
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