The economics of complete dentures and implant-related services: A framework for analysis and preliminary outcomes
Identifieur interne : 005F62 ( Istex/Corpus ); précédent : 005F61; suivant : 005F63The economics of complete dentures and implant-related services: A framework for analysis and preliminary outcomes
Auteurs : Michael I. Macentee ; Joanne N. WaltonSource :
- The Journal of Prosthetic Dentistry [ 0022-3913 ] ; 1998.
English descriptors
- KwdEn :
- Acrylic resin, Acta psychiatr scand, Bone density, British columbia, Clinical evaluation, Clinical study, Clinical treatment, Community dent, Complete denture, Complete denture wearers, Complete dentures, Conventional denture, Conventional dentures, Dent, Dent assoc, Dental implants, Dentistry, Denture, Denture therapy, Denturist, Dietary selection, Economic measures, Edentulous, Edentulous jaws, Edentulous mandible, Edentulous maxilla, Edentulous patients, Effectiveness studies, Efficacy trials, Endosseous implants, Financial costs, Health care, Implant, Implant prosthesis, Longitudinal study, Macentee, Management strategy, Mandibular, Mandibular overdentures, Mandibular prostheses, Masticatory function, Maxillary bone resorption, Maxillofac, Natural teeth, Oral disorders, Oral health, Oral implants, Oral maxillofac implants, Oral maxillofac surg, Oral status, Orofacial image, Osseointegrated, Osseointegrated implants, Overdentures, Patient satisfaction, Physiologic, Physiologic costs, Prosthesis, Prosthet, Prosthet dent, Prosthetic, Prosthetic dentistry, Prosthetic dentistry macentee, Prosthodontic treatment, Psychometric measures, Psychosocial, Psychosocial costs, Psychosocial measures, Public health, Quantitative methods, Randomized trial, Removable, Removable overdenture, Resorption, Retrospective, Retrospective study, Sage publications, Sickness impact profile, Specific outcomes, Tooth loss, Transmandibular implant.
- Teeft :
- Acrylic resin, Acta psychiatr scand, Bone density, British columbia, Clinical evaluation, Clinical study, Clinical treatment, Community dent, Complete denture, Complete denture wearers, Complete dentures, Conventional denture, Conventional dentures, Dent, Dent assoc, Dental implants, Dentistry, Denture, Denture therapy, Denturist, Dietary selection, Economic measures, Edentulous, Edentulous jaws, Edentulous mandible, Edentulous maxilla, Edentulous patients, Effectiveness studies, Efficacy trials, Endosseous implants, Financial costs, Health care, Implant, Implant prosthesis, Longitudinal study, Macentee, Management strategy, Mandibular, Mandibular overdentures, Mandibular prostheses, Masticatory function, Maxillary bone resorption, Maxillofac, Natural teeth, Oral disorders, Oral health, Oral implants, Oral maxillofac implants, Oral maxillofac surg, Oral status, Orofacial image, Osseointegrated, Osseointegrated implants, Overdentures, Patient satisfaction, Physiologic, Physiologic costs, Prosthesis, Prosthet, Prosthet dent, Prosthetic, Prosthetic dentistry, Prosthetic dentistry macentee, Prosthodontic treatment, Psychometric measures, Psychosocial, Psychosocial costs, Psychosocial measures, Public health, Quantitative methods, Randomized trial, Removable, Removable overdenture, Resorption, Retrospective, Retrospective study, Sage publications, Sickness impact profile, Specific outcomes, Tooth loss, Transmandibular implant.
Abstract
Abstract: It is not always clear that the implant-prosthesis offers distinct advantages over the conventional complete denture for managing the edentulous jaw. This article discusses the measurement, distribution, impact, and management of the edentulous jaw, and describes a framework for analyzing the economic costs and benefits associated with the conventional denture and the implant prosthesis. There are physiologic and psychosocial costs and benefits to both the conventional denture and the implant prosthesis, which indicates that neither method is distinctly superior. The physiologic costs are low and the psychosocial costs are similar for both treatments, whereas the direct financial costs associated with the implant prosthesis are substantially higher. (J Prosthet Dent 1998;79:24-30.)
Url:
DOI: 10.1016/S0022-3913(98)70189-1
Links to Exploration step
ISTEX:C00DC3D55889DB74234DE5FD320E1107CC2A31A5Le document en format XML
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There are physiologic and psychosocial costs and benefits to both the conventional denture and the implant prosthesis, which indicates that neither method is distinctly superior. The physiologic costs are low and the psychosocial costs are similar for both treatments, whereas the direct financial costs associated with the implant prosthesis are substantially higher. 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MacEntee, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, CANADA</note><note>10/1/86945</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">The economics of complete dentures and implant-related services: A framework for analysis and preliminary outcomes</title><author xml:id="author-0000"><persName><forename type="first">Michael I.</forename><surname>MacEntee</surname></persName><roleName type="degree">PhD, FRCD(C),a</roleName><affiliation>Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Joanne N.</forename><surname>Walton</surname></persName><roleName type="degree">DDS, FRCD(C)b</roleName><affiliation>Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada</affiliation></author><idno type="istex">C00DC3D55889DB74234DE5FD320E1107CC2A31A5</idno><idno type="DOI">10.1016/S0022-3913(98)70189-1</idno><idno type="PII">S0022-3913(98)70189-1</idno></analytic><monogr><title level="j">The Journal of Prosthetic Dentistry</title><title level="j" type="abbrev">YMPR</title><idno type="pISSN">0022-3913</idno><idno type="PII">S0022-3913(05)X7048-2</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1998"></date><biblScope unit="volume">79</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="24">24</biblScope><biblScope unit="page" to="30">30</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1998</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>It is not always clear that the implant-prosthesis offers distinct advantages over the conventional complete denture for managing the edentulous jaw. This article discusses the measurement, distribution, impact, and management of the edentulous jaw, and describes a framework for analyzing the economic costs and benefits associated with the conventional denture and the implant prosthesis. There are physiologic and psychosocial costs and benefits to both the conventional denture and the implant prosthesis, which indicates that neither method is distinctly superior. The physiologic costs are low and the psychosocial costs are similar for both treatments, whereas the direct financial costs associated with the implant prosthesis are substantially higher. (J Prosthet Dent 1998;79:24-30.)</p></abstract></profileDesc><revisionDesc><change when="1998">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/C00DC3D55889DB74234DE5FD320E1107CC2A31A5/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier doc found" wicri:toSee="Elsevier, no converted or simple article"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 5.0.1//EN//XML" URI="art501.dtd" name="istex:docType"><istex:entity SYSTEM="gr1" NDATA="IMAGE" name="gr1"></istex:entity></istex:docType><istex:document><article docsubtype="fla" xml:lang="en"><item-info><jid>YMPR</jid><aid>86945</aid><ce:pii>S0022-3913(98)70189-1</ce:pii><ce:doi>10.1016/S0022-3913(98)70189-1</ce:doi><ce:copyright type="other" year="1998">Editorial Council of The Journal of Prosthetic Dentistry.</ce:copyright></item-info><head><ce:article-footnote><ce:label>☆</ce:label><ce:note-para>Supported by the British Columbia Medical Services Foundation and the National Health Research Development Programme of Canada.</ce:note-para></ce:article-footnote><ce:article-footnote><ce:label>☆☆</ce:label><ce:note-para><ce:sup>a</ce:sup>Professor and Chair, Division of Prosthodontics.</ce:note-para></ce:article-footnote><ce:article-footnote><ce:label>★</ce:label><ce:note-para><ce:sup>b</ce:sup>Associate Professor, Division of Prosthodontics.</ce:note-para></ce:article-footnote><ce:article-footnote><ce:label>★★</ce:label><ce:note-para>Reprint requests: Dr. Michael I. MacEntee, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, CANADA</ce:note-para></ce:article-footnote><ce:article-footnote><ce:label>♢</ce:label><ce:note-para><ce:bold>10/1/86945</ce:bold></ce:note-para></ce:article-footnote><ce:title>The economics of complete dentures and implant-related services: A framework for analysis and preliminary outcomes</ce:title><ce:presented>Presented at the annual meeting of the Academy of Prosthodontics, Halifax, Nova Scotia, Canada, May 1997.</ce:presented><ce:author-group><ce:author><ce:given-name>Michael I.</ce:given-name><ce:surname>MacEntee</ce:surname><ce:degrees>PhD, FRCD(C),<ce:sup>a</ce:sup></ce:degrees></ce:author><ce:author><ce:given-name>Joanne N.</ce:given-name><ce:surname>Walton</ce:surname><ce:degrees>DDS, FRCD(C)<ce:sup>b</ce:sup></ce:degrees></ce:author><ce:affiliation><ce:textfn>Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada</ce:textfn></ce:affiliation></ce:author-group><ce:abstract><ce:section-title>Abstract</ce:section-title><ce:abstract-sec><ce:simple-para>It is not always clear that the implant-prosthesis offers distinct advantages over the conventional complete denture for managing the edentulous jaw. This article discusses the measurement, distribution, impact, and management of the edentulous jaw, and describes a framework for analyzing the economic costs and benefits associated with the conventional denture and the implant prosthesis. There are physiologic and psychosocial costs and benefits to both the conventional denture and the implant prosthesis, which indicates that neither method is distinctly superior. The physiologic costs are low and the psychosocial costs are similar for both treatments, whereas the direct financial costs associated with the implant prosthesis are substantially higher. (J Prosthet Dent 1998;79:24-30.)</ce:simple-para></ce:abstract-sec></ce:abstract></head><body><ce:sections><ce:para>The long-term success and widespread acceptance of endosseous oral implants have changed the practice of prosthodontics over the last quarter of a century by offering patients a reasonably predictable alternative to the conventional mucosally supported complete denture. The growth of this service is unprecedented in dentistry. In the United States alone, between 1986 and 1990, there has been at least a 50% expansion in the number of dentists offering implant-related treatment, and about a 275% increase in the number of implants placed in the jaws.<ce:cross-ref refid="bib1"><ce:sup>1</ce:sup></ce:cross-ref></ce:para><ce:para>There is a large body of evidence showing that implants usually integrate securely and indefinitely in bone to support either fixed or removable prostheses,<ce:cross-refs refid="bib2 bib3"><ce:sup>2,3</ce:sup></ce:cross-refs> but there is little information about the economic impact of this treatment compared with the conventional complete denture. In this article, the economy of the implant-prosthesis (IP) as an alternative to the conventional complete denture will be evaluated. At the outset, the more commonly used economic measures used in healthcare are explained and identified. Secondly, tooth loss and denture therapy within the context of a framework supporting our knowledge of clinical diseases and disorders will be explored. And lastly, from an economic perspective involving physiologic and psychosocial measures, the implant-related treatment will be contrasted with the conventional denture.</ce:para><ce:section><ce:section-title>Economic Measures</ce:section-title><ce:para>Cost-effectiveness, cost-benefit, and cost-utility are used widely to measure and compare the costs and benefits of alternative treatments.<ce:cross-ref refid="bib4"><ce:sup>4</ce:sup></ce:cross-ref></ce:para><ce:para>Cost-effectiveness is a limited measure that contrasts different therapies against very specific outcomes. The Sickness Impact Profile in medical sociology<ce:cross-ref refid="bib5"><ce:sup>5</ce:sup></ce:cross-ref> and the decayed, missing, and filled teeth (DMF) index in dentistry<ce:cross-refs refid="bib6 bib7 bib8"><ce:sup>6-8</ce:sup></ce:cross-refs> are examples of specific outcomes used to measure the impact of functional handicap in general, and of caries in particular.</ce:para><ce:para>Cost-benefit measurement usually includes physiologic and psychosocial impacts. It is used to compare a patient's preference or "willingness-to-pay" for different treatments, and it has been used in dentistry to analyze the value of perioprostheses<ce:cross-ref refid="bib9"><ce:sup>9</ce:sup></ce:cross-ref> and of dental implants.<ce:cross-ref refid="bib10"><ce:sup>10</ce:sup></ce:cross-ref> A patient's willingness is demonstrated by various actions such as improved oral hygiene or acceptance of fluoride in the water supply. It can be expressed also in a survey questionnaire or an interview. Surveys are the most popular media for exploring health-related beliefs and behaviors, despite the fact that considerable bias can be introduced by misleading, ambiguous, or inappropriate questions.<ce:cross-ref refid="bib11"><ce:sup>11</ce:sup></ce:cross-ref></ce:para><ce:para>Cost-utility refers to a broader or multidimensional perspective on treatment. It attempts to address the limitations of the cost-effectiveness measure by analyzing both the quantity and quality of treatment. Cost-effectiveness considers only a reduction in the number of complaints, but a measure of cost-utility may also include an assessment of the nature or quality of the complaints. Recently, there is an emerging interest in developing measures capable of addressing the impact of health or disease on quality of life; however, the psychometric measures used currently for this purpose in dental research are very insensitive.<ce:cross-ref refid="bib11"><ce:sup>11</ce:sup></ce:cross-ref> Fortunately, there are other methods of determining the impact of treatment on quality of life.</ce:para><ce:section><ce:section-title>A framework for investigation</ce:section-title><ce:para>Measurement, distribution, impact, and management are the four foundations to the framework supporting our knowledge of clinical disease and disorder: One cannot report reliably on the distribution of a disorder if it cannot be measured. One also cannot appreciate the full impact of the disorder without data on its distribution, and, lastly, we are ill-equipped to initiate a management strategy without knowing how it will impact on a person or a society. Our knowledge of tooth loss and denture therapy will be explored within the context of these four foundations because they all influence a broad economic perspective of the conventional prosthesis and the IP.</ce:para></ce:section><ce:section><ce:section-title>Measurement</ce:section-title><ce:para><ce:bold><ce:italic>Physical measures.</ce:italic></ce:bold> Measurement of tooth loss or the edentulous condition in a population poses little difficulty if the task is simply to count missing teeth, but there are substantial problems when one attempts to measure or evaluate the quantity or quality of the residual ridges. It is known that alveolar bone resorbs when teeth are extracted and that the resorption is more rapid in the mandible than in the maxilla,<ce:cross-ref refid="bib12"><ce:sup>12</ce:sup></ce:cross-ref> yet variations in bone form, bone density, and resorption patterns within persons are less clearly understood.<ce:cross-refs refid="bib13 bib14"><ce:sup>13,14</ce:sup></ce:cross-refs></ce:para><ce:para><ce:bold><ce:italic>Psychosocial measures.</ce:italic></ce:bold> How are the patients' perceptions and expectations measured? The problems increase when an attempt is made to measure the significance of complaints from denture wearers. Although instructions are available for appraising the appearance, mastication, speech, supporting mucosa, and security of a denture,<ce:cross-ref refid="bib15"><ce:sup>15</ce:sup></ce:cross-ref> the practical implications of the appraisals remain controversial.<ce:cross-ref refid="bib16"><ce:sup>16</ce:sup></ce:cross-ref> Research on psychosocial behavior can be viewed from two methodologic perspectives. From one point of view, there are quantitative or psychometric methods, and from the other there are qualitative or "real life" methods.<ce:cross-ref refid="bib17"><ce:sup>17</ce:sup></ce:cross-ref> Quantitative methods aided by statistical tests of causal relationships are suitable for measuring the impact of specific interventions or to testing predetermined hypotheses. Qualitative methods, in contrast, seek to discover and explain behaviors and beliefs. Most of the investigations of dentally related beliefs and behaviors have used survey responses based on quantitative methods to collect and analyze psychometric data. Several techniques, such as the visual analog scale, are available for improving the reliability of responses<ce:cross-refs refid="bib18 bib19"><ce:sup>18,19</ce:sup></ce:cross-refs>; nonetheless, the value of the measure or scale depends solely on the validity of the question that generates the measured response.<ce:cross-ref refid="bib11"><ce:sup>11</ce:sup></ce:cross-ref> Although a structured interview can isolate subjective feelings if the questions offer a multidimensional response, this is possible only if the investigator knows in advance all the choices that the respondent is likely to select.<ce:cross-ref refid="bib20"><ce:sup>20</ce:sup></ce:cross-ref> There is mounting evidence that structured interviews and questionnaires can be misleading, especially when there are cultural and social barriers between the investigator and the subjects,<ce:cross-ref refid="bib21"><ce:sup>21</ce:sup></ce:cross-ref> whereas the unstructured interview can serve as a penetrating probe when used in a disciplined and accountable manner.<ce:cross-refs refid="bib11 bib22 bib23"><ce:sup>11,22,23</ce:sup></ce:cross-refs> Therefore, when investigators have limited information on their subjects, they should use less structured interviews to explore beliefs and behaviors.</ce:para></ce:section><ce:section><ce:section-title>Distribution</ce:section-title><ce:para>Currently, approximately 16% of the Canadian population have no natural teeth, and regional variations in this distribution range from 14% in British Columbia to 27% in Quebec.<ce:cross-ref refid="bib24"><ce:sup>24</ce:sup></ce:cross-ref> It is encouraging to find that the number of people losing all their natural teeth has decreased substantially in most industrialized societies over the last 25 years. In the United States, for instance, the edentulous rate has dropped from 46% of the population in the early 1970s to 28% at the beginning of the 1990s.<ce:cross-refs refid="bib25 bib26"><ce:sup>25,26</ce:sup></ce:cross-refs> The impact of this decrease in tooth loss is obvious also in data collected from populations over 65 years of age where edentulous rates range from 29% in Norway to 69% in Britain.<ce:cross-ref refid="bib27"><ce:sup>27</ce:sup></ce:cross-ref> Although these figures indicate a desire to retain natural teeth for life, the fact remains that three of four elders in Vancouver, B.C., have at least one edentulous jaw.<ce:cross-ref refid="bib28"><ce:sup>28</ce:sup></ce:cross-ref> Moreover, one can extrapolate from current life expectancy measures that every general dentist in North America could have responsibility well into the next century for about 200 elderly patients, each with one or two edentulous jaws. It is also noteworthy that less affluent members of society are particularly prone to have teeth extracted,<ce:cross-ref refid="bib29"><ce:sup>29</ce:sup></ce:cross-ref> which will probably favor the less expensive treatments for tooth loss. Therefore it is reasonable to conclude that the need and demand for complete dentures will remain constant for a considerable time even in countries with sophisticated dental services.</ce:para></ce:section><ce:section><ce:section-title>Impact</ce:section-title><ce:para>There are conflicting opinions on the personal or social impact of oral disorders. Tooth loss has been described at one extreme as little more than a chronic indisposition,<ce:cross-ref refid="bib30"><ce:sup>30</ce:sup></ce:cross-ref> and at the other as a handicap that can cause significant anxiety and social isolation.<ce:cross-refs refid="bib31 bib32 bib33"><ce:sup>31-33</ce:sup></ce:cross-refs> These extremes are due in large part, no doubt, to the insensitivity of the psychometric measures currently available for assessing quality of life. Oral health is experienced by persons within the context of the three interacting themes of (1) comfort, (2) hygiene, and (3) health, and the adaptive ability of elderly denture wearers is enhanced by the company of peers who accept tooth loss as the norm and denture discomfort with resignation.<ce:cross-ref refid="bib34"><ce:sup>34</ce:sup></ce:cross-ref> It is not so certain that older age groups in the future will adapt so readily to dentures when alternative treatments are readily accessible and tooth loss is the exception rather than the rule.</ce:para></ce:section><ce:section><ce:section-title>Management</ce:section-title><ce:para>Safety, efficacy, effectiveness, and outcomes are the four themes that influence the management strategy for tooth loss.<ce:cross-ref refid="bib35"><ce:sup>35</ce:sup></ce:cross-ref></ce:para><ce:para><ce:bold><ce:italic>Safety.</ce:italic></ce:bold> The long history of complete dentures, from wood or ivory to acrylic resin, attests to the safety of conventional complete dentures. Continuous pressure from a denture base, especially if it is ill-fitting, structurally defective, or infected, can induce a low grade inflammation in the supporting mucosa and in the underlying bone.<ce:cross-refs refid="bib36 bib37 bib38"><ce:sup>36-38</ce:sup></ce:cross-refs> However, there is no evidence that the inflammation is either irreversible or serious.<ce:cross-ref refid="bib39"><ce:sup>39</ce:sup></ce:cross-ref> More recently, the use of titanium implants has been supported by a very creditable array of biologic tests and clinical trials, with the overwhelming conclusion that they pose minimal risk to the recipients when used judiciously and appropriately.<ce:cross-refs refid="bib40 bib41 bib42 bib43"><ce:sup>40-43</ce:sup></ce:cross-refs> There are reports of altered sensations due to residual nerve damage after placement of mandibular implants,<ce:cross-ref refid="bib44"><ce:sup>44</ce:sup></ce:cross-ref> and of technical difficulties associated with the prostheses placed on the implants.<ce:cross-ref refid="bib45"><ce:sup>45</ce:sup></ce:cross-ref> Nonetheless, the IP appears to be a reasonably safe alternative to the conventional denture, if rendered with appropriate skill and care.<ce:cross-ref refid="bib46"><ce:sup>46</ce:sup></ce:cross-ref></ce:para><ce:para><ce:bold><ce:italic>Efficacy.</ce:italic></ce:bold> The objective of an efficacy trial is to assess the benefits of treatment under ideal conditions when all the intervening variables are under optimal control, usually by means of a randomized trial and a long-term prospective clinical investigation. Although the complete denture has never been subjected to the rigors of a randomized trial, the efficacy of this treatment is not in doubt. In fact, the early dental literature was intimately entwined with the clinical evaluation of various denture techniques, albeit in a haphazard and inefficient way. Therefore we can conclude that the conventional denture will restore acceptable oral function and appearance for most patients. Titanium oral implant, in glaring contrast, has been subjected to a plethora of reasonably well-controlled and long-term prospective investigations with supportive results. However, it is only recently that similar attention has been given to the efficacy of the prosthesis supported by implants.<ce:cross-ref refid="bib18"><ce:sup>18</ce:sup></ce:cross-ref></ce:para><ce:para><ce:bold><ce:italic>Effectiveness.</ce:italic></ce:bold> The next step in the structured evaluation of a new treatment is to measure clinical performance or effectiveness in the "real" world. Again, it is reasonable to conclude that the conventional complete denture has been tested extensively for more than a century and that it is an effective prosthesis, although with definite limitations.<ce:cross-ref refid="bib47"><ce:sup>47</ce:sup></ce:cross-ref></ce:para><ce:para>Retrospective and prospective studies focused on implants have for the most part been conducted in academic clinics with rigorous control.<ce:cross-refs refid="bib48 bib49 bib50 bib51 bib52 bib53 bib54 bib55 bib56 bib57 bib58 bib59 bib60"><ce:sup>48-60</ce:sup></ce:cross-refs> Consequently, they are efficacy rather than effectiveness studies. In fact, it is not so certain in research reports on oral implants where the efficacy trials end and the community-based effectiveness studies begin. Much less is known about the IP within the ordinary routine of daily life where patients and dentists are unbiased by the research environment. Although we do not wish to be unfairly pessimistic about the effectiveness of prostheses supported by implants, we believe that the outcome of treatment could be less predictable than the efficacy trials suggest.</ce:para><ce:para><ce:bold><ce:italic>Outcomes.</ce:italic></ce:bold> The outcome of treatment expressed as costs and benefits can be explored from both a physiologic and a psychosocial perspective (Fig. 1).
<ce:display><ce:figure><ce:label>Fig. 1</ce:label><ce:caption><ce:simple-para>Factors pertinent to outcome analysis of clinical treatment.</ce:simple-para></ce:caption> <ce:link locator="gr1"></ce:link></ce:figure></ce:display>Mortality is not a term that is associated with conventional dentures, which easily leads to the belief that dentures are benign prostheses resting passively on the gums! Actually, the expansion of dental services worldwide owes much to the prevalence of this belief within the general public and among political legislators.<ce:cross-ref refid="bib61"><ce:sup>61</ce:sup></ce:cross-ref> Similarly, the current enthusiasm for oral implants has led some influential politicians or their advisors to view treatments that involve prostheses on implants as appropriate to the capabilities of a denturist,<ce:cross-ref refid="bib62"><ce:sup>62</ce:sup></ce:cross-ref> notwithstanding the possibility that endosseous implants could be harmful systematically.<ce:cross-ref refid="bib63"><ce:sup>63</ce:sup></ce:cross-ref> It is true also that morbidity has been low in the controlled clinical environment of the retrospective and prospective trials involving the IP; however, it is equally true that efficacy rather than effectiveness has been the outcome of these trials.<ce:cross-ref refid="bib35"><ce:sup>35</ce:sup></ce:cross-ref> Therefore caution along with additional community-based investigations are needed before we can determine with any certainty the extent of morbidity we can expect from the IP.</ce:para><ce:para>There is widespread belief that function and productivity play a central role in the psychosocial theory of health.<ce:cross-ref refid="bib64"><ce:sup>64</ce:sup></ce:cross-ref> This functional theory dominates the structure of psychometric instruments, where illness disrupts a patient's ability to function productively in society, and a clinician serves to restore the patient to full productivity.<ce:cross-ref refid="bib65"><ce:sup>65</ce:sup></ce:cross-ref> It has been influential in studies of oral health where the outcome of treatment is aimed at a complete recovery of oral function and appearance.<ce:cross-ref refid="bib11"><ce:sup>11</ce:sup></ce:cross-ref> However, measurement of treatment against this ideal is far from realistic. It does not acknowledge that patients rarely recover fully from tooth loss, and it does not allow for the likelihood that patients will adapt without much concern to the chronic impairment or disability associated with conventional dentures.<ce:cross-ref refid="bib34"><ce:sup>34</ce:sup></ce:cross-ref> In our opinion, this lack of realism probably explains why multivariate models with sophisticated statistics explain so little of human behavior or belief relating to oral health.<ce:cross-ref refid="bib11"><ce:sup>11</ce:sup></ce:cross-ref> It is suggested as an alternative to psychometry that a more qualitative assessment of a patient's and a clinician's expectations and abilities, including consideration of the impact on quality of life, should be central to a full economic assessment of the costs and benefits of implant-related treatments.</ce:para></ce:section></ce:section><ce:section><ce:section-title>An Economic Analysis</ce:section-title><ce:para>This framework involving the physiologic and psychosocial measures previously described provides a medium for comparing the economics of the conventional complete denture with the IP.</ce:para><ce:section><ce:section-title>Physiologic analysis</ce:section-title><ce:para><ce:bold><ce:italic>Mastication.</ce:italic></ce:bold> Chewing efficiency has served as a measure of success relating closely to the function of dentures. Indeed, the possibility of providing a solid foundation to enhance mastication is one of the most appealing expectations from oral implants, and efficacy trials indicate clearly that this expectation is attainable.<ce:cross-refs refid="bib66 bib67 bib68"><ce:sup>66-68</ce:sup></ce:cross-refs> Apparently, it matters little to mastication or even to comfort whether the IP is designed as fixed partial dentures or as a removable overdenture, at least when the overdenture is supported by a rigid bar.<ce:cross-ref refid="bib69"><ce:sup>69</ce:sup></ce:cross-ref> Moreover, in one longitudinal study over 10 years, chewing efficiency and bite force did increase initially when a mandibular IP was replaced by a conventional denture, but there was no further improvement when an IP replaced the opposing maxillary denture.<ce:cross-ref refid="bib19"><ce:sup>19</ce:sup></ce:cross-ref></ce:para><ce:para><ce:bold><ce:italic>Bone resorption.</ce:italic></ce:bold> The influence of the conventional denture or the IP on the remaining alveolar bone is unclear. There is some concern that an edentulous maxilla opposed by an IP is at greater risk to resorption.<ce:cross-refs refid="bib70 bib71"><ce:sup>70,71</ce:sup></ce:cross-refs> There is also the conflicting observation that the resorption of bone in the edentulous maxilla is less pronounced when the opposing conventional denture is replaced by an IP.<ce:cross-ref refid="bib72"><ce:sup>72</ce:sup></ce:cross-ref> The explanation offered for this surprising observation is that a mandibular conventional denture may be less stable and therefore more stressful than the IP to bone underlying the maxillary denture. Other reports have raised the possibility that implants will stimulate bone deposition much like teeth,<ce:cross-refs refid="bib73 bib74"><ce:sup>73,74</ce:sup></ce:cross-refs> but the results are quite speculative and far from conclusive. So, in all, we do not know what impact either prosthesis has on bone resorption.</ce:para></ce:section><ce:section><ce:section-title>Psychosocial analysis</ce:section-title><ce:para><ce:bold><ce:italic>Satisfaction.</ce:italic></ce:bold> The motivation to obtain implants is usually spurred by the discomfort, insecurity, and overall dissatisfaction with conventional dentures. Therefore it should come as no surprise to learn that the IP is perceived almost unanimously as much more satisfying to use than the conventional denture,<ce:cross-refs refid="bib49 bib75 bib76 bib77 bib78"><ce:sup>49,75-78</ce:sup></ce:cross-refs> apparently because it feels like an integral part of the body.<ce:cross-ref refid="bib79"><ce:sup>79</ce:sup></ce:cross-ref> There is the possibility, of course, that a subject who compares a conventional denture with an IP after surgery will be biased by "retrospective justification," due to the expense and effort associated with the implants, but this is unlikely to be a major bias considering the widespread enthusiasm for the IP.<ce:cross-ref refid="bib51"><ce:sup>51</ce:sup></ce:cross-ref></ce:para></ce:section><ce:section><ce:section-title>Dietary selection</ce:section-title><ce:para>The ability to chew more effectively is possible with an IP, as mentioned previously, but there is good evidence that the diet does not change significantly when a conventional denture is replaced by an IP.<ce:cross-refs refid="bib80 bib81"><ce:sup>80,81</ce:sup></ce:cross-refs> Therefore there is little justification for informing a patient that the use of implants will improve health generally through a better diet. However, further research on health promotion may find that the use of implants will encourage patients to adopt a more nutritious diet.</ce:para><ce:para><ce:bold><ce:italic>Orofacial image.</ce:italic></ce:bold> It is possible that persons who seek implants to support their dentures are more extroverted than those who are content with conventional dentures,<ce:cross-ref refid="bib51"><ce:sup>51</ce:sup></ce:cross-ref> although it does seem that the body image of patients with conventional dentures is similar to the image of those with dentures supported by implants.<ce:cross-ref refid="bib82"><ce:sup>82</ce:sup></ce:cross-ref> Again, we believe that this apparent conflict is due to the limitations of the psychometric measures used to solicit information on orofacial image. In any event, there is no serious doubt that the mouth is a core feature of overall appearance, both personally and socially. Consequently, any prosthesis that improves appearance should enhance a person's orofacial image. This reality is highlighted most aptly in a comment from an elderly woman who believed that "if you've got nice teeth, you've got half the battle won for sure. Take a look at your ads.on TV or in the paper or almost anything. There's usually a nice looking girl.smiling a bright smile. It's very important. That's the first thing that catches your eye."<ce:cross-ref refid="bib34"><ce:sup>34</ce:sup></ce:cross-ref> Both the conventional denture and the IP can look natural, although occasionally the location of the endosseous implants will disturb the natural location and arrangement of the artificial teeth on the prosthesis.</ce:para><ce:para><ce:bold><ce:italic>Financial implications.</ce:italic></ce:bold> All indicators point to the fact that implants are expensive and accessible predominantly to persons with higher than average incomes.<ce:cross-ref refid="bib77"><ce:sup>77</ce:sup></ce:cross-ref> Indeed, denturists justify the conventional denture services that they provide currently in Canada,<ce:cross-ref refid="bib83"><ce:sup>83</ce:sup></ce:cross-ref> and the services involving the IP that they want to provide,<ce:cross-ref refid="bib62"><ce:sup>62</ce:sup></ce:cross-ref> with a plea for fair competition in the professional market. Estimates from data supplied by insurance carriers suggest that dentists and denturists during 1996 in British Columbia were paid about $8.5 million(Can) ($1 US = $1.3 CAN) for conventional complete denture services (Table I).
<ce:display><ce:table colsep="0" rowsep="0" frame="topbot"><ce:label>Table I</ce:label><ce:caption><ce:simple-para>Estimated insurance-based income from conventional complete dentures in British Columbia 1996</ce:simple-para></ce:caption><tgroup cols="7"><colspec colname="col1" colsep="0"></colspec><colspec colname="col2" colsep="0"></colspec><colspec colname="col3" colsep="0"></colspec><colspec colname="col4" colsep="0"></colspec><colspec colname="col5" colsep="0"></colspec><colspec colname="col6" colsep="0"></colspec><colspec colname="col7" colsep="0"></colspec><thead><row rowsep="1"><entry valign="bottom" colsep="1"></entry><entry namest="col2" nameend="col3" align="center" valign="bottom" colsep="1">Dentists (<ce:italic>n</ce:italic> = 2160)</entry><entry colname="col4" align="center" valign="bottom" colsep="1"></entry><entry align="center" valign="bottom" colsep="1"></entry><entry valign="bottom" colsep="1">Denturists (<ce:italic>n</ce:italic> = 200)</entry><entry align="center" valign="bottom"></entry></row><row rowsep="1"><entry valign="bottom" colsep="1"></entry><entry align="center" valign="bottom" colsep="1"></entry><entry namest="col3" nameend="col4" align="center" valign="bottom" colsep="1">Income</entry><entry colname="col5" align="center" valign="bottom" colsep="1"></entry><entry namest="col6" nameend="col7" align="center" valign="bottom">Income</entry></row><row rowsep="1" valign="bottom"><entry colsep="1"></entry><entry align="center" colsep="1">(Cost/denture)</entry><entry align="center" colsep="1">Total</entry><entry align="center" colsep="1">Each</entry><entry align="center" colsep="1">(Cost/denture)</entry><entry align="center" colsep="1">Total</entry><entry align="center">Each</entry></row></thead><tbody><row rowsep="1"><entry colsep="1">Complete denture</entry><entry align="center" colsep="1">($630)</entry><entry align="center" colsep="1">$439,740</entry><entry align="center" colsep="1">$204</entry><entry align="center" colsep="1">($470)</entry><entry align="center" colsep="1">$6,891,140</entry><entry align="center">$34,455</entry></row><row rowsep="1"><entry colsep="1">Immediate complete denture</entry><entry align="center" colsep="1">($635)</entry><entry align="center" colsep="1">$401,955</entry><entry align="center" colsep="1">$186</entry><entry align="center" colsep="1">($546)</entry><entry align="center" colsep="1">$733,278</entry><entry align="center">$3,666</entry></row><row><entry colsep="1">All</entry><entry align="center" colsep="1"></entry><entry align="center" colsep="1">$841,695</entry><entry align="center" colsep="1">$390</entry><entry align="center" colsep="1"></entry><entry align="center" colsep="1">$7,624,418</entry><entry align="center">$38,121</entry></row></tbody></tgroup></ce:table></ce:display>On the basis of the fact that only 58% of the population in British Columbia had dental insurance in 1990,<ce:cross-ref refid="bib24"><ce:sup>24</ce:sup></ce:cross-ref> and on the likelihood that the population without insurance is older, less affluent, and more in need of dentures, it is estimated further that the total professional income from conventional complete dentures alone shared by a population of 2160 dentists and 200 denturists in 1996 exceeded $13 million(Can). It is worth noting also that the income was directed overwhelmingly toward the relatively small number of denturists, indicating that they have been very successful in this market.</ce:para><ce:para>A similar distribution of services between dentists and denturists has been reported from Alberta, along with the information that 21% of the dentures made by denturists, but only 7% of the dentures made by dentists, were replaced every 5 years.<ce:cross-ref refid="bib84"><ce:sup>84</ce:sup></ce:cross-ref> Whether or not this indicates that the dentists are providing a more durable service warrants further research. The impact of denturists on implant-related services remains to be seen, but it is reasonable to assume from past experiences that it will be significant.</ce:para><ce:para>The amount of clinical time required to insert and maintain an IP can range from 43 to 58 hours.<ce:cross-ref refid="bib85"><ce:sup>85</ce:sup></ce:cross-ref> Previous analysis of prosthodontic practices in Vancouver, B.C., has shown that the clinical costs associated with IP are approximately two thirds to three quarters higher than nonclinical costs.<ce:cross-ref refid="bib86"><ce:sup>86</ce:sup></ce:cross-ref> It seems that a prosthesis fixed to five implants is more than twice the cost of a removable overdenture supported by two implants, and approximately 17 times more expensive than a conventional denture (Table II).
<ce:display><ce:table colsep="0" rowsep="0" frame="topbot"><ce:label>Table II</ce:label><ce:caption><ce:simple-para>Relative financial costs* of inserting a conventional denture and an implant-prosthesis</ce:simple-para></ce:caption><tgroup cols="7"><colspec colname="col1" colsep="0"></colspec><colspec colname="col2" colsep="0"></colspec><colspec colname="col3" colsep="0"></colspec><colspec colname="col4" colsep="0"></colspec><colspec colname="col5" colsep="0"></colspec><colspec colname="col6" colsep="0"></colspec><colspec colname="col7" colsep="0"></colspec><thead><row rowsep="1"><entry valign="bottom" colsep="1"></entry><entry namest="col2" nameend="col7" align="center" valign="bottom">Expenses</entry></row><row rowsep="1" valign="bottom"><entry colsep="1"></entry><entry align="center" colsep="1">Components</entry><entry align="center" colsep="1">Laboratory</entry><entry align="center" colsep="1">Clinic</entry><entry align="center" colsep="1">Surgery</entry><entry align="center" colsep="1">Total</entry><entry align="center">Ratio</entry></row></thead><tbody><row rowsep="1"><entry colsep="1">Conventional denture</entry><entry align="center" colsep="1">—</entry><entry align="center" colsep="1">$270</entry><entry align="center" colsep="1">$480</entry><entry align="center" colsep="1">—</entry><entry align="center" colsep="1">$750</entry><entry align="center">1</entry></row><row rowsep="1"><entry namest="col1" nameend="col7">Implant-prosthesis</entry></row><row rowsep="1"><entry colsep="1">Removable†</entry><entry align="center" colsep="1">$569</entry><entry align="center" colsep="1">$469</entry><entry align="center" colsep="1">$1,235</entry><entry align="center" colsep="1">$3,000</entry><entry align="center" colsep="1">$5,363</entry><entry align="center">7</entry></row><row rowsep="1"><entry colsep="1">Fixed‡</entry><entry align="center" colsep="1">$800</entry><entry align="center" colsep="1">$1,236</entry><entry align="center" colsep="1">$3,254</entry><entry align="center" colsep="1">$7,500</entry><entry align="center" colsep="1">$12,790</entry><entry align="center">17</entry></row><row><entry namest="col1" nameend="col7"></entry></row></tbody></tgroup><ce:legend><ce:simple-para>*Based on material and data in Walton et al.<ce:sup>86</ce:sup></ce:simple-para><ce:simple-para>†Removable = 2 implants.</ce:simple-para><ce:simple-para>‡Fixed = 5 implants</ce:simple-para></ce:legend></ce:table></ce:display>Extending these estimates to determine the overall cost of inserting, maintaining, and replacing a prostheses over a 12-year period, it is suggested that the fixed IP is about twice the cost of the removable IP and about 10 times the cost of the conventional denture (Table III).
<ce:display><ce:table colsep="0" rowsep="0" frame="topbot"><ce:label>Table III</ce:label><ce:caption><ce:simple-para>An estimate of the financial costs* associated with a conventional and an implant-prosthesis over 12 years</ce:simple-para></ce:caption><tgroup cols="6"><colspec colname="col1" colsep="0"></colspec><colspec colname="col2" colsep="0"></colspec><colspec colname="col3" colsep="0"></colspec><colspec colname="col4" colsep="0"></colspec><colspec colname="col5" colsep="0"></colspec><colspec colname="col6" colsep="0"></colspec><thead><row rowsep="1"><entry valign="bottom" colsep="1"></entry><entry namest="col2" nameend="col6" valign="bottom">Expenses per year</entry></row></thead><tbody><row rowsep="1"><entry colsep="1"></entry><entry colsep="1">0</entry><entry colsep="1">4</entry><entry colsep="1">8</entry><entry colsep="1">12</entry><entry></entry></row><row rowsep="1"><entry colsep="1"></entry><entry align="center" colsep="1">New treatment</entry><entry align="center" colsep="1">Reline I</entry><entry align="center" colsep="1">Reline II</entry><entry align="center" colsep="1">New treatment</entry><entry align="center">Total</entry></row><row rowsep="1"><entry colsep="1">Conventional</entry><entry colsep="1">$750</entry><entry colsep="1">$250</entry><entry colsep="1">$270</entry><entry colsep="1">$950</entry><entry>$2,220</entry></row><row rowsep="1"><entry namest="col1" nameend="col6">Implant-prostheses</entry></row><row rowsep="1"><entry colsep="1">Removable</entry><entry colsep="1">$6,000†</entry><entry colsep="1">$250</entry><entry colsep="1">$270</entry><entry colsep="1">$3,805</entry><entry>$10,325</entry></row><row rowsep="1"><entry colsep="1">Fixed</entry><entry colsep="1">$13,000†</entry><entry colsep="1"></entry><entry colsep="1"></entry><entry colsep="1">$7,609</entry><entry>$20,609</entry></row><row><entry namest="col1" nameend="col6"></entry></row></tbody></tgroup><ce:legend><ce:simple-para>*Cost based on 2% annual increase.</ce:simple-para><ce:simple-para>†Including surgery: Removable = 2 implants; fixed = 5 implants.</ce:simple-para></ce:legend></ce:table></ce:display>The assumptions underlying this estimate are that the conventional denture and the overdenture will need a processed relining of the base on two occasions, and that all the prostheses (but not the implants) will be replaced in the twelfth year.</ce:para></ce:section></ce:section><ce:section><ce:section-title>Conclusions</ce:section-title><ce:para><ce:list><ce:list-item><ce:label>1.</ce:label><ce:para>The analytical framework provided in this article offers a comprehensive physiologic and psychosocial base for assessing the economics of clinical treatment.</ce:para></ce:list-item><ce:list-item><ce:label>2.</ce:label><ce:para>The physiologic costs of conventional and implant-supported dentures are low; whereas, the psychosocial costs are similar for both designs.</ce:para></ce:list-item><ce:list-item><ce:label>3.</ce:label><ce:para>The financial costs associated with the IP are between 5 and 12 times more expensive than the costs associated with the conventional denture.</ce:para></ce:list-item></ce:list></ce:para></ce:section></ce:sections></body><tail><ce:bibliography><ce:section-title>References</ce:section-title><ce:bibliography-sec><ce:bib-reference id="bib1"><ce:label>1</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>N</ce:given-name><ce:surname>Stillman</ce:surname></sb:author><sb:author><ce:given-name>CW.</ce:given-name><ce:surname>Douglass</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>The developing market for dental implants</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Am Dent Assoc</sb:maintitle></sb:title><sb:volume-nr>124</sb:volume-nr></sb:series><sb:date>1993</sb:date></sb:issue><sb:pages><sb:first-page>51</sb:first-page><sb:last-page>56</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib2"><ce:label>2</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>R</ce:given-name><ce:surname>Adell</ce:surname></sb:author><sb:author><ce:given-name>B</ce:given-name><ce:surname>Eriksson</ce:surname></sb:author><sb:author><ce:given-name>U</ce:given-name><ce:surname>Lekholm</ce:surname></sb:author><sb:author><ce:given-name>PI</ce:given-name><ce:surname>Brånemark</ce:surname></sb:author><sb:author><ce:given-name>T.</ce:given-name><ce:surname>Jemt</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>A long-term follow-up study of osseointegrated implants in the treatment of totally edentulous jaws</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Oral Maxillofac Implants</sb:maintitle></sb:title><sb:volume-nr>5</sb:volume-nr></sb:series><sb:date>1990</sb:date></sb:issue><sb:pages><sb:first-page>347</sb:first-page><sb:last-page>359</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib3"><ce:label>3</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>T</ce:given-name><ce:surname>Jemt</ce:surname></sb:author><sb:author><ce:given-name>J</ce:given-name><ce:surname>Chai</ce:surname></sb:author><sb:author><ce:given-name>J</ce:given-name><ce:surname>Harnett</ce:surname></sb:author><sb:author><ce:given-name>MR</ce:given-name><ce:surname>Heath</ce:surname></sb:author><sb:author><ce:given-name>JE</ce:given-name><ce:surname>Hutton</ce:surname></sb:author><sb:author><ce:given-name>RB</ce:given-name><ce:surname>Johns</ce:surname></sb:author><sb:et-al></sb:et-al></sb:authors><sb:title><sb:maintitle>A 5-year prospective multicenter follow-up report on overdentures supported by osseointegrated implants</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Oral Maxillofac Implants</sb:maintitle></sb:title><sb:volume-nr>11</sb:volume-nr></sb:series><sb:date>1996</sb:date></sb:issue><sb:pages><sb:first-page>291</sb:first-page><sb:last-page>298</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib4"><ce:label>4</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>M</ce:given-name><ce:surname>Johannesson</ce:surname></sb:author><sb:author><ce:given-name>B</ce:given-name><ce:surname>Jonsson</ce:surname></sb:author><sb:author><ce:given-name>G.</ce:given-name><ce:surname>Karlsson</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Outcome measurement in economic evaluation</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Health Econ</sb:maintitle></sb:title><sb:volume-nr>5</sb:volume-nr></sb:series><sb:date>1996</sb:date></sb:issue><sb:pages><sb:first-page>279</sb:first-page><sb:last-page>296</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib5"><ce:label>5</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>BS</ce:given-name><ce:surname>Gilson</ce:surname></sb:author><sb:author><ce:given-name>JS</ce:given-name><ce:surname>Gilson</ce:surname></sb:author><sb:author><ce:given-name>M</ce:given-name><ce:surname>Bergner</ce:surname></sb:author><sb:author><ce:given-name>RA</ce:given-name><ce:surname>Bobbit</ce:surname></sb:author><sb:author><ce:given-name>S</ce:given-name><ce:surname>Kressel</ce:surname></sb:author><sb:author><ce:given-name>WE</ce:given-name><ce:surname>Pollard</ce:surname></sb:author><sb:et-al></sb:et-al></sb:authors><sb:title><sb:maintitle>The Sickness Impact Profile. Development of an outcome measure of health care</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Am J Public Health</sb:maintitle></sb:title><sb:volume-nr>65</sb:volume-nr></sb:series><sb:date>1975</sb:date></sb:issue><sb:pages><sb:first-page>1304</sb:first-page><sb:last-page>1310</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib6"><ce:label>6</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>H</ce:given-name><ce:surname>Klein</ce:surname></sb:author><sb:author><ce:given-name>CE</ce:given-name><ce:surname>Palmer</ce:surname></sb:author><sb:author><ce:given-name>JW.</ce:given-name><ce:surname>Knutson</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Studies on dental caries: dental status and dental needs of elementary school children</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Public Health Rep</sb:maintitle></sb:title><sb:volume-nr>53</sb:volume-nr></sb:series><sb:date>1938</sb:date></sb:issue><sb:pages><sb:first-page>751</sb:first-page><sb:last-page>765</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib7"><ce:label>7</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>B.</ce:given-name><ce:surname>Klock</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Economic aspects of a caries preventive program</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Community Dent Oral Epidemiol</sb:maintitle></sb:title><sb:volume-nr>8</sb:volume-nr></sb:series><sb:date>1980</sb:date></sb:issue><sb:pages><sb:first-page>97</sb:first-page><sb:last-page>102</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib8"><ce:label>8</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>LC</ce:given-name><ce:surname>Niessen</ce:surname></sb:author><sb:author><ce:given-name>CW.</ce:given-name><ce:surname>Douglass</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Theoretical considerations in applying benefit-cost and cost-effectiveness analyses to preventive dental programs</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Public Health Dent</sb:maintitle></sb:title><sb:volume-nr>44</sb:volume-nr></sb:series><sb:date>1984</sb:date></sb:issue><sb:pages><sb:first-page>156</sb:first-page><sb:last-page>168</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib9"><ce:label>9</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>G</ce:given-name><ce:surname>Karlsson</ce:surname></sb:author><sb:author><ce:given-name>A</ce:given-name><ce:surname>Teiwik</ce:surname></sb:author><sb:author><ce:given-name>A</ce:given-name><ce:surname>Lundstrom</ce:surname></sb:author><sb:author><ce:given-name>N.</ce:given-name><ce:surname>Ravald</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Costs of periodontal and prosthodontic treatment and evaluation of oral health in patients after treatment of advanced periodontal disease</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Community Dent Oral Epidemiol</sb:maintitle></sb:title><sb:volume-nr>23</sb:volume-nr></sb:series><sb:date>1995</sb:date></sb:issue><sb:pages><sb:first-page>159</sb:first-page><sb:last-page>164</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib10"><ce:label>10</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>B</ce:given-name><ce:surname>Jonsson</ce:surname></sb:author><sb:author><ce:given-name>G.</ce:given-name><ce:surname>Karlsson</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Cost-benefit evaluation of dental implants</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Int J Technol Assess Health Care</sb:maintitle></sb:title><sb:volume-nr>6</sb:volume-nr></sb:series><sb:date>1990</sb:date></sb:issue><sb:pages><sb:first-page>545</sb:first-page><sb:last-page>557</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib11"><ce:label>11</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>MI.</ce:given-name><ce:surname>MacEntee</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Measuring the impact of oral health in old age: a qualitative reaction to some quantitative views</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Gerodontol</sb:maintitle></sb:title><sb:volume-nr>13</sb:volume-nr></sb:series><sb:date>1996</sb:date></sb:issue><sb:pages><sb:first-page>76</sb:first-page><sb:last-page>81</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib12"><ce:label>12</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>A.</ce:given-name><ce:surname>Tallgren</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>The continuing reduction of the residual alveolar ridges in complete denture wearers: a mixed-longitudinal study covering 25 years</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Prosthet Dent</sb:maintitle></sb:title><sb:volume-nr>27</sb:volume-nr></sb:series><sb:date>1972</sb:date></sb:issue><sb:pages><sb:first-page>120</sb:first-page><sb:last-page>132</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib13"><ce:label>13</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>AP.</ce:given-name><ce:surname>Esteves</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>The relationship between systemic metabolism and the structure and deposition of human jaw bone. A thesis submitted in partial fulfillment of the requirements for the degree of MSc</sb:maintitle></sb:title></sb:contribution><sb:host><sb:book><sb:date>1994</sb:date><sb:publisher><sb:name>The University of British Columbia</sb:name><sb:location>Vancouver</sb:location></sb:publisher></sb:book></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib14"><ce:label>14</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>E.</ce:given-name><ce:surname>Klemetti</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>A review of residual ridge resorption and bone density</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Prosthet Dent</sb:maintitle></sb:title><sb:volume-nr>75</sb:volume-nr></sb:series><sb:date>1996</sb:date></sb:issue><sb:pages><sb:first-page>512</sb:first-page><sb:last-page>514</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib15"><ce:label>15</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:surname>World Health Organization</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Oral health surveys, basic methods</sb:maintitle></sb:title></sb:contribution><sb:host><sb:edited-book><sb:edition>2nd ed</sb:edition><sb:date>1977</sb:date><sb:publisher><sb:name>WHO</sb:name><sb:location>Geneva</sb:location></sb:publisher></sb:edited-book><sb:pages><sb:first-page>47</sb:first-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib16"><ce:label>16</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>SR.</ce:given-name><ce:surname>Gordon</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Measurement of oral status and treatment need among subjects with dental prostheses: are the measures less reliable than the prostheses? Part I: oral status in removable prosthodontics</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Prosthet Dent</sb:maintitle></sb:title><sb:volume-nr>65</sb:volume-nr></sb:series><sb:date>1991</sb:date></sb:issue><sb:pages><sb:first-page>664</sb:first-page><sb:last-page>668</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib17"><ce:label>17</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>MQ.</ce:given-name><ce:surname>Patton</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Qualitative evaluation and research methods</sb:maintitle></sb:title></sb:contribution><sb:host><sb:book><sb:edition>2nd ed</sb:edition><sb:date>1990</sb:date><sb:publisher><sb:name>Sage Publications</sb:name><sb:location>Newbury Park</sb:location></sb:publisher></sb:book></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib18"><ce:label>18</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>JS</ce:given-name><ce:surname>Feine</ce:surname></sb:author><sb:author><ce:given-name>P</ce:given-name><ce:surname>de Grandmont</ce:surname></sb:author><sb:author><ce:given-name>P</ce:given-name><ce:surname>Boudrias</ce:surname></sb:author><sb:author><ce:given-name>N</ce:given-name><ce:surname>Brien</ce:surname></sb:author><sb:author><ce:given-name>C</ce:given-name><ce:surname>LaMarche</ce:surname></sb:author><sb:author><ce:given-name>R</ce:given-name><ce:surname>Tache</ce:surname></sb:author><sb:et-al></sb:et-al></sb:authors><sb:title><sb:maintitle>Within-subject comparisons of implant-supported mandibular prostheses: choice of prosthesis</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Dent Res</sb:maintitle></sb:title><sb:volume-nr>73</sb:volume-nr></sb:series><sb:date>1994</sb:date></sb:issue><sb:pages><sb:first-page>1105</sb:first-page><sb:last-page>1111</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib19"><ce:label>19</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>GE</ce:given-name><ce:surname>Carlsson</ce:surname></sb:author><sb:author><ce:given-name>LW.</ce:given-name><ce:surname>Lindquist</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Ten-year longitudinal study of masticatory function in edentulous patients treated with fixed complete dentures on osseointegrated implants</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Int J Prosthodont</sb:maintitle></sb:title><sb:volume-nr>7</sb:volume-nr></sb:series><sb:date>1994</sb:date></sb:issue><sb:pages><sb:first-page>448</sb:first-page><sb:last-page>453</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib20"><ce:label>20</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>M</ce:given-name><ce:surname>Ruggeri</ce:surname></sb:author><sb:author><ce:given-name>R</ce:given-name><ce:surname>Dall'Agnola</ce:surname></sb:author><sb:author><ce:given-name>C</ce:given-name><ce:surname>Agostini</ce:surname></sb:author><sb:author><ce:given-name>G.</ce:given-name><ce:surname>Bisoffi</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Acceptability, sensitivity and content validity of the VECS and VSSS in measuring expectations and satisfaction in psychiatric patients and their relatives</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Soc Psychiatry Psychiatr Epidemiol</sb:maintitle></sb:title><sb:volume-nr>29</sb:volume-nr></sb:series><sb:date>1994</sb:date></sb:issue><sb:pages><sb:first-page>265</sb:first-page><sb:last-page>276</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib21"><ce:label>21</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>L</ce:given-name><ce:surname>Stone</ce:surname></sb:author><sb:author><ce:given-name>JG.</ce:given-name><ce:surname>Campbell</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>The use and misuse of surveys in international development: an experiment from Nepal</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Human Org</sb:maintitle></sb:title><sb:volume-nr>43</sb:volume-nr></sb:series><sb:date>1984</sb:date></sb:issue><sb:pages><sb:first-page>27</sb:first-page><sb:last-page>37</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib22"><ce:label>22</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>YS</ce:given-name><ce:surname>Lincoln</ce:surname></sb:author><sb:author><ce:given-name>EG.</ce:given-name><ce:surname>Guba</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Naturalistic inquiry</sb:maintitle></sb:title></sb:contribution><sb:comment>Chapter 11</sb:comment><sb:host><sb:book><sb:date>1985</sb:date><sb:publisher><sb:name>Sage Publications</sb:name><sb:location>Beverly Hills</sb:location></sb:publisher></sb:book></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib23"><ce:label>23</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>A</ce:given-name><ce:surname>Steckler</ce:surname></sb:author><sb:author><ce:given-name>KR</ce:given-name><ce:surname>McLeroy</ce:surname></sb:author><sb:author><ce:given-name>RM</ce:given-name><ce:surname>Goodman</ce:surname></sb:author><sb:author><ce:given-name>ST</ce:given-name><ce:surname>Bird</ce:surname></sb:author><sb:author><ce:given-name>L.</ce:given-name><ce:surname>McCormick</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Toward integrating qualitative and quantitative methods: an introduction</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Health Educ Q</sb:maintitle></sb:title><sb:volume-nr>9</sb:volume-nr></sb:series><sb:date>1992</sb:date></sb:issue><sb:pages><sb:first-page>1</sb:first-page><sb:last-page>8</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib24"><ce:label>24</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>A.</ce:given-name><ce:surname>Charette</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Dental health</sb:maintitle></sb:title></sb:contribution><sb:host><sb:edited-book><sb:book-series><sb:editors><sb:editor><ce:given-name>T</ce:given-name><ce:surname>Stephens</ce:surname></sb:editor><sb:editor><ce:given-name>GD</ce:given-name><ce:surname>Fowler</ce:surname></sb:editor></sb:editors><sb:series><sb:title><sb:maintitle>Canada's health promotion survey 1990. Technical report. Health and Welfare Canada.</sb:maintitle></sb:title></sb:series></sb:book-series><sb:date>1993</sb:date><sb:publisher><sb:name>Minister of Supply and Services Canada</sb:name><sb:location>Ottawa</sb:location></sb:publisher></sb:edited-book><sb:pages><sb:first-page>211</sb:first-page><sb:last-page>217</sb:last-page></sb:pages></sb:host><sb:comment>Chapter 15</sb:comment></sb:reference></ce:bib-reference><ce:bib-reference id="bib25"><ce:label>25</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>SE</ce:given-name><ce:surname>Marcus</ce:surname></sb:author><sb:author><ce:given-name>LM</ce:given-name><ce:surname>Kaste</ce:surname></sb:author><sb:author><ce:given-name>LJ.</ce:given-name><ce:surname>Brown</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Prevalence and demographic correlates of tooth loss among the elderly in the United States</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Spec Care Dent</sb:maintitle></sb:title><sb:volume-nr>14</sb:volume-nr></sb:series><sb:date>1994</sb:date></sb:issue><sb:pages><sb:first-page>123</sb:first-page><sb:last-page>127</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib26"><ce:label>26</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>JA</ce:given-name><ce:surname>Brunelle</ce:surname></sb:author><sb:author><ce:given-name>DM</ce:given-name><ce:surname>Marcus</ce:surname></sb:author><sb:author><ce:given-name>DM</ce:given-name><ce:surname>Winn</ce:surname></sb:author><sb:author><ce:given-name>LJ.</ce:given-name><ce:surname>Brown</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Trends in oral health status of the elderly, 1971-1991</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Dent Res</sb:maintitle></sb:title></sb:series><sb:date>1996</sb:date></sb:issue><sb:pages><sb:first-page>75</sb:first-page></sb:pages></sb:host><sb:comment>(abstract 192)</sb:comment></sb:reference></ce:bib-reference><ce:bib-reference id="bib27"><ce:label>27</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>MI.</ce:given-name><ce:surname>MacEntee</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>The effects of aging on the edentulous state</sb:maintitle></sb:title></sb:contribution><sb:host><sb:edited-book><sb:book-series><sb:editors><sb:editor><ce:given-name>GA</ce:given-name><ce:surname>Zarb</ce:surname></sb:editor><sb:editor><ce:given-name>CL</ce:given-name><ce:surname>Bolender</ce:surname></sb:editor><sb:editor><ce:given-name>GE</ce:given-name><ce:surname>Carlsson</ce:surname></sb:editor></sb:editors><sb:series><sb:title><sb:maintitle>Prosthodontic treatment for edentulous patients.</sb:maintitle></sb:title></sb:series></sb:book-series><sb:date>1997</sb:date><sb:publisher><sb:name>Mosby</sb:name><sb:location>St Louis</sb:location></sb:publisher></sb:edited-book></sb:host><sb:comment>Chapter 3</sb:comment></sb:reference></ce:bib-reference><ce:bib-reference id="bib28"><ce:label>28</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>P</ce:given-name><ce:surname>Mojon</ce:surname></sb:author><sb:author><ce:given-name>Ml</ce:given-name><ce:surname>MacEntee</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Discrepancy between need for prosthodontic treatment and complaints in an elderly edentulous population</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Community Dent Oral Epidemiol</sb:maintitle></sb:title><sb:volume-nr>20</sb:volume-nr></sb:series><sb:date>1992</sb:date></sb:issue><sb:pages><sb:first-page>48</sb:first-page><sb:last-page>52</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib29"><ce:label>29</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>BA.</ce:given-name><ce:surname>Burt</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Epidemiology of dental diseases in the elderly</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Clin Geriat Med</sb:maintitle></sb:title><sb:volume-nr>8</sb:volume-nr></sb:series><sb:date>1992</sb:date></sb:issue><sb:pages><sb:first-page>447</sb:first-page><sb:last-page>459</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib30"><ce:label>30</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>P.</ce:given-name><ce:surname>Davis</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Compliance structures and the delivery of health care: the case of dentistry</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Soc Sci Med</sb:maintitle></sb:title><sb:volume-nr>10</sb:volume-nr></sb:series><sb:date>1976</sb:date></sb:issue><sb:pages><sb:first-page>329</sb:first-page><sb:last-page>337</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib31"><ce:label>31</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>JM</ce:given-name><ce:surname>Smith</ce:surname></sb:author><sb:author><ce:given-name>A.</ce:given-name><ce:surname>Sheiham</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>How dental conditions handicap the elderly</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Community Dent Oral Epidemiol</sb:maintitle></sb:title><sb:volume-nr>7</sb:volume-nr></sb:series><sb:date>1979</sb:date></sb:issue><sb:pages><sb:first-page>305</sb:first-page><sb:last-page>310</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib32"><ce:label>32</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>ST</ce:given-name><ce:surname>Reisine</ce:surname></sb:author><sb:author><ce:given-name>J</ce:given-name><ce:surname>Fertig</ce:surname></sb:author><sb:author><ce:given-name>J</ce:given-name><ce:surname>Weber</ce:surname></sb:author><sb:author><ce:given-name>S.</ce:given-name><ce:surname>Leder</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Impact of dental conditions on patients' quality of life</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Community Dent Oral Epidemiol</sb:maintitle></sb:title><sb:volume-nr>17</sb:volume-nr></sb:series><sb:date>1989</sb:date></sb:issue><sb:pages><sb:first-page>7</sb:first-page><sb:last-page>10</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib33"><ce:label>33</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>D.</ce:given-name><ce:surname>Locker</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>The burden of oral disorders in a population of older adults</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Community Dent Health</sb:maintitle></sb:title><sb:volume-nr>9</sb:volume-nr></sb:series><sb:date>1992</sb:date></sb:issue><sb:pages><sb:first-page>109</sb:first-page><sb:last-page>124</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib34"><ce:label>34</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>MI</ce:given-name><ce:surname>MacEntee</ce:surname></sb:author><sb:author><ce:given-name>R</ce:given-name><ce:surname>Hole</ce:surname></sb:author><sb:author><ce:given-name>E.</ce:given-name><ce:surname>Stolar</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>The significance of the mouth in old age</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Soc Sci Med</sb:maintitle></sb:title><sb:volume-nr>45</sb:volume-nr></sb:series><sb:date>1997</sb:date></sb:issue><sb:pages><sb:first-page>1449</sb:first-page><sb:last-page>1458</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib35"><ce:label>35</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>AD</ce:given-name><ce:surname>Guckes</ce:surname></sb:author><sb:author><ce:given-name>MS</ce:given-name><ce:surname>Scurria</ce:surname></sb:author><sb:author><ce:given-name>DA.</ce:given-name><ce:surname>Shugars</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>A conceptual framework for understanding outcomes of oral implant therapy</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Prosthet Dent</sb:maintitle></sb:title><sb:volume-nr>75</sb:volume-nr></sb:series><sb:date>1996</sb:date></sb:issue><sb:pages><sb:first-page>633</sb:first-page><sb:last-page>639</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib36"><ce:label>36</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>RB.</ce:given-name><ce:surname>Lytle</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Complete denture construction based on a study of the deformation of the underlying soft tissues</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Prosthet Dent</sb:maintitle></sb:title><sb:volume-nr>9</sb:volume-nr></sb:series><sb:date>1959</sb:date></sb:issue><sb:pages><sb:first-page>539</sb:first-page><sb:last-page>551</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib37"><ce:label>37</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>WL</ce:given-name><ce:surname>Kydd</ce:surname></sb:author><sb:author><ce:given-name>CH.</ce:given-name><ce:surname>Daly</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>The biologic and mechanical effects of stress on oral mucosa</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Prosthet Dent</sb:maintitle></sb:title><sb:volume-nr>47</sb:volume-nr></sb:series><sb:date>1982</sb:date></sb:issue><sb:pages><sb:first-page>317</sb:first-page><sb:last-page>329</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib38"><ce:label>38</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>WJ.</ce:given-name><ce:surname>Tarbet</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Denture plaque: quiet destroyer</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Prosthet Dent</sb:maintitle></sb:title><sb:volume-nr>48</sb:volume-nr></sb:series><sb:date>1982</sb:date></sb:issue><sb:pages><sb:first-page>647</sb:first-page><sb:last-page>652</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib39"><ce:label>39</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>JJ.</ce:given-name><ce:surname>Sharry</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Complete denture prosthodontics</sb:maintitle></sb:title></sb:contribution><sb:host><sb:book><sb:edition>3rd ed</sb:edition><sb:date>1974</sb:date><sb:publisher><sb:name>McGraw-Hill</sb:name><sb:location>New York</sb:location></sb:publisher></sb:book></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib40"><ce:label>40</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>PI</ce:given-name><ce:surname>Brånemark</ce:surname></sb:author><sb:author><ce:given-name>BO</ce:given-name><ce:surname>Hansson</ce:surname></sb:author><sb:author><ce:given-name>R</ce:given-name><ce:surname>Adell</ce:surname></sb:author><sb:author><ce:given-name>U</ce:given-name><ce:surname>Breine</ce:surname></sb:author><sb:author><ce:given-name>J</ce:given-name><ce:surname>Lindstrom</ce:surname></sb:author><sb:author><ce:given-name>O</ce:given-name><ce:surname>Hallen</ce:surname></sb:author><sb:et-al></sb:et-al></sb:authors><sb:title><sb:maintitle>Osseointegrated implants in the treatment of the edentulous jaw. Experience from a ten year period</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Scand J Plast Reconstr Surg</sb:maintitle></sb:title><sb:volume-nr>16</sb:volume-nr></sb:series><sb:issue-nr>Suppl</sb:issue-nr><sb:date>1977</sb:date></sb:issue><sb:pages><sb:first-page>1</sb:first-page><sb:last-page>132</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib41"><ce:label>41</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>R</ce:given-name><ce:surname>Adell</ce:surname></sb:author><sb:author><ce:given-name>U</ce:given-name><ce:surname>Lekholm</ce:surname></sb:author><sb:author><ce:given-name>B</ce:given-name><ce:surname>Rockler</ce:surname></sb:author><sb:author><ce:given-name>PI.</ce:given-name><ce:surname>Brånemark</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>A 15-year study of osseointegrated implants in the treatment of the edentulous jaw</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Oral Surg</sb:maintitle></sb:title><sb:volume-nr>10</sb:volume-nr></sb:series><sb:date>1981</sb:date></sb:issue><sb:pages><sb:first-page>387</sb:first-page><sb:last-page>416</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib42"><ce:label>42</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>IA</ce:given-name><ce:surname>Small</ce:surname></sb:author><sb:author><ce:given-name>D.</ce:given-name><ce:surname>Misiek</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>A sixteen-year evaluation of the mandibular staple bone plate</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Oral Maxillofac Surg</sb:maintitle></sb:title><sb:volume-nr>44</sb:volume-nr></sb:series><sb:date>1986</sb:date></sb:issue><sb:pages><sb:first-page>60</sb:first-page><sb:last-page>66</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib43"><ce:label>43</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>H</ce:given-name><ce:surname>Bosker</ce:surname></sb:author><sb:author><ce:given-name>RD</ce:given-name><ce:surname>Jordan</ce:surname></sb:author><sb:author><ce:given-name>S</ce:given-name><ce:surname>Sindet-Pedersen</ce:surname></sb:author><sb:author><ce:given-name>R.</ce:given-name><ce:surname>Koole</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>The transmandibular implant: a 13-year survey of its use</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Oral Maxillofac Surg</sb:maintitle></sb:title><sb:volume-nr>49</sb:volume-nr></sb:series><sb:date>1991</sb:date></sb:issue><sb:pages><sb:first-page>482</sb:first-page><sb:last-page>492</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib44"><ce:label>44</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>LG.</ce:given-name><ce:surname>Ellies</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Altered sensation following mandibular implant surgery: a retrospective study</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Prosthet Dent</sb:maintitle></sb:title><sb:volume-nr>68</sb:volume-nr></sb:series><sb:date>1992</sb:date></sb:issue><sb:pages><sb:first-page>664</sb:first-page><sb:last-page>671</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib45"><ce:label>45</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>JN</ce:given-name><ce:surname>Walton</ce:surname></sb:author><sb:author><ce:given-name>MI.</ce:given-name><ce:surname>MacEntee</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Problems with prostheses on implants: a retrospective study</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Prosthet Dent</sb:maintitle></sb:title><sb:volume-nr>71</sb:volume-nr></sb:series><sb:date>1994</sb:date></sb:issue><sb:pages><sb:first-page>283</sb:first-page><sb:last-page>288</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib46"><ce:label>46</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>GA</ce:given-name><ce:surname>Zarb</ce:surname></sb:author><sb:author><ce:given-name>A.</ce:given-name><ce:surname>Schmitt</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>The longitudinal clinical effectiveness of osseointegrated dental implants: the Toronto study. Part III: Problems and complications encountered</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Prosthet Dent</sb:maintitle></sb:title><sb:volume-nr>64</sb:volume-nr></sb:series><sb:date>1990</sb:date></sb:issue><sb:pages><sb:first-page>185</sb:first-page><sb:last-page>194</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib47"><ce:label>47</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>B</ce:given-name><ce:surname>Bergman</ce:surname></sb:author><sb:author><ce:given-name>GE.</ce:given-name><ce:surname>Carlsson</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Clinical long-term study of complete denture wearers</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Prosthet Dent</sb:maintitle></sb:title><sb:volume-nr>53</sb:volume-nr></sb:series><sb:date>1985</sb:date></sb:issue><sb:pages><sb:first-page>56</sb:first-page><sb:last-page>61</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib48"><ce:label>48</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>S</ce:given-name><ce:surname>Blomberg</ce:surname></sb:author><sb:author><ce:given-name>LW.</ce:given-name><ce:surname>Lindquist</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Psychological reactions to edentulousness and treatment with jawbone-anchored bridges</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Acta Psychiatr Scand</sb:maintitle></sb:title><sb:volume-nr>68</sb:volume-nr></sb:series><sb:date>1983</sb:date></sb:issue><sb:pages><sb:first-page>251</sb:first-page><sb:last-page>262</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib49"><ce:label>49</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>HA</ce:given-name><ce:surname>Kiyak</ce:surname></sb:author><sb:author><ce:given-name>BH</ce:given-name><ce:surname>Beach</ce:surname></sb:author><sb:author><ce:given-name>P</ce:given-name><ce:surname>Worthington</ce:surname></sb:author><sb:author><ce:given-name>T</ce:given-name><ce:surname>Taylor</ce:surname></sb:author><sb:author><ce:given-name>C</ce:given-name><ce:surname>Bolender</ce:surname></sb:author><sb:author><ce:given-name>J.</ce:given-name><ce:surname>Evans</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Psychological impact of osseointegrated dental implants</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Int J Oral Maxillofac Implants</sb:maintitle></sb:title><sb:volume-nr>5</sb:volume-nr></sb:series><sb:date>1990</sb:date></sb:issue><sb:pages><sb:first-page>61</sb:first-page><sb:last-page>69</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib50"><ce:label>50</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>D</ce:given-name><ce:surname>Wismeyer</ce:surname></sb:author><sb:author><ce:given-name>MA</ce:given-name><ce:surname>Van Waas</ce:surname></sb:author><sb:author><ce:given-name>JI.</ce:given-name><ce:surname>Vermeeren</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Overdentures supported by ITI implants: a 6.5-year evaluation of patient satisfaction and prosthetic aftercare</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Int J Oral Maxillofac Implants</sb:maintitle></sb:title><sb:volume-nr>10</sb:volume-nr></sb:series><sb:date>1995</sb:date></sb:issue><sb:pages><sb:first-page>744</sb:first-page><sb:last-page>749</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib51"><ce:label>51</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>J</ce:given-name><ce:surname>Hoogstraten</ce:surname></sb:author><sb:author><ce:given-name>LM.</ce:given-name><ce:surname>Lamers</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Patient satisfaction after insertion of an osseointegrated implant bridge</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Oral Rehabil</sb:maintitle></sb:title><sb:volume-nr>14</sb:volume-nr></sb:series><sb:date>1987</sb:date></sb:issue><sb:pages><sb:first-page>481</sb:first-page><sb:last-page>487</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib52"><ce:label>52</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>T</ce:given-name><ce:surname>Jemt</ce:surname></sb:author><sb:author><ce:given-name>K</ce:given-name><ce:surname>Book</ce:surname></sb:author><sb:author><ce:given-name>B</ce:given-name><ce:surname>Linden</ce:surname></sb:author><sb:author><ce:given-name>G.</ce:given-name><ce:surname>Urde</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Failures and complications in 92 consecutively inserted overdentures supported by Brånemark implants in severely resorbed edentulous maxillae: a study from prosthetic treatment to first annual check-up</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Int J Oral Maxillofac Implants</sb:maintitle></sb:title><sb:volume-nr>7</sb:volume-nr></sb:series><sb:date>1992</sb:date></sb:issue><sb:pages><sb:first-page>162</sb:first-page><sb:last-page>167</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib53"><ce:label>53</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>DE</ce:given-name><ce:surname>Tolman</ce:surname></sb:author><sb:author><ce:given-name>WR.</ce:given-name><ce:surname>Laney</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Tissue-integrated prosthesis complications</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Int J Oral Maxillofac Implants</sb:maintitle></sb:title><sb:volume-nr>7</sb:volume-nr></sb:series><sb:date>1992</sb:date></sb:issue><sb:pages><sb:first-page>477</sb:first-page><sb:last-page>484</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib54"><ce:label>54</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>PS</ce:given-name><ce:surname>Wright</ce:surname></sb:author><sb:author><ce:given-name>RM</ce:given-name><ce:surname>Watson</ce:surname></sb:author><sb:author><ce:given-name>MR.</ce:given-name><ce:surname>Heath</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>The effects of prefabricated bar design on the success of overdentures stabilized by implants</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Int J Oral Maxillofac Implants</sb:maintitle></sb:title><sb:volume-nr>10</sb:volume-nr></sb:series><sb:date>1995</sb:date></sb:issue><sb:pages><sb:first-page>79</sb:first-page><sb:last-page>87</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib55"><ce:label>55</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>KW</ce:given-name><ce:surname>Hemmings</ce:surname></sb:author><sb:author><ce:given-name>A</ce:given-name><ce:surname>Schmitt</ce:surname></sb:author><sb:author><ce:given-name>GA.</ce:given-name><ce:surname>Zarb</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Complications and maintenance requirements for fixed prostheses and overdentures in the edentulous mandible: a 5-year report</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Int J Oral Maxillofac Implants</sb:maintitle></sb:title><sb:volume-nr>9</sb:volume-nr></sb:series><sb:date>1994</sb:date></sb:issue><sb:pages><sb:first-page>191</sb:first-page><sb:last-page>196</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib56"><ce:label>56</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>JN</ce:given-name><ce:surname>Walton</ce:surname></sb:author><sb:author><ce:given-name>MI.</ce:given-name><ce:surname>MacEntee</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>A retrospective study on the maintenance and repair of implant-supported prostheses</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Int J Prosthodont</sb:maintitle></sb:title><sb:volume-nr>6</sb:volume-nr></sb:series><sb:date>1993</sb:date></sb:issue><sb:pages><sb:first-page>451</sb:first-page><sb:last-page>455</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib57"><ce:label>57</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>RB</ce:given-name><ce:surname>Johns</ce:surname></sb:author><sb:author><ce:given-name>T</ce:given-name><ce:surname>Jemt</ce:surname></sb:author><sb:author><ce:given-name>MR</ce:given-name><ce:surname>Heath</ce:surname></sb:author><sb:author><ce:given-name>JE</ce:given-name><ce:surname>Hutton</ce:surname></sb:author><sb:author><ce:given-name>S</ce:given-name><ce:surname>McKenna</ce:surname></sb:author><sb:author><ce:given-name>DC</ce:given-name><ce:surname>McNamara</ce:surname></sb:author><sb:et-al></sb:et-al></sb:authors><sb:title><sb:maintitle>A multi-center study of overdentures supported by Brånemark implants</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Int J Oral Maxillofac Implants</sb:maintitle></sb:title><sb:volume-nr>7</sb:volume-nr></sb:series><sb:date>1992</sb:date></sb:issue><sb:pages><sb:first-page>513</sb:first-page><sb:last-page>522</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib58"><ce:label>58</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>I</ce:given-name><ce:surname>Naert</ce:surname></sb:author><sb:author><ce:given-name>M</ce:given-name><ce:surname>De Clercq</ce:surname></sb:author><sb:author><ce:given-name>G</ce:given-name><ce:surname>Theuniers</ce:surname></sb:author><sb:author><ce:given-name>E.</ce:given-name><ce:surname>Schepers</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Overdentures supported by osseointegrated fixtures for the edentulous mandible: a 2.5 year report</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Int J Oral Maxillofac Implants</sb:maintitle></sb:title><sb:volume-nr>3</sb:volume-nr></sb:series><sb:date>1988</sb:date></sb:issue><sb:pages><sb:first-page>191</sb:first-page><sb:last-page>196</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib59"><ce:label>59</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>R.</ce:given-name><ce:surname>Mericske-Stern</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Clinical evaluation of overdenture restorations supported by osseointegrated titanium implants: a retrospective study</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Int J Oral Maxillofac Implants</sb:maintitle></sb:title><sb:volume-nr>5</sb:volume-nr></sb:series><sb:date>1990</sb:date></sb:issue><sb:pages><sb:first-page>375</sb:first-page><sb:last-page>383</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib60"><ce:label>60</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>D</ce:given-name><ce:surname>Buser</ce:surname></sb:author><sb:author><ce:given-name>R</ce:given-name><ce:surname>Mericske-Stern</ce:surname></sb:author><sb:author><ce:given-name>JP</ce:given-name><ce:surname>Bernard</ce:surname></sb:author><sb:author><ce:given-name>A</ce:given-name><ce:surname>Behneke</ce:surname></sb:author><sb:author><ce:given-name>N</ce:given-name><ce:surname>Behneke</ce:surname></sb:author><sb:author><ce:given-name>HP</ce:given-name><ce:surname>Hirt</ce:surname></sb:author><sb:et-al></sb:et-al></sb:authors><sb:title><sb:maintitle>Long-term evaluation of nonsubmerged ITI implants. Part 1: 8-year Life table analysis of a prospective multicenter study with 2359 implants</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Clinic Oral Implant Res</sb:maintitle></sb:title><sb:volume-nr>8</sb:volume-nr></sb:series><sb:date>1997</sb:date></sb:issue><sb:pages><sb:first-page>161</sb:first-page><sb:last-page>172</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib61"><ce:label>61</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>MI.</ce:given-name><ce:surname>MacEntee</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Denturists and oral health in the aged</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Prosthet Dent</sb:maintitle></sb:title><sb:volume-nr>71</sb:volume-nr></sb:series><sb:date>1994</sb:date></sb:issue><sb:pages><sb:first-page>192</sb:first-page><sb:last-page>196</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib62"><ce:label>62</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>I</ce:given-name><ce:surname>Epstein</ce:surname></sb:author><sb:author><ce:given-name>A</ce:given-name><ce:surname>Kazanjian</ce:surname></sb:author><sb:author><ce:given-name>D.</ce:given-name><ce:surname>MacAulay</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Health Professions Council Report on designation of denturism</sb:maintitle></sb:title></sb:contribution><sb:host><sb:book><sb:date>1997</sb:date><sb:publisher><sb:name>Government of British Columbia</sb:name><sb:location>Victoria (BC)</sb:location></sb:publisher></sb:book></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib63"><ce:label>63</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>W.</ce:given-name><ce:surname>Hunter</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Editorial: an address on the role of sepsis and of antisepsis in medicine</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Lancet</sb:maintitle></sb:title><sb:volume-nr>1</sb:volume-nr></sb:series><sb:date>1911</sb:date></sb:issue><sb:pages><sb:first-page>79</sb:first-page><sb:last-page>86</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib64"><ce:label>64</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>I</ce:given-name><ce:surname>McDowell</ce:surname></sb:author><sb:author><ce:given-name>C.</ce:given-name><ce:surname>Newell</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Measuring health: a guide to rating scales and questionnaires</sb:maintitle></sb:title></sb:contribution><sb:host><sb:book><sb:date>1987</sb:date><sb:publisher><sb:name>Oxford University Press</sb:name><sb:location>Oxford (UK)</sb:location></sb:publisher></sb:book></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib65"><ce:label>65</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>T.</ce:given-name><ce:surname>Parson</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>The social system</sb:maintitle></sb:title></sb:contribution><sb:host><sb:book><sb:date>1951</sb:date><sb:publisher><sb:name>Free Press of Glencoe</sb:name><sb:location>London</sb:location></sb:publisher></sb:book></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib66"><ce:label>66</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>T</ce:given-name><ce:surname>Jemt</ce:surname></sb:author><sb:author><ce:given-name>GE.</ce:given-name><ce:surname>Carlsson</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Aspects of mastication with bridges on osseointegrated implants</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Scand J Dent Res</sb:maintitle></sb:title><sb:volume-nr>94</sb:volume-nr></sb:series><sb:date>1988</sb:date></sb:issue><sb:pages><sb:first-page>66</sb:first-page><sb:last-page>71</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib67"><ce:label>67</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>T</ce:given-name><ce:surname>Haraldson</ce:surname></sb:author><sb:author><ce:given-name>G.</ce:given-name><ce:surname>Zarb</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>A 10-year follow-up study of the masticatory system after treatment with osseointegrated implant bridges</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Scand J Dent Res</sb:maintitle></sb:title><sb:volume-nr>96</sb:volume-nr></sb:series><sb:date>1988</sb:date></sb:issue><sb:pages><sb:first-page>243</sb:first-page><sb:last-page>252</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib68"><ce:label>68</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>A</ce:given-name><ce:surname>Slagter</ce:surname></sb:author><sb:author><ce:given-name>M</ce:given-name><ce:surname>Geertman</ce:surname></sb:author><sb:author><ce:given-name>M</ce:given-name><ce:surname>van't Hof</ce:surname></sb:author><sb:author><ce:given-name>MA</ce:given-name><ce:surname>van Waas</ce:surname></sb:author><sb:author><ce:given-name>W.</ce:given-name><ce:surname>Kalk</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Masticatory performance and chewing experience with mandibular implant-retained overdentures</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Dent Res</sb:maintitle></sb:title><sb:volume-nr>75</sb:volume-nr></sb:series><sb:date>1996</sb:date></sb:issue></sb:host><sb:comment>Abstract 1318</sb:comment></sb:reference></ce:bib-reference><ce:bib-reference id="bib69"><ce:label>69</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>JS</ce:given-name><ce:surname>Feine</ce:surname></sb:author><sb:author><ce:given-name>K</ce:given-name><ce:surname>Maskawi</ce:surname></sb:author><sb:author><ce:given-name>P</ce:given-name><ce:surname>de Grandmont</ce:surname></sb:author><sb:author><ce:given-name>WB</ce:given-name><ce:surname>Donohue</ce:surname></sb:author><sb:author><ce:given-name>R</ce:given-name><ce:surname>Tanguay</ce:surname></sb:author><sb:author><ce:given-name>JP.</ce:given-name><ce:surname>Lund</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Within subject comparison of implant-supported mandibular prostheses: evaluation of masticatory function</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Dent Res</sb:maintitle></sb:title><sb:volume-nr>73</sb:volume-nr></sb:series><sb:date>1994</sb:date></sb:issue><sb:pages><sb:first-page>1646</sb:first-page><sb:last-page>1656</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib70"><ce:label>70</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>H</ce:given-name><ce:surname>Barber</ce:surname></sb:author><sb:author><ce:given-name>R</ce:given-name><ce:surname>Scott</ce:surname></sb:author><sb:author><ce:given-name>B</ce:given-name><ce:surname>Maxson</ce:surname></sb:author><sb:author><ce:given-name>R.</ce:given-name><ce:surname>Fonseca</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Evaluation of anterior maxillary ridge resorption when opposed by the transmandibular implant</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Oral Maxillofac Surg</sb:maintitle></sb:title><sb:volume-nr>48</sb:volume-nr></sb:series><sb:date>1990</sb:date></sb:issue><sb:pages><sb:first-page>1283</sb:first-page><sb:last-page>1287</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib71"><ce:label>71</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>D</ce:given-name><ce:surname>Wismeijer</ce:surname></sb:author><sb:author><ce:given-name>MA</ce:given-name><ce:surname>van Waas</ce:surname></sb:author><sb:author><ce:given-name>W.</ce:given-name><ce:surname>Kalk</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Factors to consider in selecting an occlusal concept for patients with implants in the edentulous mandible</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Prosthet Dent</sb:maintitle></sb:title><sb:volume-nr>74</sb:volume-nr></sb:series><sb:date>1995</sb:date></sb:issue><sb:pages><sb:first-page>380</sb:first-page><sb:last-page>384</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib72"><ce:label>72</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>R</ce:given-name><ce:surname>Jacobs</ce:surname></sb:author><sb:author><ce:given-name>D</ce:given-name><ce:surname>van Steenberghe</ce:surname></sb:author><sb:author><ce:given-name>M</ce:given-name><ce:surname>Nys</ce:surname></sb:author><sb:author><ce:given-name>I.</ce:given-name><ce:surname>Naert</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Maxillary bone resorption in patients with mandibular implant-supported overdentures or fixed prostheses</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Prosthet Dent</sb:maintitle></sb:title><sb:volume-nr>70</sb:volume-nr></sb:series><sb:date>1993</sb:date></sb:issue><sb:pages><sb:first-page>135</sb:first-page><sb:last-page>140</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib73"><ce:label>73</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>TD.</ce:given-name><ce:surname>Taylor</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Osteogenesis of the mandible associated with implant reconstruction: a patient report</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Int J Oral Maxillofac Implants</sb:maintitle></sb:title><sb:volume-nr>4</sb:volume-nr></sb:series><sb:date>1989</sb:date></sb:issue><sb:pages><sb:first-page>227</sb:first-page><sb:last-page>231</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib74"><ce:label>74</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>MP</ce:given-name><ce:surname>Powers</ce:surname></sb:author><sb:author><ce:given-name>H.</ce:given-name><ce:surname>Bosker</ce:surname></sb:author><sb:author><ce:given-name>H.</ce:given-name><ce:surname>Van Pelt</ce:surname></sb:author><sb:author><ce:given-name>N.</ce:given-name><ce:surname>Dunbar</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>The transmandibular implant: from progressive bone loss to controlled bone growth</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Oral Maxillofac Surg</sb:maintitle></sb:title><sb:volume-nr>52</sb:volume-nr></sb:series><sb:date>1994</sb:date></sb:issue><sb:pages><sb:first-page>904</sb:first-page><sb:last-page>910</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib75"><ce:label>75</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>AL</ce:given-name><ce:surname>Grogono</ce:surname></sb:author><sb:author><ce:given-name>DM</ce:given-name><ce:surname>Lancaster</ce:surname></sb:author><sb:author><ce:given-name>IM.</ce:given-name><ce:surname>Finger</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Dental implants: a survey of patients' attitudes</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Prosthet Dent</sb:maintitle></sb:title><sb:volume-nr>62</sb:volume-nr></sb:series><sb:date>1989</sb:date></sb:issue><sb:pages><sb:first-page>573</sb:first-page><sb:last-page>576</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib76"><ce:label>76</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>JM</ce:given-name><ce:surname>Clancy</ce:surname></sb:author><sb:author><ce:given-name>AU</ce:given-name><ce:surname>Buchs</ce:surname></sb:author><sb:author><ce:given-name>A.</ce:given-name><ce:surname>Homayoun</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>A retrospective analysis of one implant system in an oral surgery practice. Phase I: patient satisfaction</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Prosthet Dent</sb:maintitle></sb:title><sb:volume-nr>65</sb:volume-nr></sb:series><sb:date>1991</sb:date></sb:issue><sb:pages><sb:first-page>265</sb:first-page><sb:last-page>271</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib77"><ce:label>77</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>G</ce:given-name><ce:surname>Kent</ce:surname></sb:author><sb:author><ce:given-name>R.</ce:given-name><ce:surname>Johns</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Controlled longitudinal study on the psychological effects of osseointegrated dental implants</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Int J Oral Maxillofac Implants</sb:maintitle></sb:title><sb:volume-nr>6</sb:volume-nr></sb:series><sb:date>1991</sb:date></sb:issue><sb:pages><sb:first-page>470</sb:first-page><sb:last-page>474</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib78"><ce:label>78</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>M</ce:given-name><ce:surname>Tavares</ce:surname></sb:author><sb:author><ce:given-name>LG</ce:given-name><ce:surname>Branch</ce:surname></sb:author><sb:author><ce:given-name>L.</ce:given-name><ce:surname>Schulman</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Dental implant patients and their satisfaction with treatment</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Dent Educ</sb:maintitle></sb:title><sb:volume-nr>54</sb:volume-nr></sb:series><sb:date>1990</sb:date></sb:issue><sb:pages><sb:first-page>670</sb:first-page><sb:last-page>679</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib79"><ce:label>79</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>S</ce:given-name><ce:surname>Blomberg</ce:surname></sb:author><sb:author><ce:given-name>LW.</ce:given-name><ce:surname>Lindquist</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Psychological reaction to edentulousness and treatment with jawbone-anchored bridges</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Acta Psychiatr Scand</sb:maintitle></sb:title><sb:volume-nr>68</sb:volume-nr></sb:series><sb:date>1983</sb:date></sb:issue><sb:pages><sb:first-page>251</sb:first-page><sb:last-page>262</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib80"><ce:label>80</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>B</ce:given-name><ce:surname>Sandstrom</ce:surname></sb:author><sb:author><ce:given-name>LW.</ce:given-name><ce:surname>Lindquist</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>The effect of different prosthetic restorations on the dietary selection in edentulous patients. A longitudinal study of patients initially treated with optimal complete dentures and finally with tissue-integrated prostheses</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Acta Odontol Scand</sb:maintitle></sb:title><sb:volume-nr>45</sb:volume-nr></sb:series><sb:date>1987</sb:date></sb:issue><sb:pages><sb:first-page>423</sb:first-page><sb:last-page>428</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib81"><ce:label>81</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>NG</ce:given-name><ce:surname>Sebring</ce:surname></sb:author><sb:author><ce:given-name>AD</ce:given-name><ce:surname>Guckes</ce:surname></sb:author><sb:author><ce:given-name>SH</ce:given-name><ce:surname>Li</ce:surname></sb:author><sb:author><ce:given-name>GR.</ce:given-name><ce:surname>McCarthy</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Nutritional adequacy of reported intake of edentulous subjects treated with new conventional or implant-supported mandibular dentures</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Prosthet Dent</sb:maintitle></sb:title><sb:volume-nr>74</sb:volume-nr></sb:series><sb:date>1995</sb:date></sb:issue><sb:pages><sb:first-page>358</sb:first-page><sb:last-page>363</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib82"><ce:label>82</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>AD</ce:given-name><ce:surname>Guckes</ce:surname></sb:author><sb:author><ce:given-name>N</ce:given-name><ce:surname>Sebring</ce:surname></sb:author><sb:author><ce:given-name>SH</ce:given-name><ce:surname>Li</ce:surname></sb:author><sb:author><ce:given-name>GR</ce:given-name><ce:surname>McCarthy</ce:surname></sb:author><sb:author><ce:given-name>JS.</ce:given-name><ce:surname>Brahim</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Efficacy of mandibular implant fixed detachable complete dentures</sb:maintitle></sb:title></sb:contribution><sb:comment>[Abstract]</sb:comment><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Dent Res</sb:maintitle></sb:title><sb:volume-nr>72</sb:volume-nr></sb:series><sb:issue-nr>Special Issue</sb:issue-nr><sb:date>1993</sb:date></sb:issue><sb:pages><sb:first-page>191</sb:first-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib83"><ce:label>83</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>MI.</ce:given-name><ce:surname>MacEntee</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>The denturist movement in Canada: part III-current status and potential</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Can Dent Assoc</sb:maintitle></sb:title><sb:volume-nr>47</sb:volume-nr></sb:series><sb:date>1981</sb:date></sb:issue><sb:pages><sb:first-page>528</sb:first-page><sb:last-page>533</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib84"><ce:label>84</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>DW</ce:given-name><ce:surname>Lewis</ce:surname></sb:author><sb:author><ce:given-name>GW</ce:given-name><ce:surname>Thompson</ce:surname></sb:author><sb:author><ce:given-name>A.</ce:given-name><ce:surname>Folkins</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Denture replacement during a 14-year period in Alberta's universal dental plan for the elderly</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Prosthet Dent</sb:maintitle></sb:title><sb:volume-nr>74</sb:volume-nr></sb:series><sb:date>1995</sb:date></sb:issue><sb:pages><sb:first-page>264</sb:first-page><sb:last-page>269</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib85"><ce:label>85</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>R.</ce:given-name><ce:surname>Lee</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Implant economics</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Calif Dent Assoc</sb:maintitle></sb:title><sb:volume-nr>20</sb:volume-nr></sb:series><sb:date>1992</sb:date></sb:issue><sb:pages><sb:first-page>63</sb:first-page><sb:last-page>68</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib86"><ce:label>86</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>JN</ce:given-name><ce:surname>Walton</ce:surname></sb:author><sb:author><ce:given-name>MI</ce:given-name><ce:surname>MacEntee</ce:surname></sb:author><sb:author><ce:given-name>R.</ce:given-name><ce:surname>Hanvelt</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>A cost analysis of fabricating implant prostheses</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Int J Prosthodont</sb:maintitle></sb:title><sb:volume-nr>9</sb:volume-nr></sb:series><sb:date>1996</sb:date></sb:issue><sb:pages><sb:first-page>271</sb:first-page><sb:last-page>276</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference></ce:bibliography-sec></ce:bibliography></tail></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>The economics of complete dentures and implant-related services: A framework for analysis and preliminary outcomes</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>The economics of complete dentures and implant-related services: A framework for analysis and preliminary outcomes</title></titleInfo><name type="personal"><namePart type="given">Michael I.</namePart><namePart type="family">MacEntee</namePart><namePart type="termsOfAddress">PhD, FRCD(C),a</namePart><affiliation>Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Joanne N.</namePart><namePart type="family">Walton</namePart><namePart type="termsOfAddress">DDS, FRCD(C)b</namePart><affiliation>Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1998</dateIssued><copyrightDate encoding="w3cdtf">1998</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><abstract lang="en">Abstract: It is not always clear that the implant-prosthesis offers distinct advantages over the conventional complete denture for managing the edentulous jaw. This article discusses the measurement, distribution, impact, and management of the edentulous jaw, and describes a framework for analyzing the economic costs and benefits associated with the conventional denture and the implant prosthesis. There are physiologic and psychosocial costs and benefits to both the conventional denture and the implant prosthesis, which indicates that neither method is distinctly superior. The physiologic costs are low and the psychosocial costs are similar for both treatments, whereas the direct financial costs associated with the implant prosthesis are substantially higher. (J Prosthet Dent 1998;79:24-30.)</abstract><note>Supported by the British Columbia Medical Services Foundation and the National Health Research Development Programme of Canada.</note><note>aProfessor and Chair, Division of Prosthodontics.</note><note>bAssociate Professor, Division of Prosthodontics.</note><note>Reprint requests: Dr. Michael I. MacEntee, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, CANADA</note><note>10/1/86945</note><relatedItem type="host"><titleInfo><title>The Journal of Prosthetic Dentistry</title></titleInfo><titleInfo type="abbreviated"><title>YMPR</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><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">199801</dateIssued></originInfo><identifier type="ISSN">0022-3913</identifier><identifier type="PII">S0022-3913(05)X7048-2</identifier><part><date>199801</date><detail type="volume"><number>79</number><caption>vol.</caption></detail><detail type="issue"><number>1</number><caption>no.</caption></detail><extent unit="issue-pages"><start>6</start><end>106</end></extent><extent unit="pages"><start>24</start><end>30</end></extent></part></relatedItem><identifier type="istex">C00DC3D55889DB74234DE5FD320E1107CC2A31A5</identifier><identifier type="ark">ark:/67375/6H6-FTQSHF2Q-7</identifier><identifier type="DOI">10.1016/S0022-3913(98)70189-1</identifier><identifier type="PII">S0022-3913(98)70189-1</identifier><accessCondition type="use and reproduction" contentType="copyright">©1998 Editorial Council of The Journal of Prosthetic Dentistry.</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-HKKZVM7B-M">elsevier</recordContentSource><recordOrigin>Editorial Council of The Journal of Prosthetic Dentistry., ©1998</recordOrigin></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/document/C00DC3D55889DB74234DE5FD320E1107CC2A31A5/metadata/json</uri></json:item></metadata></istex></record>Pour manipuler ce document sous Unix (Dilib)
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