Estetik Zonda Gerçekleştirilen Dental Implant Uygulamalarına İlişkin Hasta Memnuniyetinin Değerlendirilmesi
Topcu, Ali Orkun
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The aims of the present study were; to evaluate dental implant patients' general level of satisfaction and the various parameters that have a potential impact on satisfaction level and quality of life. The present study also aimed to evaluate the possible differences in the aesthetic perception between patients, dentists, and dental specialists. A total of 103 patients, who were provided with dental implant treatment between years 2003-2011 were volunteered to participate. A total of 164 implant-supported fixed prothesis and 264 dental implant sites in the anterior esthetic zone were included. During the routine examination probing depth (PD), plaque index (PI), gingival index (GI), presence of bleeding on gentle probing (BOP) and gingival recession (GR) were recorded. Marginal bone levels were evaluated by periapical radiographs using parallelling technique. Oral health related quality of life was measured by Oral Health Impact Profile-14 (OHIP-14) questionnare and supported with VAS questionnare to evaluate patient satisfaction, esthetics and how patients perceived their implant-supported fixed partial dentures. Besides patients, esthetics features of the implant-supported prothesis were also comparetively evaluated by one periodontist, one prosthodontist and one orthodontist. Dentists used visual analog scale (VAS) to evaluate all implant-supported fixed prothesis and also Pink Esthetic Score/White Esthetic Score (PES/WES) for implant-supported single tooth restorations. The mean patient satisfaction score was 87.42 ± 11.86. OHIP scores, patient satisfaction, chewing and speech comfort, cleanability, phonetics, patient expectations, willingness to go under the same treatment or suggestion to friends/relatives have been shown to be unaffected by age and gender variables. Individuals who have implant-supported bridge are shown to be more dissatisfied about pre-treatment information regarding surgery, cleaning ability, phonetics, discomfort regarding surgery and have higher OHIP scores compared to single-tooth restorations. Patients who had been provided with hard/soft tissue augmentation have significantly higher overall satisfaction scores, on the other hand these patients are shown to avoid cleaning their implant-supported restorations compared to their non-augmented counterparts. In the present study no correlation was found between patient and dentist esthetic VAS scores. When the mean esthetic VAS scores were considered, orthodontist had significantly lower scores compared to periodontist and prosthodontist. Dentists' esthetics VAS scores were significantly lower for implant-supported bridge group and implants with a history of periodontitis. Although significantly lower PES scores for periodontist, lower WES scores for prosthodontist were detected, overall PES/WES scores did not significantly differ among the observers. Inter-observer agreement was found to be 47% for VAS scores, and 86% for PES/WES scores. When the high VAS scores and low OHIP scores were considered, it can be concluded that, patients with fixed implant-supported restorations in the esthetic zone have high satisfaction rates and good oral health related quality of life. In the limits of the present study, it can be suggested that type of prosthesis, presence of soft/hard tissue augmentation, augmentation type, reason for tooth loss may have an impact on patient satisfaction and esthetic perception.