Practice‐Based Evidence from 29‐Year Outcome Analysis of Management of the Edentulous Jaw Using Osseointegrated Dental Implants
Identifieur interne : 000161 ( Istex/Corpus ); précédent : 000160; suivant : 000162Practice‐Based Evidence from 29‐Year Outcome Analysis of Management of the Edentulous Jaw Using Osseointegrated Dental Implants
Auteurs : Matilda Dhima ; Vladimira Paulusova ; Christine Lohse ; Thomas J. Salinas ; Alan B. CarrSource :
- Journal of Prosthodontics [ 1059-941X ] ; 2014-04.
Abstract
The aim of this retrospective study was to summarize practice‐based evidence associated with long‐term outcomes (>20 years) in the management of edentulous patients. The patient population was managed with implant‐supported prostheses, following the original osseointegration protocol, provided over the period from 1983 to 1991 in the group prosthodontics practice at the Mayo Clinic. The data are an example of practice quality assurance monitoring and are used to refine care delivery when needed and to provide information regarding expected outcomes in a shared decision‐making interaction with prospective patients.
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DOI: 10.1111/jopr.12084
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ISTEX:2E6778876276F0D49918C14459DE3F6F9B0D35BDLe document en format XML
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Salinas</name><affiliation><mods:affiliation>Professor, Mayo Clinic College of Medicine and Consultant, Department of Dental Specialties, Division of Prosthetic and Esthetic Dentistry, Mayo Clinic, MN, Rochester</mods:affiliation></affiliation></author><author><name sortKey="Carr, Alan B" sort="Carr, Alan B" uniqKey="Carr A" first="Alan B." last="Carr">Alan B. Carr</name><affiliation><mods:affiliation>Professor, Mayo Clinic College of Medicine and Consultant, Chair, Department of Dental Specialties, Division of Prosthetic and Esthetic Dentistry, Mayo Clinic, MN, Rochester</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: carr.alan@mayo.edu</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:2E6778876276F0D49918C14459DE3F6F9B0D35BD</idno><date when="2014" year="2014">2014</date><idno type="doi">10.1111/jopr.12084</idno><idno type="url">https://api.istex.fr/document/2E6778876276F0D49918C14459DE3F6F9B0D35BD/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">000161</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000161</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main">Practice‐Based Evidence from 29‐Year Outcome Analysis of Management of the Edentulous Jaw Using Osseointegrated Dental Implants</title><author><name sortKey="Dhima, Matilda" sort="Dhima, Matilda" uniqKey="Dhima M" first="Matilda" last="Dhima">Matilda Dhima</name><affiliation><mods:affiliation>Assistant Professor, Mayo Clinic College of Medicine and Chief Resident, Prosthodontics and Maxillofacial Prosthetics, Department of Dental Specialties, Division of Prosthetic and Esthetic Dentistry, Mayo Clinic, MN, Rochester</mods:affiliation></affiliation></author><author><name sortKey="Paulusova, Vladimira" sort="Paulusova, Vladimira" uniqKey="Paulusova V" first="Vladimira" last="Paulusova">Vladimira Paulusova</name><affiliation><mods:affiliation>Assistant Professor, Department of Dentistry, Faculty of Medicine and University Hospital in Hradec Králové, Charles University, Prague, Czech Republic</mods:affiliation></affiliation></author><author><name sortKey="Lohse, Christine" sort="Lohse, Christine" uniqKey="Lohse C" first="Christine" last="Lohse">Christine Lohse</name><affiliation><mods:affiliation>Statistician, Department of Biostatistics, Mayo Clinic, MN, Rochester</mods:affiliation></affiliation></author><author><name sortKey="Salinas, Thomas J" sort="Salinas, Thomas J" uniqKey="Salinas T" first="Thomas J." last="Salinas">Thomas J. Salinas</name><affiliation><mods:affiliation>Professor, Mayo Clinic College of Medicine and Consultant, Department of Dental Specialties, Division of Prosthetic and Esthetic Dentistry, Mayo Clinic, MN, Rochester</mods:affiliation></affiliation></author><author><name sortKey="Carr, Alan B" sort="Carr, Alan B" uniqKey="Carr A" first="Alan B." last="Carr">Alan B. Carr</name><affiliation><mods:affiliation>Professor, Mayo Clinic College of Medicine and Consultant, Chair, Department of Dental Specialties, Division of Prosthetic and Esthetic Dentistry, Mayo Clinic, MN, Rochester</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: carr.alan@mayo.edu</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Journal of Prosthodontics</title><title level="j" type="alt">JOURNAL OF PROSTHODONTICS</title><idno type="ISSN">1059-941X</idno><idno type="eISSN">1532-849X</idno><imprint><biblScope unit="vol">23</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="173">173</biblScope><biblScope unit="page" to="181">181</biblScope><biblScope unit="page-count">9</biblScope><date type="published" when="2014-04">2014-04</date></imprint><idno type="ISSN">1059-941X</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1059-941X</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">The aim of this retrospective study was to summarize practice‐based evidence associated with long‐term outcomes (>20 years) in the management of edentulous patients. The patient population was managed with implant‐supported prostheses, following the original osseointegration protocol, provided over the period from 1983 to 1991 in the group prosthodontics practice at the Mayo Clinic. The data are an example of practice quality assurance monitoring and are used to refine care delivery when needed and to provide information regarding expected outcomes in a shared decision‐making interaction with prospective patients.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Matilda Dhima DMD, MS</name><affiliations><json:string>Assistant Professor, Mayo Clinic College of Medicine and Chief Resident, Prosthodontics and Maxillofacial Prosthetics, Department of Dental Specialties, Division of Prosthetic and Esthetic Dentistry, Mayo Clinic, MN, Rochester</json:string></affiliations></json:item><json:item><name>Vladimira Paulusova MD</name><affiliations><json:string>Assistant Professor, Department of Dentistry, Faculty of Medicine and University Hospital in Hradec Králové, Charles University, Prague, Czech Republic</json:string></affiliations></json:item><json:item><name>Christine Lohse MS</name><affiliations><json:string>Statistician, Department of Biostatistics, Mayo Clinic, MN, Rochester</json:string></affiliations></json:item><json:item><name>Thomas J. Salinas DDS</name><affiliations><json:string>Professor, Mayo Clinic College of Medicine and Consultant, Department of Dental Specialties, Division of Prosthetic and Esthetic Dentistry, Mayo Clinic, MN, Rochester</json:string></affiliations></json:item><json:item><name>Alan B. Carr DMD, MS</name><affiliations><json:string>Professor, Mayo Clinic College of Medicine and Consultant, Chair, Department of Dental Specialties, Division of Prosthetic and Esthetic Dentistry, Mayo Clinic, MN, Rochester</json:string><json:string>E-mail: carr.alan@mayo.edu</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Edentulous jaw</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>dental implants</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>outcome analysis</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>practice‐based evidence</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>hybrid</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>implant‐retained dental prosthesis</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>complications</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>follow‐up</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>management</value></json:item></subject><articleId><json:string>JOPR12084</json:string></articleId><arkIstex>ark:/67375/WNG-3W4T553X-T</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>The aim of this retrospective study was to summarize practice‐based evidence associated with long‐term outcomes (>20 years) in the management of edentulous patients. The patient population was managed with implant‐supported prostheses, following the original osseointegration protocol, provided over the period from 1983 to 1991 in the group prosthodontics practice at the Mayo Clinic. 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Osseointegrated Dental Implants</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Publishing Ltd</publisher><availability><licence>© 2013 by the American College of Prosthodontists</licence></availability><date type="published" when="2014-04"></date></publicationStmt><notesStmt><note type="content-type" subtype="article" source="article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="article"><analytic><title level="a" type="main">Practice‐Based Evidence from 29‐Year Outcome Analysis of Management of the Edentulous Jaw Using Osseointegrated Dental Implants</title><title level="a" type="short">Edentulous Jaw and Implants, 29‐Year Outcome Analysis</title><author xml:id="author-0000"><persName><forename type="first">Matilda</forename><surname>Dhima</surname><roleName type="degree">DMD, MS</roleName></persName><affiliation><orgName>Assistant Professor, Mayo Clinic College of Medicine and Chief Resident, Prosthodontics and Maxillofacial Prosthetics, Department of Dental Specialties, Division of Prosthetic and Esthetic Dentistry</orgName><orgName>Mayo Clinic</orgName><address><settlement type="city">Rochester</settlement><region>MN</region></address></affiliation></author><author xml:id="author-0001"><persName><forename type="first">Vladimira</forename><surname>Paulusova</surname><roleName type="degree">MD</roleName></persName><affiliation><orgName>Assistant Professor, Department of Dentistry, Faculty of Medicine and University Hospital in Hradec Králové</orgName><orgName>Charles University</orgName><address><settlement type="city">Prague</settlement><country key="CZ">Czech Republic</country></address></affiliation></author><author xml:id="author-0002"><persName><forename type="first">Christine</forename><surname>Lohse</surname><roleName type="degree">MS</roleName></persName><affiliation><orgName>Statistician, Department of Biostatistics</orgName><orgName>Mayo Clinic</orgName><address><settlement type="city">Rochester</settlement><region>MN</region></address></affiliation></author><author xml:id="author-0003"><persName><forename type="first">Thomas J.</forename><surname>Salinas</surname><roleName type="degree">DDS</roleName></persName><affiliation><orgName>Professor, Mayo Clinic College of Medicine and Consultant, Department of Dental Specialties, Division of Prosthetic and Esthetic Dentistry</orgName><orgName>Mayo Clinic</orgName><address><settlement type="city">Rochester</settlement><region>MN</region></address></affiliation></author><author xml:id="author-0004" role="corresp"><persName><forename type="first">Alan B.</forename><surname>Carr</surname><roleName type="degree">DMD, MS</roleName></persName><affiliation><orgName>Professor, Mayo Clinic College of Medicine and Consultant, Chair, Department of Dental Specialties, Division of Prosthetic and Esthetic Dentistry</orgName><orgName>Mayo Clinic</orgName><address><settlement type="city">Rochester</settlement><region>MN</region></address></affiliation><affiliation>Correspondence Alan B. Carr, DMD, MS, Mayo Clinic 200 1st St. SW, Rochester, MN 55905. E‐mail: carr.alan@mayo.edu</affiliation></author><idno type="istex">2E6778876276F0D49918C14459DE3F6F9B0D35BD</idno><idno type="ark">ark:/67375/WNG-3W4T553X-T</idno><idno type="DOI">10.1111/jopr.12084</idno><idno type="unit">JOPR12084</idno><idno type="toTypesetVersion">file:JOPR.JOPR12084.pdf</idno></analytic><monogr><title level="j" type="main">Journal of Prosthodontics</title><title level="j" type="alt">JOURNAL OF PROSTHODONTICS</title><idno type="pISSN">1059-941X</idno><idno type="eISSN">1532-849X</idno><idno type="book-DOI">10.1111/(ISSN)1532-849X</idno><idno type="book-part-DOI">10.1111/jopr.2014.23.issue-3</idno><idno type="product">JOPR</idno><imprint><biblScope unit="vol">23</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="173">173</biblScope><biblScope unit="page" to="181">181</biblScope><biblScope unit="page-count">9</biblScope><date type="published" when="2014-04"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract style="main"><head>Abstract</head>
Purpose
<p>The aim of this retrospective study was to summarize practice‐based evidence associated with long‐term outcomes (>20 years) in the management of edentulous patients. The patient population was managed with implant‐supported prostheses, following the original osseointegration protocol, provided over the period from 1983 to 1991 in the group prosthodontics practice at the Mayo Clinic. The data are an example of practice quality assurance monitoring and are used to refine care delivery when needed and to provide information regarding expected outcomes in a shared decision‐making interaction with prospective patients.</p>
Materials and Methods
<p>Two hundred and sixty four patients with at least one edentulous jaw were identified. Of these, 255 completed their care and follow‐up at the Mayo Clinic (209 mandible only, 35 maxilla only, 11 mandible and maxilla). Prosthodontic outcomes categorized as anticipated or unanticipated prosthetic and biologic events and the respective interventions required for each were recorded to assess follow‐up event dynamics for this care modality.</p>
Results
<p>The mean duration of follow‐up for 190 of the 255 patients (65 died at a mean follow‐up of 12.6 years) was 13.0 years (median 13.6; range 0.3 to 28). At least one prosthetic event was experienced by 148 patients (58%), and 81 (32%) experienced at least one biologic event. Overall, patients experienced 3.8 times more prosthetic events than biologic events. Twenty‐four (9%) patients experienced 35 implant failures. Overall survival rates at 20 years were 86% for prostheses, 15% survived free of any event, and 92% experienced survival free of implant failure (95% confidence interval).</p>
Conclusion
<p>Anticipated and unanticipated prosthetic events occur throughout the life of the hybrid prosthesis. Prosthetic events significantly surpass (four times more) biologic events and occur significantly later in the follow‐up. For this patient group, 8.6% (22/255) had implant‐supported prostheses remade during follow‐up in this patient population. These findings support the recommendation that prosthodontic care for missing teeth be thought of in a “chronic condition” context, recognizing that long‐term outcome monitoring to provide realistic care expectations is important for demonstrating care value in oral health promotion.</p></abstract><textClass><keywords><term xml:id="jopr12084-kwd-0001">Edentulous jaw</term><term xml:id="jopr12084-kwd-0002">dental implants</term><term xml:id="jopr12084-kwd-0003">outcome analysis</term><term xml:id="jopr12084-kwd-0004">practice‐based evidence</term><term xml:id="jopr12084-kwd-0005">hybrid</term><term xml:id="jopr12084-kwd-0006">implant‐retained dental prosthesis</term><term xml:id="jopr12084-kwd-0007">complications</term><term xml:id="jopr12084-kwd-0008">follow‐up</term><term xml:id="jopr12084-kwd-0009">management</term></keywords><keywords rend="articleCategory"><term>Original Article</term></keywords><keywords rend="tocHeading1"><term>Original Articles</term></keywords></textClass><langUsage><language ident="en"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en" xml:id="JOPR12084"><header><publicationMeta level="product"><doi origin="wiley" registered="yes">10.1111/(ISSN)1532-849X</doi><issn type="print">1059-941X</issn><issn type="electronic">1532-849X</issn><idGroup><id type="product" value="JOPR"></id></idGroup><titleGroup><title type="main" sort="JOURNAL OF PROSTHODONTICS">Journal of Prosthodontics</title><title type="short">Journal of Prosthodontics</title></titleGroup></publicationMeta><publicationMeta level="part" position="04103"><doi>10.1111/jopr.2014.23.issue-3</doi><copyright ownership="thirdParty">© 2014 American College of Prosthodontists</copyright><numberingGroup><numbering type="journalVolume" number="23">23</numbering><numbering type="journalIssue">3</numbering></numberingGroup><coverDate startDate="2014-04">April 2014</coverDate></publicationMeta><publicationMeta level="unit" position="10" type="article" status="forIssue"><doi origin="wiley">10.1111/jopr.12084</doi><idGroup><id type="unit" value="JOPR12084"></id></idGroup><countGroup><count type="pageTotal" number="9"></count></countGroup><titleGroup><title type="articleCategory">Original Article</title><title type="tocHeading1">Original Articles</title></titleGroup><copyright ownership="thirdParty">© 2013 by the American College of Prosthodontists</copyright><eventGroup><event type="manuscriptAccepted" date="2013-04-27"></event><event type="xmlCreated" agent="Aptara" date="2013-06-17"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.3.0 mode:FullText" date="2014-04-16"></event><event type="publishedOnlineEarlyUnpaginated" date="2013-07-26"></event><event type="firstOnline" date="2013-07-26"></event><event type="publishedOnlineFinalForm" date="2014-04-16"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.6.4 mode:FullText" date="2015-10-07"></event></eventGroup><numberingGroup><numbering type="pageFirst">173</numbering><numbering type="pageLast">181</numbering></numberingGroup><correspondenceTo><b>Correspondence</b> Alan B. Carr, DMD, MS, Mayo Clinic 200 1st St. SW, Rochester, MN 55905. E‐mail: <email>carr.alan@mayo.edu</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:JOPR.JOPR12084.pdf"></link></linkGroup></publicationMeta><contentMeta><titleGroup><title type="main">Practice‐Based Evidence from 29‐Year Outcome Analysis of Management of the Edentulous Jaw Using Osseointegrated Dental Implants</title><title type="shortAuthors">Dhima <i>et al</i></title><title type="short">Edentulous Jaw and Implants, 29‐Year Outcome Analysis</title></titleGroup><creators><creator xml:id="jopr12084-cr-0001" creatorRole="author" affiliationRef="#jopr12084-aff-0001"><personName><givenNames>Matilda</givenNames><familyName>Dhima</familyName><degrees>DMD, MS</degrees></personName></creator><creator xml:id="jopr12084-cr-0002" creatorRole="author" affiliationRef="#jopr12084-aff-0002"><personName><givenNames>Vladimira</givenNames><familyName>Paulusova</familyName><degrees>MD</degrees></personName></creator><creator xml:id="jopr12084-cr-0003" creatorRole="author" affiliationRef="#jopr12084-aff-0003"><personName><givenNames>Christine</givenNames><familyName>Lohse</familyName><degrees>MS</degrees></personName></creator><creator xml:id="jopr12084-cr-0004" creatorRole="author" affiliationRef="#jopr12084-aff-0004"><personName><givenNames>Thomas J.</givenNames><familyName>Salinas</familyName><degrees>DDS</degrees></personName></creator><creator xml:id="jopr12084-cr-0005" creatorRole="author" affiliationRef="#jopr12084-aff-0005" corresponding="yes"><personName><givenNames>Alan B.</givenNames><familyName>Carr</familyName><degrees>DMD, MS</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="jopr12084-aff-0001"><orgDiv>Assistant Professor, Mayo Clinic College of Medicine and Chief Resident, Prosthodontics and Maxillofacial Prosthetics, Department of Dental Specialties, Division of Prosthetic and Esthetic Dentistry</orgDiv><orgName>Mayo Clinic</orgName><address><city>Rochester</city><countryPart>MN</countryPart></address></affiliation><affiliation xml:id="jopr12084-aff-0002" countryCode="CZ"><orgDiv>Assistant Professor, Department of Dentistry, Faculty of Medicine and University Hospital in Hradec Králové</orgDiv><orgName>Charles University</orgName><address><city>Prague</city><country>Czech Republic</country></address></affiliation><affiliation xml:id="jopr12084-aff-0003"><orgDiv>Statistician, Department of Biostatistics</orgDiv><orgName>Mayo Clinic</orgName><address><city>Rochester</city><countryPart>MN</countryPart></address></affiliation><affiliation xml:id="jopr12084-aff-0004"><orgDiv>Professor, Mayo Clinic College of Medicine and Consultant, Department of Dental Specialties, Division of Prosthetic and Esthetic Dentistry</orgDiv><orgName>Mayo Clinic</orgName><address><city>Rochester</city><countryPart>MN</countryPart></address></affiliation><affiliation xml:id="jopr12084-aff-0005"><orgDiv>Professor, Mayo Clinic College of Medicine and Consultant, Chair, Department of Dental Specialties, Division of Prosthetic and Esthetic Dentistry</orgDiv><orgName>Mayo Clinic</orgName><address><city>Rochester</city><countryPart>MN</countryPart></address></affiliation></affiliationGroup><keywordGroup type="author"><keyword xml:id="jopr12084-kwd-0001">Edentulous jaw</keyword><keyword xml:id="jopr12084-kwd-0002">dental implants</keyword><keyword xml:id="jopr12084-kwd-0003">outcome analysis</keyword><keyword xml:id="jopr12084-kwd-0004">practice‐based evidence</keyword><keyword xml:id="jopr12084-kwd-0005">hybrid</keyword><keyword xml:id="jopr12084-kwd-0006">implant‐retained dental prosthesis</keyword><keyword xml:id="jopr12084-kwd-0007">complications</keyword><keyword xml:id="jopr12084-kwd-0008">follow‐up</keyword><keyword xml:id="jopr12084-kwd-0009">management</keyword></keywordGroup><abstractGroup><abstract type="main"><title type="main">Abstract</title><section xml:id="jopr12084-sec-0010"><title type="main">Purpose</title><p>The aim of this retrospective study was to summarize practice‐based evidence associated with long‐term outcomes (>20 years) in the management of edentulous patients. The patient population was managed with implant‐supported prostheses, following the original osseointegration protocol, provided over the period from 1983 to 1991 in the group prosthodontics practice at the Mayo Clinic. The data are an example of practice quality assurance monitoring and are used to refine care delivery when needed and to provide information regarding expected outcomes in a shared decision‐making interaction with prospective patients.</p></section><section xml:id="jopr12084-sec-0020"><title type="main">Materials and Methods</title><p>Two hundred and sixty four patients with at least one edentulous jaw were identified. Of these, 255 completed their care and follow‐up at the Mayo Clinic (209 mandible only, 35 maxilla only, 11 mandible and maxilla). Prosthodontic outcomes categorized as anticipated or unanticipated prosthetic and biologic events and the respective interventions required for each were recorded to assess follow‐up event dynamics for this care modality.</p></section><section xml:id="jopr12084-sec-0030"><title type="main">Results</title><p>The mean duration of follow‐up for 190 of the 255 patients (65 died at a mean follow‐up of 12.6 years) was 13.0 years (median 13.6; range 0.3 to 28). At least one prosthetic event was experienced by 148 patients (58%), and 81 (32%) experienced at least one biologic event. Overall, patients experienced 3.8 times more prosthetic events than biologic events. Twenty‐four (9%) patients experienced 35 implant failures. Overall survival rates at 20 years were 86% for prostheses, 15% survived free of any event, and 92% experienced survival free of implant failure (95% confidence interval).</p></section><section xml:id="jopr12084-sec-0040"><title type="main">Conclusion</title><p>Anticipated and unanticipated prosthetic events occur throughout the life of the hybrid prosthesis. Prosthetic events significantly surpass (four times more) biologic events and occur significantly later in the follow‐up. For this patient group, 8.6% (22/255) had implant‐supported prostheses remade during follow‐up in this patient population. These findings support the recommendation that prosthodontic care for missing teeth be thought of in a “chronic condition” context, recognizing that long‐term outcome monitoring to provide realistic care expectations is important for demonstrating care value in oral health promotion.</p></section></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="jopr12084-note-0001" numbered="no"><p><i>The findings of this manuscript were presented at the American College of Prosthodontists Annual Session, Baltimore, Maryland 2012</i>.</p></note><note xml:id="jopr12084-note-0002" numbered="no"><p><i>The authors deny any conflicts of interest</i>.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Practice‐Based Evidence from 29‐Year Outcome Analysis of Management of the Edentulous Jaw Using Osseointegrated Dental Implants</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Edentulous Jaw and Implants, 29‐Year Outcome Analysis</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Practice‐Based Evidence from 29‐Year Outcome Analysis of Management of the Edentulous Jaw Using Osseointegrated Dental Implants</title></titleInfo><name type="personal"><namePart type="given">Matilda</namePart><namePart type="family">Dhima</namePart><namePart type="termsOfAddress">DMD, MS</namePart><affiliation>Assistant Professor, Mayo Clinic College of Medicine and Chief Resident, Prosthodontics and Maxillofacial Prosthetics, Department of Dental Specialties, Division of Prosthetic and Esthetic Dentistry, Mayo Clinic, MN, Rochester</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Vladimira</namePart><namePart type="family">Paulusova</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Assistant Professor, Department of Dentistry, Faculty of Medicine and University Hospital in Hradec Králové, Charles University, Prague, Czech Republic</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Christine</namePart><namePart type="family">Lohse</namePart><namePart type="termsOfAddress">MS</namePart><affiliation>Statistician, Department of Biostatistics, Mayo Clinic, MN, Rochester</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Thomas J.</namePart><namePart type="family">Salinas</namePart><namePart type="termsOfAddress">DDS</namePart><affiliation>Professor, Mayo Clinic College of Medicine and Consultant, Department of Dental Specialties, Division of Prosthetic and Esthetic Dentistry, Mayo Clinic, MN, Rochester</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Alan B.</namePart><namePart type="family">Carr</namePart><namePart type="termsOfAddress">DMD, MS</namePart><affiliation>Professor, Mayo Clinic College of Medicine and Consultant, Chair, Department of Dental Specialties, Division of Prosthetic and Esthetic Dentistry, Mayo Clinic, MN, Rochester</affiliation><affiliation>E-mail: carr.alan@mayo.edu</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><dateIssued encoding="w3cdtf">2014-04</dateIssued><dateCreated encoding="w3cdtf">2013-06-17</dateCreated><dateValid encoding="w3cdtf">2013-04-27</dateValid><copyrightDate encoding="w3cdtf">2014</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><abstract>The aim of this retrospective study was to summarize practice‐based evidence associated with long‐term outcomes (>20 years) in the management of edentulous patients. The patient population was managed with implant‐supported prostheses, following the original osseointegration protocol, provided over the period from 1983 to 1991 in the group prosthodontics practice at the Mayo Clinic. The data are an example of practice quality assurance monitoring and are used to refine care delivery when needed and to provide information regarding expected outcomes in a shared decision‐making interaction with prospective patients.</abstract><abstract>Two hundred and sixty four patients with at least one edentulous jaw were identified. Of these, 255 completed their care and follow‐up at the Mayo Clinic (209 mandible only, 35 maxilla only, 11 mandible and maxilla). Prosthodontic outcomes categorized as anticipated or unanticipated prosthetic and biologic events and the respective interventions required for each were recorded to assess follow‐up event dynamics for this care modality.</abstract><abstract>The mean duration of follow‐up for 190 of the 255 patients (65 died at a mean follow‐up of 12.6 years) was 13.0 years (median 13.6; range 0.3 to 28). At least one prosthetic event was experienced by 148 patients (58%), and 81 (32%) experienced at least one biologic event. Overall, patients experienced 3.8 times more prosthetic events than biologic events. Twenty‐four (9%) patients experienced 35 implant failures. Overall survival rates at 20 years were 86% for prostheses, 15% survived free of any event, and 92% experienced survival free of implant failure (95% confidence interval).</abstract><abstract>Anticipated and unanticipated prosthetic events occur throughout the life of the hybrid prosthesis. Prosthetic events significantly surpass (four times more) biologic events and occur significantly later in the follow‐up. For this patient group, 8.6% (22/255) had implant‐supported prostheses remade during follow‐up in this patient population. These findings support the recommendation that prosthodontic care for missing teeth be thought of in a “chronic condition” context, recognizing that long‐term outcome monitoring to provide realistic care expectations is important for demonstrating care value in oral health promotion.</abstract><subject><genre>keywords</genre><topic>Edentulous jaw</topic><topic>dental implants</topic><topic>outcome analysis</topic><topic>practice‐based evidence</topic><topic>hybrid</topic><topic>implant‐retained dental prosthesis</topic><topic>complications</topic><topic>follow‐up</topic><topic>management</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Prosthodontics</title></titleInfo><titleInfo type="abbreviated"><title>Journal of Prosthodontics</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><subject><genre>article-category</genre><topic>Original Article</topic></subject><identifier type="ISSN">1059-941X</identifier><identifier type="eISSN">1532-849X</identifier><identifier type="DOI">10.1111/(ISSN)1532-849X</identifier><identifier type="PublisherID">JOPR</identifier><part><date>2014</date><detail type="volume"><caption>vol.</caption><number>23</number></detail><detail type="issue"><caption>no.</caption><number>3</number></detail><extent unit="pages"><start>173</start><end>181</end><total>9</total></extent></part></relatedItem><identifier type="istex">2E6778876276F0D49918C14459DE3F6F9B0D35BD</identifier><identifier type="ark">ark:/67375/WNG-3W4T553X-T</identifier><identifier type="DOI">10.1111/jopr.12084</identifier><identifier type="ArticleID">JOPR12084</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2014 American College of Prosthodontists© 2013 by the American College of Prosthodontists</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-L0C46X92-X">wiley</recordContentSource></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/document/2E6778876276F0D49918C14459DE3F6F9B0D35BD/metadata/json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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