PROSTHETIC RECONSTRUCTIONS AND REFERRING IMPLANT SURVIVAL IN A POSTGRADUATE PROGRAM: A RETROSPECTIVE STUDY
Table 1. Number of implants according to the gender and the dental status
Implants in maxilla Implants in mandible Total implants Gender Male 556 575 1131( 48.4 %)
Female 569 637 1206( 51.6 %) Dental status Partially dentate 527 421 948( 40.6 %)
Edentulous 598 791 1389( 59.4 %) Total 1125( 48.1 %) 1212( 51.9 %) 2337( 100 %)
Table 2. Number of implants according to the type of ISR performed
Type of ISR
Maxilla Implants / ISRs
Mandible Implants / ISRs
Total Implants / ISRs
Lost implants preload; loaded
Fixed SC * 180 * / 180 157 * / 157 337( 14.4 %)* / 337 1; 6
FDP 207 / 92 215 / 98 422( 18.1 %) / 190 1; 3 IB 228 / 39 66 / 15 294( 12.8 %) / 54 1; 2
Removable RDP * 236 * / 121 138 * / 77 374( 16.0 %)* / 198 1; 3 Bar-IOD 274 / 66 636 / 288 910( 38.9 %) / 354 8; 5
Total 1125 / 498 1212 / 635 2337( 100 %) / 1133 12; 19
* non-splinted implants from SCs and RDP( total 711, 30.4 %) ISR: Implant supported reconstruction SC: Single crown FDP: short-span fixed dental prosthesis IB: Full-arch FDP( Implant bridge) RDP: Removable dental prosthesis IOD: Implant-Overdenture
survey was part of a quality control assessment of the dental consultation. The data were based on an abstraction of the oral examinations and were collected strictly anonymously. The study respected the regulations of the Helsinki Declaration from 1975 and was performed in accordance with the STROBE statements. The study protocol was reviewed and approved by the University of Bern School of Dental Medicine Institutional Ethical Committee. The progress of the patients’ treatment was regularly supervised and documented in case presentations either live chairside or with adequate digital presentations. The case presentations followed the PICO structure 19, 20, meaning that decision making and implant therapy should be based on the best evidence available and meet the patients’ needs. The students performed the implant surgery and prosthetic rehabilitation under the guidance and supervision of the director and staff specialists of the Department. Detailed records and photographs were obtained from all patients during the entire treatment period. When the treatment was completed all patients were included in a well-organized maintenance program. The goal of the 3-year training curriculum was to reach a competency level of grade A( advanced) for surgical and prosthodontic procedures according to the ITI treatment guide. Complex treatments and invasive approaches that were not frequently encountered were performed by the supervisors and assisted by the students. 2.3. Patient management The patients involved in the graduate curriculum were partially dentate or edentulous in one or both jaws. They often presented failures of old reconstructions and teeth not worth being maintained. They had a different background( recall, prevention, etc.) and the reasons for tooth loss were long in the past. The patient management followed a strict protocol as described below:
• The patient’ s chief complaint and demands were assessed.
• The records of the patient’ s history comprised social aspects, general health, special habits( smoking, bruxism, alcohol and drug abuse) and dental history. Records on medications were kept and the family physician was contacted, if necessary.
• Clinical examination and dental / oral diagnosis: It included the periodontal status, caries, tooth wear and in single case a dietary protocol by the patient, occlusal analysis and assessment of the vertical dimension, functional analysis of temporomandibular joints( TMJ), single radiographs, status of endodontically treated teeth, pathologies of oral mucosa or pathological findings on the panoramic radiography, atrophic jaw( areas), evaluation of old reconstructions, aesthetic analysis( facial morphology, smile line, gummy smile, gingival border and papillae, tooth axis, lip closure and biotype of gingiva).
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