Single Missing Tooth Research Articles

Evaluation of treatment modalities selected by patients for replacing single missing tooth: A questionnaire-based study

Evaluation of treatment modalities selected by patients for replacing single missing tooth: A questionnaire-based study

Success rate of immediately loaded implants in the posterior zone.

Dental implants are considered an ideal treatment for a missing single tooth. Immediate loading of implants can hasten the procedure, providing comfort to the patients. Recently, immediate loading of implants has gained much importance as it helps hasten the procedure and provides more comfort to patients. A previous systematic review published 5 years ago compared the success rates between immediate and conventional loading. There are several factors that influence the success rate of implants that were not discussed in detail in the previous review. Hence, the present systematic review is done to report differences in the outcomes from single implant restorations of missing teeth in the posterior region in patients who were subjected to immediate loading and conventional loading. A follow up for 1 year was done. Electronic databases of Medline, Scopus, and Web of Science were searched for publications in the English Language during May 2021. The search results yielded 306 articles, out of which 225 were excluded based on title and abstract screening. Screening of the remaining 81 full text articles yielded 14 original research articles that satisfied the predefined inclusion criteria. Meta analysis was not possible due to the heterogeneity of the data. The overall success rate of the immediate loading of a single implant is 94.31%. Implants in the maxillary region had a higher survival rate than those in the mandibular region. The age range between 18 and 80 years showed good prognosis and outcomes in older individuals. Good oral hygiene was emphasized for all patients to prevent any secondary conditions or delays in healing.

Screening and analysis of prognostic factors of repairing single missing tooth by autotransplantation of teeth

Objective: To screen and analyze the factors affecting the prognosis of replacing single missing tooth by autograft tooth, so as to provide reference for clinical judgment of surgical prognosis. Methods: A total of 176 patients (188 teeth) underwent autotransplantation of teeth in the Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University from January 2017 to December 2019, including 85 teeth of males and 103 teeth of females were involved. The age was (33.0±9.8) years (16-65 years). The possible factors affecting the prognosis of replacing single missing tooth by autograft tooth were summarized and grouped, and the clinical and imaging data were recorded and judged. The surgical records and photographic data from the patients' previous medical records were retrospectively analyzed. The survival analysis method was used for statistical analysis to screen out the factors affecting the cumulative survival rate of transplanted teeth. Results: The 5-year cumulative survival rate of 188 transplanted teeth was 88.4%. Univariate Log-Rank analysis showed that age (P<0.001), sex (P=0.008), smoking (P<0.001), position of recipient area (P<0.001), height of alveolar bone in recipient area (P<0.001), time of donor tooth in vitro (P<0.001), use of donor model (P<0.001) and initial stability (P<0.001) were significantly correlated with cumulative survival rate of transplanted teeth. Multivariate Cox proportional hazard regression analysis showed that smoking (β=-2.812, P=0.049), alveolar bone height (β=1.521, P=0.020), donor time (β=-2.001, P=0.019), use of donor model (β=1.666, P=0.034) and initial stability (β=-1.417, P=0.033) were significantly correlated with the cumulative survival rate of transplanted teeth. Conclusions: The prognosis of autogenous tooth transplantation can be predicted by smoking, height of alveolar bone in recipient area, time of donor teeth in vitro, use of donor model and initial stability. Good prognosis of transplanted teeth can be obtained by using donor model during operation, reducing the time of donor teeth in vitro, taking effective methods to restore alveolar bone height, maintaining good initial stability, and good oral health education after operation.

Single tooth implant versus resin-bonded bridge: A study of patient’s satisfaction

Abstract Objective: To compare the patients’ satisfaction between patients treated with single tooth implant (STI) or resin bonded bridge (RBB) for single missing tooth replacement. Methods: A cross-sectional study was conducted in Faculty of Dentistry, Universiti Teknologi MARA (UiTM). Patients treated using STI (n=26) and RBB (n=26) were prospectively recruited. A validated patient satisfaction questionnaire was given to the participants to assess the aesthetics, masticatory function, phonetics, ease of cleaning and cost satisfaction using 7- point Likert scale. Demographic data (gender and age) and treatment data (site of treatment) were also collected. Differences in various aspects of satisfaction were compared. Results: STI and RBB groups has similar demographic and treatment characteristics. Both groups revealed high satisfaction with most of the aspects in the questionnaire. There was no statistically significant difference in overall satisfaction between the two treatment groups (p = 0.189). However, STI group had a significant higher score in existing appearance (p = 0.010), mastication (p = 0.018) and phonetics (p = 0.029) compared with RBB. Level of satisfaction did not differ by gender, age and site of the prostheses (p &gt; 0.05). Almost all of the participants would choose to undergo the same treatment again in UiTM (STI = 96.2%, RBB = 92.3%). Conclusion: Both STI and RBB participants were highly satisfied with the aesthetics, phonetics, cost and found that the treatment fees were justified and reasonable in UiTM. Therefore, both treatment options are good to be indicated for single missing tooth replacement.

Periodontal Evaluation of One-Piece and Two-Piece Single Implant Loaded in Esthetic Zone

Background: Soft tissue around dental implant is an important anatomical feature contributing to the long-term implant success and esthetics, different factors may influence the soft tissue-implant interface. The purposes of the current study were to evaluate the soft tissue profile around one-piece and two-piece implants loaded in esthetic zone. Method: Totally thirty patients who had single missing tooth in premaxillary region were included in the study. Fifteenth patients’ group-A were assigned to immediate loading one-piece implant and fifteen patients’ group-B were assigned to early loading two-piece implant protocol. Flapless approach was performed for both groups. In group-A, implants were loaded immediately with a temporary crown within 48h, while group-B, were loaded after two months following conventional impression for metal ceramic crown. Clinical outcomes were evaluated after two and six months in terms of success rate, papillary index, plaque index and width of keratinized mucosa. Results: The success rate in group-A found to be 80%, which was lower than the success rate in group-B (100%). On comparison, there was no statistically significant difference in success rate between the two study groups. There was no statistically significant difference between both groups over time in clinical parameters like plaque index, width of keratinized gingiva and papillary index. Conclusion: The results of this study indicated that using either immediately loading one-piece implants or early loaded two-piece implants protocol demonstrated the same enhancements of implant esthetics

Evaluation of Marginal Bone Level Changes Around Microthreaded Platform Switched Implant in The Aesthetic Zone

Aim: This study was designed to evaluate marginal bone level change around microthreaded platform switched implant in the aesthetic zone. Subjects and methods: Eighteen implant fixture were inserted in 16 patients with missing single tooth in upper anterior area and divided equally into two groups. The patients were selected from those attending outpatient clinic, Oral and Maxillofacial Surgery Department, at the Faculty of Dental Medicine, Boys, Cairo, Al-Azhar University. Clinical examination was made to all patients as: Inspection and palpation of muscles of mastication, tempromandibular joint , lymph nodes, occlusion, condition of the existing teeth and oral mucosa and available inter arch space. Preoperative periapical radiograph as well as, cone beam CT radiograghy for evaluation of the implant site. The patients were assessed clinically at the operative day and post-operatively for 6 months to evaluate implant stability with osstell, Probing depth (PD) and PES/WES score. Marginal bone loss was measured 6 months post-operatively using CBCT radiography. Results: The mean value of vertical bone loss after 6 months was 0.52± 0.15 in group I and 0.92± 0.26 in group II . This bone loss was increased in group II more than group I with statistical significant difference. The mean value of PES/WES total was 13.44± 1.81 in group II and 15.67±1.66 in Group I. This value was decreased in group II more than group I with statistical significant difference. Conclusion: The use of micro threads on the implant neck with platform switch was most effective design to maintain and preserve marginal bone level.

EVALUATION OF USE OF NARROW DIAMETER IMPLANTS IN POSTERIOR REGION OF THE JAWS

The molars are one of the first teeth to be lost over lifetime; thus, their replacement is frequently needed. Implantation is generally the preferred choice to replace a missing single tooth avoiding vital teeth preparation and bridge fabrication. Placement of implant to replace a molar presents diagnostic, surgical, and prosthetic demands, such as an enlarged mesiodistal dimension and occlusal forces distribution. Poor bone quality in the posterior regions, especially the maxilla, could jeopardize the short- and long-term implant success. Anatomical considerations and adjacent vital structures (ie, maxillary sinus and mandibular canal), occlusal loads, and the occlusal table, which is frequently wider than the implant diameter, should also be of some concern. Quality and density of the bone in the posterior regions can compromise initial implant stabilization and load transfer to the bone. The most frequent single molar to be replaced is the first mandibular molar, because this tooth is lost first. Implantation in the posterior area is a predictable procedure over time. The low rate of complications in addition to the high long-term success rate make implant restoration a reliable solution to treat posterior partial edentulism. Hence the present study was planned for evaluation for evaluation of use of narrow diameter implants in in posterior region of the jaws.&#x0D; The present study was planned in Department of Impalantology, Manipal College of dental sciences Manipal. Total 20 cases were enrolled in the present study. Out of that 10 cases were scheduled for single unit prosthetic rehabilitation supported by implant in the posterior region of the jaws was evaluated in Group A. These cases were implemented with the Narrow Diameter Implant (NDI). Remaining 10 cases were evaluated in the Group B as control cases. These control patients received the Regular Diameter Implant (RDI).&#x0D; The data generated from the present study concludes that NDIs placed in posterior region of the jaws without sufficient bone thickness for placement of RDIs presented a high success and survival rate. In addition to that, NDIs presented marginal bone loss patterns similar to those for RDIs, both in the maxilla and mandible. Thus, it can be suggested that NDIs may be successfully used in the posterior regions of the jaws. More studies with longer follow-up intervals are, however, necessary to further evaluate single crowns supported by NDIs in the posterior region of the jaws.&#x0D; Keywords: Narrow Diameter Implants, Posterior Region of the Jaws, Regular Diameter Implant, NDI, RDI, etc.

Prevalence Of Hypodontia In Patients Attending Orthodontic Clinic In Kuala Terengganu

Introduction: The objective of this study was to determine the prevalence and the pattern of hypodontia among orthodontic patients in Klinik Pergigian Jalan Sultan Mahmud, Kuala Terengganu. Materials and Methods: A retrospective of 351 orthodontic patients record review study was conducted; comprised of 104 males and 247 females. The records were reviewed by trained dental officer between October 2016 and June 2017. The Chi-square and Fisher's Exact Tests were carried out for statistical analysis. Results: The prevalence of hypodontia was 10.8%. Thirty-eight patients were found to have at least single missing tooth. A significant difference was found between males and females of having hypodontia (p = 0.048). No significant difference was found for hypodontia patients by races (p = 0.829). The maxillary lateral incisor was the most frequently missing tooth followed by mandibular second premolars and mandibular lateral incisors. Hypodontia cases observed tended to be more likely occurred in the upper left arch compared to the lower arch. The majority of hypodontia patients had single missing tooth, but rarely more than 3 missing teeth. Hypodontia patients had mainly Class III malocclusion, however no statistically significant was found (p= 0.081). Conclusion(s): The prevalence of hypodontia of this study was within the range of what is being reported in the literature and showed gender significant. Hypodontia was mainly involved maxillary lateral incisors; more prevalent in the upper arch; and mostly observed in patients with Class III malocclusion in the study sample. Early detection and accurate diagnosis are essential. Therefore, alternative treatment modalities can be well planned under multidisciplinary team approach in restoring the aesthetic and function.

Complications in implant dentistry.

After tooth loss, an individual may seek tooth replacement so that his/her function and esthetics could be restored. Clinical prosthodontics, during the past decade, has significantly improved and developed according to the advancements in the science and patient's demands and needs. Conventional options in prosthodontics for substituting a missing single tooth include the removable partial denture, partial and full coverage bridgework, and resin-bonded bridgework. Dental implants have gained increasing popularity over the years as they are capable of restoring the function to near normal in both partial and completely edentulous arches. With substantial evidence available, fixed implant-supported prosthesis are fully acknowledged as a reliable treatment option for the replacement of single or multiple missing teeth nowadays. While dental implants are increasingly becoming the choice of replacement for missing teeth, the impediments associated with them are progressively emerging too.

Evaluation of peri-implant soft tissue and bone levels around early loaded implant in restoring single missing tooth: A clinico-radiographic study.

Background:One-stage nonsubmerged protocol which can achieve success rates comparable to implants placed in a two-staged submerged procedure also the preconditions for periimplant bone regeneration has lead to more refined concepts of implant loading.Materials and Methods:Twenty sites with single missing tooth were included in this study. Clinical parameters included sulcus bleeding index (sBI), probing pocket depth (PD), and papilla index (PI) and radiographic parameters included crestal bone level were assessed for a period of 9 months.Results:The crestal bone loss showed mean value ranging from baseline 0.25 ± 0.11 to 0.31 ± 0.08 at 3 weeks, to 0.67 ± 0.13 at 3 months, to 0.85 ± 0.09 at 6 months, and to 0.88 ± 0.12 at 9 months. Probing PD, the mean value for probing PD at 3 weeks 1.20 ± 0.83, 3 months 1.60 ± 1.1, at 6 months 1.40 ± 1.14, and at 9 months 1.20 ± 1.0. sBI, mean value for sBI at 3 weeks 0.00 ± 0.00, 3 months 0.3 ± 0.11, at 6 months 0.09 ± 0.25, and at 9 months 0.08 ± 0.24. PI, showed a significant difference among at different points of time with P = 0.000.Conclusion:The dental implants showed <1 mm of crestal bone loss at 9 months follow-up, clinically significant marginal bone loss occurred between the time of implant placement and 3 months. Subsequent to that, bone loss observed around the implant up to 9 months was minimal. The periimplant soft tissue maturity was maintained throughout the study.

Using Dental Implants in the Prosthetic Rehabilitation of Patients with Cleft Defect Type II

A dental implant may be used in prosthetic tooth reconstruction in cleft patients. There are three main indications for this approach: substitution of a missing single tooth, an abutment for the framework, and an abutment for a fixed dental prosthesis (we designate these as defect types I, II, and III). A clinical report about prosthetic rehabilitation using dental implants instead of a fixed or removable partial prosthesis is presented. A patient with a unilateral cleft defect was treated at the University Hospital in Prague, Czech Republic. Together with a missing lateral incisor, the defect was associated with agenesis of the two upper canines and three second premolars. The treatment was completed by prosthetic dental reconstruction using the framework with a dental implant as an abutment. This approach allowed minimizing the preparation of adjacent teeth to a single tooth functioning as the second abutment. If classical fixed prosthodontics had been performed, the preparation would have involved a larger group of intact teeth with the risk of their viability loss. The procedure had no complications. The outcome was of high quality and brought satisfaction to the patient.

Tooth loss and implant replacement.

Osseointegrated dental implants are increasingly used to replace missing teeth in a variety of situations ranging from the missing single tooth to complete edentulism. The implant possibility must be carefully considered because treatment involves extended time frames, considerable expense and is not without risk. Accordingly, treatment-planning decisions should have an evidence-based strategy with appropriate risk assessment. Implant systems need to be adequately tested before they are released for general use and success rates should be assessed from peer review scientific publication data and not commercial promotional literature. It is the responsibility of the dentist to ensure the patient is educated so an informed decision can be made on difficult treatment alternatives. The clinical decision making process must respect the issues to assure quality of care and reduction of liability for negligent care. Today, the three-unit fixed bridge can no longer be considered as the standard of care for restoration of a single missing tooth. The evidence has accumulated that the single tooth implant supported replacement is more conservative, more cost-effective and more predictable with respect to long-term outcome in uncomplicated cases.

Single tooth replacement—expanded treatment options

The aim of any prosthesis is to restore function and aesthetics by replacing the missing tooth with minimal risks to adjacent tissues. The options presently available to the patient for the replacement of a missing single tooth include the removable partial denture, partial and full coverage bridgework, resin-bonded bridgework and the single-tooth implant prosthesis. The relative merits and guidelines for successful application of these treatment modalities are presented.