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Borges GA, Codello DJ, Del Rio Silva L, Dini C, Barão VAR, Mesquita MF. Factors and clinical outcomes for standard and mini-implants retaining mandibular overdentures: A systematic review and meta-analysis. J Prosthet Dent 2023; 130:677-689. [PMID: 35120735 DOI: 10.1016/j.prosdent.2021.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 11/02/2021] [Accepted: 11/02/2021] [Indexed: 11/21/2022]
Abstract
STATEMENT OF PROBLEM Standard-diameter dental implants are not always applicable because of anatomic limitations of the residual ridge. Thus, mini-implants have been increasingly used and offer an alternative. However, data regarding prosthetic complications, maintenance factors, and clinical outcomes are limited. PURPOSE The purpose of this systematic review and meta-analysis was to compare prosthetic complications and maintenance events and clinical outcomes in residual ridges rehabilitated with mandibular implant overdentures (IODs) by using standard implants or mini-implants. MATERIAL AND METHODS Nine electronic databases were searched. Quantitative analyses to measure the risk ratio (RR) and standardized mean difference (SMD) were applied. Those methods were used to assess prosthetic complications and maintenance events (abutment adjustments, replacement of retentive element, occlusal adjustment, and overdenture fracture) and clinical outcomes related to postoperative pain, probing depth (PD), plaque index (PI), marginal bone loss (MBL), and implant survival rate. RESULTS Altogether, 7 publications were selected. Mini-implants presented reduced abutment adjustments (RR 0.23 [0.07, 0.73], P=.01), replacement of retentive element (RR 0.41 [0.31, 0.54], P<.001), occlusal adjustment (RR 0.53 [0.31, 0.91], P=.02), and overdenture fracture (RR 0.46 [0.23, 0.94], P=.03) compared with standard implants. Additionally, mini-implants presented lower values for PI at 6 months (SMD -0.27 [-0.47, -0.08], P=.006) and 12 months (SMD -0.25 [-0.46, -0.05], P=.01). No additional tangible differences were noted. CONCLUSIONS Mini-implants might be an alternative choice based on the number of prosthetic complications and maintenance events. This was also confirmed by the comparable clinical data between standard implants and mini-implants.
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Affiliation(s)
- Guilherme Almeida Borges
- PhD student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Denise Juncom Codello
- Predoctoral student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Letícia Del Rio Silva
- PhD student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Caroline Dini
- PhD student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Valentim Adelino Ricardo Barão
- Associate Professor, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Marcelo Ferraz Mesquita
- Full Professor, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.
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Alshenaiber R, Barclay C, Silikas N. The Effect of Mini Dental Implant Number on Mandibular Overdenture Retention and Attachment Wear. BIOMED RESEARCH INTERNATIONAL 2023; 2023:7099761. [PMID: 37168235 PMCID: PMC10164865 DOI: 10.1155/2023/7099761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 09/02/2022] [Accepted: 04/05/2023] [Indexed: 05/13/2023]
Abstract
Purpose Evaluate the effect of different mini-implant numbers on overdenture retention and evaluate attachment wear following one year of simulated placement/removal. Material and Methods. Nine models simulating atrophic mandibles held 27 mini dental implants in three groups of 2, 3, and 4 mini-implants. A total of 1080 simulated placement/removal cycles were carried out, and a digital force gauge was used to measure the overdenture dislodgment force. The means of the retention forces were analyzed using SPSS with one-way ANOVA and post hoc (p < 0.05). The inner diameter of attachment inserts was evaluated using a light microscope before and after testing. A paired t-test was used to compare the mean of inner ring diameters (p < 0.05). Results The retention was significantly reduced regardless of the mini dental implant number, but the number affected overdenture retention. The placement of 4 mini dental implants provided higher retention and less reduction in retentiveness. However, no significant difference was found when 3 mini dental implants were compared to 2 mini dental implants (p = 0.21). Microscopic examination showed abrasion wear in all inserts following testing. However, the inserts of the 4 mini dental implants showed less wear than those used for 2 or 3 mini dental implants with p ≤ 0.001 and p ≤ 0.001, respectively. Conclusion Mini dental implant overdenture retention force and attachment wear could improve by increasing the mini dental implants to 4. However, there was no difference in retention force or attachment wear when 2 or 3 mini dental implant overdentures were compared.
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Affiliation(s)
- Rafif Alshenaiber
- Prosthetic Dental Sciences Department at College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Craig Barclay
- Oral Rehabilitation, University Dental Hospital of Manchester, Manchester, UK
| | - Nick Silikas
- Division of Dentistry, Faculty of Biology, Medicine and Health, University of Manchester, Coupland 3 Building, UK Manchester M13 9PL
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Vi S, Pham D, Du YYM, Arora H, Tadakamadla SK. Mini-Implant-Retained Overdentures for the Rehabilitation of Completely Edentulous Maxillae: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084377. [PMID: 33924167 PMCID: PMC8074399 DOI: 10.3390/ijerph18084377] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 11/16/2022]
Abstract
Purpose: Mini-dental implants (MDIs) have been used to support and retain overdentures, providing patients with a less invasive placement procedure. Although lucrative, the use of MDIs to retain a maxillary overdenture is still not an established treatment modality. This systematic review aims to answer the question: Do mini-implant-retained maxillary overdentures provide a satisfactory treatment outcome for complete edentulism? Methods: A systematic search for relevant articles was conducted to include articles published until April 2021 in the following electronic databases: CINAHL, Cochrane, EMBASE, PubMed, and Web of Science. All empirical studies evaluating the biological, survival, or patient-reported outcomes after placing mini-implant-retained overdentures in maxilla were considered for inclusion. The risk of bias was assessed by utilizing the Joanna Briggs Institute critical appraisal checklist. Study screening and data extraction were conducted by three reviewers independently. Results: The electronic search retrieved 1276 titles after omitting duplicates. Twenty articles were considered for full-text review, of which six studies were included in this systematic review. The included studies evaluated a total of 173 participants with a mean age of 66.3 years. The overall mini-implant survival rate was 77.1% (95% CI: 64.7–89.5%) with a mean follow-up time of 1.79 years (range: 6 months to 3 years). Implant survival differed significantly when comparing complete and partial palatal coverage overdentures. Those with complete palatal coverage exhibited less bone loss overall compared to partial coverage overdentures. Participants of all studies reported an increase in the quality of life and in satisfaction after rehabilitation treatment with MDIs. Conclusions: The survival rate of mini-implants retaining an overdenture in the maxilla was observed to be lower than the values reported for traditional implants in the literature. Improvements were observed in all aspects in terms of patient satisfaction, quality of life, oromyofunction, and articulation after the treatment.
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Affiliation(s)
- Serena Vi
- School of Medicine and Dentistry, Griffith University, Gold Coast 4222, Australia; (S.V.); (D.P.); (Y.Y.M.D.); (S.K.T.)
| | - Damon Pham
- School of Medicine and Dentistry, Griffith University, Gold Coast 4222, Australia; (S.V.); (D.P.); (Y.Y.M.D.); (S.K.T.)
| | - Yu Yian Marina Du
- School of Medicine and Dentistry, Griffith University, Gold Coast 4222, Australia; (S.V.); (D.P.); (Y.Y.M.D.); (S.K.T.)
| | - Himanshu Arora
- School of Dentistry, The University of Queensland, Brisbane 4006, Australia
- Correspondence:
| | - Santosh Kumar Tadakamadla
- School of Medicine and Dentistry, Griffith University, Gold Coast 4222, Australia; (S.V.); (D.P.); (Y.Y.M.D.); (S.K.T.)
- Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia
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Proposal for a Clinical Approach to Geriatric Patients with Anchor Need on Implant for Removable Denture: New Technique. PROSTHESIS 2020. [DOI: 10.3390/prosthesis2030016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A method is proposed using a silicone tube to allow the restoration of incongruous prostheses due to the retention of removable prostheses anchored to implants by ball-attachment, also in medical facilities Health Care Residence (RSA) where the equipment characteristic of dental clinics is lacking. One hundred and thirty-seven patients belonging to the Health Care Residence of the Monza and Brianza area were analyzed. Of these, 13 required retention replacement for ball attachment of total lower prostheses to implant anchorage. The new retention procedure was carried out with the patients bedridden according to the methodology of the present work. All 13 patients were perfectly rehabilitated in the Health Care Residence offices without discomfort and pain. The method presented is easily repeatable, risk-free and can also be carried out in structures not dedicated to dentistry, saving economic resources and inconveniences for patients who are not cooperative.
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Borges GA, Presotto AGC, Caldas RA, Pisani MX, Mesquita MF. Is one dental mini-implant biomechanically appropriate for the retention of a mandibular overdenture? A comparison with Morse taper and external hexagon platforms. J Prosthet Dent 2020; 125:491-499. [PMID: 32278498 DOI: 10.1016/j.prosdent.2020.01.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/27/2020] [Accepted: 01/27/2020] [Indexed: 11/16/2022]
Abstract
STATEMENT OF PROBLEM Limited information is available to clinicians on the use of dental mini-implants (MI) as opposed to standard-diameter implants (SDIs) for the stabilization of implant-retained mandibular overdentures (MOs). PURPOSE The purpose of this in vitro and finite element analysis study was to analyze and compare the biomechanical behavior of MOs with either 1 or 2 implants with external hexagon (EH), Morse taper (MT) SDIs, and MIs. MATERIAL AND METHODS Thirty photoelastic models (n=30) of each group (n=5) of SDIs (EH-1, EH-2, MT-1, MT-2) and MI (MI-1, MI-2) were fabricated for posterior, peri-implant, and total maximum shear stress evaluation by quantitative photoelastic analysis. One specimen of each group was further used to create the 6 computational models to be analyzed by finite element analysis. The maximum von Mises values and stress maps were plotted for each ductile component. Two types of load were applied to the overdenture: a150-N load bilaterally and simultaneously on the first molar and a 100-N load on the incisal edge of the central incisors at a 30-degree angle. The data were subjected to the 2-way ANOVA test and the Tukey honestly significant difference test (α=.05). RESULTS The EH-2 and MT-2 showed the lowest posterior (P<.001) and total (P<.05) mean shear stress values. For peri-implant shear stress, no difference was found among all groups (P>.05). Regardless of the loading area, the MI-1 and MI-2 groups showed the lowest von Mises stress values. However, for implant housing, the MI-1 group, under incisor loading, presented greater stress, followed by MT-1, EH-1, EH-2, MI-2, and MT-2. The attachment was the most overloaded structure, with high values under incisor loading, especially for the groups with 2 implants (MT-2, EH-2) as compared with the other models. CONCLUSIONS Biomechanically, regardless of the implant number, MI is a promising rehabilitation method with similar peri-implant shear stress and lower von Mises stress on the implant when compared with SDIs for MOs.
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Affiliation(s)
- Guilherme Almeida Borges
- Doctoral student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Anna Gabriella Camacho Presotto
- Research Fellow, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Ricardo Armini Caldas
- Professor, Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil.
| | - Marina Xavier Pisani
- Research Fellow, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Marcelo Ferraz Mesquita
- Full Professor, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
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Enkling N, Moazzin R, Geers G, Kokoschka S, Abou-Ayash S, Schimmel M. Clinical outcomes and bone-level alterations around one-piece mini dental implants retaining mandibular overdentures: 5-year follow-up of a prospective cohort study. Clin Oral Implants Res 2020; 31:549-556. [PMID: 32096255 DOI: 10.1111/clr.13591] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 02/11/2020] [Accepted: 02/15/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To report on the clinical outcomes of one-piece mini dental implants (MDIs) retaining mandibular implant overdentures (IODs), including marginal bone-level alterations (ΔMBLs), clinical peri-implant parameters, and technical- and biological complications during a 5-year follow-up. The null hypothesis was that ΔMBLs would be equal in subjects older than 65 years relative to younger subjects. MATERIALS AND METHODS Four 1.8-mm diameter one-piece MDIs with ball attachments were placed in the interforaminal region of 20 edentulous subjects. The existing complete dentures were converted to IODs. Standardized radiographs of each implant were taken at implant placement (baseline) and during the five-year follow-up. ΔMBLs and potential influencing factors were evaluated, and peri-implant parameters, and biological and technical complications were recorded. RESULTS The implant and prosthetic survival rates were both 100%. IODs fractured in seven participants. The overall mean ΔMBL after 5 years was -1.18 mm (standard deviation: 0.79 mm). ΔMBLs per month were most pronounced within the first 3 months after implant placement. ΔMBLs were not influenced by the implant location, the presence of keratinized mucosa, or gender. However, ΔMBLs were significantly smaller in subjects older than 65 years (p = .007). CONCLUSIONS One-piece MDIs retaining mandibular IODs with O-ring attachments are a predictable treatment option, providing stable peri-implant bone and soft tissue conditions over a mid-term follow-up. Incorporating a metal reinforcement can prevent denture fracturing when converting a complete denture into an IOD. The presence of keratinized mucosa does not necessarily lead to decreased bone-level changes. Advanced age might be beneficial in terms of peri-implant bone stability.
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Affiliation(s)
- Norbert Enkling
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland.,Department of Prosthodontics, Preclinical Education and Dental Materials Science, University of Bonn, Bonn, Switzerland
| | - Rim Moazzin
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | - Gregor Geers
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | - Stephanie Kokoschka
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
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