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Leles CR, Curado TFF, Nascimento LN, Silva JR, de Paula MS, McKenna G, Schimmel M. Changes in masticatory performance and bite force after treatment with mandibular overdentures retained by four titanium-zirconium mini implants: One-year randomised clinical trial. J Oral Rehabil 2024; 51:1459-1467. [PMID: 38685704 DOI: 10.1111/joor.13722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/12/2024] [Accepted: 04/19/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE This prospective study is part of a randomised clinical trial and reports the changes in masticatory performance (MP) and bite force, and explores their influential factors, 1 year after the provision of mandibular overdentures retained by four titanium-zirconium mini implants. METHODS Edentulous patients received conventional complete dentures, followed by placement of four mini implants (Straumann® Mini Implant System) in the anterior mandible and converting the conventional prosthesis into a mandibular overdenture. Treatment protocols were randomised using a 2×2 factorial design combining different surgical (flapped vs. flapless) and loading (immediate vs. delayed) protocols. MP was assessed using a two-colour mixing ability test and a colorimetric analysis to measure the level of colour mixing (Variance of Hue-VoH). Maximum voluntary bite force (MBF) was measured by a digital gnathodynamometer in the posterior and anterior regions. Sex, age, surgical and loading protocols and ridge morphology were tested as independent variables. MP and MBF tests were performed at baseline (pre-treatment) and the 3-, 6- and 12-month after implant loading. Descriptive statistics, independent t-test, and linear mixed-effect model (LMM) regression were used for data analysis. RESULTS Seventy-four participants were assessed and 73 completed the 1-year follow-up. Statistically significant improvements in functional parameters were observed in all follow-up periods compared to baseline (p < .001). The flapless protocol was associated with higher improvement in MP at the 3-month follow-up (p = .004), while less resorbed ridges were associated with better MP (p = .038) and higher MBF (p < .001). CONCLUSION The mandibular overdenture protocol using four titanium-zirconium mini implants was effective in improving MP and MBF of edentulous patients, compared to pre-treatment values. The findings also suggest that improvements in chewing function and bite force are impacted by clinical factors since better outcomes were observed for flapless surgeries and less resorbed edentulous ridges. CLINICAL TRIAL REGISTRATION ClinicalTrials.Gov ID NCT04760457.
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Affiliation(s)
- Cláudio Rodrigues Leles
- School of Dentistry, Federal University of Goias, Goiania, Brazil
- Division of Gerodontology, Department of Reconstructive Dentistry, School of Dental Medicine of the University of Bern, Bern, Switzerland
| | | | | | | | | | - Gerald McKenna
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Martin Schimmel
- Division of Gerodontology, Department of Reconstructive Dentistry, School of Dental Medicine of the University of Bern, Bern, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
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Maniewicz S, Curado TFF, Srinivasan M, Leles CR, Müller F. Mandibular overdenture with a single implant in the canine region (c-SIMO): a feasibility study. Clin Oral Investig 2024; 28:330. [PMID: 38772987 PMCID: PMC11108892 DOI: 10.1007/s00784-024-05723-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/13/2024] [Indexed: 05/23/2024]
Abstract
OBJECTIVES The aim of this multi-center pilot study was to assess the viability and feasibility of a novel treatment concept - the canine-positioned single implant mandibular overdenture (c-SIMO), with the single implant placed on the patient's preferred chewing side instead of the midline. MATERIALS AND METHODS Participants received a single implant in the canine region of their preferred chewing side, based on an Asymmetry Index observed during mastication. The pre-existing mandibular denture was transformed into a c-SIMO on a spherical attachment. The primary outcome was oral health-related quality of life (OHRQoL), measured with GOHAI and OHIP-EDENT. Secondary outcomes included denture satisfaction index (DSI), chewing efficiency (CE), maximum bite force (MBF), implant survival and success, and prosthetic maintenance. Data analysis included descriptive statistics and bivariate comparison tests. RESULTS Fifteen participants received the c-SIMO treatment (mean age: 69.9 ± 7.0). Implant success and survival rates were 100% at 1 year. Patient-reported outcome measures improved significantly compared to pre-treatment values (OHIP-EDENT: p = 0.001; DSI: p = 0.001; GOHAI: p = 0.002). Masticatory outcomes also improved significantly (CE: p = 0.001; overall MBF: p = 0.005). Post-implant, MBF was significantly higher in the ipsilateral side compared to the contralateral side at 2 weeks (p = 0.019) and 3 months (p = 0.015), but no longer at T3 (p = 0.730). Common prosthodontic events included denture base adjustments (n = 17) and matrix activation (n = 9). CONCLUSIONS This pilot study concludes that c-SIMO is a promising treatment option, and a potential alternative to the single midline implant overdenture. CLINICAL RELEVANCE The novel treatment concept of a canine-positioned single implant mandibular overdenture could be a viable treatment alternative to the midline positioning.
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Affiliation(s)
- Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.
| | | | - Murali Srinivasan
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
- Clinic of General-, Special Care and Geriatric Dentistry, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Cláudio Rodrigues Leles
- Department of Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Brazil
- Clinic of General-, Special Care and Geriatric Dentistry, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Thônex, Switzerland
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Elawady D, Adam MA, Allam H, Mahmoud II, Alqutaibi AY, Shon AA. Single Implant-Retained Mandibular Overdentures: A Literature Review. Cureus 2024; 16:e52486. [PMID: 38371006 PMCID: PMC10874113 DOI: 10.7759/cureus.52486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 02/20/2024] Open
Abstract
The absence of teeth, known as edentulism, poses considerable obstacles in prosthodontic care and greatly affects a person's well-being. Conventional complete dentures frequently lead to problems like instability and insufficient retention, especially in the lower jaw. Fortunately, the introduction of dental implants has transformed the way we approach edentulous patients, as they now offer support and enhanced retention for removable prostheses, thus revolutionizing their treatment. While a consensus exists on using two implants for retaining mandibular overdentures, the associated cost may be prohibitive for economically disadvantaged individuals. As a solution, the concept of single implant-retained mandibular overdentures has emerged, catering to individuals with limited financial resources and complete tooth loss. This review explores the efficacy and suitability of the single implant overdenture approach, along with an overview of treatment options for edentulous patients, including traditional dentures, tooth-supported overdentures, and implant-supported overdentures. The preservation of bone, improvements in functional abilities, and psychological benefits associated with overdentures are discussed. Moreover, various classifications and prosthetic options for implant overdentures, specifically for mandibular cases, are presented. This literature review aims to provide a comprehensive understanding of possible treatment options and focus on the single implant-retained mandibular overdenture approach and its implications in prosthodontic rehabilitation for edentulous patients.
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Affiliation(s)
- Dina Elawady
- Prosthodontics, October University for Modern Sciences and Arts, Cairo, EGY
| | - Maya Ali Adam
- Prosthodontics, October University for Modern Sciences and Arts, Cairo, EGY
| | | | | | - Ahmed Yaseen Alqutaibi
- Substitutive Dental Sciences, Taibah University, Madinah, SAU
- Prosthodontics, Ibb University, Ibb, YEM
| | - Ahmed Atef Shon
- Prosthodontics, Al-Azhar University, Cairo, EGY
- Prosthodontics, Al Mouwasat Hospital, Madinah, SAU
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de Souza R, Jabbar A, Jafarpour D, Bedos C, Esfandiari S, Makhoul N, Dagdeviren D, Abi Nader S, Feine J. Single-Implant Overdentures Retained by a Novel Attachment: A Mixed Methods Crossover Randomized Clinical Trial. JDR Clin Trans Res 2024; 9:27-41. [PMID: 36127832 PMCID: PMC10725123 DOI: 10.1177/23800844221124083] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Single-implant mandibular overdentures (SIMOs) are one of the least invasive implant treatments for edentulism. The new Novaloc attachment system can improve the clinical performance of implant-retained overdentures but has not been tested for SIMOs. OBJECTIVES To compare Novaloc and a gold standard system (Locator) for SIMOs in an edentate elderly population in terms of patient-reported outcomes and device- and treatment-related complications. METHODS In this single-center crossover randomized clinical trial (RCT), 10 edentulous participants received an implant in the lower midline and had their lower complete dentures converted to SIMOs. The participants received each attachment system for 3 mo in a randomized order, followed by measurement of patient satisfaction and oral health-related quality of life via the McGill Denture Satisfaction Questionnaire and the Oral Health Impact Profile for Edentulous People questionnaire, respectively. Complications were registered throughout the RCT. Patients were interviewed for their experiences with SIMOs and preference for one of the attachment systems. Quantitative analysis employed mixed linear models and chi-square tests (α = 0.05), whereas interview data underwent thematic analysis and, in turn, integration into quantitative data (mixed methods explanatory design). RESULTS All 10 randomized participants completed the trial. Mean ± SD general satisfaction was 92% ± 8% with Novaloc versus 85% ± 13% with Locator (mean difference, 9%; 95% CI, 1% to 17%). For specific McGill Denture Satisfaction Questionnaire items, only denture stability was significantly increased for Novaloc. Seven participants preferred Novaloc over Locator at the end of the RCT (chi-square, P = 0.045). No difference was found between the attachments in terms of oral health-related quality of life based on the Oral Health Impact Profile for Edentulous People and complications. Thematic analysis revealed high patient satisfaction with SIMOs, with denture stability the main criterion for their satisfaction and attachment preference. CONCLUSION Among elderly edentulous patients wearing SIMOs, Novaloc led to increased patient satisfaction and preference. Better patient-perceived denture stability may explain this result. The attachment systems exhibited similar short-term maintenance needs. TRIAL REGISTRATION ClinicalTrials.gov: NCT03126942 (first registered on April 13, 2017). Secondary identifiers: A03-M07-17A (McGill University, Institutional Review Board) and 2018-3873 (McGill University Health Centre, Research Ethics Board). KNOWLEDGE TRANSFER STATEMENT The results of this mixed methods study can be used by clinicians when choosing which attachment system to use for SIMOs. Results suggest that edentulous patients prefer attachments with a better-defined seating position, such as that of the Novaloc system, as opposed to the nylon matrix on metallic abutment of the Locator system.
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Affiliation(s)
- R.F. de Souza
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - A.A. Jabbar
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - D. Jafarpour
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - C. Bedos
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - S. Esfandiari
- Faculty of Dentistry, Université de Montréal, Montreal, Canada
| | - N.M. Makhoul
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - D. Dagdeviren
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - S. Abi Nader
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - J.S. Feine
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
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Altayyar S, Al‐zordk W, Algabri R, Rajah E, Al‐baadani A, Alqutaibi AY, Madina MA, Ghazy MH. Prospective evaluation of implants-supported, tooth-implant supported, and teeth-supported 3-unit posterior monolithic zirconia fixed restorations: Bite force and patient satisfaction. Clin Exp Dent Res 2023; 9:810-819. [PMID: 37703213 PMCID: PMC10582233 DOI: 10.1002/cre2.780] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/12/2023] [Accepted: 08/27/2023] [Indexed: 09/15/2023] Open
Abstract
OBJECTIVES This study aimed to evaluate the maximum bite force (MBF) and satisfaction of patients restored with implants, combined tooth-implants, and teeth-supported monolithic zirconia fixed dental prostheses (FDPs). MATERIALS AND METHODS Thirty partially edentulous patients in need of three units of FDPs in their mandibular posterior region were divided into three equal groups (n = 10) as follows: Group-1 patients received two implants for each at the second premolar and second molar regions, Group-2 patients received one implant for each at the second molar region, and Group-3 patients with missing lower first molar. All the restorations were constructed from monolithic zirconia. Patients were evaluated 1 week after placement of restorations (baseline) and then after 6, 12, and 24-month intervals for MBF using force transducer occlusal force meter and satisfaction (function, esthetic, and overall satisfaction) using a visual analog scale. RESULTS The mean MBF for Group 1 was higher than Group 2 (p = .044) but not that of Group 3 (p = .923). Additionally, Group 3 displayed a higher MBF than Group 2, although this difference was not statistically significant (p = .096). Concerning patient satisfaction, all study groups reported high levels of satisfaction across all satisfaction elements, and no significant differences were observed between the groups. CONCLUSION Within the limitations of this study, it can be concluded that Group 1 gives comparable anticipated treatment outcomes as Group 3 concerning biting force and patient satisfaction. However, Group 2 gives comparable satisfaction results with biting force value within the normal range; thus, it might be used as a treatment option in a specific situation.
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Affiliation(s)
- Sadeq Altayyar
- Prosthodontic Department, Faculty of DentistryIBB UniversityIbbYemen
| | - Walid Al‐zordk
- Fixed Prosthodontic Department, Faculty of DentistryMansoura UniversityMansouraEgypt
| | - Radwan Algabri
- Prosthodontic Department, Faculty of DentistryIBB UniversityIbbYemen
- Prosthodontic Department, National UniversityIbb‐BranchIbbYemen
| | - Eshraq Rajah
- Prosthodontic Department, Faculty of DentistrySana'a UniversitySana'aYemen
| | | | - Ahmed Yaseen Alqutaibi
- Department of Prosthodontic and Implant Dentistry, College of DentistryTaibah UniversityAl MadinahSaudi Arabia
- Department of Prosthodontics, College of DentistryIbb UniversityIbbYemen
| | - Manal Abo Madina
- Fixed Prosthodontic Department, Faculty of DentistryMansoura UniversityMansouraEgypt
| | - Mohammed H. Ghazy
- Fixed Prosthodontic Department, Faculty of DentistryMansoura UniversityMansouraEgypt
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Trang BNH, Kanazawa M, Murakami N, Wakabayashi N, Hada T, Sahaprom N, Komagamine Y, Minakuchi S. Stress distribution of one-piece and two-piece mini-Implant overdentures with various attachment systems and diameters: A finite element analysis. J Prosthodont Res 2023; 67:430-436. [PMID: 36372437 DOI: 10.2186/jpr.jpr_d_22_00108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
PURPOSE We investigated and compared the stress distribution within one- and two-piece mini-implants for overdentures with three different attachments (ball, Locator, and magnet) and two different diameters using three-dimensional finite element (3D FE) analysis and a monotonic bending test. The goal was to identify the most beneficial implant attachment system design for mini-implant overdentures with a lower risk of implant fracture. METHODS Twelve 3D FE models simulating a mandible segment with one- and two-piece mini-implants with different attachment systems, diameters, and overdentures were created using three-dimensional computer-aided design (CAD) software. Vertical and oblique forces (45° to the longitudinal axis of the implant) of 100 N were applied to the dentures. The stress distribution was analyzed. A bending test was performed on a mini-implant (Locator, 2.4 mm) using a testing machine to quantify the load at yield stress. RESULTS One-piece mini-implants showed lower maximum stress compared to two-piece mini-implants. Among the three designs, the magnet attachment systems showed the maximum stress. The maximum von Mises stress occurred at the neck of the implants, which was surrounded by cortical bone in all models, and under both loading conditions. CONCLUSIONS Focusing on the attachments and one- and two-piece designs of mini-implant overdentures using CAD models to reduce confounding factors affecting the stress distribution, we concluded that one-piece mini-implants tended to show lower stress compared to two-piece mini-implants. Mini-implant overdentures with Locator and ball attachments demonstrated lower stress within the implants compared to those with magnet attachments under vertical and oblique loading conditions.
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Affiliation(s)
- Bui Ngoc Huyen Trang
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Manabu Kanazawa
- Digital Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Natsuko Murakami
- Advanced Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Noriyuki Wakabayashi
- Advanced Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Tamaki Hada
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Namano Sahaprom
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
- Dental Hospital, Faculty of Dentistry, Chulalongkorn University, Thailand
| | - Yuriko Komagamine
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Shunsuke Minakuchi
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
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Passia N, Kern M. The Single Midline Implant in the Edentulous Mandible-Current Status of Clinical Trials. J Clin Med 2023; 12:jcm12113773. [PMID: 37297967 DOI: 10.3390/jcm12113773] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
The single midline implant in the edentulous mandible is a treatment concept that has often been controversially discussed. Nearly 30 years ago, the first available clinical results revealed high implant survival rates and remarkable improvements in oral comfort, function, patient satisfaction and oral health-related quality of life for edentulous patients compared to the situation with no implant. However, the clinical trials were predominantly conducted with a small number of patients over a short to medium follow-up period. Today, numerous clinical investigations on the single midline implant in the edentulous mandible, which increasingly include longer-term observation periods, are available. It is the aim of this overview to present the current literature and to highlight the clinical problems. This article is a 2023 update of a review published by the authors in the German language in 2021 in the German journal Implantologie. In total, 19 prospective clinical trials with a follow-up period of 0.5-10 years were analyzed. Over this observation period, single implants with modern rough implant surfaces in the edentulous mandible reveal high implant survival rates of between 90.9 and 100% when a conventional delayed loading protocol was applied.
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Affiliation(s)
- Nicole Passia
- Department of Prosthodontics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University at Kiel, Arnold-Heller-Str. 3, Haus B, 24105 Kiel, Germany
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Singh S, Mishra SK, Chowdhary R. Patient satisfaction and crestal bone changes with one-piece and two-piece single implant-retained mandibular overdenture: A randomized controlled clinical study. J Prosthodont Res 2023; 67:112-120. [PMID: 35321961 DOI: 10.2186/jpr.jpr_d_20_00315] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE The present study was done to assess patient satisfaction and crestal bone changes with one-piece and two-piece single implant-retained mandibular overdentures (SIMOs). METHODS The participants included in Group 1 (n=12) received one-piece SIMOs; the participants in Group 2 (n=12) received two-piece SIMOs.Scheduled follow-ups were done at 1 month and 1 year after implant placement. Patient satisfaction and crestal bone changes were evaluated. The data obtained were analyzed statistically with independent Student t-test. RESULTS Visual analogue scale (VAS) score for patient satisfaction with one-piece and two-piece SIMOs were statistically significant at 1-year of follow-up. The patient satisfaction level on the VAS score increased (38.1 to 51.1) with group one-piece SIMOs and two-piece SIMOs (36.6 to 46.8) at baseline to 1 month (P=0.13). The patient satisfaction level increased (38.1 to 56.6) with group one-piece SIMOs and two-piece SIMOs (36.6 to 52.2) at baseline to 1 year (P=0.03). At the 1 year follow-ups, group 1 had mean crestal bone loss of 0.80 ± 0.49 mm and group 2 had 1.24 ± 0.90 mm (P=0.16). Crestal bone loss was greater in the two-piece SIMOs group at 1 month and 1 year follow-ups, but statistically it was insignificant. CONCLUSIONS One-piece SIMOs seemed to be a viable treatment option with increased patient satisfaction on a VAS. Crestal bone loss was greater in the patients with two-piece SIMOs during follow-up. One-piece SIMOs was comparatively simple with less invasive procedures and needed fewer components,so considerable number of patients requiring implant retained dentures could be benefited.
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Affiliation(s)
- Swati Singh
- Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India
| | - Sunil Kumar Mishra
- Department of Prosthodontics, Rama Dental College, Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Ramesh Chowdhary
- Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India
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Using Different Low-Profile Abutments for Assisting Mandibular Implant Overdenture: A Split-Mouth Study. Int J Dent 2022; 2022:8738220. [PMID: 35437443 PMCID: PMC9013306 DOI: 10.1155/2022/8738220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/08/2022] [Accepted: 03/20/2022] [Indexed: 11/18/2022] Open
Abstract
Background Using a pair of different low-profile abutments to assist mandibular implant overdenture (MIOD) in limited restorative space is questionable due to the different morphology. Objective To investigate the marginal bone level (MBL) change and peri-implant-tissue health (PITH) around a pair of OT Equator® and Locator® suprastructures assisting MIOD. Methods Seventeen edentulous patients received MIOD assisted by OT Equator® and Locator®. MBL change was investigated at the implant loading (T1), after six months (T2) and twelve months (T3) of implant loading. PITH was evaluated at T2 and T3. Results There was within abutment significant difference in MBL change after T2 and T3 of loading for Locator (0.05 ± 0.02 and 0.32 ± 0.08, respectively) (P=0.01); and for Equator (0.11 ± 0.08 and 0.21 ± 0.09, respectively) (P=0.01). Also, there was a significant difference between Locator and Equator on the modified plaque index (MPI) after T3 (P=0.01). The significant results were recorded for the MPI at T2 and T3 for Locator (0.92 ± 0.26 and 1.5 ± 0.51, respectively) (P=0.01) and for Equator (0.82 ± 0.26 and 1.42 ± 0.51, respectively) (P=0.003). For modified bleeding index, there was significant difference at T2 and T3 for Locator (0.57 ± 0.19 and 1.14 ± 0.41, respectively) (P=0.03) and for Equator (0.46 ± 0.22 and 1.07 ± 0.41, respectively) (P=0.01). For gingival index, there was significant difference at T2 and T3 for Locator (0.57 ± 0.11 and 1.28 ± 0.35, respectively) (P=0.001) and for Equator (0.35 ± 0.21 and 1.1 ± 0.46, respectively) (P=0.001). Conclusions Using different pairs of the low-profile OT Equator® and Locator® abutments to assist MIOD is clinically acceptable based on the MBL change and PITH outcomes.
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Passia N, Ali S, Behrendt C, Fritzer E, Kohal RJ, Luthardt RG, Maltzahn NFV, Rädel M, Reissmann DR, Schwindling FS, Wolfart S, Kern M. Single mandibular implant study - chewing efficiency - 5-year results from a randomized clinical trial using two different implant loading protocols. J Prosthodont Res 2022; 66:610-617. [PMID: 35197416 DOI: 10.2186/jpr.jpr_d_21_00216] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To investigate the chewing efficiency of edentulous patients wearing complete dentures, treated with a single implant in the mandible, placed underneath the existing mandibular dentures, using two different loading protocols (immediate loading or conventional loading), over an observation period of 5 years. METHODS One-hundred and fifty-eight (158) edentulous seniors aged 60-89 years received an implant in the midline of the lower jaw and were randomized either to the immediate loaded group A (n=81) or the conventional loaded group B (n=77). Chewing efficiency was obtained before treatment, one month after implant placement during the submerged healing phase (only group B) and 1, 4, 12, 24 and 60 months after implant loading. RESULTS After 5 years, chewing tests from 89 patients (45 in the immediate loading group and 44 in the conventional loading group) were available for every recall visit and thus statistically analyzed. The chewing efficiency increased over time in both groups. A significant increase was observed up to 4 months after loading (p≤0.05). Later, chewing efficiency further increased, but not significantly. Between the two loading protocols, chewing efficiency did not differ significantly (p>0.05) at any follow-up investigation. CONCLUSION A single mandibular implant placed underneath existing mandibular dentures improves chewing efficiency of edentulous patients significantly over an observation period of 5 years, irrespective of the loading protocol.
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Affiliation(s)
- Nicole Passia
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Germany.,Department of Prosthetic Dentistry, Faculty of Medicine Carl Gustav Carus, TU Dresden, Germany
| | - Shurouk Ali
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Germany
| | - Christoph Behrendt
- Department of Prosthodontics, Gerodontology and Biomaterials, Greifswald University Hospital, Germany
| | - Elfriede Fritzer
- Center for Clinical Studies, Christian-Albrechts University at Kiel, Germany
| | - Ralf Joachim Kohal
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic dentistry, Faculty of Medicine, University of Freiburg, Germany
| | - Ralph G Luthardt
- Center of Dentistry, Department of Prosthetic Dentistry, Ulm University Hospital, Germany
| | | | - Michael Rädel
- Department of Prosthetic Dentistry, Faculty of Medicine Carl Gustav Carus, TU Dresden, Germany
| | - Daniel R Reissmann
- Center for Dental and Oral Medicine, Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Germany
| | | | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Medical Faculty, RWTH Aachen University, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Germany
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Sailer I, Karasan D, Todorovic A, Ligoutsikou M, Pjetursson BE. Prosthetic failures in dental implant therapy. Periodontol 2000 2022; 88:130-144. [PMID: 35103329 PMCID: PMC9305548 DOI: 10.1111/prd.12416] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Both fixed and removable implant-supported prostheses are well-established methods for replacing missing teeth in partially or fully edentulous patients. Numerous systematic reviews have been performed in recent years to evaluate the survival and complication rates of implant-retained fixed dental prostheses and implant-retained overdentures, displaying high 5-year survival rates ranging from 97.1% for fixed dental prostheses to 95%-100% for implant-retained overdentures. However, the survival rates only represent the prostheses remaining in use for a defined follow-up time, and do not account for the potential prosthetic complications that may have arisen and influence the general success of the implant treatment. The most common technical complications of fixed implant-retained single crowns are crown fracture, fractures of ceramic implant abutments, and esthetic problems. The predominant technical complication at multiple-unit, implant-retained fixed dental prostheses is fracture/chipping of the veneering ceramic. Reported technical complications for implant-retained overdentures are overdenture fracture or chipping of the veneer materials, whereas mechanical complications include implant fracture, attachment failure, and attachment housing or insert complications. To reduce the risk of such failures, a comprehensive pretreatment diagnostic work-up is essential, including defining the prosthetic goal with the aid of a wax-up or set-up and the associated ideal, prosthetically oriented three-dimensional implant position. Furthermore, selection of the ideal type of prosthesis, including the respective implant components and materials, is important for clinical long-term treatment success.
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Affiliation(s)
- Irena Sailer
- Division of Fixed Prosthodontics and BiomaterialsUniversity Clinics for Dental MedicineUniversity of GenevaGenevaSwitzerland
| | - Duygu Karasan
- Division of Fixed Prosthodontics and BiomaterialsUniversity Clinics for Dental MedicineUniversity of GenevaGenevaSwitzerland
| | - Ana Todorovic
- Division of Fixed Prosthodontics and BiomaterialsUniversity Clinics for Dental MedicineUniversity of GenevaGenevaSwitzerland
- Division of ProsthodonticsFaculty of Dental MedicineUniversity of BelgradeBelgradeSerbia
| | - Maria Ligoutsikou
- Division of Fixed Prosthodontics and BiomaterialsUniversity Clinics for Dental MedicineUniversity of GenevaGenevaSwitzerland
| | - Bjarni Elvar Pjetursson
- Division of Fixed Prosthodontics and BiomaterialsUniversity Clinics for Dental MedicineUniversity of GenevaGenevaSwitzerland
- Department of Reconstructive DentistryFaculty of OdontologyUniversity of IcelandReykjavikIceland
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12
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Komagamine Y, Kanazawa M, Sato D, Iwaki M, Miyayasu A, Minakuchi S. Patient-reported outcomes with immediate-loaded two-implant-supported mandibular overdentures: Results of a 5-year prospective study. J Dent Sci 2022; 17:70-77. [PMID: 35028022 PMCID: PMC8739250 DOI: 10.1016/j.jds.2021.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/13/2021] [Indexed: 11/26/2022] Open
Abstract
Background/purpose Few studies have comprehensively assessed long-term patient-reported outcomes for overdentures supported by two immediate implants. The purpose of the study was to evaluate patient-reported outcomes of immediately loaded two-implant-supported overdentures retained by ball attachments over a 5-year evaluation period. Material and methods Nineteen participants with edentulous mandibles were provided with immediately loaded two-unsplinted-implant-supported overdentures retained by ball attachments. The participants completed the Japanese version of the Oral Health Impact Profile (OHIP)-EDENT-19 and the Patient's Denture Assessment (PDA). Additionally, patient satisfaction was measured by a 100-mm visual analog scale (VAS). Measurements were performed at baseline, and at 1 and 5 years following implant surgery. Results Seventeen participants and 14 participants were evaluated at the 1-year and 5-year assessment, respectively. Considering the OHIP-EDENT-19, there was a significant decrease in the total (p = 0.046), “functional limitation” (p = 0.021), and “physical disability” (p = 0.034) scores at 1 year and the total (p = 0.045) and “physical disability” (p = 0.024) scores at 5 years following surgery, compared to the baseline scores. Considering the PDA, there was a significant increase in the “function” (p = 0.038) and “lower denture” (p = 0.003) scores at 1 year and the “function” (p = 0.032), “lower denture” (p = 0.008), and “esthetic and speech” (p = 0.043) scores at 5 years following surgery, compared to the baseline scores. Patient satisfaction at 1 year following surgery was significantly greater than that at baseline (p = 0.005). Conclusion Immediately loaded two-unsplinted-implant-supported overdentures retained by ball attachments improved the oral health-related quality of life and self-assessment of dentures by the patients up to 5 years following implant surgery.
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Affiliation(s)
- Yuriko Komagamine
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Manabu Kanazawa
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Daisuke Sato
- Department of Implant Dentistry, School of Dentistry, Showa University, Tokyo, Japan.,Oral Implantology and Regenerative Dental Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Maiko Iwaki
- Oral Diagnosis and General Dentistry, University Hospital of Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Anna Miyayasu
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shunsuke Minakuchi
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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13
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Komagamine Y, Kanazawa M, Sato D, Iwaki M, Miyayasu A, Minakuchi S. Patient-reported outcomes for the immediate loading of mandibular overdentures supported by two implants soon after implant surgery. J Dent Sci 2022; 17:560-567. [PMID: 35028084 PMCID: PMC8739795 DOI: 10.1016/j.jds.2021.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/21/2021] [Indexed: 11/28/2022] Open
Abstract
Background/purpose No studies have comprehensively assessed short-term patient-reported outcomes after the provision of overdentures supported by two immediate implants. The purpose of this study was to evaluate short-term patient-reported outcomes for mandibular overdentures retained by ball attachments on two immediately loaded implants. Materials and methods Nineteen participants with mandibular edentulism were provided with overdentures retained by ball attachments on two immediately loaded, unsplinted implants. The participants' self-assessment of their dentures and oral health-related quality of life were evaluated with the 22-item Patient's Denture Assessment (PDA), and the 19-item Japanese version of the Oral Health Impact Profile (OHIP-EDENT), respectively. Patient satisfaction was measured on a 100 mm visual analogue scale. Assessments were conducted at baseline, and at 1 and 6 months after implant surgery. Results There were significant increases in the PDA “Lower denture” (P = 0.009) at 1 month, as well as “Function” (P = 0.002) and “Lower denture” (P = 0.009) scores at 6 months. Patient satisfaction was also significantly increased at 1 month (P = 0.007) and 6 months (P ≤ 0.000). Significant decreases were observed in the OHIP-EDENT “Physical pain” (P = 0.046) score at 1 month, as well as the summary score (P = 0.033), “Functional limitation” (P = 0.020) and “Psychological discomfort” (P = 0.019) scores at 6 months. Conclusion The use of two immediately loaded implants for lower mandibular complete overdentures is associated with improvements in patient's self-assessment of dentures, satisfaction, and oral health-related quality of life, up to 6 months after implant surgery.
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Affiliation(s)
- Yuriko Komagamine
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Manabu Kanazawa
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Daisuke Sato
- Department of Implant Dentistry, School of Dentistry, Showa University, Tokyo, Japan.,Oral Implantology and Regenerative Dental Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Maiko Iwaki
- Oral Diagnosis and General Dentistry, University Hospital of Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - A Miyayasu
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shunsuke Minakuchi
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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14
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Fouda K, Fahmy A, Aziz K, Aal MA, Naguib A, Nabi NA. Implant Stability Changes for a Single Implant Mandibular Overdenture. Eur J Dent 2021; 16:619-626. [PMID: 34879396 PMCID: PMC9507585 DOI: 10.1055/s-0041-1736416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Objectives
To compare the changes in implant stability for the nonsubmerged and submerged protocols for a single-implant retained mandibular overdenture using Cendres and Metaux Locator attachment throughout a 24-month follow-up.
Materials and Methods
Eighty edentulous patients who were seeking to install a single implant in the midline of the completely edentulous mandible. At the day of implant installation, patients were randomized into two groups using sealed envelopes: the nonsubmerged and submerged groups. After 3 months of healing period, randomization using sealed envelopes was performed and patients were randomized to receive the Cendres and Metaux Locator attachment. The periotest readings were recorded using the Periotest M device, every 3 months for the first year and annually in the second year. The scope of this clinical trial focused only on results of the Cendres and Metaux attachment.
Statistical Analysis
The Mann–Whitney
U
-test was used for comparison between study groups for independent samples. Two-sided
p
-values less than 0.05 were considered statistically significant.
Results
There was no statistically significant difference between the mean periotest readings of both groups throughout the 24-month follow-up. Both groups showed an improvement in mean periotest readings with the submerged group tending to show greater stability at 6, 12, and 24-month follow-ups.
Conclusions
The nonsubmerged and the submerged healing protocols resulted in reliable periotest readings with the submerged group showing greater improvement than the nonsubmerged, although this improvement is nonsignificant when using the Cendres and Metaux attachment for a single mandibular overdenture.
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Affiliation(s)
- Karim Fouda
- Department of Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Ahmed Fahmy
- Department of Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Khaled Aziz
- Department of Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Marwa Abdel Aal
- Department of Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Amr Naguib
- Department of Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Nouran Abdel Nabi
- Department of Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
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15
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Nogueira TE, Silva JR, Nascimento LN, Cardoso JB, Srinivasan M, McKenna G, Leles CR. Immediately loaded single-implant mandibular overdentures compared to conventional complete dentures: A cost-effectiveness analysis. J Dent 2021; 115:103846. [PMID: 34637892 DOI: 10.1016/j.jdent.2021.103846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 09/14/2021] [Accepted: 09/30/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND In recent years, the single-implant mandibular overdenture (SIMO) has been proposed as an alternative to more complex overdenture designs as a simplified implant intervention for edentulous patients. OBJECTIVE The aim of this study was to run a cost-effectiveness analysis alongside a randomized clinical trial comparing the SIMO and the conventional complete denture (CCD) treatment. Imediately loaded external hexagon implant and ball attachment were used for the overdenture goup. Direct costs related to therapies were identified and valuated throughout a 1-year period after delivery, in Brazilian currency (R$) and converted into international dollars (I$) using purchase power parity exchange rates. Treatment effectiveness was measured using the OHIP-Edent and satisfaction scores for calculation of incremental cost-effectiveness ratios (ICER). RESULTS Outcomes were assessed at the 1-year follow-up for 65 patients (CCD=34; SIMO=31). Overall OHIP-Edent and satisfaction scores improved significantly in the SIMO group, while remained unchanged in the CCD group. The mean overall costs were R$1,179.04 (I$590.99) for the CCD group and R$2,127.91 (I$1,068.20) for the SIMO group - 80.7% incremental cost for SIMO. The ICER calculation for SIMO treatment showed a mean cost of I$48.20 for 1-point reduction in OHIP-Edent scores, and I$12.56 for 1-point increase in satisfaction score. CONCLUSIONS Findings support the effectiveness of this simplified and low-cost implant intervention for edentulous patients. SIMO also seems a cost-effective alternative to the CCD and the relatively low incremental cost may potentially increase the utilization of dental implants among older subjects, especially those with limited financial resources. CLINICAL SIGNIFICANCE The immediately loaded single-implant mandibular overdenture was superior to the conventional complete denture in terms of patient-reported outcome measures at a low incremental cost.
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Affiliation(s)
| | | | | | | | - Murali Srinivasan
- Clinic of General, Special Care, and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Gerald McKenna
- Centre for Public Health, Queen's University, School of Medicine Dentistry & Biomedical Sciences, Institute of Clinical Science, Belfast, United Kingdom
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16
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Implant Stability Changes for Nonsubmerged and Submerged Protocols for a Single Implant Mandibular Overdenture Using Ball Attachment. Int J Dent 2021; 2021:8269197. [PMID: 34594381 PMCID: PMC8478597 DOI: 10.1155/2021/8269197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/08/2021] [Indexed: 12/02/2022] Open
Abstract
Objectives To compare the changes in implant stability for the nonsubmerged (NS) and submerged (S) protocols for the single implant retained mandibular overdenture using ball attachment throughout a 24-month follow-up. Materials and Methods Eighty completely edentulous patients were seeking to improve retention of their lower complete denture by installing a single implant in the midline of the completely edentulous mandible. At the day of implant installation, patients were randomized into 2 groups using sealed envelopes: the nonsubmerged (NS) and submerged (S) group. After a 3-month healing period, all patients were randomized using sealed envelopes into ball attachment and CM-LOC attachment. The Periotest readings (PTV) was recorded using the Periotest M device and was recorded every 3 months for the first year and then annually in the second year. The scope of this clinical trial focused only on results of the ball attachment. The Mann–Whitney U test was used for comparison between study groups for independent samples. Two-sided p values less than 0.05 was considered statistically significant. Results There was no statistically significant difference in the mean change in PTV reading between the NS and S group at the different follow-up intervals. Initially, at the day of pickup (baseline) and 3-month follow-up, the mean PTV reading for the NS was greater than that of the S group (−4.471 ± 1.489, −4.391 ± 1.4727 (p=0.913)), while the S group has shown a greater improvement in PTV than the NS group after 6-month follow-up and continued throughout the 24-month follow-up (−5.730 ± 1.7804, −50855 ± 1.2581 (p=1)). Conclusion Both the nonsubmerged and the submerged healing protocol have shown reliable Periotest readings using ball attachment for a single implant retained overdenture. The submerged group has resulted in a greater improvement in Periotest readings after the 12- and 24-month follow-up period when compared to the nonsubmerged group although this improvement was not statistically significant.
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17
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Masticatory Ability for a Single Implant Mandibular Overdenture Retained by Two Different Attachments: A Randomized Controlled Trial. Int J Dent 2021; 2021:1632848. [PMID: 34539786 PMCID: PMC8445715 DOI: 10.1155/2021/1632848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 08/23/2021] [Indexed: 12/18/2022] Open
Abstract
Objective The aim of this randomized clinical trial was to compare the masticatory ability subjectively between ball and Cendres+Métaux Locator (CM-LOC) attachment for a single implant retained mandibular overdenture throughout a 24-month follow-up period. Materials and Methods Eighty completely edentulous patients were recruited. All patients received new complete dentures, and masticatory ability was recorded using a questionnaire (baseline record). All patients received a single implant in the midline of the completely edentulous mandible. After 3-month healing period, patients were randomized using sealed envelopes into two groups: ball or CM-LOC attachment. The same masticatory ability questionnaire was used to record masticatory ability for both groups after 2 weeks of pickup and 3-, 6-, 9-, 12-, and 24-month follow-up. Comparison between the study groups was done using Mann–Whitney U test for independent samples. Two-sided P values less than 0.05 were considered statistically significant. Results The mean masticatory scores improved for both attachments, with no statistically significant difference between them throughout the 24-month follow-up. The CM-LOC attachment group showed a greater improvement change in masticatory ability after 6- and 12-month follow-up (−12.47 ± 12.006, −11.46 ± 14.625; P=0.826), while the ball attachment group showed a slight improvement after the 24-month follow-up (−11.72 ± 12.368, −10.88 ± 11.963; P=0.778). Conclusion Single implant retained mandibular overdenture improved masticatory ability subjectively with no significant difference between both attachments used although the ball attachment showed better masticatory ability scores after 24-month follow-up.
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18
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Rocha COM, Longhini D, Pereira RP, Lima ALO, Bonafé FSS, Arioli Filho JN. Masticatory efficiency in complete denture and single implant-retained mandibular overdenture wearers with different occlusion schemes: A randomized clinical trial. J Prosthet Dent 2021:S0022-3913(21)00345-0. [PMID: 34517991 DOI: 10.1016/j.prosdent.2021.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 06/20/2021] [Accepted: 06/21/2021] [Indexed: 11/15/2022]
Abstract
STATEMENT OF PROBLEM How the masticatory function of complete denture wearers is influenced by the positioning and occlusion of posterior teeth or by the presence of a single mandibular implant is unclear. PURPOSE The purpose of this randomized crossover clinical trial was to evaluate the masticatory efficiency of wearers of bimaxillary complete dentures and of wearers of maxillary complete denture and single implant-retained mandibular overdentures, both with bilateral balanced occlusion and lingualized occlusion. MATERIAL AND METHODS Participants received 2 sets of complete dentures with interchangeable teeth in the mandibular prosthesis to allow a change in the occlusion scheme. Subsequently, 1 implant was placed in the mandibular symphysis region, and the mandibular complete dentures were converted to overdentures. The masticatory efficiency was measured by the sieve method for both occlusal schemes. RESULTS Repeated measures ANOVA showed no statistically significant difference in the masticatory efficiency with the 2 occlusal schemes for conventional complete dentures (P=.707) or overdentures (P=.407). When comparing the type of prosthesis, statistical differences were found for masticatory efficiency (P=.012), with improved mastication for the overdentures. CONCLUSIONS A mandibular single implant improved the masticatory efficiency of patients with complete dentures, but the occlusal scheme did not influence this factor.
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Affiliation(s)
- Cibele O M Rocha
- PhD student, Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Sao Paulo, Brazil
| | - Diogo Longhini
- Researcher, Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Sao Paulo, Brazil
| | - Rodrigo P Pereira
- Postdoctoral Researcher, Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Sao Paulo, Brazil
| | - Amanda L O Lima
- PhD student, Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Sao Paulo, Brazil
| | - Fernanda S S Bonafé
- Researcher, Dental Sciences, Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, Sao Paulo, Brazil
| | - João N Arioli Filho
- Associate Professor, Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Sao Paulo, Brazil.
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19
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Meira IA, Pinheiro MA, Prado-Tozzi DA, Cáceres-Barreno AH, de Moraes M, Rodrigues Garcia RCM. Speech and the swallowing threshold in single implant overdenture wearers: A paired control study. J Oral Rehabil 2021; 48:1262-1270. [PMID: 34368975 DOI: 10.1111/joor.13240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/25/2021] [Accepted: 08/03/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Single implant mandibular overdentures (SIMOs) can improve mastication in edentulous elderly people. However, little attention has been paid to their effects on articulation disorders and the swallowing threshold relative to those of conventional complete dentures (CDs). OBJECTIVE To compare the effects of new conventional CD set and SIMOs on articulation disorders, mandibular movements during speech and swallowing threshold using a paired study design. METHODS Twenty-two edentulous Brazilian Portuguese-speaking elderly people (mean age 66.7 ± 4.6 years) were first evaluated whilst wearing their old conventional CDs. Articulation disorders were analysed by audio and video recordings, mandibular movements during speech were measured by kinesiography, and the swallowing threshold was assessed by masticatory cycle counting and medium particle size (X50 ) calculation. Participants then received new conventional CDs, and evaluations were repeated 2 months later. Subsequently, single implants were installed in the midlines of subjects' mandibles, and the conventional CDs were converted to SIMOs. After 2 months of SIMOs use, the evaluations were repeated. Data were submitted to the Cochran-Mantel-Haenszel and ANOVA. RESULTS No difference in articulation disorders was found between new conventional CD and SIMO use. The frequency of anterior lisp during /s/ and /z/ phoneme pronunciation was reduced with new conventional CD use relative to old conventional CD use (p < .05). The X50 decreased progressively with new conventional CD and SIMO use (both p < .05). CONCLUSION SIMOs do not alter speech relative to new well-fitted conventional CDs, but improved the swallowing threshold, in edentulous elderly people.
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Affiliation(s)
- Ingrid Andrade Meira
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Mayara Abreu Pinheiro
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | | | | | - Márcio de Moraes
- Department of Oral and Maxillofacial Surgery, Piracicaba Dental School, University of Campinas, Brazil
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20
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Ikbal LK, Duygu K, Ravza E, Zeynep K, Kerem K. A 5-Year Retrospective Study Evaluating Periodontal Health and Oral Health-Related Quality of Life of Implant-Supported Overdentures With Locator and Magnetic Attachments. J ORAL IMPLANTOL 2021; 47:303-309. [PMID: 32870316 DOI: 10.1563/aaid-joi-d-20-00064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study compared peri-implant vertical bone loss, the periodontal index, prosthodontic maintenance requirements and oral health-related quality of life (OHQoL) of patients using mandibular implant-supported overdentures with 2 different attachment systems after an average of 5 years of use. Sixteen mandibular overdenture patients with magnet attachments (group 3), 24 with implant-supported mandibular overdentures with Locator attachments (group 2), and 25 conventional complete denture patients (group 1) were included in the study. The existing at least 5 years old dentures of all patients were evaluated for prosthodontic maintenance by the same prosthodontist and the patients were administered the oral health impact profile-14-Turkish version (OHIP-TR-14) questionnaire. Peri-implant tissue health was evaluated clinically in terms of plaque scores, bleeding scores, probing depth, and gingival index. Radiographic evaluation was performed in terms of peri-implant vertical bone loss. Radiographic evaluations were performed 5 years after overdenture insertion. There were no statistically significant differences between the groups in terms of total OHIP-TR-14 scores (P > .05). Although the average vertical bone resorption measured in group 2 at the end of 5 years was 1.38 mm, there was an average vertical bone loss of 1.45 mm in group 3, but this difference was not statistically significant (P > .05). Among the periodontal health indicators, there were no statistically significant differences in the mean values for periodontal indexes. According to results of the study, there were no differences in peri-implant vertical bone loss in groups 2 and 3, in periodontal health in mandibular overdentures with groups 2 and 3, or between total OHIP-TR-14 scores of patients in all groups.
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Affiliation(s)
| | - Kilic Duygu
- Department of Periodontology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Eraslan Ravza
- Department of Periodontology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey.,Ortoperio Dental Clinic, Kayseri, Turkey
| | - Karacalar Zeynep
- Department of Prosthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Kilic Kerem
- Department of Prosthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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21
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Pinheiro MA, do Amaral CF, Meira IA, Carletti TM, Câmara-Souza MB, Souza CSV, de Moraes M, Rodrigues Garcia RCM. Single implant overdenture reinforced with a metallic framework: A 2-year clinical follow-up. SPECIAL CARE IN DENTISTRY 2021; 41:607-618. [PMID: 33964178 DOI: 10.1111/scd.12601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/08/2021] [Accepted: 04/24/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION To prevent single-implant overdenture (SIO) fracture, the inclusion of a framework in the overdenture has been suggested. However, no investigations verified their benefits. OBJECTIVE To evaluate prosthetic maintenance events, patient satisfaction, and mastication of SIO reinforced by metallic framework users. MATERIAL AND METHODS Fifteen volunteers had a new set of complete dentures converted into an SIO containing a framework. Maintenance events were recorded, while patient satisfaction was assessed using a visual analog scale. Masticatory performance (MP) was evaluated using the sieving method, maximum bite force (MBF) by pressure sensors, and masseter thickness by ultrasound. Measurements were performed 2, 12, and 24 months after SIO use. Repeated-measures ANOVA and paired Student's t-tests (p < 0.05) were applied. RESULTS Matrix exchange was the most prevalent maintenance event (83.6%), and no SIO was fractured during the entire follow-up. Satisfaction with the SIO stability decreased (p < 0.01) after 12 months. MP did not change between evaluations (p > 0.05). Conversely, MBF and masseter thickness improved after 12 and 24 months of SIO use (p < 0.05). CONCLUSIONS Reinforced SIO did not fracture during 2 years but requires maintenance. It improves bite force and muscle thickness, maintaining MP values. Satisfaction with SIO stability decreased in the first year of use.
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Affiliation(s)
- Mayara Abreu Pinheiro
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Camilla Fraga do Amaral
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Ingrid Andrade Meira
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Talita Malini Carletti
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Mariana Barbosa Câmara-Souza
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Carolina Santos Ventura Souza
- Department of Oral and Maxillofacial Surgery, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Marcio de Moraes
- Department of Oral and Maxillofacial Surgery, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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Turker N, Buyukkaplan US. Effects of overdenture attachment systems with different working principles on stress transmission: A three-dimensional finite element study. J Adv Prosthodont 2021; 12:351-360. [PMID: 33489019 PMCID: PMC7790603 DOI: 10.4047/jap.2020.12.6.351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/19/2020] [Accepted: 09/03/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aim of the present study was to compare the stress distributions on the dental implants, abutments, and bone caused by different overdenture attachment types under functional chewing forces. MATERIALS AND METHODS The 3D finite element models of the mandible, dental implants, attachment types, and prostheses were prepared. In accordance with a conventional dental implant supported overdenture design, the dental implants were positioned at the bone level in the canine teeth region bilaterally. A total of eight models using eight different attachment systems were used in this study. All the models were loaded to simulate chewing forces generated during the centric relationship (450 N), lateral movement (400 N), protrusive movement (400 N), and also in the presence of a food mass unilaterally (200 N). Stress outputs were obtained as the maximum principal stress and the equivalent von-Mises stress. RESULTS In all attachment types, higher stress values were observed in the abutments, dental implants, and bone in the magnet attachments in different loading conditions. The highest stress values were observed among the magnet systems in the components of the Titanmagnetics model in all loading conditions (stresses were 15.4, 17.7, and 33.1 MPa on abutment, dental implant, and bone, respectively). The lowest stress value was observed in the models of Zest and O-Ring attachments. CONCLUSION The results of the present study implied that attachment types permitting rotation and tolerating various angles created lower stresses on the bone, dental implants, and abutments.
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Affiliation(s)
- Nurullah Turker
- Department of Prosthodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
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Km S, Koli DK, Jain V, Pruthi G, Nanda A. Comparison of ridge resorption and patient satisfaction in single implant-supported mandibular overdentures with conventional complete dentures: A randomised pilot study. J Oral Biol Craniofac Res 2020; 11:71-77. [PMID: 33376669 DOI: 10.1016/j.jobcr.2020.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 11/19/2020] [Accepted: 11/21/2020] [Indexed: 10/22/2022] Open
Abstract
Purpose To compare ridge resorption (RR) and patient satisfaction in single implant-supported mandibular overdentures (SIMO) with conventional complete dentures (CCD) over a period of one year. Material and methods This prospective, randomized trial enrolled 30 completely edentulous participants following inclusion and exclusion criteria. The study was completed by 28 participants. Rehabilitation of 14 participants was done by using SIMO (group I) and CCD (group C) each according to randomization chart. For both the groups, RR was computed in millimeters from residual ridge height measured by using orthopantogram at 6 months (T1), 9 months (T2), and 12 months (T3) at 3 anatomic locations: maxillary posterior (L1), maxillary anterior (L2), and mandibular posterior (L3). Patient satisfaction was evaluated by using Geriatric Oral Health Assessment Index Hindi version (GOHAI-Hi) at 1week and 12 months after denture delivery. Results At 12 months, minimum RR was observed at L2 of group I (0.62 ± 0.20 mm) and maximum RR was observed at L3 of group C (1.04 ± 0.15 mm). Comparison of ridge resorption between group I and group C was statistically significant at T3 (P = .001 for L1, P = .006 for L2, and P = .028 for L3). At T3, in group I, RR was more at L3 than L2 region (P = .011) and L1 region (P = .015). Statistically significant difference of GOHAI-Hi scores was observed between group I and group C at end of 12 months (P = .003). Conclusions SIMO cause less RR and higher patient satisfaction as compared to CCD and can be recommended with higher predictability of success than CCD.
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Affiliation(s)
- Subin Km
- Department of Prosthodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Dheeraj Kumar Koli
- Department of Prosthodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Veena Jain
- Department of Prosthodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Gunjan Pruthi
- Department of Prosthodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Aditi Nanda
- Department of Prosthodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, 110029, India
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Kern M, Behrendt C, Fritzer E, Kohal RJ, Luthardt RG, Maltzahn NFV, Rädel M, Reissmann DR, Schwindling FS, Wolfart S, Passia N. 5-year randomized multicenter clinical trial on single dental implants placed in the midline of the edentulous mandible. Clin Oral Implants Res 2020; 32:212-221. [PMID: 33258136 DOI: 10.1111/clr.13692] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This multicenter randomized controlled clinical trial was conducted to investigate whether the loading protocol of single dental implants placed in the midline of edentulous mandibles will influence the implant survival or prosthetic maintenance. MATERIALS AND METHODS In total, 158 patients were randomly assigned either to the immediate loading group (n = 81) or to the delayed loading group (n = 77). All implants were loaded with an overdenture retained by a ball attachment. RESULTS After 5 years, 102 patients attended the follow-up investigation. Immediately loaded single implants in the midline of the edentulous mandible revealed a statistically significant lower survival rate than implants loaded conventionally over an observation period of 5 years. In the immediate loading group, 9 implants failed within the first three months of implant loading. No further implant loss was recorded for this group. Two implants failed in the delayed loading group, whereas one implant had to be removed during second-stage surgery and the second five years after implant loading. Non-inferiority of the survival rate of the midline implant of the immediate loading group, compared with the delayed loading group, could not be shown (p = .79, CI immediate loading: 74.9%; 100.0%, CI delayed loading: 73.0%; 100.0%). The observed difference in implant survival between the two treatment groups over time was statistically significant. CONCLUSIONS The results of the present study indicate that immediate loading of a single mandibular implant in the edentulous mandible should be considered only in exceptional cases.
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Affiliation(s)
- Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University at Kiel, Kiel, Germany
| | - Christoph Behrendt
- Department of Prosthodontics, Gerodontology and Biomaterials, Greifswald University Hospital, Greifswald, Germany
| | - Elfriede Fritzer
- Center for Clinical Studies, University Hospital Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Ralf J Kohal
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center - University Hospital Freiburg, Freiburg, Germany
| | - Ralph G Luthardt
- Center of Dentistry, Department of Prosthetic Dentistry, Ulm University Hospital, Ulm, Germany
| | - Nadine Frfr V Maltzahn
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover, Germany
| | - Michael Rädel
- Faculty of Medicine Carl Gustav Carus, TU Desden, Dresden, Germany
| | - Daniel R Reissmann
- Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Nicole Passia
- Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University at Kiel, Kiel, Germany.,Universitätsklinikum Schleswig-Holstein - Campus Kiel
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Zhou H, Jiao Y, Ma CF, Wang C, Zhao SJ, Tian M, Tay FR, Chen JH. Clinical outcomes of implant-retained mandibular overdentures using the bar and magnetic attachment systems: an up to 5-year retrospective study. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1360. [PMID: 33313105 PMCID: PMC7723526 DOI: 10.21037/atm-20-2531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Implant-retained mandibular overdentures (IODs) represent an effective and reliable treatment modality for edentulous patients. The present retrospective study compared the clinical outcomes of IODs using bar attachment (BA) system with those using magnetic attachment (MA) system after functioning for up to 5 years. Methods Human subjects treated with IODs between 01-01-2010 and 12-31-2014 were identified from patient records. Of the 54 subjects who met the inclusion criteria, 48 subjects including 26 treated with BA-IODs and 22 with MA-IODs (96 mandibular implants) were recruited for the study. The implant units and prostheses were evaluated individually for peri-implant health. Prosthetic complications and maintenance during follow-up were recorded. The subjects responded to the visual analog scale (VAS) and the Oral Health Impact Profile questionnaires for evaluation of patient satisfaction and oral health-related quality of life (OHRQoL). Results The survival rates of the implants and prostheses were 96.9% and 95.8%, respectively, over a mean observation period of 48±11.3 (range, 13-64) months. Peri-implant probing depth (PPD) and plaque index (PI) were significantly better for the MA group compared with the BA group (P<0.05), while marginal bone loss (MBL) and sulcus bleeding index (SBI) showed no significant differences (P>0.05). Prosthetic complications and maintenance were attachment-dependent. Most recruited subjects were satisfied with their prostheses. There was no statistically significant difference regarding general patient satisfaction or OHRQoL between the two groups (P>0.05). Nevertheless, patients complained that the BA-IODs were significantly more difficult to clean than the MA-IODs (P<0.05). Conclusions IODs have an ideal medium-term outcome irrespective of the attachment design. It is recommended that oral hygiene instructions and regular clinical examination be given to subjects wearing IODs.
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Affiliation(s)
- Huan Zhou
- National Clinical Research Center for Oral Diseases, State Key Laboratory of Military Stomatology, Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, Xi'an, China
| | - Yang Jiao
- Department of Stomatology, the 7 Medical Center, Chinese PLA General Hospital, Beijing, China.,Outpatient Department of PLA Macao Garrison, Macao, China
| | - Chu-Fan Ma
- National Clinical Research Center for Oral Diseases, State Key Laboratory of Military Stomatology, Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, Xi'an, China
| | - Chao Wang
- Department of Stomatology, the 7 Medical Center, Chinese PLA General Hospital, Beijing, China
| | - San-Jun Zhao
- National Clinical Research Center for Oral Diseases, State Key Laboratory of Military Stomatology, Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, Xi'an, China
| | - Min Tian
- National Clinical Research Center for Oral Diseases, State Key Laboratory of Military Stomatology, Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, Xi'an, China
| | - Franklin R Tay
- Department of Endodontics, the Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Ji-Hua Chen
- National Clinical Research Center for Oral Diseases, State Key Laboratory of Military Stomatology, Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, Xi'an, China
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Swelem AA, Abdelnabi MH. Attachment-retained removable prostheses: Patient satisfaction and quality of life assessment. J Prosthet Dent 2020; 125:636-644. [PMID: 32893014 DOI: 10.1016/j.prosdent.2020.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 07/16/2020] [Accepted: 07/16/2020] [Indexed: 11/24/2022]
Abstract
STATEMENT OF PROBLEM Studies on the impact of incorporating attachments in removable prostheses on patient-based outcomes are scarce. PURPOSE The purpose of this clinical study was to investigate oral health-related quality of life (OHRQoL) and patient satisfaction in partially edentulous participants before and after rehabilitation with mandibular attachment-retained removable prostheses as compared with conventional removable prostheses. MATERIAL AND METHODS This crossover study included 74 participants (aged 36 to 57). Initially, 56 received conventional clasp-retained removable dental prostheses (RDPs), and 18 received conventional overdentures (ODs) based on their mandibular partially edentulous state. Two months later, of the 56 RDP participants, 24 had received extracoronal attachment-retained RDPs, 17 received telescope-retained RDPs, and 15 received bar-attachment retained RDPs. The 18 OD participants received ball attachment-retained ODs. Assessments included Oral Health Impact Profile-short version-14 for OHRQoL and a visual analog scale (VAS) for patient satisfaction. Assessments were done before treatment and 2 months after wearing each prosthesis with a 1-month washout period. Statistical analysis included the Friedman then the Wilcoxon signed rank test for Oral Health Impact Profile-short version-14 scores and repeated measures ANOVA then the Bonferroni or paired t test for VAS scores (α=.05). RESULTS There were no dropouts. Rehabilitation, irrespective of prosthesis type, significantly improved OHRQoL in all domains and significantly increased overall patient satisfaction (P<.05). When compared with the conventional prostheses, attachment-retained prostheses significantly improved functional limitation, psychological discomfort, and physical limitation domains in all groups (P<.05), as well as the physical pain domain in the OD group (P=.041). General satisfaction, stability, comfort, ability to speak, and ability to masticate significantly increased (P<.05) with attachment-retained prostheses. Conventional prostheses were significantly easier to clean (P<.05) in all groups, except for the telescope-attachment group. CONCLUSIONS Both conventional and attachment-retained prostheses significantly increased patient satisfaction and improved OHRQoL in all domains as compared with before treatment. However, incorporation of attachments further improved functional limitation, psychological discomfort, and physical limitation domains in all groups, as well as the physical pain domain in the OD group. Participants were more satisfied with their attachment-retained prostheses in most aspects.
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Affiliation(s)
- Amal A Swelem
- Professor, Oral and Maxillofacial Prosthodontic Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; Removable Prosthodontic Department, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt.
| | - Mohamed H Abdelnabi
- Professor, Oral and Maxillofacial Prosthodontic Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; Removable Prosthodontic Department, Faculty of Oral and Dental Medicine, Minia University, Minia, Egypt
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Nischal K, Mishra SK, Chowdhary R. Crestal Bone Changes and Patient Satisfaction with Single Implant-Retained Mandibular Overdentures with Dalla Bona and Locator Attachments with Immediate Loading Protocols. A Randomized Controlled Clinical Study. J Prosthodont 2020; 29:756-765. [PMID: 32743968 DOI: 10.1111/jopr.13230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2020] [Indexed: 01/10/2023] Open
Abstract
PURPOSE There is no enough evidence present on the success of single implant-retained mandibular overdentures (SIMO) with Dalla Bona and Locator attachments. This study aims to compare crestal bone loss and patient satisfaction with SIMO with Dalla Bona and Locator attachment following immediate loading protocols. MATERIAL AND METHODS Twelve patients included in Group 1 received immediate SIMO with Dalla Bona attachments, and another twelve patients in Group 2 received immediate SIMO with Locator attachments in the mid symphyseal region. The follow-up was scheduled at 6 and 12 months after implant placement. The patient satisfaction with the denture was evaluated with the visual analog scale (VAS) score. The data obtained were statistically analyzed with the independent student t-test for intergroup comparison and repeated measures of ANOVA followed by Bonferroni's Post hoc analysis for intragroup comparison of mean crestal bone loss at a different time interval. RESULTS Ten patients each in both the groups were available for follow-up. Crestal bone loss at 6 months follow-up for Dalla Bona group was 0.42 ± 0.10 mm on the mesial side and 0.43 ± 0.14 mm on the distal side and at 1 year 1.54 ± 0.16 mm on the mesial side and 1.66 ± 0.13 mm on the distal side. The mean crestal bone loss at 6 months follow-up for Locator group was 0.48 ± 0.16 mm on the mesial side and 0.45 ± 0.11 mm on the distal side and at 1 year was 1.71 ± 0.22 mm on mesial side and 1.74 ± 0.28 mm on the distal side. There was difference in bone loss at 6 months (mesial: 0.06 mm, p = 0.327; distal:0.02 mm; p = 0.726) and at 1 year (mesial: 0.17 mm, p = 0.063; distal: 0.08 mm; p = 0.423) in between two groups but the difference was statistically insignificant. There was a significant difference found in the VAS score for patient satisfaction with SIMO with Dalla Bona attachments and Locator attachments at 6 months (54.2 vs. 51.8, p = 0.005) and 1 year (60.6 vs. 55.2, p = 0.005). CONCLUSIONS Patient satisfaction with SIMO with Dalla Bona attachments was higher during the follow-up. SIMO with Dalla Bona attachments had less crestal bone loss and less prosthetic complications when compared to Locator attachments, although the difference in the bone loss was statistically insignificant.
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Affiliation(s)
- Kunal Nischal
- Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India
| | - Sunil Kumar Mishra
- Department of Prosthodontics, Peoples College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Ramesh Chowdhary
- Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India
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Pinheiro MA, Meira IA, Magno MB, Maia LC, Rodrigues Garcia RC. Masticatory function improvement with the use of mandibular single-implant overdentures in edentulous subjects: a systematic literature review. MINERVA STOMATOLOGICA 2020; 69:256-268. [PMID: 32945635 DOI: 10.23736/s0026-4970.20.04327-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION In this systematic review, several masticatory function parameters assessed during mandibular single-implant overdenture (SIO) use were compared to pre- SIO placement values in edentulous patients with aim of contributing to a consensus regarding denture treatment options. EVIDENCE ACQUISITION This study was registered a priori in the PROSPERO database (CRD42018106567). Two independent reviewers carried out electronic searches in eight databases, without language or time frame limitations, to collate clinical studies comparing masticatory function of edentulous patients before versus after SIO installation with the implant placed on the mandibular midline. Risk of bias was assessed with a before-and-after tool and evidence certainty level was evaluated with the Grading of Recommendations Assessment, Development and Evaluation program. EVIDENCE SYNTHESIS Eleven studies were included in this review (1 prospective, 3 crossover trials, 4 randomized clinical trials, 2 paired clinical trials, and 1 pilot). Enrolled patients were mostly over 60 years old; all patients were using conventional complete dentures (CD) prior to SIO installation. Masticatory performance, masticatory efficiency, bite force, and muscle activity were improved after the SIO placement compared to during mandibular CD use. Mandibular movement and masticatory ability data were inconclusive. Most of the studies had low risk of bias, but all had very low certainly level ratings due to methodological heterogeneity. CONCLUSIONS Placement of SIO improves masticatory function, as reflected mostly by masticatory performance and efficiency data, relative to CD use. Further studies comparing dental rehabilitation options, including SIOs, are needed to improve the quality of evidence in the literature.
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Affiliation(s)
- Mayara A Pinheiro
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Ingrid A Meira
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Marcela B Magno
- Department of Paediatric Dentistry and Orthodontic, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucianne C Maia
- Department of Paediatric Dentistry and Orthodontic, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Renata C Rodrigues Garcia
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil -
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Asami M, Kanazawa M, Lam TV, Thu KM, Sato D, Minakuchi S. Preliminary study of clinical outcomes for single implant-retained mandibular overdentures. J Oral Sci 2020; 62:98-102. [PMID: 31996534 DOI: 10.2334/josnusd.19-0079] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This study evaluated marginal bone loss and prosthetic complications associated with single implant-retained mandibular overdentures (1-IODs) with locator attachments. The 1-IOD was placed in the mandibular midline by using a conventional loading protocol in 22 patients with an edentulous mandible. Marginal bone loss at the start of loading and 12 months postoperatively was assessed by radiographic and crestal bone evaluation. The crestal bone was defined as the distance between the customized abutment shoulder and the top of the bone, as indicated by probing. In addition, implant stability quotient and prosthetic complications were recorded. The cumulative implant survival rate was 95.5%. Median implant stability quotient remained greater than 80, and median radiographic bone loss was 0.56 mm. Crestal measurement showed a median crestal bone loss of 0.16, 0.43, 0.39, and 0.52 mm on the buccal, right, lingual, and left sides, respectively. Both radiographic and crestal bone loss values significantly differed between the start of implant loading and 12 months postoperatively (except on the buccal and lingual sides; P < 0.05). The need to replace the nylon insert was the most common complication. Conventional loading of a 1-IOD with a locator attachment resulted in a high survival rate, good implant stability, and acceptable marginal bone loss.
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Affiliation(s)
- Mari Asami
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Manabu Kanazawa
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Thuy V Lam
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Khaing M Thu
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Daisuke Sato
- Department of Implant Dentistry, School of Dentistry, Showa University
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
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In Vitro Effects of Cyclic Dislodgement on Retentive Properties of Various Titanium-Based Dental Implant Overdentures Attachment System. MATERIALS 2019; 12:ma12223770. [PMID: 31744164 PMCID: PMC6888218 DOI: 10.3390/ma12223770] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 11/14/2019] [Accepted: 11/15/2019] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to evaluate the change in the retentive forces of four different titanium-based implant attachment systems during the simulation of insert–removal cycles in an artificial oral environment. Five types of titanium-based dental implant attachment systems (Locator, Kerator, O-ring, EZ-Lock, and Magnetic) were studied (n = 10). The specimens underwent insert–removal cycles in artificial saliva, and the retentive force was measured following 0, 750, 1500, and 2250 cycles. Significant retention loss was observed in all attachment systems, except the magnetic attachments, upon completion of 2250 insertion and removal cycles, compared to the initial retentive force (p < 0.05). A comparison of the initial retentive forces revealed the highest value for Locator, followed by the Kerator, O-ring, EZ-Lock, and Magnetic attachments. Furthermore, Kerator demonstrated the highest retentive loss, followed by Locator, O-ring, EZ-Lock, and Magnetic attachments after 2250 cycles (p < 0.05). In addition, the Locator and Kerator systems revealed significant decrease in retentive forces at all measurement points (p < 0.05). The retention force according to the insert–removal cycles were significantly different according to the types of dental implant attachment systems.
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Taha NEKS, Dias DR, Oliveira TMC, Souza JAC, Leles CR. Patient satisfaction with ball and Equator attachments for single‐implant mandibular overdentures: A short‐term randomised crossover clinical trial. J Oral Rehabil 2019; 47:361-369. [DOI: 10.1111/joor.12895] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/19/2019] [Accepted: 09/19/2019] [Indexed: 12/16/2022]
Affiliation(s)
| | - Danilo Rocha Dias
- Department of Oral Rehabilitation School of Dentistry Federal University of Goias Goiania Brazil
| | | | - João Antônio Chaves Souza
- Department of Stomatological Sciences School of Dentistry Federal University of Goias Goiania Brazil
| | - Cláudio Rodrigues Leles
- Department of Oral Rehabilitation School of Dentistry Federal University of Goias Goiania Brazil
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Lam Vo T, Kanazawa M, Myat Thu K, Asami M, Sato D, Minakuchi S. Masticatory function and bite force of mandibular single-implant overdentures and complete dentures: a randomized crossover control study. J Prosthodont Res 2019; 63:428-433. [DOI: 10.1016/j.jpor.2019.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 02/25/2019] [Accepted: 03/04/2019] [Indexed: 11/25/2022]
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Comparison of Three Different Types of Two-Implant-Supported Magnetic Attachments on the Stress Distribution in Edentulous Mandible. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2019; 2019:6839517. [PMID: 31089390 PMCID: PMC6476138 DOI: 10.1155/2019/6839517] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 01/21/2019] [Indexed: 11/17/2022]
Abstract
Two-implant-retained mandibular overdentures with magnetic attachments can provide an effective treatment modality for edentulous patients. In this study, a three-dimensional finite element analysis was used to compare the biomechanical characteristics of three different types of magnetic attachments in two-implant-retained mandibular overdentures. Flat-type, dome-type, and cushion-type of the magnetic attachments were designed to retain the overdenture. Four types of load were applied to the overdenture in each model: 100 N vertical and oblique loads on the right first molar and a 100 N vertical load on the right canine and the lower incisors. The biomechanical behaviors of peri-implant bone, abutment, and mucosa were recorded. In vertical incisors, vertical right canine, and oblique molar loading condition, the flat-type group exhibited the highest levels of maximum equivalent strain/stress in the peri-implant bone. The total deformation of mucosa and the maximum equivalent strain/stress in the oblique molar loading condition are about two times as the vertical molar loading condition. These results suggested that both cushion-type and dome-type of the magnetic attachments are better choices in two-implant-retained mandibular overdentures, and oblique loading is more harmful than vertical loading.
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Kuramochi A, Shiga H. Effect of denture treatment on masticatory movement in patients with complete dentures. J Prosthodont Res 2019; 63:245-249. [DOI: 10.1016/j.jpor.2018.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 12/04/2018] [Accepted: 12/12/2018] [Indexed: 10/27/2022]
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Komagamine Y, Kanazawa M, Sato D, Minakuchi S. A preliminary comparison of masticatory performances between immediately loaded and conventionally loaded mandibular two-implant overdentures with magnetic attachments. Clin Implant Dent Relat Res 2018; 21:130-137. [DOI: 10.1111/cid.12698] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 09/14/2018] [Accepted: 10/13/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Yuriko Komagamine
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences; Tokyo Medical and Dental University; Tokyo Japan
| | - Manabu Kanazawa
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences; Tokyo Medical and Dental University; Tokyo Japan
| | - Daisuke Sato
- Department of Implant Dentistry, School of Dentistry; Showa University; Tokyo Japan
| | - Shunsuke Minakuchi
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences; Tokyo Medical and Dental University; Tokyo Japan
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Nogueira TE, Schimmel M, Leles CR. Changes in masticatory performance of edentulous patients treated with single-implant mandibular overdentures and conventional complete dentures. J Oral Rehabil 2018; 46:268-273. [DOI: 10.1111/joor.12744] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 10/26/2018] [Accepted: 10/31/2018] [Indexed: 11/30/2022]
Affiliation(s)
| | - Martin Schimmel
- School of Dental Medicine; University of Bern; Bern Switzerland
| | - Cláudio R. Leles
- School of Dentistry; Federal University of Goias; Goiânia Brazil
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Sidenö L, Hmaidouch R, Brandt J, von Krockow N, Weigl P. Satisfaction level in dental-phobic patients with implant-supported rehabilitation performed under general anaesthesia: a prospective study. BMC Oral Health 2018; 18:182. [PMID: 30382830 PMCID: PMC6211469 DOI: 10.1186/s12903-018-0644-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 10/18/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Phobic patients avoid dental treatment impairing their oral health and making it challenging to offer them prosthetic rehabilitation. This study evaluated patients' experience of implant-supported prosthetic treatment after implantation performed under general anaesthesia due to dental phobia and severe pharyngeal reflexes (SPR). The effect of gender, age and location of implantation on patient satisfaction was tested. METHODS Two hundred five patients underwent implantation under general anesthesia both in maxilla and mandible, respectively. After a trans-gingival healing period of 6-8 weeks, fixed implant bridges were inserted. Patients completed oral health impact profile questionnaire (OHIP-14). An additional set of six special questions was also developed and considered. Analysis of the OHIP-14 total score was made using logistics regression. Wald chi-square test was used to analyse the effect of age, gender and location of implantation. Effect sizes were estimated as odds-ratios and associated 95% Wald confidence intervals. RESULTS Eighty two of 205 patients were included after prosthetic treatment. After start, 38 patients were excluded (4 died and 34 couldn't be reached). OHIP-14-analyses were made by 43 patients (30-90 years). 67% of patients were totally satisfied with the whole implant rehabilitation (scoring 0). Mean of total score was 2.5. Only age affected significantly (p = 0.014) patients satisfaction. The obtained data indicate that younger patients (30-64 years) especially women are less satisfied (4.95) than older patients (0.3) for age group (65-90 years).Special questions' data showed that 94.5% were satisfied with their treatment. 77.3% continued regular check-up after treatment and 96.9% would undergo the same treatment again. 95.5% would recommend implants to a friend of colleague. CONCLUSION Gender and location of implantation have no significant influence on patient satisfaction. Younger patients especially women are less satisfied than older patients. Phobic patients are totally satisfied with implant rehabilitation under general anaesthesia which means that this treatment can be considered as a treatment of choice giving these patients the same opportunity like others to improve their oral health and well-being.
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Affiliation(s)
- Louise Sidenö
- Department of Postgraduate Education, Master of Oral Implantology, Oral and Dental Medicine at Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7 / building 29, 60596, Frankfurt am Main, Germany.,, Stockholm, Sweden
| | - Rim Hmaidouch
- Department of Postgraduate Education, Master of Oral Implantology, Oral and Dental Medicine at Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7 / building 29, 60596, Frankfurt am Main, Germany.
| | - Jan Brandt
- Department of Dental Prosthodontics, Faculty of Oral and Dental Medicine at Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7 / building 29, 60596, Frankfurt am Main, Germany
| | - Nadine von Krockow
- Department of Oral Surgery, Faculty of Oral and Dental Medicine at Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7 / building 29, 60596, Frankfurt am Main, Germany
| | - Paul Weigl
- Department of Postgraduate Education, Master of Oral Implantology, Oral and Dental Medicine at Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7 / building 29, 60596, Frankfurt am Main, Germany
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Paleari AG, Oliveira Junior NMD, Marin DOM, Rodriguez LS, Arioli Filho JN, Pero AC, Compagnoni MA. One-year prospective clinical study comparing patient satisfaction and masticatory performance of mandibular overdentures supported by one versus two implants. J Appl Oral Sci 2018; 26:e20160628. [PMID: 30304120 PMCID: PMC6172020 DOI: 10.1590/1678-7757-2016-0628] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 10/03/2017] [Indexed: 11/30/2022] Open
Abstract
There is a lack of clinical evidence on mandibular overdentures (MOD) supported by a single implant.
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Affiliation(s)
- André Gustavo Paleari
- Universidade Federal de Alfenas, Faculdade de Odontologia, Departamento de Odontologia Restauradora, Alfenas, Minas Gerais, Brasil
| | - Norberto Martins de Oliveira Junior
- Univ. Estadual Paulista, Faculdade de Odontologia de Araraquara, Departamento de Materiais Odontológicos e Prótese, Araraquara, São Paulo, Brasil
| | - Danny Omar Mendoza Marin
- Univ. Estadual Paulista, Faculdade de Odontologia de Araraquara, Departamento de Materiais Odontológicos e Prótese, Araraquara, São Paulo, Brasil
| | - Larissa Santana Rodriguez
- Univ. Estadual Paulista, Faculdade de Odontologia de Araraquara, Departamento de Materiais Odontológicos e Prótese, Araraquara, São Paulo, Brasil
| | - João Neudenir Arioli Filho
- Univ. Estadual Paulista, Faculdade de Odontologia de Araraquara, Departamento de Materiais Odontológicos e Prótese, Araraquara, São Paulo, Brasil
| | - Ana Carolina Pero
- Univ. Estadual Paulista, Faculdade de Odontologia de Araraquara, Departamento de Materiais Odontológicos e Prótese, Araraquara, São Paulo, Brasil
| | - Marco Antonio Compagnoni
- Univ. Estadual Paulista, Faculdade de Odontologia de Araraquara, Departamento de Materiais Odontológicos e Prótese, Araraquara, São Paulo, Brasil
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Clinical viability of single implant-retained mandibular overdentures: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2018; 47:1166-1177. [DOI: 10.1016/j.ijom.2018.01.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 01/13/2018] [Accepted: 01/30/2018] [Indexed: 12/18/2022]
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40
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Threeburuth W, Aunmeungtong W, Khongkhunthian P. Comparison of immediate-load mini dental implants and conventional-size dental implants to retain mandibular Kennedy class I removable partial dentures: A randomized clinical trial. Clin Implant Dent Relat Res 2018; 20:785-792. [DOI: 10.1111/cid.12646] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 05/25/2018] [Accepted: 05/28/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Waruth Threeburuth
- Center of Excellence for Dental Implantology, Faculty of Dentistry; Chiang Mai University; Chiang Mai Thailand
| | - Weerapan Aunmeungtong
- Center of Excellence for Dental Implantology, Faculty of Dentistry; Chiang Mai University; Chiang Mai Thailand
| | - Pathawee Khongkhunthian
- Center of Excellence for Dental Implantology, Faculty of Dentistry; Chiang Mai University; Chiang Mai Thailand
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Schwindling FS, Raedel M, Passia N, Freitag-Wolf S, Wolfart S, Att W, Mundt T, Reissmann D, Ismail F, von Königsmark V, Kern M. The single mandibular implant study – Short-term effects of the loading protocol on Oral Health-related Quality of Life. J Prosthodont Res 2018; 62:313-316. [DOI: 10.1016/j.jpor.2017.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 09/28/2017] [Accepted: 12/15/2017] [Indexed: 10/17/2022]
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Nogueira TE, Aguiar FMO, de Barcelos BA, Leles CR. A 2-year prospective study of single-implant mandibular overdentures: Patient-reported outcomes and prosthodontic events. Clin Oral Implants Res 2018; 29:541-550. [DOI: 10.1111/clr.13151] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2018] [Indexed: 11/30/2022]
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43
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Kern M, Att W, Fritzer E, Kappel S, Luthardt RG, Mundt T, Reissmann DR, Rädel M, Stiesch M, Wolfart S, Passia N. Survival and Complications of Single Dental Implants in the Edentulous Mandible Following Immediate or Delayed Loading: A Randomized Controlled Clinical Trial. J Dent Res 2017; 97:163-170. [PMID: 29045800 PMCID: PMC6029143 DOI: 10.1177/0022034517736063] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
It was the aim of this 24-mo randomized controlled clinical trial to investigate
whether the survival of a single median implant placed in the edentulous
mandible to retain a complete denture is not compromised by immediate loading.
Secondary outcomes were differences in prosthetic complications between the
loading principles. Each of the 158 patients who received an implant was
randomly assigned to the immediate loading group (n = 81) or the delayed loading group (n = 77). Recall visits were performed 1 mo after implant placement
(for only the delayed loading group) and 1, 4, 12, and 24 mo after implant
loading. Nine implants failed in the immediate loading group, all within the
first 3 mo of implant loading, and 1 implant failed in the delayed loading group
prior to loading. Noninferiority of implant survival of the immediate loading
group, as compared with the delayed loading group, could not be shown (P = 0.81). Consistent with this result, a secondary
analysis with Fisher exact test revealed that the observed difference in implant
survival between the treatment groups was indeed statistically significant
(P = 0.019). The most frequent prosthetic
complications and maintenance interventions in the mandible were retention
adjustments, denture fractures, pressure sores, and matrix exchanges. There was
only 1 statistically significant difference between the groups regarding the
parameter “fracture of the denture base in the ball attachment area” (P = 0.007). The results indicate that immediate
loading of a single implant in the edentulous mandible reveals inferior survival
than that of delayed loading and therefore should be considered only in
exceptional cases (German Clinical Trials Register: DRKS00003730).
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Affiliation(s)
- M Kern
- 1 Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University at Kiel, Kiel, Germany
| | - W Att
- 2 Department of Prosthodontics, University Hospital Freiburg, Freiburg, Germany
| | - E Fritzer
- 3 Center for Clinical Studies, Christian-Albrechts University at Kiel, Kiel, Germany
| | - S Kappel
- 4 Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - R G Luthardt
- 5 Department of Prosthetic Dentistry, Center of Dentistry, Ulm University Hospital, Ulm, Germany
| | - T Mundt
- 6 Department of Prosthodontics, Gerodontology and Biomaterials, Greifswald University Hospital, Greifswald, Germany
| | - D R Reissmann
- 7 Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Rädel
- 8 Department of Prosthodontics, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - M Stiesch
- 9 Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover, Germany
| | - S Wolfart
- 10 Department of Prosthodontics and Biomaterials, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - N Passia
- 1 Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University at Kiel, Kiel, Germany
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Single mandibular implant study (SMIS) − masticatory performance − results from a randomized clinical trial using two different loading protocols. J Dent 2017; 65:64-69. [DOI: 10.1016/j.jdent.2017.07.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/19/2017] [Accepted: 07/07/2017] [Indexed: 12/17/2022] Open
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45
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Nogueira TE, Dias DR, Leles CR. Mandibular complete denture versus single-implant overdenture: a systematic review of patient-reported outcomes. J Oral Rehabil 2017; 44:1004-1016. [PMID: 28805255 DOI: 10.1111/joor.12550] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2017] [Indexed: 11/28/2022]
Abstract
The single-implant mandibular overdenture (SIMO) has been proposed as an alternative for edentulous patients who are poorly adapted to their dentures due to low retention and stability of the conventional mandibular complete denture (CD). However, there is a lack of evidence regarding the effectiveness of SIMO, which can be measured by examining patient perception of treatment effects. The aim of this systematic review was to assess the comparative results of CD and SIMO treatments using patient-reported outcome measures. A literature search was carried out in PubMed, Scopus and Cochrane Central databases. The search included studies published up to July 2017. The focus question was: 'Do single-implant mandibular overdentures improve patient-reported outcomes compared to conventional complete dentures in edentulous patients?' Eligible studies were randomised clinical trials (RCT) and prospective studies. After initial screening for eligibility and full-text analysis, 11 studies were included for data extraction and quality assessment (five parallel-group RCTs, two crossover RCTs and four prospective studies). All studies reported marked improvement in satisfaction with the dentures and quality of life measures after SIMO treatment, irrespective of variations in implant treatment protocols and retention systems. Methodological considerations revealed a lack of evidence from RCTs on the comparative effectiveness of the two treatment strategies. Hence, although available evidence suggests considerable improvement in patient-reported outcomes following the insertion of a single implant to retain a mandibular denture, further well-designed comparative studies between SIMO and CD are required to improve the level of evidence and to support the indication of SIMO treatment in routine practice.
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Affiliation(s)
- T E Nogueira
- Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Brazil
| | - D R Dias
- Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Brazil
| | - C R Leles
- Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Brazil
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46
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Al-Dharrab A. Three-year Prospective Evaluation of Immediately Loaded Mandibular Implant Overdentures retained with Locator Attachments. J Contemp Dent Pract 2017; 18:842-850. [PMID: 28874652 DOI: 10.5005/jp-journals-10024-2137] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Immediate implant-loading protocol has progressed because of various clinical advantages offered by this treatment approach. However, available studies on edentulous patients are still few compared to those in which delayed implant-loading protocol was applied. AIM This prospective study was to evaluate the implant survival rate and the peri-implant tissue response in a group of patients who received two unsplinted immediately loaded dental implants in the mandibular anterior region to retain a complete overdenture using locator attachments. MATERIALS AND METHODS A total of 24 edentulous patients with a mean age of 63.4 years were involved in this study following certain inclusion criteria. All patients received a new set of complete dentures before implant positioning. Two Prima Connex tapered implants were put in the interforaminal area of the mandible with a flapless surgical procedure, and the prefabricated dentures were immediately retained with a zest locator attachment. Clinical and radiographic records of the patients were reviewed immediately after placement of the implant, at 3 months, and at 1, 2, and 3 years following fixture installation. The obtained data were analyzed using paired samples t-test and the Wilcoxon signed-rank test at 0.05 significance level. RESULTS At 3 years, all implants had osseointegrated with a 100% survival rate. In addition, the total mean marginal bone change was -0.89 ± 0.14 mm, and the mean periotest value was -7.631 ± 0.921. CONCLUSION Results of this study propose that immediate loading of mandibular implant overdentures that are retained with locator attachments was a feasible treatment alternative for this particular group of patients. CLINICAL SIGNIFICANCE Immediate implant- loading of mandibular implant overdentures that are retained with locator attachments is a reliable treatment option Keywords: Immediate implant loading, Implant survival rate, Locator attachments, Overdenture.
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Affiliation(s)
- Ayman Al-Dharrab
- Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia, Phone: +96626403316, e-mail:
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47
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Cost-effectiveness analysis of the single-implant mandibular overdenture versus conventional complete denture: study protocol for a randomized controlled trial. Trials 2016; 17:533. [PMID: 27814749 PMCID: PMC5097429 DOI: 10.1186/s13063-016-1646-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 10/05/2016] [Indexed: 12/03/2022] Open
Abstract
Background Preliminary clinical studies on the single-implant mandibular overdenture (SIMO) have reported favorable results as an alternative to the conventional complete dentures for rehabilitation of the edentulous mandible. Clinical and patient-reported outcomes were assessed but no evidence is available with respect to the cost-effectiveness of this treatment, which is particularly important to test whether the incremental cost associated with the implant treatment is justified facing the benefits from the intervention. Thus, the aim of this study is to assess the cost-effectiveness of single-implant mandibular overdentures. Methods/design This randomized clinical trial will include edentulous individuals who meet eligibility criteria. Participants will be randomized into one of the treatment groups: a conventional complete denture group or a single-implant mandibular overdenture group. Direct costs related to therapies in both groups will be identified, measured and valuated for 1 year after treatment. Oral health-related quality of life and satisfaction with the dentures will be the primary outcome variables. Incremental cost-effectiveness ratios will be estimated and graphically presented on cost-effectiveness planes. A Markov decision tree will be constructed to set out the consequences of the competing alternatives. Sensitivity analysis on the most important assumptions will be performed in order to assess the robustness of the model. Discussion This is the first trial-based cost-effectiveness study on single-implant mandibular overdentures. Specific challenges in designing the protocol are considered. The expected results are of high clinical relevance and may contribute to the decision-making process when choosing between different alternatives for the rehabilitation of the edentulous mandible. Trial registration ClinicalTrials.gov Identifier: NCT02710357, registered on 11 March 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1646-0) contains supplementary material, which is available to authorized users.
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Wu MK, Song N, Liu F, Kou L, Lu XW, Wang M, Wang H, Shen JF. Corrosion behaviours of the dental magnetic keeper complexes made by different alloys and methods. Int J Oral Sci 2016; 8:155-63. [PMID: 27388806 PMCID: PMC5113091 DOI: 10.1038/ijos.2016.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2016] [Indexed: 02/05/2023] Open
Abstract
The keeper and cast dowel–coping, as a primary component for a magnetic attachment, is easily subjected to corrosion in a wet environment, such as the oral cavity, which contains electrolyte-rich saliva, complex microflora and chewing behaviour and so on. The objective of this in vitro study was to examine the corrosion resistance of a dowel and coping-keeper complex fabricated by finish keeper and three alloys (cobalt–chromium, CoCr; silver–palladium–gold, PdAu; gold–platinum, AuPt) using a laser-welding process and a casting technique. The surface morphology characteristics and microstructures of the samples were examined by means of metallographic microscope and scanning electron microscope (SEM). Energy-dispersive spectroscopy (EDS) with SEM provided elements analysis information for the test samples after 10% oxalic acid solution etching test. Tafel polarization curve recordings demonstrated parameter values indicating corrosion of the samples when subjected to electrochemical testing. This study has suggested that massive oxides are attached to the surface of the CoCr–keeper complex but not to the AuPt–keeper complex. Only the keeper area of cast CoCr–keeper complex displayed obvious intergranular corrosion and changes in the Fe and Co elements. Both cast and laser-welded AuPt–keeper complexes had the highest free corrosion potential, followed by the PdAu–keeper complex. We concluded that although the corrosion resistance of the CoCr–keeper complex was worst, the keeper surface passive film was actually preserved to its maximum extent. The laser-welded CoCr– and PdAu–keeper complexes possessed superior corrosion resistance as compared with their cast specimens, but no significant difference was found between the cast and laser-welded AuPt–keeper complexes. The Fe-poor and Cr-rich band, appearing on the edge of the keeper when casting, has been proven to be a corrosion-prone area.
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Affiliation(s)
- Min-Ke Wu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ning Song
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Fei Liu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Liang Kou
- Ningbo Dental Hospital, Ningbo, China
| | | | - Min Wang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hang Wang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jie-Fei Shen
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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49
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Mahoorkar S, Bhat S, Kant R. Single implant supported mandibular overdenture: A literature review. J Indian Prosthodont Soc 2016; 16:75-82. [PMID: 27134432 PMCID: PMC4832806 DOI: 10.4103/0972-4052.164881] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PURPOSE Rehabilitation of the edentulous mandible by implant-supported prosthesis is a successful and satisfying treatment as suggested by many clinical trials. However, the minimum number of implants required for this restoration is debatable. Single implant retained overdenture (SIROD) has gained popularity as a simple protocol. The purpose of this review is to systematically analyze the literature on SIROD. MATERIALS AND METHODS An electronic search was done in the PubMed and Medline databases using the key words "central single implant overdenture," "implant overdenture retained by one implant," "implant overdenture retained by single implant," "mandibular single implant overdenture," "mandibular SIRODs." Articles from 1993 to November 2012 were included in the review. Out of 208 articles, only 18 had relevant data pertaining to mandibular single implant overdenture. Two more were hand-picked from journals that are non-PubMed indexed but from reputed publishing houses. RESULTS Majority of studies supported the concept of SIROD. Success outcome was addressed in relation to surgical, prosthetic, functional parameters, and patient satisfaction. 65% studies evaluated the primary stabilities of the placed implants, 50% of studies assessed the marginal bone loss quarterly across a 1-year period. Prosthesis outcome was a criterion for evaluation of success rate in 45% of studies. CONCLUSION The SIROD is proved to be successful and an economic treatment protocol. However, the clinical parameters such as masticatory efficiency bite force, retention, and stability needs to be investigated.
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Affiliation(s)
- Sudhindra Mahoorkar
- Department of Prosthodontics, HKES's SN Institute of Dental Sciences and Research, Gulbarga, Karnataka, India
| | - Srinidhi Bhat
- Department of Prosthodontics, Sharavathi College of Dental Sciences and Hospital, Shimoga, Karnataka, India
| | - Radhika Kant
- Department of Prosthodontics, HKES's SN Institute of Dental Sciences and Research, Gulbarga, Karnataka, India
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50
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Bhat S, Chowdhary R, Mahoorkar S. Comparison of masticatory efficiency, patient satisfaction for single, two, and three implants supported overdenture in the same patient: A pilot study. J Indian Prosthodont Soc 2016; 16:182-6. [PMID: 27141169 PMCID: PMC4837769 DOI: 10.4103/0972-4052.176522] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 11/20/2015] [Indexed: 11/17/2022] Open
Abstract
STATEMENT OF PROBLEM Over 30% of the world population suffers from edentulism. Implant supported overdenture have been a relatively successful treatment option for edentulism and have shown to slowed the rate of residual resorption and maintain the vertical height of the residual. PURPOSE The purpose of this study was to measure patient masticatary efficiency and satisfaction with the mandibular one-, two-, and three-implant-retained overdenture therapy when compared with conventional denture in a the same patients. MATERIALS AND METHODS Ten complete edentulous patients, who were wearing conventional complete dentures, were involved in this study. Three single piece endosseous implant of 3.0 mm in diameter and 13 mm in length were surgically placed in the mandible in the region of B, C, and D. Mandibular denture was connected for single, two, and three implant supported overdenture periodically and checked for masticatory efficiency using a bite gauge and patient satisfaction using a questionnaire. RESULTS Statistical analysis was done using Wilcoxon signed rank test. Four groups of bite forces when compared to each other. Group 1 was compared with Group 2, with the statistical value showing significance. Signed rank test showed no significance (0.268) when Group 2 was compared with Group 3. When Group 3 was compared with Group 4, and Group 1 compared with Group 4, rank test showed significant values. Four groups were compared with each other for patient satisfaction, Group 1 was compared with Group 2, with the statistical value showing no significance. CONCLUSIONS A single midline implant supported overdenture can be considered as a suitable and cost-effective treatment option over conventional denture. The study concludes that masticatory efficiency of this single midline implant supported overdenture is better than the conventional complete denture.
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Affiliation(s)
- Srinidhi Bhat
- Department of Prosthodontics, S. Nijalingappa Institute of Dental Sciences and Research, Gulbarga, Karnataka, India
| | - Ramesh Chowdhary
- Branemark Osseointegration Centre India, Gulbarga, Karnataka, India
| | - Sudhindra Mahoorkar
- Department of Prosthodontics, S. Nijalingappa Institute of Dental Sciences and Research, Gulbarga, Karnataka, India
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