Residual Teeth Research Articles

Long-term follow-up of a patient with Parkinson’s disease under nursing care after replacement of fixed implant-supported prostheses with an implant overdenture: a case report

BackgroundIn older patients with progressive neurodegeneration, replacing fixed implant-supported prostheses (FIP) with implant overdentures (IOD) has been proposed to prevent future mucosal injury and create an oral environment that is easier for caregivers to clean. However, there have been no reports on the progress after replacing FIP with IOD. In this report, we present the progress of an older patient with Parkinson’s disease in whom FIP was replaced with IOD.Case presentationAn 81-year-old male patient with Parkinson’s disease presented to our outpatient clinic with bruxism and crossbites. FIPs, with five Brånemark system implants, were placed in the bilateral lower molars. The FIP was replaced with an IOD with two locator attachments to create an oral environment that was easier for caregivers to clean and allow easy recovery of masticatory function if residual teeth were fractured in the care environment. As his systemic condition deteriorated, treatment was changed from outpatient to in-home visits. During dental care visits, professional oral cleaning and denture repair were continued, and good nutritional status was maintained. However, the patient developed cholecystitis and was hospitalized. During hospitalization, gastrostomy was performed because he developed aspiration pneumonia. After discharge from the hospital, the patient remained in bed all day and could not wear an IOD, resulting in buccal mucosa ulceration due to abrasion of the locator abutment. We decided to replace the abutment with cover screws; however, not all the implants could sleep submucosally. Although regular oral cleaning was resumed, new ulcers developed even when cover screws were installed. Additionally, swelling and drainage were observed at the peri-implant mucosal site where peri-implantitis had once occurred during an outpatient visit. The patient was readmitted to the hospital for a urinary tract infection, and subsequent visits were abandoned.ConclusionsBy replacing FIP with IOD in an older patient with Parkinson’s disease, we addressed a barrier to caregiver-provided oral management. The removable prosthesis facilitated smooth oral care by caregivers and functional recovery in the event of trouble with residual teeth. However, it could not completely avoid the recurrence of buccal mucosal ulcers or peri-implantitis.

Association between tea types and number of teeth: a cross-sectional study of the Chinese Longitudinal Healthy Longevity Survey

BackgroundPrevious studies have suggested that tea consumption may have a positive impact on oral health. However, the effects of different tea types on oral health remain unclear. Therefore, this study aimed to determine the association between residual teeth and consumption habits of different types of tea (green tea, black tea, oolong tea, and scented tea) in older adults.MethodsWe conducted a secondary analysis using data from the Chinese Longitudinal Healthy Longevity Survey in 2018. In a sample of 6,387 older adults, we performed logistic regression analysis to examine the relationship between persistent tea consumption and oral health according to sex and brushing frequency. The indices for particularly healthy oral health and relative health were set at more than 20 teeth and more than 10 teeth, respectively.ResultsThe study included 2,725 males and 3,662 females, both aged 65 and older. Among individuals with more than 20 teeth, drinking green tea significantly improved oral health in men (adjusted odds ratio [ORs]: 1.377; 95% confidence interval [CI]: 1.082–1.752) and drinking black tea significantly improved the oral health of women (ORs: 2.349, 95%CI: 1.028–5.366). In the daily brushing group, green tea had a significant beneficial effect on increasing the number of teeth in men and black tea had a significant beneficial effect in women. Among individuals with more than 10 teeth, drinking green tea significantly improved oral health in men (ORs: 1.539; 95% CI: 1.209–1.959) and drinking green tea and scented tea significantly improved the oral health of women (ORs: 1.447, 95%CI: 1.052–1.991; ORs: 1.948, 95%CI: 1.137–3.340). In the daily brushing group, consumption of green tea and black tea had significant beneficial effects on increasing the number of teeth in men, whereas that of green tea, black tea, and scented tea had significant beneficial effects in women.ConclusionLong-term green tea consumption in males and black tea consumption in females were significantly associated with maintaining functional dentition (≥20 teeth). Similarly, long-term green tea consumption in males and green tea and scented tea consumption in females were associated with avoiding severe tooth loss (≥10 teeth). Furthermore, in the daily tooth brushing group, long-term consumption of black tea was associated with avoiding severe tooth loss in both sexes. However, tea consumption alone had no effect on oral health without good brushing habits.

Implant-assisted removable partial denture with residual teeth and implants: a case report

Implant-assisted removable partial denture with residual teeth and implants: a case report

Implant-assisted removable partial denture restoration in small number of residual teeth in mandible: A case report

Implant-assisted removable partial denture restoration in small number of residual teeth in mandible: A case report

Scientific mapping of hotspots and trends of post and core research based on the Web of Science: A bibliometric analysis

Statement of problemPost and core (PC) restoration has been widely used to restore endodontically treated teeth. Nevertheless, bibliometric studies focusing on PC research are lacking. PurposeThe purpose of this bibliometric analysis was to review the general situation and determine the research direction of PC restoration by means of visualization, including the time development, countries, institutions, authors, journals, research categories, and the information of references with the strongest citation burst. Material and methodsThe search was carried out within the topic field of the Web of Science (WoS) database. CiteSpace, VOSviewer, and R language were used to analyze the literature. Bibliometric indicators in terms of title, keyword, reference, publication time, institution, country and citation information were analyzed. ResultsBetween 1966 and 2022, dental research on PC trended upward, especially in 2011 and up to 2022. Scholars in Brazil, the United States, and Italy actively participated in PC research. The country that published the most was Brazil. Italy both ranked first in the H-index and average citations per item and had cooperative relations with several countries. The United States ranked first in the world in total citation count. The University of Siena published the most articles. The Journal of Prosthetic Dentistry (JPD) was the major contributing journal. The top three authors in this field were Ferrari M, Goracci C and Naumann M. The largest cooperative network of authors consisted of four Italian scholars. There were six main clusters of research topics on PC through CiteSpace co-citations. In addition, CiteSpace co-citations, CiteSpace Burst detection and VOSviewer keyword analysis showed the most important research interests, such as bond strength, fiber post, fracture resistance, and finite element analysis. Photodynamic therapy is the latest research hotspot. Finally, there were the top 25 references with the strongest citation bursts, which mainly focused on four aspects, namely, studies related to fiber posts, PC bonding strength, finite element analysis, and residual teeth and the ferrule effect. ConclusionsThis bibliometric analysis provides a comprehensive overview of PC research, including the research time, country, institution, author, journal, article clustering, article keywords, and important literature analysis, so that researchers can have a clear understanding of the research situation in this field.

A Root-Supported Overdenture: An Approach to Preventive Prosthodontics

The use of residual teeth to support an attachment-retained overdenture is an alternative therapy to extractions and complete removable denture, particularly for the mandibular arch. Overdenture offers several advantages, including maintenance of the alveolar ridge and proprioception. Retention and stability are also enhanced by means of attachment systems, which improves schwing efficiency and better psychological integration of the prosthesis. This article describes, through a clinical case, the fabrication and interest of a tooth-supported overdenture using two axial attachments.

Reconstruction of the anterior maxillary defect using a vascularized bone flap with residual teeth in the posterior maxilla.

Microsurgical bone reconstruction is challenging in cases of anterior maxillary defects because of the presence of residual teeth. The study analyzed the method and feasibility of using vascularized bone flaps to reconstruct anterior maxillary defects. We retrospectively analyzed 15 patients treated at the Department of Oral and Maxillofacial Surgery, Peking University School, and Hospital of Stomatology between November 2017 and January 2023. A total of 14 patients were successfully reconstructed using the digital technique: 6 deep circumflex iliac artery (DCIA) flaps and 8 fibular free flaps. Palatal and buccal pedicle paths were used in 4 and 10 cases, respectively, for vascular anastomosis. The implant coverage rates of the DCIA and fibular free flaps were 87.2% and 92.6%, respectively (p > 0.05). Anterior maxillary defects reconstructed with the DCIA and fibular free flaps are reliable methods. Furthermore, the palatal and buccal paths are recommended for vascular anastomosis.

Full-Arch Implant-Prosthetic Rehabilitation in Patients Affected by Hypertension: A Randomized Clinical Trial at 7 Years Follow-Up

The aim of this clinical study was to investigate and compare implant survival rates, marginal bone loss, and surgical and prosthetic complications of healthy patients and subjects affected by hypertension receiving full-arch implant-prosthetic rehabilitation. From January 2016 to November 2016, patients affected by total edentulism of one or both arches or severe impairment of residual teeth who needed full-arch implant-prosthetic rehabilitation and who had the absence of any systemic diseases or the presence of hypertension as a single pathology were randomly selected. According to the inclusion criteria, 39 patients were enrolled for this study. The sample was divided into two groups: A total of 18 patients were included in Group A (healthy patients), and 21 patients were included in Group B (patients affected by hypertension). No statistically significant difference in implant survival rates, marginal bone loss, and prosthetic complications were observed between Group A and Group B. Except for variable bleeding, the results of the Pearson’s chi-square test and z-test at a 99% confidence level suggest that there is no statistically significant difference in clinical complications between the groups. Within the limitations of this study, full-arch implant-prosthetic rehabilitation could be a feasible option for treating patients with hypertension, provided that hypertension is compensated and controlled.

Accuracy of Computerized Optical Impression Making in Fabrication of Removable Dentures for Partially Edentulous Jaws: An In Vivo Feasibility Study.

The use of computerized optical impression making (COIM) for the fabrication of removable dentures for partially edentulous jaws is a rising trend in dental prosthetics. However, the accuracy of this method compared with that of traditional impression-making techniques remains uncertain. We therefore decided to evaluate the accuracy of COIM in the context of partially edentulous jaws in an in vivo setting. Twelve partially edentulous patients with different Kennedy classes underwent both a conventional impression (CI) and a computerized optical impression (COI) procedure. The CI was then digitized and compared with the COI data using 3D analysis software. Four different comparison situations were assessed: Whole Jaw (WJ), Mucosa with Residual Teeth (M_RT), Isolated Mucosa (IM), and Isolated Abutment Teeth (AT). Statistical analyses were conducted to evaluate group differences by quantifying the deviation values between the CIs and COIs. The mean deviations between the COIs and CIs varied significantly across the different comparison situations, with mucosal areas showing higher deviations than dental hard tissue. However, no statistically significant difference was found between the maxilla and mandible. Although COIM offers a no-pressure impression method that captures surfaces without irritation, it was found to capture mucosa less accurately than dental hard tissue. This discrepancy can likely be attributed to software algorithms that automatically filter out mobile tissues. Clinically, these findings suggest that caution is required when using COIM for prosthetics involving mucosal tissues as deviations could compromise the fit and longevity of the prosthetic appliance. Further research is warranted to assess the clinical relevance of these deviations.

Potential Recurrence of Odontogenic Keratocyst Post-Surgery, Rapid Review

Background: Odontogenic keratocyst is one of the most frequent cysts found in the jaw. Odontogenic keratocyst, or OKC, is a benign but locally aggressive cyst with a higher recurrence rate than other odontogenic cysts after surgical treatment. The OKC recurrence rate is reported to be around 2.5% to 62.5%. Objective: This rapid review analyzes the most frequent recurrence potential factors after surgical procedures. Material and Methods: Articles search by using a combination of the keywords "odontogenic keratocyst" "keratocystic odontogenic tumor," "potential," "probability," "recur," "relapse,” "recurrence" in three databases; PubMed, ScienceDirect, and Google Scholar. Article inclusion criteria include articles that have data on the recurrence of odontogenic keratocyst after surgical treatment; in the English language; issued within the last 10 years (2012-2022); and using observational research with all types of study designs (cohort, cross-sectional, and case-control). This study used the PRISMA protocol (Preferred Reporting Items for Systematic Review and Meta-Analysis). Results: Thirteen articles with an observational study design were included in this rapid review, consisting of thirteen articles with retrospective cohort design. This study recorded two hundred fifty-three cases of recurrence out of 1263 cases of OKC, with a mean follow-up period of 53.6 months. Recurrences were found more often in male patients than female patients (1.58:1), especially in the third and fourth decades of age. The multilocular form of the lesion (n = 52), especially on the mandible, was more common than the unilocular form of the lesion (n = 83). Teeth preserved in the sites of involvement caused incomplete cyst removal and increased the risk of recurrence. Conclusion: This rapid review showed that the percentage of potential OKC recurrences ranged from 7.1% to 45%, with an average recurrence rate of 22.5%. The presence of a daughter or satellite cyst and residual teeth or teeth preserved in the lesion area that was not removed in the form of a large multilocular cyst affects the potential for recurrence.

Use of Digital Articulator in Implant Supported Prosthetics. A Case Report

Introduction: A case report is presented to demonstrate advantages of a new fully digital approach, from planning through to execution to immediate loading implant-prosthetic rehabilitation. Until now, the function of the diagnostic wax-up has not been assessable and the functionalization of the finished product, be it either a provisional or a definitive, has been entrusted entirely to the ability of the technician. Case Description: A female patient, unaffected by systemic disease and cranio-cervico-mandibular muscular pain, required removal of hopeless residual teeth of the upper arch and substitution with immediately loaded implants using guided surgery. A fully digital technique was performed using specific software to record individual condylar (axiography) movements and mastication cycles and to correlate these with initial intra-oral scans in order to create a virtual 3D individual value articulator. Seven implants were placed using guided surgery and the prosthetic rehabilitation was successfully performed as planned. Conclusion: The use of guided surgery guarantees atraumaticity and procedure predictability as documented in recent literature. However, in this case, for the first time, using the digital axiograph and digital articulator, it was possible to record the axiography of condylar movements in order to 'functionalize' the diagnostic wax-up prior to its insertion into guided surgery software. This clinical case suggests how the software's compatibility with intra-oral scan files, diagnostic wax-up, facial scans, CBCT and, in the near future, electromyography of mastication muscles permits the clinician to work on a virtual patient and analyze all critical aesthetic and functional parameters prior to guided surgery.

3D printed interim immediate denture by using the occlusal plane digital transfer method of the POP BOW system in a patient planning to extract upper and lower residual teeth: a case report

3D printed interim immediate denture by using the occlusal plane digital transfer method of the POP BOW system in a patient planning to extract upper and lower residual teeth: a case report

Real-world evidence of the impact of obesity on residual teeth in the Japanese population: A cross-sectional study.

Tooth loss is associated with nutritional status and significantly affects quality of life, particularly in older individuals. To date, several studies reveal that a high BMI is associated with tooth loss. However, there is a lack of large-scale studies that examined the impact of obesity on residual teeth with respect to age and tooth positions. We assessed the impact of obesity on the number and position of residual teeth by age groups using large scale of Japanese database. This was a cross-sectional study of 706150 subjects that were included in the database that combined the data from health insurance claims and health check-up, those lacking information about BMI, HbA1c level, smoking status, and the number of residual teeth were excluded. Thus, a total of 233517 aged 20-74 years were included. Subjects were classified into 4 categories based on BMI, and the number of teeth was compared between age-groups. The percentage of subjects with residual teeth in each position was compared between groups with obesity (BMI ≥25.0 kg/m2) and non-obesity. Logistic regression analysis was performed to clarify whether obesity predicts having <24 teeth. Higher BMI was associated with fewer teeth over 40s (P for trend <0.0001 when <70s). Obesity was associated with the reduction of residual teeth in the maxillary; specifically, the molars were affected over the age 30. Smoking status further affected tooth loss at positions that were not affected by obesity alone. After adjusting for age, sex, smoking status, and HbA1c ≥6.5%, obesity remained an independent predictive factor for having <24 teeth (ORs: 1.35, 95% CIs: 1.30-1.40). We found that an increase in BMI was associated with a decrease in the number of residual teeth from younger ages independently of smoking status and diabetes in the large scale of Japanese database.

Estimating Age Using Nationwide Survey Data on the Number of Residual Teeth

Given that tooth loss is a degenerative change, the number of residual teeth may be used to specify a particular age range as a marker for age estimation. This study examined changes in the number of teeth with age using a nationwide oral survey database and derived the age distribution of the Korean population according to the number of teeth. Data on the number of teeth and age were extracted from the oral examination data of the Korean National Health and Nutrition Examination Survey (KNHANES) from 2016 to 2018. Statistical analyses of a complex sample survey were performed using weighted values. The distribution range of the number of teeth by age was broad. The proportion of young people decreased progressively as the number of remaining teeth decreased. In contrast, the proportion of those from the older age group decreased slightly as the number of teeth increased. The number of teeth was subdivided into groups of four, age was categorized into 5-year intervals, and the distribution of age groups by the number of teeth was analyzed. We attempted to determine the age group threshold at approximately 95th percentile for age. In summary, we found that if there were ≤4, 5-12, and 13-20 residual teeth, the estimated age was ≥60, ≥55, and ≥50 years, respectively, with an approximately 95% probability. When many teeth are lost and it is difficult to apply conventional dental age estimation methods, our method may assist in narrowing the age range, although it is not an accurate age determination method.

Tooth Loss Related with Prevalence of Metabolic Syndrome in a General Urban Japanese Population: The Suita Study

We examined whether the number of teeth could be a surrogate marker for metabolic syndrome (MetS) risk in cross-section. A total of 3771 individuals from the general urban Japanese population (1690 men, 2081 women; mean age 67.1 ± 11.0 years) participated in this study. Participants were diagnosed with MetS with three or more components hypertension, hyperglycemia, lipid metabolism abnormality, and abnormal abdominal girth. Questionnaires were administered to determine the number of teeth, smoking status, drinking status, and past illnesses. To clarify the relationships between the number of teeth and the presence of MetS components, we divided subjects into two groups: those with less than 20 residual teeth and those with 20 or more, then statistical analyses (Mantel-Haenszel tests and logistic regression analysis) were performed. MetS were higher for those with ≤19 teeth than those with ≥20 teeth when examining all participants and women-only groups. Hyperglycemia, low HDL cholesterol, high triglycerides, and diagnosis with MetS were all significantly higher in the ≤19 teeth group for both sexes combined and for women. These results suggest that less than 20 teeth may be a surrogate marker for MetS risk, but further studies on gender differences and pathological background are needed.

Interaction between serum vitamin C levels and smoking on the periodontal condition in older adults.

Several epidemiological studies have reported that smokers have a higher prevalence and severity of periodontal disease than do nonsmokers, and that smoking negatively affects nutritional status and is associated with a reduced intake of antioxidants, particularly vitamin C. The present investigation aimed to examine the relationship between serum vitamin C levels and smoking and its influence on the periodontal condition in older adults. A total of 353 respondents met the inclusion criteria and were enrolled in the present study. The periodontal status of the study participants was determined through examinations of one or more residual teeth, which included a measurement of the probing pocket depth (PPD) and clinical attachment level (CAL) at six regions of each tooth. Blood samples were collected during the dental examinations and then sent to a laboratory to evaluate serum vitamin C and cotinine levels. A serum cotinine concentration of 100ng/ml was considered a relevant threshold for active smoking. After dividing the participants into two groups according to serum cotinine levels, Poisson regression analysis was carried out to compare vitamin C levels with the prevalence rate ratio (PRR) for periodontal condition markers for each group based on serum cotinine levels. We evaluated differences in the PRR of serum vitamin C tertiles between participants with high (≥100ng/ml) or low (<100ng/ml) serum cotinine levels after adjusting for sex, the use of interdental brushes or dental floss, and the number of teeth. A negative tendency between the PRR of vitamin C tertiles for the PPD or CAL was seen for both groups. Especially, a bigger difference was observed in the group with high serum cotinine levels. The PRR of the first tertiles in the high serum cotinine group was 5.03, compared with 2.69 in the low serum cotinine group (relative risk: 1.9). The results of this study suggest a potential association between vitamin C levels and the periodontal condition, which may be influenced by smoking status.

Prevalence of endo-perio lesions according to the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Disease in a university hospital.

Teeth with combined endodontic-periodontal lesions (EPLs) have favorable to hopeless prognoses. The new classification system was developed by the World Workshop on the Classification of Periodontal and Peri-Implant Disease in 2017 and suitable epidemiologic data related to this new system are currently lacking. This study aims to contribute data about the prevalence of EPLs according to the new system. A total of 1,008 panoramic views taken in 2019 were analyzed, recording the presence of an EPL and other periodontic parameters. Radiographs of bad quality and of the same person were excluded. Additionally, the EPLs' radiographic patterns were rated by two raters according to their shape (j-shaped vs cone-shaped). Descriptive statistical methods as well as t tests for continuous and chi-squared tests for categorical variables were used. Overall, 866 patients (with 18,963 teeth) were included. Prevalence of EPLs was 4.9% (n = 43) (patient-related)/0.4% (n = 71) (tooth-related). Mean age (62.3 years vs 51.5 years), mean maximal percentage of bone loss (60% vs 30%), and mean age-adjusted bone-loss index (1.0 vs 0.6) were considerably higher compared to patients without EPL. A total of 67 EPLs were found in patients with stage III/IV periodontitis and 4 in patients with stage II periodontitis. This is the first study showing prevalence of EPLs (4.9%/0.4%) according to the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Disease. Patients with EPLs have a substantially higher maximal percentage of bone loss and a higher age-adjusted bone-loss index at residual teeth, excluding teeth with EPLs. All patients have at least stage II periodontitis.

Retrospective analysis of the effects of non-communicable diseases on periodontitis treatment outcomes.

PurposeWe retrospectively analysed patients’ dental and periodontal status according to the presence of non-communicable diseases (NCDs) and the effects of NCDs on periodontal treatment outcomes. Factors influencing disease recurrence were investigated using decision tree analysis.MethodsWe analysed the records of patients who visited the Department of Periodontology, Pusan National University Dental Hospital from June 2014 to October 2019. As baseline subjects, 1,362 patients with periodontitis and who underwent full-mouth periodontal examinations before periodontal treatment were selected. Among them, 321 patients who underwent periodontal examinations after the completion of periodontal treatment and 143 who continued to participate in regular maintenance were followed-up.ResultsForty-three percent of patients had a NCD. Patients without NCDs had more residual teeth and lower sum of the number of total decayed, missing, filled teeths (DMFT) scores. There was no difference in periodontal status according to NCD status. Patients with a NCD showed significant changes in the plaque index after periodontal treatment. The decision tree model analysis demonstrated that osteoporosis affected the recurrence of periodontitis.ConclusionsThe number of residual teeth and DMFT index differed according to the presence of NCDs. Patients with osteoporosis require particular attention to prevent periodontitis recurrence.

Research progress of implant restoration in the treatment of periodontal disease

Periodontal disease is one of the most important clinical factors of oral missing teeth. This kind of disease specifically refers to the disease of the tissue around the teeth, which can have a serious impact on the quality of life of patients. If we do not carry out scientific and effective treatment for patients in time, the disease can continue to develop and eventually all the teeth will fall off. In clinic, tooth loss caused by periodontal disease is often accompanied by inclination, loosening of residual teeth and loss of alveolar bone. Based on the above factors, it can not only significantly improve the difficulty of clinical repair, but also conventional repair is difficult to achieve the ideal effect. Patients often complain of unstable denture retention, tenderness and low chewing efficiency, which affect the doctor-patient relationship. When periodontal disease patients are not suitable for other missing tooth restoration schemes, the use of implant technology can better solve the above problems.

Clinical and radiographic evaluations of implants as surveyed crowns for Class I removable partial dentures: A retrospective study.

PURPOSEThe purpose of this study was to evaluate survival rates and marginal bone loss (MBL) of implants in IC-RPDs.MATERIALS AND METHODSSeventy implants were placed and used as surveyed crowns in 30 RPDs. The survival rates and MBL around implants based on multiple variables, e.g., position, sex, age, opposing dentitions, splinting, type of used retainer, and first year bone loss, were analyzed. Patient reported outcome measures (PROMs) regarding functional/esthetic improvement after IC-RPD treatment, and complications were also inspected.RESULTSThe 100% implant survival rates were observed, and 60 of those implants showed MBL levels less than 1.5 mm. No significant differences in MBL of implants were observed between implant positions (maxilla vs. mandible; P = .341) and type of used retainers (P = .630). The implant MBL of greater than 0.5 mm at 1 year showed significantly higher MBL after that (P < .001). Splinted implant surveyed crowns showed lower MBL in the maxilla (splinted vs. non-splinted; P = .037). There were significant esthetic/functional improvements observed after treatment, but there were no significant differences in esthetic results based on implant position (maxilla vs. mandible). Implants in mandible showed significantly greater improvement in function than implants in the maxilla (P = .002). Prosthetic complication of IC-RPD was not observed frequently. However, 2 abutment teeth among 60 were failed. The bone loss of abutment teeth was lower than MBL of implants in IC-RPDs (P = .001).CONCLUSIONClass I RPD connected to residual teeth and strategically positioned implants as surveyed crowns can be a viable treatment modality.