Abstract The retention of a complete denture and the patient’s adaptation varies considerably among different individuals. Resorption of the edentulous alveolar ridge differs greatly and some patients need implant-retained overdentures to enable adequate retention of their prostheses. In some extreme cases it is necessary to increase the volume of the alveolar ridge with bone grafts. The aim of this study was to examine the outcome of implant-supported overdenture treatment conducted in Oulu University Hospital. The aim was also to assess the impact of treatment on oral health-related quality of life and patient satisfaction. The study group was comprised of patients treated with a mandibular or maxillary implant overdenture and a group of patients with extreme mandibular bone resorption treated with extraoral bone grafts and implants. The treatments were performed in 1985–2013 thus also providing long-term results. The results of this study showed predictable and successful treatment outcomes also among elderly patients and in severe situations with bone deficiency. The most frequent complication in the clinical follow-up was loosening of the retention mechanism, commonly noted in other previous studies. Despite some minor mechanical defects in prosthetic structures or mild mucosal inflammation around the implants, they did not hinder everyday use of the prostheses. Neither the number of supporting implants nor the connection type seemed to have a great impact on patient satisfaction. Older patients with a mandibular overdenture seemed to be most satisfied. In conclusion, treatment with implant overdentures seems to be successful also in the long-term. / Tiivistelmä Kokoproteesin pysyvyys ja potilaan sopeutuminen proteesiin vaihtelee huomattavasti eri yksilöiden välillä. Hampaattoman luuharjanteen resorptiossa on eroja, ja osalle potilaista implanttikiinnitteinen peittoproteesi on välttämätön riittävän proteesin pysymisen mahdollistamiseksi. Hyvin pitkälle edenneissä luuharjanteen resorptioissa voi leukaluun lisääminen luusiirteillä olla tarpeellista. Tutkimuksen tarkoituksena oli selvittää Oulun yliopistollisessa sairaalassa tehtyjen implanttikiinnitteisten peittoproteesihoitojen tuloksia. Tavoitteena oli myös arvioida hoidon vaikutusta suunterveyteen liittyvään elämänlaatuun ja potilastyytyväisyyteen. Tutkittava ryhmä koostui potilaista, joille oli valmistettu alaleukaan tai yläleukaan implanttikiinnitteinen peittoproteesi, ja potilasjoukosta, jolle hyvin pitkälle edenneen luuresorption vuoksi implanttihoito oli tehty luusiirteiden avulla. Hoidot tehtiin vuosina 1985–2013, ja tutkimuksissa voitiin arvioida myös peittoproteesihoidon pitkäaikaistuloksia. Tutkimus osoitti, että hoitotulokset olivat ennustettavia ja onnistuneita myös iäkkäillä potilailla sekä potilailla, joilla luupuutos oli kaikkein vaikein. Yleisin todettu komplikaatio kliinisessä tutkimuksessa oli proteesin kiinnitysmekanismin löystyminen. Pienet proteesirakenteiden rikkoutumiset tai lievät limakalvon tulehdusreaktiot implanttien ympärillä eivät kuitenkaan haitanneet proteesin toimintaa ja päivittäistä käyttöä. Peittoproteesia tukevien implanttien määrällä tai kiinnitystyypillä ei todettu olevan suurta vaikutusta potilastyytyväisyyteen. Kaikkein tyytyväisimpiä vaikuttivat olevan iäkkäät potilaat, joille oli tehty alaleuan peittoproteesi. Tutkimus osoittaa, että implanttikiinnitteinen peittoproteesihoito on menestyksellistä myös pitkällä aikavälillä.

The purpose of this study was to ascertain whether simplifying mandibular overdenture treatment utilising single stage surgery and immediate prosthetic loading of a single implant, will achieve similar implant success rates and functional improvement to that expected using conventional techniques. As part of this study, the Mk III Brånemark implant with an oxidised surface (TiUnite™ Nobel Biocare AB, Göteborg, Sweden) was compared to the classical machined Mk III Brånemark fixture.Materials and Methods: 35 patients with a mean age of 68 years and problematic mandibular dentures were treated. The primary complaints among the patients referred to the clinic for treatment related to poor retention of the mandibular denture, instability, denture sores and phonetic problems. Patients were initially placed randomly into the “machined surface” or “oxidised surface” group. A single implant was placed into the mandibular midline with high initial stability. A ball attachment was placed and the retentive cap incorporated into the existing denture. Reviews took place at 3,12 6 6 and 36 months. Clinical assessments, radiographs made with custom film holders, and stability measurements by both manual and resonance frequency analysis methods were recorded. All complications, failures, maintenance and reasons for dropout were noted. Visual analogue scale questionnaires were utilised to record patient satisfaction. (ANOVA p<.05) Results: Three out of 8 machined surface implants failed, representing an unacceptably high failure rate (37.5%). The machined surface was therefore discontinued for this study. Three oxidised surface implants did not achieve sufficient primary stability to be immediately loaded, so were treated with a two stage delayed loading protocol. The 25 immediately loaded oxidised surface implants were all classified as surviving at the 36-month recall. Patient satisfaction was very high with a significant increase in all comfort and functional parameters. Conclusions: Within the limitations of this study and research design, it appears that the immediately loaded single implant retained mandibular overdenture, using an oxidised implant surface in a small group of maladaptive patients, can provide a beneficial treatment outcome over a three year observation period. If insufficient stability at insertion is not achieved for immediate loading, then a delayed loading protocol should be utilised.

Background and hypothesis. Edentulous patients may be at risk for malnutrition and cardiovascular disease even with well made dentures. Improvements in methods used to assess nutritional status suggest that functional biomarkers such as plasma homocysteine (tHcy), in addition to traditional methods, will provide a better quality assessment. The hypothesis is that there is an association between functional biomarkers of nutritional status and traditional cardiovascular disease risk factors in a community dwelling edentulous elderly population. / Methods. This was a cross-sectional study of the baseline characteristics of a convenient sample of 254 edentulous community dwelling elderly over 65 years. Measurements included anthropometric, body composition, homocysteine, vitamins and relevant blood components. Correlations, multiple regression models and Adjusted Odds Ratios (AOR) for tertiles were used to assess the relationship between vitamins and other parameters with hyperhomocystenemia, defined as THcy value of &ge; 14mmol/L. The independent effect of edentulism on hyperhomocysteinemia was sought using the NHANES III data. / Results. The prevalence of hyperhomocysteinemia was 49.2%. Effect of folate on hyperhomocysteinemia was significant (p = 0.037). Low folate tertile group had a 2.45 times higher odds (CI: 1.23, 4.87) of hyperhomocysteinemia than patients in the higher tertile (p = 0.019). Groups with normal folate did not have higher odds of hyperhomocysteinemia regardless of levels of vitamin B6 or B12. AOR for vitamin B12 tertiles in relation to hyperhomocysteinemia were 2.36 (CI: 1.18, 4.75) and 2.12 (1.07, 4.22) for lower vs. high. A weak inverse relationship existed between tHcy and vitamin C (r= -0.11, p= 0.045). A borderline negative correlation existed between HDL and THcy adjusted for age (r = - 0.12; P = 0.05). Significant correlation existed between THcy and BMI (r = 0.15, P = 0.02), small waist circumference (r = 0.22; p = 0.0004) and waist/hip ratio (r = 0.23, p = 0.0003). In a multivariate analyses, edentulism was associated with hyperhomocysteinemia (p = 0.012). / Conclusions. In this sample, homocysteine levels appeared much higher than one would expect with folate fortification, and were related to several cardiovascular risk factors. Using data from NHANES III, edentulism was found to independently predict hyperhomocysteinemia. The inverse relationship between homocysteine and vitamin C and the effect of folate on hyperhomocysteinemia suggests that increasing dietary intake of fruit and vegetables in edentulous individuals might be beneficial. Furthermore, the latter are at risk of developing hyperhomocysteinemia, a condition associated with cognitive impairment, dementia and coronary artery disease risk.

Diss. (sammanfattning) Uppsala : Univ., 2001. / Härtill 5 uppsatser.

Made available in DSpace on 2014-06-11T19:35:02Z (GMT). No. of bitstreams: 0 Previous issue date: 2004-06-25Bitstream added on 2014-06-13T19:24:14Z : No. of bitstreams: 1 ribeiro_ra_dr_arafo.pdf: 762199 bytes, checksum: 5940dcea4937e50fc38fed81681be9c8 (MD5) / Foi avaliado o efeito da qualidade técnica das próteses totais (PTs) na incidência de sinais e sintomas de disfunção temporomandibular (DTM) em pacientes portadores de PTs bi-maxilares. Para a realização deste trabalho, foi aplicado um questionário a 154 pacientes contendo os dados pessoais, o histórico das próteses, o índice anamnésico para DTM e o índice de qualidade de prótese, além do exame físico específico para o diagnóstico de sinais da DTM. Considerando-se a metodologia empregada e a população estudada, pôde-se concluir que a qualidade das PTs não influenciou na presença de sinais e sintomas de DTM. / The aim of the current study was to evaluate the effect of the technical quality of dentures in the incidence of temporomandibular dysfunction (TMD) signs and symptoms in 154 patients wearing complete upper and lower dentures. For the accomplishment of this work a questionnaire was applied containing personal data, the report of the prostheses, anamnestic index to DTM, quality of the dentures index and clinical examination. Through this work, it could be concluded that the quality of the prosthesis not interfered in the incidence of TMD signs and symptoms.

Orientador: Francisco de Assis Mollo Junior / Banca: Sérgio Russi / Banca: João Neudenir Arioli Filho / Banca: Marcelo Ferraz Mesquita / Banca: Marco Antonio Compagnoni / Resumo: Foi avaliado o efeito da qualidade técnica das próteses totais (PTs) na incidência de sinais e sintomas de disfunção temporomandibular (DTM) em pacientes portadores de PTs bi-maxilares. Para a realização deste trabalho, foi aplicado um questionário a 154 pacientes contendo os dados pessoais, o histórico das próteses, o índice anamnésico para DTM e o índice de qualidade de prótese, além do exame físico específico para o diagnóstico de sinais da DTM. Considerando-se a metodologia empregada e a população estudada, pôde-se concluir que a qualidade das PTs não influenciou na presença de sinais e sintomas de DTM. / Abstract: The aim of the current study was to evaluate the effect of the technical quality of dentures in the incidence of temporomandibular dysfunction (TMD) signs and symptoms in 154 patients wearing complete upper and lower dentures. For the accomplishment of this work a questionnaire was applied containing personal data, the report of the prostheses, anamnestic index to DTM, quality of the dentures index and clinical examination. Through this work, it could be concluded that the quality of the prosthesis not interfered in the incidence of TMD signs and symptoms. / Doutor

Made available in DSpace on 2014-07-29T15:21:59Z (GMT). No. of bitstreams: 1 DISSERTACAORafael Ragonezi.pdf: 1166394 bytes, checksum: 9a9d8ec52156e116033645a5d7ed068c (MD5) Previous issue date: 2008-03-03 / The aim of the study was to explore preferences and reasons for choosing or refusing prosthetic treatments in partially edentulous patients. Clinical and oral-related quality of life measures were collected from 165 patients undergoing dental treatment in undergraduate clinical activities in the School of Dentistry of the University Federal of Goiás. Reasons for choosing or refusing prosthetic treatments were investigated using an instrument containing 32 questions about the importance of these items for the patient s decisions about treatment in a 5-point Likert scale, ranging from 1 (no importance) until 5 (absolutely important). Descriptive statistics, chi-square and ANOVA were used to compare patients preferences according to clinical independent variables. Discriminant analysis was used to analyze the impact of patients reasons for choosing or refusing removable (RPD), fixed (FD) or implant (ID) prosthesis. Results showed that older patients (p<0.001) and with greater OHIP scores (p<0,05) were more likely to choose for removable partial dentures and implant prosthesis were preferred in patients with higher school levels (p<0.01). Discriminant functions reveal that the desire of having a fixed or removable appliance had great impact on patients decisions. The removal of natural teeth structure was the main reason for refusing conventional fixed dentures and cost had great impact on refusing implant dentures. Overall agreement percentages between actual patients decisions and predicted by discriminate analysis were over 90% for all types of treatment. It was concluded that acceptance or rejection of prosthodontic modalities have great variations among patients and individual perceptions are important determinants of treatment decisions. The main reasons for choosing or refusing treatments focused in this study can be used to guide shared decision making process, providing treatments that better match patients expectations and desires / Foram avaliados as preferências e os motivos determinantes na eleição ou recusa de modalidade de tratamentos protéticos em pacientes desdentados parciais. Além disso foram estudadas as características clínicas, variáveis sócio-demográficas, a influência da saúde bucal na qualidade de vida através do Oral Health Impact Profile -14 (OHIP-14), além dos motivos que determinaram a escolha ou recusa de opções de tratamento medidos pela importância de cada um de 32 itens numa escala de Likert de 5 pontos. Uma amostra 165 indivíduos parcialmente desdentados em atendimento na Faculdade de Odontologia da Universidade Federal de Goiás foi estudada. Realizou-se a análise descritiva dos dados e a comparação de variáveis de acordo com a preferência protética foi realizada pelos testes de qui-quadrado e análise de variância. O impacto dos itens do QPP (Questões sobre Preferência Protética) sobre a eleição ou recusa de tratamentos foi avaliado por meio de análise discriminante. Nos resultados a idade (p<0,001) e o escore do OHIP (p<0,05) foram significativamente maiores nos indivíduos que tiveram a prótese parcial removível como tratamento de eleição. A escolaridade mais alta (p<0,01) foi encontrada nos pacientes que optaram por prótese sobre implante. Através de análise discriminante linear, determinou-se que os principais motivos que impactaram na eleição e recusa para PPRs foram para ambas as arcadas, respectivamente, a possibilidade de se retirar a prótese para higienizar e o desejo de se ter uma prótese fixa na boca. O fato da prótese ser fixa na boca foi o principal motivo determinante na eleição da PPF, enquanto que a necessidade de se desgastar dentes naturais foi o principal motivo de recusa. Em relação à PI, o desejo de se ter dentes individualizados e de se ter uma prótese fixa foram os motivos de eleição e o maior custo do tratamento foi o motivo de recusa. O modelo final da análise discriminante teve um acerto total acima de 90% para cada uma das modalidades de tratamentos. Concluiu-se que há grande variação nas opções de eleição ou recusa de tratamentos protéticos entre os pacientes desdentados parciais e que fatores relacionados a percepções individuais dos pacientes são importantes determinantes de escolhas por tipos de tratamentos protéticos. Os motivos que apresentaram maior impacto na eleição ou recusa de tratamentos podem ser utilizados como importantes questões para o direcionamento das tomadas de decisão de tratamento em pacientes desdentados parciais

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2018-01-16T10:15:28Z No. of bitstreams: 2 Dissertação - William José Morandini - 2006.pdf: 1451681 bytes, checksum: c9fd554150fbddb17c6a5d1d70618a4f (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2018-01-16T10:16:09Z (GMT) No. of bitstreams: 2 Dissertação - William José Morandini - 2006.pdf: 1451681 bytes, checksum: c9fd554150fbddb17c6a5d1d70618a4f (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-01-16T10:16:09Z (GMT). No. of bitstreams: 2 Dissertação - William José Morandini - 2006.pdf: 1451681 bytes, checksum: c9fd554150fbddb17c6a5d1d70618a4f (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2006-05-29 / Self-perception of potential outcomes of prosthodontic treatment, including benefits, risks and consequences of not replacement of missing teeth, were studied in edentulous patients. Initially, using a qualitative approach, it was developed a instrument containing 41 affirmatives that comprise a scale and sub-scales that measure subject’s perception score in a 5-point Likert-type scale (1=strongly disagree; 2=disagree; 3=neutral; 4=agree; 5=strongly agree). Subsequently 126 partially or totally edentulous subjects were interviewed. Mean age was 51.8-years (SD=12.3), 74% female. Cronbach’s alfa coefficient of scale and sub-scale ranged from 0.70 and 0.90. Influence of age, gender and clinical variables were tested using analysis of variance and independent t-test. Sum of scores for each subject ranged from 123 to 198, mean score was 173.8 (SD=14.8). Subjects tended to agree with the proposed affirmatives (scores 4 and 5). Considering the total scale, lower scores were obtained by younger (p=0.033), male (p=0.019) and subjects with a single missing tooth (p=0.004). Using sub-scale of benefits, with single missing teeth subjects ranked lower scores (p=0.021). No variables showed significant relationship with perception scores using risks sub-scale. When considering sub-scale that measures perception of consequences of not replacement, lower scores were obtained by males (p=0.033), single missing tooth (p=0.018) and non wearers of prosthodontics (p=0.000). It was concluded that perception of potential outcomes of prosthodontic treatment was influenced by clinical variables. Older subjects, female, subjects with grater number of missing teeth and that have been previously treated have greater perception of benefits and risks of prosthodontic treatment. / Foi avaliada em indivíduos desdentados a percepção de desfechos potenciais relacionados a benefícios e riscos do tratamento e conseqüências do não tratamento protético. Inicialmente foi desenvolvido um instrumento com 41 afirmativas que compuseram as escalas e sub-escalas com categorias ordinais tipo-Likert de 5 pontos (1=discordo totalmente; 2=discordo; 3=neutro; 4=concordo; 5=concordo totalmente). A seguir foram entrevistados 126 indivíduos desdentados parciais ou totais, usuários ou não de prótese, idade média de 51,8 anos (DP=12,3), sendo 74% do sexo feminino. O coeficiente alfa de Cronbach da escala e sub-escalas variou entre 0,70 e 0,90. A influência da idade, sexo e dados clínicos foram avaliados através de análise de variância e teste t não pareado. A soma dos escores dos 41 itens para cada indivíduo variou entre 123 e 198, média de 173,8 (DP=14,8), com valor mínimo de 41 e valor máximo de 205. A proximidade da soma dos escores com valores máximos indicou tendência dos indivíduos em concordar com as afirmativas da escala (escores 4 e 5). Na escala total os menores escores foram para indivíduos jovens (p=0,033), do sexo masculino (p=0,019) e com espaços protéticos unitários (p=0,004). Na sub-escala de benefícios os menores escores foram para os desdentados unitários (p=0,021). Nenhumas das variáveis foram significativas para a sub-escala de riscos. Na sub-escala de conseqüências da não reposição, os menores escores foram para os homens (p=0,033), desdentados unitários (p=0,018) e não usuários de prótese (p=0,00). A percepção individual dos desfechos do tratamento protético foi influenciada por variáveis clínicas, sendo mais alta em indivíduos com maior idade, mulheres, maior número de dentes perdidos e usuários de prótese.

This study evaluated the survival rates of dental implants and prostheses in patients with maxillary edentulism using both randomized controlled trials (RCT) and prospective studies. The follow-up time for the selected articles ranged from 5 to 15 years. The implant survival rates ranged from 51% to 100% in RCT studies and 72% to 99% in prospective studies. Prostheses survival rates ranged from 78% to 100% in prospective studies, while RCT studies reported rates between 91% to 100%. Marginal bone loss rates ranged from 0.5mm to 2.45mm in RCT studies and 0.23mm to 1.39mm in prospective studies. This study suggests that the number and location of implants, need for sinus lift, and the type of opposing dentition can impact implant and prosthesis survival rates. Overall, this study provides valuable insights for clinicians in the management of maxillary edentulism using implant-supported prostheses.

No description available.