Effects of various prosthetic methods for patients with Kennedy Class I partial edentulism on oral hypofunction, subjective symptoms, and oral health-related quality of life.

PURPOSE: This propensity score matching, multicenter, cross-sectional study was performed to examine the effects of various prosthetic methods for dental clinic outpatients with Kennedy Class I partial edentulism (KCIPE) on oral hypofunction, subjective frailty symptoms, and oral health-related quality of life (QOL). METHODS: Patients (n = 348) were classified into the following three groups for analysis: NT, patients with natural dentition providing intermaxillary contact in four occlusal supporting zones; RPD, patients with KCIPE who received removable partial dentures; and ISFP, patients with KCIPE who received implant-supported fixed prostheses. Participants' basic characteristics were recorded, and oral function tests were conducted. Subjective symptoms of physical and oral frailty were investigated via questionnaire. Oral health-related QOL was assessed using the Japanese short version of the Oral Health Impact Profile (OHIP-JP16). Propensity score matching was performed to adjust for patient background factors that could influence oral hypofunction in each group. RESULTS: Compared with the ISFP group, the RPD group had significantly higher rates of poor oral hygiene, reduced occlusal force, decreased masticatory function, and declines in swallowing function and oral hypofunction; the odds ratio for oral hypofunction was 4.67. Compared with the ISFP group, the RPD group had significantly greater subjective symptoms of physical frailty and oral frailty, as well as higher OHIP scores. CONCLUSIONS: Prosthetic treatment of KCIPE affected oral hypofunction, subjective frailty symptoms, and oral health-related QOL in dental clinic outpatients.

Retrospective cohort study of rough-surface titanium implants with at least 25 years' function.

BACKGROUND: The longitudinal clinical outcomes over decades contribute to know potential factors leading to implant failure or complications and help in the decision of treatment alternatives. METHODS: The cases of all patients who received dental implants treated with titanium plasma-sprayed surfaces and whose prostheses were set in the period 1984-1990 at seven private practices were retrospectively analyzed. The cumulative survival rate, the cumulative incidence of peri-implantitis, and the complication-free prosthesis rate were calculated with Kaplan-Meier survival curves, and the factors' influence on implant survival rate and the incidence of peri-implantitis were determined by a single factor in univariate analyses and multivariate analyses. RESULTS: A total of 223 implants and 106 prostheses were applied to 92 patients, and approx. 62% of the implants and patients dropped out over the 25 years following their treatment. The cumulative survival rates of the implants at 10, 15, and 25 years were 97.4, 95.4, and 89.8%, respectively. A significant difference was observed in the implant position. The cumulative incidences of peri-implantitis at 10, 15, and 25 years were 15.3, 21.0, and 27.9%, respectively. Significant differences were observed in the gender, implant type, and width of keratinized mucosa around the implant. The cumulative survival rates of mechanical complication-free prostheses at 10, 15, and 25 years were 74.9, 68.8, and 56.4%, respectively. The difference in the type of prosthesis resulted in significant differences. CONCLUSIONS: The high rate of dropout during follow-up indicates the difficulty of determining long-term (> 25 years) prognoses. The gender, location, and width of keratinized mucosa affected the development of peri-implantitis, resulting in late failures. Implant-supported overdentures were frequently repaired. Tooth implant-supported prostheses are not recommended for long-term survival.