Option For Replacement Of Teeth Research Articles

Prosthodontic rehabilitation of patients with stage IV periodontitis

Stage IV Periodontitis is characterized by complex symptoms, including the loss of teeth, occlusal instability/collapse, ridge defects and increased tooth mobility. The management of such issues requires interdisciplinary collaboration to optimise outcomes. This article outlines the key guidelines from the recent EFP clinical practice guidelines on the efficacy of prosthodontic rehabilitation (fixed/removable) in the management of these complex patients. CPD/Clinical Relevance: An understanding of the clinical decision making when considering tooth replacement options in stage IV periodontitis patients is important.

Selection of Dental Implants and Restorations Among Dentists in the Kingdom of Saudi Arabia: A Cross-Sectional, Questionnaire-Based Survey.

Background Dental implants play a crucial role in modern dentistry, offering a durable and aesthetic option for tooth replacement. Understanding the preferences and practices of dentists regarding implant selection and restoration can provide critical insights into current trends and potential areas for improvement. As such, the objective of this study was to discover characteristics determining the selection criteria and preferences for dental implants and restorations among Saudi Arabian dentists. Methodology A cross-sectional, questionnaire-based survey was conducted among Saudi Arabian dentists to assess their practices and preferences for dental implant selection and restoration. The survey explored variables, including age, gender, educational status, regional practice distribution, implant-related experience, loading protocols, and implant system preferences. Results A total of 742 dental professionals responded to our questionnaire. The study revealed that a significant majority of Saudi Arabian dentists had placed (78.7%) and restored (72.9%) implants. Most dentists (78.6%) had participated in implant treatment planning. However, consistent usage of implant planning software was relatively low (29.8%). Loading protocol preferences varied, with early loading favored for anterior teeth and immediate loading for posterior teeth and edentulous patients. The main deterrents to immediate loading were patient type (27.0%), lack of training (19.9%), additional surgeries (19.9%), and administrative restrictions (17.8%). Straumann was the most preferred implant system, with aesthetic outcomes considered the most important factor in system selection. Conclusions The study provides a comprehensive overview of dental implant practices among Saudi Arabian dentists. It highlights a strong emphasis on aesthetic outcomes, a diverse approach to loading protocols, and room for increased usage of implant planning software. The findings suggest potential areas for further training and support, particularly in the use of immediate loading and implant planning software.

Oral Health-Related Quality of Life Among Non-institutionalized Elderly in Malaysia: A Teaching Hospital-Based Survey.

Background In Malaysia, the Geriatric Oral Health Assessment Index (GOHAI) has been recognized as a vital instrument for evaluating oral health-related quality of life among the elderly population. Its integration into the National Health and Morbidity Survey (NHMS) in 2018 demonstrates the country's dedication to understandingand addressing the unique oral health challenges faced by older individuals. The NHMS, led by the Ministry of Health Malaysia, serves as a crucial platform for identifying and addressing healthcare needs, while also working towards achieving sustainable development goals. This study aimed to provide valuable information for stakeholders and researchers by investigating the relationship between quality of life related to oral health and demographic factors, with the ultimate goal of enhancing oral healthcare for older individuals. Objective The objective of this research was to identify the variables that impact the Oral Health-Related Quality of Life (OHRQoL) of non-institutionalized elderly individuals who visit the Klinik Pergigian Manipal University College Malaysia (MUCM). By utilizing the OHRQoL, dental practitioners can gain insight into the elderly's oral health-related quality of life, which is crucial information for dental healthcare providers to effectively reach out to and cater to the elderly at the institution. Methodology A cross-sectional design was employed, utilizing a non-probability sampling method to select eligible elderly individuals at the clinic. A validated questionnaire comprising 18 items covering sociodemographic details and the Geriatric Oral Health Assessment Index (GOHAI) was distributed to individuals above 60 years via printed forms. One way ANOVA, unpaired t-test and multiple linear regression analysis were performed to analyze the data. Results The overall mean GOHAI score among non-institutionalized elderly attending Klinik Pergigian MUCM was 48.38±9.33, indicating poor OHRQoL. The psychosocial impact domain had a mean score of 19.33±5.21, surpassing the pain and discomfort domain with a score of 10.73±2.82, highlighting the significant impact of psychosocial factors on poor oral health-related quality of life. Multiple linear regression analysis revealed no significantassociations between OHRQoL and factors such asethnicity, living arrangements apart from spouse and family, or tertiary education among older individuals after adjusting for confounding variables. Conclusions This study indicates that sociodemographic aspects have minimal impact on the OHRQoLof seniors. Further examination is needed to understand the economic aspects of tooth replacement options and preventive measures in this age group. To enhance the OHRQoLof older adults, especially those not living infacilities like nursing homes or assisted living centers,tailored oral healthcare plans and strategies arecrucial. Interdisciplinary collaboration among mental health professionals, geriatric experts, and oral healthcare providers is crucial for empowering both healthcare practitioners and seniors to maintain optimal oral health.

SURFACE MATTERS THAN THE IMPLANT ITSELF-A REVIEW

Nowadays dental implants are a predictable and popular treatment option for tooth replacement in completely or partially edentulous patients. Implants are preferred over conventional treatment due to certain advantages it offers like preservation of bone; preservation of adjacent teeth, durability, better mastication and speech etc.Implant comes in direct bone contact and anchors through osseointegration. Successful osseointegration revolves around many factors such as biocompatibility of the implant material, quality and quantity of the available bone, surface treatment of the implant, loading and surgical protocol and various other systemic and local factors. Predictability of clinical success of dental implants can be enhanced by using newer materials or alterations in designs, surgical or loading protocols on the basis of available literature. Various studies have suggested that rough surface of implant enhances its integration with bone than a smooth implant surface. Several approaches are used to attain a rough surface and to improve the process of osseointegration of titanium dental implants. The present paper reviews different methods of treating implant surfaces to enhance bone implant interaction starting from the basic material used in dental implant manufacture.

Group 4 ITI Consensus Report: Patient benefits following implant treatment in partially and fully edentulous patients.

The aim of Working Group 4 was to address patient benefits associated with implant dentistry. Focused questions on (a) dental patient-reported outcomes (dPROs), (b) improvement in orofacial function, and (c) preservation of orofacial tissues in partially and fully edentulous patients following provision of implant-retained/supported dental prostheses were addressed. Three systematic reviews formed the basis for discussion. Participants developed statements and recommendations determined by group consensus based on the findings of the systematic reviews. These were then presented and accepted following further discussion and modifications as required by the plenary of the 7th ITI Consensus Conference, taking place in 2023 in Lisbon, Portugal. Edentulous patients wearing complete dentures (CD) experience substantial improvements in overall dPROs and orofacial function following treatment with either complete implant-supported fixed dental prostheses (CIFDP) or implant overdentures (IODs). With respect to dPROs, mandibular IODs retained by two implants are superior to IODs retained by one implant. However, increasing the number of implants beyond two, does not further improve dPROs. In fully edentulous patients, rehabilitation with CIFDP or IOD is recommended to benefit the preservation of alveolar bone and masseter muscle thickness. Completely edentulous patients benefit substantially when at least the mandible is restored using an CIFDP or an IOD compared to CD. In fully edentulous patients, implant prostheses are the best option for tooth replacement. The availability of this treatment modality should be actively promoted in all edentulous communities, including those with limited access and means.

A Case Report with Two-Year Follow-Up of Auto-Transplantation Tooth

Autotransplantation of a maxillary premolar tooth is a considerable option for tooth replacement in young adult patients, while Hemisection is a conservative way of preserving teeth. In this case report, we describe successful autotransplantation of the mesial root of the mandibular molar to replace the first maxillary premolar with complete root formation. The donor root was immediately placed at the recipient site and splinted for 14 days. Root canal treatment (RCT) was initiated 3 weeks after transplantation. Clinical and radiographic findings at 24 months of follow-up are compared with the results described in the literature. In case of non-extraction, adjacent teeth can be preserved in an economical way, also, case selection is essential in performing sequences of procedures for the success of treatment.

Clinical Assessment of Immediate Autotransplantation of Mandibular Third Molars: An In Vivo Study.

Transplanting a tooth from one area of the mouth to another is known as autogenous tooth transplantation. It is a great choice for restoring young patients' teeth with developing alveolar bone because it uses the patient's own tooth as the replacement rather than a false one. This study aims to evaluate pain, infection, mobility, resorption, ankylosis, and success rate in the replacement of mandibular non-restorable molars through an immediate autotransplantation of the nonfunctional impacted mandibular third molar. In this in vivo study, 20 patients between the ages of 22 and 50 were selected. The cases in which the first or second mandibular molar was nonrestorable and had an impacted third molar for transplantation were selected. In all the cases, the nonrestorable molar was extracted and replaced with a nonfunctional, impacted third molar. All the cases were evaluated for pain, infection, mobility, ankylosis, and resorption at the postoperative second week, one month, third month, and six months. The pain was assessed on the visual analog scale (VAS), infection was assessed by the presence of purulent discharges, mobility was assessed on a clinical examination of tooth movements, ankylosis was seen radiographically as the obliteration of the periodontal ligament space, and the absence of the lamina dura and resorption were seen radiographically as radiolucency on the root surface. All the readings were tabulated and statistically analyzed. Pain was seen to be maximal at two weeks and minimum at six months. Infection was not seen at all time intervals. Mobility was reduced with time. There was no significant ankylosis or resorption. Out of the 20 cases, four patients required extractions due to resorption and grade 3 mobility. One patient showed ankylosis. The success rate of the autotransplantation was 75%. Fifteen patients showed well-defined lamina dura without ankylosis or resorption. Autotransplantation is a valuable tooth replacement option and more economical, especially when provided with proper case selection.

The Ideal Hybrid Framework Material? - A Literature Review

Hybrid denture prosthesis have been used popularly in prosthodontics as a tooth replacement option. with some controversy. Hybrid dentures consist of one of the most novel options in the restoration of the edentulous arches. The implants are only placed only in the anterior region and the prosthesis is provided in the posterior region with the assistance of a cantilevered bar or framework. Conventionally the framework for such a prosthesis is fabricated using titanium or cobalt-chromium metal. Traditionally the frameworks were fabricated using metal casting. However, with the advent of digital dentistry CAD CAM frameworks have become very popular which have allowed the use of an array of materials such as zirconia,peek amongst other traditionally used metals.With a focus on materials used in the fabrication process of hybrid dentures, the goal of this study was to summarise the pertinent literature in this area.In conclusion, hybrid dentures seem like a viable treatment option which can be fabricated using multiple materials such as PEEK,zirconia,titanium,cast base metals, noble metals etc.

Unusual Indications of Teeth Transplantation: A Literature Review.

Dental implants are one of the best valid tooth replacement options, though these are not always appropriate in growing young patients. Tooth autotransplantation can be indicated then. However, this is not the only scenario where dental transplantation can be indicated. This comprehensive literature review discusses a wide range of unusual indications of dental transplantation as reported throughout the medical literature. Surprisingly, these indications include management of some developmental dental anomalies, hypodontia, oroantral communications, alveolar clefts, deficient alveolar ridges, ectopic teeth, and maxillofacial injuries. Limited high-quality evidence in this field regarding most of these unusual indications warrants further research of high-quality design.

Current Undergraduate Dental Implantology Teaching in UK.

Dental Implants are a popular treatment option for tooth replacement, with documented long-term success and survival rates of more than 95% over a period of 10 years. However, incorporating dental implantology into an undergraduate dental curriculum has issues associated. Therefore, the aim of this research was to examine and evaluate current undergraduate dental implantology education in the UK, investigate the amount of time allocated to this subject and analyse the barriers that are currently impeding the development of the programmes. An online questionnaire hosted by Online Surveys was designed, piloted, and sent to 16 dental schools providing undergraduate education in the UK. Ethical approval was gained from The University of Salford to conduct the study. Out of the 16 dental schools contacted, eight questionnaire responses were received, hence a response rate of 50% was achieved. The hours dedicated to the implant teaching programme varied from 3 h to 25 h, with a mean average of 11 h. It was identified from the results that no teaching of dental implantology was conducted in year 2; 12% of the schools responded that the subject was taught in year 1, 37% in year 3, 75% in year 4 and 50% in year 5. The methods used to deliver the programme were mainly lecture-based teaching, with only one dental school allowing students to place implants on patients. The main barriers to progression of the programme were financial (75%), followed by time limitations imposed by the curriculum (37%) and liability insurance (37%). However, there appears to be a consensus that further training beyond bachelor’s degree level is required to teach implantology effectively.

Editorial: Save the Tooth or Place an Implant: A Routine Dental Decision

Richard Herman, DDS: Single-tooth replacement is frequently considered in most dental practices. Thoughtful diagnostic treatment planning is required when evaluating endodontic vs implant treatment in order to ensure comfort, esthetics, and longevity for the patient. The American Association of Endodontists position statement on implants states that, apart from survival rates, components such as the restorability of the tooth, quality of bone, esthetic demands, cost-benefit ratio, and systemic factors should be taken into account when deciding whether to treat the tooth endodontically or to place a single implant.¹ One study evaluated the 10-year success rate of 1,175 endodontically treated teeth, and the life table analysis reported that 93% of the teeth survived 10 years after endodontic treatment.² Further, it was shown that the ability to locate second mesiobuccal canals increased from 53% to 93% when evaluated under a surgical operating microscope.^3–7 Technologic and technical advances in endodontics continue to enhance a dental treatment regime that has been universally accepted. These advances include the surgical operating microscope, mechanical titanium instrumentation, hydrodynamic irrigation, mineral trioxide aggregate, bioceramics, CBCT, and microsurgical instrumentation. It must be stated that dental implants are an extraordinary service and have made possible some treatment options that were never before imagined. The science of osseointegrated implants has advanced considerably with the development of new implant designs, surface characteristics, materials, and methods. High success rates have helped make single-tooth implants a viable and accepted option for tooth replacement. However, a healthy, natural dentition is still the best alternative requested by patients. Assessing whether to rehabilitate a tooth requiring endodontic treatment or to replace it with an implant involves a challenging and complex decision-making process,⁷ and all treatment decisions must be evidence-based. When comparable criteria are applied to the outcome, survival rates of endodontically treated teeth and single-tooth implants are similar. A compromised tooth should be managed with a multidisciplinary approach (endodontics, periodontics, and prosthetics), and implants should be reserved for the patient with true end-stage tooth failure. Endodontics, periodontics, and implantology should complement each other, not compete. The overall goal is the long-term health of the patient, using the least invasive treatment method possible, and incorporating function, comfort, and esthetics. Richard Herman, DDS Boca Raton, Florida, USA

IMAGING IN DENTAL IMPLANTS

Dental implants have gained a lot of popularity among patients as a viable option for tooth replacement. It has recently become a standard treatment plan in many dental practices, and proper treatment planning is required to ensure a satisfactory outcome. As a result, radiography is an indispensable tool in providing information to clinicians so that an appropriate diagnosis and treatment strategy may be devised. Since the emergence of advanced imaging techniques, determining an appropriate implant imaging modality has become a challenge, and many of these modalities are being used for implant imaging. When it comes to imaging, the technique should take into account not only the anatomy but also the dimensional accuracy. As a result, all of the associated advantages and drawbacks should be considered while deciding on the type of imaging modalities.

Public awareness, knowledge, attitude and acceptance of dental implants as a treatment modality among patients visiting dental college setups in the state of Himachal Pradesh, India: A pilot study

: Edentulism is one of the most commonly encountered condition affecting the oral cavity. Dental implants have emerged as a widely accepted prosthetic treatment option. However, lack of public awareness and cost of the treatment act as barriers which limit their applicability.A questionnaire-based survey was conducted in five dental colleges in the state of Himachal Pradesh, India to assess the knowledge, attitude and perception of participants regarding the importance of replacing missing teeth and dental implants.Epi-info software version 7.Majority of the patients were partially edentulous and believed that replacement of missing teeth is important but only half of participants had undergone treatment for the same. A large number of patients were aware about tooth replacement options but the awareness regarding dental implants was scarce. High cost and lack of information seem to be the major barriers in delivering dental implant treatment. Efforts are needed to educate and spread the awareness about implants among general population.

Tooth replacement options for partially dentate older adults: a survival analysis

ObjectivesTo compare the success of two different tooth replacement strategies for partially dentate older adults; namely resin bonded bridgework (RBB) provided to restore patients according to the principles of the shortened dental arch concept (SDA) and conventional full-arch rehabilitation with removable dental prostheses (RDPs). MethodsA randomised controlled clinical trial (RCT) was conducted with partially dentate adults aged 65 years or older. Each patient from the RDP group had all missing natural teeth replaced with cobalt–chromium framework RDPs. Each patient from the SDA group was restored to 10 occluding pairs of natural and replacement teeth using RBB. Patients were followed-up at 6, 12, 24, 36 months. Success rates were generated according to defined success criteria. Log-rank tests and Cox’s proportional hazard models were used to compare the success of the two treatment strategies. ResultsAfter 36 months, 89 patients completed the RCT; n = 45 in the RDP group and n = 44 in the SDA group. The overall success rate of the SDA treatment was 90.4% compared to 73.0% for RDPs (p = 0.005). In the upper arch SDA treatment was 100% successful compared to 86.4% for RDPs (p = 0.019). In the lower arch, lower success rates were reported for both the SDA treatment (80.0%) and RDPs (60.0%) (p = 0.054). Further analyses with cox’s proportional hazard models demonstrated that SDA treatment was significantly more successful than RDPs (Hazard Ratio: 2.47, p = 0.04). ConclusionsAfter 36 months SDA treatment using RBB was significantly more successful than RDPs used for conventional full-arch rehabilitation in partially dentate older adults. Clinical significanceFunctionally orientated treatment according to the principles of the SDA is a feasible alternative to RDPs for partially dentate older patients. SDA treatment using RBB can achieve higher success rates compared to RDPs in this patient group.

The restoration of structurally compromised endodontically treated teeth: principles and indications of post and core restorations

The use of posts to retain indirect restorations in structurally compromised teeth is a technique that has been used for many years. There are many factors that need to be considered prior to the provision of post- and core-retained crowns to reduce the risk of failure. This includes case selection and an understanding of the cumulative prognostic endodontic, periodontal and prosthodontic factors. Many clinicians are hesitant to use post- and core-retained restorations, due to an uncertainty of whether the treatment modality would work, and with some seeing it as an out-dated clinical technique. The evolution and widespread use of dental implants has also provided an additional fixed tooth replacement option, which may result in a reduced drive to retain structurally compromised teeth. As a result, fewer post-retained restorations are being placed, with the majority of these being old restorations present in the older age demographic. It is important for this treatment modality to remain within a clinician's armamentarium, not only for application when clinically appropriate but, with an ageing population with a heavily restored dentition, clinicians must be able to repair and replace these restorations when necessary. CPD/Clinical Relevance: A sound understanding of the biological and technical considerations in the provision of post and core restorations will allow clinicians to offer this treatment modality to appropriate patients with greater predictability and reduced failure rates.

Precision Planning in Autotransplantation of Teeth by Using CBCT – An Effective Prosthetic Approach

Auto transplantation can be considered a valid and predictable treatment option for rehabilitating patients with permanent teeth loss when a suitable donor tooth is present. Once thought to have unfavorable prognosis, auto transplantation has achieved high success rates and is an outstanding option for tooth replacement. This case report illustrates auto transplantation of a fully developed third molar in the place of a first molar with the guidance of CBCT (Cone Beam Computed Tomography).The added advantages of CBCT helps to make the process of auto transplantation more predictable, easier and less time consuming which will encourage many dental surgeons to add this treatment to their armamentarium.

Functional analysis of chondroitin 4 sulfate constituting osseointegration

Osseointegration can be defined as a direct connection, both structural and functional, between living bone and the surface of an artificial implant. Indeed, the word comes from the Greek term for 'bone' and 'to make whole'. In dentistry, once dental implants are placed, the body will react with osseointegration, enabling the implants to become a permanent part of the jaw. There are many benefits to this type of implant, compared with traditional tooth replacement options, not least that dental implants mimic the strength and functionality of a natural tooth. Dr Shuhei Tsuchiya is a researcher based in the Division of Oral and Maxillofacial Surgery at Nagoya University, Japan, who is interested in a range of areas, including regenerative medicine and the extracellular matrix. One of his key preoccupations, though, is shedding light on osseointegration. He and his team are working to unravel the mysteries of the mechanism.

Ten-year clinical evaluation of posterior fixed-movable resin-bonded fixed partial dentures

ObjectivesTwo-unit cantilevered resin-bonded fixed partial dentures (RBFPDs) offer long-term retention for anterior and premolar-sized spans. At this center, molar and longer spans have been restored with fixed-movable (FM) RBFPDs to overcome the lower retention rates of fixed-fixed RBFPDs. This retrospective study aimed to evaluate the long-term longevity and the patient-reported outcomes of posterior FM-RBFPDs. MethodsPosterior FM-RBFPDs that had been inserted at least five years were reviewed. Survival was “retention of the original prosthesis in mouth” and success was “survival of prosthesis and absence of complications requiring treatment intervention”. Prosthesis location, number of units, insertion year, tooth/teeth replaced and operator experience were collected. Patients’ acceptance to FM-RBFPDs were assessed using prosthesis satisfaction questionnaire and Oral Health Impact Profile (OHIP-49). Results were analyzed using log-rank and cox-regression tests at significance level α = 0.05. ResultsOne-hundred-and-one prostheses were examined. The mean observation time was 126.4 ± 32.2 months. Thirty-six (35.6%) and 63 (62.4%) FM-RBFPDs were rated as success and survival respectively. Prostheses inserted after year 2001 (n = 69) experienced 42.0% (n = 29) success and 75.4% (n = 52) survival, and its survival rate was significantly better than those inserted in or before 2001 (p = 0.01). Five- and ten-year cumulative survival probability of FM-RBFPDs inserted after year 2001 were 82.3% and 74.1% respectively. The most frequent complications were debonding among 34 (33.7%) prostheses. Patients’ acceptance were high. ConclusionsMore recently inserted prostheses showed improved longevity and patients’ acceptance to posterior FM-RBFPDs were high. Clinical significanceFix-Movable RBFPDs are a viable tooth replacement option in the posterior region.

Root Elongation After Autotransplantation in 58 Transplanted Premolars: The Radiographic Width of the Apex as a Predictor

Autotransplantation of premolars with incomplete root development is a reliable treatment option for tooth replacement. Nevertheless, little is known about root development after transplantation of teeth. The aim of this study was to evaluate preoperative root development stage and radiographic width of the apex as predictors for root elongation after autotransplantation. A retrospective cohort study was implemented and composed of patients who underwent autotransplantation of at least 1 premolar. Using panoramic radiographs (orthopantomograms), calibrated measurements were taken to record the root development stage of the donor tooth, width of the apex, and root length of the transplanted tooth. Forty-five patients (58 transplants) were included. Mean follow-up time was 12months (range, 4 to 26months). Fifty-three transplanted teeth (91.4%) showed root elongation. Mean root elongation at end of follow-up was 1.9mm (range, 0.0 to 4.3mm). A wide-open apex before transplantation was significantly associated with root elongation after autotransplantation (P<.01). Root development stage (P=.82) did not show significant associations with root elongation. A wide-open apex (>2.0mm) is an important predictor of root elongation after autotransplantation of premolars. This might be a better predictor for root development than preoperative root development stage.

Knowledge and awareness about dental implant as an option for replacement of teeth: a survey among saudi adults

Knowledge and awareness about dental implant as an option for replacement of teeth: a survey among saudi adults