Effect of implant support for prostheses on electromyographic activity of masseter muscle and jaw movement in patients after mandibular fibula free flap reconstruction.

Purpose: Dental implants are used to stabilize, support, and retain prostheses in the mandible following fibula free flap reconstruction. A previous longitudinal prospective study showed that an implant-supported prosthesis (IP) provided additional improvement in masticatory performance compared to a conventional prosthesis (CP). Therefore, in this paper, the impact of implant retention and support of mandibular prostheses on neuromuscular function is reported via a within-subject analysis.

Economic outcomes in prosthodontics.

Purpose: A systematic literature review was conducted to identify the types of economic measures currently used in implant prosthodontics and determine the degree to which cost of care is considered in the context of any positive outcome of the care provided.

Materials And Methods: A literature search was conducted using the following set of terms plus some additional hand searching: "dental implants" (Mesh) AND ("cost") OR "maintenance" OR "healthcare policy" OR "access to care" OR "third party" OR "economic") AND (("1995/01/01"[PDat]:'2009/12/31"[PDat]) AND (Humans[Mesh]) AND (English[lang])).

Results: After a review of the 466 titles and abstracts identified by the search, 18 articles were accepted for further consideration, as some attempt at economic outcome measures was made.

Psychologic outcomes in implant prosthodontics.

Consensus regarding outcomes of the treatment of tooth loss, especially the psychologic outcomes, is needed to guide discovery of best practices and enable a better understanding of patient management for this chronic condition. This paper presents the findings of the ORONet Psychological Working Group for prosthodontics and aims to identify psychologic outcomes with properties deemed critical to meet clinical trial and clinical practice needs for the future. References obtained using a PubMed/Medline search were reviewed for clinical outcomes measures of interest.

Functional outcomes for clinical evaluation of implant restorations.

The functional outcomes related to treating patients afflicted with tooth loss are an important hallmark in substantiating prosthodontic intervention. The Oral Rehabilitation Outcomes Network (ORONet) conducted two international workshops to develop a core set of outcome measures, including a functional domain. The process followed the general format used in the Outcome Measures in Rheumatology (OMERACT) workshops to develop consensus for clinical outcome measures in arthritis research, which included: developing a comprehensive list of potential outcomes in the literature; submitting them to a filter for validity, clinical discrimination, and feasibility; and ranking those measures meeting all the filter criteria for relative value.

Clinical outcomes measures for assessment of longevity in the dental implant literature: ORONet approach.

The Oral Rehabilitation Outcomes Network (ORONet) Longevity Working Group undertook a search of the literature from 1995 to 2009 on randomized controlled trials related to longevity of osseointegrated implants. Outcomes measures used in these studies were identified and subjected to the OMERACT component criteria of truth, validity, and feasibility. Through this process, it was a challenge to identify clinical outcomes measures that fully met the criteria.

Oral Rehabilitation Outcomes Network-ORONet.

The published literature describing clinical evidence used in treatment decisionmaking for the management of tooth loss continues to be characterized by a lack of consistent outcome measures reflecting not only clinical performance but also a range of patient concerns. Recognizing this problem, an international group of clinicians, educators, and scientists with a focus on prosthodontics formed the Oral Rehabilitation Outcomes Network (ORONet) to promote strategies for improving health based on comprehensive, patient-centered evaluations of comparative effectiveness of therapies for oral rehabilitation. An initial goal of ORONet is to identify outcome measures for prosthodontic therapies that represent multiple domains with patient relevance, are amenable to utilization in both institutional and practice-based environments, and have established validity.

Mandibular fracture in conjunction with bicortical penetration, using wide-diameter endosseous dental implants.

Prosthodontic rehabilitation of a patient with an atrophic edentulous mandible presents a significant challenge in restoring esthetics and function. The purpose of this clinical report is to describe fracture of an atrophic edentulous mandible opposing maxillary natural dentition in association with endosseous dental implants. The patient received two wide-diameter implants in the anterior mandible for an implant-assisted mandibular overdenture, in which the implants penetrated the inferior border of the mandible for bicortical stabilization.

The frequency of replacement of dental restorations may vary based on a number of variables, including type of material, size of the restoration, and caries risk of the patient.

Subjects: The authors analyzed the dental records of 2780 Navy (cohort 1 = 1078 entered the Navy in 1997) and US Marine Corps recruits (cohort 2 =1053 entered the USMC in 1999-2000; cohort 3 = 649 entered the USMC in 2002-2005). The records were reviewed at 16 US Navy dental treatment facilities at the following time periods: cohort 1, 2001; cohort 2, 2002-2003; and cohort 3, 2005-2006. The mean age of the subjects was 20 years, and 85% were men.

The social solution-denture esthetics, phonetics, and function.

Tooth loss and rehabilitation with dentures can have tremendous patient impact and social implications. In an image-conscious society, dentures restore a sense of normalcy and allow the patient the ability to interact with others. The most frequent denture complaints include chewing discomfort and objectionable esthetics and phonetics.

Optimization of maxillary obturator thickness using a double-processing technique.

Preservation of remaining structures is a primary goal of prosthetic rehabilitation. Continuously applied stresses on the remaining tissues from a large, heavy obturator jeopardize the health of the tissues, compromise the function of the prosthesis, and affect patient comfort. Various techniques have been described for hollowing the bulb of an obturator after processing to reduce its weight; however, access to the inner aspects of the bulb is limited, preventing adequate control of thickness of the walls.

Maxillofacial restoration after head and neck tumor therapy.

Oral and pharyngeal cancers are among the leading cancer sites. Surgery, radiation, chemotherapy, or combination therapies are common treatment modalities. Radiotherapy and chemotherapy cause significant morbidity and long-term irreversible sequelae in the oral cavity.

Masticatory and swallowing threshold performances with conventional and implant-supported prostheses after mandibular fibula free-flap reconstruction.

Statement Of Problem: Significant strides in microvascular surgical techniques allow predictable restoration of bony and soft tissue orofacial defects. In combination with prosthetic rehabilitation, varying degrees of improvement in esthetics, speech intelligibility, and swallowing have been noted; however, the relative impact of conventional and implant-supported prostheses on restoration of masticatory function are not known.

Purpose: The purpose of this study was to determine whether conventional or implant-supported dental prostheses and current surgical reconstructive procedures restore patients' masticatory function to presurgical levels.

Use of osseointegrated implants in the restoration of head and neck defects.

Osseointegrated implants can be applied to facilitate retention, stability, and support for facial and intraoral prostheses used to restore head and neck defects. At the University of California, Los Angeles, Maxillofacial Prosthetics Clinic, retrospective studies have indicated that in nonirradiated maxillectomy patients, implant survival rates are 82.6 percent.

Dental implant-assisted prosthetic rehabilitation of a patient with a bilateral maxillectomy defect secondary to mucormycosis.

Prosthodontic rehabilitation of patients with bimaxillary resection involving the maxillae, hard and soft palates, and paranasal sinuses presents a significant challenge in restoring speech, deglutition, mastication, and respiration. This clinical report describes the prosthodontic management of a young girl treated for leukemia who required a bilateral maxillectomy secondary to mucormycosis. Distraction osteogenesis, bone grafts, osseointegrated implants, and magnet attachments were used to provide retention, support, and stability of a large definitive obturator.

Efficacy of conventional and implant-supported mandibular resection prostheses: study overview and treatment outcomes.

Statement Of Problem: While surgical restoration of mandibular resections has advanced dramatically with free-flap techniques, oral function and patient perceptions of function, as well as treatment outcomes, often indicate significant impairment.

Purpose: This longitudinal prospective study was designed to determine whether conventional prostheses (CP) or implant-supported prostheses (IP) and current surgical reconstructive procedures restore patients' oral functions and quality of life to their status prior to segmental mandibulectomy with immediate fibula free-flap reconstruction. Study design and implementation, characteristics of the study sample, treatment completion rates, and selected presurgical and postsurgical functional and perceptual outcomes are presented.

Treatment satisfaction with facial prostheses.

Statement Of Problem: Facial defects secondary to the treatment of neoplasms, congenital malformations, and trauma result in multiple functional and psychosocial difficulties. Prosthetic rehabilitation attempts to restore these facial disfigurements and may improve the level of function and self-esteem for these patients. However, a limited number of studies have evaluated the change in perceived quality of life after maxillofacial prosthetic rehabilitation.

Osseointegrated craniofacial implants in the rehabilitation of orbital defects: an update of a retrospective experience in the United States.

Statement Of Problem: Since their introduction, craniofacial implants have been used in prosthetic rehabilitation of facial defects. The literature, however, indicates marked variability in outcomes using implants for the retention of orbital prostheses.

Purpose: A multicenter report updating the experience in the United States with the use of craniofacial implants for prosthetic rehabilitation of orbital defects is presented.

Comparisons of chewing difficulty of consumed foods with mandibular conventional dentures and implant-supported overdentures in diabetic denture wearers.

Purpose: This study compared the chewing difficulty of foods in diets of denture wearers with mandibular conventional and implant-supported overdentures.

Materials And Methods: One-week dietary logs were evaluated for 58 subjects with controlled diabetes at baseline with their original dentures and with new dentures 6 months after treatment completion. Subjects received new maxillary and mandibular complete dentures, 21 with mandibular conventional dentures and 37 with implant-supported overdentures.

Implant-retained prostheses for facial defects: an up to 14-year follow-up report on the survival rates of implants at UCLA.

Purpose: An analysis of retrospective data was conducted to establish the survival rates of osseointegrated implants used to retain orbital, nasal, and auricular prostheses over a 14-year period and to recommend guidelines in the restorative treatment of such facial defects.

Materials And Methods: Included in this study were all patients who received implant-retained prostheses for auricular, nasal, or orbital defects from 1987 to 2001 in the Maxillofacial Clinics at the UCLA and City of Hope Medical Centers. Data were obtained from patient charts.

A randomized clinical trial comparing the efficacy of mandibular implant-supported overdentures and conventional dentures in diabetic patients. Part V: food preference comparisons.

Statement Of Problem: The functional benefits of replacing old dentures with new conventional mandibular dentures or implant-supported overdentures has not been fully determined.

Purpose: This study assessed the impact of these 2 types of replacement dentures on the food choices of diabetic patients.

Material And Methods: A total of 68 diabetic patients with original complete dentures participated in this study.