Agenesis differs by continent and gender: the prevalence for both sexes was higher in Europe (males 4.6%; females 6.3%) and Australia (males 5.5%; females 7.6%) than for North American Caucasians (males 3.2%; females 4.6%). In addition, the prevalence of dental agenesis in females was 1.37 times higher than in males. The mandibular second premolar was the most affected tooth, followed by the maxillary lateral incisor and the maxillary second premolar. The occurrence of dental agenesis was divided into three main groups: common (P2(i) > I2(s) > P2(s)), less common (I1(i) > I2(i) & P1(s) > C(s) & M2(i)) and rare (M2(s) & M1(s) > C(i) > M1(i) & I1(s)). Unilateral occurrence of dental agenesis is more common than bilateral occurrence. However, bilateral agenesis of maxillary lateral incisors is more common than unilateral agenesis. The overall prevalence of agenesis in the maxilla is comparable with that in the mandible, but a marked difference was found between both jaws regarding tooth type. Absence of one or two permanent teeth is found in 83% of the subjects with dental agenesis. A practical application of the results of the meta-analysis is the estimation of dental treatment need.
Shortened dental arches with intact premolar regions and at least one occluding pair of molars provide sufficient chewing ability. Shortened arches with 3-4 pairs of occluding premolars and asymmetric arches with a long side result in impairment of chewing ability, especially for hard foods. In extremely shortened arches comprising 0-2 occluding premolars, chewing ability is severely impaired.
In early tooth movement, mediator levels in juveniles are more responsive than levels in adults, which agrees with the finding that the initial tooth movement in juveniles is faster than in adults and starts without delay.
The aim of this prospective randomized controlled clinical trial was to evaluate the clinical outcomes and prosthetic aftercare of edentulous patients with a mandibular overdenture retained by two IMZ implants or two Brånemark implants during a 10-year period. Patients were allocated to the IMZ group (n=29) or the Brånemark group (n=32) by a computerized balancing method. In the IMZ group, four implants were lost during the 10-year follow-up (survival rate: 93%). In the Brånemark group, nine implants were lost (survival rate: 86%). All patients were re-operated successfully. Multiple prosthetic revisions were necessary in both groups; especially the precision attachment system in the overdenture (23% of the total number of revisions) and the denture base and teeth (26% of the total number of revisions) were subject to frequent fracture. From this study, it can be concluded that both the IMZ implant and the Brånemark implant systems supporting an overdenture are functioning well after 10 years of follow-up. There are no indications of a worsening of clinical or radiographical state after 10 years.
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