Within the limitations of this study, the results suggest that clinical success is associated to framework design with retention pins equal or longer than 4 mm. Quality of life improved with IFCD treatment, even in patients with mechanical complications.
Implant-supported fixed complete dentures (IFCD) have clinical and functional advantages over conventional dentures and overdentures, but failures and complications are frequently observed in implants and prostheses over time [1,2]. Technical variables seem to have a greater influence than biological ones on IFCD complications in prospective studies [3,4], and biomechanical variables may play a role in the success of oral rehabilitation.Biomechanical factors related to the number and position of implants in the arch, geometric relationships, and prosthesis design may influence the magnitude and distribution of occlusal forces in the prosthesis-implant-bone system. In the classic study by Skalak[5], a mathematical model demonstrated that a more spread arrangement of implants supporting an IFCD with a cantilever was the main factor improving the distribution of masticatory forces. More recently, Wentaschek et al. [6] showed that the use of inclined implants increased the polygon resistance area by up to 20% using virtual planning in tomographic images. Others have suggested that the shape of the ridge influences the arrangement of the number of implants along the arch, and an oval shape of the mandible would allow a more favorable antero-posterior distribution of implants than a rectangular shape would [7].According to mechanical theory, the use of a cantilever increases the risk of overload in implants and IFCD [8,9]. However, contro-J Prosthodont Res. 2022; **(**):
RESUMEN:Este trabajo ha realizado una revisión narrativa de la literatura para analizar los instrumentos usados en la investigación clínica para los resultados centrados en el paciente en rehabilitación oral soportada por implantes. La búsqueda ha sido realizada en bases indexadoras de periódicos nacionales e internacionales, sin restricción temporal, en los idiomas portugués e inglés, utilizando las palabras-clave: implantes dentales, investigación clínica, resultados reportados por pacientes, cualidad de vida. Actualmente, los estudios clínicos deben incluir resultados obtenidos por relatos autorales de percepción de los beneficios del tratamiento cuanto a los aspectos funcionales, sicológicos y sociales. La mayoría de los estudios utiliza instrumentos que añaden diferentes dimensiones de cualidad de vida, tales como GOHAI (Geriatric Oral Health Assessment Index), DIDL (Dental Impacton Daily Living), OHIP (Oral Health Impact Profile), OHQoL-UK (W), OIDP (Oral Impactson Daily Performances). En general, los ítems de estos cuestionarios han sido formulados de manera negativa, con el enfoque en los problemas, siendo el OHIP-14 lo más utilizado por ser sencillo, validado para varios idiomas y consolidado para las diferentes situaciones clínicas. Otros instrumentos de sicología positiva, como los cuestionarios de Rosenberg y McCullough, han sugestionado evaluar la percepción de la autoestima y de la gratitud, con el enfoque en el bienestar y en la satisfacción del paciente a largo plazo. Estudios cualitativos o con métodos mistos pueden fornecer también más comprensión de los resultados centrados en los pacientes en rehabilitación soportada por implantes. Con base en la literatura observada se concluye que el estudio de resultados centrados en los pacientes puede ser enriquecido con el uso de diversos métodos para capturar la percepción del paciente de los beneficios de la rehabilitación soportada por implantes. Se sugestiona el uso del OHIP-14, aunque, su uso presente limitaciones que en parte pueden ser reprimidas por la aplicación de los cuestionarios relacionados a la sicología positiva como lo de la gratitud y lo de la autoestima, los cuales presentan dominios positivos.PALABRAS CLAVE: implantes dentales, resultados centrados en los pacientes, cualidad de vida.
Background This study analysed the impact of oral rehabilitation with implant‐supported fixed complete dentures (IFCDs) on the oral health‐related quality of life (OHRQoL) and its relationship with self‐esteem and gratitude. Methods 66 patients were interviewed to collect data on OHRQoL (OHIP‐14), gratitude and self‐esteem, after denture delivery. OHIP‐14 scores were analysed over time and contrasted between groups with IFCD complication or not. Results OHIP‐14 changed from 22.1 ± 13.8 at baseline to 1.8 ± 2.3 after rehabilitation. Gratitude and self‐esteem mean scores were 38.6 ± 3.0 and 36.9 ± 3.8, respectively. OHIP‐14 was statistically different from baseline (22.1 ± 13.8) and 1, 3 and 5 years after rehabilitation (2.3 ± 3.7, 1.9 ± 3.1 and 1.8 ± 2.3). No difference was found between the follow‐up times and among OHIP‐14 domains. Thirteen out of 66 patients (19.7%) had repairable prosthetic complications, but OHIP‐14 did not differ between patients with or without complications. Gratitude and self‐esteem showed a moderate association (rs = 0.36; P = 0.003), but no association with OHIP‐14. Conclusions IFCD treatment has a long‐term positive impact on patient's OHRQoL, even among patients who had prosthetic complications. The long‐term stability in improved OHRQoL is not associated with self‐esteem and gratitude. © 2022 Australian Dental Association
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