Prosthetic Treatment Modalities Research Articles

Awareness about Prosthodontic Treatment Modalities based on Socioeconomic Status among Patients Visiting Dental Colleges in Jharkhand, India- A Patient Survey

Introduction: The questionnaire-based survey was carried out to evaluate about different types of prosthetic treatment modalities specifically removable prosthesis, fixed teeth supported prosthesis and implants in relation to different socioeconomic factors. Materials and Methods: A close–ended questionnaire-based study was carried out between January 2021 to February 2022 and a total of 1000 patients between 18 to 80 years were selected who were satisfying the inclusion criteria. Results: Females were more aware about removable prosthesis (41.86%) and dental implants (11.99%). Patients with primary level of education were more aware about removable prosthesis (41.25 %). Patients with elementary occupation were least aware (46.61%) about different types of treatment modalities. Professionals had more knowledge about FPD (66.66%). Tendency of fixed teeth supported prosthesis and overall awareness were significantly higher among the patients with monthly income more than Rs.6000/-. Conclusion: Females were more aware about different prosthetic treatment options. Patients with higher education and income were more aware about fixed prosthetic treatment. Patients who were in service and skilled workers were almost equally aware about removable and fixed prosthesis treatment.

Awareness about Prosthodontic Treatment Modalities Based on Socioeconomic Status among Patients Visiting Dental Colleges in Jharkhand, India – A Patient Survey

Introduction: The questionnaire-based survey was carried out to evaluate about different types of prosthetic treatment modalities specifically removable prosthesis, fixed teeth supported prosthesis and implants in relation to different socioeconomic factors. Materials and Methods: A close–ended questionnaire-based study was carried out between January 2021 to February 2022 and a total of 1000 patients between 18 to 80 years were selected who were satisfying the inclusion criteria. Results: Females were more aware about removable prosthesis (41.86%) and dental implants (11.99%). Patients with primary level of education were more aware about removable prosthesis (41.25 %). Patients with elementary occupation were least aware (46.61%) about different types of treatment modalities. Professionals had more knowledge about FPD (66.66%). Tendency of fixed teeth supported prosthesis and overall awareness were significantly higher among the patients with monthly income more than Rs.6000/-. Conclusion: Females were more aware about different prosthetic treatment options. Patients with higher education and income were more aware about fixed prosthetic treatment. Patients who were in service and skilled workers were almost equally aware about removable and fixed prosthesis treatment.

Prosthetic Treatment Modalities on Zygomatic Implants: A Review

Prosthetic Treatment Modalities on Zygomatic Implants: A Review

Prosthetic rehabilitation modalities and their socioeconomic association in a sample of adult Egyptians

Background Teeth loss results in significant complications that can severally affect the individuals’ general health and social activities. Several studies have documented the association between socioeconomic issues and the prevalence of oral diseases and prosthetic rehabilitation. Thus, this study aimed to explore the impact of socioeconomic factors on prosthetic rehabilitation modalities in a sample of adult urban and rural Egyptian populations. Patients and methods A total of 400 adults of age over 18 years were included in this study. Half of them were from urban governorates (Cairo and Giza). And the other half were from the rural governorate (Al-Fayoum). Information concerning demographic (sex and age) and socioeconomic (education level, occupation, and income) factors were collected using the modified WHO questionnaire. In addition, prosthetic rehabilitation status was evaluated through intraoral examination. Results The percentage of female participants was higher than males in both urban and rural regions. The age range for more than two-thirds of the participants was from 30 to 60 years. In urban areas, about 39% of participants were completely dentulous, 34.5% were partially edentulous without prosthetic rehabilitation, and only 26.5% made dental prostheses. Regarding rural participants, about 35% of them were completely dentulous, 64.5% partially edentulous without prosthetic treatment, and only 0.05% received prosthesis. Comparison between the urban and rural dentition status and rehabilitation modalities showed a statistically significant difference (P<0.05). Socioeconomic factors (education, occupation, and income) affect the type of prosthetic treatment modalities, particularly fixed prostheses especially in the urban area. Conclusion Socioeconomic determinants greatly affected prosthetic rehabilitation modalities in the studied urban and rural Egyptians. In rural areas, socioeconomic factors negatively impacted the capability of prosthetic treatment.

Patterns of Prosthetic Treatment Modalities in Implant Dentistry in a Saudi Population

Aim:The aim of this study was to detect and describe the patterns of implant prosthetic treatment modalities placed in partially and fully edentulous Saudi patients restored with dental implants in Saudi Arabia, and to detect the status of the health insurance covering dental implants in Saudi Arabia.
 Materials and Methods: 520 Saudi patients aged ≥18 years residing in Saudi Arabia and treated with at least one dental implant done in dental health premises in Saudi Arabia were randomly included in the study. Clinical and radiographic examination were used to detect implant prostheses types (single-tooth implant, implant-supported long or short span conventional fixed bridge, implant overdenture). The health insurance covering dental implants was detected too. The data obtained including age, gender, systemic disease, and tobacco smoking were documented in a patient examination form then statistically analyzed using Chi-Square Test and U-Test.
 Results: The most frequently tooth type replaced by dental implants was the molars (45.5%), followed by premolars (40%), incisors (7.7%), and canines (6.8%); mandibular first molars were the most common tooth type replaced by implants. Single-tooth implant was the most common prosthetic treatment modality (85.2%), followed by implant-supported short span conventional fixed bridge (9.8%), implant overdenture (2.8%), and implant-supported long span conventional fixed bridge (2.2%). The majority of implant overdenture prostheses were seen in the age group ≥ 60 years. Implant-supported long span fixed bridge prostheses were more in patients aged ≥ 50 years than in patients aged < 50 years, while single-tooth implant prostheses were more in patients aged < 50 years than in patients aged ≥ 50 years. Of all teeth types replaced by dental implants, molars were the most common type seen in implant-supported long span fixed bridges and in single-tooth implants, whereas canines were the most common type seen in overdentures. There was an insignificant difference in the median number of dental implants between males and females. 
 Conclusion: Single-tooth implant is major. Health insurance policy doesn’t cover dental implants in Saudi Arabia.
 Keywords: Implant, Modalities, Prostheses/Prosthetic, Type

A Viable Rehabilitation Approach with Maxillary Cast Partial Denture and Mandibular Over Denture - A Case Report

Prosthodontic rehabilitation is indicated to restore function, esthetics and phonetics. The prosthetic options for rehabilitation of partial edentulism include removable partial dentures (RPD), over dentures, and implant supported prosthesis. Any tooth replacement should be performed by a detailed evaluation of the existing dental situation and functional condition of the patient. Besides, the risks, benefits and costs of the selected treatment modality should be discussed with the patient. Choice of prosthetic treatment modality is mainly determined by the patient’s needs and expectations, social and economic aspects, educational level, as well as the general health status, oral functional benefits, esthetics, prognosis of the remaining teeth and patient motivation to maintain oral hygiene. This clinical report describes rehabilitation of a partially edentulous patient with maxillary cast partial denture (CPD) and mandibular tooth supported over denture.

Patterns of Treatment Modalities in Saudi Patients Treated with Dental Implants

Aim: The primary aim of this study was to detect the patterns of implant prosthetic treatment modalities among Saudi adults restored with dental implants in the Kingdom of Saudi Arabia. The secondary objective was to describe the status of the health insurance covering dental implants in Saudi Arabia.
 Materials and Methods: 323 Saudi patients aged ≥18 years residing in Saudi Arabia and treated with at least one dental implant were randomly selected and clinically examined for implant prostheses types (single-tooth, implant-supported long or short span conventional fixed bridge, implant overenture) done in dental premises (hospitals, polyclinics, private clinics, etc…) in Saudi Arabia. Radiographs were used too. The health insurance covering dental implants was detected. The data obtained including age, gender, systemic disease, and tobacco smoking were documented in a patient examination form then statistically analyzed using Chi-Square Test or Fisher-Freeman-Halton Test and U-Test.
 Results: The most frequently tooth type replaced by dental implants was the molars (46.9%), followed by premolars (41.6%), incisors (6.5%), and canines (5%); mandibular first molars were the most common tooth type replaced by implants. Single-tooth implant was the most common prosthetic treatment modality (88.3%), followed by implant-supported short span conventional fixed bridge (9.3%), implant overdenture (1.6%), and implant-supported long span conventional fixed bridge (0.9%). The percentages of single-tooth implant and implant-supported short span fixed bridge were higher in patients <40 years than in patients ≥40 years; however, in all age groups, single-tooth implant was the most common prosthesis type, and short span fixed bridge was the second most common prosthesis type. Of all teeth types replaced by dental implants, molars were the most common type in long span fixed bridges (36.1%) and in single-tooth implants (50.2%), and premolars were the most common type in short span fixed bridges (43.9%); also, of all teeth types replaced by dental implants, canines were the most common type in overdentures (56.7%). Incisors were mainly replaced by single-tooth implants (52.8%). There was an insignificant difference in the median of dental implants between males and females. 
 Conclusion: Single-tooth implant is major. Health insurance policy doesn’t cover dental implants in Saudi Arabia. Dental implant therapy is no more a complementary or an accessory procedure.

Primary vs secondary zygomatic implant placement in patients with head and neck cancer-A 10-year prospective study.

Zygomatic implants can provide excellent remote anchorage to support the prosthetic rehabilitation of patients treated for maxillary and midfacial tumors. Patients who underwent zygomatic implant placement by the author between 2006 and 2016 as part of their oncology treatment were followed prospectively. Forty-nine consecutively treated patients received 131 zygomatic implants of which 9 failed and were removed from 4 patients; 24 patients (49%) received radiotherapy either before or after implant insertion. The overall 12-month survival estimate was 94% and the 60-month estimate was 92%. The use of zygomatic implants in the management of maxillary and midfacial malignancy is a predictable prosthetic treatment modality to support complex oral and facial prostheses. Their use with or without free tissue transfer can provide effective prosthetic rehabilitation with high implant survival irrespective of the timing of placement or the need for adjuvant radiotherapy. Zygomatic Implants provide an excellent platform for the restoration of the dentition and facial structures affected by maxillary and midfacial malignant disease.

Public awareness, knowledge, attitude and acceptance of dental implants as a treatment modality among patients visiting SDM College of Dental Sciences and Hospital, Dharwad.

Background:The use of dental implants as a prosthetic treatment modality for partially edentulous or completely edentulous patients is increased more commonly ever since the concept of osseointegration has been accepted.Objective:The objective of this study is to assess the awareness, knowledge, attitude, and acceptance of dental implants as a treatment modality among patients visiting SDM Dental College, Dharwad.Materials and Methods:A cross-sectional survey was conducted among 500 patients visiting SDM College of Dental Sciences and Hospital (SDMCDSH), Dharwad, using a self-explanatory questionnaire.Results:A total of 500 individuals participated in the survey. The results of this survey indicate that 93.4% of the patients knew about dental implants, and for majority of them, the major source of information was through their dentist followed by relatives and friends and electronic media. About 60.4% patients disapproved the removable prosthesis as an option for the replacement of missing teeth. 77.2% patients expressed that they could not afford for the dental implant treatment. The major deterioration for this treatment was related to the cost in 80.4% patients, surgical procedure in 11.6% patients, and a long treatment time in 5.6% patients. While 60.4% patients felt that dental implants being expensive, is the treatment option only for the rich.Conclusion:The results of this survey showed that majority of the patients visiting SDMCDSH, Dharwad, were aware about dental implants as a treatment modality for the replacement of missing teeth. Although the attitude was positive and they did accept dental implants as a treatment option, the treatment cost mainly was the major reason to take a back step.

Patient Expectation and Satisfaction with Different Prosthetic Treatment Modalities.

To investigate the relationships between gender, age, patients' perceptions about the dentists' conduct, number of adjustments, treatment type, and expectation prior to prosthetic treatment and patient satisfaction with their treatments. Data were integrated from four studies that measured patient expectations before treatment and satisfaction after treatment using a visual analog scale (VAS) from 0 to 10. These scores were given for each of four aspects of the therapeutic outcomes: chewing, esthetics, phonetics, and comfort. Patients' perceptions about the dentists' conduct was also assessed using a Likert-scale questionnaire. The total sample size, after combining the data from all four studies, was 223 subjects. Bivariate and multivariable analyses were performed. The covariates entertained were gender, age, treatment type, patients' perceptions about the dentists' conduct, number of adjustments, and expectation prior to denture fabrication. In the entire sample, 115 (51.57%) patients were females and 108 (48.43%) were males. They ranged in age from 28 to 81 years old; the mean age was 53.2 years (SD = 11.5). Combining four treatments together, there was no significant difference between patients' expectation and satisfaction scores for all four items. There were no significant differences between expectation and satisfaction for different genders. Multivariable analysis showed that patient expectation, satisfaction and the difference (satisfaction score-expectation score) scores for all four aspects were associated with treatment type (implant treatments were favored), and expectation prior to prosthetic treatment (the higher the expectation, the higher the satisfaction) was associated with satisfaction and difference scores. Satisfaction and difference scores for chewing were associated with number of adjustments and satisfaction, and satisfaction and difference scores for phonetics and comfort were associated with how well the dentist explained the intended treatment before performing it. Patient satisfaction was associated with treatment type (implant treatments were favored), expectations prior to prosthetic treatment (the higher the expectation, the higher the satisfaction), and how well the dentist explained the intended treatment before performing it.

Different Prosthetic Treatment Modalities for Chest Wall Reconstruction: Experience With 96 Patients

We report the outcomes of patients who underwent reconstruction with Mersilene mesh–methyl methacrylate (MM–MM) sandwich and polytetrafluoroethylene (PTFE) grafts after a large chest wall resection. Between June 1990 and July 2017, 96 consecutive patients (57 men, 39 women; mean age 45.6 years [range 5–74]) underwent large chest wall resection (>5 cm diameter) and reconstruction with prosthetic material. In total, 21 patients (22%) underwent reconstruction with a PTFE graft (group 2) between 1990 and 1994, and 64 patients (67%) underwent reconstruction with an sandwich graft (group 1) between 1994 and 2017. A titanium rib was used in 11 (11%) patients (group 3). Operative morbidity ratios were 2.5% (n = 2/64) in group 1 and 24% (n = 5/21) in group 2 (P = .02). The paradoxical respiration ratio was significantly higher (P = .01) in group 2 (n = 5/21 [24%]) compared with group 1 (n = 1/64 [1.6%]). The operative mortality ratio was 4.5% (n = 1/21) in group 2 and 0% in group 1. Mean length of hospital stay was 7.3 days (range 4-21) in group 1 and 13.3 days (range 7-36) in group 2 (P = .011). The Sandwich graft is inexpensive and easy to apply, provides better cosmetic options, and offers minimal morbidity. We therefore recommend that the sandwich graft be used rather than the PTFE graft for large defects of the anterolateral chest wall and sternum where successful prevention of paradoxical respiration is required.

Single-tooth replacement: factors affecting different prosthetic treatment modalities

BackgroundThe choice between several treatment options for replacing a single missing tooth is influenced by clinical, dentist- and patient-immanent factors. This study aimed to determine the patient factors that would affect the treatment decision to replace a single missing tooth and to assess the satisfaction with several options.Method200 volunteers involved (121 females and 79 males) divided into four groups, Group A: consisted of patients with conventional fixed partial dentures or patients with resin bonded fixed partial dentures. Group B: consisted of patients who received removable partial dentures while Group C: consisted of patients who received a single implant supported crown, and a control group D: consisted of patients who received no treatment. Data were collected using a questionnaire.ResultsThe highest percentage of males within groups (58%) was within the removable prostheses category. The majority of the subjects in the study reported that the main reason for replacing a missing tooth was for esthetic and function. Most important factor affecting the choice between treatment modalities was damaging the neighboring teeth. Pain, post operative sensitivity and dental phobia were important factors in choosing the prosthesis type and affected the control group patients not to have any treatment. The highest satisfaction percentage among groups studied was recorded for dental implants then FPD groups, while the least percentage were in both the control and RPD groups, for all aspects of function, esthetic and speech efficiency.ConclusionsThe final choice between FPD, RPD and implant depended on several factors which affected the decision making; among these is cost and patients' awareness of the different treatment options.

A 10‐year prospective study of ITI dental implants placed in the posterior region. II: Influence of the crown‐to‐implant ratio and different prosthetic treatment modalities on crestal bone loss

To evaluate the influence of the crown-to-implant ratio (C/I) ratio and different implant prosthetic treatment modalities on crestal bone loss around dental implants placed in the posterior region. A total of 192 ITI dental implants were consecutively placed in premolars and molars of 83 partially edentulous patients. All implants were restored by means of ceramic-to-metal fused fixed partial dentures or a single crown. Patients were followed as part of a prospective longitudinal study focusing on implant success. Surgical, radiographic and clinical variables were collected at the 1-year recall after implant placement and at the most recent clinical evaluation. Radiographic parameters were evaluated on periapical radiographs taken with a standardized long-cone paralleling technique. Implant restorations were divided into three groups according to their respective clinical C/I ratios: (a) 0-0.99, (b) 1-1.99 and (c) >or=2. The mean clinical C/I ratio was 1.77+/-0.56 mm. A total of 51 implants (26.5%) showed a clinical C/I ratio equal to or greater than 2. In this group, three implants failed, giving a cumulative survival rate of 94.1%. Crestal bone loss was -0.34+/-0.27 mm in group a, -0.03+/-0.15 mm in group b and -0.02+/-0.26 mm in group c. Differences among groups were statistically significant (P=0.009). Mode of retention, splinting or presence of cantilever extensions did not have an effect on crestal bone loss around ITI dental implants. Implant restorations with C/I ratios between 2 and 3 may be successfully used in the posterior areas of the jaw.

《再生医療と歯科補綴学の接点》補綴治療における再生医療のニーズと現時点での研究動向―確実かつ質の高いインプラント治療をめざして―

Appropriate dental implants are known to improve the quality of life in totally and partially edentulous patients, as well as to prevent future tooth loss, and so prosthetic treatment modalities have drastically changed recently with reconstruction therapy. However, dental implant therapy did not win the confidence of the dental community in the early developmental stage, until osseointegration between titanium and surrounding bone tissue was discovered and the modality utilizing osseointegration became reliable and produced durable treatment outcomes for long-term function. On the other hand, the biological mechanism of osseointegration has not been clarified yet and the time required for osseointegration is still long, e.g. three to four months. As well, when the implant is applied in the upper posterior region, the acquisition of osseointegration and the long-term survival of the implant are still not clinically adequate. Therefore, to reduce the time required for osseointegration and to regenerate enough alveolar bone mass in the target implantation site, the oral implant modality must be made more useful and potent as one of the treatment options for partial and total edentulism. With this background, we have studied biological strategies for reducing the time required for osseointegration and for regenerating enough alveolar bone mass, e.g., investigation of the specific genes for osseointegration between titanium and bone, nano-level surface modification of the titanium, biodegradable apatite foam for alveolar bone regeneration, application of bone formation-related growth factors with biological scaffold, and autologous cell transplantation of bone marrow derived mesenchymal stem cells. In this article, we review the current status of regenerative medicine being applied in prosthodontics and discuss our future research direction.