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1.
Clin Implant Dent Relat Res ; 23(1): 131-139, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33592676

RESUMEN

BACKGROUND: There is lack of reliable predictors for success of conventional complete denture (CCD) therapy, which in turn might affect the effectiveness of subsequent implant-retained overdenture (IOD) therapy. PURPOSE: To investigate relationships between digitally obtained geometrical mandibular residual ridge measures and perceived CCD-stability. MATERIALS AND METHODS: 30 CCD wearing patients (67.9 ± 7.0 years) for whom a new set of CCDs was advised, were treated with new CCDs. Digitalized mandibular gypsum models were measured using the Geomagic Studio 2013 software. Data were obtained for (1) height, width, and cross-section surface area of the residual ridge at different locations (midline, premolar, and anterior edge of retromolar pad) and (2) denture base surface area. Scatter plots and multivariate regression analyses were used to investigate associations between the geometric data and denture base surface area, and correlated with denture stability scores (Spearman rank test). RESULTS: Scatter plots showed that best model fit for denture base surface area was mean ridge height (R2 = 0.906). Multivariate regression showed that height at premolar location (p = 0.001) had largest effect on denture base surface area (R2 = 0.796). Ridge morphology variables, except width at midline location, were significantly correlated with CCD-stability (p-values <0.05). CCD-stability was significantly correlated with denture base surface area (p ≤ 0.001). CONCLUSION: Residual ridge height at premolar location was most predictive for denture base surface area and perceived CCD-stability.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Prótesis Dental de Soporte Implantado , Retención de Dentadura , Dentadura Completa , Dentadura Completa Inferior , Humanos , Mandíbula
2.
Clin Implant Dent Relat Res ; 23(1): 140-148, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33592681

RESUMEN

BACKGROUND: The significance of mandibular residual ridge height and satisfaction with conventional complete dentures (CCD) as predictors for the added value of implant-overdenture (IOD) therapy is unknown. PURPOSE: To investigate the predictive value of thresholds for (1) residual ridge height at premolar location (PRH), and (2) satisfaction with CCD-stability for the added value of two intraforaminal implants supporting the mandibular CCD. METHODS: Thirty CCD wearing patients (67.9 ± 7.0 years) for whom a new CCD was advised, received a new CCD. Mandibular gypsum models were digitally measured. After 3 months free of complaints (T1), perceived CCD-stability was evaluated, and participants received two intraforaminal implants. At T1 and T2 (3 months free of complaints after IOD therapy) participants completed OHIP14-CN, and denture satisfaction (VAS) questionnaires, and performed mixing ability tests. Participants were grouped according to PRH of ≥6.15 mm versus < 6.15 mm, and perceived CCD-stability satisfied vs. dissatisfied. Scores at T2 were compared to T1 (paired t-tests). Predictive values of PRH and CCD-stability were analyzed with logistic multivariate regression models. RESULTS: At T2, only participants with PRH of <6.15 mm or dissatisfied with CCD-stability had significant lower OHIP-total and domain scores for 'physical pain' and 'physical disability' and significantly higher VAS scores for perceived chewing function, denture retention and oral comfort. Regression analyses showed that participants with PRH of <6.15 mm, or dissatisfied with CCD-stability had significantly higher chance for lower OHIP-total and domain scores 'physical pain' and 'physical disability', and for higher VAS scores for perceived chewing function, denture retention and oral comfort at T2. Masticatory performance improved significantly after IOD therapy, but independent of PRH and CCD-stability. CONCLUSION: PRH and satisfaction with CCD-stability were adequate prognostic indicators for improvement of oral health-related quality of life and denture satisfaction by mandibular IOD therapy.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Prótesis Dental de Soporte Implantado , Retención de Dentadura , Dentadura Completa , Dentadura Completa Inferior , Humanos , Mandíbula , Masticación , Satisfacción del Paciente , Calidad de Vida
3.
Int J Prosthodont ; 34(1): 7-12, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33570514

RESUMEN

PURPOSE: To determine whether the use of implant-supported overdentures (IODs) with different attachments influences the Mini Nutritional Assessment (MNA) and Geriatric Oral Health Assessment Index (GOHAI) scores in edentulous patients > 65 years of age. MATERIALS AND METHODS: The MNA and GOHAI were administered to 54 edentulous patients > 65 years of age (mean age = 68.35 ± 4.1 years) before treatment (A) and 6 months after treatment (B): 10 with maxillary + mandibular conventional complete dentures (CDs); 10 with a maxillary conventional CD + mandibular magnetic-retained IOD; 12 with a maxillary conventional CD + mandibular ball-retained IOD; 12 with a maxillary conventional CD + mandibular Locator-retained IOD; and 10 with a maxillary conventional CD + mandibular bar-retained IOD. Statistical differences between treatment types were evaluated using one-way analysis of variance and paired-sample t tests. The correlation between MNA and GOHAI scores was determined using Pearson correlation analysis (α = .05). RESULTS: The difference between mean GOHAI-A and GOHAI-B scores was statistically significant for each type of denture (P < .005). The difference between the mean MNA-A and MNA-B scores was statistically significant for all types of denture except for conventional CDs (P < .05). There was a statistically significant positive correlation between MNA and GOHAI scores (P < .01). CONCLUSION: Regardless of the type of denture used, treatment of edentulous geriatric patients is important for improving nutritional status and self-rated oral health.


Asunto(s)
Implantes Dentales , Calidad de Vida , Anciano , Preescolar , Prótesis Dental de Soporte Implantado , Retención de Dentadura , Dentadura Completa , Dentadura Completa Inferior , Prótesis de Recubrimiento , Humanos , Estado Nutricional , Satisfacción del Paciente
4.
Clin Oral Implants Res ; 32(3): 359-368, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33417279

RESUMEN

OBJECTIVE: This randomized clinical trial aimed to compare the outcomes of the mandibular overdenture retained by one (1-IOD) or two (2-IOD) implants. MATERIALS AND METHODS: Participants received new complete dentures, were assessed at baseline and randomly assigned to groups. Early loaded single midline implant (1-IOD) or two implants in the canine regions bilaterally (2-IOD). Ball attachments were used for overdenture retention. Post-treatment outcomes (6- and 12-month follow-ups) included patient satisfaction, oral health-related quality of life measures, and chewing function. Data analysis included within- and between-group comparisons, and Generalized Estimating Equations. Both superiority and non-inferiority hypotheses were tested. RESULTS: Forty-seven participants were included (1-IOD = 23; 2-IOD = 24). Significant improvements in OHIP-Edent were observed after insertion of new dentures and at the 1-year follow-up compared with baseline. No differences were found between the 1- and 2-IOD groups for the OHIP-Edent and QoLFAST scores. Patient satisfaction with the mandibular denture improved significantly from baseline to the 6-month follow-up and remained unaltered until 1 year, with no differences between groups. The magnitudes of treatment effect sizes were moderate to large for patient-reported outcomes. Progressive improvement in chewing function occurred in both groups. Non-inferiority testing based on a 15% non-inferiority margin showed inconclusive results for patient-reported outcomes, whilst chewing function in the 1-IOD group was concluded to be not inferior to the 2-IOD group. CONCLUSIONS: Results support the use of both 1- and 2-IOD. The 1-IOD was also an acceptable alternative to the 2-IOD as a secondary option for the treatment of the edentulous mandible.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Prótesis Dental de Soporte Implantado , Retención de Dentadura , Dentadura Completa Inferior , Humanos , Mandíbula/cirugía , Satisfacción del Paciente , Calidad de Vida , Titanio , Resultado del Tratamiento , Circonio
5.
Gerodontology ; 37(3): 233-243, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32491236

RESUMEN

OBJECTIVES: To examine the McGill Denture Satisfaction Questionnaire (MDSQ) in terms of dimensionality, item reduction and construct validity in a binational sample of complete denture wearers. MATERIALS AND METHODS: We conducted secondary analyses of baseline data from two studies on implant-retained overdentures: a quasi-experimental study in the United States (n = 145) and a randomised trial in Brazil (n = 120). All participants wore upper/lower dentures and responded at baseline to the MDSQ items concerning their original mandibular dentures. A putative model of the MDSQ items resulted in two question subsets: (a) overall satisfaction, retention/stability, aesthetics, cleaning, speech and comfort, plus general chewing ability; (b) mastication of specific foods. Analyses focused on the internal consistency of each subset and possible item reduction, using Cronbach's alpha (Cα), inter-item correlation and exploratory factor analysis (EFA). RESULTS: The 1st subset showed high inter-item correlation for most question combinations and no redundancy (r ≤ .8). An item on cleaning had low correlation, but its removal does not increase internal consistency (Cα ≥ .83). Results were similar for both studies, with EFA showing a single significant factor (namely "overall satisfaction, lower denture") able to explain nearly 54% of the variance. The 2nd subset also shows strong internal consistency (Cα ≥ .95) and inter-item correlation, with a single factor representing 65% of the variation. CONCLUSIONS: This study discloses the reliability and construct validity of the MDSQ for patient-centred evaluation of complete dental prostheses in the edentulous mandible. Findings also support the use of both "overall satisfaction" and "masticatory ability" as summary scores, for improved outcome assessment.


Asunto(s)
Prótesis Dental de Soporte Implantado , Dentadura Completa , Satisfacción Personal , Brasil , Retención de Dentadura , Dentadura Completa Inferior , Prótesis de Recubrimiento , Estética Dental , Análisis Factorial , Humanos , Masticación , Satisfacción del Paciente , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
6.
J Oral Rehabil ; 47(6): 757-765, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32242956

RESUMEN

Occlusal analysis is a substantial tool for the functional improvement evaluation after using implant-retained overdenture comparing to complete denture without dental implant retaining. To evaluate occlusal pattern, chewing force distribution in mini-dental implant-retained mandibular overdentures by computerised occlusal analysis system and to compare patient satisfaction after 1-year function. Thirty-one patients wearing complete dentures were included in the study. Prior to mini-dental implant-retained treatment, all patients were assessed for occlusion and force distribution using computerised occlusal analysis system (T-Scan® ), and then, all patients received two mini-dental implant-retained mandibular overdentures. Mini-dental implants were immediately loaded using low vertical profile attachments (Equator® ). T-Scan® was used to evaluate chewing force and force distribution at 1 day, 3 months, 6 months and 12 months. The patient satisfactions before implant placement and after 1 year were evaluated using questionnaires which included satisfaction of denture quality, psychosocial behaviour and chewing efficiency modified from the validated questionnaires. Clinical evaluation of two mini-dental implant-retained mandibular overdentures showed 100% success rate after 1 year. T-Scan® demonstrated that maximum occlusal contact force increased continuously. The force distribution; the tooth contact number increased over the period. At 1-year follow-up, overall patient satisfaction was significantly greater than before receiving mini-dental implant treatment (P < .001). Using computerised occlusal analysis, mini-dental implants improve complete denture function significantly in terms of maximum occlusal contact force, tooth contact number without the impairment of force distribution. The oral function of the patients has been enhanced.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Prótesis Dental de Soporte Implantado , Retención de Dentadura , Dentadura Completa Inferior , Humanos , Mandíbula , Satisfacción del Paciente , Estudios Prospectivos
7.
Int J Oral Maxillofac Implants ; 35(2): 423-431, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32142580

RESUMEN

PURPOSE: The aim of this crossover study was to evaluate patient satisfaction and oral health related-quality of life (OHRQoL) with different connectors used for implant-retained overdentures in subjects with resorbed mandibles. MATERIALS AND METHODS: Eighteen edentulous patients with atrophied mandibular bone received traditional maxillary and mandibular dentures (control). After 3 months, two implants were inserted in the canine regions. Three months later, each patient received the following overdentures using a crossover design: (1) bar overdentures, (2) telescopic overdentures, and (3) stud overdentures. Patient satisfaction (primary outcome) was measured by visual analog scale (VAS). OHRQoL (secondary outcome) was measured by oral health impact profile (OHIP-14). Questions of VAS and OHIP-14 were evaluated after 3 months of using conventional dentures, bar overdentures, telescopic overdentures, and stud overdentures. RESULTS: For all questionnaires, conventional dentures recorded significantly lower satisfaction than implant overdentures. Stud overdentures showed significantly higher satisfaction with maxillary denture comfort, self-consciousness, and feeling that the prosthesis is a part of the patient compared with other attachments. Bar and telescopic overdentures showed higher satisfaction during biting of hard and soft foods, while telescopic and stud overdentures showed higher satisfaction with oral hygiene. No significant differences between attachments regarding other VAS and OHIP-14 questions were noted. CONCLUSION: Implant overdentures for subjects with mandibular bone resorption improved patient satisfaction and OHRQoL compared with traditional dentures regardless of the form of attachments. However, studs are more advantageous in terms of comfort with maxillary overdentures, self-consciousness, and feeling that the prosthesis is a part of the patient. Bar and telescopic attachments had more satisfaction during biting of soft and hard foods, while telescopic and stud attachments had more satisfaction with oral hygiene.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Estudios Cruzados , Prótesis Dental de Soporte Implantado , Retención de Dentadura , Dentadura Completa Inferior , Humanos , Mandíbula , Salud Bucal , Satisfacción del Paciente , Satisfacción Personal , Calidad de Vida
8.
J Prosthodont Res ; 64(4): 417-423, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32061571

RESUMEN

PURPOSE: This randomized controlled trial aimed to study the effects of lining mandibular complete dentures with silicone-based resilient denture liners, especially with respect to sensation. METHODS: The trial included completely edentulous patients who were willing to fabricate new set of complete denture. A random permuted block method (block size: 4) was used to assign participants to one of the following groups: mandibular conventional denture (CD) group or mandibular denture with resilient denture liner (RD) group. The outcomes were evaluated using both, objective measures (current perception threshold (CPT) and pain threshold (PT)) for external stimuli measured using the Neurometer CPT® and subjective measures (physical pain and psychological discomfort measured using the Japanese version of Oral Health Impact Profile for Edentulous patients-OHIP-EDENT-J). The outcomes were measured twice, at immediately after completion of denture adjustments (first measurement), and 3 months after the completion of denture adjustments (second measurement). All outcomes were analyzed using the Student t-test. A p-value of <0.05 was considered statistically significant. RESULTS: CPT was significantly higher with RD than CD only at second measurement with frequency level of 2000 Hz and 5 Hz. The pain thresholds were significantly higher in the RD group than the CD group. The physical pain and psychological discomfort scores were significantly lower in the RD group than in the CD group. CONCLUSION: This study concludes that edentulous patients wearing mandibular complete dentures with silicone-based resilient denture liners dull perception mandibular ridge mucosa and felt less pain than those without the liners.


Asunto(s)
Alineadores Dentales , Resinas Acrílicas , Dentadura Completa , Dentadura Completa Inferior , Humanos , Dolor , Siliconas
9.
J Prosthet Dent ; 123(5): 675-679, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-31421891

RESUMEN

Implant-supported overdentures can significantly increase function and satisfaction during the first year and can last for 5 to 10 years. The 2-implant-supported mandibular overdenture is recommended as a standard treatment for edentulous patients. In the recent years, studies have reported the use of digital complete dentures. However, as a modified technique for complete dentures, few studies have evaluated the use of digital techniques in the fabrication of overdentures. The purpose of this article was to introduce a digital workflow for fabricating overdentures by using information from the existing dentures.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Prótesis Dental de Soporte Implantado , Dentadura Completa Inferior , Humanos , Mandíbula , Satisfacción del Paciente , Flujo de Trabajo
10.
J Oral Rehabil ; 47(3): 361-369, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31549416

RESUMEN

BACKGROUND: Retention and stabilisation of a single-implant mandibular overdenture (SIMO) are influenced by the biomechanical properties and clinical performance of the attachment system. PURPOSE: To compare clinical and patient-reported outcomes following the use of two retention systems, a ball and a stud-type Equator attachment used for SIMO. MATERIAL AND METHODS: Eighteen fully edentulous participants were treated with a SIMO opposing to a maxillary complete denture. They received two retentive attachments (ball and Equator) in alternate periods (sequences A-B and B-A) and outcomes were assessed after the 1 week (initial) and 3 months (final) periods. In the final assessment, patients were also asked about their preferred retention system. RESULTS: Compared with baseline, there was an improvement in patient satisfaction using both attachments, whilst no difference was observed between initial and final periods. Similarly, no significant differences were observed when comparing the ball and Equator at the initial (P = .330) and final (P = .08) periods. The multilevel mixed-model analysis revealed that the patients' satisfaction was predicted only by their satisfaction with dentures before implant placement. Although no significant difference was found between attachments regarding patient preference, this may be biased by the sequence of attachment use, which suggests that a learning effect might be present in this crossover study design. CONCLUSION: The use of a single midline implant to retain a mandibular overdenture significantly improves patient satisfaction irrespective of the attachment used, but patients' preference for the second treatment suggested a learning effect in this study.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Estudios Cruzados , Prótesis Dental de Soporte Implantado , Retención de Dentadura , Dentadura Completa Inferior , Humanos , Mandíbula , Satisfacción del Paciente , Resultado del Tratamiento
11.
Clin Exp Dent Res ; 5(4): 316-325, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31452942

RESUMEN

Food ingress under dentures is a common problem that may be reduced by denture adhesive use. The objective of this study was to explore the effect of the mode of application of a denture adhesive on reducing accumulation of food particles under dentures. This was a single-centre, controlled, single-blind, randomized, three-treatment, three-period, crossover study in participants with complete, removable well-fitting, well-made upper/lower dentures. Treatments were: 1) experimental denture adhesive application (test adhesive) applied with a precision applicator as continuous strips; 2) marketed denture adhesive (positive control) applied using a flat ribbon nozzle as dabs; 3) no adhesive. Food-occlusion testing was performed by assessing peanut particle migration under dentures with denture retention/stability evaluated using the Kapur Index (Olshan modification). Differences were assessed using an ANOVA model. Adhesive oozing and perceptions of the adhesives were assessed by questionnaire. All 83 randomized participants completed the study. There were no significant differences between positive control or test adhesives versus no adhesive, or between test adhesive and positive control, for mass of peanut particles recovered from dentures. Both adhesives had significantly higher retention and stability scores compared with no adhesive (all P < .01). Participants reported significantly higher scores for denture comfort, confidence, satisfaction and movement with both adhesives versus no adhesive (all P < .01). No differences in adhesive ooze were reported between adhesives. No adverse events were reported. In conclusion, there was no difference in performance, as measured by peanut particle mass recovered from upper/lower dentures, for the test adhesive, positive control and no adhesive.


Asunto(s)
Adhesivos/administración & dosificación , Retención de Dentadura/métodos , Dentadura Completa Inferior/efectos adversos , Dentadura Completa Superior/efectos adversos , Masticación , Adhesivos/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Estudios Cruzados , Femenino , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Método Simple Ciego , Resultado del Tratamiento
12.
Spec Care Dentist ; 39(5): 471-477, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31368121

RESUMEN

AIMS: To compare prosthesis satisfaction and nutritional intake of edentulous elderly people wearing a conventional complete denture (CD) with those wearing a single implant mandibular overdenture (SIO) after 6 months of use. METHODS AND RESULTS: Completely edentulous elderly patients (n = 22) were divided between a group rehabilitated with CDs in both dental arches and a group receiving a mandibular SIO with a conventional CD in the upper arch (n = 11/group). Patients completed a visual analog scale for degree of satisfaction with their prostheses in seven categories. Nutritional intake of patients (based on patient diaries) was evaluated over a 3-day period. SIO wearers were more satisfied with their prostheses than were CD wearers. Six months after rehabilitation, the SIO group consumed foods higher in vitamins B2 and B6, whereas the CD group consumed more sodium. CONCLUSION: SIO wearers are more satisfied with their prosthesis and consume greater amounts of vitamin B2 and vitamin B6 in their diets than CD wearers. Brazilian Registry of Clinical Trials (#RBR-3kgttj and #RBR-37gdst).


Asunto(s)
Prótesis Dental de Soporte Implantado , Prótesis de Recubrimiento , Anciano , Brasil , Dentadura Completa Inferior , Dieta , Humanos , Mandíbula , Masticación , Satisfacción del Paciente , Satisfacción Personal
13.
Clin Oral Implants Res ; 30(9): 940-951, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31264259

RESUMEN

OBJECTIVES: This prospective study analyses the 5-year clinical outcome, patient satisfaction and the technical outcome of a 2-implant overdenture on stud abutments. In addition, the influence of mandibular resorption and implant position on these outcomes was assessed. MATERIAL AND METHODS: Patients received two implants in a one-stage delayed protocol. Final prosthesis on stud abutments was finalized after 3 months. Implant survival, bone loss, plaque and sulcus bleeding index, OHIP-14, technical outcome and costs were assessed after 5 years. The Cawood-Howell classification defined the mandibular resorption. Inter-implant distances and angles (frontal, sagittal) were digitally measured. The significance level was p < .05. RESULTS: Fifty-six patients, 23 female and 33 males (mean age = 66.3, range 41-82), completed the follow-up. No implants were lost. Radiographical crestal bone loss was on average 1.25 mm (standard deviation SD 1.06), bleeding index was 0.75 (SD 0.73), and plaque index was 1.15 (SD 0.75) and higher for low mandibles (p = .001). The OHIP-14 reduction post-connection and after 5 years was significant (p < .001). Five-year maintenance required on average 6.7 (SD 4.8, range 0-25) interventions per patient. A larger inter-implant distance was associated with fewer replacement of retention inserts (p = .034) and less interventions (p = .006). Larger frontal (p = .023) and sagittal (p = .046) inter-implant angles (non-parallelism) required more inserts. The maintenance cost negatively influences the patient satisfaction (p = .004). 83% of the stud abutments showed wear. CONCLUSION: The implant overdenture on cylindrical stud abutments is a good and stable solution, irrespective of the resorption profile of the mandible. OHIP-14 improved permanently up to 5 years but is negatively influenced by complication cost. A small inter-implant distance, more frontal, sagittal inter-implant divergence increased maintenance.


Asunto(s)
Resorción Ósea , Implantes Dentales , Arcada Edéntula , Anciano , Prótesis Dental de Soporte Implantado , Retención de Dentadura , Dentadura Completa Inferior , Prótesis de Recubrimiento , Femenino , Estudios de Seguimiento , Humanos , Masculino , Mandíbula , Satisfacción del Paciente , Estudios Prospectivos , Resultado del Tratamiento
14.
J Prosthodont Res ; 63(4): 428-433, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30956160

RESUMEN

PURPOSE: The study aimed to compare the mixing ability (MA), comminuting ability (CA), and maximum bite force (MBF) of single-implant overdentures (IODs) and clinically acceptable complete dentures (CDs) through a randomized crossover control trial. METHODS: New CDs were fabricated for 22 patients. One implant was inserted in the middle of the symphyseal region for each patient. The patients were randomly allocated into two groups: group IC received an IOD, whereas group CI received a CD, for 2 months; the treatments were interchanged for the next 2 months. The MA, CA, and MBF were evaluated with the old CDs, new CDs (at the end of CD treatment period), and IODs (at the end of IOD treatment period). RESULTS: The MA, CA, and MBF of the IODs were significantly higher than those of the old and new CDs (p < 0.01). New CDs only showed a significant improvement in MA (p < 0.05), while there were no significant differences in CA and MBF between the old and new CDs. CONCLUSIONS: Compared with the CD, IOD is more effective in restoring the MA, CA, and MBF of edentulous mandibles.


Asunto(s)
Fuerza de la Mordida , Prótesis Dental de Soporte Implantado , Dentadura Completa , Prótesis de Recubrimiento , Retención de Dentadura , Dentadura Completa Inferior , Humanos , Mandíbula , Masticación , Satisfacción del Paciente
15.
Int J Prosthodont ; 32(3): 251-253, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31034539

RESUMEN

PURPOSE: To verify whether single-implant-supported mandibular overdentures improve thickness discrimination. MATERIALS AND METHODS: A selection of edentulous patients treated with single-implant-supported overdentures underwent interocclusal thickness discrimination tests using dedicated metal strips. Fifteen patients were included, and recordings were repeated five times: with complete dentures in place before placement of implants, the day of the prosthetic connection, and 1 month, 1 year, and 6 years after the connection. RESULTS AND CONCLUSION: Thickness discrimination improved at the 1-month recall recording, while after 1 year, it remained stable at low levels.


Asunto(s)
Implantes Dentales , Arcada Edéntula , Prótesis Dental de Soporte Implantado , Dentadura Completa Inferior , Prótesis de Recubrimiento , Estudios de Seguimiento , Humanos , Mandíbula
16.
J Prosthodont ; 28(4): 373-378, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30875139

RESUMEN

PURPOSE: Blood flow disturbance from functional pressure may lead to ischemia and accumulation of metabolites leading to residual ridge resorption (RRR) underneath complete dentures. The purposes of this study were to determine the effect of mandibular complete denture (CD) and implant-retained overdenture (IRO) on blood flow disturbance in the opposing denture bearing-mucosa of maxillary CD and to compare the blood flow disturbance to RRR of the anterior maxilla. MATERIALS AND METHODS: The test group included 9 participants rehabilitated by maxillary CD opposing mandibular IRO, while the control group consisted of 4 participants with CDs. Blood flow was measured by laser Doppler flowmetry (LDF) after denture removal for 0, 30, 60, and 90 minutes. RRR was quantified as reduction in bone volume a year post-treatment. The measurement of blood flow was then compared to the quantification of RRR. RESULTS: The mean blood flow measure for the IRO group was significantly lower than CD after immediate denture removal and 30 minutes later. After 60 minutes, the mean difference was not significant between groups, and at 90 minutes, the mean blood flow of both groups equalized to reach a steady state of 377 BPU. The mandibular IRO had reduced the initial blood flow measure in the opposing anterior maxilla mucosa to almost a quarter (103 BPU) of the steady state value (377 BPU) compared to the CD, which reduced it to only about one half (183 BPU), suggesting greater blood flow disturbance in the IRO group. This result is in tandem with the greater reduction of bone volume observed in the IRO group, which was 7.3 ± 1.3% after a year, almost three times higher than CD group at 2.6 ± 1.7%. CONCLUSION: IRO may cause significantly higher blood flow disturbance than CD and may have contributed to greater RRR in the anterior maxilla.


Asunto(s)
Pérdida de Hueso Alveolar , Prótesis de Recubrimiento , Prótesis Dental de Soporte Implantado , Retención de Dentadura , Dentadura Completa Inferior , Humanos , Mandíbula , Maxilar , Membrana Mucosa
17.
Clin Oral Implants Res ; 30(3): 261-276, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30714227

RESUMEN

OBJECTIVE: To prospectively evaluate patient-reported outcome measures (PROMs) and treatment outcomes of mandibular two-implant retained overdentures (IOD) in an edentulous geriatric cohort with history of deficient complete dentures (CD). MATERIALS AND METHODS: A total of 103 patients with deficient CD received new optimal CD. After a period of 3 months, 80 of the patients voluntarily received IOD. Outcomes collected at pre-, post-CD/post-IOD treatment annually up to 5 years, included (a) Clinical outcomes: denture-quality (Woelfel's index), complications, and maintenance events, (b) PROMs: patient complaints (maxillary, mandibular functional complaint scores, generic aesthetic complaint scores, frequency, and intensity of complaints) and patient satisfaction, and (c) Maintenance events: technical complications and adverse events. RESULTS: Five-year data were collected from 67 patients (mean age at initiation = 71.3 years, mean observation = 5.9 years) with cumulative implant survival rate = 98.72%. Multiple comparisons for 8 time points showed significant improvements in denture quality and PROMs after new CD and IOD delivery. Further significant improvements were only after IOD delivery in: mandibular denture-quality, mandibular and generic functional complaints, frequency, intensity of complaints, and overall patient satisfaction score. Thereafter, denture-quality and PROMs remained stable. Maintenance events clustered on 1st year and within a minority of patients. Technical complications and overall maintenance events significantly correlated with overall patient satisfaction score at 1st year. CONCLUSIONS: Mandibular IOD was a beneficial treatment option for seniors with history of deficient CD, improving denture-quality, patient satisfaction, and reducing patient complaints up to 5 years. Maintenance events clustered on 1st year, showing no significant impact on long-term patient satisfaction and other PROMs.


Asunto(s)
Prótesis de Recubrimiento , Medición de Resultados Informados por el Paciente , Anciano , Prótesis Dental de Soporte Implantado , Retención de Dentadura , Dentadura Completa Inferior , Estética Dental , Humanos , Mandíbula , Satisfacción del Paciente , Estudios Prospectivos , Resultado del Tratamiento
18.
Clin Implant Dent Relat Res ; 21(2): 369-376, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30741469

RESUMEN

BACKGROUND: The effect of maxillary implant overdentures on masticatory ability in edentulous patients with complaints regarding their conventional maxillary dentures is unknown. PURPOSE: To assess the change in objective masticatory ability (mixing ability index, MAI), patient reported masticatory ability (questionnaire), and patient satisfaction (GSS) after maxillary implant overdenture treatment with either solitary attachments or bars. MATERIALS AND METHODS: Two groups randomly received four-implant maxillary overdentures on either solitary attachments (group I, n = 25) or bars (group II, n = 25). The MAI, questionnaire, and GSS were scored before (T0) and 12 months (T12) after treatment. RESULTS: After treatment, both groups had significantly better MAI outcomes, better questionnaire scores and better GSS. Post-treatment questionnaire scores and GSS were significantly better for group II. Before treatment a strong, positive correlation between the MAI and the questionnaire was found for all participants who had had full conventional dentures combined (group I, n = 17; group II, n = 3). CONCLUSION: Mixing ability was the same for all the participants treated with maxillary implant overdentures on either solitary attachments or bars. Patient reported masticatory ability and satisfaction was better for participants treated with maxillary implant overdentures on bars. There was a correlation between MAI and patient reported masticatory ability in participants with full conventional dentures.


Asunto(s)
Prótesis Dental de Soporte Implantado , Prótesis de Recubrimiento , Retención de Dentadura , Dentadura Completa Inferior , Estudios de Seguimiento , Humanos , Mandíbula , Masticación , Maxilar , Satisfacción del Paciente
19.
Clin Oral Implants Res ; 30(3): 218-228, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30681193

RESUMEN

OBJECTIVES: To examine the impact of adding a third midline implant with stud attachment to a mandibular two-implant overdenture on patient-oriented outcomes. METHODS: In this pre-post design clinical trial, following the standard procedures, mandibular two-implant overdentures of 17 edentulous individuals (61.9 ± 6.6 years) were converted to three-implant overdentures by adding a stud attachment to an unloaded midline implant. Patient-oriented outcomes included patient expectations and satisfaction with implant overdenture as well as willingness to pay the cost of conversion. Data were collected at baseline and at the 6-week follow-up using visual analog and binary scales as well as open-ended questions. Statistical analysis included descriptive statistics, Spearman's correlation, Fisher exact test, Mann-Whitney U test, and the exact sign test. RESULTS: After connecting the third midline implant to the mandibular two-implant overdenture, there was a statistically significant decrease in the anteroposterior movement (p = 0.005) as evaluated by clinicians. Moreover, study participants reported an increase in perceived stability of the overdenture (95% CI; 0.68-1.00, p = 0.002) and in their ability to speak (95% CI; 0.63-1.00, p = 0.008). The addition of a third implant met the expectations of 94% of patients in regard to lower denture stability, 100% for retention, and 82.4% for comfort. The mandibular three-implant overdenture increased patient general satisfaction over a short period of time, but this improvement was not statistically significant. About 80% of patients would recommend this type of prosthesis to their peers but only 47% of them would agree to pay a large increase in the cost of treatment compared to a two-implant overdenture. CONCLUSIONS: The addition of a midline third implant to an existing mandibular two-implant overdenture resulted in several improved patient-reported outcomes.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Prótesis Dental de Soporte Implantado , Retención de Dentadura , Dentadura Completa Inferior , Humanos , Mandíbula , Satisfacción del Paciente , Atención Dirigida al Paciente , Resultado del Tratamiento
20.
J Prosthodont ; 28(7): 844-848, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-29239054

RESUMEN

Previous clinical research has shown promising results in oral rehabilitation of elderly adults by a single implant-retained mandibular overdenture; however, the high incidence of fracture in the anterior region of these overdentures is a concern for clinicians. To minimize catastrophic overdenture fracture, we propose a technique to insert an individualized metal framework in single implant-retained overdentures prior to implant surgery.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Adulto , Anciano , Cromo , Cobalto , Prótesis Dental de Soporte Implantado , Retención de Dentadura , Dentadura Completa Inferior , Humanos , Mandíbula
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