Publications by authors named "Urs Braegger"

4 Publications

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Group 3 ITI Consensus Report: Patient-reported outcome measures associated with implant dentistry.

Clin Oral Implants Res 2018 Oct;29 Suppl 16:270-275

Universidad Inter Continental, Mexico City, Mexico.

Objectives: The aim of Working Group 3 was to focus on three topics that were assessed using patient-reported outcome measures (PROMs). These topics included the following: (a) the aesthetics of tooth and implant-supported fixed dental prostheses focusing on partially edentulous patients, (b) a comparison of fixed and removable implant-retained prostheses for edentulous populations, and (c) immediate versus early/conventional loading of immediately placed implants in partially edentate patients. PROMs include ratings of satisfaction and oral health-related quality of life (QHRQoL), as well as other indicators, that is, pain, general health-related quality of life (e.g., SF-36).

Materials And Methods: The Consensus Conference Group 3 participants discussed the findings of the three systematic review manuscripts. Following comprehensive discussions, participants developed consensus statements and recommendations that were then discussed in larger plenary sessions. Following this, any necessary modifications were made and approved.

Results: Patients were very satisfied with the aesthetics of implant-supported fixed dental prostheses and the surrounding mucosa. Implant neck design, restorative material, or use of a provisional restoration did not influence patients' ratings. Edentulous patients highly rate both removable and fixed implant-supported prostheses. However, they rate their ability to maintain their oral hygiene significantly higher with the removable prosthesis. Both immediate provisionalization and conventional loading receive positive patient-reported outcomes.

Conclusions: Patient-reported outcome measures should be gathered in every clinical study in which the outcomes of oral rehabilitation with dental implants are investigated. PROMs, such as patients' satisfaction and QHRQoL, should supplement other clinical parameters in our clinical definition of success.
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October 2018

A digital approach for one-step formation of the supra-implant emergence profile with an individualized CAD/CAM healing abutment.

J Prosthodont Res 2016 Jul 9;60(3):220-3. Epub 2016 Feb 9.

Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, University of Bern, Switzerland.

Purpose: This Technical Procedure describes a novel workflow for a one-step formation of the supra-implant emergence profile in the esthetic zone - the 'Digitally Flip Technique' (DFT).

Methods: After implant placement, a post-operative intra-oral optical scan (IOS) was performed to capture the final three-dimensional implant position. Based on the superimposition of the digitally slice-wise DICOM-segmentation of the digitally flipped (mirrored) contra-lateral tooth and the STL-file of the IOS, an individualized healing abutment was CAD/CAM-fabricated out of PMMA-based restoration material in a fully digital workflow and seated at the stage of reopening surgery. One single treatment step was necessary for final modulation of the supra-implant mucosa architecture in order to mimic the morphological emergence profile of the contra-lateral tooth within a short-span time frame of four days after insertion of the individualized healing abutment.

Conclusions: The implant crown emergence profile could be shaped immediately after reopening according to the three-dimensional radiographic contour of the digitally flipped contra-lateral tooth. Estimating the emergence profile or time-consuming step-by-step conditioning of the mucosa through an additionally produced implant provisional was therefore avoided.
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July 2016

Cost-benefit, cost-effectiveness and cost-utility analyses of periodontitis prevention.

Urs Braegger

J Clin Periodontol 2005 ;32 Suppl 6:301-13

Department of Periodontology and Fixed Prosthodontics, School of Dental Medicine, University of Bern, Bern, Switzerland.

Objective: The aim of this paper was to determine whether there is evidence that periodontitis prevention is economically justified.

Material And Methods: The characteristics of economic assessments such as cost-benefit, cost-effectiveness and cost-utility analyses were first derived from the literature on health economy. A literature search was conducted using PubMed up to December 2004. Inclusion criteria required that economic analyses be based on scientific principles including a hypothesis, valid comparative groups as well as a cost/benefit, cost/effectiveness and cost/utility assessment.

Results: Only 14 papers were located, which included, in the broadest sense, economic parameters. From these papers, three were systematic reviews, three were randomized controlled studies, four were controlled studies, one was a longitudinal cohort study and three papers were based on statistical modelling. Only one paper reported actual costs for periodontal and dental treatment. Extensive programmes aimed at prevention of periodontal disease in a general population group showed no economic benefit. Adjunctive genetic/and or microbiological testing likewise showed no economic benefit. Economic assessments and real costs are not generally available in the literature. Statistical modelling suggested that non-surgical periodontal procedures are more economical compared with surgical interventions. The use of local delivery devices as an adjunct to Sc/RP showed no economic advantage.

Conclusion: It is suggested that economic parameters as well as patient-centred outcomes be included in clinical trials. These data are essential for the appropriate allocation of resources for preventive measures on an individual patient and population base.
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October 2005

Quality of dental implants.

Int Dent J 2003 ;53(6 Suppl 2):409-43

Institute of Clinical Dentistry, University of Oslo, Blindern, Norway.

Background: Clinicians need quality research data to decide which dental implant should be selected for patient treatment. AIM(S)/OBJECTIVE(S): To present the scientific evidence for claims of relationship between characteristics of dental implants and clinical performance.

Study Design: Systematic search of promotional material and Internet sites to find claims of implant superiority related to specific characteristics of the implant, and of the dental research literature to find scientific support for the claims.

Main Outcome Measures: Critical appraisal of the research documentation to establish the scientific external and internal validity as a basis for the likelihood of reported treatment outcomes as a function of implant characteristics.

Results: More than 220 implant brands have been identified, produced by about 80 manufacturers. The implants are made from different materials, undergo different surface treatments and come in different shapes, lengths, widths and forms. The dentist can in theory choose among more than 2,000 implants in a given patient treatment situation. Implants made from titanium and titanium alloys appear to perform well clinically in properly surgically prepared bone, regardless of small variations of shapes and forms. Various surface treatments are currently being developed to improve the capacity of a more rapid anchorage of the implant into bone. A substantial number of claims made by different manufacturers on alleged superiority due to design characteristics are not based on sound and long-term clinical scientific research. Implants are, in some parts of the world, manufactured and sold with no demonstration of adherence to any international standards.

Conclusions: The scientific literature does not provide any clear directives to claims of alleged benefits of specific morphological characteristics of dental implants.
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February 2004