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Jafarpour D, Feine JS, Morris M, Souza RFD. Patient-reported outcomes and clinical performance of CAD/CAM removable dentures: A scoping review. INT J PROSTHODONT 2023; 0:4499965. [PMID: 37824115 DOI: 10.11607/ijp.8556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
PURPOSE This scoping review mapped the literature on CAD/CAM (computer-aided design and manufacturing) removable complete and partial dentures regarding patient and clinician-reported outcomes. MATERIALS AND METHODS We performed an electronic search of the Cochrane Central Register of controlled trials (CENTRAL), MEDLINE (Ovid), EMBASE, SCOPUS, and Web of Science databases (last update: March 2023). All clinical trials or observational studies investigating CAD/CAM removable dentures (conventional or implant-retained) were included. RESULTS The search yielded 4035 records and led to 58 included studies. Results suggest that CAD/CAM complete and partial dentures, when compared to the conventional ones, can save time and resources while being rated either non-inferior or superior by patients and clinicians in most studies. However, consensus on which workflow offers fewer adjustments and postoperative sessions is still pending. CONCLUSION The literature suggests that CAD/CAM complete and partial dentures can combine substantial time and cost savings with patient and clinician experiences at least comparable to the conventional prostheses. Given the low evidence level of existing studies, future well-designed randomized trials with large sample size are required to confirm those advantages.
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Sherigar SR, Feine JS, Cooper LF, Stanford CM, Barwacz CA, McGuire M, Abi Nader S, de Souza RF. Can patients detect peri‑implant mucosal inflammation? Results from a multicentre randomized trial. J Dent 2023; 135:104592. [PMID: 37330036 DOI: 10.1016/j.jdent.2023.104592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/31/2023] [Accepted: 06/14/2023] [Indexed: 06/19/2023] Open
Abstract
PURPOSE The objective of this study was to compare patient-reported outcomes (PROs) of peri‑implant soft tissue inflammation and aesthetics around single-tooth implants in the anterior maxillary region with three different implant-abutment interface designs. METHODS Participants were randomized to one of three different types of implant-abutment interface designs [Conical (CI), flat-to-flat (FI), and Platform Switched (PS)]. Implants and provisional crowns with prefabricated titanium abutments were placed 5 months following extraction and/or ridge augmentation. Permanent ceramic crowns with zirconia abutments were placed after 12 weeks. To assess PROs, appearance and inflammation questionnaires were completed from provisional crown placement to the 3-year follow-up. RESULTS Tooth appearance at the 3-year follow-up revealed a difference amongst CI, FI and PS implants (p=0.049; Kruskal-Wallis test). PS was rated better than FI (p=0.047) at 1 year for appearance of soft-tissue and satisfaction with colour. There were no differences for self-consciousness, smile and pain/discomfort while eating/hard food items. CONCLUSIONS Although participants tended to rate the health of mucosa around PS implants as slighty better than the other two implant systems, the differences were minimal and inconsistent. Thus, patient satisfaction in terms self-perceived gingival health and esthetics was high for all 3 systems tested, suggesting that patients are unable to detect mucosal inflammation. CLINICAL SIGNIFICANCE Patients find it difficult to perceive mucosal inflammation; hence, it is recommended that patients attend implant follow-up visits, even if they do not perceive inflammation. The study suggests that there is a relationship between the PROs and the clinical outcomes of tested implants.
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Affiliation(s)
- Shwetha R Sherigar
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, 3640, University St., # M/65A, Montreal, Quebec H3A2B2, Canada
| | - Jocelyne S Feine
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, 3640, University St., # M/65A, Montreal, Quebec H3A2B2, Canada
| | - Lyndon F Cooper
- Oral Biology Dept, University of Illinois at Chicago, College of Dentistry, Chicago, IL, USA
| | - Clark M Stanford
- Edwin B. Green Endowed Chair. College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Christopher A Barwacz
- Department of Family Dentistry, The University of Iowa College of Dentistry, Iowa City, IA, USA
| | | | - Samer Abi Nader
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, 3640, University St., # M/65A, Montreal, Quebec H3A2B2, Canada
| | - Raphael F de Souza
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, 3640, University St., # M/65A, Montreal, Quebec H3A2B2, Canada.
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Feine JS. From Caries Prevention in Children to Adults with Cancer: New Evidence and Ideas. JDR Clin Trans Res 2023; 8:204-206. [PMID: 37339162 DOI: 10.1177/23800844231177991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023] Open
Affiliation(s)
- J S Feine
- Population Health, Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
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Feine JS. Social Justice in Dental Research. JDR Clin Trans Res 2023; 8:108-109. [PMID: 36930292 PMCID: PMC10026150 DOI: 10.1177/23800844231158258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Affiliation(s)
- J S Feine
- Oral Health and Society Division, Faculty of Dentistry, McGill University, Quebec, Canada
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Herrero F, de Souza RF, Feine JS, Alexander PP, Green AV, Oates TW. The impact of implant-retained overdentures on type-2 diabetic and non-diabetic edentulous patients: Satisfaction and quality of life in a prospective cohort study. J Dent 2022; 127:104357. [PMID: 36351489 PMCID: PMC9691604 DOI: 10.1016/j.jdent.2022.104357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/07/2022] [Accepted: 11/04/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES To evaluate the benefits of implant therapy for patients with diabetes, we compared (i) healthy, (ii) well controlled T2DM and (iii) poorly controlled T2DM patients, in terms of oral health-related quality of life (OHRQoL) and satisfaction with mandibular 2-implant overdentures over 12 months following restoration. MATERIALS AND METHODS This single-center, prospective, cohort study recruited 165 edentulous adults (HbA1c<12%) to receive two endosseous implants in the anterior mandible to support mandibular overdentures. Participants were enrolled as having T2DM or not, with T2DM participants divided according to HbA1c into well-controlled (<8.1%) and poorly controlled (≥ 8.1%) groups. Participants provided responses to the OHIP-20 (OHRQoL) and the McGill Denture Satisfaction Questionnaire, before implant therapy and 6 and 12 months after overdenture insertion using Locator attachments. HbA1c was measured at the same time points. The effect of groups and time was verified using generalized estimating equations (α=0.025). RESULTS At 12 months, 137 participants provided responses. The two diabetes groups showed improvements in OHRQoL to the same extent as the non-diabetic control group at both 6 and 12 months. Patient satisfaction showed similar improvements with no between-group differences and similar increases identified at 6 and 12 months. HbA1c was not affected by time or groups. CONCLUSIONS Dental implant therapy provided significant improvements in patient-perceived benefits of mandibular two-implant overdentures for T2DM individuals, which are similar to those found for healthy edentulous individuals. Importantly, those benefits extend to those individuals with poorly controlled glycaemia. The addition of 2-implant supported mandibular overdentures did not affect glycaemic status over 12 months following insertion. CLINICAL SIGNIFICANCE As risks for implant therapy relative to glycaemic status are better understood, this study documents that implant therapy may offer important benefits in QoL for T2DM patients independent of glycaemic status.
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Affiliation(s)
- Frances Herrero
- Department of Advanced Oral Sciences & Therapeutics, School of Dentistry, University of Maryland, Baltimore, United States
| | - Raphael F de Souza
- Oral Health and Society, Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - Jocelyne S Feine
- Oral Health and Society, Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - Peggy P Alexander
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, United States
| | - Adriana Vargas Green
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, United States
| | - Thomas W Oates
- Department of Advanced Oral Sciences & Therapeutics, School of Dentistry, University of Maryland, Baltimore, United States.
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Feine JS. Oral Health Care Access, Inequity, and Inequality. JDR Clin Trans Res 2022; 7:332-333. [PMID: 36121148 PMCID: PMC9490433 DOI: 10.1177/23800844221121301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- J S Feine
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Quebec, Canada
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Inglehart MR, Albino J, Feine JS, Okunseri C. Sociodemographic Changes and Oral Health Inequities: Dental Workforce Considerations. JDR Clin Trans Res 2022; 7:5S-15S. [PMID: 36121138 DOI: 10.1177/23800844221116832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND By midcentury, the US population will be remarkably more racially and ethnically diverse, with a dramatic increase in the proportion of older adults. This report addresses ongoing oral health disparities and inequitable access to care related to these changes, with emphasis on implications for the workforce, taking note of effects of the COVID-19 pandemic. RELEVANT CONSIDERATIONS Considering that social determinants shape health behaviors, reflection on the most effective type of dental workforce should take into account population characteristics and the relationship of oral health with overall health and general well-being. The dental workforce composition will need to mirror changing demographics, and effective dental health teams will be characterized by cultural competence, humility, readiness, and capacity to adapt to changes. In addition, the influence of social histories and the pandemic on health and dental care utilization is important. Equally important are the inclusion of oral health literacy in treatment planning and disease prevention, as well as oral health-related quality of life in considering outcomes of care. Providing patient-centered care for a diverse population requires tailored treatment modalities, as well as intra- and interprofessional approaches. In this way, the whole person can be cared for, including those with special health care needs, whether related to chronic disease, mental health conditions, or behavioral, physical, and social differences. CONCLUSIONS Changing demographics will affect the delivery of oral health care, including who can best provide care and how, what the needs are, and in what ways prevention and treatment can most effectively be accomplished. The education of dentists must address unmet population needs, including for those with special health care concerns and older adults. These population groups are influenced by a variety of social determinants, and provision of services may need to occur in alternative care delivery settings. Identifying and addressing the needs of every patient within this broad array of new requirements will challenge dental professionals to redefine what it means to be a health care practitioner. KNOWLEDGE TRANSFER STATEMENT This article describes how sociodemographic changes in the United States will challenge the dental workforce in new ways and points to research and practice needs to address these challenges. Oral health disparities and the changing oral health care needs of patients from diverse and underserved groups are discussed, with a focus on the implications for delivery of care and policies that are needed to improve oral health outcomes for all.
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Affiliation(s)
- M R Inglehart
- Department of Periodontics and Oral Medicine, School of Dentistry and Department of Psychology, College of Literature, Science & Arts, University of Michigan, Ann Arbor, MI, USA
| | - J Albino
- Colorado School of Public Health, Anschutz Medical Campus, Aurora, CO, USA
| | - J S Feine
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - C Okunseri
- Marquette University School of Dentistry, Milwaukee, WI, USA
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Emami E, Lavigne G, Feine JS, Karp I, Rompré PH, Almeida FR, Huynh NT. Effects of nocturnal wearing of dentures on the quality of sleep and oral-health-related quality in edentate elders with untreated sleep apnea: a randomized cross-over trial. Sleep 2021; 44:zsab101. [PMID: 33955479 PMCID: PMC8503827 DOI: 10.1093/sleep/zsab101] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/07/2021] [Indexed: 11/28/2022] Open
Abstract
STUDY OBJECTIVES This study aims to assess whether the nocturnal wear of dentures has an effect on the quality of sleep and oral-health-related quality of life of the edentulous elderly with untreated sleep apnea. METHODS A single-blind randomized cross-over design with two sequences and two periods was used. Participants (n = 77) were randomly assigned either to sequence 1 (nocturnal wear followed by nocturnal nonwear of the denture for 30-30 days) or sequence 2 (nocturnal nonwear followed by nocturnal wear of denture for 30-30 days). The primary sleep outcome was the quality of sleep, assessed through sleep fragmentation measured as Apnea-Hypopnea Index (AHI) and respiratory arousal from portable polysomnography. Secondary outcomes were daytime sleepiness, sleep quality (Pittsburgh Sleep Quality Index, PSQI) and oral-health-related quality of life measured by validated questionnaires. RESULTS The mean paired difference in AHI scores for the period of wearing versus not wearing dentures at night was small 1.0 event per hour (p = 0.50; 95% confidence interval (CI) = -2.0 to 4.1). The mean respiratory arousal index was higher when wearing dentures at night than when not wearing dentures at night, with a mean paired difference of 2.3 events per hour (p = 0.05; 95% CI = 0.0 to 4.6). No difference in sleepiness and PSQI were noted. Wearing dentures at night resulted in a statistically significantly higher mean score of psychological discomfort when compared to not wearing dentures at night. CONCLUSIONS The results provide some support to usual practice guidelines to remove dentures at night in edentulous elders suffering from sleep apnea. CLINICAL TRIAL REGISTRATION NCT01868295.
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Affiliation(s)
- Elham Emami
- Faculty of Dentistry, McGill University, Montréal, Québec, Canada
| | - Gilles Lavigne
- Faculty of Dentistry, Université de Montréal, Montréal, Québec, Canada
| | - Jocelyne S Feine
- Faculty of Dentistry, McGill University, Montréal, Québec, Canada
| | - Igor Karp
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario,Canada
| | - Pierre H Rompré
- Faculty of Dentistry, Université de Montréal, Montréal, Québec, Canada
| | - Fernanda R Almeida
- Faculty of Dentistry, University of British Colombia, Vancouver, British Columbia, Canada
| | - Nelly T Huynh
- Faculty of Dentistry, Université de Montréal, Montréal, Québec, Canada
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Alhozgi A, Feine JS, Tanwir F, Shrivastava R, Galarneau C, Emami E. Rural-urban disparities in patient satisfaction with oral health care: a provincial survey. BMC Oral Health 2021; 21:261. [PMID: 33992110 PMCID: PMC8122552 DOI: 10.1186/s12903-021-01613-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 05/06/2021] [Indexed: 11/17/2022] Open
Abstract
Background Identifying spatial variation in patient satisfaction is essential to improve the quality of care. Thus, the objective of this study was to investigate rural–urban disparities in patient satisfaction and to determine the factors that could influence satisfaction with oral health care. Methods Data from 1788 parents/caregivers of children who participated in the Quebec Ministry of Health clinical study were subject to secondary analysis. The Perneger model of patient satisfaction was used as the conceptual framework for the study. Satisfaction with oral health care was measured using the WHO-sponsored International Collaborative Study of Oral Health Outcomes (ICS-II). Explanatory variables included predisposing factors and enabling resources. Statistical analyses included descriptive statistics, as well as bivariate and linear regression models. Results Individuals with higher income, dental insurance coverage, having a family dentist, reporting ease in finding a dentist, and having access to a private dental clinic were more satisfied with oral health care (p < 0.001). There were statistically significant differences between rural and urban Quebec residents in their ratings of patient satisfaction on four items, including dental office location (p = 0.013), dental equipment (p = 0.016), cost of dental treatment (p < 0.001), and cleanliness of dental office (p = 0.004), with greater satisfaction for urban dwellers. The multiple linear regression model showed that major determinants of patient satisfaction were being born in Canada, income ≥ 40,000$ CAD, having a family dentist, and having visited the dentist in the last year for regular checkups. However, ethnicity, having difficulty finding a dentist, and being in need of dental treatment negatively influenced patient satisfaction with oral health care. Conclusions These findings suggest that Quebec rural–urban disparity exists in patient satisfaction with care and that determinants of health influence this outcome. Intensive and powerful knowledge dissemination activities are needed to mobilize policymakers in implementing public health strategies to reduce this disparity.
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Affiliation(s)
- Abdalgader Alhozgi
- Faculty of Dentistry, McGill University, 2001 Avenue McGill College #500, Montreal, QC, H3A 1G1, Canada
| | - Jocelyne S Feine
- Faculty of Dentistry, McGill University, 2001 Avenue McGill College #500, Montreal, QC, H3A 1G1, Canada
| | - Farzeen Tanwir
- Faculty of Dentistry, McGill University, 2001 Avenue McGill College #500, Montreal, QC, H3A 1G1, Canada
| | - Richa Shrivastava
- Sri Aurobindo College of Dentistry, Sanwer Road, Indore, India.,Faculty of Dentistry, Université de Montréal, C.P. 6128, succursale centre-ville, Montreal, QC, H3C 3J7, Canada
| | - Chantal Galarneau
- Institut National de Santé Publique du Québec, 190 Boul Crémazie E, Montreal, QC, H2P 1E2, Canada
| | - Elham Emami
- Faculty of Dentistry, McGill University, 2001 Avenue McGill College #500, Montreal, QC, H3A 1G1, Canada.
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Affiliation(s)
- E Ioannidou
- University of Connecticut School of Dental Medicine, Farmington, CT, USA
| | - J S Feine
- Oral Health and Society Division, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
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11
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de Souza RF, Ribeiro AB, Oates TW, Feine JS. The McGill Denture Satisfaction Questionnaire revisited: Exploratory factor analysis of a binational sample. Gerodontology 2020; 37:233-243. [PMID: 32491236 DOI: 10.1111/ger.12477] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 03/05/2020] [Accepted: 05/08/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine the McGill Denture Satisfaction Questionnaire (MDSQ) in terms of dimensionality, item reduction and construct validity in a binational sample of complete denture wearers. MATERIALS AND METHODS We conducted secondary analyses of baseline data from two studies on implant-retained overdentures: a quasi-experimental study in the United States (n = 145) and a randomised trial in Brazil (n = 120). All participants wore upper/lower dentures and responded at baseline to the MDSQ items concerning their original mandibular dentures. A putative model of the MDSQ items resulted in two question subsets: (a) overall satisfaction, retention/stability, aesthetics, cleaning, speech and comfort, plus general chewing ability; (b) mastication of specific foods. Analyses focused on the internal consistency of each subset and possible item reduction, using Cronbach's alpha (Cα), inter-item correlation and exploratory factor analysis (EFA). RESULTS The 1st subset showed high inter-item correlation for most question combinations and no redundancy (r ≤ .8). An item on cleaning had low correlation, but its removal does not increase internal consistency (Cα ≥ .83). Results were similar for both studies, with EFA showing a single significant factor (namely "overall satisfaction, lower denture") able to explain nearly 54% of the variance. The 2nd subset also shows strong internal consistency (Cα ≥ .95) and inter-item correlation, with a single factor representing 65% of the variation. CONCLUSIONS This study discloses the reliability and construct validity of the MDSQ for patient-centred evaluation of complete dental prostheses in the edentulous mandible. Findings also support the use of both "overall satisfaction" and "masticatory ability" as summary scores, for improved outcome assessment.
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Affiliation(s)
- Raphael F de Souza
- Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Adriana B Ribeiro
- School of Dentistry, University of São Paulo, Ribeirão Preto, Brazil
| | - Thomas W Oates
- School of Dentistry, University of Maryland, Baltimore, MD, USA
| | - Jocelyne S Feine
- Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
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Abstract
To assess and improve the quality of oral healthcare, we must first agree on what constitutes good care. Currently there is no internationally accepted definition for quality of oral healthcare. Therefore, the purpose of the study was to establish a working definition for quality of oral healthcare that would help to advance further improvements in the field of quality improvement in oral healthcare. The development of the working definition included a 3-step approach: 1) literature screening; 2) expert-based compilation of an initial list of topics, leaning on the National Academy of Medicine framework for quality of care; and 3) a World Café with voting, which took place during the annual general meeting of the International Association for Dental Research in 2018. Following this approach, the collective intelligence of involved participants yielded a comprehensive list of items, prioritized by relevance. The resulting working definition comprises 7 domains—patient safety, effectiveness, efficiency, patient-centeredness, equitability, timeliness, access to care—and 30 items, which together characterize quality of oral healthcare. This aspirational working definition provides the potential to facilitate further conversations and activities aiming at quality improvement in oral healthcare.
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Affiliation(s)
- A J Righolt
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry - Quality and Safety of Oral Healthcare, Nijmegen, the Netherlands
| | - M F Walji
- Center for Oral Healthcare Quality and Safety, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - J S Feine
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - D M Williams
- Institute of Dentistry, Bart's and The London School of Medicine and Dentistry, Queen Mary, University of London, London, UK
| | - E Kalenderian
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California-San Francisco, San Francisco, CA, USA
| | - S Listl
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry - Quality and Safety of Oral Healthcare, Nijmegen, the Netherlands.,Section for Translational Health Economics, Medical Faculty, Heidelberg University, Heidelberg, Germany
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Abstract
OBJECTIVES Dental services in many countries are funded out-of-pocket by patients whose acceptance of a dental treatment depends on their valuation of it. Using a willingness-to-pay (WTP) strategy, this study aimed to determine how people who do not wear dentures value the benefits of dentures retained by implants and what factors explain variations in WTP among subjects. METHODS Telephone numbers of a representative Canadian sample were obtained from a consumer database provider. Respondents completed either an internet-based or telephone survey with 3 payment scenarios: paying oneself (out-of-pocket), coverage with private health insurance, and publicly financed through additional taxes. Personal information data (e.g., age, income) were used as independent variables in regression models to assess the determinants of WTP amounts. RESULTS Among 1,096 respondents, 317 participated in the survey (response rate, 28.9%). The mean WTP of participants (mean ± SD age: 41.2 ± 0.6 y; 54.3% male) who were dentate/partially edentate was $5,347 for implant overdentures. Considering a 1 in 5 chance of becoming edentate, they were willing to pay $26.93 as monthly payments for private insurance. They were also willing to pay an additional yearly tax of $103.63 to support a public program. WTP private payments increased substantially with increase in household income and dental needs. CONCLUSION This preference study provides information to dentists, insurance companies, and policy makers on what dentate people are willing to pay for implant overdentures, whether directly or with insurance/government coverage. KNOWLEDGE TRANSFER STATEMENT This study provides results of interest to many stakeholders. For clinicians, the results reveal what people are willing to pay for implant overdentures for themselves. It also provides information to employers and insurance companies on how people value having coverage for this kind of service. Furthermore, it provides public policy makers the value that people place on public funding of such treatments and how they would support a decision to publicly fund such a treatment.
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Affiliation(s)
- A Srivastava
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - S Esfandiari
- Faculty of Dentistry, University of Montreal, Montreal, QC, Canada
| | - S A Madathil
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - S Birch
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.,Centre for Health Economics, University of Manchester, Manchester, UK.,Centre for the Business and Economics of Health, University of Queensland, Brisbane, Australia
| | - J S Feine
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
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Feine JS. Health Services Research: Furthering Advances in Oral Health. JDR Clin Trans Res 2019; 3:220-221. [PMID: 30938604 DOI: 10.1177/2380084418781783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- J S Feine
- 1 Oral Health and Society Division, Faculty of Dentistry, McGill University, Montreal, QC, Canada
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15
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Feine JS. Advanced Methodologies in Oral Health Research. JDR Clin Trans Res 2019; 3:324-325. [PMID: 30931784 DOI: 10.1177/2380084418796813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- J S Feine
- 1 Faculty of Dentistry, McGill University, Montreal, QC, Canada
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Feine JS. It's All About Improving Health. JDR Clin Trans Res 2019; 4:104-105. [PMID: 30931702 DOI: 10.1177/2380084419833667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- J S Feine
- 1 Oral Health and Society Division, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
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17
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Feine JS. Cross-Disciplinary Team Science Can Start with One Conversation. JDR Clin Trans Res 2019; 3:116-117. [PMID: 30931772 DOI: 10.1177/2380084418761370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- J S Feine
- 1 Oral Health and Society Division, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
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Khiyani MF, Ahmadi M, Barbeau J, Feine JS, de Souza RF, Siqueira WL, Emami E. Salivary Biomarkers in Denture Stomatitis: A Systematic Review. JDR Clin Trans Res 2019; 4:312-322. [PMID: 30931724 DOI: 10.1177/2380084419830941] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Denture stomatitis (DS) is an oral biofilm-associated inflammation of the denture-bearing mucosa. The objective of this review was to identify and evaluate the quality of evidence on the association between the levels of salivary biomarkers and DS among adults with and without palatal DS. MATERIALS AND METHODS Following the PRISMA guidelines, Medline, PubMed, EMBASE, and the Cochrane Central Register for Controlled Trials were searched for eligible studies from the beginning of the archives until December 2018. Experimental and observational studies with adult participants were included that had a control group or subgroup analysis and provided data on salivary biomarkers and DS. Articles in languages other than English or French were excluded. The level of evidence and grades of recommendation were established with the 2011 scale of the Oxford Centre for Evidence-Based Medicine. Additionally, the assessment of methodological quality was conducted with the STROBE statement (Strengthening the Reporting of Observational Studies in Epidemiology) and graded according to the Olmos scale. RESULTS From 1,008 citations, 9 studies were included in the systematic review (8 observational, 1 clinical trial). Seven studies suggested a statistically significant difference in the levels of salivary cytokines (IL-6, CCL3, TGF-β, CXCL8, GM-CSF, and TNF-α) between participants with DS and controls (P < 0.05). In contrast, 2 studies concluded that the difference in the levels of several salivary cytokines (IL2, IL12, IFN-g, IL-4, IL-8, IL-10, IL-17, TNF-α, and ICAM-1) between the groups was not statistically significant. The level of evidence for the majority of studies was 3, while the grade of recommendation for all the studies was B, interpreted as "favorable." In terms of methodological quality, most studies met 50% to 80% of STROBE criteria and were graded B. CONCLUSION Palatal inflammation in DS is significantly associated with the levels of salivary cytokines. KNOWLEDGE TRANSFER STATEMENT The results of this study identified altered levels of specific salivary biomarkers associated with denture stomatitis, which may aid in the early diagnosis and treatment of this disease.
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Affiliation(s)
- M F Khiyani
- Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada
| | - M Ahmadi
- Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada
| | - J Barbeau
- Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada
| | - J S Feine
- Faculty of Dentistry, McGill University, Montréal, QC, Canada
| | - R F de Souza
- Faculty of Dentistry, McGill University, Montréal, QC, Canada
| | - W L Siqueira
- Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
| | - E Emami
- Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada.,Faculty of Dentistry, McGill University, Montréal, QC, Canada
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Kawai Y, Muarakami H, Feine JS. Do traditional techniques produce better conventional complete dentures than simplified techniques? A 10-year follow-up of a randomized clinical trial. J Dent 2018; 74:30-36. [PMID: 29758255 DOI: 10.1016/j.jdent.2018.04.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 04/27/2018] [Accepted: 04/28/2018] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES The use of a simplified method (S) of fabricating complete dentures has been shown to be more cost-efficient than the traditional method (T), and there are no negative consequences that detract from the cost savings in the short term. However, it is not clear whether this remains constant over a decade. The objective of this study was to clarify patients' perspectives and determine any differences between the dentures fabricated with these two different techniques after a decade of use. MATERIAL AND METHODS Edentate individuals participated in a randomized controlled clinical trial and completed a 6-month follow-up from 2001 to 2003 (T group n = 50; S group n = 54). For this 10-year follow-up, they were interviewed by telephone. The assessment included whether the denture was still in use or replaced, the condition of the dentures, patient satisfaction and oral health-related quality of life (OHRQoL). Between and within-group differences and the factors that cause deterioration of oral health-related quality of life (OHRQoL) were determined. RESULTS Among 54 responders (25 T and 29 S), 14T and 21S kept the original dentures. Both groups were similar in ratings of satisfaction and OHRQoL (maxilla T: 80.0 S: 86.0, p = 0.36; mandibular; T: 66.1 S: 72.3, p = 0.48; OHRQoL T: 111.1 S: 108.5, p = 0.46). Irrespective of fabrication method, discomfort, chewing difficulty and esthetics were the factors that deteriorate OHRQoL (adjusted r = 0.76, p < 0.001). CONCLUSION The results indicate that the simplified method remains more cost-efficient than the traditional method over a 10-year period. (IRB approval: A09-E71-12 B McGill University, trial registry: ClinicalTrial.org; NCT02289443).
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Affiliation(s)
- Yasuhiko Kawai
- McGill University Faculty of Dentistry, 2001 3640 rue University, Montreal, QC, H3A 0C7, Canada; Nihon University School of Dentistry at Matsudo, 2-870-1 Sakaecho Nishi, Matsudo, Chiba, 271-8587, Japan.
| | - Hiroshi Muarakami
- Nihon University School of Dentistry at Matsudo, 2-870-1 Sakaecho Nishi, Matsudo, Chiba, 271-8587, Japan.
| | - Jocelyne S Feine
- McGill University Faculty of Dentistry, 2001 3640 rue University, Montreal, QC, H3A 0C7, Canada.
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20
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de Souza RF, Bedos C, Esfandiari S, Makhoul NM, Dagdeviren D, Abi Nader S, Jabbar AA, Feine JS. Single-implant overdentures retained by the Novaloc attachment system: study protocol for a mixed-methods randomized cross-over trial. Trials 2018; 19:243. [PMID: 29685161 PMCID: PMC5913792 DOI: 10.1186/s13063-018-2606-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 02/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Overdentures retained by a single implant in the midline have arisen as a minimal implant treatment for edentulous mandibles. The success of this treatment depends on the performance of a single stud attachment that is susceptible to wear-related retention loss. Recently developed biomaterials used in attachments may result in better performance of the overdentures, offering minimal retention loss and greater patient satisfaction. These biomaterials include resistant polymeric matrixes and amorphous diamond-like carbon applied on metallic components. The objective of this explanatory mixed-methods study is to compare Novaloc, a novel attachment system with such characteristics, to a traditional alternative for single implants in the mandible of edentate elderly patients. METHODS/DESIGN We will carry out a randomized cross-over clinical trial comparing Novaloc attachments to Locators for single-implant mandibular overdentures in edentate elderly individuals. Participants will be followed for three months with each attachment type; patient-based, clinical, and economic outcomes will be gathered. A sample of 26 participants is estimated to be required to detect clinically relevant differences in terms of the primary outcome (patient ratings of general satisfaction). Participants will choose which attachment they wish to keep, then be interviewed about their experiences and preferences with a single implant prosthesis and with the two attachments. Data from the quantitative and qualitative assessments will be integrated through a mixed-methods explanatory strategy. A last quantitative assessment will take place after 12 months with the preferred attachment; this latter assessment will enable measurement of the attachments' long-term wear and maintenance requirements. DISCUSSION Our results will lead to evidence-based recommendations regarding these systems, guiding providers and patients when making decisions on which attachment systems and implant numbers will be most appropriate for individual cases. The recommendation of a specific attachment for elderly edentulous patients may combine positive outcomes from patient perspectives with low cost, good maintenance, and minimal invasiveness. TRIAL REGISTRATION ClinicalTrials.gov, NCT03126942 . Registered on 13 April 2017.
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Affiliation(s)
- Raphael F de Souza
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montréal, QC, H3A 1G1, Canada.
| | - Christophe Bedos
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montréal, QC, H3A 1G1, Canada
| | - Shahrokh Esfandiari
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montréal, QC, H3A 1G1, Canada
| | - Nicholas M Makhoul
- Division of Oral & Maxillofacial Surgery, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Didem Dagdeviren
- Division of Oral Diagnostic Sciences, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Samer Abi Nader
- Division of Restorative Dentistry, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Areej A Jabbar
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montréal, QC, H3A 1G1, Canada
| | - Jocelyne S Feine
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montréal, QC, H3A 1G1, Canada
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21
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Affiliation(s)
- J S Feine
- 1 Oral Health and Society Division, Faculty of Dentistry, McGill University, Montreal, QC, Canada
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22
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Affiliation(s)
- J S Feine
- 1 Oral Health and Society Division, Faculty of Dentistry, McGill University, Montreal, QC, Canada
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23
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Gaber A, Galarneau C, Feine JS, Emami E. Rural-urban disparity in oral health-related quality of life. Community Dent Oral Epidemiol 2017; 46:132-142. [PMID: 28940682 DOI: 10.1111/cdoe.12344] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 08/22/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVES The objective of this population-based cross-sectional study was to estimate rural-urban disparity in the oral health-related quality of life (OHRQoL) of the Quebec adult population. METHODS A 2-stage sampling design was used to collect data from the 1788 parents/caregivers of schoolchildren living in the 8 regions of the province of Quebec in Canada. Andersen's behavioural model for health services utilization was used as a conceptual framework. Place of residency was defined according to the Statistics Canada Census Metropolitan Area and Census Agglomeration Influenced Zone classification. The outcome of interest was OHRQoL measured using the Oral Health Impact Profile (OHIP)-14 validated questionnaire. Data weighting was applied, and the prevalence, extent and severity of negative oral health impacts were calculated. Statistical analyses included descriptive statistics, bivariate analyses and binary logistic regression. RESULTS The prevalence of poor oral health-related quality life (OHRQoL) was statistically higher in rural areas than in urban zones (P = .02). Rural residents reported a significantly higher prevalence of negative daily-life impacts in pain, psychological discomfort and social disability OHIP domains (P < .05). Additionally, the rural population showed a greater number of negative oral health impacts (P = .03). There was no significant rural-urban difference in the severity of poor oral health. Logistic regression indicated that the prevalence of poor OHRQoL was significantly related to place of residency (OR = 1.6; 95% CI = 1.1-2.5; P = .022), perceived oral health (OR = 9.4; 95% CI = 5.7-15.5; P < .001), dental treatment needs factors (perceived need for dental treatment, pain, dental care seeking) (OR = 8.7; 95% CI = 4.8-15.6; P < .001) and education (OR = 2.7; 95% CI = 1.8-3.9; P < .001). CONCLUSION The results of this study suggest a potential difference in OHRQoL of Quebec rural and urban populations, and a need to develop strategies to promote oral health outcomes, specifically for rural residents. Further studies are needed to confirm these results.
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Affiliation(s)
- Amal Gaber
- Faculty of Dentistry, McGill University, Montréal, QC, Canada.,Faculty of Dentistry, Université de Montréal, Montréal, QC, Canada
| | | | | | - Elham Emami
- Faculty of Dentistry, McGill University, Montréal, QC, Canada.,Faculty of Dentistry, Université de Montréal, Montréal, QC, Canada.,School of Public Health, Public Health Research Institute, CRCHUM, Université de Montréal, Montréal, QC, Canada
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24
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Dhaliwal JS, Albuquerque RF, Murshed M, Feine JS. Erratum to: Osseointegration of standard and mini dental implants: a histomorphometric comparison. Int J Implant Dent 2017; 3:28. [PMID: 28660592 PMCID: PMC5489440 DOI: 10.1186/s40729-017-0088-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 06/12/2017] [Indexed: 11/10/2022] Open
Affiliation(s)
- Jagjit S Dhaliwal
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec, H3A 1G1, Canada.
| | - Rubens F Albuquerque
- Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Monzur Murshed
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec, H3A 1G1, Canada.,Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Jocelyne S Feine
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec, H3A 1G1, Canada
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25
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Dhaliwal JS, Albuquerque RF, Murshed M, Feine JS. Osseointegration of standard and mini dental implants: a histomorphometric comparison. Int J Implant Dent 2017; 3:15. [PMID: 28462508 PMCID: PMC5411366 DOI: 10.1186/s40729-017-0079-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 04/26/2017] [Indexed: 11/17/2022] Open
Abstract
Background Mini dental implants (MDIs) are becoming increasingly popular for rehabilitation of edentulous patients because of their several advantages. However, there is a lack of evidence on the osseointegration potential of the MDIs. The objective of the study was to histomorphometrically evaluate and compare bone apposition on the surface of MDIs and standard implants in a rabbit model. Methods Nine New Zealand white rabbits were used for the study to meet statistical criteria for adequate power. Total 18 3M™ESPE™ MDIs and 18 standard implants (Ankylos® Friadent, Dentsply) were inserted randomly into the tibia of rabbits (four implants per rabbit); animals were sacrificed after a 6-week healing period. The specimens were retrieved en bloc and preserved in 10% formaldehyde solution. Specimens were prepared for embedding in a light cure acrylic resin (Technovit 9100). The most central sagittal histological sections (30–40 μm thick) were obtained using a Leica SP 1600 saw microtome. After staining, the Leica DM2000 microscope was used, the images were captured using Olympus DP72 camera and associated software. Bone implant contact (BIC) was measured using Infinity Analyze software. Results All implants were osseointegrated. Histologic measures show mineralized bone matrix in intimate contact with the implant surface in both groups. The median BIC was 58.5 % (IQR 8.0) in the MDI group and 57.0 % (IQR 5.5) in the control group (P > 0.05; Mann-Whitney test). There were no statistical differences in osseointegration at 6 weeks between MDIs and standard implants in rabbit tibias. Conclusions Based on these results, it is concluded that osseointegration of MDIs is similar to that of standard implants.
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Affiliation(s)
- Jagjit S Dhaliwal
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec, H3A 1G1, Canada.
| | - Rubens F Albuquerque
- Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Monzur Murshed
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec, H3A 1G1, Canada.,Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Jocelyne S Feine
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec, H3A 1G1, Canada
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26
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Affiliation(s)
- J S Feine
- 1 Faculty of Dentistry, McGill University, Montreal, Canada
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27
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Dhaliwal JS, Albuquerque RF, Fakhry A, Kaur S, Feine JS. Customized SmartPeg for measurement of resonance frequency of mini dental implants. Int J Implant Dent 2017; 3:4. [PMID: 28150188 PMCID: PMC5289123 DOI: 10.1186/s40729-017-0066-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 01/13/2017] [Indexed: 12/03/2022] Open
Abstract
Background One-piece narrow diameter implants (NDIs) have been recommended as “Single-tooth replacements in the anterior zones, single posterior, multiple-unit fixed dental prosthesis (FDP), edentulous jaws to be rehabilitated with FDP, and edentulous jaws rehabilitation with overdentures in situations with reduced mesiodistal space or reduced ridge width.” (ITI consensus 2013). Since NDIs can be immediately loaded, it is important to be able to carry out stability testing. We developed and validated a customized SmartPeg for this type of implant to measure the Implant Stability Quotient (ISQ). The ISQ of mini dental implants (MDIs) was measured and compared with the stability of standard and in a rabbit model. Objective The aim of the study is to test the feasibility of a customized SmartPeg for resonance frequency measurement of single-piece mini dental implants and to compare primary stability of a standard and the mini dental implant (3M™ESPE™ MDI) in a rabbit model after 6 weeks of healing. Methods Eight New Zealand white rabbits were used for the study. The protocol was approved by the McGill University Animal Ethics Review Board. Sixteen 3M™ESPE™ MDI and equal number of standard implants (Ankylos® Friadent, Dentsply) were inserted into the tibia/femur of the rabbits and compared. Each rabbit randomly received two 3M™ESPE™ MDI and two Ankylos® implants in each leg. ISQ values were measured with the help of an Osstell ISQ device using custom-made SmartPegs for the MDIs and implant-specific SmartPegs™ (Osstell) for the Ankylos®. Measurements were obtained both immediately following implant placement surgery and after a 6-week healing period. Each reading was taken thrice and their average compared using Wilcoxon matched pairs signed-rank tests. Results The median ISQ and interquartile range (IQR) values were 53.3 (8.3) at insertion and 60.5 (5.5) at 6 weeks for the 3M™ESPE™MDI and, respectively, 58.5 (4.75) and 65.5 (9.3) for the Ankylos® implant. These values also indicate that both types of implants achieved primary and secondary stability, and this is supported by histological data. ISQ values of both 3M™ESPE™ MDI and Ankylos® increased significantly from the time of insertion to 6 weeks post-insertion (p < 0.05). Conclusions The new custom-made SmartPeg is suitable for measuring the Implant Stability Quotient of 3M™ESPE™MDIs. The primary stability of 3M™ESPE™MDIs is similar to the primary stability attained by standard implants in the rabbit tibia.
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Affiliation(s)
- Jagjit Singh Dhaliwal
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec, H3A 1G1, Canada.,PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, ᅟ, Brunei Darussalam
| | - Rubens F Albuquerque
- Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ali Fakhry
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec, H3A 1G1, Canada
| | - Sukhbir Kaur
- Department of Zoology, Panjab University, Chandigarh, India
| | - Jocelyne S Feine
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec, H3A 1G1, Canada.
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Feine JS. Interdisciplinary Approaches to Research on Dental Disease. JDR Clin Trans Res 2017; 2:4. [PMID: 30938641 DOI: 10.1177/2380084416680201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- J S Feine
- 1 Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
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29
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Heydecke G, Penrod JR, Takanashi Y, Lund JP, Feine JS, Thomason JM. Cost-effectiveness of Mandibular Two-implant Overdentures and Conventional Dentures in the Edentulous Elderly. J Dent Res 2016; 84:794-9. [PMID: 16109986 DOI: 10.1177/154405910508400903] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Implementation of new therapies is usually governed by financial considerations, so efficacy studies should also include cost comparisons. The cost and effectiveness of mandibular conventional dentures (CD, n = 30) and two-implant overdentures (IOD, n = 30) were compared in elderly subjects. Effectiveness (Oral Health Impact Profile, OHIP-20) and cost were measured up to one year post-treatment. Data for subsequent years were estimated by the Delphi method. Using an average life expectancy of 17.9 years, the equalized annual costs (in Canadian dollars) were $399 for CD and $625 for IOD (p < 0.001), and the equalized annual values for the outcome (OHIP-20) were 47.0 for CD and 31.3 for IOD treatment (p < 0.05). These values translate into a yearly additional cost for IOD treatment of $14.41 per OHIP-20 point. These results are key to the implementation of programs to provide this form of therapy for edentulous adults.
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MESH Headings
- Aged
- Canada
- Cost-Benefit Analysis
- Dental Implantation, Endosseous/economics
- Dental Implantation, Endosseous/psychology
- Dental Implants/economics
- Dental Implants/psychology
- Denture, Complete, Lower/economics
- Denture, Complete, Lower/psychology
- Denture, Overlay/economics
- Female
- Health Care Costs
- Humans
- Jaw, Edentulous/economics
- Jaw, Edentulous/psychology
- Jaw, Edentulous/rehabilitation
- Male
- Mandible
- Quality of Life
- Sickness Impact Profile
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Affiliation(s)
- G Heydecke
- Faculty of Dentistry, McGill University, 3640 University Street, M73, Montreal, Quebec H3A 2B2, Canada
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Abstract
Speech is often perturbed after placement of maxillary implant-retained prostheses. We tested the hypothesis that the rate of speech errors varies with prosthetic design. Thirty edentulous subjects with mandibular implant prostheses entered two within-subject crossover trials. Subjects wore maxillary fixed prostheses and removable long-bar overdentures (Trial 1), or overdentures with and without palates (Trial 2). Test words from a French language speech battery were recorded after each prosthesis had been worn for two months. The percentages of stops, fricatives, and vowels correctly perceived by lay judges were calculated. Subjects produced a significantly higher percentage of sounds correctly with overdentures than with fixed prostheses. Between-treatment differences were significant for stops and fricatives (p < 0.01), but not for vowels. There were no significant differences in error rates between the two overdentures. In conclusion, maxillary implant overdentures with and without palates enable patients to produce more intelligible speech than fixed prostheses.
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Affiliation(s)
- G Heydecke
- Faculty of Dentistry, McGill University, 3640 University Street, Montreal, Quebec H3A 2B2, Canada
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Affiliation(s)
- J S Feine
- 1 Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
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Feine JS. Improving Health and Well-being through Research. JDR Clin Trans Res 2016; 1:104-105. [PMID: 30931793 DOI: 10.1177/2380084416651079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- J S Feine
- 1 McGill University, Oral Health and Society Research Unit, Montréal, Canada
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Feine JS, Heft MW, Krebsbach PH. Promoting Research-driven Oral Health Care. JDR Clin Trans Res 2016; 1:4-5. [PMID: 30931691 DOI: 10.1177/2380084416636566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- J S Feine
- 1 Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - M W Heft
- 2 University of Florida, Gainesville, FL, USA
| | - P H Krebsbach
- 3 Biologic and Materials Sciences, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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McGuire MK, Scheyer T, Ho DK, Stanford CM, Feine JS, Cooper LF. Esthetic outcomes in relation to implant-abutment interface design following a standardized treatment protocol in a multicenter randomized controlled trial--a cohort of 12 cases at 1-year follow-up. INT J PERIODONT REST 2015; 35:149-59. [PMID: 25738335 DOI: 10.11607/prd.2341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The design of an implant-abutment interface may have an impact on the peri-implant soft tissue esthetics. In an ongoing randomized controlled trial (RCT) with 141 participants, the authors evaluated the peri-implant tissue responses around three different implant-abutment interface designs used to replace single teeth in the esthetic zone. The aim of this report is to describe the treatment protocol utilized in this ongoing RCT by (1) demonstrating in detail a clinical case treated under this protocol and (2) reporting peri-implant soft tissue responses in a cohort of 12 representative cases from the RCT at 1-year follow-up. Male and female adults requiring single implants in the anterior maxilla were enrolled in the RCT according to the study protocol. Five months following any required extraction and/or socket bone grafting/ridge augmentation, one of the following three implant-abutment interfaces was placed and immediately provisionalized: (1) conical interface (CI; OsseoSpeed, Dentsply Implants), n = 4; (2) flat-to-flat interface (FI; NobelSpeedy Replace, Nobel Biocare), n = 4; or (3) platform-switch interface (PS; NanoTite Certain Prevail, Biomet 3i), n = 4. Twelve weeks later, definitive crowns were delivered. Throughout the treatment, peri-implant buccal gingival zenith height and mesial/distal papilla height were measured on stereotactic device photographs, and pink esthetic scores (PES) were determined. The demographics of the participants in each of the three implant-abutment interface groups were very similar. All 12 study sites had ideal ridge form with a minimum width of 5.5 mm following implant site development performed according to the described treatment protocol. Using this treatment protocol for single-tooth replacement in the anterior maxilla, the clinicians were able to obtain esthetic peri-implant soft tissue outcomes with all three types of implant-abutment interface designs at 1-year follow-up as shown by the Canfield data and PES. The proposed treatment protocol for single-tooth replacement in the esthetic zone provides a reliable method to obtain and assess the esthetic outcome as a function of implant-abutment interface design and is now in its fifth year of follow-up.
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Emami E, Nguyen PTH, Almeida FR, Feine JS, Karp I, Lavigne G, Huynh N. The effect of nocturnal wear of complete dentures on sleep and oral health related quality of life: study protocol for a randomized controlled trial. Trials 2014; 15:358. [PMID: 25218696 PMCID: PMC4177759 DOI: 10.1186/1745-6215-15-358] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 09/09/2014] [Indexed: 11/23/2022] Open
Abstract
Background Edentulism and sleep disturbance are chronic conditions that are common in older people and have serious adverse consequences for their functioning and quality of life. Edentulism can disturb sleep through the alteration of the craniofacial structure and surrounding soft tissue. However, the effect of prosthetic rehabilitation of edentulism on sleep quality is still not well understood. The objectives of this study are to test whether nocturnal denture wear affects sleep quality, daytime sleepiness, and the oral health related quality of life of edentate older people with moderate to severe sleep apnea, and to identify modifiers of effect of nocturnal denture wear. Methods/design We will carry out a single-blind randomized cross-over trial. Seventy edentate older people with moderate to severe obstructive sleep apnea will be enrolled. The study participants will be assigned to wear and not wear their dentures on alternate periods of 30 days. The outcome measures will be sleep quality (assessed by portable polysomnography), daytime sleepiness (assessed by the Epworth Sleepiness Scale), and oral health related quality of life (assessed by validated questionnaire). A number of characteristics (sociodemographic, oropharyngeal morphology, oral and prosthesis characteristics, and perceived general health quality of life) will be assessed by means of clinical examination, 3D imaging of the craniofacial structure, and validated questionnaires at baseline. Linear mixed effects regression models for repeated measures will be fitted to test the study hypotheses. The main analyses will be based on the intention-to-treat principle. To assess the robustness of the findings to potential incomplete adherence, sensitivity analyses will be conducted while applying the per-protocol principle. Discussion This practice-relevant evidence could represent a preventive approach to improve sleep characteristics of the older population and improve their well-being and quality of life. Trial registration ClinicalTrials.gov NCT01868295.
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Affiliation(s)
- Elham Emami
- Faculty of Dentistry, Université de Montréal, 2900 Edouard-Montpetit, Montreal, QC H3T 1J4, Canada.
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Emami E, de Souza RF, Bernier J, Rompré P, Feine JS. Patient perceptions of the mandibular three-implant overdenture: a practice-based study. Clin Oral Implants Res 2014; 26:639-43. [DOI: 10.1111/clr.12351] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Elham Emami
- Department of Restorative Dentistry; Faculty of Dentistry; Université de Montréal; Montreal QC Canada
- Department of Social and Preventive Medicine; School of Public Health; Université de Montréal; Montreal QC Canada
| | - Raphael F. de Souza
- Department of Dental Materials and Prosthodontics; Ribeirão Preto Dental School; University of São Paulo; Ribeirão Preto Brazil
| | | | - Pierre Rompré
- Département de Stomatologie; Faculté de Médecine Dentaire; Université de Montréal; Montreal QC Canada
| | - Jocelyne S. Feine
- Oral Health and Society Research Unit; Faculty of Dentistry; McGill University; Montreal QC Canada
- Department of Epidemiology and Biostatistics and Department of Oncology; Faculty of Medicine; McGill University; Montreal QC Canada
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Tikhonova SM, Feine JS, Pustavoitava NN, Allison PJ. Reproducibility and diagnostic outcomes of two visual-tactile criteria used by dentists to assess caries lesion activity: a cross-over study. Caries Res 2013; 48:126-36. [PMID: 24335157 DOI: 10.1159/000353094] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 05/17/2013] [Indexed: 11/19/2022] Open
Abstract
UNLABELLED The aim of this study was to evaluate the reproducibility and differences in diagnostic outcomes by practicing dental clinicians previously inexperienced in using the Nyvad criteria and the ICDAS II criteria with the Lesion Activity Assessment system (ICDAS II + LAA). Four volunteer dentists were randomly allocated to one of two groups. Both groups of dentists examined the same voluntary sample (n = 140) of caries active young adults using Nyvad and ICDAS II + LAA criteria in different sequences. The first group used the Nyvad criteria during period 1, followed by ICDAS II + LAA during period 2; the second group did the examinations in the opposite sequence. Before the period 1 and 2 examinations, dentists from both groups were trained with the Nyvad or ICDAS II + LAA criteria, depending on the group to which they were assigned. Intra-examiner agreement for lesion severity was high for both diagnostic instruments (weighted kappa 0.62-0.80). For lesion activity the intra-examiner unweighted kappa values ranged from 0.31 to 0.61 for ICDAS II + LAA and from 0.36 to 0.51 for Nyvad. The mean number of active non-cavitated caries lesions was significantly higher for ICDAS II + LAA (6.14 ± 5.4) than for Nyvad (3.90 ± 3.9) (p < 0.001). Active cavitated/dentinal caries lesions were significantly higher for ICDAS II + LAA (4.14 ± 4.1) than for Nyvad (2.13 ± 3.1) (p < 0.001). Both the Nyvad and ICDAS II + LAA diagnostic criteria showed high reproducibility for lesion severity assessment. The mean number of active caries lesions among high caries risk subjects was significantly higher using the ICDAS II + LAA criteria, which may subsequently lead to more caries treatment. TRIAL REGISTRATION ISRCTN65592532.
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Affiliation(s)
- S M Tikhonova
- Faculty of Dentistry, McGill University, Montreal, Canada
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Emami E, Kabawat M, Rompre PH, Feine JS. Linking evidence to treatment for denture stomatitis: a meta-analysis of randomized controlled trials. J Dent 2013; 42:99-106. [PMID: 24316341 DOI: 10.1016/j.jdent.2013.11.021] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 11/08/2013] [Accepted: 11/29/2013] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The aim of this meta-analysis was to compare the efficacy of antifungal therapy with any other alternative methods used for the treatment of denture stomatitis. DATA SOURCES MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews were searched, complemented by hand searching, until the first week of January 2013. STUDY SELECTION Included studies consisted of randomized clinical trials published in English or French, which compared antifungals with any other alternative or placebo, used for the treatment of denture stomatitis. The remission of clinical signs of denture stomatitis, and the reduction in Candida colony counts were considered as the clinical and microbiological outcomes, respectively. Random effects models were used to conduct the statistical analyses. RESULTS From 233 identified articles, a total of 15 manuscripts on 14 randomized controlled trials were included in systematic review and 8 in the meta-analysis. No statistically significant difference between antifungal treatment and disinfection methods was found for both clinical (OR=0.7; 95% CI: 0.32-1.36; Z=-1.14; p=0.256) and microbiological (OR=0.8; 95% CI: 0.26-2.5; Z=-0.35; p=0.724) outcomes. The meta-analysis showed a statistically significant difference between an antifungal and a placebo for the microbiological outcome (OR=0.32; 95% CI: 0.12-0.89; Z=-2.2; p=0.028), favouring the antifungals. However, there was no statistically significant difference between antifungal and placebo for the clinical outcome (OR=0.2; 95% CI: 0.04-1.04; Z=-1.9; p=0.056). CONCLUSIONS Disinfection agents, antiseptic mouthwashes, natural substances with antimicrobial properties, microwave disinfection and photodynamic therapy could be suggested as an adjunct or alternative to antifungal medications in the treatment of denture stomatitis.
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Affiliation(s)
- Elham Emami
- Département de Dentisterie et de Restauration, Faculté de Médecine Dentaire, Université de Montréal, Montreal, Canada.
| | - Marla Kabawat
- Département de Dentisterie et de Restauration, Faculté de Médecine Dentaire, Université de Montréal, Montreal, Canada
| | - Pierre H Rompre
- Département de Stomatologie, Faculté de Médecine Dentaire, Université de Montréal, Montreal, Canada
| | - Jocelyne S Feine
- Oral Health and Society Research Unit, Faculty of Dentistry; Department of Epidemiology and Biostatistics and Department of Oncology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
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Hamdan NM, Gray-Donald K, Awad MA, Johnson-Down L, Wollin S, Feine JS. Do implant overdentures improve dietary intake? A randomized clinical trial. J Dent Res 2013; 92:146S-53S. [PMID: 24158335 DOI: 10.1177/0022034513504948] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
People wearing mandibular two-implant overdentures (IOD) chew food with less difficulty than those wearing conventional complete dentures (CD). However, there is still controversy over whether or not this results in better dietary intake. In this randomized clinical trials (RCT), the amounts of total dietary fiber (TDF), macronutrients, 9 micronutrients, and energy in diets consumed by persons with IOD and CD were compared. Male and female edentate patients ≥ 65 yrs (n = 255) were randomly divided into 2 groups and assigned to receive a maxillary CD and either a mandibular IOD or a CD. One year following prosthesis delivery, 217 participants (CD = 114, IOD = 103) reported the food and quantities they consumed to a registered dietician through a standard 24-hour dietary recall method. The mean and median values of TDF, macro- and micronutrients, and energy consumed by both groups were calculated and compared analytically. No significant between-group differences were found (ps > .05). Despite quality-of-life benefits from IODs, this adequately powered study reveals no evidence of nutritional advantages for independently living medically healthy edentate elders wearing two-implant mandibular overdentures over those wearing conventional complete dentures in their dietary intake at one year following prosthesis delivery.
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Affiliation(s)
- N M Hamdan
- Faculty of Dentistry, McGill University, Montreal, Canada
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Srivastava A, Feine JS, Esfandiari S. Are people who still have their natural teeth willing to pay for mandibular two-implant overdentures? ACTA ACUST UNITED AC 2013; 5:117-24. [PMID: 23857925 DOI: 10.1111/jicd.12057] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 04/13/2013] [Indexed: 11/27/2022]
Abstract
AIM Oral health in Canada and most developed and developing countries is funded by private payers, whose acceptance of treatment depends on their valuation of it. This study aims to determine how dentate individuals in Quebec, Canada, would value the benefits of mandibular two-implant overdentures based on their willingness to pay (WTP) for the treatment, either directly or with insurance/government coverage. METHODS A total of 39 individuals (23-54 years) completed a Web-based WTP survey that consisted of three cost scenarios: (a) out-of-pocket payment; (b) private dental insurance coverage; and (c) public funding through additional taxes. Variations in WTP amounts were measured using regression models. RESULTS Among respondents who were dentate or missing some teeth, average WTP out of pocket for implant overdentures was CAD$5419 for a 90% success rate. They were willing to pay an average CAD$169 as one-time payment for private dental insurance, with a one in five chance of becoming edentate. WTP amounts increased substantially with the probability of success of implant overdenture therapy. The results of regression analyses were consistent with theoretical predictions for education level and income (P < 0.05). CONCLUSIONS The results of this study, within its limitations, suggest that dentate individuals would be willing to pay a significant amount to receive mandibular two-implant overdentures if and when they become edentate.
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Affiliation(s)
- Akanksha Srivastava
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
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Emami E, Salah MH, Rompré P, Huynh N, Beauchamp A, Feine JS. The nocturnal use of complete dentures and sleep stability in edentulous elders. J Dent 2013; 41:703-9. [PMID: 23751879 DOI: 10.1016/j.jdent.2013.05.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 05/20/2013] [Accepted: 05/30/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To evaluate the stability of sleep quality and the impact of nocturnal use of complete dentures on sleep quality in an elderly edentulous population over a one-year period. MATERIALS AND METHODS Written informed consent was obtained from 172 edentulous elders who agreed to enrol in a longitudinal cohort study. A total of 153 participants completed the follow-up after one year. Perceived quality of sleep and daytime sleepiness were measured using the Pittsburgh Sleep Quality Index (PSQI, score 0-21) and the Epworth Sleepiness Scale (ESS, score 0-24) at baseline (T0) and at follow-up (T1). Data on oral health related quality of life, type of mandibular dentures (conventional versus implant-retained mandibular overdenture), nocturnal wear of the dentures and socio-demographic status were obtained by means of the OHIP-20 questionnaire, a clinical examination form and a socio-demographic questionnaire. RESULTS No statistically significant differences were detected in the global PSQI mean scores and EES mean scores from baseline (PSQI 4.77 ± 3.32; EES 5.35 ± 3.72) to the follow-up assessment (PSQ1 5.04 ± 3.50; EES 5.53 ± 4.34). Edentate elders wearing prostheses at night had poorer daytime sleepiness scores than those who removed their prostheses at night (p=0.003 unadjusted model; p=0.058 adjusted for age, gender, type of prosthesis and the OHIP-20 total score). CONCLUSION Results of this study suggest that wearing complete dentures while sleeping has little effect on sleep quality or daytime sleepiness.
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Affiliation(s)
- Elham Emami
- Faculté de Médecine Dentaire, Université de Montréal, Montreal, QC, Canada.
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Awad MA, Rashid F, Feine JS. The effect of mandibular 2-implant overdentures on oral health-related quality of life: an international multicentre study. Clin Oral Implants Res 2013; 25:46-51. [DOI: 10.1111/clr.12205] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Manal A. Awad
- Department of General & Specialist Dental Practice; College of Dentistry; University of Sharjah; Sharjah UAE
| | - Faahim Rashid
- Faculty of Dentistry; Ajman University of Science & Technology; Ajman UAE
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Michaud PL, de Grandmont P, Feine JS, Emami E. Measuring patient-based outcomes: Is treatment satisfaction associated with oral health-related quality of life? J Dent 2012; 40:624-31. [DOI: 10.1016/j.jdent.2012.04.007] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 04/08/2012] [Accepted: 04/10/2012] [Indexed: 01/17/2023] Open
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Abstract
We conducted a randomized clinical trial to determine whether providing simple mandibular implant overdentures (IODs) to elderly individuals would give them a significantly better nutritional profile than those who receive complete dentures (CDs). Two hundred fifty-five edentate patients > 65 yrs were randomly assigned to receive maxillary CDs and mandibular IODs (n = 128) or CDs (n = 127). Six-month and one-year post-treatment outcomes were blood plasma levels of homocysteine (tHcy), vitamin B12, vitamin B6, albumin, serum folate, and C-reactive protein concentrations, as well as dietary intake. The association between treatment and tHcy levels was not statistically significant. A decline of folate from baseline values in both study groups, as well as those of vitamins B6 and B12 and albumin, was observed. Significant between-group differences were detected in food preparation and in the individuals' ability to chew a variety of foods. This study suggests that implant overdentures do not have a more positive effect on the nutritional state of elderly edentate individuals at 6 and 12 mos post-treatment than new complete dentures. However, those wearing IODs are significantly more likely to take in their nutrients through fresh, whole fruits and vegetables.
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Affiliation(s)
- M A Awad
- Department of General & Specialist Dental Practice, College of Dentistry, University of Sharjah, Sharjah, United Arab Emirates
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Pan S, Dagenais M, Thomason JM, Awad M, Emami E, Kimoto S, Wollin SD, Feine JS. Does mandibular edentulous bone height affect prosthetic treatment success? J Dent 2010; 38:899-907. [DOI: 10.1016/j.jdent.2010.08.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Revised: 08/01/2010] [Accepted: 08/03/2010] [Indexed: 11/26/2022] Open
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Abstract
PURPOSE Conventional dentures will remain the only treatment available to most edentulous people for the foreseeable future. In this study, we compared the efficiency of two methods of making complete conventional dentures-the traditional academic standard (T) and a simplified technique (S) used in private practice. We have previously shown that they produce similar levels of patient satisfaction and denture quality. MATERIALS AND METHODS Data were gathered during a randomized controlled clinical trial of 122 subjects from initial examination until 6-month follow-up. For this report, the direct costs of providing one set of conventional complete dentures by T or S techniques were estimated. All materials used were recorded and their cost was calculated in Canadian dollars (CAN$). The costs of fabrication in an outside laboratory were added. Clinician's labor time was recorded for every procedure. Between-group comparisons for each clinical procedure were carried out with independent t-tests. The number of patients in each group who needed postdelivery treatment was compared with Chi-square tests. The effect of group assignment and of treatment difficulty on outcomes was analyzed with multiple regression analysis. RESULTS The mean total cost of the T method was significantly greater than S (CAN$166.3; p < 0.001), and clinicians spent 90 minutes longer (p < 0.001) on clinical care. The difficulty of the case had no significant influence on outcomes. CONCLUSIONS The results indicate that the S method is the more cost-efficient method and that there are no negative consequences that detract from the cost savings.
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Emami E, Feine JS. Resin-bonded Cantilever Partial Dentures are Effective in Terms of Patient Satisfaction in the Restoration of the Mandibular Shortened Dental Arch. J Evid Based Dent Pract 2010; 10:64-6. [PMID: 20230975 DOI: 10.1016/j.jebdp.2009.11.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Elham Emami
- Oral Health and Rehabilitation Research Unit, Faculté de médecine dentaire, Université de Montréal, C.P.6128, Succursale Centre-ville, Montréal, QC, H3C3J7, Canada
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Emami E, Heydecke G, Rompré PH, de Grandmont P, Feine JS. Impact of implant support for mandibular dentures on satisfaction, oral and general health-related quality of life: a meta-analysis of randomized-controlled trials. Clin Oral Implants Res 2009; 20:533-44. [PMID: 19515032 DOI: 10.1111/j.1600-0501.2008.01693.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to examine systematically the data published on the efficacy of mandibular implant-retained overdentures from the patient's perspective. MATERIAL AND METHODS Medline, Embase, The Cochrane Central Register of Controlled Trials and The Cochrane Systematic Reviews Database were searched and complemented by hand searching. All randomized-controlled trials published in English or French up to April 2007 were included, in which conventional dentures and mandibular implant overdentures in adult edentulous individuals were compared. The outcomes of interest were patient satisfaction, oral and general health-related quality of life. Random effects models were used to pool the effect sizes (ES) of all included studies. RESULTS Ten publications of seven randomized-controlled trials were identified and eight were included in the meta-analysis. When compared with mandibular conventional dentures, implant overdentures were rated to be more satisfactory at a clinically relevant level [pooled ES 0.80, z=3.56, 95% confidence intervals (CI) 0.36-1.24, P=0.0004], but a statistical heterogeneity was found (chi(2)=31.63, df=5, P<0.00001, I(2)=84%). The pooled ES for oral health quality of life was -0.41 (z=1.31, 95% CI, -1.02 to 0.20; P=0.19, chi(2)=11.53, df=2, P<0.003, I(2)=83%). There was a lack of evidence to show the impact of mandibular implant overdenture on perceived general health. CONCLUSIONS Our findings suggest that, although mandibular implant-retained overdentures may be more satisfying for edentulous patients than new conventional dentures, the magnitude of the effect is still uncertain. There is a need for additional evidence including cost-effectiveness analyses on the impact of mandibular implant overdentures and conventional dentures.
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Affiliation(s)
- Elham Emami
- Départment de Dentisterie et de Restauration, Faculté de Médecine Dentaire, Université de Montréal, Montréal, QC, Canada
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