Assessment of Peri-Implant Soft Tissues Conditions around Short and Ultra-Short Implant-Supported Single Crowns: A 3-Year Retrospective Study on Periodontally Healthy Patients and Patients with a History of Periodontal Disease.

The aim of this retrospective study was to evaluate implant survival, marginal bone loss and peri-implant complications in 326 short and ultra-short implants. Implants were placed in the maxillary and mandibular posterior regions of 140 patients with (PP) and without (NPP) a history of periodontal disease. Clinical and radiographic examinations were performed at 3-year recall appointments. The 8.0, 6.0 and 5.0 mm-length implants placed in PP and NPP were respectively 43.75% and 38.46%, 35.10% and 34.19%, 21.15% and 27.35%; 325 implants (one early failure) were rehabilitated with single crowns in 139 patients. Overall implant survival after 3 years of follow-up was 97.55%, 98.08% and 96.61% for PP and NPP (p = 0.46). Crestal bone level variations were not statistically different among PP and NPP; 15.41% of implants presented signs of mucositis, 14.71% and 16.67% in PP and NPP (p = 0.64). Setting the threshold for bone loss at 2 mm after 36 months, peri-implantitis prevalence was 2.2%, 1.96% and 2.63% in PP and NPP (p = 0.7). Overall implant success was 82.39%, 83.33% and 80.7% for PP and NPP (p = 0.55). Short-term outcomes suggest that short and ultra-short locking-taper implants can successfully be restored with single crowns in the posterior jaws both in PP and NPP.

Satisfaction and Patient-Related Outcomes in 128 Patients with Single Implant Crowns In Situ for up to 14 Years.

PURPOSE: To assess patient satisfaction and patient-related outcomes across the domains of appearance, cleansibility, and costs; the perceived value and worth when single implant crowns (SICs) had been in situ up to 14 years; whether satisfaction differed between patients; and whether certain characteristics might affect the questionnaire response rate. MATERIALS AND METHODS: Patients treated at a private prosthodontic practice between 2001 and 2014 (n = 207) who received a SIC (n = 256) were prospectively included. A previously validated patient satisfaction questionnaire (PSQ) exploring patient-centered outcomes was mailed to participants. Demographic (sex, age) and treatment data (number of SICs, time in situ, failure experience, complication experience) were collected. Visual analog scale (VAS) responses were converted to percentages. Differences between respondents and nonrespondents, differences in satisfaction between prosthesis placement and survey date, and differences with respect to demographic and treatment data were assessed. Averages were medians bounded by interquartile ranges. Statistical significance was set at P = .05. RESULTS: Respondents (n = 128, 61.8%) and nonrespondents (n = 79, 38.2%) had similar demographic and treatment characteristics. Prostheses had been in situ for up to 14 years (median, 5 years; interquartile range [IQR], 24 to 96 months). Participants reported that treatment met their expectations (median, 93%; IQR, 85% to 100%); they reported high satisfaction with tooth color, tooth contour, peri-implant mucosa, appearance overall, and ease of cleaning (medians ranging from 90.5% to 95%, IQR ranging from 80% to 100%) and medium satisfaction with costs when prostheses were placed (median, 50%; IQR, 29% to 80%). Satisfaction with tooth contour, peri-implant tissues, overall appearance, and costs significantly improved over time (96%, 92.5%, 91.7%, and 75%, respectively; P < .001 to P = .049). Levels of satisfaction did not differ by sex, number of implants, survival, complications, number of complications, and time in situ. Younger patients were less satisfied with the overall appearance and costs than older patients (P = .004, P = .007, respectively). All patients would choose to undergo treatment again and would recommend it to a friend. CONCLUSION: Patients with SICs that were in situ up to 14 years who responded to the validated PSQ were highly satisfied with the appearance and cleansibility, noted improvements in peri-implant tissue contours, and found the treatment to be valuable and worthwhile. They reported that upfront costs were high, but this concern decreased when the SICs had been in the mouth for a period of time.

Programmatic assessment of a university-based implant training program using patient-reported outcomes.

The University of Kentucky College of Dentistry (UKCD) established an implant training program that provides training in the use of a single implant system, evidence-based diagnostic and treatment protocols (standardized work practices), and a total quality management system (Implant Quality Assurance Program). The aim of this study was to assess the programmatic effectiveness of the UKCD implant training program by reporting the success and survival of implants placed, using patient-reported outcomes and comparing them to previously established benchmarks. A total of 415 patients (963 implants) were interviewed, approximately 50 percent of all qualified patients. The implant survival rate was 97 percent, and 88 percent of the implants were considered successful (as determined by patient-centric criteria). These outcomes were consistent with the program's previously established benchmarks of 90 percent. These results suggest that work standardization (in the form of specific treatment protocols) and the use of a formal, incremental learning system can result in positive patient outcomes. Clinical outcomes should be monitored in academic dental settings as part of clinical process improvement, and these outcomes can provide a means of assessing the effectiveness of the training program.

[Aftercare for durability and profitability of single-unit and multi-unit fixed dental prostheses]. / Nazorg voor dutrzaamheid en profijtelijkheid van kronen en bruggen.

An important aim ofa treatment with single-unit and multi-unit fixed dental prostheses is a durable and profitable treatment outcome. That requires aftercare, too. First, the frequency of routine oral examinations should be assessed, using an individual risk profile. The objectives of the routine oral examinations are the prevention and, when necessary, the treatment of pathological conditions and complications. With regard to prevention, attention should be paid to information and instruction, oral biofilm and calculus, non-functional activities, hard tooth tissues, periodontal and peri-implant tissues, and saliva. Subsequently, it can be determined whether the intended durability and profitability have been achieved or can still be achieved, whether or not through indicated adjustments. Special attention should be paid to endodontically treated teeth. Restorative, repair or replacement treatments may be indicated in case ofcomplications, such as loose single- or multi-unitfixed dental prosthesis, fracture of a fixed dental prosthesis unit, lost tooth pulp vitality, tooth root fracture, and implant or implant abutment problems.