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Veterans Administration Cooperative Dental Implant Study — Comparisons between fixed partial dentures supported by blade-vent implants and removable partial dentures. Part I: Methodology and comparisons between treatment groups at baseline

Identifieur interne : 005B86 ( Istex/Checkpoint ); précédent : 005B85; suivant : 005B87

Veterans Administration Cooperative Dental Implant Study — Comparisons between fixed partial dentures supported by blade-vent implants and removable partial dentures. Part I: Methodology and comparisons between treatment groups at baseline

Auteurs : K. K. Kapur [États-Unis]

Source :

RBID : ISTEX:7D9DBBB00BD4DA61A2D2148DE50CD99568D8E52C

Descripteurs français

English descriptors

Abstract

Abstract: This study was conducted to determine whether fixed partial dentures supported by dental implants provide an acceptable alternative to conventional removable partial dentures in patients with Kennedy class I or class II edentulous conditions. The acceptability of the new treatment will be based on success rates, impact on the health of the remaining dentition, masticatory performance, patient satisfaction, and maintenance care and cost. The study was planned also to provide comparisons between two designs commonly used by dentists for fabricating removable partial dentures. The designs differed only in terms of the type of the retainer (clasp type) and tooth support (rest location).A total of 272 patients with Kennedy class I and class II edentulous conditions were assigned on a random basis to one of the treatment groups, 134 to receive a removable partial denture and 138 a fixed partial denture supported by a blade-vent implant. All of the patients were medically screened and met prespecified criteria for oral hygiene, bone support for abutment teeth, and size of the residual ridge.Thirty-four patients were eliminated from the study before completion of their treatment. An additional six patients with early implant failures were reentered in the study and followed up as a separate group. The remaining 232 patients received comprehensive dental care, including removable partial dentures for 118 and fixed partial dentures for 114 patients.A series of examinations, radiographs, masticatory performance tests, patient satisfaction, food selection questionnaires, and dietary history were completed before initiation of the treatment, 16 weeks after the insertion of an RPD or an implant, and thereafter at 6-, 18-, 36-, and 60-month intervals. In addition, patients were seen at 6-month intervals for a recall dental examination, oral prophylaxis, plaque instructions, radiographic survey of the implant, and any needed dental treatment.The randomization stratification approach produced two treatment groups with comparable age, number of remaining maxillary and mandibular teeth, type of opposing dentition, and percent of patients with Kennedy class I and class II edentulous conditions. The mean scores of bone support, tooth mobility, and sulcular depths of abutment teeth were also similar. Significant but comparable improvements in oral hygiene and sulcular depth occurred in the two groups after treatment. The periodontal health scores at the 16-week interval serve as the baseline to measure subsequent changes in periodontal health. This prospective longitudinal study with prespecified criteria for implant and removable partial denture failure should provide reliable estimates of failure rates, number and types of complications, maintenance care needs, and total costs for the two treatment modalities and the two RPD designs.

Url:
DOI: 10.1016/0022-3913(87)90283-6


Affiliations:


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ISTEX:7D9DBBB00BD4DA61A2D2148DE50CD99568D8E52C

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<name sortKey="Kapur, K K" sort="Kapur, K K" uniqKey="Kapur K" first="K. K." last="Kapur">K. K. Kapur</name>
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<term>Abutment</term>
<term>Abutment teeth</term>
<term>Abutment tooth</term>
<term>Anatomic anorganic endosteal</term>
<term>Baseline</term>
<term>Baseline interval</term>
<term>Baseline scores</term>
<term>Biomed mater</term>
<term>Biostatistician</term>
<term>Blade implants</term>
<term>Bone changes</term>
<term>Bone height</term>
<term>Bone height measurements</term>
<term>Bone support</term>
<term>Buccal</term>
<term>Buccal recession</term>
<term>Calculus</term>
<term>Calculus score</term>
<term>Clinical studies</term>
<term>Comparable improvements</term>
<term>Condition abutment</term>
<term>Cooperative studies program</term>
<term>Cooperative study</term>
<term>Data collection</term>
<term>Dent</term>
<term>Dent assoc</term>
<term>Dent clin</term>
<term>Dental endosseous implants</term>
<term>Dental examination</term>
<term>Dental implants</term>
<term>Dental materials</term>
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<term>Dental services</term>
<term>Dental treatment</term>
<term>Dentistry</term>
<term>Dentition</term>
<term>Dentition characteristics</term>
<term>Denture</term>
<term>Denture wearers</term>
<term>Distal bone heights</term>
<term>Early implant failures</term>
<term>Edentulous</term>
<term>Edentulous conditions</term>
<term>Edentulous patients</term>
<term>Edentulous ridge</term>
<term>Endosseous</term>
<term>Endosseous implants</term>
<term>Endosteal</term>
<term>Endosteal implant</term>
<term>Endosteal implants</term>
<term>Executive committee</term>
<term>Fibrous tissue</term>
<term>Final sample</term>
<term>Food selection</term>
<term>Gingival</term>
<term>Gingival inflammation</term>
<term>Gingival inflammation scores</term>
<term>Gingival recession</term>
<term>Human rights committee</term>
<term>Implant</term>
<term>Implant study</term>
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<term>Implant systems</term>
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<term>Insertion</term>
<term>Intraoral radiographs</term>
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<term>Kennedy class</term>
<term>Large number</term>
<term>Lingual</term>
<term>Lingual gingival recession</term>
<term>Lingual recession</term>
<term>Local anesthetic</term>
<term>Longitudinal</term>
<term>Longitudinal study</term>
<term>Maintenance care</term>
<term>Mandibular</term>
<term>Mandibular abutment teeth</term>
<term>Mandibular staple bone plate</term>
<term>Mandibular teeth</term>
<term>Masticatory</term>
<term>Masticatory performance</term>
<term>Masticatory performance tests</term>
<term>Maxillary</term>
<term>Maxillary arch</term>
<term>Maxillary teeth</term>
<term>Medical center</term>
<term>Medical centers</term>
<term>Metal implants</term>
<term>Neurovascular bundle involvement</term>
<term>Nonabutment teeth</term>
<term>Nonstudy patients</term>
<term>Occlusal index</term>
<term>October</term>
<term>Operations committee</term>
<term>Oral hygiene</term>
<term>Oral prophylaxis</term>
<term>Oral surg cranin</term>
<term>Ordinal scales</term>
<term>Osseointegrated implants</term>
<term>Other hand</term>
<term>Other teeth</term>
<term>Partial denture</term>
<term>Partial dentures</term>
<term>Patient satisfaction</term>
<term>Periapical radiographs</term>
<term>Periodontal</term>
<term>Periodontal health</term>
<term>Periodontal health comparisons</term>
<term>Periodontal health scores</term>
<term>Periodontal health status</term>
<term>Plaque</term>
<term>Plaque calculus gingival inflammation sulcus depth</term>
<term>Plaque control instructions</term>
<term>Plaque index</term>
<term>Plate perforation</term>
<term>Pocket depth</term>
<term>Preliminary report</term>
<term>Prespecified criteria</term>
<term>Prespecified requirements</term>
<term>Prosthesis</term>
<term>Prosthetic dentistry</term>
<term>Prosthetic dentistry table</term>
<term>Radiograph</term>
<term>Random basis</term>
<term>Removable</term>
<term>Removable prosthodontics</term>
<term>Residual</term>
<term>Residual ridge</term>
<term>Residual ridges</term>
<term>Restorative procedures</term>
<term>Sample size</term>
<term>Separate group</term>
<term>Serious complications</term>
<term>Southern california</term>
<term>Staff prosthodontist</term>
<term>Study biostatistician</term>
<term>Study chairman</term>
<term>Study group</term>
<term>Subperiosteal</term>
<term>Success rates</term>
<term>Sulcular depth</term>
<term>Sulcus</term>
<term>Sulcus depth</term>
<term>Surg</term>
<term>Surgical</term>
<term>Surgical placement</term>
<term>Table viii</term>
<term>Test foods</term>
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<term>Treatment coordinator</term>
<term>Treatment groups</term>
<term>Treatment modalities</term>
<term>Treatment procedures</term>
<term>Veterans administration</term>
</keywords>
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<term>Abutment</term>
<term>Abutment teeth</term>
<term>Abutment tooth</term>
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<term>Baseline</term>
<term>Baseline interval</term>
<term>Baseline scores</term>
<term>Biomed mater</term>
<term>Biostatistician</term>
<term>Blade implants</term>
<term>Bone changes</term>
<term>Bone height</term>
<term>Bone height measurements</term>
<term>Bone support</term>
<term>Buccal</term>
<term>Buccal recession</term>
<term>Calculus</term>
<term>Calculus score</term>
<term>Clinical studies</term>
<term>Comparable improvements</term>
<term>Condition abutment</term>
<term>Cooperative studies program</term>
<term>Cooperative study</term>
<term>Data collection</term>
<term>Dent</term>
<term>Dent assoc</term>
<term>Dent clin</term>
<term>Dental endosseous implants</term>
<term>Dental examination</term>
<term>Dental implants</term>
<term>Dental materials</term>
<term>Dental research</term>
<term>Dental services</term>
<term>Dental treatment</term>
<term>Dentistry</term>
<term>Dentition</term>
<term>Dentition characteristics</term>
<term>Denture</term>
<term>Denture wearers</term>
<term>Distal bone heights</term>
<term>Early implant failures</term>
<term>Edentulous</term>
<term>Edentulous conditions</term>
<term>Edentulous patients</term>
<term>Edentulous ridge</term>
<term>Endosseous</term>
<term>Endosseous implants</term>
<term>Endosteal</term>
<term>Endosteal implant</term>
<term>Endosteal implants</term>
<term>Executive committee</term>
<term>Fibrous tissue</term>
<term>Final sample</term>
<term>Food selection</term>
<term>Gingival</term>
<term>Gingival inflammation</term>
<term>Gingival inflammation scores</term>
<term>Gingival recession</term>
<term>Human rights committee</term>
<term>Implant</term>
<term>Implant study</term>
<term>Implant surgery</term>
<term>Implant systems</term>
<term>Inflammation</term>
<term>Insertion</term>
<term>Intraoral radiographs</term>
<term>Kapur</term>
<term>Kennedy class</term>
<term>Large number</term>
<term>Lingual</term>
<term>Lingual gingival recession</term>
<term>Lingual recession</term>
<term>Local anesthetic</term>
<term>Longitudinal</term>
<term>Longitudinal study</term>
<term>Maintenance care</term>
<term>Mandibular</term>
<term>Mandibular abutment teeth</term>
<term>Mandibular staple bone plate</term>
<term>Mandibular teeth</term>
<term>Masticatory</term>
<term>Masticatory performance</term>
<term>Masticatory performance tests</term>
<term>Maxillary</term>
<term>Maxillary arch</term>
<term>Maxillary teeth</term>
<term>Medical center</term>
<term>Medical centers</term>
<term>Metal implants</term>
<term>Neurovascular bundle involvement</term>
<term>Nonabutment teeth</term>
<term>Nonstudy patients</term>
<term>Occlusal index</term>
<term>October</term>
<term>Operations committee</term>
<term>Oral hygiene</term>
<term>Oral prophylaxis</term>
<term>Oral surg cranin</term>
<term>Ordinal scales</term>
<term>Osseointegrated implants</term>
<term>Other hand</term>
<term>Other teeth</term>
<term>Partial denture</term>
<term>Partial dentures</term>
<term>Patient satisfaction</term>
<term>Periapical radiographs</term>
<term>Periodontal</term>
<term>Periodontal health</term>
<term>Periodontal health comparisons</term>
<term>Periodontal health scores</term>
<term>Periodontal health status</term>
<term>Plaque</term>
<term>Plaque calculus gingival inflammation sulcus depth</term>
<term>Plaque control instructions</term>
<term>Plaque index</term>
<term>Plate perforation</term>
<term>Pocket depth</term>
<term>Preliminary report</term>
<term>Prespecified criteria</term>
<term>Prespecified requirements</term>
<term>Prosthesis</term>
<term>Prosthetic dentistry</term>
<term>Prosthetic dentistry table</term>
<term>Radiograph</term>
<term>Random basis</term>
<term>Removable</term>
<term>Removable prosthodontics</term>
<term>Residual</term>
<term>Residual ridge</term>
<term>Residual ridges</term>
<term>Restorative procedures</term>
<term>Sample size</term>
<term>Separate group</term>
<term>Serious complications</term>
<term>Southern california</term>
<term>Staff prosthodontist</term>
<term>Study biostatistician</term>
<term>Study chairman</term>
<term>Study group</term>
<term>Subperiosteal</term>
<term>Success rates</term>
<term>Sulcular depth</term>
<term>Sulcus</term>
<term>Sulcus depth</term>
<term>Surg</term>
<term>Surgical</term>
<term>Surgical placement</term>
<term>Table viii</term>
<term>Test foods</term>
<term>Tooth length</term>
<term>Treatment coordinator</term>
<term>Treatment groups</term>
<term>Treatment modalities</term>
<term>Treatment procedures</term>
<term>Veterans administration</term>
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<front>
<div type="abstract" xml:lang="en">Abstract: This study was conducted to determine whether fixed partial dentures supported by dental implants provide an acceptable alternative to conventional removable partial dentures in patients with Kennedy class I or class II edentulous conditions. The acceptability of the new treatment will be based on success rates, impact on the health of the remaining dentition, masticatory performance, patient satisfaction, and maintenance care and cost. The study was planned also to provide comparisons between two designs commonly used by dentists for fabricating removable partial dentures. The designs differed only in terms of the type of the retainer (clasp type) and tooth support (rest location).A total of 272 patients with Kennedy class I and class II edentulous conditions were assigned on a random basis to one of the treatment groups, 134 to receive a removable partial denture and 138 a fixed partial denture supported by a blade-vent implant. All of the patients were medically screened and met prespecified criteria for oral hygiene, bone support for abutment teeth, and size of the residual ridge.Thirty-four patients were eliminated from the study before completion of their treatment. An additional six patients with early implant failures were reentered in the study and followed up as a separate group. The remaining 232 patients received comprehensive dental care, including removable partial dentures for 118 and fixed partial dentures for 114 patients.A series of examinations, radiographs, masticatory performance tests, patient satisfaction, food selection questionnaires, and dietary history were completed before initiation of the treatment, 16 weeks after the insertion of an RPD or an implant, and thereafter at 6-, 18-, 36-, and 60-month intervals. In addition, patients were seen at 6-month intervals for a recall dental examination, oral prophylaxis, plaque instructions, radiographic survey of the implant, and any needed dental treatment.The randomization stratification approach produced two treatment groups with comparable age, number of remaining maxillary and mandibular teeth, type of opposing dentition, and percent of patients with Kennedy class I and class II edentulous conditions. The mean scores of bone support, tooth mobility, and sulcular depths of abutment teeth were also similar. Significant but comparable improvements in oral hygiene and sulcular depth occurred in the two groups after treatment. The periodontal health scores at the 16-week interval serve as the baseline to measure subsequent changes in periodontal health. This prospective longitudinal study with prespecified criteria for implant and removable partial denture failure should provide reliable estimates of failure rates, number and types of complications, maintenance care needs, and total costs for the two treatment modalities and the two RPD designs.</div>
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