Implant-retained maxillary overdentures - Challenges and treatment modalities

Patients who experience problems with their conventional maxillary dentures may benefit from an implant-supported overdenture. However, placing implants for retaining such an overdenture can be challenging, especially in case of severe atrophy of the maxilla. A favourable treatment option for the upper jaw is a four-implant overdenture with bar-clip retained attachments. The use of two implants could be an alternative, as well as the use of a solitary anchoring system. However, this PhD research shows that both alternatives perform less well in terms of implant survival and show more bone loss around the implants. However, the patients treated with these alternatives are equally satisfied compared to patients with four implants and a bar-clip retained overdenture. Re-treatment with implants of patients in whom all implants in the already edentulous upper jaw have been lost or are about to be removed due to peri-implantitis also yields a good result, provided that a jaw reconstruction is performed and the overdenture is retained with at least four implants and a bar-clip attachment system. In other words, a four-implant overdenture in the maxilla with a bar-clip attachment system remains the gold standard

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Chemically driven switches for online detection of pH changes in microfluidic devices

The internal walls of microfabricated fluidic channels were functionalized with a selfassembled monolayer of Rhodamine B lactam. This molecule has the capability to interconvert between its open fluorescent amide form and the closed non-fluorescent lactam form upon changes of the pH conditions. The interconversion (switch) between the two reversible forms is achieved by addition of an acid or a base and is consistent with a reaction mechanism of the first order. This paper describes the online observation of such fluorescent switch covalently anchored to the channel and proposes this method as a possible sensor for the monitoring of pH changes in microreactors

Canine and feline pregnancy loss due to viral and non-infectious causes : a review.

Among the causes for pregnancy loss, viruses and non-infectious factors are among the most important. In both dogs and cats, research and clinical evidence provide proof that there is an increasing incidence of pregnancy loss associated with infectious diseases like herpesvirus, as well as the presence of toxicants or chemicals in the animal's diet and environment. Endocrine causes must be taken into consideration when dealing with pregnancy loss. This review will cover the most recent knowledge regarding viral and non-infectious of pregnancy losses in the dog and cat

Retreatment of multiple failing maxillary implants after full arch rehabilitation:a retrospective, observational cohort study

The aim of this study was to assess implant retreatment in a group of patients whose maxillary implants were all failing after full arch rehabilitation. Treatment involved implant removal, augmentation, and placement of an overdenture supported by four to six implants. All consecutive patients referred between 2008 and 2018, following multiple late implant failures in the rehabilitated maxilla, were included in the study. Seventy implants in 15 patients were evaluated at 3.3 +/- 2.5 years (range 1.1-8.6 years) after loading. Implant survival, complications, clinical parameters, marginal bone loss, and patient-related outcome measures were recorded at the time of evaluation. Overall implant survival was 95.7%. Three implant failures occurred within the first year of function. Marginal bone loss was 0.32 +/- 0.46 mm; pocket probing depth was 4.55 +/- 1.59 mm. Plaque, calculus, inflammation, and bleeding were hardly seen (median index score 0). Patients scored their satisfaction with their overdentures as high (mean overall score 8.7 +/- 1.2, maximum 10). Chewing soft and tough food was scored as 'good' and hard food as 'moderate'. The mean Oral Health Impact Profile score was 29.5 +/- 33.3. It can be concluded that the replacement of multiple failing implants in an edentulous maxilla after bone augmentation is a safe and predictable treatment procedure when applied as an implant-supported overdenture

Incidence of peri-implant mucositis and peri-implantitis in patients with a maxillary overdenture:A sub-analysis of two prospective studies with a 10-year follow-up period

Background: Though studies on maxillary overdentures show satisfying results on implant survival, patient-related outcomes and prosthetic complications, the epidemiology of peri-implant diseases in this specific group of patients has hardly been reported. While the general patient-level prevalence of peri-implant mucositis and peri-implantitis are estimated at similar to 45% and similar to 20%, respectively, the risk of developing these diseases within a specific period is less dear. To fully appreciate the epidemiology of peri-implant diseases, more long-term data on incidence of peri-implant diseases are needed. Purpose: The purpose of this sub-analysis of two prospective studies was to assess the incidence of peri-implant mucositis and peri-implantitis in fully edentulous patients with implant-retained maxillary overdentures during a 10-year follow-up period. Materials and Methods: One hundred and sixteen patients treated with implant-supported maxillary overdentures were available from two clinical trials. Data on biological complications, clinical and radiographical parameters were collected for 106 patients at 5-year, for 82 patients at 10-year follow-up. The incidence was calculated following the consensus of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Extent and severity then were calculated to enable an appropriate epidemiological description of peri-implantitis. Results: The patient-level incidence of peri-implant mucositis was 37.7% after 5 years and 64.6% after 10 years whereas the patient-level incidence of peri-implantitis was 10.4% after 5 years and 19.5% after 10 years. After 10 years, the extent of peri-implant mucositis and peri-implantitis is 52.8% and 43.8%, respectively. In terms of severity, 26.5% of all affected implants suffered from >3 mm bone loss and 17.6% of all affected implants was lost. Conclusion: Three of five fully edentulous patients with implant-supported maxillary overdentures experience peri-implant mucositis after 10 years. Peri-implantitis occurs in one of five patients after 10 years. In spite of these incidence rates, implant survival remains high