Effects of probiotics in periodontal diseases: a systematic review.

OBJECTIVES: This study was designed to determine the effects of probiotics in prevention and/or treatment of periodontal diseases. MATERIALS AND METHODS: We performed broad searches in the MEDLINE, Embase, and Cochrane databases and selected articles that satisfied the description of randomized clinical trials comparing the administration of probiotics versus placebo or another intervention to prevent or treat periodontal diseases in adult patients. RESULTS: Four randomized clinical trials were analyzed in the final review process. For the primary outcome, probing pocket depth, there would be no clinical beneficial effect of probiotics. For secondary outcomes, probiotics have shown small benefits on plaque index and gingival inflammation. CONCLUSIONS: Based on the results of this review, the effectiveness of probiotics on the prevention and treatment of periodontal diseases is questionable. There is currently insufficient evidence demonstrating the benefits of systematic preventative use of probiotics in patients with periodontal diseases. CLINICAL RELEVANCE: The use of probiotics are described to prevent or treat periodontal diseases in some clinical trials; therefore, a systematic review of the evidence for the effect of periodontal diseases is needed.

Differences in self-perceived OHRQoL between fully dentate subjects and edentulous patients depending on their prosthesis type, socio-demographic profile, and clinical features.

OBJECTIVES: This observational cross-sectional study aimed to evaluate and compare the oral health-related quality of life (OHRQoL) and clinical performance between dentate subjects and edentulous patients restored with conventional dentures or implant overdentures. METHODS: 85 edentulous patients were grouped as follows: Group-1 (CD): conventional denture wearers (n = 42), and Group-2 (IO): implant-retained overdenture wearers (n = 43). For the OHRQoL comparisons, a control group of subjects with a healthy natural dentition (Group-3, ND; n = 50) was included. Participants completed three validated questionnaires (OHIP-14sp, OHIP-20sp, and QoLIP-10). Socio-demographic data, prosthesis-related factors, clinical condition of the mouth, and patient subjective evaluations, were gathered. Descriptive and non-parametric probes were run (α = 0.05). RESULTS: The ND group was the most unsatisfied (OHIP-14sp; p ≤ 0.001). The OHIP-20sp attributed significantly worse Psychological disability (p = 0.029) and Handicap (p = 0.027) to CD wearers when compared to IO wearers. The CD group showed the significantly highest need for relining (p = 0.041), and the lowest retention (p = 0.011). The OHIP-14sp disclosed a significantly worse OHRQoL for those volunteers who had a job (p = 0.003), a basic education instead of a secondary one (p = 0.022), and no partner (p = 0.006). CONCLUSIONS: The overall OHRQoL was comparable for both prosthodontic groups, being modulated by socio-demographic and prosthesis-related features. Nonetheless, CD wearers presented prosthetic complications more frequently. CLINICAL SIGNIFICANCE: While dentate subjects were the most critical about their oral condition and its repercussion in their life, implant overdenture wearers tended to observe a better OHRQoL and clinical performance compared to conventional denture wearers.

Impact of the retention system of implant fixed dental restorations on the peri-implant health, state of the prosthesis, and patients' oral health-related quality of life.

OBJECTIVES: To investigate the impact of the retention system (screwed or cemented) of implant fixed dental prostheses (i-FDPs) on the peri-implant health, prosthesis' state, patient self-evaluation of functionality and aesthetics, and oral health-related quality of life (OHRQoL). METHODS: 35 participants were classified into two groups according to the retention system of their metal-ceramic i-FDPs. For the analysis of peri-implant health and prosthetic complications, the implant units were individually assessed. Group 1 (SPD; n = 22): implant units for screwed i-FDPs; and Group 2 (CPD; n = 36): implant units for cemented i-FDPs. Data related to socio-demographics, design and installation of the superstructures, peri-implant condition, prosthetic complications, functionality, and aesthetics, were gathered. Patients answered the Oral Health Impact Profile (OHIP-14sp) questionnaire. Descriptive and parametric probes were run to evaluate the impact scores considering the study variables (α = 0.05). RESULTS: The plaque index, gingival index, functionality, aesthetics, and global evaluation made by the patient recorded significantly better results for the SPD group. The most affected OHIP-14sp domain was 'Physical pain', followed by 'Psychological discomfort', and 'Functional limitation'. The subscales: 'Functional limitation', 'Physical disability', and 'Social disability', attributed significantly worst OHRQoL to CPD users. CONCLUSION: A major presence of peri-implant disease, together with a worse functionality, aesthetics, and patient satisfaction were recorded in cemented i-FDPs with respect to the screwed ones. CLINICAL SIGNIFICANCE: The retention system of i-FDPs can impact the peri-implant health, the subjective functional and aesthetic evaluation of the restoration, and the patients' OHRQoL; the screw retention providing superior results than the cementation.

Validation of the "Quality of Life related to function, aesthetics, socialization, and thoughts about health-behavioural habits (QoLFAST-10)" scale for wearers of implant-supported fixed partial dentures.

OBJECTIVES: To validate the 'Quality of Life related to function, aesthetics, socialization, and thoughts about health-behavioural habits (QoLFAST-10)' questionnaire for assessing the whole concept of oral health-related quality of life (OHRQoL) of implant-supported fixed partial denture (FPD) wearers. METHODS: 107 patients were assigned to: Group 1 (HP; n=37): fixed-detachable hybrid prostheses (control); Group 2 (C-PD, n=35): cemented partial dentures; and Group 3 (S-PD, n=35): screwed partial dentures. Patients answered the QoLFAST-10 and the Oral Health Impact Profile (OHIP-14sp) scales. Information on global oral satisfaction, socio-demographic, prosthetic, and clinical data was gathered. The psychometric capacity of the QoLFAST-10 was investigated. The correlations between both indices were explored by the Spearman's rank test. The effect of the study variables on the OHRQoL was evaluated by descriptive and non-parametric probes (α=0.05). RESULTS: The QoLFAST-10 was reliable and valid for implant-supported FPD wearers, who attained comparable results regardless of the connection system being cement or screws. Both fixed partial groups demonstrated significantly better social, functional, and total satisfaction than did HP wearers with this index. All groups revealed similar aesthetic-related well-being and consciousness about the importance of health-behavioural habits. Several study variables modulated the QoLFAST-10 scores. CONCLUSIONS: Hybrid prostheses represent the least predictable treatment option, while cemented and screwed FPDs supplied equal OHRQoL as estimated by the QoLFAST-10 scale. CLINICAL SIGNIFICANCE: The selection of cemented or screwed FPDs should mainly rely on clinical factors, since no differences in patient satisfaction may be expected between both types of implant rehabilitations.

Validation of a new, specific, complete, and short OHRQoL scale (QoLFAST-10) for wearers of implant overdentures and fixed-detachable hybrid prostheses.

OBJECTIVES: To validate a new index for assessing the whole concept of oral health-related quality of life (OHRQoL) of implant-prosthesis wearers. METHODS: 113 patients who were not requesting dental treatment were assigned to: Group 1 (CD; n=38): complete denture users (control); Group 2 (IO; n=38): implant overdenture wearers; and Group 3 (HP; n=37): hybrid implant prosthesis users. Patients answered the newly-designed 'Quality of Life related to Function, Aesthetics, Socialization, and Thoughts about health-behavioural habits' (QoLFAST-10) and the Oral Health Impact Profile (OHIP-20sp) questionnaires. Information on global oral satisfaction, socio-demographic, clinical, and prosthetic-related data were gathered. The QoLFAST-10 was investigated for reliability and validity. The Spearman's test determined the correlations between both indices' scores. Descriptive and non-parametric probes were run to assess the influence of the study variables on the OHRQoL (α=0.05). RESULTS: The QoLFAST-10 confirmed its psychometric capacity. HP wearers reported significantly better global and functional satisfaction than did IO wearers. The latter revealed significantly less consciousness about the importance of health-behavioural habits than did CD and HP groups. The level of education, complaints about the mouth, and the global oral satisfaction measures significantly modulated the QoLFAST-10 scores. CONCLUSIONS: Implant overdentures supplied lower functional and global satisfaction than did hybrid prostheses, and represent the least predictable option concerning the maintenance of the restoration. CLINICAL SIGNIFICANCE: The QoLFAST-10 may help in estimating the impact of implant restorations on patients' well-being. In this regard, hybrid prostheses seem to be the implant treatment of choice when compared with overdentures.

Validation of the 'Quality of Life with Implant Prostheses (QoLIP-10)' questionnaire for wearers of cement-retained implant-supported restorations.

OBJECTIVES: To validate the 'Quality of Life with Implant-Prostheses (QoLIP-10)' questionnaire for assessing the impact of cemented implant prostheses on Oral Health-Related Quality of Life (OHRQoL). METHODS: 84 subjects wearing implant restorations were distributed as follows: Group 1 (SD-I; n=35): screwed FDPs (fixed dental prostheses) supported by 2 implants; Group 2 (SD-II; n=7): screwed FDPs supported by 3-5 implants; Group 3 (CD-I; n=36): cemented FDPs supported by 2 implants; and Group 4 (CD-II; n=6): cemented FDPs supported by 3-5 implants. The QoLIP-10 and the Oral Health Impact Profile (OHIP-14sp) scales were used. Data related to global oral satisfaction, socio-demographics, health-behaviors, and prostheses, were gathered. Reliability and validity of the QoLIP-10 were investigated. Correlations between both indices were explored with the Spearman's rank test. Descriptive and non-parametric probes were run to evaluate the effect of the study variables on the OHRQoL (α=0.05). RESULTS: The QoLIP-10 confirmed its psychometric capacity for cemented implant prosthesis wearers. Both tests were inversely correlated. The QoLIP-10 attributed the significantly worst QoL to long-span cemented prostheses. Groups were significantly discriminated by the QoLIP-10 performance dimension. The variable complaints about the mouth and the three global oral satisfaction measures significantly modulated the OHRQoL. CONCLUSIONS: Patient satisfaction depends upon the extension and the type of retention of implant FDPs. CLINICAL SIGNIFICANCE: The QoLIP-10 may help estimating the effect of cemented FDPs on patients' well-being. When compared to screwed FDPs, short cemented implant restorations lead to greater improvements in patients' self-perceived QoL.

Oral aesthetic-related quality of life of muco-supported prosthesis and implant-retained overdenture wearers assessed by a new, short, specific scale (QoLDAS-9).

OBJECTIVES: To validate a new questionnaire for evaluating the 'Oral aesthetic-related quality of life (OARQoL)' of prosthetically restored patients. 'OARQoL' assesses the impact of the self-perceived dental aesthetics on patients' well-being. METHODS: The 'Quality of Life associated with Dental Aesthetic Satisfaction (QoLDAS)' index was designed. After a pilot trial, 70 patients were distributed into two groups depending on their type of prosthetic rehabilitation: Group 1 (CD; n=34): muco-supported complete dentures, and Group 2 (IO; n=36): implant-retained overdentures. Patients answered the QoLDAS and the Oral Health Impact Profile (OHIP-20sp) questionnaires, and reported their satisfaction on a visual analogue scale (VAS). Socio-demographic and prosthesis-related factors were registered. Psychometric properties of the QoLDAS were investigated. Correlations between both indices were explored using the Spearman's rank test. Descriptive and non-parametric probes were run to evaluate the effect of the study variables on the OARQoL (α=0.05). RESULTS: The QoLDAS-9 was reliable and valid. The factor analysis confirmed the existence of three dimensions and meaningful inter-correlations among the nine finally included items. Both scales were inversely correlated. The self-reported aesthetic and functional satisfaction and the education level significantly modulated the OARQoL as measured with the QoLDAS-9. CONCLUSIONS: The QoLDAS-9 confirmed its psychometric capacity for assessing the OARQoL of CD and IO wearers. Both groups showed comparably high OARQoL. Superior education degrees lead to lower OARQoL. CLINICAL SIGNIFICANCE: The QoLDAS-9 may be recommended for anticipating the effect of prosthetic restorations on OARQoL. CD and IO are predictable treatment options for improving the aesthetic self-perception of edentulous patients.

A new, short, specific questionnaire (QoLIP-10) for evaluating the oral health-related quality of life of implant-retained overdenture and hybrid prosthesis wearers.

OBJECTIVES: This study aimed to validate a new questionnaire for assessing the oral health-related quality of life (OHRQoL) of implant-prosthesis wearers. METHODS: A group of specialists designed the 10-item scale: 'Quality of Life with Implant-Prostheses' (QoLIP-10). After completing a pilot trial, 150 subjects wearing implant-prostheses or complete dentures who were not requesting dental treatment participated in the main investigation. They were divided into three groups (n=50 each) depending on the type of dental restoration. Group 1 (CD): complete denture wearers (control); Group 2 (IO): implant-retained overdenture wearers and Group 3 (HP): subjects with fixed implant hybrid prostheses. Participants answered the QoLIP-10 and the Oral Health Impact Profile (OHIP-20sp) questionnaires. Information on global oral satisfaction, socio-demographic, health-behavioural, clinical and prosthetic-related data were gathered. The psychometric characteristics of the QoLIP-10 were investigated. The Spearman's rank correlation test was used to determine the association between the total scores of the QoLIP-10 and OHIP-20sp. Descriptive and non-parametric probes were run to evaluate the impact scores obtained depending on the study variables. RESULTS: The QoLIP-10 scale is reliable and valid. The factor analysis confirmed the existence of three dimensions and meaningful inter-correlations among the 10 items. HP wearers demonstrated better biopsychosocial QoL, as indicated by their answers to Item 1 (oral pain) and Item 3 (chewing difficulty). CONCLUSIONS: The QoLIP-10 index confirmed its psychometric capacity for assessing the OHRQoL of implant overdenture and hybrid prosthesis wearers. Overall, the participants were satisfied with their mouth and implant-restorations. CLINICAL SIGNIFICANCE: The QoLIP-10 may be recommended for determining the influence of implant-retained overdentures and hybrid prostheses on the well-being of future patients. Hybrid prostheses are the most predictable treatment option for improving patient satisfaction in terms of oral pain and chewing functionality when compared to implant overdentures and complete dentures.

Impact of various screwed implant prostheses on oral health-related quality of life as measured with the QoLIP-10 and OHIP-14 scales: a cross-sectional study.

OBJECTIVES: This study aimed to validate the Quality of Life with Implant-Prostheses (QoLIP-10) questionnaire for assessing the impact of screwed implant-supported rehabilitations on oral health-related quality of life (OHRQoL). METHODS: 131 patients wearing screw-retained implant restorations were assigned to the following groups: Group 1 (HP; n=50): fixed-detachable hybrid prostheses (control), Group 2 (S-PD; n=43): metal-ceramic screwed partial dentures, and Group 3 (S-CD; n=38): metal-ceramic screwed complete dentures. Impacts on OHRQoL were evaluated using the QoLIP-10 and Oral Health Impact Profile (OHIP-14sp) scales. Data on global oral satisfaction, socio-demographics, health-behaviours, and prosthetics were gathered. Reliability and validity of the QoLIP-10 were investigated for screwed prosthesis wearers. The Spearman's rank test was applied to determine the correlation between both indices. Descriptive and non-parametric probes were run to evaluate the influence of the study variables on OHRQoL. RESULTS: The QoLIP-10 confirmed its psychometric capacity for screwed prosthesis wearers. Both tests were inversely correlated. HP wearers reported the worst dental-facial aesthetics, performance, and functional limitation outcomes. Gender, education level, complaints about the mouth, perception of treatment needs, and prosthetic status modulated the OHRQoL. CONCLUSIONS: Screwed implants restorations provide better OHRQoL than do fixed-detachable hybrid prostheses.

Differences in impact of patient and prosthetic characteristics on oral health-related quality of life among implant-retained overdenture wearers.

OBJECTIVES: To evaluate the oral health-related quality of life (OHRQoL) of implant-retained overdenture users. METHODS: 63 patients aged 50-90 years treated with at least one implant overdenture at the Complutense University (Madrid) in 2000-2010 were included. Of those, 42 answered the Oral Health Impact Profile (OHIP-14 sp) questionnaire. The additive method was used in the OHIP analysis. Data regarding sociodemographic background, overdenture features, and clinical factors were recorded. Sociodemographic and overdenture-related variables for the lost patients (n=21) were also gathered from their history files. Descriptive probes, Mann-Whitney and Kruskal-Wallis tests, and the Spearman correlation coefficient were applied (p ≤ 0.05). RESULTS: The predominant participants' profile was that of a 71-80-year-old woman wearing a mandibular overdenture with a bar retention system and a complete denture in the opposite jaw. 71.4% of the respondents suffered from some kind of impact on OHRQoL, showing an average score of 2.7 ± 3.0 (range: 0-13). 100% of respondents reported no impact for the "social disability" and "handicap" dimensions. The most prevalently affected domain was "physical pain", followed by "functional limitation" and "psychological discomfort". Variables such as the overdenture location or the retention system affected specific OHIP subscales (p ≤ 0.05). The greatest total score was achieved when the antagonist was a complete denture (p<0.01). CONCLUSIONS: Implant-retained overdentures provide a seemingly acceptable quality of life in the elderly population studied, irrespective of the influence of the location, retention system, and antagonist. CLINICAL SIGNIFICANCE: Although further research is necessary, mandibular implant overdentures are more comfortable than maxillary ones. Ball-retained prostheses facilitate eating the most, whereas the presence of oral ulcers and/or candidiasis was only detected in the case of bars, thus impairing OHRQoL. A complete denture as antagonist decreases the patient overall satisfaction.