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Abstract Objectives To examine the differences in treatment outcomes for patients who received subsidized complete dentures in private dental clinics and in public dental clinics over 20?years in Victoria, Australia. Methods Betwe...
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Abstract Objectives To examine the differences in treatment outcomes for patients who received subsidized complete dentures in private dental clinics and in public dental clinics over 20?years in Victoria, Australia. Methods Between 2000 and 2019, 187?227 complete dentures were provided to eligible public patients by the Victorian public dental system. Of these, approximately 52% were provided to public patients in private clinics through the voucher system. Of the 97?107 participants who received denture care in private clinics, 70?818 were matched 1:1 by propensity score (PS) quantiles with participants who received denture care in public clinics. The PS matching balanced the characteristics between these two groups. Subsequently, a conditional logistic regression model investigated the binary outcome of denture replacement whilst a conditional Poisson regression modelled the number of years to denture replacement. A frailty Cox regression after PS matching investigated denture survival over time. Results Dentures provided in public clinics had a mean time to replacement of 5.5?years (SD: 34.0) and 25.9% were replaced during the observation period. In the first year of denture service, incidence rate per person year (IR) for complete denture replacement in public clinics was 0.04 (95% CI: 0.04–0.04). Dentures provided in private clinics had a mean time to replacement of 6.5?years (SD: 3.8) with 29.4% replaced during the observation period. In the first year of denture service, the IR for complete denture replacement in private clinics was 0.02 (95% CI: 0.02–0.02), which was less than half that of the public IR. Multivariate analyses found that although private dentures were more likely to be replaced during the observation period than those provided in the public sector (odds ratio [OR]: 1.31, 95% CI: 1.28–1.35, p?收起
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Introduction: Implant osseointegration is strongly influenced by the bone quality at the implant insertion site. The present work aims to create distribution diagrams showing the average bone density at each position within the ja...
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Introduction: Implant osseointegration is strongly influenced by the bone quality at the implant insertion site. The present work aims to create distribution diagrams showing the average bone density at each position within the jaws. Materials and Methods: Data were retrospectively collected from 4 oral surgeons who sought bone-density measurements during implant placement using a torque-measuring implant micromotor. Statistical analyses were performed to investigate whether bone density correlated with the patients' sex and age and whether the bone-density values at different positions within each arch correlated to each other. Results: Records of 2408 patients and 6060 bone-density readings were retrieved, and density distribution diagrams were created. Density values showed a significant variation within subjects. Within the same jaw, density between adjacent positions showed significant differences. Density at a given position correlated significantly with that at the other positions in most cases. Bone density was significantly lower in women than in men; no significant correlation was found between bone density and the patient age. Conclusions: Bone density of patients displays significant interindividual variation, thus meaningful assessment must be conducted on a patient-by-patient basis.
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For decades, the edentulous population has been unrecognized in its need to be treated in an effective manner. The debilitating condition affects quality of life. Implants have provided a strategy for developing a standard of care...
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For decades, the edentulous population has been unrecognized in its need to be treated in an effective manner. The debilitating condition affects quality of life. Implants have provided a strategy for developing a standard of care. The McGill consensus statement provided evidence that 2 implants supporting a mandibular overdenture should be the first choice in the treatment of edentulism. Success in implementing this standard of care into an institution's curriculum depends on a close collaboration between the surgeon and the restoring dentist and an understanding of biomechanics and bone biology.
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Abstract Purpose The changing dynamics of an aging mouth influence the position of the neutral zone (NZ). While the advantage of the NZ concept in complete denture treatment is quite established, what is not clearly understood is ...
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Abstract Purpose The changing dynamics of an aging mouth influence the position of the neutral zone (NZ). While the advantage of the NZ concept in complete denture treatment is quite established, what is not clearly understood is its position in relation to the crest of the residual ridge due to conflicting reports from previous studies. The purpose of this study was to investigate the distance and direction of NZ position in relation to crest of the residual ridge in edentulous patients and its association with age, gender, and period of edentulism. Materials and Methods A cross‐sectional study was conducted in 133 patients (70 males, 63 females) with a mean age of 58.81 ± 11.78 years. NZ recording was done using admix material by following standard procedures. Two metallic wires were adapted, one on the ridge and another on the center of the occlusal rims, and standardized digital radiographs were made. The position of NZ in relation to the crest of the residual ridge was recorded by noting the direction and measuring the distance between the adapted wires digitally at five locations (right molar, right premolar, incisor, left molar, left premolar regions). Results Age, gender, and period of edentulism had no significant association with the position of NZ. No specific trend was observed in the in NZ position with a non‐significant correlation. Conclusions Distance and the direction of neutral zone position in relation to crest of the residual ridge in edentulous patients bear no significant relationship with factors such as age, gender, and period of edentulism.
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Edentulous patients may be restored with complete-arch implant-supported fixed complete dental prostheses (IFCDPs) on angled distal implants or on parallel implants distributed equally across the mandible to increase the area of s...
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Edentulous patients may be restored with complete-arch implant-supported fixed complete dental prostheses (IFCDPs) on angled distal implants or on parallel implants distributed equally across the mandible to increase the area of support. A treatment is presented to introduce the clinical concept of providing edentulous patients with an implant-supported fixed complete dental prosthesison parallel tissue-level implants in the mandible with standard length implants interforaminally and ultrashort implants distally. A structured prosthetic approach was used for the tooth arrangement with a modified workflow as per the Biofunctional Prosthetic System adapted for static computeraided implant surgery (s-CAIS) and computer-aided design and computer-aided manufacturing (CAD-CAM) of the screw-retained implant-supported fixed complete dental prosthesis. The concept offered advantages in challenging anatomic, surgical, and prosthetic conditions; providing distal nonangled abutments and implant platforms, which were straightforward to clean. If necessary, the prosthesis could have been easily converted into a removable overdenture using the existing digital prosthetic arrangement. Should implant removal be required, the extrashort implants can be removed with minimal surgical risk or morbidity. (J Prosthet Dent 2021;126:137-43)
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OBJECTIVES: This study aimed at assessing the clinical outcome of narrow diameter implants in the treatment of knife-edge edentulous maxillas of adequate bone height but inadequate width (class IV of Cawood and Howell). MATERIAL A...
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OBJECTIVES: This study aimed at assessing the clinical outcome of narrow diameter implants in the treatment of knife-edge edentulous maxillas of adequate bone height but inadequate width (class IV of Cawood and Howell). MATERIAL AND METHODS: Twelve consecutive patients (eight women and four men, mean age 58 years) with class IV atrophic edentulous maxillas were included in the study. Seventy-three microthreaded TiO(2)-blasted implants were placed and the resonance frequency measured. All the implants had a diameter of 3.5 mm. After 6 months of submerged healing, fixed implant-supported prostheses were delivered to the patients and resonance frequency and radiographic examinations performed. After the first year of loading, the implant outcome was again evaluated clinically, radiographically and with resonance frequency analysis. RESULTS: All the implants were followed up to 1 year of loading and their survival rate was 100%. Bone loss after 1 year of loading was (mean+/-SD) 0.30+/-0.13 mm. Stability values were (mean+/-SD) 63+/-5.8 ISQ at placement, 60+/-4.7 ISQ at the abutment connection and 61+/-5 ISQ after 1 year of loading. A significant difference resulted between placement and abutment connection values (P=0.03). CONCLUSIONS: According to the present study, narrow implants may be used to restore edentulous maxillas with atrophies of class IV of Cawood and Howell. When planning the treatment of edentulous maxillas with such a resorption pattern, this possibility has to be considered as an alternative to more demanding grafting techniques.
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Purpose: To investigate the influence of age and time since edentulism on masticatory function and quality of life related to oral health (OHRQoL) in totally edentulous patients after implant-retained mandibular overdenture (IMO) ...
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Purpose: To investigate the influence of age and time since edentulism on masticatory function and quality of life related to oral health (OHRQoL) in totally edentulous patients after implant-retained mandibular overdenture (IMO) loading. Materials and Methods: The sample consisted of 33 patients categorized in two age groups ( 65 years, respectively), and two time since edentulism groups ( = 25 years). The masticatory function was evaluated through the masticatory performance and swallowing threshold tests before IMO loading, and 1, 3, 6, and 12 months after IMO loading. The OHRQoL was evaluated by applying the Oral Health Impact Profile (OHIP-EDENT) and Geriatric Oral Health Assessment Index (GOHAI) questionnaires, before loading and after 3, 6, and 12 months. Data were subjected to the Mann-Whitney test and Wilcoxon signed-rank test for paired samples. Results: The masticatory performance and swallowing threshold were not influenced by the age nor by time since edentulism, except 6 months after IMO loading when patients <= 65 years of age performed the swallowing threshold test in a significantly shorter time with a reduced number of masticatory cycles (P < .05). The masticatory performance and swallowing threshold outcomes showed a gradual improvement up to 12 months, irrespective of the patient categorization. The GOHAI questionnaire scores showed that the OHRQoL was influenced by age in complete denture wearers with a difference between groups in the psychosocial and global domains. The time since edentulism was not affected by the GOHAI scores of complete denture wearers (P < .05). The OHIP-EDENT questionnaire only indicated significant differences as a function of age or time since edentulism between complete denture wearers. Age was associated with significant differences in the physical pain domain outcome, while time since edentulism did not affect only the psychologic discomfort, psycho/ogle inability, and handicap domains. Conclusion: Neither the age nor the time since edentulism influenced the masticatory function of IMO-wearing patients. However, IMO significantly improved the masticatory function in totally edentulous patients, and this is more evident for younger patients (<= 65 years) with a shorter time since mandibular edentulism (< 25 years). The OHRQoL is only influenced by age and time since edentulism in complete denture wearers; IMO treatment eliminates these differences.
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Objective: The current study aimed to determine the prevalence and pattern of partial edentulism among dental patients attending the College of Dentistry, Aljouf University, Saudi Arabia. Patients and Methods: A total of 142 patie...
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Objective: The current study aimed to determine the prevalence and pattern of partial edentulism among dental patients attending the College of Dentistry, Aljouf University, Saudi Arabia. Patients and Methods: A total of 142 patients were selected, and the prevalence of partial edentulism among the selected patient was recorded. Patients were grouped into three age groups; Group I: 21-30 years, Group II: 31-40 years, and Group III: 41-50 years. Kennedy's classification was used to determine the pattern of partially edentulous arches. Modification areas were not included in the assessment to avoid complexity. Data was analyzed using the Statistical Package for the Social Sciences version 20.0 for windows. Results: The results showed that the occurrence of Kennedy Class III partial edentulism was 67.2 % in the maxillary arch and 64.1% in the mandibular arch. Followed by Class II in both maxillary and mandibular arch with an average of 16.3 % in maxillary arch and14.8% in the mandibular arch. Based on these results, class III has the highest prevalence in group II (31- 40 years). Class I and class II have the highest incidence among group III Patients (41-50 years). Conclusions: Among selected patients, Class III dental arch was the most prevalent pattern in maxillary and mandibular arches. Class IV being the least dominant pattern between all classes. There are a rise in Kennedy Class I and Kennedy Class II pattern and a decline in Class III and Class IV with an increase in age.
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The McGill consensus statement on overdentures (14) was published following a symposium held at McGill University in Montreal, Canada in 2002. A panel of relevant experts in the field stated that: The evidence currently available ...
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The McGill consensus statement on overdentures (14) was published following a symposium held at McGill University in Montreal, Canada in 2002. A panel of relevant experts in the field stated that: The evidence currently available suggests that the restoration of the edentulous mandible with a conventional denture is no longer the most appropriate first choice prosthodontic treatment. There is now overwhelming evidence that a two-implant overdenture should become the first choice of treatment for the edentulous mandible (14). In 2009, a further consensus statement was released as a support and follow-up to the McGill consensus statement. This report was jointly created by members of the BSSPD (British Society for the Study of Prosthetic Dentistry) Council and the panel of presenters at the BSSPD conference in York, UK in April 2009 (15). This report also highlighted that since the McGill statement in 2002, uptake by dentists of implant technology for complete denture wearers has been slow. The York statement concluded that 'a substantial body of evidence is now available demonstrating that patients' satisfaction and quality of life with ISOD mandibular overdentures is significantly greater than for conventional dentures. Much of this data comes from randomised controlled trials (15). Whilst it is accepted that the two-implant overdenture is not the gold standard of implant therapy it is the minimum standard that should be sufficient for most people, taking into account performance, patient satisfaction, cost and clinical time.
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ObjectiveThe aim of this cross-sectional study was to determine whether denture-wearing status in edentulous South Korean elders affected their nutritional intakes, using the 2008-2010 data from the Korean National Health and Nutr...
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ObjectiveThe aim of this cross-sectional study was to determine whether denture-wearing status in edentulous South Korean elders affected their nutritional intakes, using the 2008-2010 data from the Korean National Health and Nutrition Examination Survey (KNHANES).
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