Patient-reported outcomes in patients with severe maxillary bone atrophy restored with zygomatic implant-supported complete dental prostheses: a systematic review.

Introduction and Objective: Zygomatic implants (ZI) offer a good and predictable alternative to reconstructive procedures of atrophic maxillae. The main objetive of this systematic review was to assess the effect of rehabilitation with zygomatic implants on patient's quality of life (QLP) using Patient Reported Outcomes Measures (PROMs).Materials and Methods: This review followed PRISMA guidelines. An automated electronic search was conducted in four databases supplemented by a manual search for relevant articles published until the end of January 2021. The Cochrane Collaboration Risk of Bias tool and the Newcastle-Ottawa Quality Assessment Scale were used to assess the quality of evidence in the studies reviewed.Results: General findings of this systematic review showed substantial increases in Oral health-related quality of life (OHRQoL) among patients restored with ZI and high scores in terms of general satisfaction, especially in chewing ability and esthetics. An overall survival rate of ZI was 98.3% after a mean follow-up time of 46.5 months was observed. Occurrence of 13.1% biological complications and 1.8% technical complications were reported.Conclusions: Patients rehabilitated with zygomatic implant-supported complete dental prostheses showed substantial improvements in OHRQoL and general satisfaction with the treatment received.

A clinical and histological case series study on calcium sulfate for maxillary sinus floor augmentation and delayed placement of dental implants.

BACKGROUND: Maxillary sinus floor augmentation is a procedure that is indicated in cases when the volume of the posterior maxillary bone is inadequate. The goal of this treatment is to obtain sufficient amount of bone tissue in order to gain osseointegration of endosseous implants. PURPOSE: The purpose of this study was to conduct a clinical and histological analysis of calcium sulfate (CaS) as bone graft substitute in sinus floor augmentation. MATERIAL AND METHODS: Ten patients with edentulous maxillas were included in this study. They had moderate to severe atrophy of the posterior maxilla. Surgiplaster (Classimplant®, Rome, Italy) was used as graft material in the maxillary sinus and was covered by BioGide® (Geistlish Pharmaceutical, Wolhusen, Switzerland). After 4 months of graft healing, 40 dental implants were placed and a biopsy for histomorphometry was taken at these occasions. The specimens were viewed by light microscope, and the extent of bone regeneration and remaining graft material was evaluated. Radiographs were taken at the time of sinus augmentation and after 4 months of graft healing. RESULTS: At the time of abutment surgery, one implant was considered as a failure and was consequently removed, giving a survival rate of 97.5% after 1 year of loading. Radiographs showed a mean of 26.5% shrinkage of the augmented area. A significant resorption of CaS was noted with a mean value of 8.8% of remaining graft material after 4 months of healing. The biopsies also revealed new bone formation with a mean value of 21.2% of the total biopsy area. Histology showed signs of an acellular substitution of CaS with bone-like tissue. CONCLUSION: The results of this study show that new bone regeneration occurs in the maxillary sinus after augmentation with CaS. This enabled successful placement, integration, and loading of dental implants in the posterior maxilla, as only 1 of 40 implants was lost during 1 year of follow-up.

Improved denture retention in patients with retracted tongues.

BACKGROUND: Patients who wear mandibular dentures and hold their tongues in retracted positions alter the dimensions of the sublingual space and disrupt the peripheral seal that is needed for optimal denture retention. The authors studied whether retention could be improved if patients moved their tongues from a retracted resting position to an ideal resting position. METHODS: The authors observed and classified the mandibular residual ridge morphologies of 85 participants who wore complete dentures. The authors recorded and compared the retention of the mandibular denture before and after repositioning the tongue to the ideal resting position. RESULTS: When the participants' tongues were in a retracted resting position, the average retention of the mandibular denture was 75.38 gram weight (+/- 81.83 standard deviation [SD]). After participants repositioned their tongues to the ideal resting position, the average retention of the mandibular denture was 118.89 gw (+/- 93.00 SD), an increase of 57.73 percent. CONCLUSIONS: In all morphological classes, when participants held their tongues in the ideal resting position, the average mandibular denture retention increased by 57.73 percent, a statistically significant improvement compared with when participants held their tongues in a retracted resting position. CLINICAL IMPLICATIONS: Clinicians are encouraged to evaluate carefully the tongue resting position in all patients who wear dentures, help create reasonable therapeutic expectations by informing patients about the significant effect that tongue position will have on future denture retention and provide helpful neuromuscular training for patients with retracted-tongue habits.

Two-year changes in mandibular bone mass in an osteoporotic population.

Deficiency of 1,25 Dihydroxycholecalciferol (the active form of vitamin D) may be a major factor contributing to osteoporosis. This study measured mandibular bone mass over 2 years in women with postmenopausal osteoporosis and evaluated whether 1,25 Dihydroxycholecalciferol increased mandibular bone mass. All subjects increased dietary calcium to 1000 mg per day and took a multivitamin supplement with 400 IU of vitamin D daily. There was a large variation in the amount of change in mandibular bone mass, but no significant difference attributed to the administration of 1,25 Dihydroxycholecalciferol. With those dietary and vitamin supplements, 83% of the subjects were able to maintain or increase their mandibular bone mass.

Determination of vertical dimension of rest. A comparative study.

The present study was undertaken to compare the VDR determined by conventional methods and EMG with biofeedback. Twenty dentulous and 20 edentulous subjects were included in the study. The VDR was determined by conventional methods using phonetic and swallowing methods. The masseter and anterior belly of the digastric muscles were used to determine the VDR by EMG with biofeedback. VDR was determined by dentulous and edentulous subjects by conventional and electromyographic methods. In edentulous subjects the VDR relation was determined by both methods with and without dentures in the mouth. All results were subjected to statistical analysis. The following conclusions are drawn from the study: The VDR as determined by both methods was similar in dentulous subjects. In edentulous subjects the difference in the VDR with and without dentures in the mouth was not statistically significant in both methods. In edentulous subjects the VDR increased in most subjects with the insertion of dentures and decreased in the remaining few subjects by either method. The difference between the VDR determined by conventional and electromyographic methods in edentulous subjects with dentures was not significant, but without dentures the difference was statistically significant. The comparison between the two methods of determining the VDR in dentulous and edentulous subjects with or without dentures in the mouth showed that VDR determined with dentures was closer to that of dentulous subjects than without dentures. It was concluded by the authors that the determination of VDR by either conventional or electromyographic methods with dentures was more accurate than determining the VDR without dentures.