Implant Dentistry at a Glance
Jacques Malet is Clinical Professor in the European Postgraduate Program in Periodontology and Implant Surgery at the Paris Diderot University, and at the Rothschild Hospital, AP-HP France. Francis Mora is Associate Professor in Periodontology and co-Director of the European Postgraduate Program in Periodontology and Implant Surgery at the Paris Diderot University, and at the Rothschild Hospital, AP-HP France. Philippe Bouchard is Professor and Chair of the Department of Periodontology and Director of the European Postgraduate Program in Periodontology and Implant Surgery at the Paris Diderot University, and at the Rothschild Hospital, AP-HP France.
Implant Dentistry at a Glance
Quality of life associated withimplant-supported prostheses: An introduction to implant dentistry
According to the World Health Organization, 'Health is a state of complete physical, mental, and social well-being and not merely the absence of disease, or infirmity' (WHO, 1946). Based on this definition, the WHO defines quality of life (QoL) 'as individuals' perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns' (WHO, 1997). In other words, 'QoL is a popular term that conveys an overall sense of well-being, including aspects of happiness and satisfaction with life as a whole' (CDC, 2000).
The concept of health-related quality of life (HRQoL) on an individual level 'includes physical and mental health perceptions (e.g., energy level, mood) and their correlates including health risks and conditions, functional status, social support, and socio-economic status' (CDC, 2000). In short, the Centers for Disease Control and Prevention have defined HRQoL as 'an individual's or group's perceived physical and mental health over time'.
Oral health quality of life
Questionnaires have been developed to assess the impact of oral conditions on HRQoL. Oral health-related quality of life (OHRQoL) encompasses a collection of metrics such as Dental Impact on Daily Living (DIDL), Geriatric/General Oral Health Assessment Index (GOHAI), Oral Health Impact Profile (OHIP) and Oral Impacts on Daily Performances (OIDP). Among these metrics, the 14-item OHIP-14 is the most popular. The diversity of measures makes it difficult to adopt a global approach to assess the impact of missing teeth on OHRQoL.
Dental implants and oral health
Implant dentistry aims to replace missing teeth. This is a very challenging aspect of dentistry: Should dentists replace the teeth that have been lost? However, from the patient's perspective, it makes sense to ask the question: What are the benefits of dental implant placement? In other words, the following issues should be addressed:
- Should missing teeth be replaced?
- Does implant dentistry improve a patient's quality of life?
- Is implant dentistry a cost-effective option?
We hope that this chapter will help the practitioner, not to convince patients to have dental implants, but to provide them with sufficient information to assist in the decision-making process.
Should missing teeth be replaced?
It is beyond the scope of this book to explore the scientific rationale supporting the replacement of missing teeth. However, logic dictates that we need a minimum number of teeth and functional masticatory units (FMUs, defined as pairs of opposing teeth or dental restoration allowing mastication, excluding incisors) to ensure an acceptable OHRQoL.
Number of teeth
A significant link has been established between the number of teeth and OHRQoL (Tan et al. , 2016). Fewer than 17 teeth is associated with poor OHRQoL in the elderly (Jensen et al. , 2008).
The concept of shortened dental arches (SDAs) has been proposed (Witter et al. , 1999). This concept refers to dentition with intact anterior teeth and loss of posterior teeth; that is, molar teeth. It has been suggested that at least 20 teeth are required in order to maintain functional, aesthetic and natural dentition, and to meet oral health targets (Petersen and Yamamoto, 2005). Dentists advocate the practical applicability of SDAs. A recent multicentre survey showed that about 80% of participating professionals agreed with the SDA concept (Abuzar et al. , 2015).
Moreover, there is no significant difference in terms of OHRQoL between subjects with SDAs and those with removable dentures (Antunes i