Comparison of three different types of implantâ supported fixed dental prostheses: A longâ term retrospective study of clinical outcomes and costâ effectiveness

ObjectiveTo study the performance of 2â 3 posterior boneâ level dental implants constructed with either three nonâ splinted crowns (NSC), three splinted crowns (SC), or a 3â unit implantâ supported bridge over two implants (ISB).Material and methodsPatients treated with three metalâ ceramic NSC, SC, or an ISB were included in the present retrospective study. Implant survival and success rate as well as all biological and technical complications were collected. The cost associated with each of the treatment options was evaluated in the comparative analysis.ResultsOne hundred and fortyâ five patients (40 NSC, 52 SC, and 53 in the ISB) receiving 382 boneâ level implants (120 NSC, 106 ISB, and 156 SC) were included (mean followâ up of 76.2 months). Lack of success was observed in 33.8% of the total patient sample, being lower in the ISB group. Implant survival rates were 92.5% in the NSC, 100% in the ISB, and 88.5% in the SC, with significant difference noted between the ISB and SC (p = 0.01). Overall, 9.9% of the total implants were found to have periâ implantitis (PI), with 16.7% in the SC, 7.5% in the NSC, and 2.8% in the ISB. Patients presenting prosthodontic complications were significantly higher in NSC (32.5%) than ISB (13.2%) and SC (15.4%). The total cost of the ISB group was significantly lower when compared to the NSC and SC groups (p < 0.001).ConclusionsAn 3â unit implantâ supported bridge restoring 2 implants seems to present the most ideal longâ term therapeutic solution, among the investigated approaches in this study, in rehabilitating a 3â unit edentulous area.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149366/1/clr13415.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149366/2/clr13415_am.pd

Association between periodontitis and systemic medication intake: A case- control study

BackgroundTo investigate the frequency of systemic drugs taken by elderly patients with or without periodontitis and the possible association between medication consumption and the severity of periodontitis.MethodsA total of 1221 patients, including 608 with generalized moderate to severe periodontitis (periodontitis group) and 613 age- and gender- matched individuals with healthy periodontium (healthy group) were selected. Systemic conditions, medications and periodontal status were recorded. Medication intake frequency (%) was compared using unconditional logistic regression.ResultsThe top three most common medications were angiotensin- converting enzyme (ACE) inhibitors (17.9%), antidepressants (17.8%), and lipid- lowering medications (16.5%). Both ACE inhibitors and antidepressants showed statistically higher intake frequency in the periodontitis group relative to healthy controls (21.5% versus 14.4%; odds ratio [OR] = 1.64), (21.1% versus 14.5%, OR = 1.57) (P < 0.01). Additionally, intake of oral hypoglycemic agents, calcium channel blockers (CCB), insulin, and diuretics were significantly higher in the periodontitis group with OR = 2.49, 2.32, 2.08 and 1.79, respectively (P < 0.05). Several medications demonstrated a disease severity- dependent association comparing generalized severe periodontitis with moderate periodontitis and healthy group: oral hypoglycemic agents (17.4% versus 16.8% versus 8.0%), CCB (14.8% versus 14.4% versus 8.0%) and anticonvulsants (13.4% versus 7.7% versus 6.4%) with OR of 2.43, 1.99, and 2.28 (severe periodontitis versus healthy group), respectively.ConclusionThere was a significantly higher frequency of medication intake related to cardiovascular disease and diabetes in patients with periodontitis. A disease severity- dependence with medication intake frequency was also noted. This study provides indirect evidence for the possible relationship between systemic diseases and periodontitis.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163409/2/jper10532_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163409/1/jper10532.pd

Long-term Clinical Outcomes and Cost-Effectiveness of Full-Arch Implant-Supported Zirconia-Based and Metal-Acrylic Fixed Dental Prostheses: A Retrospective Analysis

Purpose: To provide a long-term comparison of metal-acrylic and zirconia implant-supported fixed complete dental prostheses. Materials and methods: Patients treated with a metal-acrylic or zirconia fixed implant prosthesis with a minimum 5-year follow-up were included. All complications were registered, along with events such as peri-implantitis and implant failure. Survival and all costs associated with the prostheses were assessed to provide an overall evaluation of each type of fixed implant prosthesis protocol. Results: Seventy-four rehabilitated arches (43 metal-acrylic, 31 zirconia, mean follow-up: 8.7 ± 3.37 years) were included. Delayed complications accompanied the metal-acrylic prostheses more frequently. In both groups, single tooth chipping/fracture was the most prominent minor complication, and incidence of multiple teeth and framework fracture was the most frequent major complication. Zirconia fixed implant prostheses demonstrated higher prosthetic survival rates than the metal-acrylic prostheses (93.7% ± 5.5% at 5 years vs 83.0% ± 11.1%). No difference was observed for peri-implantitis or implant failure. The initial cost for zirconia prosthesis fabrication was significantly higher than metal-acrylic hybrids (an estimated difference of $7,829 [P < .001]); however, due to reduced complication rates for the zirconia fixed implant prosthesis, maintenance and treatment for complications did not greatly differ between groups. Conclusion: Within the limitations, zirconia fixed implant prostheses presented higher initial costs than metal-acrylic hybrids, however, with satisfactory outcomes, reduction of overall complications, and superior survival rates.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/169152/1/Barootchi et al. 2020 - Long-term clinical outcomes and cost-effectiveness of full-arch.pdfDescription of Barootchi et al. 2020 - Long-term clinical outcomes and cost-effectiveness of full-arch.pdf : Full text of published articleSEL

Influence of restorative design on the progression of peri- implant bone loss: A retrospective study

BackgroundClinical data on the restorative designs affecting the early progression of peri- implantitis are scarce. The aim of this retrospective study was to evaluate the influence of several restorative factors (e.g., restoration emergence angle, and internal screw length/diameter) on the marginal bone loss around implants with peri- implantitis.MethodsImplants diagnosed with peri- implantitis having 1- (T1) and 2- year (T2) follow- ups were included. In addition, within 6 months pre- diagnosis (Tb), all cases required to have full documentation in which no evidence of peri- implantitis was not indicated. Changes in marginal bone levels (MBLs) from Tb to T1 and from T1 to T2 were evaluated. The effect of several variables on MBLs changes was assessed via univariate and multivariate generalized estimating equations.ResultsEighty- three bone- level implants from 65 patients were selected. The mean follow- up before peri- implantitis diagnosis was 99.47 ± 47.93 months. The radiographic mean marginal bone loss was 1.52 ± 1.33 mm (Tb to T1) and 0.58 ± 0.52 mm (T1 to T2). Restoration emergence angle and frequency of maintenance visits significantly affected MBLs from Tb to T1. Besides, 66.3% of the included implants- bone levels were in a zone within 1 mm of the apical end of the internal screw at T1 and remained in this zone during the second follow- up year.ConclusionsSignificant marginal bone loss occurred in the early post- diagnosis period of peri- implantitis, which could be affected by the restoration emergence angle. Peri- implant MBLs were frequently located in a zone within 1 mm of the apical end of the internal screw.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/167523/1/jper10652.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/167523/2/jper10652_am.pd

Metaâ analysis of randomized clinical trials comparing clinical and patientâ reported outcomes between extraâ short (â ¤6Â mm) and longer (â ¥10Â mm) implants

AimTo compare the clinical outcomes of â ¤6 mm extraâ short implants (test group) versus â ¥10 mm long implants (control group), with and without bone augmentation procedures.Materials and MethodsA systemic literature search of randomized clinical trials was performed using the PubMed (MEDLINE) and EMBASE databases. A quantitative metaâ analysis was conducted to compare all the outcome variables. Metaâ regression analysis determined the effect of bone augmentation procedures and the influence of other clinical covariates on the results.ResultsEighteen studies comprising 1,612 implants (793 extraâ short and 820 long implants) were selected for the metaâ analysis. No statistically significant difference in the survival rate was observed at 1 and 3 years (p > 0.05). Extraâ short implants displayed less marginal bone loss (MBL) from both implant placement time points (1 and 3 years) and prosthetic placement (1 year), as well as less biological complications, surgical time and treatment cost (p < 0.05). Contrarily, a statistically significant small number of prosthetic complications were reported with long implants (p < 0.05).ConclusionsPlacement of extraâ short implants (â ¤6 mm) presented as an equivalent option in the treatment of patients with an atrophic posterior arch up to 3â year followâ up. However, the longâ term effectiveness of extraâ short dental implants remains to be further studied.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147756/1/jcpe13026_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/147756/2/jcpe13026.pd