Serveur d'exploration sur le patient édenté

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Clinical outcomes of three Parkinson's disease patients treated with mandibular implant overdentures

Identifieur interne : 008F75 ( Main/Exploration ); précédent : 008F74; suivant : 008F76

Clinical outcomes of three Parkinson's disease patients treated with mandibular implant overdentures

Auteurs : Siegfried Martin Heckmann ; Josef Georg Heckmann ; Hans-Peter Weber [États-Unis]

Source :

RBID : ISTEX:98563C64B66396765B0B0DF0E1B343820D110D81

Descripteurs français

English descriptors

Abstract

Parkinson's disease (PD) often affects the oro‐pharyngeal musculature, leading to problems with speaking, chewing and swallowing. The inevitable reduction in food and fluid intake contributes to the further deterioration of neurological symptoms. Parkinson's disease patients have great difficulties in adjusting to the use of complete dentures. It is the purpose of this report to evaluate the benefit of using dental implants combined with overdentures to improve chewing and predigestion capacity in severely handicapped PD patients. Three edentulous PD patients (2 male, 1 female; mean age 75.7 years; mean PD duration 4.3 years; PD severity grade III according to Hoehn and Yahr; mean edentulousness 19.3 years) complaining of poor chewing ability were included in this evaluation. One‐stage dental implants were placed in the interforaminal region of the mandible. After completion of healing, new overdentures were fabricated. Custom‐made non‐rigid (resilient) telescopic attachments were used for retention of the overdentures on the implants. Follow‐up examinations of the 3 patients were made between 28 and 42 months after the completion of treatment, and peri‐implant tissue conditions as well as the patients' self‐assessed satisfaction level were recorded. A modified gastrointestinal symptoms questionnaire, Hoehn and Yahr Scale and body weight measurements were used to monitor gastrointestinal impairment and PD severity. The peri‐implant parameters indicated healthy soft tissue conditions and all Periotest values were in the negative range. The patients judged their chewing abilities to be greatly improved. Since placing the implants, PD severity had deteriorated to grade IV (Hoehn and Yahr scale) in 2 patients and was stable in 1 patient. The body weight had improved slightly in all patients (mean 2.2 kg). On the gastrointestinal scale, all patients had improved from a mean score of 8.7 to 5.7. Non‐rigid telescopic attachments for overdenture stabilization are particularly suitable for PD patients as they are easy to handle and to clean. The patients reported remarkable improvement in their chewing ability, an assessment which would seem to be supported by the improved gastro‐intestinal index. The regimen described appears to be a useful adjunctive treatment in edentulous Parkinson's disease patients and may be considered for patients with diseases similarly affecting motor skills.

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DOI: 10.1034/j.1600-0501.2000.011006566.x


Affiliations:


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<title level="j" type="main">Clinical Oral Implants Research</title>
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<term>Abdominal bloating</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Body Weight</term>
<term>Body weight</term>
<term>Cette etude</term>
<term>Complete dentures</term>
<term>Dental Implants</term>
<term>Dental Prosthesis, Implant-Supported</term>
<term>Dental implants</term>
<term>Dental medicine</term>
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<term>Denture Retention</term>
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<term>Heckmann</term>
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<term>Implant</term>
<term>Implant stability</term>
<term>Implants research</term>
<term>Inevitable reduction</term>
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<term>Maladie</term>
<term>Male</term>
<term>Mandible (surgery)</term>
<term>Mastication (physiology)</term>
<term>Maxillofacial implants</term>
<term>Movement disorders</term>
<term>Negative range</term>
<term>Oral Hygiene Index</term>
<term>Overdenture stabilization</term>
<term>Overdentures</term>
<term>Pacientes</term>
<term>Panoramic radiographs</term>
<term>Para</term>
<term>Parkinson</term>
<term>Parkinson Disease (complications)</term>
<term>Patient Satisfaction</term>
<term>Patienten</term>
<term>Patients characteristics</term>
<term>Periodontal Index</term>
<term>Periotest values</term>
<term>Predigestion capacity</term>
<term>Prospective study</term>
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<term>Removable prostheses</term>
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<term>Telescopic attachments</term>
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<term>Humains</term>
<term>Implants dentaires</term>
<term>Indice d'hygiène buccodentaire</term>
<term>Indice parodontal</term>
<term>Maladie de Parkinson ()</term>
<term>Mandibule ()</term>
<term>Mastication (physiologie)</term>
<term>Mâchoire édentée ()</term>
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<term>Prothèse dentaire implanto-portée</term>
<term>Résultat thérapeutique</term>
<term>Rétention d'appareil de prothèse dentaire</term>
<term>Satisfaction du patient</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Études de suivi</term>
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<term>Dental Implants</term>
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<term>Parkinson Disease</term>
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<keywords scheme="MESH" qualifier="physiologie" xml:lang="fr">
<term>Digestion</term>
<term>Mastication</term>
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<keywords scheme="MESH" qualifier="physiology" xml:lang="en">
<term>Digestion</term>
<term>Mastication</term>
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<keywords scheme="MESH" qualifier="rehabilitation" xml:lang="en">
<term>Jaw, Edentulous</term>
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<term>Mâchoire édentée</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en">
<term>Jaw, Edentulous</term>
<term>Mandible</term>
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<term>Abdominal bloating</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Body Weight</term>
<term>Body weight</term>
<term>Cette etude</term>
<term>Complete dentures</term>
<term>Dental Prosthesis, Implant-Supported</term>
<term>Dental implants</term>
<term>Dental medicine</term>
<term>Denture</term>
<term>Denture Design</term>
<term>Denture Retention</term>
<term>Denture, Complete, Lower</term>
<term>Denture, Overlay</term>
<term>Disease patients</term>
<term>Edentulous disease patients</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Gastrointestinal symptoms</term>
<term>Heckmann</term>
<term>Hoehn</term>
<term>Hoehn yahr</term>
<term>Humans</term>
<term>Hygiene index</term>
<term>Implant</term>
<term>Implant stability</term>
<term>Implants research</term>
<term>Inevitable reduction</term>
<term>Interforaminal region</term>
<term>International journal</term>
<term>Maladie</term>
<term>Male</term>
<term>Maxillofacial implants</term>
<term>Movement disorders</term>
<term>Negative range</term>
<term>Oral Hygiene Index</term>
<term>Overdenture stabilization</term>
<term>Overdentures</term>
<term>Pacientes</term>
<term>Panoramic radiographs</term>
<term>Para</term>
<term>Parkinson</term>
<term>Patient Satisfaction</term>
<term>Patienten</term>
<term>Patients characteristics</term>
<term>Periodontal Index</term>
<term>Periotest values</term>
<term>Predigestion capacity</term>
<term>Prospective study</term>
<term>Prosthesis</term>
<term>Removable prostheses</term>
<term>Telescopic</term>
<term>Telescopic attachments</term>
<term>Telescopic system</term>
<term>Tissue conditions</term>
<term>Treatment Outcome</term>
<term>Voluntary movements</term>
<term>Yahr</term>
<term>Yahr scale</term>
<term>Yahr skala</term>
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<term>Femelle</term>
<term>Humains</term>
<term>Implants dentaires</term>
<term>Indice d'hygiène buccodentaire</term>
<term>Indice parodontal</term>
<term>Maladie de Parkinson</term>
<term>Mandibule</term>
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<term>Prothèse dentaire implanto-portée</term>
<term>Résultat thérapeutique</term>
<term>Rétention d'appareil de prothèse dentaire</term>
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<front>
<div type="abstract" xml:lang="en">Parkinson's disease (PD) often affects the oro‐pharyngeal musculature, leading to problems with speaking, chewing and swallowing. The inevitable reduction in food and fluid intake contributes to the further deterioration of neurological symptoms. Parkinson's disease patients have great difficulties in adjusting to the use of complete dentures. It is the purpose of this report to evaluate the benefit of using dental implants combined with overdentures to improve chewing and predigestion capacity in severely handicapped PD patients. Three edentulous PD patients (2 male, 1 female; mean age 75.7 years; mean PD duration 4.3 years; PD severity grade III according to Hoehn and Yahr; mean edentulousness 19.3 years) complaining of poor chewing ability were included in this evaluation. One‐stage dental implants were placed in the interforaminal region of the mandible. After completion of healing, new overdentures were fabricated. Custom‐made non‐rigid (resilient) telescopic attachments were used for retention of the overdentures on the implants. Follow‐up examinations of the 3 patients were made between 28 and 42 months after the completion of treatment, and peri‐implant tissue conditions as well as the patients' self‐assessed satisfaction level were recorded. A modified gastrointestinal symptoms questionnaire, Hoehn and Yahr Scale and body weight measurements were used to monitor gastrointestinal impairment and PD severity. The peri‐implant parameters indicated healthy soft tissue conditions and all Periotest values were in the negative range. The patients judged their chewing abilities to be greatly improved. Since placing the implants, PD severity had deteriorated to grade IV (Hoehn and Yahr scale) in 2 patients and was stable in 1 patient. The body weight had improved slightly in all patients (mean 2.2 kg). On the gastrointestinal scale, all patients had improved from a mean score of 8.7 to 5.7. Non‐rigid telescopic attachments for overdenture stabilization are particularly suitable for PD patients as they are easy to handle and to clean. The patients reported remarkable improvement in their chewing ability, an assessment which would seem to be supported by the improved gastro‐intestinal index. The regimen described appears to be a useful adjunctive treatment in edentulous Parkinson's disease patients and may be considered for patients with diseases similarly affecting motor skills.</div>
</front>
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