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Objectives: The aim of the present study was to assess the long-term course of OHRQoL and the impact of the loading protocol in patients receiving a single mandibular implant supporting a complete denture over a period of five years., Methods: In this multicenter RCT, a total of 158 edentulous patients were initially included and were randomly allocated immediately after placement of a mandibular midline implant to either immediate loading (IL) or to conventional loading (CL) with submerged healing. The assessment of OHRQoL was performed with the 49-item Oral Health Impact Profile (OHIP) at baseline and 1, 4, 12, 24, and 60 months after loading. At 5-year follow-up, 100 patients (mean age: 69.2 years; 45.0% female) with completed OHIP were available for analyses. A mixed-effects model with patients as random effect and an unstructured covariance matrix was developed to address repeated outcome measurement., Results: The OHRQoL improved substantially after loading, indicated by a decrease of mean OHIP summary scores from 51.0 points at baseline, by 14.2 (95%-CI: 9.4 - 19.1; p<0.001) points to 37.2 points at 1-month follow-up, and by continuous improvement to 20.4 OHIP points at final follow-up. Considering constant treatment effects, the loading protocol had no significant effect on OHIP scores (-3.7, 95%-CI: -9.4 - 2.2; p = 0.204). Time effect was statistically significant with -0.21 (95%-CI: -0.28 - -0.15; p<0.001) points per month., Conclusion: Both the immediate and conventional loading of a single mandibular midline implant supporting a complete denture offer long-lasting high levels of OHRQoL, with no significant or clinically relevant long-term differences., Clinical Significance: The study firstly presents long-term data for OHRQoL by investigating the loading protocol of single mandibular implant-supported complete dentures. Since immediate loading has been associated with a reduced implant survival rate for this concept, information on patient benefits is essential for evidence-based decision making., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

Background: When dental patients seek care, treatments are not always successful,that is patients' oral health problems are not always eliminated or substantially reduced. Identifying these patients (treatment non-responders) is essential for clinical decision-making. Group-based trajectory modeling (GBTM) is rarely used in dentistry, but a promising statistical technique to identify non-responders in particular and clinical distinct patient groups in general in longitudinal data sets., Aim: Using group-based trajectory modeling, this study aimed to demonstrate how to identify oral health-related quality of life (OHRQoL) treatment response patterns by the example of patients with a shortened dental arch (SDA)., Methods: This paper is a secondary data analysis of a randomized controlled clinical trial. In this trial SDA patients received partial removable dental prostheses replacing missing teeth up to the first molars (N = 79) either or the dental arch ended with the second premolar that was present or replaced by a cantilever fixed dental prosthesis (N = 71). Up to ten follow-up examinations (1-2, 6, 12, 24, 36, 48, 60, 96, 120, and 180 months post-treatment) continued for 15 years. The outcome OHRQoL was assessed with the 49-item Oral Health Impact Profile (OHIP). Exploratory GBTM was performed to identify treatment response patterns., Results: Two response patterns could be identified - "responders" and "non-responders." Responders' OHRQoL improved substantially and stayed primarily stable over the 15 years. Non-responders' OHRQoL did not improve considerably over time or worsened. While the SDA treatments were not related to the 2 response patterns, higher levels of functional, pain-related, psychological impairment in particular, and severely impaired OHRQoL in general predicted a non-responding OHRQoL pattern after treatment. Supplementary, a 3 pattern approach has been evaluated., Conclusions: Clustering patients according to certain longitudinal characteristics after treatment is generally important, but specifically identifying treatment in non-responders is central. With the increasing availability of OHRQoL data in clinical research and regular patient care, GBTM has become a powerful tool to investigate which dental treatment works for which patients., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: A shortened dental arch (SDA) is an established treatment concept for patients with missing molars. However, little is known regarding long-term course of oral health-related quality of life (OHRQoL) in patients with SDA and the benefits from replacement of missing molars., Objective: Purpose of this multi-center randomized clinical trial was to assess OHRQoL over a period of 15 years in patients with molar replacement by a removable partial denture (RPD) compared to patients with a restored SDA without molar replacement., Methods: Patients at least 35 years of age with all molars missing in 1 jaw and at least the canine and one premolar present on each side were included. Patients received either a precision attachment-retained, RPD for replacement of missing molars (n = 79), or the dental arch ended with the second premolar (SDA) that had to be present or replaced by a cantilever fixed dental prosthesis (n = 71). Follow-up examinations continued for 15 years. OHRQoL was assessed with the 49-item Oral Health Impact Profile (OHIP). OHIP summary and dimension scores were longitudinally modeled in the statistical analyses to assess course of OHRQoL over time applying an intention-to-treat approach. In addition, scores for the OHRQoL dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact were analyzed., Results: After an initial improvement in OHRQoL indicated by a mean decrease of 20.0 OHIP points with an effect size of 0.61 in the entire study population, OHRQoL stayed relatively constant over the entire follow-up period. Assuming a constant time and treatment effects over the study period, OHRQoL did not differ statistically significant between the 2 treatments (0.4 OHIP points; 95%-CI: 7.1 - 6.2). OHRQoL after treatment did not change notably over 15 years and was statistically nonsignificant as well (P = .872). Similar findings were observed in all 4 OHRQoL dimensions., Conclusions: In patients, missing all molars in one jaw OHRQoL improved providing RPD or restoring SDA to a clinically relevant degree. Treatment-related improvement remained mostly stable over a period of at least 15 years. Therefore, patients can be informed that both treatment concepts are equivalent concerning long-term OHRQoL. Accordingly, patients' preferences regarding treatment options should be granted priority in treatment decision making with the SDA treatment option being the default., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Purpose: A single implant can be placed to retain an overdenture in the edentulous mandible. This study aimed at the development of Oral Health-related Quality of Life comparing immediate and delayed implant loading, i.e., loading after 3 months of submerged healing., Methods: In a randomized controlled trial, 158 participants received a single mandibular implant in the midline. Quality of life was measured using the summary score of the German 49-item Oral Health Impact Profile at baseline, one month after implant placement (direct loading group) as well as one and four months after loading., Results: Mean scores at baseline were comparable. Four months after implantation, a decrease of mean scores was recognized for both groups, indicating a significantly enhanced quality of life after treatment. When comparing the groups after both 1 and 4 months of loading, quality of life was insignificantly higher in the delayed loading group (1 month: 42.1 vs. 32.3; 4 months: 33.6 vs. 27.7). For immediate loading, an insignificant tendency to an earlier improvement was recognized (Δ 1month-baseline : 9.7, compared to Δ 1month-baseline : 6.4)., Conclusions: The single mandibular implant concept was associated with a positive impact on quality of life. However, no statistically significant influence of implant loading on quality of life was found., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives: Although the shortened dental arch (SDA) concept is a widely accepted strategy to avoid overtreatment, little is known on its impact on oral health-related quality of life (OHRQoL). This multicenter randomized controlled trial aimed to investigate the OHRQoL for removable partial dental prostheses (RPDP) with molar replacement versus the SDA concept., Material and Methods: In both groups, missing anterior teeth were replaced with fixed dental prosthesis. Two hundred fifteen patients with bilateral molar loss in at least one jaw were included. The Oral Health Impact Profile (OHIP-49) was completed before; 6 weeks (baseline), 6 months, and 12 months after treatment; and thereafter annually until 5 years., Results: Of the initial cohort, 81 patients were assigned to the RPDP group and 71 to the SDA group (age, 34 to 86 years). Before treatment, the median OHIP score was similar in both groups (RPDP, 38.0; SDA, 40.0; n.s.). Results indicate marked improvements in OHRQoL in both groups between pretreatment and baseline (RPDP, 27.0; SDA, 19.0; p ≤ 0.0001) which continued in the RPDP group until the 1-year follow-up (p = 0.0002). These significant reductions in OHIP scores are reflected in its subscales. No further differences were seen within and between groups during the remainder observation period., Conclusion: Both treatments show a significant improvement in OHRQoL which continued in the RPDP group until the 1-year follow-up. No significant differences were seen between groups., Clinical Relevance: For improving OHRQoL, it is not necessary to replace missing molars with a RPDP.

Objective: One aim of this prospective clinical study was to measure the effects of strategicimplant placement under removable partial dental prostheses (RPDPs) and among removable complete dental prostheses (RCDPs) on oral health-related quality of life (OHRQoL)., Materials and Methods: Twenty-three patients participated in this study restored with RCDPs (n = 12) or RPDPs retained by telescopic crowns with 1-2 abutment teeth (n = 11). The total number of abutments was increased to 5-6 (maxilla) or to 4 (mandible) by placing implants in strategically advantageous regions. Ball attachments were attached to the implants and integrated in the existing denture. The Oral Health Impact Profile (49 questions) was completed by patients before implant placement, at baseline (integration of ball attachments), and during 12- and 24-month follow-up visits., Results: There were marked reductions of impacts in both groups when comparing pre-treatment scores and scores at baseline (P < 0.0001), 12-month (P < 0.0001), and 24-month follow-up visits (P < 0.0001), respectively. For none of the visits, a significant difference between the two groups was detected (P > 0.05)., Conclusion: It can be concluded that a strategic placement of implants under the existing dental prostheses improves OHRQoL in both treatment groups., (© 2012 John Wiley & Sons A/S.)

Objectives: The aim of this preliminary prospective study was to evaluate the clinical outcome, the oral health-related quality of life (OHRQoL), and the subjective chewing ability of patients with mandibular complete dentures retained by a single implant placed in the mandible midline., Methods: Patients wearing complete dentures were treated with a single implant in the mandible, followed by relining of the dentures and incorporation of ball attachments for implant retention. Implant outcome, prosthodontic maintenance, subjective chewing ability, and the oral health impact profile of the patients were assessed at baseline and at four weeks after connecting the denture and implant., Results: Eleven patients were enrolled in this investigation, and the mean observation period was 43.4 months (minimum period: 35, maximum period: 52 months). No implants were lost during observation period, but four dentures needed repair because of the fracture of the denture base in the midline area. A significant improvement was observed in the OHRQoL of the patients after the attachment of the mandibular dentures with a single midline implant. Furthermore, the subjective chewing ability of the patients was significantly improved after implant connection., Conclusions: Within the limitations of this preliminary prospective clinical study, single implant-supported mandibular overdentures were a successful treatment option for older edentulous patients who showed improvements in their OHRQoL and chewing ability., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Purpose: This study aimed to correlate the general well-being of patients and their judgment about their dental appearance., Materials and Methods: Based on internationally accepted guidelines regarding dental esthetics, a questionnaire was developed to measure subjective assessments of dental appearance. Fourteen items defined an esthetic sum score (0 = satisfied; 56 = dissatisfied). Further, general well-being was evaluated with a long-established and highly reliable test. Eighty participants were included (47 women, 33 men). Participants were.drawn from 4 different groups (n = 20): natural dentition (group N), fixed partial dentures (group F), removable partial dentures (group R), and patients who had an esthetic problem with their teeth (group P)., Results: Seventy-five participants showed a normal well-being. Five participants showed a depressive state and formed a new group (group D). The medians of the sum scores (25th, 75th percentile) were: group N: 12 (10, 14); group F: 14 (8, 29); group R: 14 (9, 27); group P: 23 (18, 35); group D: 30 (26, 35). Significant differences were found between groups N and P, as well as between group D and groups N, F, and R., Conclusion: Because of the significant difference between groups N and P, basis validation of the sum score was achieved. Further, self-assessments of dental appearance appeared to be more negative for participants with a depressive state compared with the other groups. In clinical studies, selection bias can be prevented by using a test that measures well-being to verify if a study sample includes a normal number of depressive subjects and therefore represents the general population.

A multi-centre randomized clinical trial is under way at 14 university dental schools in Germany to compare prosthodontic treatments for the shortened dental arch (SDA). One of the aims of this pilot-study was to measure the effect of two treatment options of the SDA on oral health-related quality of life and on the Research Diagnostic Criteria (RDC) for temporomandibular disorders (TMD). Thirty-four patients participated in the pilot-study. Inclusion criteria were: all molars were missing and the presence of at least both canines and one premolar in each quadrant. Participants were randomly assigned to receive either removable partial dentures including molar replacement (RPD&#95;group) or retain a premolar occlusion (PROC&#95;group). The Oral Health Impact Profile (OHIP-49) and the RDC for TMD were completed by participants before treatment (pre-treatment), 6 weeks (6 wks), 6 months (6m) and 12 months (12 m) after treatment. At the 12-month follow up, data of 10 women and 11 men (mean age: 62 +/- 10 years) were available. Medians of the OHIP total-scores were as follows: RPD (n = 10), 43.5 (pre-treatment), 18.2 (6 wks), 13.3 (6m), 14.7 (12 m). PROC (n = 11): 31.8 (pre-treatment), 27.1 (6 wks), 8.8 (6m), 8.3 (12 m). Significant differences were shown for RPD&#95;group between pre-treatment and 6m/12 m and for PROC&#95;group between pre-treatment and 6m. There were no significant differences between treatment groups at any time. Within each group, an improvement of life-quality was observed. No significant difference could be reported between the two therapy concepts. This may be due to the low sample size within the pilot study.