title: Dental phobia is no contraindication for oral implant therapy.
abstract: OBJECTIVE
  Dental phobia is a psychological disease and a possible contraindication for implant therapy. The study aimed to show that implant therapy in dental-phobic patients (DP, test group) after adequate psychological and dental pretreatment (PDPT) is successfully possible and results in a similar implant prognosis as in nonfearful patients (NF, control group).
  
  
  METHODS
  15 DP with PDPT and 15 NF were treated with dental implants and were re-evaluated 2 to 4 years after denture-mounting regarding: alteration of dental anxiety (Hierarchical Anxiety Questionnaire [HAQ], Visual Analog Scale [VAS]), patient satisfaction and compliance, implant success, and peri-implant health. Statistical tests of non-inferiority DP versus NF were performed with Hodges-Lehmann estimators and respective one-sided 97.5% confidence intervals of Moses, and pairwise testings with Mann-Whitney test.
  
  
  RESULTS
  The DP test group rated its anxiety significantly lower at follow- up than at baseline (PHAQ < .001). However, at follow-up, anxiety was still higher in DP than in NF (PHAQ = .046; PVAS < .001). Implant success at follow-up was 100%. Oral health was equally good in DP and NF patients. At follow-up, all patients were satisfied with implant therapy, but compliance was better for NF (100%) than for DP (73% dental checkup; 67% dental hygienist).
  
  
  CONCLUSIONS
  Implant therapy can be successfully performed in DP patients with PDPT as phobia is not negatively influenced by the invasive implant therapy. However, motivation for professional maintenance programs remains challenging.
authors.affiliation: Department of Prosthodontics, University of Berne, Switzerland. norbert.enkling@zmk.unibe.ch
authors.forename: Norbert
authors.initials: N
authors.lastname: Enkling
authors.forename: Katharina
authors.initials: K
authors.lastname: Hardt
authors.forename: Joannis
authors.initials: J
authors.lastname: Katsoulis
authors.forename: Christoph A
authors.initials: CA
authors.lastname: Ramseier
authors.forename: Alessandra
authors.initials: A
authors.lastname: Colombo
authors.forename: Peter
authors.initials: P
authors.lastname: Jöhren
authors.forename: Regina
authors.initials: R
authors.lastname: Mericske-Stern
mesh_terms: D000328:Adult; D001071:Appointments and Schedules; D016022:Case-Control Studies; D000075202:Contraindications; D016854:Dental Anxiety / Q000150:complications* / Q000523:psychology; D003758:Dental Implantation, Endosseous / Q000523:psychology*; D015921:Dental Implants / Q000523:psychology*; D003774:Dental Plaque Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008347:Manifest Anxiety Scale; D008875:Middle Aged; D009910:Oral Hygiene; D010349:Patient Compliance; D017060:Patient Satisfaction; D010512:Periodontal Index; D011300:Preoperative Care; D011379:Prognosis; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D064232:Visual Analog Scale
chemical_list: D015921:Dental Implants