ABSTRACT
PURPOSE: To assess patient satisfaction and aesthetic treatment outcome of implant-supported singletooth replacements performed by dental students as part of their undergraduate curriculum 8 to 12 years after treatment. MATERIALS AND METHODS: A total of 51 patients were consecutively treated by dental students with 55 implant-supported single-tooth replacements within the incisor, canine and premolar regions. The surgical and prosthetic treatment was performed by the dental students under the supervision of dentists and oral and maxillofacial surgeons, all with specific knowledge about oral implantology. The outcome measures were patient subjective evaluation of peri-implant soft tissues, implant crown, implant function and total implant treatment using a Visual Analogue Scale (VAS). The professional evaluation included the peri-implant soft tissues, implant crown and total implant treatment (combined scores, PES/WES) using the Pink Esthetic Score (PES) and the White Esthetic Score (WES), as well as the level of incisor edge/occlusal surface in relation to neighbouring teeth. RESULTS: A total of 42 patients with 46 implants were available for evaluation 8 to 12 years after treatment. The patients were in general satisfied with the treatment outcome and few patients had low VAS scores. Most implants were characterised by single scores of 1 or 2 resulting in a mean PES score of 8.3 (maximum 14), a mean WES score of 6.3 (maximum 10) and a mean PES/WES score of 14.6 (maximum 24). However, 33% of the implants were characterised by recession (>1 mm) of the facial soft-tissue margin. Correlation analyses involving the subjective parameters indicated that the evaluation of the total implant treatment was mainly influenced by the appearance of the implant crown and to a lesser extent by the peri-implant mucosa. There were no significant correlations between the subjective and professional evaluation. Both the subjective and professional evaluation revealed implants in infraposition. This was registered in 7% and 17% of the implants, respectively. CONCLUSIONS: The patient satisfaction and aesthetic outcome 8 to 12 years after treatment with implant-supported single-tooth replacements performed by dental students as part of their clinical undergraduate dental curriculum were characterised by high patient satisfaction and an acceptable aesthetic treatment outcome. Therefore, it seems acceptable to include implant therapy of straightforward cases in the clinical undergraduate curriculum, provided there is substantial supervision by trained clinicians. CONFLICT-OF-INTEREST STATEMENT: The study was partially supported by Nobel Biocare, Denmark. There was no conflict of interest.
Subject(s)
Dental Implants, Single-Tooth/psychology , Dental Prosthesis, Implant-Supported/psychology , Esthetics, Dental , Patient Satisfaction , Students, Dental , Alveolar Ridge Augmentation/psychology , Attitude to Health , Cementation/psychology , Crowns/psychology , Dental Implant-Abutment Design/psychology , Dental Impression Technique/psychology , Dental Prosthesis Design/psychology , Education, Dental , Follow-Up Studies , Humans , Image Processing, Computer-Assisted/methods , Periodontium/pathology , Photography, Dental/methods , Prosthodontics/education , Retrospective Studies , Treatment OutcomeABSTRACT
UNLABELLED: SOURCE OF SUPPORT: The study was partially supported by Nobel Biocare, Denmark. CONFLICT OF INTEREST: None. AIM: To evaluate the treatment outcome of implant-supported single-tooth replacements performed by dental students as part of their undergraduate dental curriculum after a mean follow-up period of 10 years (range: 7.5 to 12 years). MATERIALS AND METHODS: A total of 51 patients were consecutively treated by dental students with 55 implants supporting single crowns. The treatment was performed under supervision of dentists and oral and maxillofacial surgeons, all with special knowledge about oral implantology. Survival of implant crown, survival of implant, probing depth, bleeding on probing and peri-implant marginal bone level change were evaluated at the end of the follow-up period. In addition, biological and technical complications during the entire follow-up period were assessed. RESULTS: A total of 45 patients with 49 implants were available at the end of the study. The survival of the implant crowns as well as the implants was 94%. The mean probing depth at patient level was 4.8 mm. The probing depth varied between 2 and 10 mm at the individual site. The mean bleeding on probing score was 0.57 at patient level and absence of bleeding around all sites of the implants was rarely observed. The mean bone level change was -0.14 mm (range: 1.2 to -1.1 mm) during the first year of loading and 0.16 mm (range: 1.4 to -1.8) after 10 years at patient level. Five episodes of peri-implant inflammation due to excess cement were registered in five patients. Moreover, a fistula was observed at two implants in two patients. Finally, five technical complications occurred in five patients. CONCLUSIONS: Implant-supported single-tooth replacements performed by dental students as part of their undergraduate dental curriculum were characterised by high survival rates as well as few biological and technical complications. It seems acceptable to include implant therapy in the clinical undergraduate dental curriculum, provided a focus remains on straightforward cases with substantial supervision by trained dentists and oral and maxillofacial surgeons.
