Impact of patient characteristics on edentulous subjects' preferences for prosthodontic rehabilitation with implants.

OBJECTIVE: The aim of this study was to assess the influence of patient characteristics on edentulous subjects' preferences for different prosthodontic treatments with implants. MATERIALS AND METHODS: A cross-sectional study was carried out with 131 edentulous subjects referred for treatment at a university clinic. Participants received detailed information about available treatment options and were asked to rank their preferences among three alternatives for rehabilitation of the maxilla and mandible: conventional dentures (CD), 2-implant-retained overdentures (IOD), or 4-implant fixed dentures (IFD). Individual data and prosthodontic-related variables were assessed through interviews. Oral health-related quality of life impacts was measured using the Brazilian version of the Oral Health Impact Profile for edentulous subjects (OHIP-Edent). Descriptive statistics, bivariate tests, and binary and multinomial logistic regressions were used for data analysis. RESULTS: The majority of participants chose CD as their most preferred treatment for the maxilla (45.8%), while IFD was the most prevalent choice for the mandible (38.9%). Regression analysis showed that the OHIP-Edent "oral pain and dysfunction" (OPD) domain scores were positively associated with IOD preference for the maxilla (OR = 1.31; p = 0.010) and mandible (OR = 1.46; p = 0.002) and with IFD preference for the mandible (OR = 1.20; p = 0.031). Subjects with lower levels of formal education and those with lower income levels were less likely to choose IFD. CONCLUSION: Level of education, income, and perceived quality of life impacts are potentially predictive variables of edentulous patients' preference for rehabilitation with implants. These factors may constitute important aspects to be considered by clinicians when treatment planning for edentulous patients.

Intraoral radiographs texture analysis for dental implant planning.

BACKGROUND AND OBJECTIVES: Computer vision extracts features or attributes from images improving diagnosis accuracy and aiding in clinical decisions. This study aims to investigate the feasibility of using texture analysis of periapical radiograph images as a tool for dental implant treatment planning. METHODS: Periapical radiograph images of 127 jawbone sites were obtained before and after implant placement. From the superimposition of the pre- and post-implant images, four regions of interest (ROI) were delineated on the pre-implant images for each implant site: mesial, distal and apical peri-implant areas and a central area. Each ROI was analysed using Matlab® software and seven image attributes were extracted: mean grey level (MGL), standard deviation of grey levels (SDGL), coefficient of variation (CV), entropy (En), contrast, correlation (Cor) and angular second moment (ASM). Images were grouped by bone types-Lekholm and Zarb classification (1,2,3,4). Peak insertion torque (PIT) and resonance frequency analysis (RFA) were recorded during implant placement. Differences among groups were tested for each image attribute. Agreement between measurements of the peri-implant ROIs and overall ROI (peri-implant + central area) was tested, as well as the association between primary stability measures (PIT and RFA) and texture attributes. RESULTS: Differences among bone type groups were found for MGL (p = 0.035), SDGL (p = 0.024), CV (p < 0.001) and En (p < 0.001). The apical ROI showed a significant difference from the other regions for all attributes, except Cor. Concordance correlation coefficients were all almost perfect (ρ > 0.93), except for ASM (ρ = 0.62). Texture attributes were significantly associated with the implant stability measures. CONCLUSION: Texture analysis of periapical radiographs may be a reliable non-invasive quantitative method for the assessment of jawbone and prediction of implant stability, with potential clinical applications.

The effect of marginal bone level changes on the stability of dental implants in a short-term evaluation.

OBJECTIVES: To evaluate whether changes in marginal bone level (MBL) around implants, in sites with different bone types, affect the over time implant stability measured by resonance frequency analysis (RFA). MATERIAL AND METHODS: Seventy-eight implants were inserted into jawbones of 32 patients using a two-stage surgical protocol, and implant bone sites were grouped according to the Lekholm and Zarb bone classification. The implant stability quotient (ISQ) was measured by RFA at four time points: implant placement, uncovering, rehabilitation, and at 1-year follow-up after loading. The MBL was measured on periapical radiographs at uncovering and at 1-year follow-up. Percent change in bone level was calculated based on the difference between the implant length and height from the crestal bone level to the implant apex. Descriptive statistics, Pearson's correlation, and repeated-measures ANOVA were used for data analysis. RESULTS: Significant improvement of ISQ was found between implant insertion and uncovering surgery (P < 0.001), while no significant changes were detected throughout the remaining follow-up period. The greatest improvement of ISQ was observed for bone type 4, compared with the other groups (P < 0.001). Percent change in bone level had no effect on longitudinal measures of ISQ (P = 0.337). The ISQ difference between uncovering and 1 year after loading was not correlated with percent change in bone level (r = 0.16; P = 0.157). CONCLUSION: There was increased implant stability after implant placement, but it was not affected by changes in marginal bone level during the first year of loading.