Functional and Patient-Centered Treatment Outcomes with Mandibular Overdentures Retained by Two Immediate or Conventionally Loaded Implants: A Randomized Clinical Trial

This study aims to assess the treatment outcomes (functional and subjective) of mandibular overdentures retained on two implants with or without an immediate loading protocol. In this randomized clinical trial, twenty fully edentulous patients were treated with a mandibular two-implant-retained overdenture and a complete new maxillary denture. In half of the sample, the implants were loaded immediately by means of VulkanLoc® abutments after emplacement of the implant, but in the counterparts, these VulkanLoc® abutments were connected to implants two months after the surgery (conventional protocol), and until that time the dentures were retained by healing abutments. Treatment outcomes were assessed at two, six, and twelve months after surgery. Functional outcomes were calculated according to masticatory performance, estimated by the mixed fraction of a two-coloured chewing gum after five, ten, and fifteen chewing strokes, by the occlusal force recorded by pressure-sensitive sheets, and by the bioelectrical muscular activity. The subjective outcomes of the treatment were assessed using both the oral satisfaction scale (visual analogue scale) and the Spanish version of the Oral Health Impact Profile (OHIP-20). The findings of the present study show that new complete dentures resulted in significant improvements in chewing ability, patient satisfaction, and oral health-related quality of life and that subsequent implant-retained overdentures produced further and faster significant improvements. The loading protocol may influence those positive self-reported outcomes rather than the objective functional evaluations.

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Patient-Centered Treatment Outcomes with Full-Arch PEEK Rehabilitation Supported on Four Immediate or Conventionally Loaded Implants. A Randomized Clinical Trial

Journal of Clinical Medicine ◽

10.3390/jcm10194589 ◽

2021 ◽

Vol 10 (19) ◽

pp. 4589

Author(s):

Javier Montero ◽

Yasmina Guadilla ◽

Javier Flores ◽

Beatriz Pardal-Peláez ◽

Norberto Quispe-López ◽

...

Keyword(s):

Clinical Trial ◽

Treatment Outcomes ◽

Randomized Clinical Trial ◽

Health Impact ◽

Masticatory Performance ◽

Patient Centered ◽

Satisfaction Scale ◽

Chewing Gums ◽

Ability Tests ◽

Mixing Ability

This study aims to assess the treatment outcomes (functional and subjective) of full-arch fixed hybrid rehabilitations made of PEEK (poly-ether-ether-ketone) with milled crowns of nano-filled composite (NFC) supported on four to six implants. In this randomized clinical trial, 34 edentate patients in the upper and/or the lower jaws were treated with the fixed hybrid dentures. In 16 patients (47.1% of the sample), the implants were loaded immediately (IL) by means of a provisional fixed rehabilitation made of PMMA (polymethylmethacrylate) screwed on Multi-Unit (MU) abutments connected after emplacement of the implant; however, in the counterparts (n = 18) these MU abutments were covered by healing caps and were left unloaded during two months (conventional loading protocol—CL), when all patients received a fixed hybrid PEEK-NFC rehabilitation on the upper and/or the lower jaw. Treatment outcomes were assessed 12 months after prostheses delivery. Functional outcomes were calculated according to masticatory performance, estimated by mixing ability tests of two colored chewing gums after ten chewing strokes, by the occlusal force/area recorded by pressure-sensitive sheets, and by electromyography of masseters and temporal muscles at maximum biteforce. The subjective outcomes of the treatment were assessed using both the oral satisfaction scale (visual analog scale) and the Spanish version of the Oral Health Impact Profile (OHIP-20). The findings of the present study showed that treatment with fixed PEEK-NFC hybrid prostheses significantly improved the masticatory performance, bite force, occlusal pattern, quality of life, and satisfaction, with the IL group being those with significantly higher occlusal bite forces and greater satisfaction in comparison with CL group. It should be concluded that PEEK-NFC hybrid prostheses can improve several patient-centered outcomes and that loading protocol significantly affects the patient’s self-rated satisfaction.

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Subjective Evaluation of Denture Adhesives: A Multicenter Randomized Controlled Trial

JDR Clinical & Translational Research ◽

10.1177/2380084419837607 ◽

2019 ◽

Vol 5 (1) ◽

pp. 50-61 ◽

Cited By ~ 1

Author(s):

G. Ohwada ◽

S. Minakuchi ◽

Y. Sato ◽

H. Kondo ◽

T. Nomura ◽

...

Keyword(s):

Oral Health ◽

Controlled Trial ◽

Health Impact ◽

Control Group ◽

Randomized Controlled ◽

Chewing Ability ◽

Denture Adhesives ◽

Edentulous Patients ◽

Powder Type ◽

Group Comparisons

Introduction: Many reports show that denture adhesives improve the retention and stability of dentures. However, few randomized controlled trials have examined the effects of denture adhesives. Objective: This 10-center randomized controlled trial with parallel groups involving 200 edentulous patients wearing complete dentures aimed to evaluate the effects of short-term use of cream and powder denture adhesives. Methods: Patients were allocated into 2 cream- and powder-type adhesive groups and 1 control group. Intervention groups were treated with the 2 adhesives (1 each), and the control group received saline solution. Adhesive or control was applied to the denture-mucosal surface for 4 d, and data at baseline and after day 4 of intervention (i.e., 8 meals) were obtained. Patient satisfaction was evaluated with a 100-mm visual analog scale. Oral health–related quality of life was measured with the Japanese version of the Oral Health Impact Profile for Edentulous Patients. Perceived chewing ability was evaluated by a questionnaire regarding ease of chewing and swallowing food. Between-group comparisons were performed with Kruskal-Wallis tests with the Mann-Whitney U test adjusted by Bonferroni correction. Within-group comparisons of pre- and postintervention measurements were performed with the Wilcoxon signed-rank test. Intention-to-treat analysis was also performed. Results: Between-group comparisons showed no significant differences for general satisfaction or Oral Health Impact Profile for Edentulous Patients. However, significant differences in satisfaction with various denture functions with cream- and powder-type adhesives were seen in pre- and postintervention comparisons ( P < 0.05). Significant differences were also observed for perceived chewing ability of hard foods ( P < 0.05). Conclusion: These results suggest that although denture adhesives do not invariably improve denture function, they do affect subjective evaluations and possibly chewing of hard foods. Therefore, the effects of denture adhesive use are insufficient to resolve any fundamental dissatisfaction with dentures ( ClinicalTrials.gov NCT01712802 ). Knowledge Transfer Statement: The results of this study suggest that denture adhesives should be applied under certain conditions; however, an appropriate diagnosis is important before application. These practice-based data provide information to establish evidence-based guidelines for applying denture adhesives.

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Patient satisfaction and comfort after a full-arch immediate loaded prosthesis

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-19-00274 ◽

2020 ◽

Author(s):

Elena Dellepiane ◽

Francesco Pera ◽

Paola Zunino ◽

Maria Grazia Mugno ◽

Paolo Pesce ◽

...

Keyword(s):

Quality Of Life ◽

Oral Health ◽

Intermediate Phase ◽

Critical Issue ◽

Health Impact ◽

Immediate Loading ◽

Oral Rehabilitation ◽

Masticatory Ability ◽

Chewing Ability

The aim of this study was to assess oral health related quality of life (OHRQoL) of patients before, during and after completion of implant-supported full-arch immediate loading rehabilitation according to the Columbus Bridge Protocol (CBP). 25 patients with compromised dentition were rehabilitated according to the CBP and were assessed for OHRQoL using 4 questionnaires specifically realized for this study and inspired to the OHIP (Oral Health Impact Profile) questionnaire. Patients assessed themselves before surgery, during the healing period (1 week and 2 months after surgery) and after definitive prosthodontic treatment (4 months after surgery). The questionnaires specifically investigated patients’ pain, confort, home oral hygiene habits, satisfaction related to esthetics, masticatory ability, phonetics and general satisfaction toward the treatment.Patients reported an improvement of OHRQoL after full-arch immediate loading rehabilitation. A statistically significant improvement in aesthetic and chewing ability was found. After 4 months 92% of the patients did not feel tense with their smile, 96% did not show problems to relate with other people or smiling, 92% did not show difficulty to eat some foods. Phonetics was found to be a critical issue, especially in the intermediate phase of healing. One week after surgery the percentage of patients who was very satisfied with phonetics slightly decreased from 48% to 36%. The assessment of patients' OHRQoL related to full-arch immediate loading implant therapy exhibited a significant improvement of their quality of life. The questionnaires herein presented could be an effective tool to evaluate patients' reaction to oral rehabilitation.

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Comparative Evaluation of Various Patient Centered Outcomes Following Gingival Depigmentation Using Diode LASER in Different Modes: A Randomized Clinical Trial

Case Medical Research ◽

10.31525/ct1-nct04217434 ◽

2020 ◽

Author(s):

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Diode Laser ◽

Comparative Evaluation ◽

Patient Centered ◽

Gingival Depigmentation

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The Impact of Prior Use of Corticosteroid to Dental Extraction on Oral Health-Related Quality-of-Life and Clinical Outcomes: A Randomized Clinical Trial

Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.joms.2020.08.013 ◽

2020 ◽

Vol 78 (12) ◽

pp. 2153.e1-2153.e9

Author(s):

Heitor B. Pansard ◽

Mayara C. Prado ◽

Gabriel F. Marchi ◽

Camila S. Sfreddo ◽

Jovito A. Skupien

Keyword(s):

Quality Of Life ◽

Clinical Trial ◽

Oral Health ◽

Randomized Clinical Trial ◽

Health Related Quality ◽

Prior Use ◽

Related Quality ◽

Health Related ◽

The Impact

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Accuracy, Labor-Time and Patient-Reported Outcomes with Partially versus Fully Digital Workflow for Flapless Guided Dental Implants Insertion—A Randomized Clinical Trial with One-Year Follow-Up

Journal of Clinical Medicine ◽

10.3390/jcm10051102 ◽

2021 ◽

Vol 10 (5) ◽

pp. 1102

Author(s):

Corina Marilena Cristache ◽

Mihai Burlibasa ◽

Ioana Tudor ◽

Eugenia Eftimie Totu ◽

Fabrizio Di Francesco ◽

...

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Dental Implants ◽

Entry Point ◽

Angular Deviation ◽

Digital Workflow ◽

Position Information ◽

Patient Reported ◽

The Mean ◽

Edentulous Patients

(1) Background: Prosthetically-driven implant positioning is a prerequisite for long-term successful treatment. Transferring the planned implant position information to the clinical setting could be done using either static or dynamic guided techniques. The 3D model of the bone and surrounding structures is obtained via cone beam computed tomography (CBCT) and the patient’s oral condition can be acquired conventionally and then digitalized using a desktop scanner, partially digital workflow (PDW) or digitally with the aid of an intraoral scanner (FDW). The aim of the present randomized clinical trial (RCT) was to compare the accuracy of flapless dental implants insertion in partially edentulous patients with a static surgical template obtained through PDW and FDW. Patient outcome and time spent from data collection to template manufacturing were also compared. (2) Methods: 66 partially edentulous sites (at 49 patients) were randomly assigned to a PDW or FDW for guided implant insertion. Planned and placed implants position were compared by assessing four deviation parameters: 3D error at the entry point, 3D error at the apex, angular deviation, and vertical deviation at entry point. (3) Results: A total of 111 implants were inserted. No implant loss during osseointegration or mechanical and technical complications occurred during the first-year post-implants loading. The mean error at the entry point was 0.44 mm (FDW) and 0.85 (PDW), p ≤ 0.00; at implant apex, 1.03 (FDW) and 1.48 (PDW), p ≤ 0.00; the mean angular deviation, 2.12° (FDW) and 2.48° (PDW), p = 0.03 and the mean depth deviation, 0.45 mm (FDW) and 0.68 mm (PDW), p ≤ 0.00; (4) Conclusions: Despite the statistically significant differences between the groups, and in the limits of the present study, full digital workflow as well as partially digital workflow are predictable methods for accurate prosthetically driven guided implants insertion.

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