Consequence Of Tooth Loss Research Articles

Razões e consequências das perdas dentárias em adultos e idosos no Brasil: metassíntese qualitativa

Abstract The objective was to analyze and systematize evidence reported in qualitative studies on the reasons and consequences of tooth loss in adults and elderly people in Brazil. A systematic review of the literature on qualitative research methods and a meta synthesis of the results were performed. The study population consisted of adults over 18 years of age and elderly people in Brazil. Searches were performed in the BVS, PubMed, Scopus, Web of Science, BBO, Embase, EBSCO and SciELO databases. The thematic synthesis identified 8 analytical themes regarding reasons for tooth loss and 3 analytical themes regarding consequences of tooth loss. Dental pain, care model, financial situation and desire for prosthetic rehabilitation were determining factors for extractions. There was recognition of negligence in oral care, and the naturalness of tooth loss was linked to old age. Missing teeth caused psychological and physiological impacts. It is imperative to verify whether the factors that cause tooth loss persist, and how much those factors influence decisions to extract teeth among current young and adult populations. It is necessary to change the care model through the inclusion and qualification of oral health care for the young and elderly adult populations; otherwise, the model of dental mutilation and the culture of edentulism will persist.

МУЛЬТИ-ИМПЛАНТАЦИОННАЯ КОНЦЕПЦИЯ ДЕНТАЛЬНОЙ ИМПЛАНТАЦИИ В УСЛОВИЯХ РЕДУЦИРОВАННЫХ АЛЬВЕОЛЯРНЫХ ОТРОСТКОВ КОСТИ ЧЕЛЮСТЕЙ

Older people have special features. With age, the reserve abilities of the body are depleted, the immune and endocrine systems are suppressed, combined pathological conditions develop that require an integrated approach to treatment and force the doctor to prescribe numerous and varied drugs to one patient. Therefore, the doctor must take into account the physiological characteristics of the body in people of the older age group. The consequences of tooth loss have been covered in various works. It is accompanied by atrophy of the jaw bone tissue, which complicates the rehabilitation of the masticatory-speech apparatus using the method of dental implantation. At the same time, foreign and domestic authors confirm that the current level of development of dentistry allows for implant treatment, despite the insufficient amount of jaw bone tissue. In case of insufficient volume of bone tissue, the installation of implants requires the use of additional osteoplastic surgeries (OCS), which allow increasing the volume of the bone to the required level. The preferred bone material is an autoaugmentation from the donor zones of the jaws. Medical practice shows that in people with complete loss of teeth in the upper or lower jaw, adaptation to complete removable dentures is difficult. Discussing this with a dentist, patients often choose implant treatment. The choice of such treatment must be made taking into account the relationship of the masticatory-speech apparatus and the body as a whole. A dental implant cannot be considered as a separate object, it is part of the system “the patient's teeth - the prosthetic part of the implant - the implant - the bone tissue - the mucous membrane - the body" as a whole. One of the current priorities of modern dentistry is dental implantation. Implantology in the dental care of the population has played a significant role over the past decades. Over the past decades, negative trends have emerged in dental implantology: - a simplified idea of the method of implantation and plastics of the alveolar processes of the jaws; - superficial, insufficient examination of patients before treatment; - insufficient professional training of the dentist, dental technician, as well as the patient for implantation; - expansion of indications for osteoplastic and soft tissue operations accompanying the method of dental implantation - inflating prices for dental implantation before treatment and replacing expensive implants with cheap, uncertified ones. All this leads to negative results of dental treatment. The increase in the number of local and general complications in patients is increasing, there is a loss of time at the dentist and the discrediting of the implantation method itself.

Osteotome-Induced Blood Clot and Subsequent Bone Formation with the Use of Collagen Sponge for Integration of Single Dental Implants into the Atrophied Posterior Maxilla: A Retrospective Follow-Up of 36 Implants after 5 to 13 years.

Background Atrophy of the posterior maxilla as a consequence of tooth loss and sinus pneumatization is a frequent condition encountered in the clinical practice. Prosthetic rehabilitation with implants in these patients often requires some kind of bone regeneration procedure to increase the bone volume. Aim The aim of the present retrospective study is to analyze the survival and success rates of a series of implants placed in the atrophic posterior maxilla with a transcrestal osteotome procedure, without placing a bone grafting material. Materials and Methods From 2006 to 2014, 36 dental implants (Neoss Ltd., Harrogate, UK) were inserted in 36 patients with at least 4 mm of bone below the maxillary sinus using transcrestal osteotome sinus floor elevation and placement of collagen sponge below the sinus membrane. ISQ measurements were made after implant placement and at abutment surgery after 4 to 6 months. The vertical bone height (VBH) was evaluated in intraoral radiographs taken prior to surgery and in radiographs from annual check-up appointments 5 to 13 years after implant placement. In addition, marginal bone loss (MBL) was evaluated. Results One implant was lost after four years of prosthetic loading. The remaining 35 implants showed no complications and were loaded with single crowns after 4–6 months of healing. All 35 implants showed clinical success after 8.5 ± 2.8 years of prosthetic loading (from 5 to 13 years). The vertical bone height was 5.9 ± 1.4 mm at surgery, 9.7 ± 1.1 mm at second surgery after 4–6 months, and 8.3 ± 1.8 at the follow-up at 8.5 ± 2.8 years (from 5 to 13 years). The implant stability registered was 73.2 ± 6.2 ISQ at the surgery and 75.8 ± 3.9 at the second surgery after 4–6 months. Conclusions The present long-term follow-up study showed that the crestal approach for sinus floor bone augmentation without additional bone grafting results in predicable bone formation and high implant survival. The osteotome technique is a valid alternative to the more invasive lateral window technique in single cases with a minimum of 4 mm of VBH below the maxillary sinus.

Implant-prosthetic rehabilitation of patients with severe horizontal bone deficit on mini-implants with two-piece design\u2014retrospective analysis after a mean follow-up of 5 years

BackgroundAs a consequence of tooth loss due to trauma or extraction, a reduced alveolar crest volume limits the deployment of standard implants in certain patient cases. For this reason, minimal-invasive treatment with mini-dental implants (MDI) might be an option to allow implant treatment even in cases with severe horizontal bone loss without augmentation measures. The aim of this retrospective cohort study was to investigate clinical and radiological implant, as well as patient-related parameters after treatment with MDI.ResultsClinical and radiological records of 19 female (82.6%) and 4 male patients (17.4%) (N = 23), who received 52 mini-dental implants with a two-piece design in a single surgical center between November 2011 and October 2018, were retrospectively analyzed. Implants were submitted to conventional loading on different types of screwed superstructures. Crestal bone loss was measured on standardized periapical radiographs. Patient-related outcome parameters (PROMs) were recorded during follow-up period. Mean clinical and radiological follow-up was 69.6 months (5.8 years) and 51.6 months (4.3 years), respectively. Three implants were lost in two patients, leading to an implant survival rate of 94.2%. Mean radiological crestal bone loss was 1.6 mm. Both amount of peri-implant recession and crestal bone loss were significantly correlated (r = 0.65; p < 0.001). Likewise, a significant correlation was observed between deeper probing depths and increased peri-implant bone loss (r = 0.41; p = 0.012). Alveolar ridges with a reduced alveolar crest width were significantly correlated with higher peri-implant bone loss as well (r = − 0.33; p = 0.011). No prosthetic complications were reported during follow-up. Extent of midfacial recession and papilla height loss had a significant negative impact on most of the PROMs.ConclusionsTreatment with MDI seems to be a successful alternative treatment option, especially for elderly patients with reduced crest width at implant sites. Due to the good clinical results and high survival and success rates, this treatment option was associated with high patient satisfaction. Despite the promising results, particular consideration should be given to appropriate treatment planning in these patients due to the strong correlation between peri-implant soft-tissue parameters, crestal bone loss, and reduced alveolar crest width.

Management of localized anterior tooth wear in a patient with bilateral distal extension edentulous mandibular arches

Although managing the consequences of tooth loss is not easy, the desired outcome can be achieved with collaboration by the patient, clinician and technician. The ultimate objective is not to reverse the effects of ageing but to improve the quality of life of an affected individual by adhering to biological procedures as much as possible and replacing missing teeth in the most appropriate way. CPD/Clinical Relevance: This case report describes the management of localized anterior tooth wear in a patient with bilateral distal extension edentulous mandibular arches.

Periodontal disease and risk of non-Hodgkin lymphoma in the Health Professionals Follow-Up Study.

Periodontal disease is a chronic inflammatory condition that has been associated with chronic diseases, including cancer. In an earlier prospective cohort analysis within the Health Professionals Follow-Up Study (HPFS), we observed a 31% higher risk of non-Hodgkin lymphoma (NHL) among participants with severe periodontal disease at baseline. Here, we extend the study with an additional 8 years of follow-up, and conduct analyses with updated periodontal disease status and NHL subtypes. The HPFS is an ongoing prospective cohort study of 51,529 men in the USA Between baseline in 1986 and 2012, 875 cases of NHL were diagnosed, including 290 chronic lymphocytic leukemia/small lymphocytic lymphomas (CLL/SLL), 85 diffuse large B-cell lymphomas and 91 follicular lymphomas. We performed multivariable Cox proportional hazards regression to evaluate associations of interest. History of periodontal disease at baseline was positively associated with risk of NHL overall (hazard ratio (HR) = 1.26, 95% confidence interval (CI): 1.06-1.49) and CLL/SLL (HR = 1.41, 95% CI: 1.04-1.90). With updated periodontal status, HRs were 1.30 (95% CI: 1.11-1.51) for NHL overall and 1.41 (95% CI: 1.08-1.84) for CLL/SLL. In contrast, after adjusting for periodontal disease, tooth loss was inversely associated with NHL, suggesting that other causes or consequences of tooth loss may have different implications for NHL etiology. Our findings suggest that periodontal disease is a risk factor for NHL. Whether periodontal disease is a direct or indirect cause of NHL, or is a marker of underlying systemic inflammation and/or immune dysregulation, warrants further investigation.

Hemisection: Resection for conservation – A case report

This case report presents hemisection as a treatment option to save the extensively affected molars thereby preventing the undesirable consequences of tooth loss. Hemisection means the division of mandibular molar into two halves followed by removal of the diseased root with its accompanying crown portion. Careful case selection is necessary for long-term success.

Evaluation of the morphological changes in the mandible for dentate and totally edentate elderly population using cone-beam computed tomography

The loss of teeth considerably modifies the mandibular shape. The aim of this study was to compare the morphological changes in the mandible for dentate and totally edentate elderly subjects using cone-beam computed tomography. In total, 50 cone-beam computed tomography patients (25 dentate, 25 edentate) without any maxilla-mandibular dysmorphosis were analyzed retrospectively. Panoramic representations of the mandible with superimposed axial slices and cross-sectional slices were developed with the cone-beam computed tomography scans. Values of the mandibular cortical index, bone quality index, gonial angle, antegonial angle, antegonial depth and condyle angle in the left and right side were measured. There was a significant difference in the mandibular cortical index between the total edentate group and the dentate group in the left side of the mandible (p<0.001). There was a significant difference in the bone quality index between the total edentate group and the dentate group in the right side and the left side (p<0.001). There was a significant difference in the bone quality index between the right side and the left side (p<0.005). When comparing gender, there was only a difference in the right side (p<0.05). Our study concluded that the mandibular basal bone morphology changes as a consequence of tooth loss. Cone-beam computed tomography is shown to be a good tool in investigating and achieving these results.

Rehabilitation of occlusion – science or art?

The primary objective of rehabilitating occlusion is to improve stomatognathic function in patients experiencing dysfunction in mastication, speech, and swallowing as a consequence of tooth loss. The procedure of occlusal treatment involves improving the morphology and the stomatognathic function. Several practical methods and morphological endpoints have been described in occlusal rehabilitation. We made a selection of these (mandibular position, occlusal plane, occlusal guidance, occlusal contact, face-bow transfer, use of an adjustable articulator and occlusal support) and performed a literature review to verify the existence of compelling scientific evidence for each of these. A literature search was conducted using Medline/PubMed in March 2011. Over 400 abstracts were reviewed, and more than 50 manuscripts selected. An additional hand search was also conducted. Of the many studies investigating stomatognathic function in relation to specific occlusal schemes, most studies were poorly designed and of low quality, thus yielding ambiguous results. Overall, there is no scientific evidence that supports any specific occlusal scheme being superior to others in terms of improving stomatognathic function, nor that sophisticated methods are superior to simpler ones in terms of clinical outcomes. However, it is obvious that the art of occlusal rehabilitation requires accurate, reproducible, easy and quick procedures to reduce unnecessary technical failures and/or the requirement for compensatory adjustments. Therefore, despite the lack of scientific evidence for specific treatments, the acquisition of these general skills by dentists and attaining profound knowledge and skills in postgraduate training will be necessary for specialists in charge of complicated cases.

Het opstellen van een behandelplan voor een frameprothese

When considering prosthetic replacement of absent teeth, a treatment plan is necessary. In evaluating whether replacement of teeth is sensible, the causes and consequences of tooth loss must be considered. This concerns information about problems having to do with the patient, potential complications, purely prosthodontic problems, and specific problems. The patient-related problems require collecting data through patient history as well as a clinical and radiologic examination. Complications are risk-factors which negatively influence the prognosis of general health or of a treatment. Potential complications should be eliminated as much as possible through a preliminary treatment. Purely prosthodontic problems are conditions in the area of absence of several teeth or parts of them, and in the area of occlusal and mandibular stability and articulation. Specific problems may be related to inadequate interocclusal space and the quality of the abutment teeth. A cast metal frame removable partial denture may be a relatively inexpensive and minimally treatment alternative for an expensive and complicated treatment with 1 or more fixed partial dentures.

Influence of edentulousness on gonial angle, ramus and condylar height

It has been shown that the shape of the mandible correlates with occlusal condition and the function of the masticatory muscles. Edentulous subjects have a wider gonial angle than dentate subjects, and a gender difference has also been shown. However, some studies have reported differing results. Less is known about the effect of dental status and gender on the ramus and condylar height. The aim of this study was to evaluate the association of tooth loss on the shape of mandible (i.e., gonial angle, ramus height and condylar height) in subjects aged 60 years and older. A total of 1036 subjects (667 dentate, 389 edentulous; 554 women and 482 men) were included in the study. Interviews and clinical and panoramic radiographic examinations were carried out. The gonial angle of the mandible and the mandibular and condylar height were measured using panoramic radiographs. In edentulous subjects, the gonial angle was significantly larger, while the ramus and condylar height was significantly smaller on both sides compared with dentate subjects. Women had a significantly larger gonial angle and smaller ramus and condylar height on both sides compared with men. In conclusion, the morphology of the mandible changes as a consequence of tooth loss, which can be expressed as a widening of the gonial angle and shortening of the ramus and condylar height. These findings highlight the importance of rehabilitation of the masticatory system to maintain good functioning of the masticatory muscles for as long as possible.

Consequences of Tooth Loss: 1. The Patient Perspective – Aesthetic and Functional Implications

Tooth loss in adults is becoming less common, and the attitudes of patients and professionals towards it have changed dramatically over the last quarter of a century. This paper explores these changes, from the patient's perspective, in terms of psychological perspectives, aesthetics, function and the need or desire for tooth replacement. A second paper will examine the evidence available on the positional and functional changes following tooth loss. Clinicians need to have an awareness of changes in disease patterns, trends in patient expectations and the demand for restorative interventions.

Interleukin‐1 Gene Polymorphism, Diabetes, and Periodontitis: Results From the Study of Health in Pomerania (SHIP)

Periodontitis is a bacterial inflammatory disease leading to attachment loss with the consequence of tooth loss. There exists a multifactorial risk pattern including bacterial challenge, age, smoking, diabetes mellitus, as well as socioeconomic and genetic factors. An interleukin (IL)-1 haplotype is associated with periodontitis. We report the relationship between type 2 diabetes, the IL-1A/1B haplotype, and periodontitis in a population-based study. In a cross-sectional health survey in northeast Germany, we genotyped 1,515 subjects aged 40 to 60 years for the IL-1 genotype, examined their periodontal status, and assessed diabetes, including the history of diagnosed diabetes, the use of antidiabetic medications, and hemoglobin A(1c) (HbA(1c)) measures. Subjects with increased levels of HbA(1c) had more widespread and severe periodontal disease than normoglycemic subjects. There is a gene-environmental interaction because diabetic subjects bearing a variant IL-1 genotype C/T or T/T had an enhanced risk for periodontal disease in comparison with their IL-1 wild-type counterparts. Bleeding on probing (P = 0.007), attachment loss (P = 0.009), and number of teeth (P <0.001) were associated significantly with diabetes and the IL-1 genotype. Logistic regression and a matched-pair analysis confirmed these results. Subjects with type 2 diabetes have an increased risk for periodontitis, which is aggravated further if combined with the variant IL-1A/1B genotype.

Dose-effect relation of smoking and the interleukin-1 gene polymorphism in periodontal disease.

Periodontitis is a bacterial inflammatory disease leading to attachment loss with the consequence of tooth loss. There exists a multifactorial risk pattern including bacterial challenge, smoking, age, gender, diabetes, and socioeconomic and genetic factors. Smoking has the highest impact on the course of the disease modulated by all the other factors. Here, we report the relationship between smoking and the genetic polymorphism of interleukin-1 (IL-1). In a randomly selected population-based study, we genotyped 1,085 test persons for the IL-1 genotype, examined their periodontal status, and assessed their smoking behavior including present and past quality and quantity of smoking. There was a significant dose-effect relationship between the exposure to tobacco smoke and the extent of periodontal disease assessed as attachment loss and tooth loss. Moreover, there was a gene-environmental interaction. Subjects bearing at least one copy of the variant allele 2 at positions IL-1A -889 and IL-1B +3954 (genotype positive) had an enhanced smoking-associated periodontitis risk as compared to their IL-1 genotype-negative counterparts. With genotype-negative non-smokers as a reference, logistic regression resulted in odds ratios of 0.98 (95% confidence interval: 0.83 to 1.14), 2.37 (1.96 to 2.87), and 4.50 (2.30 to 8.82) for genotype-positive non-smokers, genotype-negative smokers, and genotype-positive smokers, respectively. There is a gene-environmental interaction between smoking and the IL-1 genetic polymorphism. Smokers bearing the genotype-positive IL-1 allele combination have an increased risk of periodontitis. The IL-1 genotype has no influence in non-smokers.

Impact of Genetic Polymorphisms on the Smoking-related Risk of Periodontal Disease: the Population-based Study SHIP

Periodontitis is a bacterial inflammatory disease leading to attachment loss with the consequence of tooth loss. There exists a multifactorial risk pattern including bacterial challenge, smoking, age, sex, diabetes, socio-economic and genetic factors. Smoking has the highest impact on the course of the disease modulated by all the other factors. Here, we report the relationship between smoking and the polymorphisms of genetic polymorphisms inflicted in the pathogenesis.In a randomly selected population-based study, 1083 subjects were typed for the polymorphisms of the IL-1 genotype, Fcγ RIIIb receptor gene, myeloperoxidase and N-acetyltransferase (NAT2) and related to their periodontal state. Smoking behavior was assessed including present and past quality and quantity of smoking.There is a significant dose-effect relationship between the exposure to tobacco smoke and the extent of periodontal disease assessed as attachment loss and tooth loss. Moreover, there are gene-environmental interactions as subjects bearing variant genotypes show an enhanced smoking-associated risk of the disease modulated by these genotypes. In non-smokers, the impact of these genetic polymorphisms is mostly negligible.This study provides support for the hypothesis that subjects bearing genetic variants of polymorphically expressed phenotypes are at an increased risk of periodontitis when smoking. Mostly, this may be accomplished via the influence of smoking-related impairment on defense mechanisms rather than on the pathogenic pathways.

Impact of Genetic Polymorphisms on the Smoking-related Risk of Periodontal Disease: the Population-based Study SHIP

Periodontitis is a bacterial inflammatory disease leading to attachment loss with the consequence of tooth loss. There exists a multifactorial risk pattern including bacterial challenge, smoking, age, sex, diabetes, socio-economic and genetic factors. Smoking has the highest impact on the course of the disease modulated by all the other factors. Here, we report the relationship between smoking and the polymorphisms of genetic polymorphisms inflicted in the pathogenesis.In a randomly selected population-based study, 1083 subjects were typed for the polymorphisms of the IL-1 genotype, Fcγ RIIIb receptor gene, myeloperoxidase and N-acetyltransferase (NAT2) and related to their periodontal state. Smoking behavior was assessed including present and past quality and quantity of smoking.There is a significant dose-effect relationship between the exposure to tobacco smoke and the extent of periodontal disease assessed as attachment loss and tooth loss. Moreover, there are gene-environmental interactions as subjects bearing variant genotypes show an enhanced smoking-associated risk of the disease modulated by these genotypes. In non-smokers, the impact of these genetic polymorphisms is mostly negligible.This study provides support for the hypothesis that subjects bearing genetic variants of polymorphically expressed phenotypes are at an increased risk of periodontitis when smoking. Mostly, this may be accomplished via the influence of smoking-related impairment on defense mechanisms rather than on the pathogenic pathways.

Discussion

It is important that the clinician be familiar with the consequences of tooth loss and its effect not only on oral function but also on facial form when planning treatment. Pre-implant surgery is intended to restore oral function and facial form by providing the hard tissue and soft tissue environment for optimal dental implant position and biomechanical function. Previous studies have tended to concentrate more on the surgical technique and implant survival rather than on the restoration of facial form and its measurement. 1 Adell R Lekholm U Grondahl K et al. Reconstruction of severely resorbed edentulous maxillae using osseointegrated fixtures in immediate autogenous bone grafts. Int J Oral Maxillofac Implants. 1990; 5: 233 PubMed Google Scholar , 2 Fonseca RJ Frost D Zeitler D et al. Osseous reconstruction of edentulous bone loss. in: Reconstructive Preprosthetic Oral and Maxillofacial Surgery. Saunders, Philadelphia, PA1986: 119-128 Google Scholar , 3 Jensen J Krantz Simonsen E Sindet-Pedersen S Reconstruction of the severely resorbed maxilla with bone grafting and osseointegrated implants: A preliminary report. J Oral Maxillofac Surg. 1990; 48: 27 Abstract Full Text PDF PubMed Scopus (180) Google Scholar , 4 Keller EE Van Roekel NB Desjardins RP et al. Prosthetic-surgical reconstruction of the severely resorbed maxilla with iliac bone grafting and tissue-integrated prostheses. Int J Oral Maxillofac Implants. 1987; 2: 155 PubMed Google Scholar In this study, the authors have gone some way to redress the balance.

Partial edentulism, prosthetic treatment and oral function in a Dutch population.

The aim of this study was to gain a better insight into the location and frequency of prosthetic replacements and the consequences of tooth loss on oral function. The sample, stratified according to socio-economic class and age, consisted of 750 subjects. The investigation was done by questionnaire and clinical examination. In the lower social levels the percentage of removable prostheses was lower than in the higher levels. An average of 60% of all open tooth spaces were not prosthetically restored. In the lower jaw 1 to 3 free-end spaces were completed with removable partial dentures (RPD). The present study did not support a relationship between missing teeth or number of contacting pairs and the functioning of the dentition. The distribution of antagonistic contacts in the dental arch seems to be of more importance.

Prevalence and awareness of malocclusion in Swedish men

Previous orthodontic treatment, the awareness of malocclusion, the demand for orthodontic treatment and the prevalence of malocclusion were studied in 389 Swedish men, aged 21-54 years (mean age 32 years). Nine percent had been treated with an orthodontic appliance and 15% reported that permanent teeth had been extracted on orthodontic indications. Malposition of teeth was found in 75%, with rotation as the most common type of malposition. Crowding was recorded in 43% and spacing in 18%. Fifty-seven percent had some occlusal anomaly. The need for orthodontic treatment was rated on a four-point scale. It was found that 76% were in need of treatment. The need for treatment was only slight in half of the men but moderate to urgent in 25% of the sample. About a quarter of the men were aware of malposition of front teeth, equally often for maxillary and mandibular teeth, but only about 1% were aware of malposition of posterior teeth. Only a few percent thought they were in need of orthodontic treatment. The presence of malocclusion was correlated to age, place of birth and educational level. This might perhaps be a consequence of tooth loss.