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Patients' satisfaction following implant therapy. A 10-year prospective cohort study
Abstract
To analyse the patients' perception of implant therapy, 10 years following installation of titanium oral implants.
As a part of a prospective cohort study of patients with ITI(R) dental implants, 104 patients were recruited to answer a questionnaire with 13 statements on the subjective perception of implant treatment, 5-15 years after implant installation (mean: 10.2 years). In addition, the patients were asked to mark a visual analogue scale (VAS) in which 0 indicated "total discontent" and 100 "total satisfaction" with the statements mentioned in the questionnaire. Results from the qualified questions answered were then compared with those obtained from VAS analysis.
One hundred and four patients, with 214 installed oral implants participated. Forty-eight percent of the implants were reconstructed with single crowns and 52% with fixed partial dentures (FPD). The cumulative survival rate of the implants at 10 years was 93%. Two of the statements addressing function and chewing comfort yielded very high patient satisfaction (97% highly satisfied or satisfied, mean VAS: 94+/-13). Comparing chewing comfort for teeth or implants, respectively, 72.1% perceived no difference between the two, 17.3% felt more secure when masticating on teeth and 7.7% when masticating on implants (mean VAS: 54+/-24). The vast majority (96%, mean VAS: 96+/-10) was highly satisfied or satisfied with phonetic function and with aesthetics (97%, mean VAS: 93+/-13). A great majority of the patients (93%, mean VAS: 89+/-19) had no problems with cleansing the implant reconstruction. Indeed, one-third (37%, mean VAS: 55+/-27) indicated more ease to clean implants than to clean teeth. About half of the patients (47%) had noticed bleeding of the mucosa or the gingiva following brushing. In addition, half (47%) of those noticing bleeding felt that bleeding was less marked around implants than around teeth. Again, the vast majority of patients (92%, mean VAS: 92+/-14) indicated complete fulfilment of the treatment, i.e. the outcome satisfied their expectations. The same majority (94%, mean VAS: 93+/-17) would be willing to undergo the same treatment again, and (89%, mean VAS: 93+/-16) would even recommend such treatment to friends and relatives, if indicated. The cost for implant therapy was deemed to be reasonable to a large extent (87%, mean VAS: 85+/-20).
Using oral implants, more than 90% of the patients were completely satisfied with implant therapy, both from a functional and aesthetic point of view. The costs associated with implant therapy were considered to be justified. This was determined by both qualified questions and the use of VAS after 10 years of function.
... 19 There are now many studies in the literature on this topic due to the increased use of implant-supported prostheses. However, while various studies evaluate the degree of satisfaction of patients after implant treatment, [20][21][22] the number of studies associated with KMA is limited. ...
... 52 Similar results were reported in similar studies. 22,[53][54][55] Also, as in our study, high satisfaction rates have been obtained in patients who received implant treatment for the rehabilitation of single tooth deficiencies. 69,56 ...
... Similarly, there are many studies in the literature reporting that patients found their speech function highly satisfactory after rehabilitation with implant-supported fixed prostheses. 22,[53][54][55]60 According to other studies, it was found that patients rehabilitated with implant-supported prostheses improved their speech function with treatment. Furthermore, it was reported that patients' selfconfidence also improved. ...
Background: The aim of this study was to evaluate the relationship between periimplant soft tissue health, the amount of periimplant keratinized mucosa, and the satisfaction of patients who applied to the Ankara University Faculty of Dentistry and had a fixed implant-assisted restoration in the premolar and/or molar region at least 1 year after the functional loading of implant treatment. Methods: 40 implants from 40 patients, of which 24 were female and 16 were male, were included in our study. Periimplant soft tissue health was objectively evaluated with clinical measurements and a radiographic examination. The amount of keratinized mucosa around the implants was measured and recorded. Afterwards, the patients were asked to fill out a (subjective) questionnaire that included socio-demographic data and evaluated their satisfaction with their implants by VAS. Results: All patients in the healthy group had keratinized mucosa. In this study, a mean total VAS score of 8.40 out of 10 indicates that patients are satisfied with implant treatments. However, the relationship between chewing, speech, aesthetics, pain and discomfort, the presence of bleeding scores, and the total VAS score was statistically significant. There was a statistically significant difference between those without keratinized mucosa, those with inadequate keratinized mucosa, and those with present/adequate keratinized mucosa in terms of speech VAS score (p=0.050). Conclusions: In our study, the presence of keratinized mucosa significantly affected VAS scores at the speech level. KEYWORDS Dental implants, oral mucosa, patient satisfaction, periimplant
... Patient satisfaction is an essential part of evaluation of the quality and effectiveness in health care (Afrashtehfar et al., 2020;Ware Jr et al., 1983). Studies have reported that approximately 90% of patients are satisfied with the treatment outcome 6-16 years following dental implant rehabilitation (Adler et al., 2016;Johannsen et al., 2012;Pjetursson et al., 2005;Simonis et al., 2010). ...
... Questionnaires used in previous studies differ, not only in the number and content of included questions but also in response alternatives and how data based on questionnaire responses are analysed and presented (Adler et al., 2016;Pjetursson et al., 2005;Simonis et al., 2010). Development of a validated questionnaire on PROs following dental implant therapy would improve quality and reproducibility. ...
... A draft survey questionnaire was developed by adapting items from previous research on PROs related to general (Perera & Usgodaarachchi, 2009) and dental implant treatment Layton & Walton, 2011;Pjetursson et al., 2005;Simonis et al., 2010). ...
Aim
The aim of this study was to assess patient‐reported outcomes (PROs) 8 years after dental implant rehabilitation in a sample with tooth loss due to periodontitis (TLP) and a sample with missing teeth for other reasons (MTOR).
Materials and Methods
The Norwegian National Insurance Scheme registry of subsidized dental implant therapy was searched, and patients ( n = 3083) rehabilitated with dental implants in 2014 were mailed a questionnaire. PROs were described by relative frequencies, and the TLP and MTOR subsamples were compared using chi‐square test. Multiple linear regression analyses were used to investigate variables potentially predicting PROs.
Results
Of the respondents ( n = 1299), more than 90% were partly or fully satisfied with the treatment outcome. Complications were reported by 44.2%. Patients who lost teeth due to periodontitis ( n = 784) reported greater oral function improvement and better pre‐treatment information, and were more likely to experience complications when compared with patients who lost teeth for other reasons ( n = 515). Age, level of education, self‐funded cost, pre‐treatment information, history of complications and the reason for missing teeth were found to predict PROs.
Conclusions
In a Norwegian population rehabilitated with dental implants in 2014, satisfaction with the treatment outcome and the aesthetic outcome was high, irrespective of the reason for missing teeth. Self‐report of complications and lack of pre‐treatment information were the strongest predictors of inferior patient satisfaction and also predicted inferior oral function.
... Hvilke faktorer motiverer pasienter til å velge eller avstå fra implantatbehandling? De fleste publiserte studier omtaler pasienters mening etter at de er ferdigbehandlet (5-7). Pjetursson et al. publiserte i 2005 en artikkel om pasienters tilfredshet etter implantatbehandling (5). Mer enn 90 % av pasientene var svaert fornøyd med behandlingen både med tanke på funksjon og estetikk 10 år etter implantatinnsetting. ...
... Mer enn 90 % av pasientene var svaert fornøyd med behandlingen både med tanke på funksjon og estetikk 10 år etter implantatinnsetting. Hele 89 % av utvalget ville anbefale slik behandling til venner og familie (5). ...
... Det viktige i disse resultatene er at negative erfaringer ikke ser ut til å vaere formidlet videre eller at det faktisk er få negative erfaringer med implantater. Resultatene samsvarer med funnene til Pjetursson et al. (5) som undersøkte pasientenes tilfredshet etter implantatbehandling hvor 89 % av pasientene meddelte at de ville anbefale behandlingen til venner og bekjente hvis slik behandling var indisert (5). En 7-års oppfølgingsstudie fra 2003 om pasienters tilfredsstillelse etter enkelttannsrestaureringer med Brånemarkfiksturer rapporterte også at de fleste deltakerne ville anbefale implantatbehandling til andre (6). ...
... Therefore, reconstruction by implant-supported single-unit crowns or fixed bridges seems a logical tool to compensate partially edentulous patients (3)(4)(5) . However, results based on patient satisfaction are an important aspect in determining treatment success (6,7) . ...
... Despite their high survival rates, patients' concerns have been reported periodically for implant-supported fixed bridges, resulting in low patient comfort (9) ; at the same time, several reports on the satisfaction of partiallyedentulous patients treated with dental implants generally report high degrees of satisfaction (6,7,10,11) . ...
... The findings showed that the majority of the patients were satisfied with the treatment. Previous studies have made a similar evaluation using a variety of questionnaires and scales (1,6,7,20) . ...
Objective: This study aims to evaluate patient satisfaction when treated with implant-supported restorations at Dental Implant Unit- Maxillofacial Surgery Department/Rizgary Teaching Hospital in Erbil-Iraq from 2015-2019. Methods: Eighty patients with implant-supported prostheses were randomly selected to participate in the study. A case sheet was created for each of them. The case sheet consisted of two parts. The first part consisted of clinical evaluation recordings: mobility, suppuration, and bleeding on probing the implant-supported prosthesis, which the examiner did. While the second part of the case sheet was a questionnaire that the patient answered. There were five questions in the questionnaire: 1- the ability to chew foods, 2- the appearance of the prosthesis, 3- the comfort of the implant-supported prosthesis, 4- speaking ability, and 5- overall satisfaction with the outcome of the treatment. The degree of satisfaction was assessed by the scale from (1-5) with 1: corresponding to Not satisfied at all, 2: Not satisfied, 3: Partially satisfied, 4: Satisfied, and 5: Highly satisfied. Results: Majority (75%) of the sample were either satisfied (30%) or highly satisfied (45%) with the outcome of treatment (overall satisfaction). Nearly the same percentages were obtained regarding the satisfaction with the ability to chew foods, the appearance of the prosthesis, comfort, and speaking ability with the implant-supported prosthesis. In addition, there were strong correlations between mobility and suppuration of the implant-supported prostheses and the patient's satisfaction.. Conclusions: Within the limitation of this study, it has been concluded that patients treated with implant-supported prostheses were highly satisfied with the treatment. Data on patient satisfaction is an important source of information that can guide dentists to provide treatment that will meet patients' expectations more.
... This questionnaire focused on the function and cleaning ability of the single dental implant, with various statements adopted from Pjetursson et al. [22]. The VAS ranged from 0 on the left end, indicating 'no, absolutely not' , to 10 on the right end, indicating 'yes, absolutely' . ...
... In our study, the patients reported that their speaking ability after implant therapy was close to the level of absolute agreement. This is consistent with Pjetursson et al. 's study [22], which found that 2% of the patients reported phonetic problems 5-15 years after implant installation, an incidence similar to our study. ...
Aims: Little attention has been paid to patients’ perception of function and esthetics with single dental implants. The aim of this study was therefore to describe patient-reported function and esthetic outcomes in single dental implants. A second aim was to study the objective esthetics in single dental implants. Material and methods: Patients with one single dental implant in the esthetic zone were selected. Two questionnaires with visual analog scales (VAS) were filled in by the patients, and intraoral photographs were taken. One of the questionnaires related to satisfaction with cleaning and function, and the other involved the esthetics of the single dental implant. One dentist reviewed the photographs using the pink esthetic score/white esthetic score (PES/WES) index. Results: For chewing and for speaking, the scores were 8.8 and 9.9 respectively on a VAS (best 10). The overall esthetic score on a VAS was 8.6 (best 10). The PES/WES in the present study was 14.6 (standard deviation [SD] ± 1.9), and 3/45 (6.7%) of the single dental implants never reached clinical acceptability. Conclusions: Patients reported high satisfaction with both the function and the esthetics of single dental implants. Both subjectively and objectively, the peri-implant mucosa was less favorable compared with the crown.
... Satisfaction with improvement in chewing ability was relatively low, as 65.6% of the patients gave scores of "excellent" and "very good"; however, when scores of "good" were included, the rate of satisfaction increased to 91.6%. This rate is in agreement with previous research, 38 which they show that about 90% of the treated patients were satisfied and pleased with their masticatory function, and with Alam et al, who reported that 95.2% of their patients were satisfied with the function of their dental implants. 2 Indeed, when we considered "excellent", "very good" and "good" response options as indicating satisfaction, our results were nearly consistent with those of Pjetursson et al, as they found that 72% of patients stated that their implants resemble their teeth in masticatory function and that 92% and 83% were satisfied with the pronunciation and aesthetic aspects of satisfaction, respectively. ...
... These findings are in agreement with our results, in which 100% of patients were satisfied with their phonetic results (61.1% when considering only "excellent" and "very good" scores); 91.5% were satisfied with the aesthetics; and 92.1% stated that their dental implant was similar to their natural teeth. 38 Similarly, Alam et al also found that all patients (100%) were satisfied with the appearance of their dental implants. 2 Obesity is considered a "public health problem" and has been shown to have an adverse effect on wound healing; it has also been associated with adverse post-surgical results such as complications due to infection and delayed healing 39 and increased occurrence of wound complications such as dehiscence, hematoma and pressure ulcers. ...
Background
Dental implants are currently one of the most preferred treatment modalities for replacing missing teeth, as they are the most comparable to natural teeth. Even so, satisfaction with such treatment may differ depending on patient nature. The aim of this article was to examine the relationships between different anthropometric measurements on dental implant patient’s satisfaction.
Methods and Material
Self-administered questionnaire (structured questions) were given to patients who had dental implant treatment to evaluate their satisfaction level with dental-implant treatment. Different anthropometric measurements were taken: body height; weight; body mass index (BMI); body composition; waist/hip ratio; and circumferences at the waist, hip, and neck.
Results
The overall BMI was 28.9±4.7 kg/m², there was a highly-significant difference in patient satisfaction among the different BMI groups (P< 0.000). The significant difference in most of those groups was between the obese group and the other groups. For neck circumference and waist/hip ratio, a significance difference between the normal weight and obese groups (P< 0.000) was found, while for percentage of muscle, the differences were between the overweight and obese groups (P< 0.000). According to BMI groups a highly significant difference in many patient satisfaction domains were found (P< 0.000). These significant differences were between the obese group and non-obese groups for most aspects of patient satisfaction. For patient satisfaction with final appearance, the normal BMI group differed significantly from the overweight BMI group (P=0.013). Additionally, for patient satisfaction with dentist performance and communication, the overweight BMI group showed significantly higher satisfaction than the normal BMI group (P=0.019). Body measurements were correlated negatively with overall patient satisfaction, and positively with satisfaction with prosthesis.
Conclusion
The obese group patients had the lowest rate of patient satisfaction. BMI and other body measurements can be used to predict patient satisfaction with the outcome of dental implant treatment.
... Technical complications were classified following Pjetursson et. al. 32 as: ...
... A six-point ordinal scale (extremely negative to extremely positive) was used for the responses. 32 Patients also rated their satisfaction with the esthetic outcome on a visual analog scale. ...
Objective: The objective of this study was to investigate the survival and biological and mechanical complications of one-piece and two-piece zirconia implants at five years of loading
Materials and Methods: Consecutive patients receiving zirconia implants were studied, collecting data at five years of loading on their clinical history, peri-implant health status, mechanical complications, esthetic results, and patient related outcomes.
Results: The study included 18 patients with 29 implants. The survival rate was 86% in implant-based analysis and 78% in patient-based analysis. There were no cases of peri-implantitis, but mucositis was present in 53% of implants. A mean of 4.1±0.81 mm was obtained for probing depth and 1.6±0.9 mm for crestal bone loss (radiographic assessment). There were no implant fractures. Major (10%) and minor (10%) prosthesis complications were observed. The esthetic outcome was moderate to almost perfect, with a high level of patient satisfaction. No significant association was found between survival rate and the presence of mucositis around one- or two-piece implants or any other study variable.
Conclusions: The survival rate is low for one- and two-piece zirconia implants. Both types of implants demonstrated a low mechanical complication rate. The incidence of periimplantitis is low but mucositis is present in 50%. Patient satisfaction related to esthetics and function is moderate to high. They represent a good option for patients requiring an alternative to titanium implants.
Clinical Relevance: Zirconia implants appear to be an alternative to the titanium option and may be indicated for patients requiring “metal-free” restorations.
... Patient-centered outcomes may be the main factor determining treatment success and can constitute an important source of information for dentists desiring to improve the quality of their treatments. 26 Immediate and early loading of dental implants often has a significant positive effect on patient satisfaction, comfort, function, and esthetics. Ultimately, with placement of the final restoration, patient satisfaction increases even further. ...
... The secondary outcome measures were IT values, Oral Health Impact Profile questionnaire (OHIP-19) and patient/ clinician satisfaction indexes. 21,22,26,35,36 Insertion torque was measured with a torque wrench (Institut Straumann) and recorded in Ncm (Figure 7a). Resonance frequency was recorded using the Osstell Mentor (Osstell, Gothenburg, Sweden) ( Figure 7b) and Penguin (PenguinRFA, Osstell) ( Figure 7c) devices at the time of implant placement (baseline) and at post-op week 6 (prior to delivery of definitive prosthetic restoration). ...
ABSTRACT The aim was to: (i) compare changes among primary and secondary implant stability between immediate and early loaded implants in edentulous maxilla, (ii) evaluate oral health related quality of life (OHRQoL) and (iii) determine patient satisfaction with 6-implant supported fixed full-arch dentures. A prospective, randomized controlled clinical trial was conducted on 24 edentulous maxilla patients. The BLT SLActive® implants in 12 patients were immediately loaded with temporary restorations while12 patients did not receive temporary restorations. Definitive (final) dentures were delivered to all patients after 6 weeks. Stability of the implants were assessed by Insertion Torque (IT) and Resonance Frequency Analysis (RFA). Oral Health Impact Profile-19 ( OHIP-19) questionnaire was used to evaluate OHRQoL and a Visual Analogue Scale (VAS) for patient satisfaction. The IT value of implants assigned for immediate and early loading group was 27.17±9.55Ncm and 25.01±11.06Ncm, respectively. Changes in implant stability from baseline to week 6 were similar in both groups when measured by Penguin ® (p=0.881) and Ostell ® (p= 0.828). Patients in the immediate load group reported significantly lower OHIP physical pain scores (p=0.016), OHIP psychological disability score (p=0.046) and significantly higher VAS function score (p=0.009) and VAS aesthetics score (p=0.009). Implant loading protocols don't have a significant effect on the change in implant stability 6 weeks after implantation, however, immediate loading significantly improves OHRQoL and satisfaction of patients with maxillary edentulism treated by fixed full-arch dentures. Future trials will determine the role of immediate loading protocol in clinical scenarios with various amounts of available jaw bone using different numbers of implants to retain a fixed prosthetic restoration in the edentulous maxilla.
... Patient satisfaction was evaluated using a questionnaire and a visual analogue scale (VAS) ranging from 0-100, after a time lapse of 12 months [33]. Ten questions were included in the questionnaire as shown in Table 2. ...
... The immediate replacement of a single tooth with an implant-prosthetic rehabilitation in the esthetic zone is considered, today, one of the most frequent indications of modern implantology, with high percentages of survival and success, as reported in the literature [33]. ...
Simple Summary
Immediate loading is nowadays a diffused technique in implantology. At the same time, digital dentistry is rapidly spreading, especially in what concerns prosthetic rehabilitation. The present study aimed to compare, through a randomized clinical trial design, the analogical vs. the traditional workflow. Single-implant restorations have been run in 50 patients, with a 12-month maximum period of follow-up after implant placement. Data were analyzed through radiological, clinical, and customer satisfaction evaluation. Importantly, and surprisingly enough, no statistically significant differences emerged between the two kinds of workflow. When assessing customer satisfaction, however, patients clearly and significantly preferred the comfort of the digital vs. traditional workflow.
Abstract
The purpose of this randomized controlled trial was to compare the immediate-loading protocol, in single restorations in the esthetic zone, by comparing the digital workflow in a test group (TG) vs. the analogical workflow in a control group (CG). A total of 50 patients were enrolled, requiring single hopeless tooth extraction. Twenty-five patients (TG) were randomly assigned to the immediate-loading protocol using the digital workflow, and twenty-five patients (CG) were assigned to the conventional workflow. Clinical and radiographic parameters were evaluated at the time of implant insertion (baseline) and after 3, 6 and 12 months, respectively. A clinician blind to conditions measured the Pink Esthetic Score (PES), as well as patient satisfaction. At 12-month follow-up, a cumulative survival rate of 100% was reported for all implants. No failures or biological complications were observed. No statistically significant differences were detected in the mean values of marginal bone loss and PES between the TG (0.12 ± 0.66 mm for MBL, 7.75 ± 0.89 for PES) and the CG (0.15 ± 0.54 mm for MBL, 7.50 ± 0.89 for PES). In 11 cases of TG, and 10 cases of CG, a one-year follow-up period showed an increased marginal bone level. No statistically significant differences were found in the mean total PES between test (7.75 ± 0.89) and control (7.5 ± 0.81) conditions. Furthermore, a customer satisfaction survey showed that patients preferred the digital workflow over the conventional workflow procedure (97.6 ± 4.3 vs. 69.2 ± 13.8). Digital workflow was more time-efficient than conventional workflow (97.2 ± 7.3 vs. 81.2 ± 11.3). Within the limitations of this study, no statistically significant differences were found between digital and traditional workflow.
... PROM following LARA with an autogenous bone block graft with or with barrier membrane coverage has solely been assessed in one long-term study disclosing high patient satisfaction, although the appearance of the surrounding mucosal gave rise to less patient satisfaction [36]. Aesthetic aspects of the implant restorations and surrounding mucosa as well as phonetics and chewing comfort are important criteria for a successful implant treatment [54]. However, previous studies have demonstrated that the cost of an implant treatment also affects the level of patient satisfaction [55,56]. ...
... The degree of patient satisfaction is also influenced by the frequency and severity of complications. Biologic and mechanical complications following LARA with or without barrier membrane coverage seems to be diminutive [54]. Mucosal dehiscence appears to be the most common complication with the two treatment modalities, which is in accordance with previous published systematic reviews [7,17,28,29]. ...
Objectives: To test the hypothesis of no difference in implant treatment outcome following lateral alveolar ridge augmentation with autogenous bone block graft with or without barrier membrane coverage.
Material and Methods: PubMed (MEDLINE), Embase and Cochrane library search in combination with a hand-search of relevant journals was conducted. Human studies published in English until the 8th of February 2021 were included. Randomised controlled trials with an observation period longer than three months were included. Survival of implants and suprastructures were considered as primary outcomes measures, whereas peri-implant marginal bone loss, dimensional changes of the alveolar ridge, bone regeneration, patient-reported outcome measures, biological and mechanical complications were secondary outcome measures, as evaluated by descriptive statistics and meta-analysis including 95% confidence interval (CI).
Results: Electronic search and hand-searching resulted in 411 entries. Five randomised controlled trials characterised by low or high risk of bias fulfilled inclusion criteria. No statistically significant difference between the two treatment modalities was observed in any of the outcome measures. However, barrier membrane coverage was associated with a non-significant gain in alveolar ridge width of 0.5 mm (95% CI = -0.1 to 1.1) and diminished resorption of -0.9 mm (95% CI = -2.4 to 0.7) compared with no barrier membrane coverage.
Conclusions: Comparable implant treatment outcomes were revealed following lateral alveolar ridge augmentation with autogenous bone block graft alone with or without barrier membrane coverage. However, postoperative dimensional changes of the augmented seems to be diminished with the use of barrier membrane coverage as evaluated by two-dimensional linear measurements.
... The patients' satisfaction was assessed by means of a five-item questionnaire, three of which (function, comfort, esthetics) were assessed in a 5-point Likert scale from "very satisfied" to "not at all satisfied" and two as dichotomous (food impaction, use of the dental floss) [22]. ...
Objective: The aim of the study was to compare medium to long-term clinical and patient-reported outcomes between implants placed with computer-assisted implant surgery (CAIS) and freehand protocols. Materials and Methods: Thirty dental implants in the anterior maxillary region with an average of 4 years after loading were assessed by means of Pink Esthetic Scores (PESs), marginal bone level (MBL), and clinical and patient-reported outcomes. Results: CAIS significantly outperformed freehand placement with regard to PES scores (p = 0.011). Likewise, implants placed with CAIS showed significantly higher MBLs (p < 0.001). Bleeding on probing, probing depth, and prevalence of mucositis did not differ between the groups, while no peri-implantitis was diagnosed. Conclusions: The use of CAIS leads to superior outcomes in terms of esthetics and MBLs for implants placed in the esthetic zone as observed in medium to long-term follow-up. No difference was however observed with regard to peri-implant mucosa inflammation. Clinical Significance: This article highlights the outcome of computer-assisted implant surgery in achieving higher esthetic, MBL, and esthetic satisfaction compared to freehand implant placement. Thai Clinical Trial Registry: TCTR20240422015.
... Another study in this field [72] aimed to identify patient satisfaction with titanium dental implants 15 years after an implant procedure. The results illustrated that the respondents were very satisfied with their survival rate (93% of the medical devices survived 10 years), the chewing comfort (more than 97% of them), and their phonetic function and aesthetics (97% of the study participants). ...
Background/objectives:
Titanium dental implants are considered to be the most modern and effective solution for replacing lost teeth. These medical devices not only restore the chewing and aesthetic functionality of the smile but also provide a stable support for crowns, bridges or dentures. The aim of this study was to identify the perceptions of patients about titanium dental implants and their effects on the human body.
Methods:
A structural equation model (SEM) was conducted to study how a series of independent variables have the ability to influence the perception and intention of the patients regarding these medical devices. A data analysis was performed using WarpPLS 8.0 software. This research was conducted on a sample of 162 respondents.
Results:
The results illustrated that patients' perception of titanium dental implants is explained by 71% of the independent variables analysed, and their intention to have a new implant in the next period is explained by 61%. The proposed econometric model was validated, with seven hypotheses accepted out of nine.
Conclusions:
Although titanium has long been used in implant dentistry, in recent years, experts have identified a number of adverse effects that can arise from its use. This study has added value both at the practical and theoretical level. Perception is influenced by respondents' perceived advantages, by the problems perceived by the respondents regarding titanium dental implants, by the degree of awareness of the risks of titanium dental implants, and by the adverse effects experienced by respondents regarding titanium dental implants.
... Selecting the right material for implant-supported crowns is essential to the longevity of prosthesis and implants because the stiffness of the crown determines how much force and stress it can withstand after a collision. Therefore, while applying brittle materials (such as ceramics) to natural teeth may not pose significant issues, using these materials for implants may result in a variety of mechanical in vivo difficulties, such as chipping or fracture (10,11) . The advantages of ceramics in terms of aesthetics, durability, and color stability have been coupled with the benefits of resin composites, such as reduced abrasiveness and high flexural strength, to create new hybrid materials called resin-based materials. ...
Objective: To compare fracture strength of screw-retained implant-supported crown of resin matrix ceramic when fabricated using CAD/CAM and 3D printing Material and method: vericom Mazic® Duro (CAD/CAM Nano Hybrid Ceramic) was used as particle-filled composite CAD/CAM material, saremco Print Crowntec (3D printable resins-based) as 3D printed composite material, and the control group was composed of IPS e.max. ZirCAD ivoclar vivadent (zirconia) was used to fabricate mandibular first molar screw-retained, implant-supported crowns. After the fabrication, the crowns were cemented with the Rely X U200 self-adhesive resin cement (3M ESPE, Germany) on stock abutments tightened to analogs embedded in acrylic resin. Finally, all crowns were subjected to a fracture resistance test. fracture strength was evaluated by using one–way ANOVA with Chi-square used for the association between the modes of fracture. Result: The results showed that there were significant differences between all the groups used, the control group (Group zirconia) was significantly higher, as the mean was equal to 6391 N. Followed by Group vericom (cad/cam) with a mean of 2558 N, then Group seramco (3D printing) with a mean of 817.92 N. Dunnett T3 test showed statistically significant differences in fracture resistance between the three groups. There was no significant difference between the modes of fracture and the methods. Conclusion: Screw-retained implant-supported crowns manufactured by CAD/CAM technique had better fracture resistance value than those of the 3D printed technique. Clinical Relevance: resin matrix ceramic is a possible substitute for zirconia in an implant-supported crown
... The vast majority of people had no problem maintaining hygiene around implants and would decide to undergo the implantation procedure again. Most participants would recommend the implantation procedure to friends and family and, surprisingly believed that the costs of the therapy were justified [39,40]. However, in the study by Wang et al., a slight deterioration in satisfaction was noted when moderate or severe inflammation of the peri-implant tissues occurred [40]. ...
Background: Highly prevalent tooth loss is observed among populations around the world. To restore masticatory function and satisfactory aesthetics, missing teeth must be replaced. Dental implants are increasingly used for this purpose. This study aimed to assess periodontal patients’ knowledge and attitudes towards dental implants. Methods: 467 anonymous questionnaires of periodontal patients were analyzed. The population participants were divided according to gender, age, education and place of residence. In the statistical analysis, the chi-squared test of independence was used (p < 0.05). The main questions addressed patients’ knowledge about dental implants and the factors influencing their decision to undergo implantation. Results: The majority of periodontal patients were aware of dental implants and the importance of oral hygiene in their maintenance. However, the population studied had many knowledge deficits, especially on the technical and biological aspects of implants. The lack of knowledge about peri-implantitis was surprising in the group seeking professional periodontal care. Patients obtained information mainly from the internet and from family and friends, with their dentists being the third source. Good functional and aesthetic outcomes would encourage them to undergo the implantation procedure, and high cost and the possibility of complications were the most discouraging factors. Conclusions: Given the growing popularity of implant treatment, patients should be provided with evidence-based knowledge about indications and possible contraindications to implants to make informed decisions.
... Введение В специальной литературе описаны методы оценки зубного и челюстного (в том числе имплантационного) протезирования, состояния здоровья полости рта и качества жизни после ортопедического стоматологического лечения [1,[3][4][5][6][7][8][9][10][12][13][14][15][16][17][18]. Количество таких разработок достаточно велико, они разнообразны, включают большое количество критериев, что усложняет обработку полученных результатов. ...
The subject of the study is a method for assessing the quality of implant prosthetics. The goal is to develop a method for patient self-assessment of the condition of peri-implant tissues. Methodology. Two computer programs developed at the Department of Orthopedic Dentistry of the First St. Petersburg State Medical University served as an analogue and prototype for the development of a visual analogue scale (VAS). acad. I.P. Pavlova: “KULOS” “Comprehensive assessment of the tissues of the prosthetic bed and the quality of dental and jaw prostheses” (Trezubov V.N. et al., 2008) and “PARMIT” “Automated portable visual analogue scale (VAS)” (Trezubov V.N. et al., 2023).Clinical testing of the developed scale was carried out. The study involved 48 people (11 men, 37 women) aged from 48 to 65 years (average age 58.2 ± 4.8 years). Statistical processing of materials was carried out using SAS v9.4 software. Results. This scale is intended for patients to self-assess the condition of peri-implant tissues. Completed by us as a questionnaire, it actually represents a six-step visual analogue scale – VAS. Successful initial clinical validation of the method was carried out. Parallel use of the questionnaire by Wolfart S. (2006) and Mericske-Stern R. et al. in the same patients. (2009), “PARMIT” (Trezubov V.N. et al., 2023) demonstrated a reliable general direction and an average degree of closeness of these questionnaires with the author’s method (respectively: r_1 = 0.468; r_2 = 0.573; r_3 = 0.698). Conclusions. A method for patient self-assessment of the condition of peri-implant tissues has been developed. The proposed method can be used in expert assessment of the quality of implant prosthetics.
... Оценка качества проведенного имплантационного протезирования -достаточно сложная клиническая задача [6][7][8][9][10][11]. Рентгенологическое обследование, большой ресурс инструментальных лабораторных методов диагностики не всегда позволяют выявить все необходимые признаки, систематизировать их, а также дать заключение [12][13][14][15][16]. Систематизация в виде компьютерной программы для ЭВМ будет хорошим подспорьем в решении данной проблемы [1,3]. ...
The subject of the research – expert assessment of the quality of implant prosthetics. The goal – creation of an instrument and clinical testing of the TAPATR computer program for assessing the condition of soft and hard peri-implant tissues, which is a diagnostic, prognostic and control method. Methodology. The subjects of the study were 48 people (11 men, 37 women) aged from 48 to 65 years (average age 58.2 ± 4.8 years). A comparative assessment of the proposed method (questionnaire) and the X-ray examination method (cone-beam tomography) was carried out. Statistical processing of materials was carried out using SAS v9.4 software. Results. Successful initial clinical validation of the method was carried out. A comparison of the survey and radiological assessment led to reliably identical results, namely, a direct pattern of deterioration in the health of peri-implant tissues depending on the degree of peri-implantitis. Statistical analysis showed that there are significant correlations between all indicators: between a high level of health and the absence of illness, a good level of health and class 2 illness, (r = 0.42 and r = 0.42, respectively). A moderate correlation has been proven between a low level of health and disease class 2 (r = 0.56) and severe – between a satisfactory level of health and class 3 (r = 0.76). Conclusion 1. An expert method for assessing the condition of soft and hard peri-implant tissues has been developed. 2. High objectivity, validity and reliability of the presented method have been proven. 3. The proposed method can be used in clinical settings, in expert assessment of the quality of prosthetics, and also in the work of conflict expert commissions.
... In contrast to wearing a complete denture, implant-supported restorations-irrespective of fixed or removable type, present a significant difference for most patients, particularly concerning quality of life [4]. A prospective study over 10 years found that more than 90% of 104 patients were completely satisfied with implant therapy, both from a functional and aesthetic point of view [5]. ...
The aim of this study was to examine the conditions of implants that had been in function for 5–17 years in stage III/IV periodontitis patients of a specialized periodontal practice. There were 83 patients (43 female/40 male, mean age 64.4 (9.69) years), with a total of 213 implants, who participated in the study. Assessments included periodontal and peri-implant probing depths, bleeding and plaque scores, and a radiographic examination. Smoking habits, participation in a supportive care program (SCP), and the Implant Disease Risk Assessment (IDRA) scores were recorded. A total of 44 patients presented with stage III periodontitis, and 39 with stage IV. In all, 85% of patients had adhered to regular SCP. On an implant/patient level, peri-implant health was found in 37.1.7% (79 implants)/24.1% (20 patients), peri-implant mucositis in 58.7% (125 implants)/66.3% (55 patients), and peri-implantitis in 4.2% (9 implants)/9.6% (8 patients). IDRA scores showed 30.5% of implants at moderate and 69.5% at high risk. The present long-term analysis shows a high prevalence of peri-implant disease in patients treated for advanced periodontitis. These findings underline the challenges involved in the long-term maintenance of oral health in stage III/IV periodontitis patients restored with dental implants.
... Longitudinal studies have demonstrated high implant survival rates and improved patient satisfaction. [11][12][13] However, potential complications, such as peri-implantitis and mechanical failures, warrant careful monitoring and maintenance to ensure long-term success. ...
Implant-supported fixed prostheses are a highly successful treatment option for replacing missing teeth, offering improved esthetics, function, and patient satisfaction. Design considerations play a crucial role in achieving optimal outcomes. Implant distribution and angulation should be carefully planned to ensure balanced load distribution and biomechanical stability. Occlusal considerations are vital to minimize mechanical complications and implant overloading, with proper adjustments and occlusal schemes implemented. The emergence profile should replicate natural tooth contours for esthetic integration and ease of oral hygiene maintenance. Material selection is essential, considering factors such as occlusal loading, esthetic requirements, and patient-specific considerations. Biomechanical analysis helps identify stress distribution patterns and optimize prosthesis design for long-term success. Patient satisfaction is high, with improved chewing ability, speech, and overall quality of life reported. Long-term success rates exceed 90%, influenced by implant survival, peri-implant health, maintenance of prosthesis integrity, and patient satisfaction. Thorough patient assessment, treatment planning, precise surgical and prosthetic execution, and comprehensive follow-up care are crucial for favorable outcomes. Implant-supported fixed prostheses provide functional and esthetic restorations, enhancing oral health and overall well-being.
... This questionnaire concerned the function and the cleaning ability with the single tooth implant from which the different statements were adopted from Pjetursson et al. 2005 [27]. The statements were as follows: The other questionnaire evaluated how the patient perceived the esthetics of the single tooth implant. ...
Background
Survival and success rates for single tooth implants have shown excellent results when measuring clinical outcomes. Less attention has been on patient´s perception of function and esthetics with single tooth implants. Therefore, the aim of the study was to describe patient reported function and esthetic outcomes in single tooth implants. A second aim was to compare the patient perceived esthetics with objective esthetics in single tooth implants.
Methods
Patients with one single-tooth implant reconstruction in the esthetic zone were selected. Two questionnaires with visual analogue scales (VAS) were filled in by the patients and intraoral photographs were taken. One questionnaire concerned satisfaction with cleaning and function and the other involved esthetics of the single tooth implant. One dentist reviewed the photographs using the pink esthetic score/white esthetic score index (PES/WES). Spearman correlation test was used to evaluate the relationship between VAS and PES/WES.
Results
For chewing and for speaking the scores were 0.1 respectively 1.2 on a VAS (best 0). The overall esthetics, on a VAS was 8.6 (best 10). PES/WES in the present study was 14.6 (SD ± 1.9) and 3/45 (6.7%) of the patients never reached clinical acceptability. VAS and PES or WES or PES/WES showed no correlation with Spearman´s correlation test (p = 0.435, p = 0.296, p = 0.245 respectively).
Conclusions
Patients reported high satisfaction with the function and the esthetics with single tooth implants. Patients’ satisfaction with the esthetics and the objective esthetics was not correlated.
... The results of this study indicated a relatively high score for patient satisfaction with implant treatment, which was in agreement with the results of a study by Olerud et al (11). Pjetursson et al. (12) evaluated patient satisfaction after implant treatment in a 10-year prospective cohort study and reported that more than 90% of patients were completely satisfied with implant treatment both functionally and esthetically. Among the studies conducted in Iran, the results of Yaghini et al. (3). ...
... [1] A majority of patients were completely satisfied with implant therapy in terms of functional and aesthetic outcomes of the treatment. [2] Previous studies showed that dental implants followed by prosthodontic rehabilitation improved oral health-related quality-of-life scores for patients with all indications for dental implants. [3] Significant improvements in oral health-related quality of life were reported in terms of both aesthetic and functional aspects in patients with at least one implant in the front dental area. ...
Introduction: The success of implant therapy is strongly related to the perceptions and expectations of the patients.
Aim: This study aimed to assess the level of social appearance anxiety and oral health-related quality of life in middle-aged adults with implant-supported fixed prostheses and compare with individuals who have tooth loss without any prosthetic rehabilitation or who have natural teeth.
Materials and methods: The participants (n=292) were divided into three groups: group 1, individuals with implant-supported fixed dental prostheses; group 2, individuals with tooth loss; and group 3, individuals with totally natural teeth. A questionnaire form including basic questions, Social Appearance Anxiety Scale (SAAS), and Oral Health Impact Profile-14 (OHIP-14) was distributed among patients.
Results: Group 2 showed a significantly higher level of SAAS and OHIP-14 scores compared with groups 1 and 3 (p<0.001). The SAAS scores were similar between groups 1 and 3, with no significant differences. The median OHIP-14 score was the lowest in group 3. For all groups, education was related to SAAS and OHIP-14 scores (p=0.037 and 0.002, respectively). The SAAS and OHIP-14 scores were significantly and positively related (p<0.001, r=0.501).
Conclusions: It was concluded that patients with tooth loss had higher levels of SAAS and OHIP-14 scores. Besides, the SAAS scores were similar for patients with implant-supported fixed prostheses and those with natural teeth. Middle-aged adults with higher educational levels tended to present better oral health-related quality of life and lower social appearance anxiety.
... Currently, the practice of implant dentistry is not regarded primarily as a specialist sector. [4][5][6][7] The problem with the available training courses is that they are neither standardized nor regulated and validated, and the majority of them differ significantly in duration, their aims and objectives, course contents, and the quality of education may lack detailed theoretical inputs and deliberations. Furthermore, dental practitioners must be conscious of their limitations in terms of appropriate knowledge and technical abilities while dealing with advanced and difficult situations. ...
Background: The aim of the present study evaluated and elevated the knowledge, attitude and awareness of people life in Hail region to dental implants as option of treatment to replace the missing teeth.Methods: The present study was conducted in dental clinics in Hail region. Study sample was consisted of total 428 individuals. Individuals, who were meted the determined inclusion criteria in this study, will be selected for answer the structured questioners. Chi-square test to determine the significant differences of the study parametersResults: Among of participants, females were 161 (37.6%) and males were 267 (62.4%) of the participants. The subjects that heard about dental implants from internet was 126 (29.4%). Majority of the subjects 207 (48.4.2%) had a friend treated with an implant. Around 326 (76.2%) responders want to learn more about implants. Most of subjects 206 (48.1%) thought that dental implant require 6 months from the first examination until your prosthesis is finished. About of 148 (34.60) believed that survival rate will be life. Around 326 (76.2%) responders wished to get dental implants inserted from a specialist. Majority of the responders 281 (65.7%) thought implants required superior cleanliness and care and that it cannot be cleansed like natural dentition.Conclusions: Patients have little information and awareness regarding dental implants.
... For an implant-supported restoration of the anterior zone, a good esthetic outcome is crucial [1][2][3][4]. Providing an immediate interim restoration after an implant surgery has been suggested as a valid and predictable treatment option in the anterior esthetic zone [5,6]. In addition, placing a well-contoured and designed interim restoration immediately after the implant placement surgery may minimize the amount of contour change of peri-implant bone and soft tissue, thus optimizing the esthetic outcomes and improving patients' satisfaction [2]. ...
This article describes a case with a full digital procedure to prefabricate an implant-supported interim restoration based on the preoperative digital implant planning. A fully guided surgical template is designed and printed, and then an interim restoration is fabricated based on the planned implant position through a dental computer-aided design (CAD) software. Once the implant was placed at the predetermined position through the fully guided surgical guide, the prefabricated interim restoration could be inserted immediately after the surgery, which can guide the healing of the soft tissue and enhance the esthetic outcomes. This novel technique eliminates the conventional impression making to insert an implant-supported interim restoration immediately after the implant placement surgery, which can guide the healing of the soft tissue, minimize the chairside time and optimize the clinical workflow.
... Replacement of the lost tooth with the implant-supported prosthetics seem to be ef cient treatment method for partial aedentia cases, nevertheless in past decades increasing trend of implant-associated complications prevalence has been observed. The latter are mostly related with improperly performed prosthetic treatment phase and periimplantitis pathology [1,5,6]. ...
Background. Tooth autotransplantation may be considered as valuable treatment option to overcome adverse effects of tooth loss and prevent implant-related complications. The essence of such manipulation based on removing targeted (donor) tooth from its present location with its further placement at some other tooth position within the oral cavity of the same patient in the least traumatic way. Objective. To systematize and analyze relevant procedural aspects of tooth autotransplantation associated with its’ clinical success. Materials and Methods. A comprehensive search strategy was realized through databases PubMed (https://pubmed.ncbi.nlm.nih.gov/) and Cochrane Library (https://www.cochranelibrary.com/), and also via Google Scholar (https://scholar.google.com/) search engine to expand possibilities for targeted publications identification. Primary extraction of the targeted studies was provided by their title and abstract. The criteria for eligibility included publications with described original practical and theoretical aspects regarding tooth autotransplantation procedure, while publications with repetitive information or non-sufficiently argumented/non evidence based statements were excluded from further analysis. Results. The final number of eligible studies for analysis was 82 publications with adequate reporting of outcomes associated with present research objective. Out of this number 8 were presented in the form of systematic reviews, 3 in the form of literature reviews, while all others were presented in forms of case reports, case series, protocols, recommendations, follow-ups, experimental and clinical studies. Conclusion. Correct surgical manipulations, which should be as atraumatic as possible to preserve the periodontal ligament of the transplanted tooth, is a key of autotransplantation successful outcome. The success of the treatment is also related with the stage of root development. In cases of transplanting the teeth with complete root development endodontic treatment should be performed approximately in 2 weeks after primary intervention.
... An implant with enough insertion and no mobility (positive survival) can be a failure (negative success) if it exhibits any coil or constant inflammation of the peri-implant soft tissue. The incidence of technical and biological complications appears to be common [2][3][4], and these complications can have substantial economic implications and effects on the perception of treatment of the patient [5][6][7][8]. As the number of patients receiving dental implants is continually growing, the prevention and treatment of associated complications represents a serious and relevant challenge. ...
Background
Peri-implantitis is a usual finding but estimates of its prevalence fluctuate very much. This may be due to the wide variety of disease definitions. This systematic review aims to estimate the overall prevalence of peri-implantitis and the effect of different study designs, function times and use of probing depth on prevalence rate.
Methods
Following electronic and manual searches of the literature published from January 2005 to December 2021, data were extracted from the studies fitting the study criteria. Fifty-seven articles were included in this study.
Results
Prevalence of peri-implantitis was 19.53% (95% CI 12.87–26.19) at the patient-level, and 12.53% (95% CI 11.67–13.39) at the implant-level and it remains highly variable even following restriction to the clinical case definition. The use of probing depth like diagnostic criteria affected the prevalence data.
Conclusion
The results indicate that it remains essential the identification of the diagnostic markers for more accurate disease classification.
... Studies on conventional implants have shown a positive impact on the patients' articulation and speech. [28,29] The special design of the occlusal scheme [19,[30][31][32] in corticobasal implantology, with no occlusal contacts in the front, necessitates empirical evidence about how this scheme affects the patients' ability to articulate. Our results showed a high level of contentment with the ease and clarity of pronunciation and speaking irrespective of periodontitis, diabetes, and smoking. ...
... It has been shown that most of them were satisfied with the longterm result (Q1, mean: 3.9) and considered their smile aesthetically pleasing compared to the general population despite the replaced tooth. Previous studies found similar results concerning long-term satisfaction (Derks et al., 2015;Pjetursson et al., 2005;Simonis et al., 2010). In a systematic review regrouping 11 articles, Arunyanak et al. (2017) found that patients were satisfied with a mean range score of 43%-93% for peri-implant soft tissue and 81%-96% for T A B L E 3 Patient satisfaction and awareness questionnaire: Answer distribution Multiple studies showed that implant restoration was rated more satisfactory than peri-implant mucosa (Cosyn et al., 2012;den Hartog et al., 2013;Meijndert et al., 2007). ...
Objectives:
To assess the vertical discrepancy between implant-supported crowns and adjacent teeth in the maxillary anterior region at least 8 years after implant placement and to evaluate the influence of this discrepancy on the level of aesthetic awareness of patients.
Material and methods:
The sample consisted of 23 adult individuals evaluated at least 8 years after placement of an implant-supported central or lateral single tooth-fixed partial denture. Patients had their crowns delivered at a mean age of 47.8 years (range: 18.9-65.8). The vertical discrepancy was measured by comparing initial and follow-up periapical radiographs using the implant as a stable structure. The patients' satisfaction with their anterior teeth condition and awareness of the possible vertical problem were evaluated using a questionnaire. The aesthetic outcome and patient awareness were related to the objective measurement of the vertical discrepancy.
Results:
The implant showed a mean infraocclusion of 0.62 mm (range: 0.15-1.63 mm). The vertical discrepancy was not associated with the patient's gender, age at implant placement, and duration between initial and recall radiograph. Patients were generally satisfied with the long-term aesthetic outcome of their smile (mean: 3.9 on a 1-5 scale, 1 unsatisfied, and 5 completely satisfied). Out of 23 patients, 8 noticed the implant infraocclusion and 4 of them found the problem severe enough to be willing to improve the situation. The amount of vertical discrepancy was not associated with the patient's perception of the discrepancy and the pink aesthetic score.
Conclusion:
Implant-supported crowns in the anterior region may suffer infraocclusion over the long term. The amount of vertical discrepancy was not dependent on the gender and age of the patient. Patients were generally satisfied with the aesthetic result of the restoration. The amount of vertical discrepancy, at least in the range we have measured, was not perceived by the patients as a complication.
... orthodontic pretreatment (Gotfredsen, 2012). With respect to the esthetic and masticatory function scores, our results are consistent with previous publications (Feine et al., 2018;Gotfredsen, 2012;Pjetursson et al., 2005). it has to be mentioned that this study has been designed with the focus on the hard-tissue conditions and that of a precise assessment of the peri-implant soft tissue dehiscence is lacking. ...
Objectives:
To report the clinical, radiographic, aesthetic and patient-reported outcomes after placement of a newly developed Narrow-Diameter Implant (NDI) in patients with congenitally Missing Lateral Incisors (MLIs).
Materials and methods:
Patients with MLIs with a mesio-distal distance between the canine and the central incisor of 5.9-6.3mm received a dental implant with a diameter of 2.9mm (Test), while a diameter of 3.3mm (Control) was used when the distance was 6.4-7.1mm. After healing, a cement-retained bi-layered zirconia crown was fabricated. At the 1-year follow-up (T2), implant survival rate, marginal Crestal Bone Level (CBL) changes, biological and technical complications were registered. The aesthetic outcome was assessed by using the Copenhagen Index Score, and the patient-reported outcomes were recorded using the OHIP-49 questionnaire.
Results:
One-hundred patients rehabilitated with 100 dental implants Ø2.9mm (n = 50) or Ø3.3mm (n = 50) were included. One Ø3.3mm implant was lost and 7 patients dropped out of the study, yielding an implant survival rate of 99% (p = 1.000). At T2 a CBL of -0.19 ± 0.25 mm (Test) and -0.25 ± 0.31 mm (Control) was detected, with no statistically significant difference between the groups (p = 0.342). Good to excellent aesthetic scores (i.e. 1-2) were recorded in most of cases. Technical complications (i.e. loss of retention, abutment fracture, chipping of veneering ceramic) occurred once in three patients with no statistically significant difference between the groups (p > 0.05). OHIP scores did not differ significantly at follow-ups between groups (p = 0.110).
Conclusion:
The use of Ø2.9mm diameter implants represents as reliable a treatment option as Ø3.3mm implants, in terms of CBL changes, biological and technical complications. Favorable aesthetics and patient-reported outcomes were recorded for both groups.
... Because it is difficult to care for removable and fixed partial prostheses in the area of tooth loss, about 74% of them require new treatment within 15 years (3). Pjetursson et al. found that more than 90% of patients who received dental implant treatments were satisfied with their functionality and aesthetics (4). In Korea, dental implants were first included in the list of procedures covered by the National Health Insurance in July 2014. ...
Background: We examined the Korean adults’ experience with dental implants and analyzed its association with various socioeconomic factors.
Methods: This study was based on the participants enrolled in the 2013-2015 KNHANES. Using the variables associated with dental implant treatment experience and other socioeconomic factors, we evaluated the statistical significance and potential associations between the dental implant treatment experience and its related factors. The final analysis in this study was performed on adults aged 20 yr and over. It comprised 4,893 subjects in the year 2013, 4,431 subjects in 2014, and 4,430 subjects in 2015.
Results: An increasing number of individuals had reported undergoing dental implant treatment. An older age was associated with a higher likelihood of undergoing dental implant treatment, particularly in adults aged ≥40 years. Additionally, the likelihood was higher in individuals with a greater income level, low-level of educational background, and married status. Factors that were observed to influence dental implant treatment experience included age, education level, income level, marital status.
Conclusion: Our analysis confirmed the growing accessibility to dental implants among Korean adults and an association between dental implant treatment experience and socioeconomic factors. We recommend a healthcare policy on dental implants that considers relevant socioeconomic factors, in order to provide dental implant treatment to individuals who are in absolute need of treatment.
... Studies on conventional implants have shown a positive impact on the patients' articulation and speech. [28,29] The special design of the occlusal scheme [19,[30][31][32] in corticobasal implantology, with no occlusal contacts in the front, necessitates empirical evidence about how this scheme affects the patients' ability to articulate. Our results showed a high level of contentment with the ease and clarity of pronunciation and speaking irrespective of periodontitis, diabetes, and smoking. ...
Introduction:
Diabetes, smoking, and periodontitis are considered risk factors for the survival of conventional dental implants; however, research about their impact on the oral health-related quality of life (OHRQoL) of patients treated with corticobasal implants is lacking.
Materials and methods:
Two hundred twenty-seven adult patients completed a postoperative OHRQoL questionnaire. Aspects of their oral health were examined in relation to periodontitis, diabetes, smoking, and against a control group with none of the conditions. A subgroup of 118 patients with pre- and postoperative OHRQoL data were studied for changes in their OHRQoL. The impact of the risk factors on the patients' posttreatment OHRQoL was examined through multiple regression analysis. The paired data were analyzed through Wilcoxon signed-rank test.
Results:
The satisfaction with the treatment was high and robust irrespective of periodontitis, diabetes, smoking, or more than one factors, P > 0.05 for all tests. The smokers' satisfaction was significantly higher than the nonsmokers, P = 0.003. The majority of the patients experienced a steady reduction in frequency to the full absence of oral health problems (P < 0.001 for all tests). The patients with periodontitis reported a significantly higher reduction in limitations related to food choice, P = 0.026. Posttreatment complications were few, mainly in the first postoperative year.
Discussion:
Our results provide reassurance to patients with periodontitis, diabetes, and smokers that corticobasal implants are an effective treatment option with the same benefits for their oral health quality of life as for patients without these risk factors.
... The first one created too many mechanical complications, such as screw loosening and fractures, although it offers tight retention. Whereas the second system created more complications, such as soft tissue inflammation nearby the implant neck due to cement intrusion, but it provides better aesthetics [3][4][5][6]. ...
Background: This research was conducted to assess and compare the stability of compressive one-piece implants with conometric caps and compressive-M implants (screw type) at the time of implant insertion, three months, and six months after insertion. Experimental: A total of 15 patients (8 females and 7 males) with a mean age of 54 ± 17.5 years participated in this study. A total of 82 implants from two implant designs (ROOTT Compressive implants with conometric caps and ROOTT Compressive-M implants with screw-type prosthesis) were placed in the lower premolar-molar areas using standard surgical protocols. The implant stability test (IST) readings were clinically measured by the Anycheck implant stability meter in both buccal and lingual directions immediately after insertion of the implant (T0), three months (T1), and six months (T2) after insertion. Results: The results displayed that the highest mean value was 63.17 using IST for Compressive implants with conometric caps on the buccal direction at T2, while the lowest mean value was 52.47 for Compressive-M implants with a screw-type prosthesis at T1. The comparison of mean values of IST showed statistically significant (P<0.05) differences between Compressive implants and Compressive-M implants at T1 and T2 but non-significant differences at T0 in both buccal and lingual directions. The mean IST values for the 39 compressive implants in lingual direction were 61.83 at T0, 59.77 at T1, and 61.57 at T2, while the mean IST values for the 35 Compressive-M implants in the same order were 59.4, 51.2, and 52.13 at T0, T1, and T2, respectively. Conclusion: We found that the stability of Compressive conometric implants is higher than that of Compressive-M implants in both T1 and T2.
... Scepanouic et. al. 40,41 in their study reported increase in patient satisfaction after few months of delivery ,they suggested that this improvement may be due to increased stability and retention of the prostheses due to the improvement of the adaptation of the prosthesis which accordingly decrease discomfort. ...
... Application of a fragile material on natural teeth is not problematic due to the presence of periodontal ligament, while the same material may cause a range of mechanical complications, including fracture and chipping when applied as implant restorations. 87 Several studies investigated the mode of failure of the implant-supported restorations using hybrid abutments. Nouh et al, observed failure in both titanium base (bending and fracture) and ceramic suprastructure (fracture and adhesive failure). ...
Ceramic implant abutments are becoming increasingly popular due to the growing esthetic demands of patients. Two-piece ceramic abutments have the advantages of both ceramic and titanium abutments. This study aimed to review the published articles regarding hybrid abutments and their characteristics.
Published articles regarding two-piece abutments were retrieved by electronic search of PubMed, Embase, Scopus, Medline, and Google Scholar databases using certain keywords. Articles highly relevant to our topic of interest were selected and reviewed.
The presence of titanium inserts in hybrid abutments can overcome the brittleness of ceramic, increase the overall fracture resistance, prevent the implant connection wear, and provide better marginal fit compared with one-piece zirconia abutments. Hybrid abutments enable the fabrication of monolithic metal-free implant restorations with optimal esthetics. Furthermore, the risk of porcelain chipping, which is a common complication of implant restorations, is eliminated due to the monolithic structure of these restorations.
According to the available literature, hybrid implant abutments have shown promising results with regard to optimal esthetics in the rehabilitation of the esthetic zone. However, long-term clinical studies are required to assess the long-term durability of all-ceramic restorations supported by hybrid abutments.
Objective
Bacterial biofilm control around dental implants is critical for the health of the peri‐implant soft tissue and longevity of dental implants. The patient's role in regular biofilm removal around dental implants is just as important as that of the dental hygienist. The purpose of this study is to identify the relationship between at‐home dental implant care and patients' perceptions of peri‐implant soft tissue health.
Methods
A 15‐item paper survey was distributed to adult patients undergoing professional dental hygiene maintenance at a specialty dental practice within a 3‐month period and had at least one dental implant. Survey items included participant demographics, patient‐reported adjunctive aids for dental implants and patient perceptions of dental implant oral hygiene practices and peri‐implant soft tissue health.
Results
There was a statistical difference between time spent cleaning dental implants and peri‐implant soft tissue health. An association was found between patients who reported spending more time cleaning their dental implants and less bleeding ( p = 0.046/54%), gingival inflammation ( p = 0.026/58%) and gingival tissue redness ( p = 0.036/53%). Additionally, patients who more frequently underwent professional dental hygiene maintenance perceived less gingival inflammation ( p = 0.001/66%).
Conclusion
To promote peri‐implant soft tissue health and reduce oral biological complications, best practice guidelines should be implemented, including optimal at‐home dental implant care and regular professional dental hygiene maintenance.
Purpose
To investigate the long‐term implant survival rate and marginal bone loss (MBL) of implants with different variables associated over an observational period of at least 20 years.
Materials and Methods
Patients with at least one implant placed prior to 2001 were recalled and visited. Data on implant macro‐design, prosthetic aspects, site distribution, and patient‐related factors were collected. MBL was evaluated on intraoral X‐rays and peri‐implant soft tissue parameters were recorded. The patients were asked to fill out a questionnaire to evaluate their satisfaction with the treatment received. Descriptive statistics indicators were estimated. Analysis of variance and analysis of covariance models were used to investigate any differences in the MBL and peri‐implant probing depth (PPD) among the variables. A chi‐square analysis was performed to investigate any association between different types of prosthetic implant‐supported rehabilitations and survival/success outcomes.
Results
Forty‐one (41) patients and 174 implants were included with a mean observational period of 23.3 ± 2.8 years. The implant survival and success rates were 96.5% and 83.3% respectively, while 3.5% of early failures were detected. The lowest success rates were observed for implants supporting fixed full‐arch rehabilitations (71.05%) and overdenture rehabilitations (86.11%). A mean MBL of 1.81 ± 0.71 mm and a mean PPD of 3.38 ± 1.62 mm were recorded. The interaction between the collected data with MBL and PPD did not reveal any statistically significant differences between the variables ( p > 0.05). A statistically significant difference was recorded when analyzing the association between the different types of prosthetic implant‐supported rehabilitations and success rates ( p = 0.014), with fixed and removable full‐arch rehabilitations presenting with lower success rates. Answers to the questionnaire showed a generally high level of satisfaction.
Conclusions
Within the limits of this retrospective study and based on the results, an implant survival rate higher than 96% was observed after a mean observational period of 23.3 ± 2.8 years. Both the implant survival rate and MBL seemed stable after a mean observational period of 23.3 ± 2.8 years. Implants supporting fixed and removable full‐arch rehabilitations seemed to present lower success rates over time. Implant rehabilitation seemed to provide patients with optimal long‐term outcomes in terms of functional and psychological aspects.
Objectives: This study evaluated the satisfaction of the patients using the oral health impact profile-14 (OHIP-14) and VAS scale after 5-8 years of the treatment. Materials and Methods: A total of healthy 185 implants were selected according to the dental implant health scale accepted by International Congress of Oral Implantologists Consensus (ICOI) and 112 fixed implant- supported prosthesis evaluated for this study. The patient-reported effect was prospectively obtained by measuring oral health impact (OHIP-14) and VAS skale with a a follow-up period ranging from 5 to 8 years. Distribution of variables was checked using 0ne-Sample test. SPSS 22.0 programme was used for the analyses. Results: The patients were defined high satisfaction results after 5-8 years by implant placement. Mean VAS-score for the satisfaction percentage with implant-supported restorations was 87.80 % (SD ± 13.79). Mean OHIP score was 2.82 (SD ± 5.44). The results of OHIP 14 and VAS scores resulted that patient satisfaction with fixed implant supported prosthesis was high in all patients. Conclusions: The fixed implant-supported restorations served high satisfaction results according to the OHIP 14 and VAS results. These restorations has a positive effect to the quality of life for oral health (OHRQoL). Key Words: Quality of life; dental implant; denture ; partial; fixed
Purpose:
This systematic review aimed to evaluate the medium-term (3-year) overall survival and success rates, marginal bone loss and different biological parameters displayed with one-piece zirconia implants.
Materials and methods:
Electronic searches were conducted of the MEDLINE (via PubMed), Scopus (Elsevier), Cochrane Library (Wiley) and Web of Science (Clarivate Analytics) databases and manual searching was also performed for relevant articles published up to 14 November 2022. The review included human studies with a minimum of 10 subjects and/or 20 implants and with a follow-up period of at least 3 years after implant placement.
Results:
Twelve studies met the inclusion criteria and were included for analysis, giving a total of 1,621 one-piece zirconia implants. Eleven studies were included to perform a meta-analysis of survival rates, and six for success rates and marginal bone loss. The survival and success rates at the 3-year follow-up were 94.4% (95% confidence interval 90.4%-98.4%; P < 0.001) and 91.6% (95% confidence interval 84.2%-98.9%; P < 0.001), respectively, and marginal bone loss was 0.231 mm (95% confidence interval 0.190-0.272; P < 0.001).
Conclusions:
One-piece zirconia implants appear to be a reliable option for restoring missing teeth, obtaining an implant survival rate of 94.4% and a success rate of 91.6% after a follow-up period of at least 3 years. Moreover, the results showed acceptable rates of marginal bone loss and adequate biological parameters.
This study aims to show a surgery-prosthetic resolution of complex atrophic maxillae with bone grafts, implants, and fixed implant prostheses in an elderly patient with radiographic follow-up. This article describes the clinical case of an elderly woman, 65 years old, who lost all superior teeth when she was 25 years old and had severe atrophic maxillae. Due to the maxillae, bone situation was planned an osteotome for sinus floor elevation and an allogeneic bone graft followed. After 16 months of bone integration, seven osseointegrated implants were placed. After 6 months of implant osseointegration, a complete fixed implant denture. Is it possible to conclude that using advanced surgical and prosthetic planning is possible to recover the esthetic and function of a severe and complex clinical case.
Unlabelled:
The purpose of this outcome audit is to evaluate the influence of the clinicians' experience on the outcome of dental implants. In addition, it is to identify the associated risk factors that might influence the success and survival of these implants.
Methodology:
The records of patients treated with SLA/SLActive Straumann implants were screened. This enabled us to have a minimum of 12 months of follow-up. Eligible patients, according to the inclusion criteria, were contacted and invited to undergo a follow-up assessment. Success was accounted for and defined in a comprehensive manner by considering four different categories: implant perspective, peri-implant soft tissue perspective, prosthetic perspective, and patient satisfaction. The patient investigations included a clinical examination of the implant mobility, suppuration, width of keratinized mucosa, probing depth, plaque accumulation, prosthetic complications, and patient satisfaction. In addition, a periapical radiograph was taken to evaluate bone loss and peri-implant radiolucency. The data were analysed using SPSS version 26.
Results:
Thirty-eight patients with 84 SLA/SLActive Straumann implants were available for the assessment. The mean age of the patients at implant surgery was 49.05 ± 13.19 years. Over the mean follow-up period of 26 months, no implant fractures were noted. Overall, eight implants were considered failures (9.5%). Two out of six patients with a history of periodontitis (HoP) and two out of five smokers exhibited failed implants. The patients' satisfaction responses showed that all the responses were statistically higher than the test median value of three. The median value of general satisfaction using a visual analogue scale was 9 out of 10.
Conclusions:
The implants placed on partially and fully edentulous patients revealed high survival and success rates (100% and 90.5%, respectively) at a mean follow-up time of 26 months. It can be concluded that the implant practise among trainees in the programme is satisfactory. A history of periodontitis and a lack of patient compliance with supportive periodontal therapy in some cases have been shown to be risk factors associated with increased implant failure, mainly peri-implantitis.
Öz Amaç: Çalışmamızın amacı; maksilla anterior bölge tek diş eksikliklerinde uygulanan dental implantları kontralateral dişlerle klinik, radyografik ve estetik olarak karşılaştırmak ve hasta memnuniyetini değerlendirmektedir. Gereç ve yöntemler Çalışmamıza fakültemizde 2010-2020 yılları arasında tek diş eksikliğinde dental implant uygulaması yapılmış ve kontralateral dişi mevcut olan 40 hasta dahil edilmiştir. Hastaların rutin kontrolleri sırasında peri-implant ve periodontal sondlama derinliği (PD), plak indeksi (PI) ve gingival indeks (GI) değerleri, sondlamada kanama (SK) varlığı, dişeti çekilmesi (DÇ) miktarı kaydedilmiştir. Her hastaya görsel analog skala (VAS, Visual Analog Scale) soruları yönelterek hasta memnuniyeti ve estetik değerlendirme gerçekleştirilmiştir. İmplant destekli restorasyonun estetiğini değerlendirmek içinde de Komplex estetik indeks (KEİ) kullanılmıştır. Bulgular Diş ve implant bölgelerinde klinik parametreler açısından anlamlı fark görülmemiştir. İmplant bölgesinde istatiksel olarak anlamlı olarak fazla sondalama derinliği tespit edilmiştir. Keratinize diş eti miktarı ise diş bölgesinde istatiksel olarak anlamlı derecede daha fazla olduğu gözlemlenmiştir. İmplant üstü restorasyonların KEİ ile değerlendirilmesinde ise çoğunlukla riskli ama klinik olarak kabul edilebilir olarak gözlenmiştir. Hastaların ortalama memnuniyet skoru 8,44±1.11’dir. Hastaların büyük çoğunluğu tedaviden memnuniyet skorunun anlamlı olarak yüksek olduğu görülmüştür. Sonuç İmplant ve diş bölgesi arasında periodonal indekslerde anlamlı farklılık bulunamıştır. Keratinize diş eti miktarı ve cep derinliği açısından iki bölgede farklılıklar mevcuttur. Estetik olarak implant üstü protezler kabul edilebilir düzeydedir. Hastalar uygulanan tedaviden memnun ve tedaviyi tavsiye etmektedirler.
Purposes:
This aim of this cross-sectional study was to investigate the factors associated with patient satisfaction in patients with a dental implant-supported single crown or fixed prosthesis.
Materials and methods:
One hundred and ninety-six patients with dental implants functioning more than 1 year were provided with a 13-question questionnaire to report their satisfaction regarding the functional aspects, aesthetic outcome, cleansing ability, general satisfaction, treatment cost, and overall satisfaction. Patient satisfaction was reported using a visual analogue scale (VAS). The association of these variables and each aspect of satisfaction were investigated by multivariate linear regression analysis.
Results:
One hundred forty-four of 196 patients reported high overall satisfaction (VAS > 80%). All aspects of patient satisfaction levels were very high (mean VAS > 80%), except for satisfaction in cleansing ability and treatment cost (mean VAS < 75%). The patients with a history of implant failure had significantly lower satisfaction in the functional aspects, aesthetic outcome, and general satisfaction than patients without implant failure (p ≤ 0.001). The subjects who experienced mechanical complication were less satisfied with treatment cost (p = 0.002). Sinus augmentation negatively affected functional satisfaction compared with individuals without sinus augmentation (p = 0.041). The subjects with a higher income or a posterior implant had significantly higher overall satisfaction (p = 0.003 and p < 0.001, respectively). Moreover, restoration by specialists positively affected general satisfaction compared with being restored by post-graduate students (p = 0.01).
Conclusion:
Patients restored with a dental implant-supported single crown or fixed prosthesis had very high patient satisfaction. Implant failure, mechanical complication, and sinus augmentation negatively affected patient satisfaction in multiple aspects. In contrast, the factors positively affecting patient satisfaction were a posterior implant, patient's monthly income, and restoration by specialists. These results have to be interpreted with care due to the cross-sectional study design.
Subject. There are methods for assessing dental and maxillary (including implant) prosthetics. Objectives. The goal is to create our own method for assessing the degree of satisfaction with the results of prosthetics, which will be compact, easy to use, perform calculations, while being objective, clear and conclusive. Methodology. Three well-known validated methods for assessing the results of dental prosthetics were analyzed: the Likert scale, Denture Satisfaction Questionnaire (DSQ) and Visual Analogue Scale (Wolfart S. e.a., 2006). The above validated scales-questionnaires were the basis for creating our own method for assessing the degree of satisfaction with the results of prosthetics. The developed scale was clinically tested. The study involved 46 people (9 men; 27 women) aged 59 to 76 years (mean age 68.2 ± 5.1 years). Results. An initial successful validation of the method was carried out. With rare exceptions, after the briefing, all the subjects quickly enough (5–7 minutes) coped with filling out the scale-questionnaire without experiencing any apparent difficulties. Parallel use in the same patients of the questionnaire by Wolfart S. (2006) and Mericske-Stern R. et al. (2009) demonstrated a significant general focus and an average degree of closeness of these questionnaires with the author's method (respectively: ; ). Conclusions: 1. A method for assessing patient satisfaction with the results of dental prosthetics has been developed. 2. A distinctive feature of the questionnaire is the scale's compactness, relative ease of use and calculations. 3. The proposed method can be used in a clinical setting, with an expert assessment of the quality of prosthetics, as well as in the work of conflict expert commissions.
Objective:
The objective of the study was to assess patient-reported preferences and outcomes in patients rehabilitated with both an implant-supported single crown (ISC) and a tooth-supported fixed dental prosthesis (FDP).
Materials and methods:
The electronic journal system at the Faculty of Dentistry, University of Oslo, was searched to find patients presenting both an ISC and an FDP replacing no more than two teeth between abutments. Identified patients that agreed answered a questionnaire followed by a clinical examination. Descriptive statistics was calculated.
Results:
Thirty patients were included. The mean function time was 11.8 years for FDPs and 6.6 years for ISCs. All but three patients were satisfied with both rehabilitation modalities. No patients were unsatisfied with aesthetics or function of either rehabilitation. All patients reported satisfactory function of their restorations and reported chewing without problems. The self-reported post-operative complications were few, but less than observed in the clinical examinations.
Conclusions:
More patients reported food impaction with their FDP as compared to their ISC. Function and aesthetics of FDPs and ISCs were rated similarly, but more patients found the ISC treatment more uncomfortable. Despite this finding, most patients would prefer to undergo ISC treatment if they were to replace another missing tooth.
Background:
The obesity epidemic is considered one of the main challenges for modern medicine. It has been proven that bariatric surgery is more effective than nonsurgical interventions to manage weight-related comorbidities. The general surgeon needs to understand how tooth erosion advances in gastroesophageal reflux in people who have had bariatric surgery. Dental erosion caused due to gastric reflux begins with the enamel, which is the tough, protective coating that covers our teeth. While it is tough, it is prone to an extremely acidic environment with a low pH, where it begins to soften and demineralize, gradually wearing away and exposing the more sensitive areas of the tooth. Because of the growing popularity of this subspecialty, general surgeons should develop a basic clinical and surgical understanding of these standard procedures and complications, regardless of their interest in obesity surgery.
Aim:
This cross-sectional study aimed to assess the awareness and attitude of surgeons regarding dental erosion on patients who underwent bariatric surgery.
Materials and methods:
This cross-sectional study was conducted on general surgeons from different regions of Saudi Arabia who perform bariatric surgeries. Data collection was done by sending the questionnaire to the general surgeons by different means of social media (WhatsApp, e-mail, Facebook, etc.), and it was also distributed through the Saudi Arabia Society of Metabolic and Bariatric Surgery.
Results:
A total of 25 general surgeons responded to the survey. Half of the respondents know what dental erosion is, 52%. Most of them, 72%, are not aware of the relationship between dental erosion and acid reflux or vomiting. They reported that 52% of patients complain of gastroesophageal reflux disorder.
Conclusion:
The general surgeons had inadequate awareness and attitude regarding dental erosion on bariatric surgery patients. Our findings suggest that a lack of adequate awareness and a negative attitude among general surgeons are grounds for concern and that more should be done to avoid oral health complications.
Background: Peri-implantitis is a usual finding but estimates of its prevalence fluctuate very much. This may be due to the wide variety of disease definitions. This systematic review aims to estimate the overall prevalence of peri-implantitis and the effect of different study designs, function times, and use of probing depth on prevalence rate.
Methods: Following electronic and manual searches of the literature published from January 2005 to December 2020, data were extracted from the studies fitting the study criteria. Fifty-seven articles were included in this study.
Results: Prevalence of peri-implantitis was 19.6% (95% CI, 15.25-24.75) at the patient-level, and 12.39% (95% CI, 9.46-15.43) at the implant-level and it remains highly variable even following restriction to the clinical case definition. The use of probing depth like diagnostic criteria affected the prevalence data.
Conclusion: The results indicate that it remains essential the identification of the diagnostic markers for more accurate disease classification.
Purpose:
To investigate the clinical performance of implant-supported dental prostheses (ISDPs), this retrospective clinical study observed influencing factors on survival of the prostheses and necessary maintenance treatments during the observation time and complications of the dental implants.
Materials and methods:
Patients who were provided either with fixed implant-supported dental prostheses (FISDPs) or telescopic-retained removable implant-supported dental prostheses (TR-RISDPs) were included in this retrospective clinical study. Potential influencing factors on the survival probability of the prostheses were observed using Kaplan-Meier analysis: patient sex, type of prosthesis, location, dentition in opposing arch, participation in follow-up visits, and whether the patient had a previous history of oral cancer. The type and number of maintenance treatments and complications of dental implants were also analyzed.
Results:
A collective of 473 patients who were provided with either FISDPs (n = 320) or TR-RISDPs (n = 153) and 1,499 implants were included in the study. 6.6% of the prostheses (24 FISDPs and 7 TR-RISDPs) had to be replaced, and 6.3% of the implants (n = 45) were lost. The calculated 5-year survival probabilities were 87.4% for FISDPs and 95.5% for TR-RISDPs. FISDPs in patients who also had ISDPs in the opposing arch showed the lowest survival probabilities (P < .05). TR-RISDPs in patients who regularly attended follow-up visits showed the highest survival rates (P < .05). Maintenance treatments had to be performed at an earlier stage for patients with TR-RISDPs, and especially for TR-RISDPs located in the mandible (P < .05).
Conclusion:
FISDPs and TR-RISDPs showed good survival rates in this study. However, when planning FISDPs, the dentition in the opposing arch should be considered to prevent possible failure. TR-RISDPs indicate a higher need for aftercare measures, especially in the early years of function. Regular attendance of follow-up visits is still a decisive factor for success.
Objective
The purpose of this study was to compare patient-reported outcomes and experiences (PROs and PREs) among three techniques of dental implant placement, including (a) conventional freehand, (b) dynamic, and (c) static computer-aided implant surgery (CAIS).
Material and methods
Ninety patients were randomly assigned to have dental implant placed with one of the three protocols. Participants were asked to fill in a series of self-administered questionnaires assessing (1) preoperative expectations, (2) postoperative healing events during the first week after surgery, and (3) experiences and overall satisfaction with the procedures at 2 weeks. Differences within the groups were analyzed by Wilcoxson signed-rank test. Kruskal–Wallis test was used for comparisons among the three groups.
Results
Eighty-eight patients completed the study. Patients' expectations on chewing difficulty, the postoperative experience of duration of pain, speaking limitations, and impact on routine activities were significantly different among groups (p = 0.04, 0.01, 0.038, and 0.046, respectively). Overall, patients appeared to significantly underestimate the duration of postoperative pain (p = 0.035) and swelling (p = 0.001). No significant difference in magnitude of postoperative pain, swelling, and painkiller consumption was found among the groups. The short-term functional limitations after surgery were deemed acceptable by most participants and 89% were satisfied by the overall procedure.
Conclusions
Surgical placement of dental implant with conventional freehand, static, and dynamic CAIS techniques did not result in any difference in the level of postoperative pain and swelling, and appeared to lead to equal levels of satisfaction as expressed by the patients postoperatively.
Introduction Dental implants are a popular option for replacing missing teeth. When searching for information regarding dental implants, patients may first look to their dental practice website. The aim of this study was to assess the variance of patient information provided regarding implant complications on dental implant practice websites.
Materials and methods Inclusion criteria for this study were dental practices within the Greater Glasgow & Clyde health board and practices with an active website. Completeness was assessed using a six-point score based on the British Association of Oral Surgeons 'Information for patients' leaflet and Association of Dental Implantology 'Considering dental implants? - A patient's guide to dental implant treatment' leaflet.
Results In total, 90.7% (n = 107) of practices provided accessible implant information on their websites. However, only 37.3% (n = 44) mentioned one or more specified dental implant complications. Pain/discomfort was the most frequently stated complication (n = 41/118); implant failure was only mentioned by 19 practices (16%). The mean number of complications mentioned by the 118 practices offering dental implants was 1.1.
Discussion As implant dentistry grows, there may be concerns over patient expectations. To overcome lack of quality assurance on the internet, dentists can provide factual information on their websites. They should be aware of their duty to provide material that is accurate, honest, informative and not potentially misleading.
This article presents the components and treatment protocol for the Astra Tech Single-Tooth Implant System, whose concept and design has been tailored to the specific needs of single-tooth replacement. Since July 1991 the author has consecutively placed 39 single-tooth implants, of which 27 are restored and in function. To date there have been no recorded fixture failures, and the bone loss seen around fixtures in the first and subsequent years is insignificant. Two crowns have had to be replaced, and three were recemented over the follow-up period. All patients have expressed considerable satisfaction with their restorations from an esthetic perspective, and the system has been shown to avoid undesirable complications when employed in patients with normal masticatory function.
Because osseointegration has been successful in the management of completely edentulous patients, it is tempting to extrapolate these results and infer the success of single-tooth replacement. Yet there are major clinical differences between edentulous and partially edentulous patients. This prospective study is a follow-up to one started at the University of Toronto in 1986. The purpose of this study was to continue longitudinal assessment of implant-supported single-tooth replacements.
The original study comprised 42 consecutively treated patients with a total of 49 implants. The patient group consisted of all University of Toronto patients treated with single Br nemark implants whose treatment had been completed more than 5 years previously (i.e., before 1994). No exclusion criteria applied. One implant was not osseointegrated at the time of stage 2 surgery, and 6 patients with reportedly successful osseointegrated implants were not available for recall. For the preparation of this report, 30 of the remaining 42 implants were assessed during recall examinations. Assessment of success was based on published criteria. In addition, soft-tissue appearance, implant immobility, occlusal contacts in centric occlusion and excursions, proximal contacts, tightness of crown and abutment screws, and patients' responses on satisfaction questionnaires were evaluated.
The criteria defining success of treatment in implant prosthodontics were met by all 30 of the single-tooth implants, which had been in place for 5 or more years. Each implant was immobile, and each had a mean vertical bone reduction of less than 0.2 mm annually.
Stable long-term results can be achieved with single Brånemark implant-supported crowns.
127 Tübingen (Frialit®) implants have been clinically evaluated for a 10 year period. The implants were placed in the anterior region of the maxillae of 101 patients to replace lost incisors, cuspids and premolars. Seventy-seven implants were placed within 3 months after loss of a natural anterior tooth, resulting in the preservation of the volume of the alveolar ridge and the contour of the surrounding soft tissues. This preservation of the volume of the alveolar ridge was due to the fact that the Tübingen implants have conical shapes and sizes, equal to those of the roots of natural teeth.
The dentine-like colour and the biological properties of the bio-inert Al2O3 implant-material, in most of the cases was an advantage to the aesthetics of the prosthetic restorations and to the condition of the soft tissues in the permucosal area. The Tübingen implant is placed with a one-phase technique implying special care for the temporary restorations to avoid premature loading. Also prevention of overloading the ceramic material by the fixed restoration needs special attention in the construction of posts, cores and crowns. The overall survival-rate in this study with a mean follow-up of 4–5 years was 87%. Patient and dentist satisfaction was high.
In a randomized, controlled clinical trial, 110 edentulous patients with atrophic mandibles were treated with International Team for Oral Implantologydental implants using three different treatment strategies: a mandibular overdenture supported by two implants with ball attachments, two implants with an interconnecting bar, or four interconnected implants. The patients' opinions and their social functioning were evaluated by means of a questionnaire directly before and 16 months after treatment. Before treatment most patients had complaints about the retention of their mandibular denture. Sixteen months after treatment almost all patients were generally satisfied with their dentures. Since no significant difference was found between the three treatment strategies, it was concluded that simple implant treatment such as an overdenture retained by two ball attachments is sufficient.
The results of the implant overdenture treatment in the maxilla remains inferior to those in the mandible. Different reasons have been alluded to, such as bone quality and quantity, number of implants, as well as the prosthesis design.
To investigate the latter, a new design for the rehabilitation of the resorbed maxillae was set up.
Thirteen patients were selected and provided with four endosseous maxillary implants, splinted with a rigid-cast bar.
After a mean loading time of 3 years, six implants were lost; three at abutment and another three shortly after abutment connection, resulting in a cumulative success rate of 88.6% at year 4. A mean marginal bone loss of 0.3 mm was observed within the first year. After the first year, the marginal bone level, the attachment level, and the Periotest scores hardly changed. The main prosthetic complication was the frequent need to renew or to activate the attachments. A strong improvement in patient satisfaction was observed when compared with the old conventional denture.
Within the limits of this study, the outcome confirmed that, on a medium-term base, implant-retained hinging overdentures on four implants were promising.
An investigation of factors controlling healing and long term stability of intra-osseous titanium implants to restore masticatory function in dogs revealed that an integrity of the good anchorage of the implant requires: (1) Non-traumatic surgical preparation of soft and hard tissues and a mechanically and chemically clean implant. (2) Primary closure of the mucoperiosteal flap, to isolate the implant site from the oral cavity until a biological barrier has been reestablished. (3) Oral hygiene to prevent gingival inflammation. Provided these precautions are taken, it is possible to subject dental prostheses, connected to the implants, to unlimited masticatory load. With these precautions such implants were found to tolerate ordinary use in dogs for periods of more than 5 years without signs of tissue injury or other indications of rejection phenomena.
Macroscopic clinical investigation, stereomicroscopy, roentgenography and light microscopy of the implant site in situ and after removal from the body showed that the soft and hard tissues had accepted the implant and incorporated it without producing signs of tissue injury. In fact the bone appeared to grow into all the minute pits and impressions in the surface of the titanium implant, without any shielding layer of buffer tissue at all.
These findings indicate that dental prostheses can be successfully anchored intra-osseously in the dog suggesting that its possible clinical use in oral rehabilitation should be given unprejudiced consideration.
Sixty-four edentulous patients with severe conventional denture problems who had been treated with 218 one-stage titanium plasma sprayed (TPS) screw implants and new overdentures were clinically evaluated and questioned on their experiences with treatment up to 6 years after implant insertion. The results demonstrated that only seven of the implants had failed during this period, resulting in a success rate of 97%. Most of the patients (95%) were satisfied with their new overdentures, and almost all patients (98%) found that their new dentures fit comfortably. Only 3% of the patients treated would not recommend that others undergo similar treatment.
Seventeen consecutive selected patients rehabilitated by means of a full maxillary bridge on osseointegrated implants ad modern Brånemark were evaluated over a 3-yr period. Besides a subjective evaluation by means of a questionnaire an examination of the occlusal relationship, chewing force, chewing efficiency and interocclusal threshold level was performed before, immediately after, 3-6 months after, and finally 3 yr after bridge installation. All subjects were very pleased with the oral rehabilitation. The chewing force and the chewing efficiency development increased over time, while the threshold level for interocclusal detection remained unchanged. The clinical dysfunction index according to Helkimo indicated that there was no marked change in signs of dysfunction of the patients' masticatory systems during the observation period. From the present longitudinal investigation one can conclude that the replacement of a full maxillary denture with a fixed prosthesis on osseointegrated implants, facing a natural dentition or an osseointegrated implant supported bridge in the opposite jaw, leads to a progressive increase of chewing efficiency and chewing force, and a constant subjective improvement of jaw function, while no masticatory dysfunction seems to occur during the observation period.
To clarify more of the tactile function of oral implants, both an interocclusal thickness detection and discrimination task were carried out in 4 different test conditions on 37 patients: t (tooth)/t, i (implant)/t, i/i and d (denture)/o (overdenture supported by implants). For the interocclusal detection of steel foils, the 50% detection threshold level (RL) in the 4 conditions was 20, 48, 64 and 108 microns, respectively, which indicates significant differences. The ability to discriminate interdental thickness differences was tested with a 0.2 and 1.0 mm standard. It was evaluated as the 75% discrimination level (DL). In the 0.2 mm discrimination task, corresponding DL-values for the t/t, i/t, i/i and d/o condition were 25, 55, 66 and 134 microns, whereas the 1.0 mm standard gave values of 193, 293, 336 and 348 microns, respectively. All results differed significantly from each other (p less than 0.05) except for the i/i-d/o comparison of the 1.0 mm discrimination task where the difference was negligible. The present findings indicate that the tactile sensibility of implants is reduced with regard to natural teeth. Remaining receptors of the peri-implant tissues might play a compensatory role in the decreased exteroceptive function.
A fixed partial denture is preferred as a prosthetic restoration supported by tissue-integrated oral implants. However, there are occasions, especially in restoring an edentulous maxilla, when a fixed partial denture does not satisfy a patient's requirements for esthetics, good phonetics, proper oral hygiene, and oral comfort. A removable hybrid prosthesis attached to a bar that is conventionally fixed to tissue-integrated implants ad modum Brånemark was therefore designed to satisfy such needs and to meet requirements for splinting of the implants. Following the placement of prostheses, patients were asked to give their opinion on the comfort, phonetics, and esthetics of the prosthesis by marking a visual analog scale. The results indicate a successful initial outcome of the treatment.
Maxillary prosthetic restorations on osseointegrated implants are often problematic because of implant location, orientation, and need for lip support. A new design for a hybrid maxillary prosthesis that will provide good esthetics and phonetics, as well as ensure optimum conditions for oral hygiene and patient comfort, is proposed. The design includes separate support, lateral stabilization, and retention. Support is derived from elevated areas at the midline and on the extensions of a bar screwed to dental implants ad modum Brånemark. Lateral stabilization is obtained by a removable framework closely fitting the bar. Four precision attachments provide adjustable retention without influencing support. Technical aspects of the procedure are described.
Glycosaminoglycans (GAG) in gingival crevicular fluid (GCF) samples were determined by cellulose acetate electrophoresis and densitometric scanning. Two GAG bands, hyaluronic acid and chondroitin-4-sulphate (C4S), were detected in GCF from implants, similar to the profile from teeth. High GCF volumes and GAG contents, notably C4S, may reflect postoperative alveolar bone responses, particularly resorption, at different stages of healing and function of successful implants. They may also indicate adverse tissue changes in failing implants. A comparison of crowned implants and matched teeth suggests that the periodontal ligament contributes to the GCF GAG profile. This may be a useful laboratory method of monitoring implants to detect adverse tissue responses at an early stage.
Eighty-six consecutive patients, provided with 84 resilient and two nonresilient overdentures (six in the upper and 80 in the lower jaw), were examined. The overdentures were supported by a total of 173 osseointegrated titanium fixtures (the standard Branemark abutment), with a mean loading time of 19.1 months (range 4 to 48 months). In each jaw only two fixtures anchored the overdentures. No failures occurred during the observation period but two fixtures were lost before loading. The radiographic annual bone loss around fixtures in the lower jaw was -0.8 mm for the first year and less than -0.1 mm for the following years. The change in marginal bone height did not correlate with parameters such as the occlusion and articulation pattern, the presence or absence of a soft liner around the abutments, and the magnitude of the interabutment distance. The patients' reactions to overdenture treatment were, on the whole, positive concerning chewing function, phonetics, and comfort. The need for maintenance care of the clip-bar attachment was minimal.
This study measured the psychologic attitudes of patients to implant prostheses and compared their status before and after therapy. Questionnaires were mailed to 95 patients with implants placed and restored at a university dental school. The implants had been in position for an average of 2.2 years. The patients had previously worn removable complete or partial dentures. Different questions addressed eating, speaking, relationships, employment, social life, esthetics, maintenance, and overall dental health. Sixty-one questionnaires were returned (64%). Satisfaction with the implant prosthesis was significantly greater than for the denture (p less than 0.0001). Responses to individual questions indicated that confidence was improved (88%), implants were worth the trouble (97%), the procedure would be worth repeating (89%), and overall dental health was improved (98%). This survey suggests that patients' attitudes toward their dental health improve significantly after treatment with implant prostheses.
A questionnaire was sent to all 189 edentulous patients with denture adaptation problems who were treated with fixed prostheses on osseointegrated oral implants during the period 1965-1978. One hundred and fifty-two patients (80%) responded. Practically all had adapted well to the prostheses and were most satisfied with the rehabilitated oral function, including chewing ability. Four out of five patients regarded the bridge as part of their own body instead of a foreign object, and 90% would not hesitate to have the treatment performed again, if necessary. Parallel with the improved oral function the patients reported a definite reduction of psychosocial problems associated with their previous oral invalidity, and increased security and self-esteem.
An investigation of factors controlling healing and long term stability of intra-osseous titanium implants to restore masticatory function in dogs revealed that an integrity of the good anchorage of the implant requires: (1) Non-traumatic surgical preparation of soft and hard tissues and a mechanically and chemically clean implant. (2) Primary closure of the mucoperiosteal flap, to isolate the implant site from the oral cavity until a biological barrier has been reestablished. (3) Oral hygiene to prevent gingival inflammation. Provided these precautions are taken, it is possible to subject dental prostheses, connected to the implants, to unlimited masticatory load. With these precautions such implants were found to tolerate ordinary use in dogs for periods of more than 5 years without signs of tissue injury or other indications of rejection phenomena.
Macroscopic clinical investigation, stereomicroscopy, roentgenography and light microscopy of the implant site in situ and after removal from the body showed that the soft and hard tissues had accepted the implant and incorporated it without producing signs of tissue injury. In fact the bone appeared to grow into all the minute pits and impressions in the surface of the titanium implant, without any shielding layer of buffer tissue at all.
These findings indicate that dental prostheses can be successfully anchored intra-osseously in the dog suggesting that its possible clinical use in oral rehabilitation should be given unprejudiced consideration.
Of the various methods for measuring pain the visual analogue scale seems to be the most sensitive. For assessing response to treatment a pain-relief scale has advantages over a pain scale. Pain cannot be said to have been relieved unless pain or pain relief has been directly measured.
This study conducted a longitudinal prospective clinical study of the single-crystal sapphire (Al2O3) cylindrical screw-shaped endosteal dental implant, and attempted to establish clinical parameters to evaluate implant success or failure. Twenty-eight mandibular implants (17 patients) were placed. After six weeks' healing, 23 implants in 15 patients served as distal abutments for fixed prostheses (baseline). Implants were evaluated for bleeding index, crevicular fluid volume index, plaque accumulation index, radiographic index, mobility index, and patient comfort. Any implant failing in three of these criteria or implants removed were judged as failures. After 10 years, of the 21 baseline implants recalled (two implants were lost to recall), 17 were fully functional, for an 81% success rate. The use of qualitative and quantitative clinical evaluation parameters as utilized in this study appears to be important and useful in assessments of the clinical serviceability of dental implants. These parameters can be used in human clinical trials as well as in experimental animal studies.
This paper presents the treatment results and experiences gained from a retrospective study of patients treated with the IMZ osseo-integrated implant system and mandibular overdentures. Patients experiencing problems wearing conventional dentures were assessed by the implant team and 65 cases were treated with 154 endosseous implants placed in the edentulous mandible. Two to four implants were placed in each case and in addition some patients have had augmentation of the mandible with hydroxyapatite. The definitive mandibular prostheses were supported by both implants and the residual ridges. A variety of retention systems were utilised, which included different types of bar and clip, stud attachments, and magnets. The patients have been followed up regularly and evaluated after periods of between one and six years. Six implants have failed over this time resulting in a success rate of over 96%. Most patients expressed a high degree of satisfaction with their new overdentures. There was, however, a considerable burden of maintenance care required for the patient group examined. The findings demonstrate that implant retained overdentures offer a highly effective means of oral rehabilitation for the atrophic mandible, restoring both oral function and facial form.
The aim of this study was to determine the threshold of tactile perception of endosseous dental implants and to assess the relative difference of that threshold between implants and teeth. Twenty-two subjects with implants of the ITI Dental Implant System were included in the study. All implants served as abutments for single tooth crowns and had been in function for a minimum of 1 year. A strain gauge glued to the shaft of an amalgam plugger served as a force sensor. It transformed the elastic deformation exerted onto the shaft into an electronic signal for recording. By use of the amalgam plugger, a continuously increasing force was exercised on the implants or teeth until the first sensation of touch was indicated by the patient. Statistical analysis revealed threshold values for the implants ranging from 13.2 to 189.4 g (1 g = 0.01 N) (mean 100.6; SD 47.7), while a range of 1.2 to 26.2 g (mean 11.5; SD 11.5) was found for control teeth. Thus, the mean threshold values for implants were 8.75 times higher than for teeth. This difference was highly statistically significant. A general linear models procedure was applied to determine the influence of patient age, jaw, implant position and the threshold values of teeth on the measurements obtained for implants. Only gender and the threshold values for contralateral teeth had a significant influence. These 2 parameters together explained 27% of the variability in threshold measurements. It is concluded that a more than 8-fold higher threshold value for tactile perception exists for implants compared with teeth.
The purpose of this study was to determine the effects of implant-overdenture treatment (IOT) on patients' complaints about dentures and the degree to which subjective treatment outcome could be predicted from baseline patient and treatment characteristics. Four groups of patients were distinguished: one pretreatment group, two posttreatment groups (1 year after treatment) and one reference group of denture wearers, who had not applied for any kind of treatment. They finished a questionnaire with 20 statements on denture complaints. Four scales concerning denture complaints could be distinguished and named after their underlying variables. Differences between the groups were analyzed. IOT treatment was shown to be very effective on a wide range of denture complaints. Little change was seen in patient satisfaction with regard to maxillary dentures when measured on the scales, although many patients wanted improvement in retention and stability for the maxillary denture after IOT treatment in the mandible. Sixteen percent of the denture wearers who had not applied for IOT expressed complaints regarding their mandibular dentures that matched or were more severe than those of the patients that had applied for IOT, before the actual start of treatment. Although generally the subjective treatment outcome of IOT was favorable, it could not be individually predicted from baseline patient and treatment characteristics.
127 Tübingen (Frialit) implants have been clinically evaluated for a 10 year period. The implants were placed in the anterior region of the maxillae of 101 patients to replace lost incisors, cuspids and premolars. Seventy-seven implants were placed within 3 months after loss of a natural anterior tooth, resulting in the preservation of the volume of the alveolar ridge and the contour of the surrounding soft tissues. This preservation of the volume of the alveolar ridge was due to the fact that the Tübingen implants have conical shapes and sizes, equal to those of the roots of natural teeth. The dentine-like colour and the biological properties of the bio-inert Al2O3 implant-material, in most of the cases was an advantage to the aesthetics of the prosthetic restorations and to the condition of the soft tissues in the permucosal area. The Tübingen implant is placed with a one-phase technique implying special care for the temporary restorations to avoid premature loading. Also prevention of overloading the ceramic material by the fixed restoration needs special attention in the construction of posts, cores and crowns. The overall survival-rate in this study with a mean follow-up of 4.5 years was 87%. Patient and dentist satisfaction was high.
This study reviewed the prosthodontic treatment and aftercare required by 29 patients with 32 implant-supported prostheses (12 fixed and 20 removable) placed on 107 implants. Patients were followed for 4 to 39 months. The majority of implant-supported prostheses (53%) were placed in the mandible. Visual analogue scales were used by the patients to rate their satisfaction with their prostheses and their chewing ability. Approximately one third of the patients studied required three or more relines of their existing dentures between first- and second-stage surgeries, while over half of the definitive implant-supported prostheses required a major adjustment or repair. Removable prostheses required 78% of the total repairs and accounted for 80% of those prostheses that needed repeated repairs. In general, patients were very satisfied with their implant-supported prostheses, but 17% complained of mild speech difficulties and 7% noted slight difficulty in cleaning their fixed prostheses. Overall, the short-term prosthetic management required for the implant-supported prostheses in this study was substantial, particularly with the removable prostheses, and this should be taken into account when evaluating prosthetic options.
Forty-six female patients participated in a survey study to assess the relative health status impact of implant-retained oral prostheses and conventional complete dentures. They completed a structured questionnaire based on three valid and reliable treatment outcome measures: the Dental Functional Status Index (DFSI), the Rand Mental Health Index (MHI), and elements of the Sickness Impact Profile (SIP). The implant patients were associated with significantly better characteristics in areas of oral mechanical ability, signs and symptoms, and eating. A favorable tendency emerged with respect to communication, self-care, psychosocial functioning, and role performance. The data demonstrated that for some patients there are clinically important, pervasive advantages of implant therapy, in terms of improved physical, psychologic, and social functioning. The results supported the usefulness of self-report, dentopsychosocial indicators to assist in defining treatment needs, evaluating quality and consequence of care, and addressing cost-benefit issues.
In order to satisfy the need to restore the aesthetics, phonetics and comfort and to facilitate optimal hygiene procedures, 20 edentulous patients were treated with a new concept of overdenture therapy on implants and modum Brånemark. After 24 +/- 3.5 months the patients were re-examined. They were asked to answer a questionnaire and use a Visual Analogue Scale (VAS) to give their opinion on the prosthetic treatment. The results indicate that an implant-retained overdenture in the maxilla with this design can satisfy the patients needs in aesthetics, phonetics and comfort and can facilitate oral hygiene measures.
This study reviews the long-term outcome of overdenture treatment in 64 completely edentulous patients who received 218 one-stage ITI implants during the period 1982 until 1988. The evaluation time averaged a period of 80 months, ranging from 66 to 119 months. The results indicate that no implants were lost during this period and that a minimum of surgical and prosthetic treatment was necessary to maintain the overdentures. Patient satisfaction was high and had not significantly changed in comparison with an earlier study on the same group of patients after a mean period of 18 months. The assumption that there would be significantly more complaints about retention of the maxillary denture is not affirmed by this study.
The aim of this study was to establish the treatment outcome of full denture treatment with or without implant support, in which the outcome assessment focuses on the patient's subjective evaluation ('denture-satisfaction').
A multicenter randomized clinical trial.
Thirty-two men and 118 women (mean age 56 +/- 9, range 35-84 years) participated in the study. The mean height of the mandible was 13 +/- 2 mm, measured on a lateral cephalometric radiograph. The patients were randomly assigned to either a group treated with implant-retained mandibular overdentures and a new maxillary denture, or to a control group treated with a new set of complete dentures.
Denture satisfaction was assessed using questionnaires focusing on denture-related complaints and 'a general satisfaction rate'.
Based on the baseline data, from the 'denture complaints' questionnaire six interpretable factors could be extracted. One factor did not vary following treatment and was excluded from the outcome analysis. At the 1-year evaluation three out of five factors showed significantly better scores for the group treated with implants than for the control-group. The same was found for the general satisfaction rate.
For patients with a severely resorbed mandible, overdentures retained by dental implants appear to provide a more satisfactory solution to their denture-related problems.
Conventional preprosthetic procedures have typically focused on improvement of denture base stability and retention and have ignore patients' concerns about facial appearance and articulation difficulties. Soft tissue procedures have been developed, combined with insertion of the transmandibular implant (TMI) system through a submental incision, for functional and cosmetic reconstruction of the lower face to improve speech and facial esthetics, and prevent gingival hyperplasia along the lateral posts of the implant.
The surgical procedure was evaluated in 146 patients with slight, moderate, severe, and extreme mandibular atrophy classified according to the proportion of muscle origin loss on the edentulous mandible. Preoperative, 3-month, and 1-year postoperative full-face and profile photographs were taken. Patients also were questioned about their satisfaction with their facial appearance and speech at these intervals. Gingival hyperplasia along the TMI posts was scored as present or absent.
Satisfaction with the soft tissue reconstruction in 146 patients treated according to this protocol was high, with almost every patient describing the positive comments they had received from their friends and relatives. Postoperatively, none of the patients requested a temporary denture to use during the 12-week incorporation period, although this was a common cosmetic and speech concern preoperatively. Gingival hyperplasia secondary to muscle pull was controlled satisfactorily.
With the described technique for placement of the TMI system, not only is masticatory function improved, but also the lower third soft tissues of the face are functionally and cosmetically reconstructed to the satisfaction of the patients.
This study is a two-center clinical trial with the aim to assess the treatment effects of implant-retained mandibular overdentures versus conventional complete dentures. Treatment had been assigned according to a balanced allocation method. The following criteria were used to enhance the comparability of the treatment groups: age, gender, the edentulous period of the mandible, the number of previously made mandibular dentures, the number of years having worn the present mandibular denture and the symphyseal bone height. 151 patients with severely resorbed mandibles participated in the study, they were treated at two centers. Ninety-one patients received an implant-retained mandibular overdenture (IRO) and 60 patients a conventional complete denture (CD). Since some patients refused the allocated treatment the "Intention To Treat" principle was applied. This implies that patients are evaluated in the originally allocated treatment group regardless of the actual treatment they received. Patient's experiences were evaluated before treatment and 1 yr after insertion of the new dentures. Results before treatment showed that both treatment groups were comparable: they were dissatisfied with their mandibular denture and they could hardly chew tough or hard foods. One year after insertion of the new dentures the IRO-group was satisfied with their mandibular denture, whereas only one third of the CD-group was satisfied. With respect to the chewing ability the IRO-group scored significantly better than the CD-group(P<0.0001).
The aim of the present study was to determine the tactile pressure thresholds perceived with dental implants during a three-month healing phase following implant placement (osseointegration phase). The absolute threshold of tactile perception was measured in a group of patients 1 week, 1, 2 and 3 months following implant placement (ITI Dental Implant System, Straumann AG, Waldenburg, Switzerland). Contralateral and neighbouring teeth were measured at the same time. For determination of the axial forces exerted on the implants and teeth, and electronic device with semi-conductor strain gauges was used (Hämmerle et al. 1995). The results demonstrated mean thresholds of tactile perception for the implants of 160.2 g (SD 61.7 g, range 77 approximately 283 g) at 1 week, 133.4 g (SD 51.9 g, range 32 approximately 239 g) at 1 month, 147.9 g (SD 53.5 g, range 70 approximately 257 g) at 2 months, and 146.9 g (SD 57.4 g, range 77 approximately 248 g) at 3 months. Statistical analysis using Student's paired t-test revealed no significant differences between the values over time. The control teeth exhibited mean values for tactile perception of 13.1 g (SD 9.6 g, range 5 approximately 47 g) at 1 week, 10.2 g (SD 6.4 g, range 4 approximately 29 g) at 1 month, 14.8 g (SD 15.9 g, range 2 approximately 58 g) at 2 months, and 15.4 g (SD 12.2 g, range 3 approximately 36 g) at 3 months. Again, these values did not differ significantly from each other and indicated the absence of systemic alterations in perceived pressure threshold over the observation period. The mean perceived pressure threshold was more than 10 times higher for implants than for natural teeth (P < 0.001) at all observation times. It is concluded that the absolute threshold of tactile perception with dental implants during the phase of osseointegration is not affected by bone and soft tissue healing taking place during the time period.
Treatment of tooth loss in the anterior maxilla can involve difficult functional, esthetic, and psychologic problems, especially in young patients with otherwise good dentition.
The purpose of this study was to provide a preliminary comparative evaluation of two implants (ITI and Astra) in single-tooth restorations.
This prospective study of 102 single-tooth replacements with 56 ITI and 46 Astra dental implants was performed in 82 patients at the Finnish Student Health Service Foundation. One Astra implant was lost before loading. The overall survival rate of the implants was 97.8% for Astra implants and 100% for the ITI system. After the initial healing period of at least 6 months, the remaining 101 implants (56 ITI, 45 Astra) were free of periimplant infection and revealed no detectable mobility. Radiographs did not reveal signs of periimplant radiolucencies. All 101 implants received single-tooth crowns.
Periimplant parameters and acceptable implant function were examined and demonstrated satisfactory results with preestablished clinical parameters and radiographs at 1 year. During the observation time the mean marginal bone loss was 0.13 mm with Astra implants and 0.11 mm with ITI implants. Subjectively all patients were satisfied with their single-tooth restorations supported by either ITI or Astra dental implants.
The favorable results of this short-term study support the application of the two implant systems for single-tooth restorations, especially in the anterior region of the maxilla.
In a randomized, controlled clinical trial, 110 edentulous patients with atrophic mandibles were treated with International Team for Oral Implantology-dental implants using three different treatment strategies: a mandibular overdenture supported by two implants with ball attachments, two implants with an interconnecting bar, or four interconnected implants. The patients' opinions and their social functioning were evaluated by means of a questionnaire directly before and 16 months after treatment. Before treatment most patients had complaints about the retention of their mandibular denture. Sixteen months after treatment almost all patients were generally satisfied with their dentures. Since no significant difference was found between the three treatment strategies, it was concluded that simple implant treatment such as an overdenture retained by two ball attachments is sufficient.
Successful rehabilitation of the edentulous condition requires functional and psychosocial adaptation by the patient. Quality of life is markedly affected by the amount of satisfaction or dissatisfaction with their dental therapy. Patient concerns are primarily related to comfort, function, and esthetics. When these do not meet the patients expectations, anxiety, insecurity, diminished self-esteem, and introversion are typical psychosocial responses.
The objectives of the study were to assess the patient's subjective feelings about: (a) comfort, (b) function, (c) esthetics, (d) speech, (e) self-image, and (f) overall dental health with their existing complete dentures, and after implant therapy and prosthodontic rehabilitation.
Two health-related quality of life (HRQL) questionnaires were developed to evaluate the effectiveness of dental implant therapy; one dealing with their feelings about their conventional complete dentures, and the second dealing with implant therapy. The first questionnaire was administered with supervision before receiving implant treatment. The second questionnaire was administered within 1 year after completion of prosthetic rehabilitation. Twenty-six patients who received implants to support a mandibular prosthesis and a new maxillary denture formed the experimental population.
Discriminative and evaluative analysis of subjective patient responses provided reliable, accurate, and reproducible results. Assessment of subject feelings before and after implant therapy and prosthodontic rehabilitation demonstrated significant differences when before treatment responses were compared with the responses after therapy.
Significant differences for comfort, function, speech, esthetics, self-image, and dental health were demonstrated when conventional complete dentures and dental implant therapy were compared. HRQL data provided scientific evidence of an improved quality of life after dental implant therapy (p < 0.000).
In this study, patient opinion on oral rehabilitation by means of Brånemark implants was investigated. All patients were referred to a periodontal clinic for implant installation and treated by one and the same operator. Prosthetic restorations were performed by dentists, who had no previous experience with prostheses on implants, but had completed a postgraduate training course. Patient opinion was obtained through questionnaires, pertaining to satisfaction and oral function. A comparison was made between pre-implant situation, short-term (< 4 months) and long-term functioning (3 years) with the implant-restorative rehabilitation. In total, 61 patients participated in the study; 23 received a full lower arch bridge and 18 a full upper arch bridge, while 20 patients got partial bridges. Of 298 installed implants, 7 failed at abutment connection (2.3%) and 1 during the 3-year follow-up interval (0.3%). The study results indicated that a great majority of patients were very satisfied with the treatment. Comfort with eating, aesthetics, phonetics and overall satisfaction improved significantly and nearly all patients said that they would undergo the treatment again or recommend it to others. Patients experienced their implants as "natural" teeth. The conclusion is that rehabilitation ad modum Brånemark, even in the hands of non-specialized dentists, can be of high quality, improving oral function and satisfying the needs and demands of patients.
Maxillary bone reconstruction in combination with placement of dental implants is a treatment modality reported since 1980 for patients suffering from maxillary atrophy and difficulties with wearing removable prosthesis. This study reports on patient experience and satisfaction among 88 consecutive patients concerning surgical and prosthetic aspects of their treatment. A questionnaire was used to gather the data. Patient satisfaction was measured on a scale from 1 to 5 (1 = bad/few, 5 = very good/much). The satisfaction index with regard to the total treatment was 4.1 +/- 0.9. A total of 90% of the patients responded that they would go through the treatment again or recommend the treatment to a friend if necessary. The post-operative pain index scored 2.6 +/- 1.2. The acceptation of the post-operative pain at the crista iliaca was 86.1% and of the maxilla 89.9%. It is concluded that the results of measurements of patient satisfaction after maxillary bone reconstruction in combination with placement of dental implants were acceptable.
Prosthetic outcome and patient satisfaction were evaluated in order to investigate whether there is a need or advantage to splint two implants in the mandible retaining a hinging overdenture. This study included 36 fully edentulous patients randomly divided into three groups according to the attachment system they received: magnets, ball attachments or straight bars (reference group). None of the implants failed during the whole observation period in any of the groups. After 5 years of observation, the Bar group presented the highest retention capacity and the least prosthetic complications but revealed more mucositis and gingival hyperplasia. Patient satisfaction rated similar for all groups although the Magnet group showed lower retention forces. All patients would repeat the same treatment even though the majority of the Magnet group would prefer a more retentive solution because of limited denture stability.
The aim of this prospective randomized controlled clinical trial was to evaluate and compare clinical aspects and satisfaction during the first year following treatment and consecutively the change in treatment during the next 4 years of follow-up. Patients were allocated to one of the following treatment modalities: an implant-retained overdenture (IRO-group, 2 endosseous implants, n = 61) or a complete denture (CD-group, n = 60). One year after placement of the denture, unsatisfied patients of the CD-group got the opportunity for a retreatment including an implant-retained overdenture. In the IRO-group 4 implants were lost during the first year and again 4 implants were lost during the next 4 years (survival rate: 93%). All patients could be re-operated successfully. In the CD-group 14 patients (23%) chose an implant-retained overdenture after 1 year. Patients of the IRO-group were significantly more satisfied than patients of the CD-group after 1 year (satisfaction score 8.3 versus 6.6, scale 1-10) and after 5 years (7.4 versus 6.4). From this study it can be concluded that endosseous implants have a high survival rate after 5-years' follow-up. Satisfaction score of the IRO-group is diminishing in time, probably because patients get used to an improved situation. After 5 years, the mean satisfaction score of the CD-group (including patients who got implants) was still lower than of the IRO-group, in spite of the opportunity to a retreatment and have implant-retained overdentures.
A total of 127 partially edentulous patients, treated according to the Brånemark protocol, was followed for 10 years after completion of prosthetic treatment. The patients ranged in age from 18 to 70 years, and 57% were female. Four hundred sixty-one implants were placed in 56 maxillae and 71 mandibles. In 125 patients, 163 fixed partial prostheses were attached to the implants; a majority of the prostheses (83%) were located in posterior regions. At the end of the 10-year period, 73% of the implants could be traced either as failed or in function, providing cumulative implant survival rates of 90.2% and 93.7% for the maxilla and mandible, respectively. Of the original fixed prostheses, 63% (cumulatively 86.5%) were still in use, whereas the level of continuous cumulative prosthesis function, including primary and remade restorations, was 94.3% at the end of the evaluation period. Marginal bone resorption at the implants was low (mean = 0.7 mm), and mucosal health was good. No severe complications apart from the above-mentioned implant and prosthetic failures were reported. The Brånemark Implant System is a safe and predictable method for restoring partially edentulous patients, as demonstrated by this 10-year follow-up investigation.
The objective of this study was to assess and compare patients' and clinicians' judgments of the esthetic outcome of implant-supported single-tooth replacements.
In all, 29 patients with 41 single implant-supported crowns in the maxillary anterior region participated in the study. The esthetic outcome of the implant-supported crowns was assessed by the patients and by 5 prosthodontists by means of a questionnaire in which various esthetics-related variables were addressed and responded to using visual analogue scales. Multiple regression analyses were used to evaluate the influence of the variables on the "overall satisfaction" with the implant-supported crown.
Most variables in the patients' assessments revealed mean values above 90% and median values close to 100%. No single factor used in the multiple regression analysis was found to influence a patient's satisfaction with appearance of the crown at a statistically significant level. The clinicians' degree of satisfaction was for all variables lower than that of the patients. In 89% of the cases the clinicians could correctly locate the single implant-supported crown. Among the variables assessed, surrounding soft tissue appearance and form of the crown had the strongest influence on the clinician's overall satisfaction with the appearance of the crown.
Appreciation of the esthetic outcome of the single implant-supported crowns was rated higher by the patients than by the prosthodontists. Furthermore, factors considered by professionals to be of significance for the esthetic result of the restorative treatment may not be of decisive importance for the patient's satisfaction.
The use of implants for prosthetic rehabilitation of partially edentulous patients is increasing. However, the possibilities of placing implants in the posterior part of the mandible are often limited. The purpose of this longitudinal study with 10 years of follow-up was to evaluate the use of short implants supporting fixed partial dentures (FPD) in the posterior part of the mandible, and to compare implant supported FPDs to tooth-implant supported FPDs.
The patient material comprised 23 patients with residual mandibular anterior teeth, and each patient received FPDs unilaterally. On one side the FPD was supported by two implants, and on the other side by one implant and one tooth, thus permitting intraindividual comparison. The distribution of the two types of FPDs in each jaw was randomized. Implant success rates, marginal bone changes, and mechanical complications were studied.
The tooth-implant connection did not demonstrate any negative influences on the overall success rates for the 10-year period, nor were the shorter implants found to be less favorable.
It is suggested that a prosthetic construction supported by both a tooth and an implant may be recommended as a predictable and reliable treatment alternative in the posterior mandible.
Outcomes of oral implant therapy have been described primarily in terms of implant survival rates and the durability of implant superstructures. Reports of patient-based outcomes of implant therapy have been sparse, and none of these studies have used oral-specific health status measures.
This study assessed the impact of implant-stabilized prostheses on the health status of complete denture wearers using patient-based, oral-specific health status measures. It also assessed the influence of preoperative expectations on outcome.
Three experimental groups requesting replacement of their conventional complete dentures completed an Oral Health Impact Profile (OHIP) and a validated denture satisfaction scale before treatment. One group received an implant-stabilized prosthesis (IG), and 2 groups received new conventional complete dentures (CDG1 and CDG2). After treatment, all subjects completed the health status measures again; preoperative data were compared with postoperative data.
Before treatment, satisfaction with complete dentures was low in all 3 groups. Subjects requesting implants (IG and CDG1) had high expectations for implant-stabilized prostheses. Improvement in denture satisfaction and OHIP scores was reported by all 3 groups after treatment. Subjects who received their preferred treatment (IG and CDG2 subjects) reported a much greater improvement than CDG1 subjects. Preoperative expectation levels did not appear to influence satisfaction with the outcomes of implant therapy in IG subjects.
Subjects who received implants (IG) that replaced conventional complete dentures reported significant improvement after treatment, as did subjects who requested conventional replacement dentures (CDG2). The OHIP appears useful in identifying patients likely to benefit from implant-stabilized prostheses.
This study investigated patients' perceptions of fixed implant-supported prostheses (ISP) in totally edentulous jaws in order to obtain a broader base for patient information.
A total of 135 patients who had received prosthetic rehabilitation treatment responded to a questionnaire on oral functions, speech, oral self-care, esthetics, lifestyle changes and self-confidence, oral comfort, and overall satisfaction with ISP. The patients also listed positive and negative experiences with the ISP.
Most patients (97%) reported overall satisfaction. Chewing ability was rated as good or very good by all but one (99.3%). Twenty-six patients (19.6%) identified bruxing and clenching habits, these were significantly younger than those free from problems. Phonetic problems were reported by 32.8% after insertion, with 18.6% (eight patients) having remaining problems after seven to 10 years. Most of the patients (87.2%) found it easy to clean the prosthesis. Improved lifestyle after ISP insertion was reported by 75% and increased self-confidence by 82% of the patients. Improvements were especially perceptible in social situations that involved conversation or eating. None of the measured variables was related to duration of having ISP.
The patients' experiences in this study lasted over a period of 10 years, thus their positive and negative aspects can serve as information support for dentistry to enable future ISP patients to make appropriate choices. The information could be made available to patients by including in a patient-targeted booklet.
Brånemark fixtures were originally prescribed to be placed in two surgical stages. During the past years, reports on the placement of machined titanium implants in a one-stage procedure have been published, and the results have been encouraging. Recently there has been considerable interest in early or immediate loading.
The purpose of this article is to report the preliminary clinical results of a new method for implant treatment of the edentulous mandible. The new protocol involves prefabricated components and surgical guides, elimination of the prosthetic impression procedure and attachment of the permanent fixed bridge on the day of implant placement.
Fifty patients (26 males, 24 females) received 150 Brånemark Novum implants and were followed from 6 months to 3 years after implant placement. Bone width and height were determined preoperatively with the use of radiographs. The jaw was reduced in height to accommodate three special 5-mm wide implants. Precise implant positioning was accomplished with special drilling templates. Drill guides were placed over the drilling templates during site preparation using a series of specially designed drills. After the mucosa had been sutured back into position, a prefabricated titanium lower bar was connected with titanium screws to the transmucosal fixture. Another titanium bar was then attached by the prosthodontist, and a bite registration was performed. The bridge was attached to the upper bar. The permanent reconstruction was provided to the patient later the same day.
Three implants were lost to follow-up and three failed, resulting in an overall survival rate of 98%. One prosthesis failed, leaving a prosthetic survival rate of 98%. The average treatment time was approximately 7 hours. At the baseline examination, the marginal bone level was 0.72 mm below the reference point. The average marginal bone loss was 0.2 mm per year and 0.26 mm between the 3-month and 1-year control visits. The accumulated mean bone loss, including baseline, was -1.25 mm. A patient questionnaire demonstrated that 94% of the patients did not experience any discomfort during treatment and all patients would recommend the procedure to others.
The results of this study indicate that the precise surgical and prosthetic protocol allows successful prosthetic rehabilitation of mandibular edentulism and that the permanent reconstruction can be provided to the patient on the day of fixture surgery.
The literature reports that the treatment of fully edentulous mandibles with implant-retained overdentures has become a recognised form of therapy: however long-term data on the success are limited. The aim of the present study was to describe the clinical effectiveness of mandibular implant-supported/retained overdentures in the management of a group of edentulous patients.
The study group consisted of 59 consecutive edentulous patients attending the clinic of prosthetic dentistry at Cardiff Dental Hospital, who had been provided with implants in the mandible for complete overdenture retention. Several clinical parameters were examined in each patient: mobility of each implant, probing pocket depth, the presence or absence of plaque and calculus on each implant, bleeding index, marginal bone loss, jaw bone quality and quantity, complications that had occurred with the implants and patients opinions of the treatment.
Of implants placed, 97% remained in function. Three fixtures had been lost. There was a high frequency of bleeding on probing. Complications associated with treatment included damage or looseness of abutment screws, fracture of the bar, entrapment of food beneath the overdenture and looseness of the opposing non-implant-retained complete denture.
In general a very high degree of patient satisfaction with the implant-retained overdentures was recorded.
In a randomized prospective study, two implant systems were compared in forty consecutive patients treated for mandibular edentulism. The patients were randomly allotted for treatment by the Brånemark two-stage (submerged) system (BRS), or the ITI(R) one-stage (non-submerged) system. In all, 102 Brånemark selftapping implants and 106 ITI hollow screw implants were installed and all patients were treated with full bridges. Biological and prosthodontic parameters, complications, success rates, clinical efficacy, patient satisfaction and resource requirements were evaluated. No differences were found in plaque accumulation, bleeding or complications during the follow-up period. The BRS group showed deeper periimplant sulcus, less attached mucosa, larger bridge-mucosa distance and higher Periotest values. Prosthetic complications were not related to the configuration of the implant systems. After 3 years, the cumulative success rates were 97.9% and 96.8% for the Brånemark and ITI systems, respectively (difference not statistically significant). One implant in the BRS group had failed to osseointegrate at the time of abutment connection, and another was lost after 2 years due to progressive breakdown of bone. In the ITI group, three implants showed progressive bone loss after 1-3 years associated with periimplant infection. All 40 bridges were intact and remained stable throughout the study. There was general patient satisfaction, but about half the Brånemark patients reported difficulty in coping with the surgical procedures. Treatment time was similar for the two systems. It is concluded that both systems meet the current requirements for dental implant systems in the treatment of mandibular edentulism.
This cohort study (n = 83) investigated whether patients with implant-stabilized overdentures would demonstrate less impact on daily life, would have less difficulty in the mastication of different types of food, and would generally be more satisfied than patients with conventional complete dentures. The groups were comparable for gender, age of dentures, and duration of edentulism. The patients were interviewed using a questionnaire, which included the Oral Impacts on Daily Performances (OIDP) sociodental indicator. Patients with implant-stabilized overdentures were more satisfied with the comfort of their dentures, could eat a wide range of food items with less difficulty, and experienced less impact on daily life than patients with conventional complete dentures. The findings of this study support the need to consider implant-stabilized overdentures in the treatment of edentulous patients.
The aim of this study was to analyse the patient evaluation of functional treatment outcome in 40 periodontally compromised patients who received implant-supported prostheses (ISPs) as part of the total treatment. The treatment protocol comprised periodontal treatment, extraction of teeth with poor prognosis, placement of dental titanium implants, and after healing, insertion of fixed ISPs. Five of the patients became edentulous in one jaw after extraction of all teeth and received a complete ISP, whereas 35 patients became partially edentulous after extraction of some teeth, 12 receiving a partial ISP on > or = 3 implants, and 23 one on two implants. The follow-up period was on average 1.8 years after the connection of the prostheses, which provided the patients a dentition with a mean of 12 occluding dental units. The first author (S.-W. Yi) performed all implant treatment. Patients' opinions on oral functions--mastication, phonetics, oral hygiene, chewing comfort and aesthetics--were evaluated by means of a questionnaire both before implant installation and at the last follow-up. A control group of 30 subjects with a healthy dentition of 14 occluding natural pairs of teeth answered the same questionnaire on one occasion. A great majority of the patients were extremely satisfied with the oral function after treatment and experienced the ISPs as 'natural teeth'. There was no significant difference between the three treatment groups and the control group for mastication, phonetics, chewing comfort and aesthetics. Patients with ISPs reported a small but significantly greater difficulty with oral hygiene procedures than the controls with natural teeth. Most patients said that they would undergo the treatment again, if necessary, and recommend it to others. It was concluded that the rehabilitation of the periodontally compromised patients, including ISPs on osseointegrated dental titanium implants, resulted in subjectively improved and satisfactory oral function.
This randomized clinical trial examined implant overdenture (IOD) fabrication and maintenance time and costs, adjustment and repair incidence, and patient satisfaction after 1 year.
Sixty-four patients received 2 mandibular implants and an IOD with either a bar with 2 clips or 2 ball attachments for denture retention.
Fabrication time, number of appointments, and chair time for adjustments were similar for the 2 denture designs. The most common adjustments for both types were to the IOD contours. Ball-attachment dentures required about 8 times longer for repairs than bar-clip prostheses. Approximately 84% of patients with ball-attachment dentures needed at least 1 repair, versus 20% of those with a bar-clip mechanism. The most common repairs were replacement of the cap spring or cap for the ball-attachment IOD and replacement of a lost or loose clip for bar-clip dentures.
Patients were equally and highly satisfied with the improvements in function, comfort, and appearance with both types of IOD compared to their original conventional dentures.
Given equivalent levels of patient satisfaction with either method of retention and a much higher repair rate for the ball attachment, it is suggested that a bar-clip design be used rather than the particular ball attachment utilized in this study.