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Attitude towards desire for implant treatment among outpatients of a teaching dental hospital, Khammam.

INTRODUCTION

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.

RESULTS

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).

DISCUSSION:

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.

CONCLUSION

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.

doi: 10.5866/2015.7.10022

Department of Public Health Dentistry, Mamata Dental College,

Khammam, Telangana State, India

Article Info:

Received: January 12, 2015

Review Completed: February 10, 2015

Accepted: March 11, 2015

Available Online: April, 2015 (www.nacd.in)

Email for correspondence: venkataramana528@gmail.com

REFERENCES:

(1.) Suprakash B, Ahammed ARY, Thareja A, Kandaswamy R, Kumar N, Bhondwe S. Knowledge and Attitude of Patients toward Dental Implants as an Option for Replacement of Missing Teeth. J Contemp Dent Pract 2013; 14(1):115-118.

(2.) Bhat AM, Prasad KD, Sharma D, Hegde R. Attitude toward Desire for Implant Treatment in South Coastal Karnataka Population: A Short-term Epidemiological Survey. Int J Oral ImplantolClin Res 2012; 3(2):63-66.

(3.) Chowdhary R, Mankani N, Chandrakar NK. Awareness of dental implant as a treatment choice in urban Indian population. Int J oral maxillofac implants 2010; 25:305-308.

(4.) Ravikumar C, Pratap KVNR, Venkateswararao G. Dental implants as an option in replacing missing teeth: a patient awareness survey in khammam, Andhrapradesh. IJDS 2011; 5(3):33-37.

(5.) Zimmer CM, Zimmer WM, Williams J, Liesener J. Public awareness and acceptance of dental implants. Int J Oral Maxillo-fac Implants 1992; 7(2):228-232.

(6.) Sulieman Al Johany, Hamad A Al Zoman, Mohannad Al Juhaini. Dental patients awareness and knowledge in using dental implants as an option in replacing missing teeth: A survey in Riyadh, Saudi Arabia. The Saudi dental journal 2010; 22:183-188.

(7.) Pragati K, Mayank K. Awareness of dental implants as a treatment modality amongst people residing in Jaipur (Rajasthan). J Clin Diagn Res 2010; 4:3622-3626.

(8.) Berge TI. Public awareness, information sources and evaluationof oral implant treatment in Norway. Clin Oral Implants Res 2000; 11(5):401-408.

(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.

(10.) Kaurani P, Kaurani M. Awareness of dental implants as atreatment modality amongst people residing in Jaipur (Rajasthan). J Clin Diagn Res 2010; 4:3622-3626

(11.) Kent G. Effects of osseointegrated implants on psychological and social well-being: A literature review. J Prosthet Dent 1992; 68(3):515-518.

Venkata Ramana M [1], Pratap KVNR [2], Madhavi Padma T [3], Siva Kalyan V [4], Bhargava ASK [5], Surya Chandra Varma L [6]

[1] Post Graduate Student

[2] Professor and HOD

[3] Professor

[4] Reader

[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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Article Details
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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
Article Type:Report
Date:Jan 1, 2015
Words:2177
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