Effectiveness, Costs and Patient Acceptance of a Conventional and a Biological Treatment Approach for Carious Primary Teeth in Children.

BACKGROUND: Over the last years, conventional restorations for the treatment of active carious lesions (CL) in primary teeth have been challenged and a more biological approach has been suggested. This approach involves less invasive techniques that alter the environment of the CL isolating it from the cariogenic biofilm and substrate. AIM: To investigate the cost-effectiveness and patient acceptance of 2 treatment approaches for the treatment of deep CLs in primary teeth in children. METHODS: This was a retrospective/prospective cohort study carried out in 2 UK specialist hospital settings. Data on cost-effectiveness was extracted retrospectively from clinical dental records of 246 patients aged 4-9 years. A prospective study design was used to explore patient acceptance of the 2 treatment approaches. One hundred and ten patients aged 4-9 years and their carers completed 2 questionnaires on treatment acceptance. RESULTS: In total, 836 primary teeth that had received treatment with either approach were included. More than 2 thirds (75.7%) of the restorations in the conventional approach were of non-selective removal to hard dentine followed by pulpotomy (24.3%). In the biological approach, most of the restorations were stainless steel crowns placed with the Hall Technique (95%) followed by selective removal to firm dentine (5%). The majority of the primary teeth remained asymptomatic after a follow-up period of up to 77 months; 95.3% in the conventional and 95.8% in the biological arm. When the treatment costs were analysed, a statistically significant difference was found between the mean costs of the 2 approaches with a mean difference of GBP 45.20 (Pound Sterling; p < 0.001), in favour of the biological approach. The majority of the children and carers were happy with the conventional or biological restorations. CONCLUSION: Although both approaches had similar successful outcomes, the biological approach consisting mainly of Hall Technique was associated with reduced treatment costs. Both approaches were accepted favourably by the children and carers.

Personal Factors Determining Patient Satisfaction with All-Ceramic Crown Treatment for Single Anterior Teeth.

The Eysenck Personality Questionnaire's (EPQ) N value (neuroticism) was used to evaluate information from 158 patients before ceramic crown treatment. Patient satisfaction was also evaluated using a satisfaction questionnaire 2 weeks post treatment. Patient expectations were not correlated with sex, age, or N value, and sex was not correlated with patient satisfaction other than in relation to crown shape. Total esthetic satisfaction and feature improvement were positively correlated with age, while satisfaction for five specific criteria was negatively correlated with N value and overall expectation. These observations underscore the importance of considering the physical and psychologic aspects of patient care when planning dental treatment.

The Effect of Full-Mouth Rehabilitation on Oral Health-Related Quality of Life for Children with Special Health Care Needs.

OBJECTIVES: Changes in oral health-related quality of life (OHRQoL) among 40 children with special health care needs (CSHCN) aged 5-14 years before and 12 months after full-mouth rehabilitation (FMR) under general anesthesia (GA) in two hospitals in Jeddah city were assessed. STUDY DESIGN: The questionnaire was delivered to the parents/caregivers at baseline (pre-operative) and at the 12-month post-operative follow-up visit. Medical and dental histories and clinical findings were correlated accordingly. RESULTS: The follow-up response rate was 87.5% with 35 children completing a 12-month follow-up visit. The age range was from 5 to 12 years with a mean of 7.3 ± 2.4 years. More than half of the study sample was boys (63%) in the 5-8 year age-group (69%). The impact on OHRQoL was reportedly negative before FMR under GA, with overall scores ranging from 12 to 68 and a mean of 43.34 ± 14.83. OHRQoL improved significantly in all aspects evaluated (P<0.05) following FMR under GA with overall scores ranging from 4 to 41 and a mean of 18.86 ± 8.54. CONCLUSIONS: Treating CSHCN under GA, with 3-month recall visits for the patients, had a significant long-term effect on their OHRQoL extending up to 12 months postoperatively.

Oral health-related quality of life before and after crown therapy in young patients with amelogenesis imperfecta.

BACKGROUND: Amelogenesis imperfecta (AI) is a rare, genetically determined defect in enamel mineralization associated with poor esthetics and dental sensitivity. Because the condition is associated with negative social outcomes, this study evaluated oral health-related quality of life (OHRQoL), dental fear, and dental beliefs before and after early prosthetic crown therapy for AI during adolescence. METHODS: The study included 69 patients with AI, aged 6-25 yr: 33 males and 36 females (mean age 14.5 ± 4.3); healthy controls (n = 80), patients with cleft lip and palate (CLP; n = 30), and patients with molar incisor hypomineralization (MIH; n = 39). All matched in age and gender, and all but the CLP group insocioeconomic area. Patients completed three questionnaires measuring OHRQoL (OHIP-14), dental fear (CFSS-DS), and dental beliefs (DBS-R). Twenty-six patients with severe AI between ages 9 and 22 yr received crown therapy and completed the questionnaires twice: before and after therapy. RESULTS: OHIP-14 scores were significantly higher among patients with AI (7.0 ± 6.7), MIH (6.8 ± 7.6) and CLP (13.6 ± 12.1) than healthy controls (1.4 ± 2.4) (p < 0.001). After crown therapy, quality of life problems in the 26 patients with severe AI decreased significantly, from 7.8 ± 6.1 to 3.0 ± 4.8 (p < 0.001). Early prosthetic therapy did not increase dental fear or negative attitudes toward dental treatment. CONCLUSIONS: OHRQoL increased after early crown therapy in patients with severe AI. Therapy did not increase dental fear or negative attitudes toward dental treatment.

Levels of Stress among General Practitioners, Students and Specialists In Pediatric Dentistry during Dental Treatment.

OBJECTIVE: To assess self-reported stress during the performance of different procedures in pediatric dentistry, according to the professional experience of the dentists. STUDY DESIGN: During the years 2010 to 2011, an anonymous survey was administered by means of an internet link, and by distribution at professional meetings of dentists . RESULTS: No statistically significant differences in stress were reported for maxilla and mandibular procedures. Placement of a rubber dam was rated as the most stressful procedure among dental students. For general practitioners and specialists, injection of local anesthesia to an anxious child was the most stressful procedure, regardless of age, sex, or years of professional experience. A negative correlation was found between years of experience and level of stress for all the procedures surveyed, but not for the use of nitrous oxide. No differences were found between male and female dentists in stress scores for any of the procedures. CONCLUSION: Higher rates of stress during operative procedures were reported among dental students than among experienced dentists. Anxiety of the pediatric patients, but not the location of the procedure: maxillary or mandibular, affected the dentists' reported level of stress.

Attitudes and preferences of parents about being present in the dental operatory.

PURPOSE: To determine if there was an association between the type of dental procedure being performed on children and parental desire to be present in the operatory. METHODS: Parents (N=339) whose children had dental appointments at a university pediatric dental clinic or affiliated practices in Southern Nevada completed a survey. Parents identified attitudes/preferences associated with five commonly conducted pediatric dental procedural scenarios. Data were analyzed using chi-square tests (P=.05). RESULTS: Most respondents (N=339) were female (N=248) and/or Hispanic (N=204), had a household income of less than $50,000 annually (N=251), and a high school education. The primary reason (78 percent) parents wanted to be present during their child's dental treatment was comfort. Most parents wanted to observe exams/X-rays (70 percent), sedation procedures (69 percent), fillings and crowns (66 percent), extractions (64 percent), and physical restraint (61 percent). Only 38 percent of parents would be content with the dentist unilaterally deciding about their presence in the operatory. CONCLUSIONS: Parents in this study expressed a preference to remain with their child during any dental treatment. Practitioners are encouraged to consider their presence customary and establish office policies and protocols that beneficially involve parents in the pediatric patient's care.

Perception of dental esthetics: influence of restoration type, symmetry, and color in four different countries.

In this study, the influence of restoration type, symmetry, and color on the perception of dental appearance was evaluated. An esthetic questionnaire was completed by 29 patients before and after esthetic rehabilitation. In addition, 94 dentists from four countries (Germany, the United Kingdom [UK], China, and Switzerland) evaluated the influence of the above factors using before-and-after rehabilitation pictures. The most invasive treatment was recommended by Chinese dentists, while German, Swiss, and UK dentists recommended comparable treatment options. As for restorative symmetry, restoration type, and color, significant differences could be found among and within the dentists of the four countries (P ± .05).

[Gingival displacement techniques in daily practice. Survey among dental surgeons in Abidjan, Ivory Coast]. / Réalisation des techniques d'ouverture sulculaire en pratique quotidienne. Enquête faite auprès des chirurgiens-dentistes d'Abidjan, Côte d'Ivoire.

INTRODUCTION: Access to cervical margins allows the practitioner to record the entire cervical margin in order to provide a true copy to the technician. This requires a gingival displacement obtainable by different techniques. This study aimed to assess the implementation of gingival displacement methods prior to impression taking in fixed prosthodontics. MATERIALS AND METHODS: This is a descriptive and cross-sectional survey of sample of 71 dentists practising in Abidjan, Ivory Coast; which ran from October 2nd, 2010 to November 14th, 2010. A survey form was administered to dentists. The questionnaire was organised around the following headings: identification of dentists and practice of gingival displacement methods. The data processing done using software Epi Info 6 and Excel XP on Window XP, allowed calculation of frequencies, means and proportions and the establishment of connection between variables with the chi2 test. The significance level was set at p < 0.05. RESULTS: The results of the survey indicate that non-surgical methods of gingival displacement, including retraction cords and temporary crowns are those they use most frequently (76.4%) because the vast majority of practitioners (87.22%) believe the most traumatic to the periodontium are surgical methods. CONCLUSION: Our study showed that the gingival displacement methods are frequently carried out in daily practice, regardless of the topography of the abutment teeth and their number, but with a preference for non-surgical methods, particularly those using retraction cords and temporary crowns. The use of injectable gingival displacement paste is not harmful to the periodontal tissues, easy to use and have a very efficient haemostatic action. It should also be known and practiced.

Randomized controlled multicentre study comparing short dental implants (6 mm) versus longer dental implants (11-15 mm) in combination with sinus floor elevation procedures. Part 1: demographics and patient-reported outcomes at 1 year of loading.

AIM: To test whether or not the use of short dental implants (6 mm) results in an implant survival rate similar to long implants (11-15 mm) in combination with sinus grafting. METHODS: This multicentre study enrolled 101 patients with a posterior maxillary bone height of 5-7 mm. Patients randomly received short implants (6 mm) (group short) or long implants (11-15 mm) with sinus grafting (group graft). Six months later, implants were loaded with single crowns and patients re-examined at 1 year of loading. Outcomes included treatment time, price calculations, safety, patient-reported outcome measures (OHIP-49 = Oral Health Impact Profile) and implant survival. Statistical analysis was performed using a non-parametric approach. RESULTS: In 101 patients, 137 implants were placed. Mean surgical time was 52.6 min. (group short) and 74.6 min. (group graft). Mean costs amounted to 941EUR (group short) and 1946EUR (group graft). Mean severity scores between suture removal and baseline revealed a statistically significant decrease for most OHIP dimensions in group graft only. At 1 year, 97 patients with 132 implants were re-examined. The implant survival rate was 100%. CONCLUSIONS: Both treatment modalities can be considered suitable for implant therapy in the atrophied posterior maxilla. Short implants may be more favourable regarding short-term patient morbidity, treatment time and price.

Perception of dental esthetics in different cultures.

PURPOSE: The purpose of this study was to compare patients' and dentists' perception of dental appearance. MATERIALS AND METHODS: Based on internationally accepted guidelines about dental esthetics, a questionnaire was developed to measure "dental appearance" (QDA). Eleven items defined a QDA score (0 = "absolutely dissatisfied" to 100 = "absolutely satisfied"). The QDA was completed by 29 patients (21 women, 8 men) before and after a complete oral rehabilitation that included restoration of the maxillary anterior teeth. Overall, 94 dentists from four countries (Germany, the United Kingdom, China, and Switzerland) evaluated the esthetics before and after rehabilitation on a visual analog scale (VAS: 0 = "absolutely unesthetic" to 100 = "absolutely esthetic"). RESULTS: Patients and dentists of all countries found a significant esthetic improvement after treatment (P ≤ .0001). Significant differences could be found when comparing the evaluation of the dentists from the various countries among one another and with the patients' self-evaluation (P ≤ .05). With the exception of the professional rating of the initial situation, no gender-related differences could be found in any of the test groups. CONCLUSIONS: In daily practice, it seems of utmost importance for dentists to incorporate the patients' feedback in order to avoid esthetic treatment failures.

Acceptability of the Hall Technique to parents and children.

OBJECTIVE: To investigate the acceptability of stainless steel crowns placed by dental therapists on children's primary molars using the Hall Technique. DESIGN: Mixed methods approach, using qualitative inductive analysis and quantitative analysis. SETTING: Hawke's Bay Community Oral Health Service METHODS: One focus group was conducted and ten thirty-minute phone interviews were undertaken with parents of children who had previously had a stainless steel crown placed using the Hall Technique (over the period 1 December 2011 to 31 May 2012). An inductive approach was used to analyse the qualitative research data, and the information was arranged into several categories based on the key themes which arose. Children treated with the Hall Technique were asked immediately after treatment whether they had enjoyed their visit to the clinic that day. RESULTS: Common themes were found with regard to appearance, pain, the procedure, and general opinions on acceptability. Nearly all (90%) of the children responded positively about their visit to the clinic. CONCLUSION: There was a high degree of acceptance among both parents and children for stainless steel crown placement using the Hall Technique in this group.

Assessing change in quality of life and dental anxiety in young children following dental rehabilitation under general anesthesia.

PURPOSE: This study's purpose was to investigate how young children's and parent/caregivers' oral health-related quality of life and children's dental fears were affected by dental rehabilitation under general anesthesia (DRGA). METHODS: A consecutive clinical sample of dyads of parents/caregivers and their four- to six-year-old children who received DRGA were surveyed before and after DRGA. Parents/caregivers responded through a self-administered questionnaire [Early Childhood Oral Health Impact Scale (ECOHIS)], and children received a dentist-administered questionnaire [children's fear survey schedule-dental subscale (CFSS-DS)]. RESULTS: The final sample consisted of 311 children/caregiver dyads. One to six teeth were extracted in 91 percent of children. There was a 44 percent decrease in total ECOHIS scores following treatment (P<.001). Overall child impact section scores decreased 34 percent following treatment (P<.001), and family impact section scores decreased 65 percent (P<.001). CFSS-DS anxiety scores after dental treatment were significantly higher for 14 of 15 situations/conditions assessed (P<.001). There was a trend of higher CFSS-DS scores in children who received increasing numbers of extractions. CONCLUSION: Children's and parent/caregivers' quality of life improved after the children received dental rehabilitation under general anesthesia, and children's fears increased for all situations tested. The number of extractions the children received was associated with increased levels of fear.

Prevalence of xerostomia and hyposalivation and their association with quality of life in elderly patients in dependence on dental status and prosthetic rehabilitation: a pilot study.

OBJECTIVES: The aims of this pilot study were to investigate the prevalence of xerostomia and hyposalivation and their impact on quality of life in a cohort of elderly patients including dental status and the character of potential prosthetic restorations as independent variables. METHODS: Patients aged 60 years or older without any objective or subjective need for prosthodontic treatment taking part in a regular recall programme were included in the trial. Quality of life was assessed using the German version of the GOHAI; prevalence and severity of xerostomia was investigated using the shortened version of the Xerostomia Inventory (XI). Stimulated salivary flow rate was determined using a sialometric approach. Dental status and the character of prosthetic restorations (no/fixed restorations and removable but tooth-supported dentures vs. gum-supported dentures) were assessed in a clinical examination by experienced dentists specialized in prosthodontic treatment. RESULTS: A total of 68 patients were included in the trial; a prevalence of xerostomia of 16% and a prevalence of hyposalivation of 31% were identified. The quality of life in the study cohort decreased significantly as a function of xerostomia severity but not salivary flow; moreover, a significant impact of the number of teeth/implants in the upper jaw and the presence of gum-supported dentures in both jaws on GOHAI scores could be identified. CONCLUSIONS: Within the limitations of a pilot study, the results support the assumption that the quality of life in elderly patients is particularly related to their subjective perception of xerostomia. A decline in salivary flow, the dental status and the character of prosthetic restorations appear to play a subordinate role for the quality of life in elderly patients. CLINICAL SIGNIFICANCE: The quality of life in elderly patients may be severely diminished due to an increased subjective perception of dry mouth. Dental treatment should focus on alleviating xerostomia, whereas the impact of dental status and prosthetic restoration appear to be subordinate.

Sensitivity to change of oral and general health-related quality of life during prosthodontic treatment.

The literature presents conflicting findings on whether health-related quality of life (HRQoL) measures have sufficient evaluative properties to assess changes caused by dental interventions. The aim of our study was to compare sensitivity to change in HRQoL and OHRQoL in prosthodontic patients. In this prospective intervention study, a total of 165 consecutively recruited patients completed the Short Form-36 (SF-36) and the 49-item Oral Health Impact Profile (OHIP), as self-administered questionnaires, before prosthodontic treatment and 1 month after treatment was finished. Differences in SF-36 and OHIP scores between baseline and follow up were tested for statistical significance using paired t-tests. Effect sizes (Cohen's d) were calculated. Health-related quality of life improved during prosthodontic treatment, indicated by a slight, but statistically significant, increase in the SF-36 physical component (difference: 1.0 points), whereas perceived mental health did not change substantially (difference: −0.5 points). Improvement in OHRQoL (difference in OHIP sum score: −6.7 points) was statistically significant. Although the OHIP effect size (of 0.2) was considered as small, according to guidelines, it was greater than for the SF-36 component scores (physical: 0.1; mental: 0.1). Sensitivity to change in quality of life measures was greater for OHRQoL than for HRQoL, limiting the usefulness of HRQoL as an outcome measure in dentistry.

Change in masticatory ability with the implant restoration of second molars.

STATEMENT OF PROBLEM: Controversy exists as to whether missing second molars should be replaced to restore masticatory ability. PURPOSE: The purpose of this study was to analyze the alteration in masticatory ability associated with the implant restoration of the second molar; the subjective effect of implant treatment on the participant was also assessed. MATERIAL AND METHODS: Twenty-one individuals (13 men and 8 women) participated. Masticatory ability was recorded before the cementation of implant-supported single crowns, immediately after cementation, and 1 month after cementation. The occlusal load (Pa), the load-bearing contact area (mm(2)), and the maximum occlusal force (N) were calculated. A subjective evaluation of masticatory ability was conducted before treatment and 1 month after treatment through the use of a questionnaire to evaluate chewing difficulties and global satisfaction with treatment. The Wilcoxon signed rank test was used to analyze the difference in scores. RESULTS: The load-bearing contact area, maximum occlusal force, and participant satisfaction were found to increase significantly 1 month after the cementation of implant-supported single crowns. The restoration of the second molar with an implant increased both objective masticatory ability and subjective satisfaction 1 month after cementation of the implant-supported single crowns. CONCLUSIONS: Patients presenting with a missing second molar may benefit from replacement with implant-supported crowns. Longer study periods and larger sample populations are needed to obtain more definitive results.

A survey of patients' preferences for the treatment of teeth with apical periodontitis.

INTRODUCTION: This research aimed to investigate the preference of patients in Toronto, Canada for management of a tooth affected by painful apical periodontitis when considering its retention via root canal treatment (RCT) and its extraction followed by no replacement, replacement with an implant-supported crown, fixed, or removable partial prostheses. METHODS: Data were collected through a mail-out survey of the University of Toronto Faculty of Dentistry patients, which was complemented by a convenience sample of patients in 10 community practices in Toronto (n = 1000, response rate = 43%). Participants were asked to select their general preference for anterior and posterior teeth with apical periodontitis between saving the tooth or extraction and their specific preference for tooth retention via RCT or extraction. By using bivariate and logistic regression analyses, we applied the Gelberg-Andersen Behavioral Model for Vulnerable Populations to the preference questions to understand the influential factors (P ≤ .05). RESULTS: Participants' specific preference for tooth retention via RCT was slightly but significantly lower than their general preference (anterior tooth, 93.7% versus 97.2%; posterior tooth, 83.8% versus 89.6%; P < .005). Higher annual income, previous RCT, functional dentition, good/excellent self-rated oral health, and regular dental visits were associated with higher preferences for tooth retention in response to different questions. CONCLUSIONS: The high preference for retaining a tooth in general was moderated by the specific consideration of RCT to retain the tooth. When RCT and extraction are viable options, patients should be advised about the treatment options in an impartial manner and encouraged to communicate their preferences.

A survey of dentists' preferences for the treatment of teeth with apical periodontitis.

INTRODUCTION: This study surveyed the preferences of Ontario, Canada dentists for teeth with apical periodontitis when selecting between retention via root canal treatment (RCT) and extraction without replacement, or replacement with implant-supported crowns (ISC), fixed, or removable partial prostheses. METHODS: A mail-out survey (census of Ontario endodontists, periodontists, prosthodontists, and oral and maxillofacial surgeons; n = 498, 40% response rate) and a Web-based survey (sample of Ontario general dentists; n = 1983, 15% response rate) were conducted. Participants ranked their treatment preferences for 4 clinical scenarios: an anterior or posterior tooth, without or with previous RCT. Associations between treatment preferences and covariates were explored by using bivariate and logistic regression analyses (P ≤ .05). RESULTS: For all 4 scenarios, the majority of participants preferred either RCT or ISC, whereas other treatment options were preferred by ≤ 3.1% of the participants in any professional registration category. A pattern of declining preference for RCT and increasing preference for ISC was noted across the scenarios, with significantly lower preference for RCT and higher preference for ISC associated with teeth needing repeated RCT compared with initial RCT (odds ratio [OR] = 3.3; confidence interval [CI], 2.5-4.4). Preferences were significantly lower for RCT and higher for ISC among general dentists (OR = 6.4; CI, 2.3-17.6), prosthodontists (OR = 9.1; CI, 3.0-28.3), periodontists (OR = 18.3; CI, 6.4-51.6), and surgeons (OR = 30.1; CI, 10.8-86.6) when compared with endodontists. CONCLUSIONS: More surveyed dentists preferred RCT than ISC for teeth with apical periodontitis requiring initial RCT than repeated RCT. The dentists' preferences were associated with their professional registration but not with other characteristics.

Traumatic dental injury with treatment needs negatively affects the quality of life of Brazilian schoolchildren.

BACKGROUND: Traumatic dental injury (TDI) has been considered a significant problem in youth, not only because of its consequences to the craniofacial structures but also for its potential impact on the quality of life of affected individuals. AIM: The aim of this study was to investigate the impact of TDI with treatment needs on the oral health-related quality of life (OHRQoL) of South Brazilian schoolchildren. DESIGN: A cross-sectional study was performed in Porto Alegre, Brazil, using a multistage probability sampling strategy. Of 1837 eligible 12-year-old schoolchildren attending public and private schools, 1528 were examined. OHRQoL was assessed by the Brazilian version of the Child Perceptions Questionnaire for 11-to 14-year-old children (CPQ11-14) - 16-item short form. Clinical examination was conducted to assess the presence of TDI in permanent incisors (Children's Dental Health Survey criteria), malocclusion, and dental caries. Parents/legal guardians answered questions on socioeconomic status. Statistical analyses were performed using Poisson regression models. RESULTS: The overall CPQ11-14 score was not associated with TDI. In the functional limitations domain, individuals presenting TDIs with treatment needs experienced significantly higher mean CPQ11-14 than individuals with no TDI or without treatment needs (RR = 1.21; 95% CI = 1.05-1.39), after adjusting for malocclusion, dental caries, gender, and socioeconomic status. No other domains were associated with TDI. CONCLUSIONS: This study revealed that TDI with treatment needs negatively affects the OHRQoL in this population of 12-year-old schoolchildren and that this impact is related to oral functions.

Patient satisfaction and aesthetic outcome of implant-supported single-tooth replacements performed by dental students: a retrospective evaluation 8 to 12 years after treatment.

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.

The psychosocial impacts of implantation on the dental aesthetics of missing anterior teeth patients.

OBJECTIVE: The aim of the current study was to investigate the psychosocial impact of dental aesthetics among patients who received anterior implant-supported prostheses. METHODS: The current study is a cross-sectional evaluation involving 115 individuals who had gone through treatment at the dental clinics of general hospitals. Participants completed the Chinese version of the psychosocial impact of dental aesthetics questionnaire (PIDAQ) before implantation and six months after crown restoration. Basic demographic information was recorded. Six months after implant crown restoration, participants were asked to self-assess their own oral aesthetics compared to before implantation. RESULTS: A total of 106 patients completed the study. PIDAQ scores correlated significantly with the self-assessment of the degree of oral aesthetics. Six months after crown restoration, the two factors (social impact and aesthetic attitude) decreased and the dental self-confidence score increased significantly compared to pre-implantation scores. Gender and education level significantly affected PIDAQ. CONCLUSIONS: Anterior implant-supported prostheses significantly affected the patients' psychosocial perception. Implantation of missing anterior teeth can significantly improve patients' negative psychosocial impact of dental aesthetics. Gender and education level are correlated with the degree of improvement. The PIDAQ can be used in assessing the psychosocial effects of implantation in missing anterior teeth.