The role of pain-related disability on treatment outcome and psychosocial symptoms in patients with temporomandibular disorders - a pilot study.

OBJECTIVE: The aim of the pilot study was to investigate the association of pain-related disability with the outcome of conservative treatment of temporomandibular disorders (TMD) and with depressive and non-specific physical symptoms among TMD pain patients utilizing Graded Chronic Pain Scale 1.0 (GCPS1.0) as a screening instrument. MATERIAL AND METHODS: The study included 80 adult patients who were referred to the Oral and Maxillofacial Department, Oulu University Hospital, Finland, due to TMD pain. At baseline, pain-related disability was assessed by using the GCPS1.0 according to the Research Diagnostic Criteria for TMD (RDC/TMD), and the patients were categorized into three TMD subtypes, 1-3. Patients were given conservative TMD treatment. At follow-up visits (1, 3, 6, and 12 months), patients evaluated the pain intensity on an NRS and described the treatment outcome and the severity of the TMD symptoms on a numerical scale. RESULTS AND CONCLUSIONS: Patients with TMD subtype 3 (moderate/severe disability) had the highest NRS scores and described their symptoms as most severe at each time point, statistically significantly so at 1-month and 6-month follow-up (p < .05). The highest proportion of depressive symptoms was found in TMD subtype 3 (p < .05). The current pilot study showed that moderate/severe TMD-related disability, based on the GCPS 1.0 as a screening tool, may be linked with poor treatment outcome and depressive symptoms. Studies with larger samples are needed to confirm the results.

Association of self-reported bruxism with temporomandibular disorders - Northern Finland Birth Cohort (NFBC) 1966 study.

OBJECTIVE: To investigate the prevalence of self-reported bruxism and its association with temporomandibular disorders (TMD). The hypothesis of the study was that self-reported bruxism is associated with TMD. METHODS: The data were gathered from 1962 subjects who participated in a field study in 2012-2013, including a questionnaire concerning bruxism and TMD symptoms as well as clinical sub-diagnoses of TMD using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Statistical method was chi-square test. Bonferroni correction was made, and a p-value of <0.003 was considered as significant. RESULTS: The prevalence of self-reported bruxism was 39.6%: 34.0% in men and 44.5% in women. Those who reported sleep bruxism (SB) or awake bruxism (AB) had significantly more pain-related TMD symptoms and signs compared to those not reporting bruxism. CONCLUSION: The prevalence of self-reported bruxism is high among middle-aged adults and is associated with TMD pain-related symptoms and signs, as well as TMD diagnoses.

The 1st Baltic Osseointegration Academy and Lithuanian University of Health Sciences Consensus Conference 2016. Summary and Consensus Statements: Group I - Peri-Implantitis Aetiology, Risk Factors and Pathogenesis.

INTRODUCTION: The task of Group 1 was to review and update the existing data concerning aetiology, risk factors and pathogenesis of peri-implantitis. Previous history of periodontitis, poor oral hygiene, smoking and presence of general diseases have been considered among the aetiological risk factors for the onset of peri-implant pathologies, while late dental implant failures are commonly associated with peri-implantitis and/or with the application of incorrect biomechanical forces. Special interest was paid to the bone cells dynamics as part of the pathogenesis of peri-implantitis. MATERIAL AND METHODS: The main areas indagated by this group were as follows: influence of smoking, history of periodontitis and general diseases on peri-implantitis development, bio-mechanics of implant loading and its influence on peri-implant bone and cellular dynamics related to the pathogenesis of peri-implantitis. The systematic reviews and/or meta-analyses were registered in PROSPERO, an international prospective register of systematic reviews: http://www.crd.york.ac.uk/PROSPERO/. The literature in the corresponding areas of interest was screened and reported following the PRISMA (Preferred Reporting Item for Systematic Review and Meta-Analysis) Statement: http://www.prisma-statement.org/. Method of preparation of the systematic reviews, based on comprehensive search strategies, was discussed and standardized. The summary of the materials and methods employed by the authors in preparing the systematic reviews and/or meta-analyses is presented in Preface chapter. RESULTS: The results and conclusions of the review process are presented in the respective papers. One systematic review with meta-analysis, three systematic reviews and one theoretical analysis were performed. The group's general commentaries, consensus statements, clinical recommendations and implications for research are presented in this article.

The Prosthetic Influence and Biomechanics on Peri-Implant Strain: a Systematic Literature Review of Finite Element Studies.

OBJECTIVES: To systematically review risks of mechanical impact on peri-implant strain and prosthetic influence on stability across finite element studies. MATERIAL AND METHODS: An online literature search was performed on MEDLINE and EMBASE databases published between 2011 and 2016. Following keywords tiered screening and selection of the title, abstract and full-text were performed. Studies of finite element analysis (FEA) were considered for inclusion that were written in English and revealed stress concentrations or strain at peri-implant bone level. RESULTS: There were included 20 FEA studies in total. Data were organized according to the following topics: bone layers, type of bone, osseointegration level, bone level, design of implant, diameter and length of implant, implant-abutment connection, type of supra-construction, loading axis, measurement units. The stress or strain at implant-bone contact was measured over all studies and numerical values estimated. Risks of overloading were accented as non-axial loading, misfits, cantilevers and the stability of peri-implant bone was related with the usage of platform switch connection of abutment. CONCLUSIONS: Peri-implant area could be affected by non-axial loading, cantilever prosthetic elements, crown/implant ratio, type of implant-abutment connection, misfits, properties of restoration materials and antagonistic tooth. The heterogeneity of finite element analysis studies limits systematization of data. Results of these studies are comparable with other findings of in vitro, in vivo, prospective and retrospective studies.

Preliminary Observations Regarding Treatment Outcomes in Patients Treated with Maxillary Implant Overdentures in a University Clinic.

PURPOSE: To evaluate the outcome of maxillary implant overdenture treatment in a selected patient sample. MATERIALS AND METHODS: Eighteen out of a total of 26 patients who were prescribed overdentures supported by two to six implants each attended a follow-up clinical assessment. Evaluative criteria included oral health-related quality of life records using the OHIP-14 questionnaire. RESULTS: Good stability and retention were observed, and mechanical failure items were recorded in eight patients. No significant differences in OHIP-14 scores were found between patients treated with two to three implants and patients treated with five to six implants, or between groups treated with a denture with palatal or horseshoe design coverage. CONCLUSION: Maxillary implant overdenture treatment was assessed as a viable treatment option for the selected patient sample, even when only two supporting implants were prescribed.

Veneered zirconia crowns as abutment teeth for partial removable dental prostheses: a clinical 4-year retrospective study.

STATEMENT OF PROBLEM: The mechanical properties of zirconia suggest that it might serve as a material for abutment crowns for partial removable dental prostheses (RDPs). Only limited clinical evidence is available for the use of ceramics as abutment crowns. PURPOSE: The purpose of this retrospective clinical study was to evaluate the outcome of veneered zirconia single crowns in abutment teeth for RPDs in participants treated by predoctoral students. MATERIAL AND METHODS: Thirty-seven veneered zirconia single crowns in 17 participants (9 men and 8 women; mean age 62.5 years) were prepared as abutment teeth for a clasp-retained RDP with a metal framework: 22 crowns with an occlusal rest seat and 15 crowns with both an occlusal rest seat and retentive clasps. The mean follow-up time was 4.2 years (2.9 to 5.4 years). In a clinical examination, the anatomic form of the crown, marginal fidelity (the border between the crown and the tooth was felt with an explorer), wear of the ceramic surface in the rest seat, and fracture of the veneering porcelain were examined and assessed as good, acceptable, or unacceptable. The retention and stability of the RDPs were recorded as good, moderate, or poor. RESULTS: The complications found were fracture of the veneering porcelain (11%) and fracture of the occlusal rest seat (3%). Wear of porcelain at the occlusal contact point was found in 24% of the zirconia single crowns. Wear of the ceramic surfaces of the rest seats for the RDPs was not found. The retention was good in all RDPs. The stability was good in 73% and moderate in 23% of the RDPs. CONCLUSIONS: Veneered zirconia single crowns are suitable in abutment teeth for RDPs with a metal framework. Fracture in the veneering porcelain remains a problem with veneered zirconia, although the zirconia surface in the rest seats for RDPs showed no wear.

Outcome of treatment of implant-retained overdenture in patients with extreme mandibular bone resorption treated with bone grafts using a modified tent pole technique.

PURPOSE: To evaluate the outcome (prosthetic maintenance, survival of implants, patient satisfaction, and quality of life) of prosthetic treatment using an implant-retained overdenture and a modified tent pole procedure for severe mandibular resorption. MATERIAL AND METHODS: Seventeen edentulous patients (mean age, 68 yr; range, 54 to 77 yr) with severely resorbed mandibles were treated with autogenous bone grafts using a modified tent pole technique and implant overdentures. A bar was used to splint the implants and the final prostheses with implant connection were completed approximately 7 months after surgery. The mean follow-up time was 5 years (1.5 to 7.4 yr). Patients filled out the Oral Health Impact Profile-14 questionnaire concerning their oral health-related quality of life, and then panoramic radiographs were taken during clinical examination. RESULTS: The stability of the overdenture was good in 58.8% of cases and retention was good in 64.7%. The most usual prosthetic complication was loosening of the attachment component, which occurred in 7 cases (41.2%). The amount of plaque and bleeding was more remarkable on the lingual surface of the implants and less remarkable on the buccal surface. Pocket depth around the implants seemed to correspond to intraoral implantation. The radiographs depicted excellent grafted bone survival. The patients' oral health-related quality of life was found to be good after treatment. CONCLUSIONS: Implant placement with bone grafting using a modified tent pole technique enables the achievement of a good prosthetic solution and the rehabilitation of occlusion, thereby improving the functionality of the prostheses and quality of life.

Quality of Life of Patients Treated With Implant-Supported Mandibular Overdentures Evaluated With the Oral Health Impact Profile (OHIP-14): a Survey of 58 Patients.

OBJECTIVES: The purpose of this study was to evaluate the oral health-related quality of life of patients treated with implant-supported mandibular overdentures and to compare the attachment systems used. MATERIAL AND METHODS: Altogether 112 patients treated with implant-supported mandibular overdentures in 1985 - 2004 were invited to the follow-up; 58 of them attended and replied to the Oral Health Impact Profile (OHIP-14) -questionnaire. There were 48 overdentures with a bar connection and 10 with a ball connection, the total number of implants installed and still in use was 197. The mean follow-up time was 13.7 years. The associations between the OHIP-14 variables and the patient's age, gender as well as the number of implants supporting the overdenture and the type of attachment used were assessed. RESULTS: The results showed that patients with implant-supported mandibular overdentures were satisfied with their oral health-related quality of life (OHRQoL). Older patients were more satisfied than younger ones in both genders. Neither the implant connection type nor the number of supporting implants seemed to have a significant influence on the OHRQoL. CONCLUSIONS: Especially older patients with mandibular implant-supported overdentures were satisfied with their oral health-related quality of life. Attachment type or the number of supporting implants did not have a significant influence on the oral health-related quality of life.

Outcome of implant-supported overdenture treatment--a survey of 58 patients.

OBJECTIVE: The aim of this follow-up study was to evaluate the long-term outcome of implant-supported or implant-retained mandibular overdenture treatment. MATERIAL AND METHODS: Altogether 112 patients treated with implant-supported overdentures between 1985 and 2004 were invited to the follow-up and 58 attended the clinical examination. The total amount of implants examined and still in use was 197. The average number of implants installed was three (range 2-4), and the mean length of the implants was 12 mm (range 8-21 mm). There were altogether 48 overdentures with a bar connection and 10 with a ball connection. RESULTS: The most frequent prosthetic complications were technical: loosening of the retentive mechanism (39.7%) and breakage of the matrices (5.2%). The most common peri-implant soft-tissue findings were bleeding and slight hyperplasia. The implant-supported overdentures of 19 patients (32.8%) had been renewed, while 39 patients (67.2%) still used their original overdentures, of which the oldest was 20 years old. CONCLUSION: The results of this long-term follow-up study show that the outcome of implant-supported mandibular overdenture treatment was excellent. The patients were satisfied with the treatment, regardless of the attachment type used. Removable overdentures are more easy to clean and can be cleaned outside the patient's mouth, whereas fixed-implant full-arch dentures in the edentulous mandible require much more time-consuming hygiene. This kind of overdenture treatment is suitable also in the elderly, even though their ability to practice appropriate oral hygiene might be decreased.