Overkappingsprothese op implantaten versus volledige prothese zonder en met mondbodemvestibulumplastiekTevredenheid en subjectief kauwvermogen

Het doel van dit gerandomiseerd klinisch onderzoek was om gedurende 5 jaar klinische resultaten, tevredenheid en subjectief kauwvermogen te evalueren na 3 behandelingsmethoden bij een edentate onderkaak. Deze methoden waren: een overkappingsprothese op 2 implantaten in de onderkaak (IMP-groep, 61 patiënten), een conventionele volledige prothese (VP-groep, 60patiënten) en een volledige prothese vervaardigd na een mondbodemvestibulumplastiek (MVP-groep, 28 patiënten). Geconcludeerd werd dat 2 enossale implantaten in een edentate onderkaak, als retentie voor een overkappingsprothese, na 5 jaar een hoog overlevingspercentage hebben (93%). De tevredenheid van de VP-groep blijft lager dan van de IMP-groep. De tevredenheid van de MVP-groep is ook lager dan die van de IMP-groep

Fabrication, workflow and delivery of reconstruction: Summary and consensus statements of group 4. The 6th EAO Consensus Conference 2021.

Objectives: To report assessments of four systematic reviews (SRs) on (i) clinical outcomes of all-ceramic implant-supported crowns (iSCs), (ii) production time, effectiveness, and costs of computer-assisted manufacturing (CAM), (iii) computer-assisted implant planning and surgery (CAIPS) time and costs, and (iv) patient-reported outcome measures (PROMS). Material and methods: An author group consisting of experienced clinicians and content experts discussed and evaluated the SRs and formulated consensus on the main findings, statements, clinical recommendations, and need for future research. Results: All four SRs were conducted and reported according to PRISMA and detailed comprehensive search strategies in at least three bibliometric databases and hand searching. The search strategies were deemed reproducible. Variation was noted regarding language restrictions and inclusion of grey literature, but the search comprehensiveness appeared persuasive. The SRs included bias risk assessments of the primary studies, and their study methodology impacted the interpretations of the extracted data. Conclusions: (i) There is limited evidence (49 NRCT) showing that veneered and monolithic all-ceramic iSCs have excellent outcomes observed up to 3 years. (ii) There is no evidence evaluating production time and effectiveness comparing subtractive and additive CAM of implant models, abutments and crowns. (iii) There is limited evidence (4 RCT) that CAIPS involves more time and costs when considering the entire workflow and for diagnostics, manufacturing, and insertion of the restoration. Time seems to be the decisive factor for higher costs. (iv) Patients' comfort increases when optical compared to conventional impressions are used for fabricating iSCs and short-span FPDs (2 RCT, 5 NRCT)