Clinical behavior of posterior fixed partial dentures with a biologically oriented preparation technique: A 5-year randomized controlled clinical trial.

STATEMENT OF PROBLEM: Evidence of the behavior of the periodontal tissues around anterior teeth restored with the biologically oriented preparation technique (BOPT) is available. However, outcomes of this technique in posterior teeth restored with fixed partial dentures (FPDs) are lacking. PURPOSE: The purpose of this randomized controlled clinical trial was to evaluate the clinical, mechanical, and biological behavior of posterior 3-unit FPDs placed on teeth prepared with BOPT. MATERIAL AND METHODS: Forty participants received a 3-unit zirconia FPD in the posterior region of the mandible or maxilla. Twenty FPDs were placed on teeth prepared with BOPT (study group) and 20 on teeth with a horizontal chamfer finishing line (control group). Follow-up examinations were performed 1, 3, and 5 years after treatment to evaluate periodontal responses around the prepared teeth by means of the following parameters: plaque index, gingival index, probing depth, and marginal stability (MS). Mechanical behavior was also assessed, as were any complications. RESULTS: After the 5-year follow-up, 57.9% of the control group and 35% of the BOPT group presented a plaque index of 1. The gingival index was 1 in 68.4% of the control group and 30% of the BOPT group after the follow-up period. In the analysis of probing depth, 26.3% of teeth in the control group had pockets of more than 3 mm in depth, whereas the BOPT group had only 10%. Marginal stability appeared in 100% of the BOPT group, whereas only 10.5% of the control group exhibited gingival stability. Complications during the follow-up period were similar, 20% in the control group and 15% in the BOPT group. CONCLUSIONS: Posterior FPDs prepared by using BOPT had a good clinical response over a 5-year follow-up, with a low gingival index, a small increase in pocket depth, and a 100% marginal stability of the surrounding tissues. High survival rates after 5 years indicated that the technique produced predictable outcomes.

Patient-centered and clinical outcomes of mandibular overdentures retained with the locator system: A prospective observational study.

STATEMENT OF PROBLEM: Whether clinical or demographic variables affect the perception of treatment in terms of quality of life and satisfaction is unknown. PURPOSE: The purpose of this prospective study was to make an evidence-based assessment of the treatment outcomes (patient- and clinically based) of locator-retained mandibular overdentures. MATERIAL AND METHODS: This prospective observational study assessed patients with edentulism who had worn mandibular overdentures supported by 2 implants and retained by the locator system for at least 1 year of functional life (N=80). Medical histories were reviewed, and patients underwent oral examinations. Prosthetic clinical outcomes and patient well-being were registered using the Oral Health Impact Profile 20 (OHIP-20) and Oral Satisfaction Scale (OSS). RESULTS: Patient well-being scored an overall OHIP-20 score of 19.0 ±14.0 of 80 (the higher the score, the greater the impact and the worse the oral health-related quality of life); overall oral satisfaction was 8.3 ±1.7 of 10. Women suffered greater social impact (0.8 ±1.0) and disability (0.4 ±0.8) than men (0.4 ±0.7 versus 0.2 ±0.4, respectively). Impact on well-being was inversely proportional to both patient age and the age of the prosthesis (r=-0.25; P<.01). Implants had been placed on average 73.6 ±39.2 months previously, showing a survival rate of 82.5%. Most of the overdentures had been functioning for over 60 months. Relining (46.3%), readjustments (82.5%), and changes of nylon retention (1.5 ±1.8 per patient over 60 months of use) devices negatively influenced well-being. CONCLUSIONS: Mandibular overdentures produced good results with regard to quality of life and oral satisfaction, but attention should be paid to factors affecting clinical outcomes and patient well-being.

Oral health-related quality of life of implant-supported overdentures versus conventional complete prostheses: Retrospective study of a cohort of edentulous patients.

BACKGROUND: This work aims to confirm if implant-supported overdentures are a good treatment option for edentulous patients and offer an improvement in quality of life compared with traditional complete prostheses (dentures). MATERIAL AND METHODS: This retrospective clinical descriptive study included three evaluation groups: validation group (n=57); control group of patients with complete removeable prostheses (n=56); study group of patients with implant-supported overdentures retained with the Locator® system (n=80). The study also validated the Oral Health Impact Profile-20 questionnaire. Individual protocols were created that included socio-demographic data, the Oral Health Impact Profile-20 (OHIP-20) questionnaire and Oral Satisfaction Scale (OSS). Descriptive and bivariate statistical analysis was carried out applying χ², Pearson, Kruskal-Wallis, and Student t tests, transferring data into SPSS-Windows® software from a Microsoft® Excel spreadsheet. RESULTS: The OHIP-20 proved to be a valid instrument and provided reliable assessment of health-related quality of life among both the Spanish general population and edentulous patients. The control and study groups proved comparable, showing socio-demographic homogeneity. For patients with overdentures retained by means of the Locator® system, these restorations had significantly lower impact on quality of life (19 vs 33), both generally and for each individual questionnaire item, and much higher satisfaction with the state of their oral cavities (8.3 vs 5.3) than patients wearing dentures; both sets of data showed a direct linear relationship, so that as the level of impact on quality of life increased, perceived oral satisfaction worsened. CONCLUSIONS: Patients rehabilitated with implant supported overdentures retained by the Locator® system, presented significantly lower levels of impact on their quality of life and significantly higher oral satisfaction than patients with conventional complete prostheses.

Dental preparation with sonic vs high-speed finishing: analysis of microleakage in bonded veneer restorations.

PURPOSE: To compare marginal microleakage in porcelain veneer restorations following dental finishing using two types of instruments to test the hypothesis that microleakage will be less when teeth are prepared with sonic oscillating burs than when prepared with high-speed rotating burs. MATERIALS AND METHODS: Fifty-six extracted human maxillary central incisors were selected and divided randomly into two groups. Group 1 samples underwent dental finishing using high-speed rotating diamond burs, while group 2 used sonic oscillating diamond burs. Buccal chamfer preparation was carried out for both groups. Forty eight of the samples (24 per group) were restored using IPS Empress ceramic veneers. 2% methylene blue was used to evaluate microleakage at the tooth/composite veneer interface. Teeth were sectioned lengthwise into three parts and microleakage was measured at two points - cervical and incisal - on each section. Before bonding, four teeth per group underwent SEM examination. RESULTS: Evaluation of microleakage at the cervical dentin margin showed a value of 10.5% in group 1 and 6.6% in group 2, which was statistically significantly different (p < 0.05). Incisal microleakage was 1.3% for group 1 and 1.2% for group 2, which was not significantly different. SEM revealed different patterns of surface texture in both areas according to the instrument used. Group 1 exhibited parallel horizontal abrasion grooves with a milled effect and thick smear layers; group 2 showed abrasive erosion, discontinuous perpendicular depressions, and thin smear layers. CONCLUSION: Tooth preparations finished with sonic burs produced significantly less microleakage in the cervical dentin area of bonded veneer restorations. No differences were found in the incisal enamel area.