Attitude towards desire for implant treatment among outpatients of a teaching dental hospital, Khammam.
The main role of prosthodontics is the rehabilitation of patients after loss of teeth and oral function. (1) Common oral conditions have been shown to have a substantial effect on well-being and quality of life. The research in dentistry resulted in many rehabilitation procedures. The compromising factors in existing procedures resulted in the development of new treatment procedures. (2)
A large number of patients experience difficulties in adapting to removable prosthesis while a smaller number are unable to accept removable prosthesis at all. (1,3) This may be because of various factors involving anatomy, physiology, psychology and Prosthodontics. Inferior masticatory ability difficulty with denture retention, speech and mastication makes removable prosthesis difficult to accept.
With advent of new technology more restorative options have become available thereby changing the face of demand for Prosthodontics treatment. Among them implant treatment has come into focus since it provides excellent long term results in rehabilitation. The unique feature of implant is able to achieve ideal goal regardless of atrophy and injury to stomatognathic system (4) Dental implants have proven to be having a high efficacy rate which is evident from several long term clinical trials. (5)
Reports from Finland, Australia, Austria have shown that the level of awareness of dental implant treatment procedure in selected group of samples is 29%, 64%, 72% respectively. (6) Awareness among people about treatment procedure like implant is the major criteria in developing countries like India. (4) Similarly, incomplete information, negative information, treatment cost, fear of surgery, long post surgical period, false believes among public are barriers to take implant treatment procedure in country. Thus the present study was conducted with an objective to determine awareness of implant supported prosthesis as a new modality to determine attitude of people towards implant treatment and to determine constraints in implant treatment like age, finance, fear of surgery etc.
MATERIALS AND METHODS
A descriptive cross sectional study was conducted on patients attending outpatient ward of the teaching Dental Hospital, Khammam. A total of 310 were approached of them 300 were agreed to participate questionnaire with a response rate of 96.77%. Patients willing to participate and between the age group of 20 to 65 years were taken into the study. Ethical clearance was obtained from the ethical committee of Dental College, Khammam.
Study instrument has two parts in which demographic data like patient age and gender are recorded in the first part. The other part included a close ended questionnaire with 11 questions. Validity of questionnaire was ensured by panel of experts in the field, framing was done as per their suggestion. A pilot study was done to assess changes in the terminology.
The results were analyzed by using SPSS18 software. Descriptive statistics were generated to summarize the response. Analysis of gender was done using chi square test.
The subjects were categorized based on gender and age group. The subjects were between 21 years to 60 years of age of which 77.33% male (232) and 22.67% female (68). The maximum numbers of respondents were between 21-30 years of age which indicates literacy rate to maximum. The age group between 51-60 years constitutes a minimum of 15% of the sample. Among the participants who answered the questionnaire 42.3% were of 21-30 years age group, 23.3% between 31-40, 19.33% between 41-50 and 15% between 51-60 years (Table 1). The mean age that have participated in study is 36.67 for male and 35.24 for female (Table 2).
98.6% of sample feels replacement of lost tooth is necessary. Majority (91.67%) says it is for performing functions and 23 (7.67%) for aesthetics. 188 (62.67%) of sample know about both removable and fixed type of prosthetic treatment. Only 78 (29.33%) are aware of implant treatment procedure. Misconceptions about implant treatment among the sample are about 93 (31%). In the sample majority 169 (56.33%) feels it is an expensive though willing cannot afford. 117 (39%) of them felt that the long duration in treatment plan is one of the drawback for treatment procedure. Fear about surgery 123 (41%) are barriers in success of implant procedure. Only 3% of the studied sample has undergone this procedure (Table 3).
Almost equal proportion of male and female in the sample responded positively about need for replacement, awareness about removable and fixed prosthesis. Fear towards surgery is more among female (57%) than that of (40%) of sample in male population and the difference was statistically significant (p=0.0270). Statistically significant difference was found between males and females with regards to age at which people can undergo implants treatment, and cost of treatment.(p=0.0000, p=0.3000) (Table 4).
Dental implant treatment has become the first choice of treatment procedure for replacing missing tooth. The unique features of implant made it widely accepted. The comfort and confidence given by a fixed prosthesis can never be compared to any ideal removable appliance. In spite of its benefits the wide acceptance of the implant treatment procedure becomes challenged in developing countries like India. Hence to evaluate a survey was conducted to know the patients' attitude to undergo implant treatment.
Around one million dental implants are inserted each year, worldwide. (7) However, information which is available to the patients regarding the procedure and its success, is often fragmentary. This problem is more compounded in developing nations. In the present study, awareness regarding implants were among 29.33% participants which was very less than other studies done by Zimmer et al (1992), Berge (2000) and Tepper et al (2003) which reported the level of awareness as 77, 70.1 and 72%, respectively. (5, 8 9) It could be due to low level of education in the study sample as most of the people belong to rural community. But the results of the present study were higher than Chowdhary R et al among Indian population in 2010. (3)
When questions were asked regarding constraints of implants, most of them mentioned high cost as the major factor. Some patients think that, the implant is a major surgical procedure because of the use of the word surgery. Similar results are obtained in most of the previously mentioned studies: Kaurani P et al (2010), Johany SA et al (2010), Tepper et al (2003), Kent (1992) and Zimmer et al (1992). (5,6,9-11)
The analyzed sample gave different results in male and female population. The poorer social awareness in female made less knowledge about implant treatment. The misconceptions and fear about surgery are more among the female sample. Male population accepted cost procedure and showed willingness with its long term results. Long duration of procedure is a disadvantage in the treatment was expressed by the male population. Statistically significant difference was found between males and females with regards to age at which people can undergo implants treatment, fear of surgery for implant placement and cost of treatment.
These barriers are to be removed by increasing awareness among the subjects. Population often showed interest to know about treatment during the study.
Interest to know new treatment modalities is high among the population. Providing proper information makes some population aware about the treatment and allow other population with misconceptions to correct them. Dentists, media, arts play an important role in this. Providing financial support also increase the proportion of implant under taking the sample.
Department of Public Health Dentistry, Mamata Dental College,
Khammam, Telangana State, India
Received: January 12, 2015
Review Completed: February 10, 2015
Accepted: March 11, 2015
Available Online: April, 2015 (www.nacd.in)
Email for correspondence: firstname.lastname@example.org
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(9.) Tepper G, Haas R, Mailath G, Teller C, Zechner W, Watzak G, et al. Representative marketing-oriented study on implants in the Austrian population. I. Level of information, sources of information and need for patient information. Clin Oral Implants Res 2003; 14(5):621-633.
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Venkata Ramana M , Pratap KVNR , Madhavi Padma T , Siva Kalyan V , Bhargava ASK , Surya Chandra Varma L 
 Post Graduate Student
 Professor and HOD
[5&6] Senior Lecturer
Table 1: Distribution of study samples by age groups and gender Age groups Male % Female % Total % 21-30yrs 100 78.74 27 21.26 127 42.33 31-40yrs 49 70.00 21 30.00 70 23.33 41-50yrs 46 79.31 12 20.69 58 19.33 51-60yrs 37 82.22 8 17.78 45 15.00 Total 232 77.33 68 22.67 300 100.00 Table 2: Mean and SD age by gender Male Female Total Mean age 36.67 35.24 36.34 SD age 11.14 11.31 11.18 Table 3: Item wise responses Items No of respondents % of respondents Q1 No 4 1.33 Yes 296 98.67 Q2. Beauty 23 7.67 Function 275 91.67 Other 2 0.67 Q3. No 112 37.33 Yes 188 62.67 Q4. No 182 70.67 Yes 118 29.33 Q5. No 207 69.00 Yes 93 31.00 Q6. No 131 43.67 Yes 169 56.33 Q7. No 113 41.00 Yes 147 49.00 Q8. No 177 59.00 Yes 123 41.00 Q9. No 183 61.00 Yes 117 39.00 Q10. No 115 36.67 Yes 145 63.33 Q11. No 291 97.00 Yes 9 3.00 Total 300 100.00 * p <0.05 Table 4: Comparison of male and females with respect to each question Chi- p- Items M % F % Tot % square value Q1 No 3 75.00 1 25.00 4 1.33 0.0126 0.9107 Yes 229 77.36 67 22.64 296 98.67 Q2 Beauty 17 73.91 6 26.09 23 7.67 0.7420 0.6900 Function 213 77.45 62 22.55 275 91.67 Other 2 100.00 0 0.00 2 0.67 Q3 No 82 73.21 30 26.79 112 37.33 1.7299 0.1884 Yes 150 79.79 38 20.21 188 62.67 Q4 No 114 75.00 38 25.00 152 50.67 0.9570 0.3280 Yes 118 79.73 30 20.27 148 49.33 Q5 No 167 80.68 40 19.32 207 69.00 4.2572 0.0391 * Yes 65 69.89 28 30.11 93 31.00 Q6 No 100 76.34 31 23.66 131 43.67 0.1320 0.7164 Yes 132 78.11 37 21.89 169 56.33 Q7 No 101 66.01 52 33.99 153 51.00 22.8273 0.0000 * Yes 131 89.12 16 10.88 147 49.00 Q8 No 129 72.88 48 27.12 177 59.00 4.8814 0.0272 * Yes 103 83.74 20 16.26 123 41.00 Q9 No 139 75.96 44 24.04 183 61.00 0.5076 0.4762 Yes 93 79.49 24 20.51 117 39.00 Q10 No 112 72.26 43 27.74 155 51.67 4.7125 0.0300 * Yes 120 82.76 25 17.24 145 48.33 Q11 No 226 77.66 65 22.34 291 97.00 0.6022 0.4377 Yes 6 66.67 3 33.33 9 3.00 Total 232 77.33 68 22.67 300 100.0 * p <0.05
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|Title Annotation:||ORIGINAL RESEARCH|
|Author:||Venkata, Ramana; Pratap, K.V.N.R.; Madhavi, Padma T.; Siva, Kalyan V.; Bhargava, A.S.K.; Surya, Chan|
|Publication:||Indian Journal of Dental Advancements|
|Date:||Jan 1, 2015|
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