Abstract
Maintenance of peri-implant health in general dental practice
Perussolo J, Donos N. Br Dent J. 2024;236(10):781-789. doi: 10.1038/s41415-024-7406-8. Epub 2024 May 24.
ABSTRACT
The long-term maintenance or restoration of peri-implant tissues’ health depends on the strategic implementation of preventive measures and interventions. These measures should be initiated before implant placement and continued throughout a patient’s lifetime, as part of a tailored and comprehensive supportive peri-implant care (SPIC) programme. Central to the clinical efforts of maintaining and rehabilitating peri-implant tissues are several key factors, including the ongoing assessment and frequent monitoring of tissue health and stability, proactive oral health promotion, the control of risk factors and indicators and the provision of professional plaque biofilm removal. It is of paramount importance to underline that SPIC should not limit its scope exclusively to patients already in a state of peri-implant health; in fact, it is imperative that it should extend its protective effect to individuals who have been previously diagnosed and treated for peri-implant diseases, focusing on preventing its recurrence and progression, thereby avoiding further complications, such as implant loss.
This narrative review presents an overview of the current literature on the maintenance of peri-implant tissues’ health and the steps of SPIC providing insights into the critical factors to be considered when managing dental implant patients in the general dental practice.
Copyright © 2024 The Authors. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY). https://creativecommons.org/licenses/by/4.0/
What every dental practitioner should know about how to examine patients with dental implants
Barrak F, Caga D, Crean S. Br Dent J. 2023;234(5):309-314. doi: 10.1038/s41415-023-5574-6. Epub 2023 Mar 10.
ABSTRACT
Dental implants are a common treatment modality provided in both primary and secondary care settings. It is increasingly common for a general dental practitioner to see patients with implant-retained restorations. This article suggests an implant safety checklist for general dental practitioners to help them examine an implant-retained prosthesis.
Copyright © 2023 The Authors. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY). https://creativecommons.org/licenses/by/4.0/
Referral patterns of general dental practitioners for implant surgery procedures
Kahn A, Masri D, Kats L, et al. Oral Health Prev Dent. 2023;21:325-330. doi: 10.3290/j.ohpd.b4438887
ABSTRACT
Purpose
The growing demand for implants has led to their implementation by general dental practitioners (GDPs) in clinical practice. The present study assessed referral patterns of GDPs for the surgical phase of implant dental treatment.
Materials and methods
One hundred fifty GDPs were asked to fill out a structured questionnaire containing their demographic data and answer six questions characterising their referral patterns for implant dentistry.
Results
Forty-one (41%) percent performed the surgical phase, and 87% provided implant restoration. Gender was the only influencing factor for the surgical phase, as 51.4% of male GDPs and 6.5% of female GDPs performed implant surgery themselves. Experience and practice set-up did not influence the referring decision. Fifty-four percent of the practitioners referred 0 to 5 patients per month, and the chosen specialists were: 80% oral and maxillofacial surgeon, 11% periodontist, and 9% selected a specialist depending on the individual case. The major reasons influencing the referral pattern were the complexity of the surgical procedure, followed by systemic medical compromise of the patient.
Conclusions
Most implant surgeries in Israel are still performed by specialists.
Copyright © 2023 The Authors. Quintessence Publishing. Reproduced with permission.
Oral health-related quality of life of patients rehabilitated with fixed and removable implant-supported dental prostheses
Duong H-Y, Roccuzzo A, Stähli A, et al. Periodontol 2000. 2022;88(1):202-239. doi: doi:10.1111/prd.12419
ABSTRACT
Dental implants have become a mainstream treatment approach in daily practice, and because of their high survival rates over time, they have become the preferred treatment option for prosthetic rehabilitation in many situations. Despite the relatively high predictability of implant therapy and high costs to patients, patient perceptions of success and patient-reported outcome measures have become increasingly significant in implant dentistry. Increasing numbers of publications deal with oral health-related quality of life and/or patient-reported outcome measures. The aim of this paper was to provide an overview of the available evidence on oral health-related quality of life of fully and partially dentate patients rehabilitated with fixed and removable implant-supported dental prostheses. A comprehensive electronic search was performed on publications in English up to 2021. A selection of standardized questionnaires and scales used for the evaluation of oral health-related quality of life were analyzed and explained. The analysis encompassed three aspects: a functional evaluation of oral health-related quality of life, an esthetic assessment of oral health-related quality of life, and a cost-related evaluation of oral health-related quality of life for rehabilitation with dental implants. The data demonstrated that the preoperative expectations of patients markedly affected the outcomes perceived by the patients. As expected, reconstructions supported by implants substantially improved the stability of conventional dentures and allowed improved function and patient satisfaction. However, from a patient’s perspective, oral health-related quality of life was not significantly greater for dental implants compared with conventional tooth-supported prostheses. The connection of the implants to the prostheses with locators or balls indicated high oral health-related quality of life. The data also suggest that patient expectation is not a good predictor of treatment outcome. In terms of esthetic outcomes, the data clearly indicate that patients’ perceptions and clinicians’ assessments differed, with those of clinicians yielding higher standards. There were no significant differences found between the esthetic oral health-related quality of life ratings for soft tissue-level implants compared with those for bone-level implants. Comparison of all-ceramic and metal-ceramic restorations showed no significant differences in patients’ perceptions in terms of esthetic outcomes. Depending on the choice of outcome measure and financial marginal value, supporting a conventional removable partial denture with implants is cost-effective when the patient is willing to invest more to achieve a higher oral health-related quality of life. In conclusion, the oral health-related quality of life of patients rehabilitated with implant-supported dental prostheses did not show overall superiority over conventional prosthetics. Clinicians’ and patients’ evaluations, especially of esthetic outcomes, are, in the majority of cases, incongruent. Nevertheless, patient-reported outcomes are important in the evaluation of function, esthetics, and the cost-effectiveness of treatment with implant-supported dental prostheses, and should be taken into consideration in daily practice.
Copyright © 2022 The Authors. Periodontology 2000 published by John Wiley & Sons Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY). https://creativecommons.org/licenses/by/4.0/
Patient satisfaction and survival of maxillary overdentures supported by four or six splinted implants: a systematic review with meta-analysis
Di Francesco F, De Marco G, Capcha EB, et al. BMC Oral Health. 2021;21(1):247. doi: 10.1186/s12903-021-01572-6
ABSTRACT
Background
Implant-supported overdentures offer enhanced mechanical properties, which lead to better patient satisfaction and survival rates than conventional dentures. However, it is unclear whether these satisfaction levels and survival rates depend on the number of implants supporting the overdenture. Therefore, this systematic review aimed to compare maxillary overdentures supported by four or six splinted implants in terms of patient satisfaction, implant survival, overdenture survival, and prosthodontic complications.
Methods
Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (PubMed), and EMBASE databases were systematically searched and complemented by hand searching from 2000 to 2019, employing a combination of specific keywords. Studies comparing the use of four versus six implants for supporting overdentures with at least one-year of follow-up after prosthesis installation and including ten fully edentulous patients were included. The risk of bias (RoB) was analyzed with Cochrane’s RoB 2 and Newcastle–Ottawa tools. Implants and prosthesis survival rates were analyzed by random-effects meta-analysis and expressed as risk ratios or risk differences, respectively, and by the non-parametric unpaired Fisher’s test.
Results
A total of 15 from 1865 articles were included, and reported follow-up times after implant placement ranged from 1 to 10 years. Irrespective of the number of implants used, high scores were reported by all studies investigating patient satisfaction. Meta-analysis and non-parametric Fisher’s test showed no statistical differences regarding the survival rate of implants (P = 0.34, P = 0.3) or overdentures (P = 0.74, P = 0.9) when using 4 versus 6 splinted implants to support overdentures, and no significant differences regarding prosthodontic complications were found between groups. Randomized studies presented high RoB and non-randomized studies presented acceptable quality.
Conclusions
Within the limits of this systematic review, we can conclude that the bar-supported overdenture on four implants is not inferior to the overdenture supported by six implants for rehabilitating the edentulous maxilla, in terms of patient satisfaction, survival rates of implants and overdentures, and prosthodontic complications.
Copyright © 2021 The Authors. This is an open access article distributed under the terms of the Creative Commons CC BY license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/
Implant survival and patient satisfaction in completely edentulous patients with immediate placement of implants: a retrospective study
Kim Hs, Cho HA, Kim Yy, et al. BMC Oral Health. 2018;18(1):219. doi: 10.1186/s12903-018-0669-1
ABSTRACT
Background
This study evaluated full-arch rehabilitation of patients with immediately placed implants in terms of the cumulative implant survival rate, risk factors for implant failure, and patient satisfaction.
Methods
Time-to-event data of 52 completely edentulous jaws (370 implants) were collected using retrospective clinical chart review for the time period from 2008 to 2014. A conventional two stage approach for surgery was adopted to immediately placed implants in the maxilla, and immediate placement and immediate loading protocols for the mandible were followed. The study calculated the 7-year cumulative survival rates (CSR), and a Bayesian hierarchical Cox proportional hazard model was used to measure the effect of covariates. Patient satisfaction on chewing ability, esthetic appearance, and overall satisfaction was also measured with a face-to-face interview survey.
Results
Of the total 370 implants, 194 were immediate placement. Two delayed loading maxillary implants failed within the first year, and another one failed in the second year of loading. Two failures were recorded in the first year and one in seven years for the immediate loading mandibular implants. The 1-, 5-, and 7-year CSR of the 370 implants were 0.989 (0.979, 1.000), 0.986 (0.975, 0.998), and 0.978 (0.957, 0.999), respectively. Only the length of the implant affected implant failure (p < 0.05); other patient characteristics, systemic diseases, implant diameter, immediate loading, and immediate placement, did not have an effect on implant failure rates. Patients reported a high degree of satisfaction regardless of their age group or length of the observation period.
Conclusions
Immediately placed implant had CSR as high as delayed placed implants, and 7-year CSRs of immediate loading were not significantly different from delayed loading. The procedure also had a high degree of chewing ability, esthetic appearance, and overall satisfaction. The study results suggested that the clinical procedures applied in this study to completely edentulous patients were acceptable rehabilitation procedures.
Copyright © 2018 The Authors. This is an open access article distributed under the terms of the Creative Commons CC BY license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/