Comparison of clinical esthetic outcomes of immediately placed implants with and without immediate provisionalization in single-tooth implants of the esthetic area: A protocol for systematic review and meta-analysis.

BACKGROUND: Immediately placed implants with immediate provisionalization have become attractive options for patients and clinicians. However, there is no agreement on the esthetic advantages of immediately placed implants with immediate provisionalization. The aim of this systematic review and meta-analysis will be to assess the effect of immediate provisionalization on the clinical esthetic outcomes of immediately placed implants in a single-tooth implant of the esthetic area. METHODS: An electronic search of MEDLINE/PubMed, EMBASE, Web of Science, Clinicaltrials.org., Cochrane Library, China Biology Medicine (CBM), Wan Fang Database, China National Knowledge Infrastructure Database (CNKI), and VIP Science Technology Periodical Database will be performed. The search will be carried out in the databases for articles published until May 2021. Two researchers will independently perform the literature selection, data extraction and quality assessment. Only randomized controlled trials (RCTs) reporting on the impact of immediate provisionalization on the clinical esthetic outcomes of implants immediately placed in a single-tooth implant of the aesthetic area will be included. The primary outcome of this study will be the esthetic outcome assessed by the objective index and patient satisfaction. The survival rate of implants and restorations and the changes in mucosa and bone around implants will also be analyzed. The included studies will be analyzed by Review Manager 5.3, and a meta-analysis will be performed. RESULTS: The study will evaluate the clinical esthetic outcomes of immediately placed implants with and without immediate provisionalization in single-tooth implants of the esthetic area. The results will provide clinicians with a better treatment approach in their application. CONCLUSION: This systematic review and meta-analysis will provide more reliable, evidence-based data for the impact of immediate provisionalization on the clinical esthetic outcomes of immediately placed implants, which may or may not be beneficial. REGISTRATION NUMBER: PROSPERO registration number: CRD42021221669.

Esthetic Evaluation of Anterior Single-Tooth Implants with Different Abutment Designs-Patients' Satisfaction Compared to Dentists' Observations.

PURPOSE: To correlate patients' satisfaction and dentists' observations regarding two abutment designs used for single crowns in the esthetic zone: a divergent one (control) and a curved one (experimental), with special emphasis on muco-gingival esthetics. MATERIALS AND METHODS: Twenty-six patients with nonadjacent missing teeth in the esthetic zone were enrolled in a randomized clinical trial (within-subject comparison). Two implants placed in each were restored using abutments of different geometry. Patients' appreciation was assessed on a visual analog scale (VAS) by recording answers to three questions, and dentists' appreciation was determined by means of the Pink Esthetic Score (PES) at T0 (crown cementation, baseline) and at T12 (1 year post-cementation). ANOVA with post hoc analysis was used to identify differences between groups and at different moments in time. Pearson correlations were calculated between all variables, both at T0 and at T12. RESULTS: No statistically significant differences were found at any time between the control and experimental abutment design, either for the PES or for the VAS score. PES slightly improved after 1 year, as did the VAS rating related to functioning with the implant-crown compared to the natural teeth. All PES and VAS scores demonstrated highly significant correlation. Both patient satisfaction and professional appreciation of muco-gingival conditions after single implant treatment in the esthetic zone were high; however, the curved, experimental abutment design performed no better than the conventional, divergent type. CONCLUSION: Curved abutment design does not significantly impact crown or gingival esthetics as assessed by PES and VAS scored by dentists and patients, respectively.

Immediate implant placement and provisionalisation in the aesthetic zone.

The aim of this retrospective study was to assess the outcome of immediate single-tooth implant placement and provisionalisation in the aesthetic zone regarding hard and soft peri-implant tissue parameters and patient-related outcome measures in a private practice. All consecutively treated patients with single-tooth immediate implant placement and provisionalisation between the period 1 January 2006 and 1 April 2013 in a referral practice in Amsterdam, the Netherlands, were included in the study. Fifty-one patients of a total of 64 could be examined at follow-up (Tfollow-up ). Radiographs were present from implant placement (Tplacement ), after definitive crown placement (Tdefinitive ), and new radiographs were taken at the follow-up appointment (Tfollow-up ). Next to this, soft tissue parameters, patients' satisfaction and professionals' aesthetic scores were measured at Tfollow-up . Implant survival was 96·9% after a mean follow-up period of 4 years following implant placement. At definitive crown placement, mean marginal bone-level loss was 0·25 mm (SD 0·19). Mean marginal bone-level loss following definitive crown placement was 0·06 mm (SD 0·10) (Tdefinitive to Tfollow-up ) after a mean follow-up period of 4 years. Plaque index, bleeding index and gingival index scores were low. Patients' satisfaction was rated very high: 9·0 (SD 0·7). Professionals aesthetic score was 16·49 (SD 1·86). From this study can be concluded that immediate placement of implants followed by immediate provisionalisation resulted in a high survival rate, minimum peri-implant bone loss, very good aesthetics and satisfied patients after a mean follow-up period of 4 years.

Oral health-related quality of life and implant therapy: A prospective multicenter study of preoperative, intermediate, and posttreatment assessment.

PURPOSE: Loss of teeth is associated with a significant reduction in quality of life. The aim of this prospective multicenter study was to assess the impact of dental implants on oral health-related quality of life (OHRQoL). MATERIAL AND METHODS: Patients with various kinds of indications for dental implants ranging from single-tooth loss to edentulous jaws were included. Quality of life related to dental implants was assessed through the Oral Health Impact Profile (OHIP-G 21), which has a score from 0 to 20 in healthy patients. RESULTS: In total, 8689 patients from 17 centers from 2009 to 2014 were enrolled in the study. The sex distribution was almost even (53.3% men, 46.7% women). The most frequent indications for the insertion of dental implants were free-end gaps (30.6%) and posterior single-tooth gaps (27%). In all, 12.4% of patients had an edentulous jaw. For all indications, patients reported significant changes in mean OHIP scores after prosthetic reconstruction. The most significant improvements in the OHIP score occurred in the groups of patients with edentulous jaws (pretreatment score: 42.3) after prosthodontic reconstruction (score: 24.8) and in the patient group with an anterior single-tooth gap (pretreatment score: 36.4) after prosthodontic reconstruction (score: 24.8). CONCLUSION: The insertion of dental implants and prosthodontic rehabilitation led to an improved OHRQoL for patients with all indications for dental implants, with the most significant improvements in patients with edentulous jaws and anterior single-tooth gaps.

Single-Tooth Implant Versus Three-Unit Fixed Partial Denture: A Study of Oral Health-Related Quality of Life.

PURPOSE: Many studies have investigated the impact of prosthetic treatment on oral health-related quality of life (OHRQoL). However, most of these have been performed among fully or partially edentulous patients. Studies involving patients with a single missing tooth are limited. The purpose of this study was to compare the OHRQoL between patients treated by single-tooth implants and three-unit fixed partial dentures (FPDs) for single missing tooth restoration. MATERIALS AND METHODS: A cross-sectional survey was conducted in Korea with patients drawn by stratified purposive sampling based on age. OHRQoL was measured using the Korean version of the 14-item Oral Health Impact Profile (OHIP-14K) questionnaire. Pre- and posttreatment OHIP-14K scores were compared by paired t test. Single-tooth implants and three-unit FPDs were compared by two-sample t test. In addition, multiple regression analysis was used to evaluate the impact of treatment mode on OHIP-14K total score after adjusting the effect of demographics and clinical factors. RESULTS: Thirty-five patients with single-tooth implants and 36 patients with three-unit FPDs were included. All participants had a significant improvement in OHRQoL compared with before the treatment (P < .0001). However, there was no statistically significant difference in the change of OHIP-14K score between the two treatment modes. In addition, the treatment mode had no significant impact on the change of OHIP-14K total score after adjusting the influence of covariates (P = .170). CONCLUSION: Both single-tooth implants and three-unit FPDs for single missing tooth replacement resulted in significant and similar improvement of OHRQoL.

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.

Fresh-Socket Implants of Different Collar Length: Clinical Evaluation in the Aesthetic Zone.

BACKGROUND: The aim of this clinical study was to compare clinical evaluations of implants in the aesthetic zone with smooth collars of different length. MATERIALS AND METHODS: Sixty-six patients requiring extractions of one, two, or three teeth in the aesthetic zone of the maxilla were enrolled in this study. Ninety-four implants were positioned and were loaded immediately after tooth extraction. Forty-seven implants with a short smooth collar of 0.5 mm (SCI) and 47 implants with a long smooth collar of 1.8 mm (LCI) were utilized in this study and were placed using a nonsubmerged approach. Clinical (gingival index, modified plaque index, modified bleeding index, probing depth, gingival recession) and intraoral digital radiographic parameters were measured at baseline and after 6, 12, 24, and 36 months of healing to evaluate crestal bone loss levels over time. RESULTS: After a follow-up period of 36 months, a survival rate of 100% was reported. The SCI group showed a mean bone loss of 1.07 ± 0.38 mm at 12 months and 1.09 ± 0.38 mm at 36 months. The LCI group showed a mean bone loss of 0.46 ± 0.14 mm at 12 months and 0.53 ± 0.12 mm at 36 months. After the 36-month follow-up period, both groups showed stable bone levels over time. Statistically significant differences were found between groups (p < .05). No statistically significant differences were found between SCI and LCI groups with regard to clinical parameters over time. CONCLUSIONS: This study revealed significant differences in radiographically observed marginal bone loss between the two types of implant with different smooth-collar lengths, but no differences in gingival vestibular margin outcome were observed.

Degree of patient pain, complications, and satisfaction after root canal treatment or a single implant: a preliminary prospective investigation.

INTRODUCTION: Dentists often face the choice between tooth retention with root canal treatment and tooth replacement with implant treatment. To date, there has not been a prospective clinical trial directly comparing nonsurgical root canal treatment and single delayed implant therapy with regard to the degree of preoperative and postoperative pain, complications, and patient satisfaction. METHODS: Twenty-four patients had initial nonsurgical root canal treatment, and another 24 had single implant treatment in healed sites. Questionnaires were given at pretreatment, 7 days, 3 months, 6 months, and 12 months. RESULTS: All patients completed the 12-month follow-up period. No significant difference in pain, complications, or overall satisfaction was noted between the 2 groups at any of the time points (P > .05). However, there were differences within each group between the time points. There was more pain at pretreatment for root canal treatment and 7-day post-treatment point for single implant treatment than any other time point. For complications, more were reported at the 7-day post-treatment point than any other time point for both groups. With overall satisfaction, there was no difference from any time point for either group. CONCLUSIONS: The results of this study suggest that patients perceive both treatments with high degrees of satisfaction with minimal pain and discomfort. Differences were found at different time points of treatment and were related to the nature of the treatment itself. This information is useful to help patients with treatment decisions.

Patient satisfaction with single-tooth implant therapy in the esthetic zone.

This prospective study assessed patient satisfaction before and after single-tooth implant therapy in the esthetic zone. Before implant therapy, patients wore an acrylic resin tissue-supported removable partial denture (RPD). A total of 153 patients were included. Self-administered questionnaires regarding function, comfort, and esthetics were used to measure patient satisfaction with the RPD and with the implant at 6 and 18 months post-implant placement. Overall satisfaction was explored with a visual analog scale. It was suggested that patient satisfaction with a single-tooth implant in the esthetic zone is high and it improved when compared with an RPD that patients wore before implant treatment.

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.

The impact of implant treatment on oral health related quality of life in a private dental practice: a prospective cohort study.

BACKGROUND: Very few studies on the impact of implant therapy on Oral Health Related Quality of Life (OHRQoL) in partially edentulous patients have been published. AIM: This study aimed at analysing the improvement of OHRQoL of patients who underwent dental implant treatment using the "functional", "psychosocial" and "pain and discomfort" categories of the Geriatric Oral Health Assessment Index (GOHAI). METHODS: Within a prospective cohort of patients rehabilitated with Straumann dental implants, the OHRQoL of 176 patients (104 women and 72 men) was assessed using the GOHAI questionnaire, at two different times, before and after implant placement. The degree of oral treatment was categorised into three classes: "Single Tooth Implant" (n = 77), "Fixed Partial Denture" (n = 75), "Fixed or Retained Full Prostheses" (n = 24). The participants' characteristics (gender, age, tobacco habits, periodontal treatment, time between both evaluations) were assessed. RESULTS: Before treatment, the GOHAI score was lower for participants with fewer teeth (F = 19, P < 0.001). After treatment, no difference was observed between participants; significant improvements were observed in the GOHAI scores obtained (repeated measures, analysis, (F = 177, P < 0.001)) for each of the GOHAI fields studied (functional, psychosocial and pain & discomfort), regardless of the degree of treatment. The best improvement was observed in patients who needed complete treatment (P < 0.001). The presence of preliminary periodontal treatment, tobacco habits, age and gender of the participants did not have a significant impact on OHRQoL. Changing the time between the two evaluations (before and after treatment) had no impact on the changes in the GOHAI score. CONCLUSIONS: Implants enhanced the OHRQoL of participants that needed oral treatment.

Long-term function of single-implant restorations: a 17- to 19-year follow-up study on implant infraposition related to the shape of the face and patients' satisfaction.

BACKGROUND: Various levels of infraposition of single-implant restorations have been observed in long-term follow-up studies, but little knowledge is available on the biological mechanism behind this pattern. PURPOSE: The primary aim of this study is to report the frequency and severeness of implant infraposition in the anterior single-implant application after 17 to 19 years in function and, secondly, to try to relate these observations to anatomical appearance of the shape of the face of the patient. MATERIALS AND METHODS: The present study comprised of 57 patients who were provided with 65 CeraOne™ single-tooth restorations (Nobel Biocare AB, Gothenburg, Sweden) between 1989 and 1991. Altogether 46 of these patients were treated with single implants in the anterior region. Besides clinical and radiographic data, clinical photographs, study casts, and patient's assessment of the long-term aesthetic result (visual analog scale) was collected at the termination of the present study. The degree of implant crown infraposition was related to assessed facial shape and to patient and clinical assessment of the aesthetic result by means of Pearson's correlation test. To increase the numbers of patients, another group of 25 patients presented in another similar study were pooled with the present material for prevalence calculations. RESULTS: Altogether 47 patients showed up for the final examination after an average of 18 years (82%). Two implants failed (18 years cumulative survival rates [CSR]- 96.8%) and eight original single-crown restorations were replaced (CSR 83.8%). Three of the replaced crowns were replaced because of infraposition of the crowns. About 40% of the patients showed signs of infraposition, similar in younger and older age groups, but more frequently observed in female patients at termination of the study (p < 0.05). There was a weak trend indicating an association between "long-face" appearance and infraposition of the crown restoration (p > 0.05), and patients were more satisfied with the aesthetic clinical result than the participating clinicians (p < 0.05). CONCLUSION: Single-implant restorations in the anterior upper jaw may present small degrees of infraposition in long-term perspectives. Female patients seem to be at a higher risk of infraposition (p < 0.05), but no clear relationship between age at implant placement or facial shape and degree of infraposition was possible to establish (p > 0.05). Patients were more satisfied with the aesthetic result, as compared with the clinicians (p < 0.05), and patients seemed to pay less attention to the degree of infraposition in their aesthetic assessments, as compared with most of the clinicians.

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.

Three-year clinical outcome of single implant-retained mandibular overdentures--results of preliminary prospective study.

OBJECTIVES: The aim of this preliminary prospective study was to evaluate the clinical outcome, the oral health-related quality of life (OHRQoL), and the subjective chewing ability of patients with mandibular complete dentures retained by a single implant placed in the mandible midline. METHODS: Patients wearing complete dentures were treated with a single implant in the mandible, followed by relining of the dentures and incorporation of ball attachments for implant retention. Implant outcome, prosthodontic maintenance, subjective chewing ability, and the oral health impact profile of the patients were assessed at baseline and at four weeks after connecting the denture and implant. RESULTS: Eleven patients were enrolled in this investigation, and the mean observation period was 43.4 months (minimum period: 35, maximum period: 52 months). No implants were lost during observation period, but four dentures needed repair because of the fracture of the denture base in the midline area. A significant improvement was observed in the OHRQoL of the patients after the attachment of the mandibular dentures with a single midline implant. Furthermore, the subjective chewing ability of the patients was significantly improved after implant connection. CONCLUSIONS: Within the limitations of this preliminary prospective clinical study, single implant-supported mandibular overdentures were a successful treatment option for older edentulous patients who showed improvements in their OHRQoL and chewing ability.

Change in subjective oral health after single dental implant treatment.

PURPOSE: The aim of this study was to evaluate changes in subjective oral health among patients receiving single dental implants in different anatomic locations. MATERIALS AND METHODS: Subjective oral health was surveyed with the Oral Health Impact Profile 14 (OHIP-14) questionnaire after implant placement but prior to uncovering and 3 months after the completion of treatment. The locations of the implants and age and gender of the patients were recorded. Mean OHIP-14 severity scores were compared before and after treatment (paired t test). RESULTS: Ninety consecutive self-referred patients were enrolled in the study, and 80 of them (28 men and 52 women) completed the OHIP-14 both before and after treatment. The mean age of the patients at the time of surgery was 52 years (range, 24 to 75 years). The patients received a total of 131 commercially available dental implants (Astra Tech) and appropriate prosthetic constructions. The mean OHIP-14 severity score decreased significantly, from 10.4 before treatment to 3.1 after treatment (P < .001). The drop was from 13.4 to 1.5 (P < .001) if the missing tooth was replaced with an implant in the anterior area, from 11.2 to 4.3 (P < .001) if it was replaced in the premolar area, and from 6.5 to 3.0 (P = .085) if it was replaced in the molar area. In general, both before and after treatment, women reported subjective oral impacts approximately three times more often than men did. CONCLUSION: Replacement of missing teeth with single dental implants in anterior and premolar areas, but not necessarily in molar areas, may significantly improve subjective oral health, especially among women.

Quality of life of endodontically treated versus implant treated patients: a University-based qualitative research study.

INTRODUCTION: Up-to-date studies comparing endodontic treatment versus implant-supported prosthesis have shown similar clinical outcome and survival rates. However, no data are available comparing both treatment modalities based on the patient's perception of quality of life. This study was designed to qualitatively describe and compare the quality of life of patients with restored, single endodontically treated teeth versus patients with single implant-supported fixed prostheses. METHODS: Forty-eight patients agreed to participate in the study (n = 24 from each treatment modality). Of those, 37 actually participated in the study: 17 were endodontically treated and 20 had an implant-supported prosthesis. Patients in each of the two groups were randomly selected from the Graduate Endodontics and Graduate Periodontics Departments, respectively. Six focus group discussions (n = 3 per treatment group) were held and audio-recorded for subsequent thematic analysis. Data were analyzed to identify common themes within each category and compared to assess any differences in quality of life between the two treatments. Additionally, a quality of life survey, the shortened version of the Oral Health Impact Profile (OHIP-14), was given before the discussion group and the responses analyzed. RESULTS: The results obtained from this study show similar overall OHIP scores and show a high rate of satisfaction with both treatment modalities. Content analysis of the discussion groups revealed several themes and subthemes. The major themes were importance of overall health, financial implications of the treatments, perception of the treatments and its outcomes, time since treatment, and follow-up dental visits. CONCLUSIONS: The results help identify patients' perception and concerns with each treatment modality and assist the clinician and patient in the selection of an optimal treatment for their given situation. In addition to the prognosis and outcomes, clinicians should consider patients' perceptions and preferences as well as the influence each therapy may have on their quality of life, both short- and long-term. Overall, all the participants in this study were pleased with the treatment received and expressed a clear message to save their natural dentition whenever possible.

Impact of anterior single-tooth implants on quality of life, articulation and oromyofunctional behaviour: a pilot study.

The main purpose of this study is to determine the impact (one and a half year after implantation) of a single-tooth implant on articulation and oromyofunctional behaviour. This information is important for dentists, orthodontists or stomatologists who treat professional speakers. Objective (acoustic analysis) as well as subjective (questionnaire, phonetic inventory, phonetic analysis, oromyofunctional assessment of lip and tongue function, blowing, sucking and swallowing) assessment techniques were used to determine the quality of life, articulation and oromyofunctional behaviour. Fourteen subjects who received a single-tooth implant and a control group of nine subjects participated in this study. The mean overall satisfaction of single-implant users was 95%. The subjects who received a single-tooth implant were capable of producing all Dutch vowels and consonants. The phonetic analysis revealed a sigmatism in 57% of the cases. Sigmatisms (stridens sigmatism followed by simplex sigmatism) were the most frequently observed phonetic disorders. There was interobserver agreement about normal lip and tongue functions. Moreover, blowing, sucking and swallowing patterns were normal (concordance value 96%). Detailed analyses 1 or 2 years after implantation of an anterior single-tooth implant revealed normal speech intelligibility and oromyofunctional behaviour. Articulation was characterised by the presence of a persistent phonetic disorder. Further research involving more subjects with an anterior single-tooth implant is needed.

Dental dilemmas: Endodontics or dental implants?

UNLABELLED: This narrative review explores treatment planning options in restorative dentistry. The growth of dental implants, as an accessible and predictable treatment option, gives practitioners a useful tool for managing the missing tooth or teeth with a hopeless prognosis. Traditionally, endodontics and fixed prosthodontics have been used to restore teeth and spaces where the outlook for such treatment appears reasonable. Practitioners may, however, question the predictability and cost effectiveness of such an approach where, at times, it might appear that replacement of a compromised tooth with a dental implant could be a more predictable option. The evidence base for these treatment options is explored and discussed, and suggestions are made for future management strategies. CLINICAL RELEVANCE: A clear knowledge and understanding of the scientific literature for implants and endodontic treatment is necessary if practitioners are to make an evidence-based approach when treatment planning these modalities for their patients. This is particularly true in cases where there may appear to be a reasonable choice between the two of these.

Comparison of nonsurgical root canal treatment and single-tooth implants.

INTRODUCTION: The aim of this review was to compare the differences between nonsurgical root canal treatment and single-tooth implants. With the emerging field of implant dentistry gaining acceptance, the choice to retain a diseased tooth through the use of root canal therapy or extract it and replace the tooth with an implant-supported crown has become controversial. Many practitioners consider the single-tooth implant as a reasonable alternative to the preservation of a diseased tooth. METHODS: An extensive search of the dental literature was accomplished to identify publications related to the differences in root canal therapy and dental implants. Several comparative studies were also considered. RESULTS: The treatment modalities were reviewed with respect to outcome measures and study design, success/failure, functional rehabilitation and psychological differences, complications related to treatment, cost differences, and factors influencing treatment planning considerations. CONCLUSIONS: With the reviewed information in hand, the practitioner should be better prepared to determine which treatment option is most appropriate for each individual patient.