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The aim of this cohort case series is to present a new subperiosteal implant device that uses CAD-CAM technologies together with 3D metal printing capabilities to produce direct bone-anchored dental prosthetic solutions for the management of atrophic edentulous alveolus and jaws. The clinical experience of 21 subperiosteal devices implanted over a 4-year period is presented. The results of this study showed 14 of the 21 cases were successful (66.7%), while 7 cases had complications including exposure of the metal frame (5 cases), mobility of the device (1 case) and 1 case failed for reasons unrelated to the device. Four of the 7 cases were successfully salvaged resulting in an overall success rate of 85.7% (18 /21 cases). This study supports the use of fully customized subperiosteal jaw implants as a simple and reliable alternative for dental rehabilitation of atrophic edentulous cases which would otherwise require bone grafts for conventional fixed dental implant solutions. With more research, the clinical potential for this device is significant as it not only avoids the need for complex and lengthy reconstructive jaw surgery but also allows for the placement of immediate prosthetic teeth at the time of implantation.

Background This study aimed to evaluate the trueness of implant placement with fully guided (FG) implant placement protocol versus partial-guided (PG) protocol. Methods The study recruited 16 fully edentulous patients with adequate maxillary bone volume. Each patient received six implants; three were planned for each side of the maxilla to support a full-arch implant-supported fixed prosthesis 3 (FP3). Patients were randomly assigned to one of two intervention groups: Group 1 (PG group), drilling was done using a surgical guide, but implant placement was done without the guide. In group 2 (FG group), both drilling and implant placement were done through the surgical guide. The spatial relationship (entry, apex, and angle deviation) between planned and placed implants was evaluated using pre- and postoperative CBCT data. Results The FG approach resulted in statistically significantly higher overall trueness in entry, apex, and angle deviation across multiple implant sites, with a statistically significant difference of 0.030, 0.013, and 0.036, respectively, though differences at individual implant sites were not consistently significant. Conclusion This trial supported the fully guided implant placement protocol for enhancing the trueness of implant positioning in the rehabilitation of edentulous maxillary arches. Clinicians should weigh the benefits of this increased trueness against practical considerations. Trial registration The current study was registered at ClinicalTrials.gov (NCT06542562) on August 5, 2024.

Objective This study aimed to evaluate the clinical performance (degree of trueness) of a novel scan body “tooth-modified Scan body” (TMSB)& conventional scan body (CSB) in implant-supported full arch screw retained cases. Methods Seven edentulous arches (two maxillae, five mandibles) in 6 patients were rehabilitated with monolithic zirconia screw-retained implant prostheses supported by 4 ( n  = 1) and 5 implants ( n  = 6) for a total amount of 34 implants. Implant locations were scanned by intra-oral scanner (IOS) using two types of scan bodies, conventional scan bodies (CSB) in group (1) and tooth-modified scan bodies (TMSB) in group (2). 68 implant positions (representing the total sample size) were captured and compared to the relative reference scans regarding angular and Euclidian deviation (ΔEUC). Results The ΔEUC deviation Of TMSB group had lower values (M = 61.46, SD = 42.12) than that Of CSB group (M = 97.97, SD = 56.69). This difference was statistically significant ( p  = .005), 95% Confidence interval. The angular deviation of TMSC group had lower values (M = 0.85, SD = 0.69) than that Of CSB group (M = 1.3, SD = 1.06) which was statistically significant ( p  = .033), 95% Confidence interval. There was a correlation between the type of Jaw and both angular and ΔEUC deviation of both groups, which was statistically significant. Conclusion A tooth-modified scan body (TMSB) may improve the ease and trueness of full-arch implant scanning, even in challenging mandibular arches. Clinical trial registry date Retrospectively registered in 20/ 12/ 2023. Clinical trial registry number NCT06177782.

Background Hyoid bone is attached to the mandible, tongue, larynx, temporal bone, and cervical spine via different types of muscles or ligaments. The tongue, mandible, and hyoid system play a crucial role in swallowing function. This within subject study aimed to evaluate the impact of mandibular implant overdentures on the displacement of the hyoid bones during the swallowing process. Methods Twenty five healthy edentulous subjects were selected for participating in the study. New complete dentures were constructed for all the participants. Subsequently two dental implants were inserted in the canine regions of the participant’s mandibular arch. In order to retain the mandibular prosthesis in place, ball attachments were incorporated into the mandibular dentures to convert them into implant overdentures. Using 10 ml of thin liquid bolus, videofluoroscopy swallowing examination was performed in three different oral conditions: without complete dentures (WCD), with complete denture (CDs), and with a mandibular implant overdenture (IODs). ANOVA with Bonferroni test was used to analyze the data in order to determine how the hyoid displacement varied throughout different oral conditions. Results Compared to complete dentures, mandibular implant overdentures showed a significant decrease ( P  < 0.05) in both anterior hyoid displacement and duration of hyoid maximum anterior excursion (DOHMAE). However, there was a non-significant difference ( P  > 0.05) between the two oral circumstances in terms of superior hyoid displacement or duration for hyoid maximum elevation (DOHME). There is no penetration or aspiration for both complete denture and implant overdenture oral conditions. Conclusion Implant retained overdentures have a positive effect on hyoid displacement during swallowing of thin liquid bolus consistency relative to conventional complete dentures. Trial registration Retrospectively registered (NCT06187181) 02/1/2024.

Background This study aims to evaluate the stress distribution under occlusal forces by using finite element analysis (FEA) to compare conventional, zygomatic, and differently designed subperiosteal implants (SI) in edentulous atrophic maxilla. Methods A 3D model of an edentulous atrophic maxilla was reconstructed from CT scans. Three models were simulated: Model 1 with zygoma and conventional implants, Model 2 with apertura piriformis and subperiosteal implants extending to the zygomaticomaxillary buttress, and Model 3 with apertura piriformis and subperiosteal implants covering the zygomatic buttress. Mechanical properties were assigned according to the literature; 150 Newton (N) force per tooth was applied for occlusal loading, and 100 N force was applied for oblique loading. Results When the highest tensile (Pmax) and compressive (Pmin) stresses in the bone under vertical and oblique forces were examined, the highest stress was observed in Model 1, and the lowest was observed in Model 3. The von Mises stress values observed in the metal substructure were the highest in Model 1 and the lowest in Model 3. The von Mises stress in the abutments and implants was highest in Model 3 and lowest in Model 1. When the subperiosteal implant screws were examined, more von Mises stress was observed in the subperiosteal implant screws used in Model 3 than in those used in Model 2. Among the three different treatment options applied in the atrophic maxilla, the highest stress in the bone occurred in the conventional and zygomatic implants, and the lowest stress occurred in the subperiosteal implant with a zygomatic bone anchor. Conclusions Different types and designs of implants may be alternatives to advanced surgical methods in the rehabilitation of atrophic maxillary lesions. This study underscores the importance of implant and bone design in choosing optimal anchorage zones, particularly in cases of severe bone loss in the edentulous maxilla. In light of these findings, we recommend implant systems that are specially developed for appropriate rehabilitation in the atrophic edentulous maxilla.

Objectives To compare the psychometric properties of three OHRQoL indicators (GOHAI, OHIP-14, and OHIP-EDENT) in a group of complete edentulous subjects and to explore the ability of these instruments to distinguish between individuals with different prosthetic and oral health status. Methods This was a cross-sectional study. Edentulous individuals aged 60 years and more were recruited between January 2019 and February 2020 in a medical and dental care centers. The Lebanese versions of GOHAI, OHIP-14, and OHIP-EDENT were used. External and internal consistencies were assessed using intraclass correlation coefficient (ICC) and Cronbach alpha, respectively. The concurrent validity was evaluated by testing the indicators against a proxy measure of a similar concept. To test their discriminative abilities, the ADD (GOHAI and OHIP) and SC (GOHAI and OHIP) scores were dichotomized according to the 25th and 75th percentile, respectively, and multivariate analyses were performed using sociodemographic, clinical, and subjective health parameters as explanatory variables. Results Two hundred and two edentulous subjects (age: 72.94 ± 7.378 years) were included. The proportion of subjects with no impact was lower for OHIP-EDENT (7.9%) compared to GOHAI (28.2%) and OHIP-14 (38.6%). Reproducibility was satisfactory for all OHRQoL tools since they were able to reproduce the results consistently in time (ICC > 0.80). The Cronbach alpha values were greater than 0.8 indicating acceptable internal consistency. The concurrent validity of the three tools was acceptable since subjects with lower OHRQoL score were less satisfied with their dentures and reported a higher need for self-rated therapy. Concerning the discriminant validity, OHIP-EDENT was more discriminant than OHIP-14 and GOHAI, since it was more able to identify patients with poor prosthetic issues or using instable denture. Conclusion The OHIP-EDENT was more effective in identifying edentulous individuals with oral and prosthetic problems. Our results can help decide which dental instrument to use to assess the perception of oral health in edentulous individuals. More prospective studies are required to compare their evaluative properties.

ObjectiveAddress oral health-related quality of life (OHRQoL) and patient satisfaction rehabilitated by the all-on-four concept as the primary outcome.Material and methodsA search was performed in the PubMed/MEDLINE, Web of Science, and Cochrane databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis criteria (PRISMA). The PICO question was used to address the following specific question: “What is the level of oral health-related quality of life and satisfaction in edentulous patients and with atrophic jaws who received dental implants for full-arch implant-supported restorations following the all-on-four in the mandible or maxilla?”ResultsEleven studies including 693 patients aged 55 to 71 years were selected. The shortest follow-up period was 3 months and the longest, 7 years. Regarding the OHRQoL assessment method and patient satisfaction, the oral health impact profile (OHIP) and the visual analog scale (VAS) were the most used.ConclusionOHRQoL and satisfaction in patients whose rehabilitation was based on the all-on-four concept were high. However, the current evidence is still limited by the quality of the available studies, making long-term randomized studies necessary to establish the real effectiveness of this surgical-prosthetic approach.Clinical relevanceCarefully analyze the aspects related to satisfaction and oral health-related quality of life of rehabilitated patients with implant-supported total prostheses made according to the all-on-four concept, aiming to achieve success through procedures with greater predictability and less complexity, as these are directly associated with recovery oral health of edentulous individuals with less morbidity and minimized costs.

Hyposalivation is an important problem in elders and could interfere with several oral functions and microbial ecology. While the number of independent elders who retain more natural teeth increases worldwide, few studies examined hyposalivation in this population. Thus, this study aims to examine relationships between hyposalivation, oral health conditions and oral Candida colonization in independent dentate elders and evaluate factors associated with salivary flow and Candida carriage. We conducted a cross-sectional study in fifty-three dentate elders (≥65 years old with at least 4 pairs of posterior occlusal contacts) with no, or well-controlled, systemic conditions. Participants were interviewed for medical history, subjective dry mouth symptoms, oral hygiene practices and denture information. Unstimulated and stimulated salivary flow rates, objective dry mouth signs, gingival, tongue-coating, and root-caries indices were recorded. Stimulated saliva was cultured on Sabouraud-dextrose agar for Candida counts. Candida species were identified using chromogenic Candida agar and polymerase chain reaction. Statistical significance level was set at p<0 . 05 . The results showed that hyposalivation was associated with higher gingival and tongue-coating indices ( p = 0 . 003 and 0 . 015 , respectively), but not root-caries index. Hyposalivation was also associated with higher prevalence of oral Candida colonization ( p = 0 . 010; adjusted OR = 4.36, 95% confidence interval = 1.29–14.72). These two indices and Candida load were negatively correlated with unstimulated and stimulated salivary flow rates. Interestingly, non- albicans Candida species were more prevalent in denture wearers ( p = 0 . 017 ). Hence, hyposalivation is a risk factor for poorer oral health and oral Candida colonization in independent dentate elders. Because of its potential adverse effects on oral and systemic health, hyposalivation should be carefully monitored in elders.

Background and Objectives: Oral rehabilitation seeks to enhance mastication, a vital component of oral function that is compromised by tooth loss. This study aimed to assess the degree of improvement of masticatory performance in partially edentulous patients rehabilitated with removable partial dentures (RPD) or fixed partial dental prosthesis (FPDP). Changes in the occlusal contact area (OCA) and satisfaction with their chewing ability during the adaptation period were also evaluated. Materials and Methods: in total, 34 partially edentulous participants (median age 65.3 years; 56% women) who received an RPD or FPDP were assessed using masticatory performance assay, OCA calculation, and a visual analog scale (VAS). Results: Masticatory performance improved by 20% (range from 17% to 25%, p < 0.05) depending on the edentulism and the rehabilitation types. The OCA improved by 4.7 mm2 (p < 0.05) and satisfaction with the masticatory function improved by 9% (p < 0.05) 3 months after prosthesis insertion. Conclusions: Conventional prostheses benefited partially edentulous individuals, improving masticatory performance by 20%. Treatment also increased the OCA in all types of partial edentulism, except in Kennedy class I patients rehabilitated with RPD. Patients’ satisfaction with their chewing ability only increased in Kennedy class III patients rehabilitated with RPD.

Non-odontogenic oral pain is prevalent among the older people and significantly impacts their quality of life. Non-odontogenic oral pain is usually persistent and accompanied by comorbidities such as psychosocial distress and sleep-related problems, which further complicate pain management. The relationship between non-odontogenic oral pain and comorbidities in the older people, however, has not been well documented. This study aimed to identify the factors associated with non-odontogenic oral pain in an edentulous older population and to subgroup this population based on the patterns of oral pain and its associated factors. In this cross-sectional study, data from completely edentulous individuals in the National Health and Nutrition Examination Survey for the period from 2017 to 2020 March (pre-pandemic) were analysed. Associations and correlations between oral pain and 46 other variables, including demographic, questionnaire, examination and laboratory data, were investigated using Pearson’s chi-squared test and Spearman’s rank correlation test. A p value of < 0.05 was considered statistically significant. Clustering of the data was performed using the k-prototypes algorithm, an unsupervised machine learning. Approximately 42% of the edentulous older people experienced oral pain. ‘Having been told to take daily low-dose aspirin’ was significantly associated with oral pain. Oral pain was positively correlated with depressive symptoms and excessive daytime sleepiness (EDS), and negatively correlated with diastolic blood pressure, red blood cell count, haemoglobin level and haematocrit. The k-prototypes algorithm identified a cluster characterised by frequent oral pain, depression and EDS. This study identified distinct patterns of comorbidities among edentulous older people living with oral pain.