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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dentistry, Oral Surgery and Oral Medicine".

Deadline for manuscript submissions: closed (30 November 2021) | Viewed by 25430

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Special Issue Editor

Prof. Javier Montero

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Guest Editor

Facultad de Medicina, Universidad de Salamanca, Salamanca, Spain
Interests: oral health-related quality of life; caries; sealants

Special Issue Information

Dear Colleagues,

We are well aware that both patients and clinicians expect that prosthodontic treatments (often preceded by a variety of surgical, periodontal, and restorative treatments) have a positive impact on oral health and wellbeing. However, since prostheses are directed towards influencing oral function and patient aesthetics, the patient´s perception may be the key parameter in assessing treatment outcomes because those relevant dimensions (oral function and aesthetics) can only be subjectively estimated by the patient.

Over the past two decades, the importance of measuring so-called patient-centered outcomes has been increasingly reported in the literature as a complementary but recommended tool for assessing prosthetic treatments. The outcomes of prosthodontic procedures are variable and cannot be assessed reliably using clinical measures alone. For example, the improvement of masticatory function after replacing missing teeth may be assessed simultaneously by subjective and objective methods to effectively quantify changes in mastication.

The focus of this Special Issue is to review what is currently known about the effect of prosthetic treatments on patient functioning and wellbeing by measuring patient-centered outcomes.

Prof. Javier Montero
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

Oral health-related quality of life
Patient centered outcomes
Self-assessment
Oral rehabilitation
Dentures
Treatment outcomes

Published Papers (6 papers)

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Editorial

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2 pages, 173 KiB

Open AccessEditorial

The Concluding Editorial Regarding the Special Issue “Latest Advances in Prosthodontics: Improving Patient-Centered Outcomes”

by Javier Montero

J. Clin. Med. 2022, 11(19), 5700; https://doi.org/10.3390/jcm11195700 - 27 Sep 2022

Viewed by 1029

Abstract

According to the current holistic concept of health, all patients require a thorough assessment of their physical, psychological, and emotional well-being, not merely a confirmation or classification of disease [...] Full article

(This article belongs to the Special Issue Latest Advances in Prosthodontics: Improving Patient-Centered Outcomes)

Research

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18 pages, 1809 KiB

Open AccessFeature PaperArticle

Patient-Centered Treatment Outcomes with Full-Arch PEEK Rehabilitation Supported on Four Immediate or Conventionally Loaded Implants. A Randomized Clinical Trial

by Javier Montero, Yasmina Guadilla, Javier Flores, Beatriz Pardal-Peláez, Norberto Quispe-López, Cristina Gómez-Polo and Abraham Dib

J. Clin. Med. 2021, 10(19), 4589; https://doi.org/10.3390/jcm10194589 - 5 Oct 2021

Cited by 8 | Viewed by 2323

Abstract

This study aims to assess the treatment outcomes (functional and subjective) of full-arch fixed hybrid rehabilitations made of PEEK (poly-ether-ether-ketone) with milled crowns of nano-filled composite (NFC) supported on four to six implants. In this randomized clinical trial, 34 edentate patients in the upper and/or the lower jaws were treated with the fixed hybrid dentures. In 16 patients (47.1% of the sample), the implants were loaded immediately (IL) by means of a provisional fixed rehabilitation made of PMMA (polymethylmethacrylate) screwed on Multi-Unit (MU) abutments connected after emplacement of the implant; however, in the counterparts (n = 18) these MU abutments were covered by healing caps and were left unloaded during two months (conventional loading protocol—CL), when all patients received a fixed hybrid PEEK-NFC rehabilitation on the upper and/or the lower jaw. Treatment outcomes were assessed 12 months after prostheses delivery. Functional outcomes were calculated according to masticatory performance, estimated by mixing ability tests of two colored chewing gums after ten chewing strokes, by the occlusal force/area recorded by pressure-sensitive sheets, and by electromyography of masseters and temporal muscles at maximum biteforce. The subjective outcomes of the treatment were assessed using both the oral satisfaction scale (visual analog scale) and the Spanish version of the Oral Health Impact Profile (OHIP-20). The findings of the present study showed that treatment with fixed PEEK-NFC hybrid prostheses significantly improved the masticatory performance, bite force, occlusal pattern, quality of life, and satisfaction, with the IL group being those with significantly higher occlusal bite forces and greater satisfaction in comparison with CL group. It should be concluded that PEEK-NFC hybrid prostheses can improve several patient-centered outcomes and that loading protocol significantly affects the patient’s self-rated satisfaction. Full article

(This article belongs to the Special Issue Latest Advances in Prosthodontics: Improving Patient-Centered Outcomes)

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15 pages, 2693 KiB

Open AccessArticle

Periodontal Behavior and Patient Satisfaction of Anterior Teeth Restored with Single Zirconia Crowns Using a Biologically Oriented Preparation Technique: A 6-Year Prospective Clinical Study

by Blanca Serra-Pastor, Naia Bustamante-Hernández, Antonio Fons-Font, María Fernanda Solá-Ruíz, Marta Revilla-León and Rubén Agustín-Panadero

J. Clin. Med. 2021, 10(16), 3482; https://doi.org/10.3390/jcm10163482 - 6 Aug 2021

Cited by 9 | Viewed by 5053

Abstract

Objectives. The aim of this study was to analyze the behavior of the periodontal tissues around teeth in the anterior region when restored with zirconia single crowns, using a biologically oriented preparation technique (BOPT), over a 6-year follow-up. Methods. The study investigated tooth-supported single crowns in the anterior region that were fabricated with a zirconia core and feldspathic ceramic covering, in 34 patients. Follow-up analysis took place annually for 6 years, assessing periodontal responses by evaluating the following variables: plaque index (PI); probing depth (PD); gingival index (GI); gingival thickness adjacent to the restoration; and stability of the gingival margin (MS). Any (biological and mechanical) complications were also recorded, as well as the patients’ satisfaction with the treatment. Results. After 6 years’ follow-up, a low mean plaque index was obtained, probing depth was stable, and gingival thickness and margin stability had increased. Complications (biological and mechanical) did not present a statistically significant incidence and a crown survival rate of 97.2% was achieved. Patients’ satisfaction obtained a mean VAS score of 9.04 under 10. Conclusion. Teeth that are prepared with BOPT in the anterior region present good periodontal behavior around the restored teeth, particularly in terms of the stability of the gingival margin and increased gingival thickness. Single crowns prepared with BOPT obtain an excellent clinical survival rate, as well as a high score in patients’ satisfaction after 6 years. Full article

(This article belongs to the Special Issue Latest Advances in Prosthodontics: Improving Patient-Centered Outcomes)

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28 pages, 1062 KiB

Open AccessArticle

Functional and Patient-Centered Treatment Outcomes with Mandibular Overdentures Retained by Two Immediate or Conventionally Loaded Implants: A Randomized Clinical Trial

by Javier Montero, Abraham Dib, Yasmina Guadilla, Javier Flores, Beatriz Pardal-Peláez, Norberto Quispe-López and Cristina Gómez-Polo

J. Clin. Med. 2021, 10(16), 3477; https://doi.org/10.3390/jcm10163477 - 6 Aug 2021

Cited by 8 | Viewed by 1906

Abstract

This study aims to assess the treatment outcomes (functional and subjective) of mandibular overdentures retained on two implants with or without an immediate loading protocol. In this randomized clinical trial, twenty fully edentulous patients were treated with a mandibular two-implant-retained overdenture and a complete new maxillary denture. In half of the sample, the implants were loaded immediately by means of VulkanLoc^® abutments after emplacement of the implant, but in the counterparts, these VulkanLoc^® abutments were connected to implants two months after the surgery (conventional protocol), and until that time the dentures were retained by healing abutments. Treatment outcomes were assessed at two, six, and twelve months after surgery. Functional outcomes were calculated according to masticatory performance, estimated by the mixed fraction of a two-coloured chewing gum after five, ten, and fifteen chewing strokes, by the occlusal force recorded by pressure-sensitive sheets, and by the bioelectrical muscular activity. The subjective outcomes of the treatment were assessed using both the oral satisfaction scale (visual analogue scale) and the Spanish version of the Oral Health Impact Profile (OHIP-20). The findings of the present study show that new complete dentures resulted in significant improvements in chewing ability, patient satisfaction, and oral health-related quality of life and that subsequent implant-retained overdentures produced further and faster significant improvements. The loading protocol may influence those positive self-reported outcomes rather than the objective functional evaluations. Full article

(This article belongs to the Special Issue Latest Advances in Prosthodontics: Improving Patient-Centered Outcomes)

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17 pages, 1902 KiB

Open AccessArticle

Clinical Performance of Implant Crown Retained Removable Partial Dentures for Mandibular Edentulism—A Retrospective Study

by Soo-Yeon Yoo, Seong-Kyun Kim, Seong-Joo Heo, Jai-Young Koak and Hye-Rin Jeon

J. Clin. Med. 2021, 10(10), 2170; https://doi.org/10.3390/jcm10102170 - 18 May 2021

Cited by 11 | Viewed by 2855

Abstract

The studies on implant-crown-retained removable partial dentures (IC-RPDs) for edentulism are scarce. The purpose of this study was to evaluate survival rates and marginal bone loss (MBL) of IC-RPDs compared to implant overdentures (IODs) in mandibular edentulism. Variables that influenced survival and marginal bone loss (MBL) of implants in both treatment modalities were analyzed and the functional/esthetic satisfaction of patients as well as prosthetic complications were also observed. Eighteen IC-RPDs with a total of 60 implant-supported survey crowns and 24 IODs with a total 94 implants retained with magnet attachments were observed. After a median observation period of 46.6 months (up to 149 months), we observed 98.3% implant survival rates for IC-RPDs and 92.5% for IODs. Kaplan–Meier survival curves based on the treatment modality showed that, at 96 months, cumulative survival rates were 98.3% in IC-RPD and 83.1% in IOD. For implant survival rates, no statistical differences were observed according to age, sex, opposing dentition, or implant positions (p = 0.515, 0.666, 0.201, 0.749, respectively). The implant MBL measurements for IC-RPD and IOD groups at the final recall check were 0.93 ± 1.22 mm and 2.12 ± 2.09 mm, respectively. Additionally, there were no significant differences between groups (p = 0.554). The implants with peri-implantitis at year 1 showed significantly higher MBL at final check-up (p < 0.001). The MBL of implants showed significant differences based on age (p = 0.008) and opposing dentition (p = 0.003). No significant differences of implant MBL were observed for the position of placed implants (p = 0.621) or sex (p = 0.666). Patient-reported outcome measures (PROMs) on functional and esthetic satisfaction were significantly improved after IC-RPD or IOD treatment (p < 0.001). The most frequent prosthetic complication of IC-RPD was clasp loosening, while for IOD group, it was attachment dislodgement. Within the limitations of this retrospective study, we concluded that IC-RPDs could be considered as a viable treatment option for edentulous patients who need few fixed abutments for satisfaction. Full article

(This article belongs to the Special Issue Latest Advances in Prosthodontics: Improving Patient-Centered Outcomes)

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Review

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12 pages, 2169 KiB

Open AccessReview

Clinical Considerations in Orthodontically Forced Eruption for Restorative Purposes

by Grace Huang, Min Yang, Mohammad Qali, Tun-Jan Wang, Chenshuang Li and Yu-Cheng Chang

J. Clin. Med. 2021, 10(24), 5950; https://doi.org/10.3390/jcm10245950 - 18 Dec 2021

Cited by 10 | Viewed by 6458

Abstract

For restorations on teeth involving invasion of the supracrestal tissue attachment (biological width), as well as for lack of ferrule effect, crown lengthening is required for long-term periodontal health and success of the restoration. In the same fashion, site development is often necessary prior to implant placement in order to provide optimal peri-implant soft and hard tissue architecture conducive to future esthetics and function. Orthodontic extrusion, also known as forced eruption, has been developed and employed clinically to serve the purposes of increasing the clinical crown length, correcting the periodontal defect, and developing the implant site. In order to provide comprehensive guidance on the clinical usage of this technique and maximize the outcome for patients who receive the dental restoration, the currently available literatures were summarized and discussed in the current review. Compared to traditional crown lengthening surgery, forced eruption holds advantages of preserving supporting bone, providing improved esthetics, limiting the involvement of adjacent teeth, and decreasing the negative impact on crown-to-root ratio compared to the traditional resective approach. As a non-invasive and natural technique capable of increasing the available volume of bone and soft tissue, forced eruption is also an attractive and promising option for implant site development. Both fixed and removable appliances can be used to achieve the desired extrusion, but patient compliance is a primary limiting factor for the utilization of removable appliances. In summary, forced eruption is a valuable treatment adjunct for patients requiring crown lengthening or implant restorations. Nonetheless, comprehensive evaluation and treatment planning are required for appropriate case selection based upon the known indications and contraindications for each purpose; major contraindications include inflammation, ankylosis, hypercementosis, vertical root fracture, and root proximity. Further studies are necessary to elucidate the long-term stability of orthodontically extruded teeth and the supporting bone and soft tissue that followed them. Full article

(This article belongs to the Special Issue Latest Advances in Prosthodontics: Improving Patient-Centered Outcomes)

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