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Curado TFF, Nascimento LN, Silva JR, de Paula MS, Schimmel M, McKenna G, Leles CR. Mandibular overdenture retained by four one-piece titanium-zirconium mini implants: A 2-year RCT on patient-reported outcomes. J Dent 2024; 149:105267. [PMID: 39067647 DOI: 10.1016/j.jdent.2024.105267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 07/22/2024] [Accepted: 07/23/2024] [Indexed: 07/30/2024] Open
Abstract
AIM The positive impact of implant interventions on dental patient-reported outcomes is an essential parameter of treatment effectiveness. This study assessed the 2-year changes in patient satisfaction and oral health-related quality of life (OHRQoL) of edentulous patients treated with a four mini implant mandibular overdenture (IOD) METHODS: The study was planned as a 2 × 2 factorial randomized clinical trial that tested two surgical approaches (flapped or flapless) and two loading protocols (immediate and delayed) using a titanium-zirconium mini implant (Straumann Mini Implant System®) and a PEEK retentive system (Straumann® Optiloc® Retentive System). Outcome measures (OHIP-Edent scores and the McGill Denture Satisfaction questionnaire) were assessed before treatment and at the 3-, 6-, 12-, and 24-month follow-ups. The Friedman test and multiple regression using Generalized Estimating Equations (GEE) were used for data analysis, considering the per-protocol (PP) and intention-to-treat (ITT) approaches RESULTS: Seventy-four patients were randomized to the study groups. No implant failure occurred during the study period. Marked improvement in all post-treatment periods compared to baseline were observed for the two outcomes. No significant effect of patient's gender, age, and surgical protocol on the study outcomes. The effect of treatment provision was significant for the two outcomes in the PP and ITT approaches (p < 0.001). A barely significant positive effect of the immediate loading was observed for OHIP-Edent in the PP approach (p = 0.020) CONCLUSION: IOD treatment significantly improved patient-reported outcomes measures, with sustained benefits over the two years of overdenture use, and can be considered a promising treatment option in for the edentulous mandible.
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Affiliation(s)
| | | | | | | | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, 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
| | - Gerald McKenna
- Centre for Public Health, Queen's University Belfast, Belfast, UK; Clinic of General, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Cláudio Rodrigues Leles
- School of Dentistry, Federal University of Goias, Goiania, Brazil; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine of the University of Bern, Bern, Switzerland; Clinic of General, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
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Silva JR, Curado TFF, Srinivasan M, Schimmel M, McKenna G, Leles CR. Mandibular overdenture retained by four one-piece titanium-zirconium mini implants: A 2-year follow-up on prosthodontic outcomes. J Dent 2024; 149:105266. [PMID: 39067651 DOI: 10.1016/j.jdent.2024.105266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/09/2024] [Accepted: 07/23/2024] [Indexed: 07/30/2024] Open
Abstract
OBJECTIVE This 2-year prospective study reports the incidence of prosthetic complications and maintenance events after treatment with mandibular overdenture retained by four mini implants opposed to a maxillary denture. METHODS Implant intervention included flapless or flapped surgery combined with immediate or delayed loading, as part of a randomized clinical trial. Four one-piece titanium-zirconium mini-implants (Straumann Mini Implant System) were inserted, and the retentive PEEK elements (Optiloc) were incorporated into the overdenture using chairside procedures. Prosthodontic complications and maintenance events were recorded over a 2-year follow-up, and the final outcome was defined according to standardized criteria. Data analysis included descriptive statistics, incidence and incidence density rates, and Kaplan-Meier survival. RESULTS 73 out of 74 patients (64.9 % female), mean age of 64 (SD=8.2) years, completed the study follow-up (one withdrew after 9 months). Implant survival was 100 %. A total of 163 prosthodontic events occurred in 53 patients (72.6 %), and 20 patients had no clinical complaints or maintenance needs. The most common procedures were adjustment/repair of the overdenture base (47.0 %), replacement of retentive inserts (19.8 %), and laboratory relining (12.9 %). A high prosthodontic success rate was achieved (93.2 %), and all patients presented serviceable overdentures and continuous use after the resolution of prosthodontic complications. The incidences of matrix replacement and laboratory relines were low in the first year, while denture base adjustments were common within the first year, especially in the first 6 months. CONCLUSION The mini implant system showed high prosthodontic success rates. Minor adjustments/repairs during the initial follow-up were common. Relines and matrix replacements tend to occur after one year of overdenture use, and matrix replacements may occur as a consequence of the need for relining.
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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
| | - Martin Schimmel
- Department of Reconstructive Dentistry, Division of Gerodontology, 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
| | - Gerald McKenna
- Oral Health Services and Gerodontology, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Cláudio Rodrigues Leles
- School of Dentistry, Federal University of Goias, Goiania, Brazil; Clinic of General-, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Department of Reconstructive Dentistry, Division of Gerodontology, School of Dental Medicine of the University of Bern, Bern, Switzerland.
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Maniewicz S, Curado TFF, McKenna G, Leles CR, Müller F. Single lateral implant for mandibular overdentures as a fallback solution or a viable treatment alternative: Four case reports. J Prosthodont 2024; 33:3-9. [PMID: 38512962 DOI: 10.1111/jopr.13841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 03/01/2024] [Indexed: 03/23/2024] Open
Abstract
This report of four clinical cases aims to illustrate the use of a lateral implant as a solution for implant overdentures in the mandible in different clinical situations. The first two cases describe the clinical situations of patients wearing two-implant mandibular overdentures until the failure of one of the implants, one due to implant loss and the other due to a fracture of an abutment screw, and how the conditions were managed. The third case illustrates the placement of a single implant to retain an overdenture, where a midline implant, as originally planned, was not feasible due to anatomic reasons. The final case describes the use of a lateral implant to support and retain a single-implant mandibular overdenture. The four cases demonstrate that a single lateral implant can be utilized as sole retention in cases of a failing contra-lateral implant and as an alternative to a single implant in the midline.
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Affiliation(s)
- Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | | | - Gerald McKenna
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Cláudio Rodrigues Leles
- Department of Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil
- 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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Celebic A, Kovacic I, Petricevic N, Alhajj MN, Topic J, Junakovic L, Persic-Kirsic S. Clinical Outcomes of Three versus Four Mini-Implants Retaining Mandibular Overdenture: A 5-Year Randomized Clinical Trial. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:17. [PMID: 38276051 PMCID: PMC10820318 DOI: 10.3390/medicina60010017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024]
Abstract
Background and Objectives: Due to a lack of long-term clinical studies that would clarify whether the insertion of three mini-implants (MDIs) can be as successful treatment as the insertion of four MDIs for the retention of mandibular overdentures (ODs), this 5-year prospective cohort study was set up. Materials and Methods: Participants (n = 83) randomly received either four or three MDIs and a mandibular OD. Clinical examinations were performed at the baseline, as well as after one, three, and five years, respectively. A total of 73 participants (38 in the four-MDI and 35 in the three-MDI groups) partook in the study. The marginal bone level change, success and survival rates, and prosthodontic maintenance were assessed. Results: Repeated measures showed that the mean peri-implant bone loss increased progressively at a small amount over five years in both groups (four-MDI group = -0.36 ± 0.74; three-MDI group = -0.33 ± 0.27 mm; p < 0.05). However, an ANCOVA revealed no significant effects of the group (no significant difference between the three- and the four-MDI groups; F = 0.085; p = 0.771), gender (F = 0.023; p = 0.88), or covariate age (F = 1.95; p = 0.167) on the dependent variable: the 5-year MBL change. The success rate (together with successful survival) was 93.8% in the four-MDI group and 91.7% in the three-MDI group. The log-rank (Mantel-Cox) test revealed no significant differences between them (X2 = 0.373; p = 0.541). Conclusions: In patients with narrow ridges, the insertion of three MDIs in the mandible for overdenture retention can be equally as successful as the insertion of four MDIs.
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Affiliation(s)
- Asja Celebic
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia; (N.P.); (S.P.-K.)
| | - Ines Kovacic
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia; (N.P.); (S.P.-K.)
| | - Nikola Petricevic
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia; (N.P.); (S.P.-K.)
| | - Mohammed Nasser Alhajj
- Department of Prosthodontics, Faculty of Dentistry, Thamar University, Thamar 87246, Yemen;
| | - Jolanda Topic
- Private Dental Office, 21300 Makarska, Croatia;
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Luka Junakovic
- Mag. Math., Libertas International University, 10000 Zagreb, Croatia;
| | - Sanja Persic-Kirsic
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia; (N.P.); (S.P.-K.)
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Park JH, Shin SW, Lee JY. Mini-implant mandibular overdentures under a two-step immediate loading protocol: A 4-6-year retrospective study. Gerodontology 2023; 40:501-508. [PMID: 37061876 DOI: 10.1111/ger.12683] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2023] [Indexed: 04/17/2023]
Abstract
OBJECTIVES This retrospective study to evaluate the treatment outcomes of mandibular mini-implant overdentures (MIODs) placed under a two-step immediate loading protocol. BACKGROUND The mini-implant overdenture emphasises the advantages of simplicity using flapless surgery and immediate loading. However, some mini-implant have lowe initial stability. MATERIALS AND METHODS A total of 30 participants who used mandibular MIODs and maxillary removable complete dentures (RCDs) over 4 years were included. Four one-piece mini-implants (<3 mm in diameter) were placed by a flapless surgical approach after fabrication of new RCDs, and the O-ring attachment was attached at least 8 weeks after implant placement. RESULTS The average observation period was 58.9 ± 9.2 months after mini-implant loading. The survival rate of the implants was 100.0%, and the overall change in mean marginal bone level (ΔMBL) was -0.9 ± 1.1 mm. The implant success rate was 83.3% at the implant level, and 66.7% at the patient level. The mean initial Periotest value was 0.9 ± 3.1, and it was positively associated with ΔMBL and implant success (P < .05). Patient satisfaction improved after conversion from RCDs to MIODs (P < .05), and mastication and pain showed greater satisfaction with longer loading time (P < .05). CONCLUSIONS The mandibular MIODs could be chosen as an alternative treatment under a two-step immediate-loading protocol in edentulous patients with limited alveolar bone volume. To ensure superior treatment outcomes of MIODs, initial stability of implant must be obtained using as wide a diameter as possible within the anatomically allowable limits.
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Affiliation(s)
- Jin-Hong Park
- Department of Prosthodontics, Korea University Guro Hospital, Korea University Medicine, Seoul, Republic of Korea
| | | | - Jeong-Yol Lee
- Department of Advanced Prosthodontics, Graduate School of Clinical Dentistry, Korea University, Seoul, Republic of Korea
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Park JH, Shin SW, Lee JY. Narrow-diameter versus regular-diameter dental implants for mandibular overdentures: A systematic review and meta-analysis. J Prosthodont 2023; 32:669-678. [PMID: 37365991 DOI: 10.1111/jopr.13726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 06/17/2023] [Indexed: 06/28/2023] Open
Abstract
PURPOSE The aim of this systematic review was to compare treatment outcomes in terms of implant survival rate, marginal bone loss, and patient-reported outcome measures (PROMs) between narrow-diameter implants and regular-diameter implants (RDIs) for mandibular implant overdentures (MIOs). METHODS This study was based on the methodology adapted as per Cochrane. Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and Scopus were searched for pertinent studies published by July 22, 2022. Outcome parameters included in this meta-analysis were implant survival rate, marginal bone loss, visual analogue scale score for patient satisfaction, and value of oral health impact profile. RESULTS A total of 782 non-duplicate articles and 83 clinical study registrations were identified from database and hand searches, of which 26 were eligible for full-text searches. Finally, 12 publications reporting on 8 independent studies were included in this review. In the meta-analysis, implant survival rate and marginal bone loss did not significantly differ between narrow-diameter implants and RDIs. Regarding RDIs, narrow-diameter implants were associated with significantly better outcomes in general patient satisfaction and oral health-related quality of life than RDIs for mandibular overdentures. CONCLUSIONS Narrow-diameter implants have competitive treatment outcomes compared to RDIs in terms of implant survival rate, marginal bone loss, and PROMs. [Correction added on July 21, 2023, after first online publication: The abbreviation RDIs was changed to PROMs in the preceding sentence.] Thus, narrow-diameter implants might be an alternative treatment option for MIOs in situations with limited alveolar bone volume.
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Affiliation(s)
- Jin-Hong Park
- Department of Prosthodontics, Korea University Guro Hospital, Korea University Medicine, Seoul, Republic of Korea
| | - Sang-Wan Shin
- Department of Advanced Prosthodontics, University Graduate School of Clinical Dentistry, Seoul, Republic of Korea
| | - Jeong-Yol Lee
- Department of Prosthodontics, Korea University Guro Hospital, Korea University Medicine, Seoul, Republic of Korea
- Department of Advanced Prosthodontics, University Graduate School of Clinical Dentistry, Seoul, Republic of Korea
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Mini-Implants Retaining Removable Partial Dentures in Subjects without Posterior Teeth: A 5-Year Prospective Study Comparing the Maxilla and the Mandible. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020237. [PMID: 36837439 PMCID: PMC9959138 DOI: 10.3390/medicina59020237] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/20/2023] [Accepted: 01/22/2023] [Indexed: 01/31/2023]
Abstract
Background and objectives: Long-term studies of clinical outcomes of mini-implants (MDIs) in the first premolar/canine sites retaining a bilateral free-ending removable partial dentures (RPD) in Kennedy class I subjects have not been well documented. The aim was to assess clinical outcomes in a prospective 5-year cohort study comparing the mandible and maxilla. Material and Methods: Participants (n = 92) who received two MDIs each and a new RPD were reviewed after one, three and five years. A total of 71 participants (82 mini-implants in the mandible; 58 in the maxilla) completed the study. Marginal bone level change, success, survival rates, Modified Plaque (MPI) and Bleeding Indices (MBI) were assessed. Results: The five-year success rate was 93.3% and 93.4% (p > 0.05), in the mandible and the maxilla, respectively. Mean peri-implant bone loss (MBL) increased significantly over five years (p < 0.01) to 0.50 mm in the mandible and 0.52 mm in the maxilla. Age had a significant effect on the MBL (higher rates in younger participants), while jaw of insertion, gender, and antagonistic jaw status did not. MPI and MBI were not significantly correlated with MBL. Conclusions: The insertion of two MDIs in previous first premolar/canine sites for retention of a free-end saddle RPD can be a successful treatment modality in subjects with narrow alveolar ridges.
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Leles CR, Leles JLR, Curado TFF, Silva JR, Nascimento LN, de Paula MS, Maniewicz S, Schimmel M, McKenna G. Mandibular bone characteristics, drilling protocols, and final insertion torque for titanium-zirconium mini-implants for overdentures: A cross-sectional analysis. Clin Implant Dent Relat Res 2023; 25:426-434. [PMID: 36623506 DOI: 10.1111/cid.13181] [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: 10/17/2022] [Revised: 12/29/2022] [Accepted: 01/01/2023] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The aim of this study was to assess the final insertion torque values achieved using site-specific drilling protocols for a novel mini implant system for removable complete overdentures. Anatomical and technical factors influencing final insertion torque were recorded and analyzed. MATERIAL AND METHODS Participants were randomized to two surgical protocol groups (flapped or flapless) and all received four mini implants (Straumann® mini implant system; Straumann AG) in the anterior mandible, using a 1.6 mm needle drill and a 2.2 mm pilot drill for the implant bed site preparation. The final insertion torque was recorded as the main outcome variable during surgery. Bone type, radiographical bone density, ridge form, implant length, and the drilling protocol were considered as independent variables. Descriptive statistics, generalized estimating equations (GEE) regression, and heatmap charts were used for data analyses. RESULTS A total of 296 mini implants were placed in 74 patients (mean age = 64.1 ± 8.0; 64.9% female) using flapless (n = 37) or flapped (n = 37) surgeries. Mean final insertion torque was 55.8 ± 18.4 Ncm (10.5% > 35 Ncm, 48.9% between 35 and 65 Ncm, and 40.6% > 65 Ncm). The needle drill was used in only 43.9% of the implant bed sites. Higher final torque values were observed for higher bone densities (bone type I > II > III, and D1-D2 > D3-D4), highly resorbed ridge forms (5-6 > 3-4), flapped surgeries, and male patients. However, regression models showed that the likelihood of achieving optimal insertion torque (≥35 and ≤65 Ncm) was higher for females (OR = 2.14; 95%CI = 1.14-4.01; p = 0.018), ridge forms 3-4 (OR = 2.87; 95%CI = 1.05-7.85; p = 0.040), and flapless surgeries (OR = 1.96; 95%CI = 1.09-3.51; p = 0.024). CONCLUSIONS Sufficient primary stability for immediate loading was achieved for the majority of the mini implants placed. Surgical implant bed preparation should be site-specific to achieve optimal primary stability for immediate loading while avoiding excessive insertion torque.
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Affiliation(s)
| | | | | | | | | | | | - Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Martin Schimmel
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.,Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Gerald McKenna
- Consultant in Restorative Dentistry, Centre for Public Health, Queen's University Belfast, Belfast, UK
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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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Ćorić A, Kovačić I, Kiršić SP, Čelebić A. Are Mini Dental Implants Suitable for Support of Crowns or Small Bridges in the Mandibular Incisor Region? A 5-year Longitudinal Study. J Oral Maxillofac Surg 2022; 80:1811-1826. [PMID: 36049532 DOI: 10.1016/j.joms.2022.07.145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 07/22/2022] [Accepted: 07/24/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE It has not been previously studied whether 1-piece category 1 narrow dental implants (≤2.5 mm wide) can successfully support crowns or small bridges. The purpose of this study was to evaluate the long-term benefits of the fixed-type mini dental implants (MDIs) for replacement of mandibular incisors. MATERIALS AND METHODS In a prospective cohort study, fixed-type 1-piece MDIs, replacing single or multiple mandibular incisors, supporting metal-ceramic single crowns (unsplinted group), or splinted crowns/small bridges (splinted group) were observed over the period of 5 years. The primary predictor was the splinting status. The primary outcome variables were peri-implant marginal bone level (MBL) change, success, and survival rates (assessed as per Pisa Consensus Conference). The secondary outcomes were dental patient-reported outcome measures (dPROMs) and oral hygiene assessment. Descriptive statistics, Chi-squared test, t-test, Mann-Whitney and Wilcoxon tests, Kaplan-Meier survival analysis, log-rank (Mantel-Cox) comparison, Cox proportional hazard analyses adjusting for number of implants, Spearman correlation, and repeated measures were used for data analysis. RESULTS From 44 participants (mean age 56.02 ± 5.72 years), 40 completed the 5-year study: 23 in the splinted and 17 in unsplinted group. Three subjects did not respond, while 1 MDI failed (third year) in the unsplinted group. Mean MBL change in both groups was small; however, it increased over time (-0.22 ± 0.38 mm after 1 year; -0.54 ± 0.56 mm after 5 years; P < .05). After 5 years mean MBL change was -0.59 ± 0.71 mm in the unsplinted and -0.50 ± 0.41 mm in the splinted group (P > .05). Survival analysis revealed no significant difference between the unsplinted (85.7% success, 4.8% failures, and 9.5% satisfactory survivals) and splinted group (93.4% success and 6.6% satisfactory survivals) (P > .05). The group affiliation (unsplinted vs splinted) and number of implants were not significant predictors of MDI failure or survival rates (P > .05). Significant improvement in dPROMs after rehabilitation remained unchanged over 5 years (P > .05). Modified plaque index significantly increased over time, correlating with the MBL loss. CONCLUSION MDIs supporting crowns and/or small bridges in the mandibular incisor region showed small rates of marginal bone loss, acceptable success, and survival rates and improved dPROMs over a 5-year observation period.
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Affiliation(s)
- Anka Ćorić
- Health Care Center Mostar, Mostar, Bosnia and Herzegovina & Assistant, Department of Prosthodontics, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Ines Kovačić
- Assistant, Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
| | - Sanja Peršić Kiršić
- Associate Professor, Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Asja Čelebić
- Professor, Department of Prosthodontics, School of Dental Medicine University of Zagreb, Zagreb, Croatia
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Ibrahim CRM, Awad S, Habib AA, Elsyad MA. Peri-implant tissue health and patient satisfaction of vertical versus inclined posterior implants used to support overdentures with bar attachments. A one-year randomized trial. Clin Implant Dent Relat Res 2022; 24:424-434. [PMID: 35704472 DOI: 10.1111/cid.13105] [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] [Received: 01/16/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This study aimed to evaluate peri-implant tissue health and patient satisfaction of vertical and inclined posterior implants for mandibular bar overdentures. MATERIALS AND METHODS Thirty edentulous participants received four implants in the interforaminal area of the mandible. The patients were randomly assigned into two equal groups; (1) vertical group (control): all implants were inserted vertically parallel to each other. Inclined group (study): the anterior implants were placed vertically, and the posterior implants were tilted 30° distally. Hader bar attachment with two 7 mm-distal cantilevers (vertical group) and without cantilevers (inclined group) was used to connect the implants to mandibular overdentures. Peri-implant tissue health (Plaque [PL] and gingival [GI] indices, pocket depth [PD], and crestal bone loss [CBL]) were evaluated after denture insertion (T0), 6 (T6), and 12 (T12) months after insertion. Patient satisfaction was evaluated using a visual analog scale after 12 months. RESULTS At T12, the vertical group showed significantly higher PL, PD, and CBL than the inclined group for anterior (p < 0.037) and posterior (p < 0.017) implants. The vertical group showed significantly higher GI than the inclined group for anterior implants (p = 0.003), and the inclined group showed significantly higher GI than the vertical group for posterior implants (p = 0.016). The inclined group showed significantly higher scores for general satisfaction (p = 0.049), prosthesis as a part of you (p = 0.013), appearance (p < 0.001), stability (p = 0.002), ease of cleaning (p < 0.001), and comfort (p = 0.001) than the vertical group. CONCLUSION Inclined posterior implants used to support mandibular bar overdentures are recommended than vertical implants, as it was associated with improved patient satisfaction and peri-implant tissue health.
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Affiliation(s)
| | - SallySayed Awad
- Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Ahmed Ali Habib
- Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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ELsyad MA, Abdraboh AE, Denewar MM, Mohamed SS. Prosthetic complications and maintenance of different attachments used to stabilize mandibular 2‐implant overdentures in patients with atrophied ridges. A 5‐year randomized controlled clinical trial. Clin Implant Dent Relat Res 2022; 24:497-509. [DOI: 10.1111/cid.13093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/30/2022] [Accepted: 04/10/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Moustafa Abdou ELsyad
- Department of Prosthodontics, Faculty of Dentistry Mansoura University Eldakahlia Egypt
| | | | - Mohamed Mahmoud Denewar
- Department of Removable Prosthodontics, Faculty of Dentistry Delta University for Science and Technology Eldakahlia Egypt
| | - Shahinaz Sayed Mohamed
- Department of Removable Prosthodontics, Faculty of Dentistry Beni Suef University Beni Suef Egypt
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13
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Nielsen HB, Schou S, Bruun NH, Starch-Jensen T. Professional and patient-reported outcomes of two surgical approaches for implant-supported single-crown restoration: 1-year results of a randomized controlled clinical trial. Clin Oral Implants Res 2021; 33:197-208. [PMID: 34866250 DOI: 10.1111/clr.13883] [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: 09/30/2020] [Revised: 11/17/2021] [Accepted: 11/25/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To test whether there is a difference in professional and patient-reported outcome measures (PROM) after single-crown restoration supported by short implants (SI) (6 mm) compared with standard length implants (SLI) (13 mm) in conjunction with maxillary sinus floor augmentation (MSFA) after 1 year of functional implant loading. MATERIAL AND METHODS Forty patients were randomly allocated to SI or SLI/MSFA. PROM included Oral Health Impact Profile (OHIP-14) questionnaire and subjective assessment of the peri-implant soft tissue (A), implant crown (B), implant function (C) and overall implant treatment outcome (D) using visual analogue scale (VAS). Professional assessment included pink aesthetic score (PES) and white aesthetic score (WES). RESULTS No significant differences in professional or PROM between the two treatment modalities were revealed at any time point (p > .05). OHIP-14 score decreased at baseline and 1 year after functional implant loading compared with preoperative measurements indicating improved quality of life with both treatment modalities. The 1-year mean VAS score was 9.4 (A), 9.3 (B), 9.6 (C) and 9.3 (D) for SI compared with 9.3 (A), 9.6 (B), 9.7 (C) and 9.2 (D) for SLI. The 1-year mean PES/WES scores were 11.3 and 8.1 for SI compared with 11.2 and 8.1 for SLI/MSFA. CONCLUSIONS Prosthetic rehabilitation of the posterior part of the maxilla with SI or SLI/MSFA revealed no significant differences in professional and PROM after 1 year of implant loading.
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Affiliation(s)
| | - Søren Schou
- Department of Periodontology, School of Dentistry, University of Copenhagen, Copenhagen, Denmark
| | - Niels Henrik Bruun
- Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
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14
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da Silva GG, Shimano MVW, Macedo AP, da Costa Valente ML, Dos Reis AC. In vitro assessment of polyetheretherketone for an attachment component for an implant-retained overdenture. J Prosthet Dent 2021; 127:319.e1-319.e8. [PMID: 34857392 DOI: 10.1016/j.prosdent.2021.07.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 07/30/2021] [Accepted: 07/30/2021] [Indexed: 11/26/2022]
Abstract
STATEMENT OF PROBLEM Frequent maintenance because of the limited lifetime of overdenture attachments with O-rings has led to the development of materials that might improve their functionality and longevity. However, testing of newly developed attachment materials is lacking. PURPOSE The purpose of this in vitro study was to evaluate a newly developed attachment made of polyetheretherketone (PEEK) for an implant-retained overdenture. MATERIAL AND METHODS Specimens of PEEK, polyacetal, and Teflon O-ring materials were prepared for analysis of roughness, surface hardness, and compressive strength. For the fatigue resistance test, new specimens based on acrylic resin were subjected to 2880 insertion and removal cycles. Compression and roughness data were compared with the Kruskal-Wallis and Dunn post hoc test; hardness data with ANOVA and t test; and fatigue and stereomicroscopy with ANOVA with repeated measures, t test, and Bonferroni adjustment (α=.05). RESULTS Polyacetal had the lowest surface roughness (P=.038). There was a significant difference in hardness among the materials (P<.05). PEEK presented the highest compressive strength among the materials (P<.001). For the fatigue resistance, only polyacetal showed a difference between the initial time-point (P<.05) and subsequent time-points. Polyacetal had a higher fatigue resistance than Teflon (P<.001) and PEEK (P<.05). Regarding the internal deformation of the attachments, a significant difference was observed among the materials (P<.05). CONCLUSIONS PEEK showed promising results regarding the physicomechanical properties necessary for use as an overdenture attachment when compared with other evaluated materials. In addition, the PEEK attachment showed results comparable to those in the control group (O-rings) in terms of retention.
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Affiliation(s)
- Geyson Galo da Silva
- Doctoral student, Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Marcos Vinicius Wada Shimano
- Graduate student, Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Ana Paula Macedo
- Research Laboratory Specialist, Department of Dental Materials and Prosthodontics, Dental School of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Mariana Lima da Costa Valente
- Doctoral student, Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Andréa Cândido Dos Reis
- Associate Professor, Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
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Kämmerer PW, Wolf JM, Buttchereit I, Frerich B, Ottl P. Prospective clinical implementation of optional implant treatment into pregraduate dental education-mini implants for retention and support of mandibular overdentures. Int J Implant Dent 2021; 7:87. [PMID: 34505196 PMCID: PMC8429539 DOI: 10.1186/s40729-021-00371-6] [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: 05/02/2021] [Accepted: 06/16/2021] [Indexed: 11/17/2022] Open
Abstract
Background The primary aim of the study was to evaluate mini implant (MDI) survival, prosthodontic maintenance, and patient-reported outcome measures after conducting an optional pregraduate academic course on patients with mandibular edentulism including fabrication of overdentures and MDI planning and placement as well as chair-side incorporation of the respective restauration. In a prospective clinical study, 20 patients received 80 MDIs that were restored with mandibular overdentures. All treatment steps including placement of 40 MDIs were conducted by undergraduate students under strict guidance of a consultant. Next to students’ perceptions after participation, survival of MDIs, and prosthodontic maintenance, patients’ perceptions as well as peri-implant parameters were assessed after 4 weeks and 3 and 12 months. Results Three MDIs fractured (two during insertion and one after 3 months; total survival 96.25%). Two overdentures fractured and a total of 23 cases of minor prosthodontic maintenance were required. Over time, patients’ satisfaction significantly increased. Besides, questionnaires showed a high rate of students’ positive perception and high self-confidence to include MDI therapy into own practice. Conclusions The results are in accordance to those reported by postgraduate dentists. In accordance, therapy with MDI-retained mandibular overdentures seems to be feasible and successful at pregraduate level if the students receive guidance.
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Affiliation(s)
- Peer W Kämmerer
- Department of Oral, Maxillofacial and Facial Plastic Surgery, University Medical Centre Mainz, Augustusplatz 2, 55131, Mainz, Germany. .,Department of Oral, Maxillofacial and Facial Plastic Surgery, University Medical Centre Rostock, Schillingallee 35, 18057, Rostock, Germany.
| | - Jens M Wolf
- Department of Prosthodontics and Materials Science, University Medical Centre Rostock, Strempelstraße 13, 18057, Rostock, Germany
| | - Ingo Buttchereit
- Department of Oral, Maxillofacial and Facial Plastic Surgery, University Medical Centre Rostock, Schillingallee 35, 18057, Rostock, Germany
| | - Bernhard Frerich
- Department of Oral, Maxillofacial and Facial Plastic Surgery, University Medical Centre Rostock, Schillingallee 35, 18057, Rostock, Germany
| | - Peter Ottl
- Department of Prosthodontics and Materials Science, University Medical Centre Rostock, Strempelstraße 13, 18057, Rostock, Germany.,Department Life, Light & Matter, University of Rostock, 18051, Rostock, Germany
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Schiegnitz E, Kämmerer PW, Hellwich P, König J, Sagheb K, Al-Nawas B. Treatment concepts of horizontally deficient ridges-A retrospective study comparing narrow-diameter implants in pristine bone with standard-diameter implants in augmented bone. Clin Oral Implants Res 2021; 32:1159-1167. [PMID: 34224171 DOI: 10.1111/clr.13807] [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: 11/12/2020] [Revised: 05/12/2021] [Accepted: 06/07/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To compare clinical and radiological outcomes of narrow-diameter implants (NDI) placed in pristine bone to standard-diameter implants placed in combination with horizontal bone augmentation procedures (SDI+A) for horizontally deficient alveolar ridges. MATERIAL AND METHODS For this retrospective study, the outcome of 597 NDI (∅ 3.3 mm, 272 patients), inserted in pristine bone, were compared with 180 SDI (∅ 4.1 mm, 83 patients), inserted in combination with horizontal augmentation procedures. Oral health-related quality of life was assessed in patients available for recall. RESULTS After a mean follow-up of 37.6 ± 40 months for the NDI and of 42.4 ± 49 months for the SDI+A, survival rates were 96.1% for NDI and 95.6% for SDI+A. Cumulative 5-year and 10-year implant survival rates were 94.3% and 92.2% for the NDI group and 97.0% and 88.3% for the SDI+A group, indicating no significant difference (p = .89). According to the criteria of Buser et al., an implant success rate of 84.3% was obtained for the NDI and an implant success rate of 81.3% for the SDI+A (p = .79). Regarding oral health-related quality of life, a similar and high patient satisfaction could be observed in both groups. CONCLUSIONS NDI without augmentation procedures showed a similar clinical outcome as SDI in combination with augmentation procedures after a follow-up of more than 3 years. Therefore, NDI might be a reasonable alternative in cases of horizontal bone atrophy (no clinical trial registration as patient inclusion started 2003).
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Affiliation(s)
- Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Philipp Hellwich
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Jochem König
- Institute of Medical Biometry, Epidemiology and Informatics, Johannes Gutenberg-University, Mainz, Germany
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
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17
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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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da Costa Valente ML, Macedo AP, Reis A. Stress distribution analysis of novel dental mini-implant designs to support overdenture prosthesis. J ORAL IMPLANTOL 2021; 48:79-83. [PMID: 33690819 DOI: 10.1563/aaid-joi-d-19-00354] [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: 11/22/2022]
Abstract
This study aimed to test and compare two novel dental mini-implant designs to support overdentures with a commercial model, regarding the stress distribution, by photoelastic analysis. Three different mini-implant designs (Ø 2.0 mm × 10 mm) were tested: G1-experimental threaded (design with threads and 3 longitudinal and equidistant self-cutting chamfers), G2-experimental helical (design with 2 long self-cutting chamfers in the helical arrangement), and G3-Intra-Lock® System. After including the mini-implants in a photoelastic resin, they were subjected to a static load of 100 N under two situations: axial and inclined model (30°). The fringe orders (n), that represents the intensity of stresses were analyzed around the mini-implants body and quantified using Tardy's method that calculates the maximum shear stress (τ) value in each point selected. In axial models, less stress was observed in the cervical third mini-implants, mainly in G1 and G2. In inclined models (30°), higher stresses were generated on the opposite side of the load application, mainly in the cervical third of G2 and G3. All mini-implant models presented lower tensions in the cervical third compared with the middle and apical third. The new mini-implants tested (G1 and G2) showed lower stresses than the G3 in the cervical third under axial load, while loading in the inclined model generated greater stresses in the cervical of G2.
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Affiliation(s)
| | - Ana Paula Macedo
- PhD, Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil. Av. do Café, s/n, 14040-904, Ribeirão Preto - SP, Brazil. E-mail:
| | - Andréa Reis
- University of São Paulo Prosthesis and dental materials Av. Café, s/n° BRAZIL Ribeirão Preto São Paulo 14040-904 55 36024044 University of São Paulo
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Valente MLC, Bolfarini C, de Oliveira DP, Dos Reis AC. Dental mini-implant designs to support overdentures: Development, biomechanical evaluation, and 3D digital image correlation. J Prosthet Dent 2021; 128:754-763. [PMID: 33640085 DOI: 10.1016/j.prosdent.2020.06.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 11/17/2022]
Abstract
STATEMENT OF PROBLEM Custom mini-implants are needed for edentulous patients with extensive mandibular deficiencies where endosteal placement is not possible. However, the best design for these mini-implants is unclear. PURPOSE The purpose of this in vitro study was to develop 2 dental mini-implant designs to support mandibular overdentures and evaluate the effect of their geometries on primary stability and stress distribution. MATERIAL AND METHODS Two mini-implant designs were developed with changes in the shape, size, and arrangement of threads and chamfers. The experimental mini-implants were made of Grade V titanium alloy (Ti-6Al-4V), (Ø2.0×10 mm) and submitted to a nanoscale surface treatment. Thirty mini-implants (n=10) were placed into fresh swine bones: experimental-threaded, experimental-helical, and a commercially available product model (Intra-Lock System) as the control. The biomechanical evaluations of the experimental mini-implants were compared with those of the control in terms of primary stability, through insertion torque (IT), and with the pullout test. The analysis of stress distribution was performed by using the method of 3D digital image correlation under 250-N axial load and 100-N oblique (30-degree angled model) load. The data were analyzed by ANOVA and the Tukey HSD test (α=.05). RESULTS The IT and pullout test presented a statistically significant difference for all mini-implants (P<.05), with higher IT for the experimental-threaded and maximum pullout force for the control, followed by threaded (P=.001) and helical (P=.001). Regarding the 3D digital image correlation, a lower incidence of stress was found in the cervical third for all mini-implants. No statistically significant differences were found between the designs evaluated (P>.05). CONCLUSIONS Comparing the experimental mini-implants with the commercially available control, the experimental-threaded model presented greater primary stability, and all mini-implants showed less stress in the cervical third.
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Affiliation(s)
- Mariana L C Valente
- Posdoctoral student, Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo, (USP), Ribeirão Preto, São Paulo, Brazil
| | - Claudemiro Bolfarini
- Full Professor, Department of Materials Engineering, Federal University of São Carlos, (UFScar), São Carlos, São Paulo, Brazil
| | - Diego P de Oliveira
- Post-doctor, Department of Materials Engineering, Federal University of São Carlos, (UFScar), São Carlos, São Paulo, Brazil
| | - Andréa C Dos Reis
- Associate Professor, Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo, (USP), Ribeirão Preto, São Paulo, Brazil.
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20
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Hussein MO, Alruthea MS. Marginal Bone Level Changes and Oral Health Impact Profile (14) Score of Smokers Treated by Mandibular Mini Implant Overdentures: A 5-Year Follow-up Study. Eur J Dent 2020; 14:590-597. [PMID: 32777837 PMCID: PMC7535974 DOI: 10.1055/s-0040-1714763] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objectives
Studies considered edentulous patients having smoking habit as a compromised oral condition. This research examined the value of using mini implant mandibular overdenture to maintain long-term satisfactory levels of oral health quality of life and marginal vertical bone loss.
Materials and Methods
Twenty-nine edentulous patients with smoking habit received four mini implants in the mandible loaded by overdentures. The present study monitored patients radiographically for vertical bone loss after (1 month, 1, 3, and 5 years) of treatment. Patients were also evaluated by oral health impact profile 14 (OHIP-14) pretreatment and at 1 and 5 years of treatment.
Statistical Analysis
Repeated measure analysis of variance with Bonferroni’s test as a post-hoc test was used to see the difference among time points. Independent sample
t
-tests were used to compare between anterior and posterior mini implant positions after 5 years of follow-up. OHIP-14 questionnaire was analyzed by Wilcoxon signed ranks for pairwise comparisons at different evaluation times. A Holm-Bonferroni correction method was used to control the familywise error rate.
Results
The mean of the bone height changes showed a significant difference between 1-month data and all other evaluation intervals while no significance was calculated among other evaluation intervals. Bone loss of the mini implants placed anteriorly was less than those placed posteriorly with a statistically significant difference. A significant reduction in the OHIP-14 score levels was observed between pretreatment and both 1 and 5 years of treatment. No significance was seen between the first and fifth year after treatment.
Conclusion
Mini implant overdenture could maintain satisfactory marginal bone level changes and oral health quality of life for patients with smoking habit after 5-year follow-up period.
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Affiliation(s)
- Mostafa Omran Hussein
- Department of Prosthodontic Sciences, College of Dentistry in Ar Rass, Qassim University, Saudi Arabia
| | - Mohammed Suliman Alruthea
- Department of Prosthodontic Sciences, College of Dentistry in Ar Rass, Qassim University, Saudi Arabia
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Three-Dimensional Radiographic Outcome of Free-Handed Flaplessly Placed Mini Dental Implants in Edentulous Maxillae after 2-Years Function. J Clin Med 2020; 9:jcm9072120. [PMID: 32635649 PMCID: PMC7408764 DOI: 10.3390/jcm9072120] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/22/2020] [Accepted: 06/29/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Free-handed, flaplessly placed mini dental implants (MDIs) are a valuable, more affordable and minimally invasive treatment to support overdentures in fully edentulous jaws, especially for medically compromised patients. However, critical 3D radiographic evaluation is lacking. This multicenter prospective case series assessed clinical outcome and carried out 3D- cone-beam computerized tomography (CBCT) analysis of free-handed flaplessly placed one-piece maxillary MDIs by an experienced maxillofacial surgeon. Methods: Thirty-one patients suffering from an ill-fitting maxillary denture relating to compromised bone volume (as confirmed on CBCT), with a dentate mandible, were selected. They received 5–6 MDIs free-hand flaplessly placed and mentally guided with preoperative CBCT. Final connection and attachment activation took place six months later. After two years each implant was individually assessed with CBCT for perforations on eight sites. Implant survival, prosthetic failure, clinical stability and sinus/nasal complaints were registered after three years. Results: 32/185 (17.3%) MDIs failed during the provisional loading with non-activated attachments; 17 replacements in 10 patients were performed. Of the 170 actively loaded 170 MDIs, 82.3% survived and 27/31 prostheses (87%) were fully functional. In total 98/170 MDIs showed no perforation. Based on 1360 CBCT observations, 231 perforations (16.9%) were registered. Of most perforations 37 (25%) were observed at the apical tip and 37 were positioned (21%) into the sinus/nasal cavity, although without clinical complaints. Conclusions: Given the compromised population, the minimally invasive procedure and the low treatment cost involved, a failure rate of 17% is substantial, however clinically acceptable given the critical bone condition. However, even in experienced surgical hands, freehanded and flapless placement yield a high risk for implant perforation, although this did not necessarily lead to complications.
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Kovačić I, Peršić S, Kranjčić J, Čelebić A. A cohort study on short mini-implants for mandibular overdentures compared to those of standard length. Clin Oral Implants Res 2019; 31:121-132. [PMID: 31541517 DOI: 10.1111/clr.13542] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 09/12/2019] [Accepted: 09/13/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To assess peri-implant bone level, survival and success rates of short (6 or 8 mm long) one-piece mini-implants (MDIs) in edentulous patients with extremely resorbed alveolar ridge (interforaminal height <10 mm) rehabilitated with mandibular implant overdentures and to compare them with patients having standard length MDIs in 1-year prospective clinical study. MATERIAL AND METHODS The Short MDI group consisted of 28 participants with interforaminal height ≤10 mm. Implants being, both, short and slim (short MDIs: 6 or 8 mm long, 2 or 2.5 mm wide) were inserted. The Standard-MDI group included 35 participants (interforaminal height >13 mm) who received standard length MDIs (10-14 mm long, 2 or 2.5 mm wide). Primary outcomes were assessments of MDI peri-implant bone level, survival and success rates; secondary outcomes were assessments of peri-implant tissue, oral hygiene, and prosthodontic maintenance. RESULTS The Short MDI group had mean marginal bone loss (MBL) of 0.26 ± 0.35 mm, 6.4% of failure, and 92.6% of, both, success and survival rates. The Standard-MDI group had mean MBL of 0.34 ± 0.40 mm, 5% of failure, 95% of survival, and 94.3% success. There were no significant differences in MBL (p = .420), survival (p = .414), and success (p = .571) between the groups. The Short MDI group had significantly less plaque (p = .001) and bleeding on probing (p < .001). CONCLUSION Within the limitations of this study, short MDIs (6 or 8 mm long) in extremely atrophied mandibles (interforaminal height <10 mm) showed good clinical results in the first year of function.
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Affiliation(s)
- Ines Kovačić
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Sanja Peršić
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Josip Kranjčić
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Asja Čelebić
- Department of Prosthodontics, School of Dental Medicine & Clinical Hospital Centre Zagreb, University of Zagreb, Zagreb, Croatia
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ELsyad MA, Elgamal M, Mohammed Askar O, Youssef Al‐Tonbary G. Patient satisfaction and oral health‐related quality of life (OHRQoL) of conventional denture, fixed prosthesis and milled bar overdenture for All‐on‐4 implant rehabilitation. A crossover study. Clin Oral Implants Res 2019; 30:1107-1117. [DOI: 10.1111/clr.13524] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 05/24/2019] [Accepted: 08/04/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Moustafa Abdou ELsyad
- Department of Removable Prosthodontics, Faculty of Dentistry University of Mansoura El dakahlia Egypt
| | - Mohamed Elgamal
- Department of Removable Prosthodontics, Faculty of Dentistry University of Mansoura El dakahlia Egypt
| | - Osama Mohammed Askar
- Department of Removable Prosthodontics, Faculty of Dentistry University of Mansoura El dakahlia Egypt
| | - Gilan Youssef Al‐Tonbary
- Department of Removable Prosthodontics, Faculty of Dentistry University of Mansoura El dakahlia Egypt
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Ortensi L, Martinolli M, Borromeo C, Ceruso FM, Gargari M, Xhanari E, Tallarico M. Effectiveness of Ball Attachment Systems in Implant Retained- and Supported-Overdentures: A Three- to Five-Year Retrospective Examination. Dent J (Basel) 2019; 7:dj7030084. [PMID: 31480546 PMCID: PMC6784476 DOI: 10.3390/dj7030084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/31/2019] [Accepted: 08/14/2019] [Indexed: 02/03/2023] Open
Abstract
Purpose: To evaluate implant and prosthetic survival rates, complications, patient satisfaction, and biological outcomes of patients rehabilitated with a ball attachment system for implant retained- and supported-overdentures (IOV), which was in function for 3 to 5 years. Methods: This retrospective study evaluated data collected from patients treated between April 2001 and May 2018 with IOV on splinted and non-splinted implants and a ball attachment system. Patients were followed for 36 to 206 months (mean follow-up was 128.1 ± 51.9 months). Data were collected at the 3- and 5-year follow-up examination. Outcome measures were implant and prosthetic survival rates, technical complications, marginal bone loss (MBL), oral health impact profile (OHIP), and periodontal parameters (bleeding on probing and plaque index). Results: A total of 46 patients (16 males and 30 females) with 124 implants were included in this study. Twenty-five implant-retained overdentures were delivered on 53 unsplinted implants, while the other 21 patients received an implant-supported overdentures and the implants were splinted. At the five-year follow-up examination, one implant and one prosthesis failed in the unsplinted group, resulting in a cumulative survival rate of 97.8% at the patient level. Two minor technical complications were experienced. Conclusions: Implant overdenture retained or supported by ball attachment systems showed high implant and prosthetic survival and success rates. A low number of complications, high patient satisfaction, and successful biological parameters were experienced in the mid-term follow-up. Data need to be confirmed by further randomized trials.
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Affiliation(s)
| | | | | | | | - Marco Gargari
- Department of Clinical Science and Translational Medicine, University of Rome, Tor Vergata, 00100 Rome, Italy
| | - Erta Xhanari
- Department of Implantology and Prosthetic Aspects, Aldent University, 1001 Tirana, Albania
- Private Practice, 1001 Tirana, Albania
| | - Marco Tallarico
- Department of Implantology and Prosthetic Aspects, Aldent University, 1001 Tirana, Albania
- Private Practice, 00151 Rome, Italy
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ELsyad MA, Abdraboh AE, Aboelnagga MM, Ghali RM, Lebshtien IT. Effect of Low-Level Laser Irradiation on Stability and Marginal Bone of Narrow Implants Retaining Overdentures in Moderately Controlled Diabetic Patients. J ORAL IMPLANTOL 2019; 45:391-397. [PMID: 31389750 DOI: 10.1563/aaid-joi-d-18-00263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The researchers investigated the influence of low-level laser irradiation (LLLI) on implant stability and marginal bone of small-diameter implants retaining mandibular overdentures in patients with moderately controlled diabetes. Twenty patients (mean age = 59.32 ± 4.1 years) with moderately controlled diabetes mellitus (glycated hemoglobin A1c [HbA1c] = 8.1%-10.0 %) were rehabilitated by maxillary and mandibular conventional dentures. Two small-diameter implants (3 × 12 mm) were inserted in the canine areas of the mandible and immediately loaded by mandibular dentures. In a split-mouth design, LLLI was applied to 1 of the 2 implants in a random order (study group [SG]); the other implant was left as a control (control group [CG]). For each patient, gallium aluminum-arsenide diode low-level laser (940-nm wavelength, 0.50 ± 2 mW output power, 0.004 cm2 spot size; Epic, Biolase, Inc, San Clemente, Calif) was applied around each implant with total delivered energy of 90 J (equally divided by 6 irradiation points) in 3 sessions. The application was done immediately after implant insertion, 3 days and 1 week after surgery. Implant stability (measured by Periotest) and marginal bone loss (MBL; measured by cone beam computerized tomography) were evaluated at implant loading (T1), 6 months (T6), and 12 months (T12). One implant failed in the CG and no failures occurred in the SG, resulting in 95% and 100% survival rates, respectively. The SG recorded higher Periotest values than the CG at all observation times. However, the difference was significant (P = .039) at T6 only. The SG recorded lower MBL values than the CG. No difference in MBL was detected between groups or peri-implant sites (mesial, distal, buccal, and lingual) at T6 and T12. Within the limits of this study, LLLI had no effect on marginal bone around immediately loaded small-diameter implants retaining overdentures in patients with moderately controlled diabetes. However, it was beneficial in improving implant stability 6 months after overdenture insertion.
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Affiliation(s)
- Moustafa Abdou ELsyad
- Department of Removable Prosthodontics, University of Mansoura, University of Delta, Eldakahlia, Egypt
| | | | - Mona M Aboelnagga
- Department of Removable Prosthodontics, University of Ain Shams, Cairo, Egypt
| | - Rami Maher Ghali
- Department of Removable Prosthodontics, University of Ain Shams, Cairo, Egypt
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Oliveira TT, Reis AC. Fabrication of dental implants by the additive manufacturing method: A systematic review. J Prosthet Dent 2019; 122:270-274. [PMID: 30928226 DOI: 10.1016/j.prosdent.2019.01.018] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 01/30/2019] [Accepted: 01/30/2019] [Indexed: 12/17/2022]
Abstract
STATEMENT OF PROBLEM Placement of dental implants depends, among other factors, on anatomic conditions such as sufficient bone height and thickness. Thus, individualized dental implants seem to offer benefits for patients with alveolar bone resorption. Additive manufacturing has allowed for the fabrication of custom implants with microscale resolution and, although the efficiency of the process is unclear, is a potential process for manufacturing dental implants. PURPOSE The purpose of this systematic review was to evaluate the current situation of additive manufacturing techniques for fabricating dental implants. MATERIAL AND METHODS An electronic search was performed in the databases PubMed, Lilacs, Cochrane Library, and Science Direct, with the terms "additive manufacturing" AND "dental implants," "rapid prototyping" AND "dental implants," "3 D printing" AND "dental implants," "electron beam melting" AND "dental implants," "selective laser melting" AND "dental implants." The articles were screened, and the final selection of articles was obtained by using the inclusion and exclusion criteria. RESULTS The database search resulted in 1322 articles, which were screened for title and/or summary according to the inclusion criteria. From the selected 38 articles, 30 remained after applying the exclusion criteria. These were read completely, resulting in a selection of 13 articles for this systematic review. Owing to the great variety of articles with different objectives, the results were based on a descriptive analysis of the following topics: additive manufacturing technique and material, printed structure and implant design, implant characteristics, mechanical analysis, surface treatment, and osseointegration. CONCLUSIONS Additive manufacturing is a new technology that may solve many problems in diverse fields. In dentistry, however, further studies are needed to improve the method for manufacturing custom dental implants because no standard methodology is available. Moreover, the advantages and disadvantages of the process are not yet clearly defined.
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Affiliation(s)
- Thaisa T Oliveira
- Postgraduate student, Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Andréa C Reis
- Associate Professor, Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo (USP), Ribeirão Preto, Brazil.
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Čelebić A, Peršić S, Kovačić I, Buković D, Lešić N, Rener-Sitar K. Comparison of Three Prosthodontic Treatment Modalities for Patients with Periodontally Compromised Anterior Mandibular Teeth: A 2-year follow-up study. Acta Stomatol Croat 2019; 53:4-16. [PMID: 31118528 PMCID: PMC6508933 DOI: 10.15644/asc53/1/1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 02/01/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To prospectively assess self-perceived chewing function (CF) and oral health-related quality of life (OHRQoL) in geriatric patients after receiving three different treatment modalities in the mandible: removable partial denture (CD-RPD), complete denture (CDs), or complete overdenture supported by mini dental implants (CD-MDI). At baseline, all patients had mobile anterior teeth (1 mm or >) and missing posterior teeth in the mandible. Patients were completely edentulous in the maxilla. After treatment, patients were recalled at the 3-month and the 2-year post-treatment period. MATERIALS AND METHODS A total of 176 patients participated (CD group, n=68; CD-RPD group, n=58; CD-MDI group, n=50). Self-reported CF was assessed using the Chewing Function questionnaire (CFQ), The OHRQoL was evaluated using the OHIP14 questionnaire, which the patients completed 1. before treatment, 2. three months after treatment, and 3. at the 2-year post-treatment stage. RESULTS The OHRQoL and the self-perceived CF significantly improved in all groups after treatment (p<0.01). The highest improvement of a CF was recorded in the CD-MDI group. The OHRQoL was significantly higher in the CD-MDI group in comparison to the CDs group after treatment (p<0.01). At the 2-year post-treatment stage, self-perceived CF significantly further improved in the CD-MDI group, while it worsened in the CD and the CD-RPD groups (p<0.01). The same pattern was recorded for the OHIP14 summary scores. The highest amount of denture repairs and adjustments was recorded in the CD-RPD group, although maintenance was also demanding in the CD-MDI group. CONCLUSION Within the limitations of this study, rehabilitation with mandibular MDI retained overdenture can be considered as preferred treatment with the constant improvement of OHRQoL and a chewing function in comparison to mandibular CD or mandibular RPD option in patients with mobile anterior mandibular teeth.
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Affiliation(s)
- Asja Čelebić
- Department of Prosthodontics, School of Dental Medicine & Clinical Hospital Centre Zagreb, University of Zagreb, Zagreb, Croatia
| | - Sanja Peršić
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Ines Kovačić
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Dino Buković
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | | | - Ksenija Rener-Sitar
- Department of Prosthodontics, Division of Dental Medicine, Faculty of Medicine, University of Ljubljana & University Medical Center, University Dental Clinics, Ljubljana, Slovenia
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Zhang Y, Chow L, Siu A, Fokas G, Chow TW, Mattheos N. Patient‐reported outcome measures (PROMs) and maintenance events in 2‐implant‐supported mandibular overdenture patients: A 5‐year prospective study. Clin Oral Implants Res 2019; 30:261-276. [DOI: 10.1111/clr.13412] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 01/10/2019] [Accepted: 01/14/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Yuxuan Zhang
- Implant Dentistry, Prosthodontics, Faculty of Dentistry The University of Hong Kong Hong Kong Hong Kong
| | - Luke Chow
- Implant Dentistry, Prosthodontics, Faculty of Dentistry The University of Hong Kong Hong Kong Hong Kong
| | - Adam Siu
- Implant Dentistry, Prosthodontics, Faculty of Dentistry The University of Hong Kong Hong Kong Hong Kong
| | - George Fokas
- Implant Dentistry, Prosthodontics, Faculty of Dentistry The University of Hong Kong Hong Kong Hong Kong
| | - Tak W. Chow
- Implant Dentistry, Prosthodontics, Faculty of Dentistry The University of Hong Kong Hong Kong Hong Kong
- Department of Preventive and Restorative Dentistry, College of Dental Medicine University of Sharjah Sharjah United Arab Emirates
| | - Nikos Mattheos
- Implant Dentistry, Prosthodontics, Faculty of Dentistry The University of Hong Kong Hong Kong Hong Kong
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刘 潇, 陈 秋, 冯 海, 王 兵, 屈 健, 孙 振, 衡 墨, 潘 韶. [Oral hygiene maintenance of locator attachments implant overdentures in edentulous population: A longitudinal study]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2019; 51:136-144. [PMID: 30773558 PMCID: PMC7433545 DOI: 10.19723/j.issn.1671-167x.2019.01.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the oral hygiene status of edentulous patients with locator attachments implant overdentures (IOD) and to analyze the relationship among daily hygiene behavior, oral hygiene status and peri-implant diseases. METHODS Edentulous patients who received IOD treatment with locator attachments from January 2012 to May 2016 were recruited. Clinical and radiographic examinations were conducted to assess the peri-implant tissue status. Modified plaque index (mPLI), sulcus bleeding index (SBI), gingival index (GI), and probing depth (PD) were recorded and peri-implant marginal bone loss (MBL) was measured using paralleling projection technique. Patients' peri-implant oral hygiene maintainence habits were investigated. The correlation between peri-implant diseases and oral hygiene status and behaviors was analyzed. RESULTS Fifty patients (125 implants) with an average follow-up time of 22 months (6-54 months) were enrolled. The mean values of mPLI, SBI, and GI were 1.4±1.2, 0.8±0.7, and 0.7± 0.6, respectively. Average PD was (2.2±0.7) mm. Mesial and distal maginal bone resorptions were (1.1±1.1) mm and (0.9±0.9) mm, respectively. The prevalance of mucositis and peri-implantitis of the implants were 49.6% and 0. The prevelance of mucositis in the patients with poor oral hygiene (mPLI≥2) was 11.9 times as much as that of those with adequate oral hygiene (mPLI<1). The patients who performed oral hygiene procedure on attachments at least twice a day achieved much lower mPLI scores than those who cleaned less than twice a day. CONCLUSION Oral hygiene condition in the group of patients with implant overdentures was poor, and it contributed to increased risk of peri-implant mucositis. The prevelance of musositis of the paitients with poor oral hygiene was 11.9 times as much as that of those with proper oral hygiene. Patients wearing IOD should pay more attention to the hygiene of the attachments.
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Affiliation(s)
- 潇倩 刘
- 北京大学口腔医学院·口腔医院, 修复科, 北京 100081Department of Prosthodontics, Beijing 100081, China
| | - 秋雯 陈
- 北京大学口腔医学院·口腔医院, 修复科, 北京 100081Department of Prosthodontics, Beijing 100081, China
| | - 海兰 冯
- 北京大学口腔医学院·口腔医院, 修复科, 北京 100081Department of Prosthodontics, Beijing 100081, China
| | - 兵 王
- 义齿加工中心, 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室, 北京 100081Department Laboratory, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 健 屈
- 义齿加工中心, 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室, 北京 100081Department Laboratory, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 振 孙
- 义齿加工中心, 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室, 北京 100081Department Laboratory, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 墨迪 衡
- 义齿加工中心, 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室, 北京 100081Department Laboratory, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 韶霞 潘
- 义齿加工中心, 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室, 北京 100081Department Laboratory, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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Retention force and deformation of an innovative attachment model for mini-implant–retained overdentures. J Prosthet Dent 2019; 121:129-134. [DOI: 10.1016/j.prosdent.2018.04.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 04/09/2018] [Accepted: 04/10/2018] [Indexed: 11/18/2022]
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Goiato MC, Sônego MV, Pellizzer EP, Gomes JMDL, da Silva EVF, dos Santos DM. Clinical outcome of removable prostheses supported by mini dental implants. A systematic review. Acta Odontol Scand 2018; 76:628-637. [PMID: 30156132 DOI: 10.1080/00016357.2018.1499958] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION For many years, edentulous patients have had no other option than conventional dentures to reestablish their oral function. To avoid the need for bone graft surgery, some professionals have suggested the use of mini dental implants (MDIs) to support prostheses. The MDIs are narrow implants, ranging approximately from 1.8 to 2.9 mm in diameter. Recently, the promising results of mini implants regarding osseointegration and patient satisfaction have led clinicians to accept them as a definitive treatment option. OBJECTIVE Therefore, the proposition of this systematic review was to assess information on the outcomes of MDIs supporting removable prostheses. METHODS The PubMed and Cochrane databases were searched for articles published before September 2017, which yielded a total of 774 studies for analysis. After exclusion and inclusion criteria, 22 prospective studies were included in this systematic review. RESULTS Most mini implants were placed in a flapless single-stage surgery and loaded immediately. Most studies reported failures in the first year and prosthetic complications. The mean survival rate of the selected studies was 95.6%, and mean follow-up was 22.8 months. CONCLUSION The MDI-supported removable prostheses successfully improved patients' chewing and speaking ability, quality of life, and satisfaction, suggesting that MDIs are a viable and safe option to support removable prostheses in the mandibular arch.
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Affiliation(s)
- Marcelo Coelho Goiato
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Univ Estadual Paulista (UNESP), Aracatuba, Brazil
| | - Mariana Vilela Sônego
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Univ Estadual Paulista (UNESP), Aracatuba, Brazil
| | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Univ Estadual Paulista (UNESP), Aracatuba, Brazil
| | - Jéssica Marcela de Luna Gomes
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Univ Estadual Paulista (UNESP), Aracatuba, Brazil
| | - Emily Vivianne Freitas da Silva
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Univ Estadual Paulista (UNESP), Aracatuba, Brazil
| | - Daniela Micheline dos Santos
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Univ Estadual Paulista (UNESP), Aracatuba, Brazil
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Schiegnitz E, Al‐Nawas B. Narrow‐diameter implants: A systematic review and meta‐analysis. Clin Oral Implants Res 2018; 29 Suppl 16:21-40. [DOI: 10.1111/clr.13272] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2018] [Indexed: 01/19/2023]
Affiliation(s)
- Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery University Medical Centre of the Johannes Gutenberg‐University Mainz Mainz Germany
| | - Bilal Al‐Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery University Medical Centre of the Johannes Gutenberg‐University Mainz Mainz 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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Disha V, Čelebić A, Rener-Sitar K, Kovačić I, Filipović-Zore I, Peršić S. Mini Dental Implant-Retained Removable Partial Dentures: Treatment Effect Size and 6-Months Follow-up. Acta Stomatol Croat 2018; 52:184-192. [PMID: 30510294 PMCID: PMC6238870 DOI: 10.15644/asc52/3/2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Objective The aim was to compare esthetic outcomes, masticatory performance and a comfort of removable partial denture (RPD) wearing after receiving: clasp-retained RPD (C-RPD) or mini dental implant-retained RPD (MDI-RPD) in the mandible. Materials and Methods A sample of 88 patients (Kennedy Class I) with all posterior teeth missing and a linear support for a RPD participated. A total of 52 patients (36 females, 16 males; 56 to 84 years old) participated in the C-RPD group and 36 patients (26 females, 10 males; 43 to 81 years old) in the MDI-RPD group. All MDIs were placed adjacent to the last remaining mandibular anterior tooth or one tooth length posteriorly. The new RPDs had Co-Cr frameworks with lingual plate major connectors; the MDI-RPDs were retained by O-ball matrices and the C-RPDs with clasps. Patients answered questions at pre-treatment and post-treatment stages and after 6-months follow-up: how satisfied they had been with esthetic appearance, how confident they were while chewing hard food, how satisfied they were with food comminution and they also evaluated a comfort of RPD wearing. The 0-10 visual-analogue scale was used. Statistics included descriptive methods, t-tests and the standardized effect-size calculation. Results The MDI-RPD wearers were more satisfied with their post-treatment esthetics, food comminution, a comfort with RPDs and had better confidence while chewing than the C-RPD wearers. The MDI-RPD wearers reported larger positive effect of the treatment. The results were consistent throughout the first 6-months period. Conclusion The MDI-RPD patients showed superior outcomes than the C-RPD patients after the treatment and over the 6-month period.
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Affiliation(s)
- Visar Disha
- - Private Dental office, Priština, Republic of Kosovo
| | - Asja Čelebić
- - Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Croatia
| | | | - Ines Kovačić
- - Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Croatia
| | - Irina Filipović-Zore
- - Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Croatia
| | - Sanja Peršić
- - Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Croatia
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Maiborodin IV, Shevela AA, Toder MS, Shevela AI. [Current trends of the choice and processing of materials for dental implantation]. STOMATOLOGII︠A︡ 2018; 97:68-76. [PMID: 30199073 DOI: 10.17116/stomat20189704168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
For assessment of the modern situation about the choice of materials for manufacture of dental implants and the processing of their surface the scientific literature for the last 2 years was study. On the basis of a large number of contradictory results of the researches devoted to each of dental implantation problems it is possible to draw a conclusion that any of primal problems of implantology is finally not solved. There is no unique opinion at the choice of optimum material for manufacture of dental implants, at the way of processing and modification of their surface. The problem of improvement of quality of dental implantation and fight against complications of this procedure cannot be solved simple drawing other substances on the implanted material surface, this task more easily and more successfully is solved via changes of product structure and various modification of implant surface. Up to the present the researches of an opportunity to influence on characteristics of the implanted materials, changing their structure and character of a surface, continue. And the publications reporting about the considerable positive effect of artificially created roughnesses on product surfaces, and the articles claiming that there are no big differences between the rough and polished implants are confirmed by objective measurements with statistical processing of the obtained data. It should be noted that among articles there are very many works of the doubtful plan or with insufficiently valid conclusions. This review leads to the conclusion that further clinical and experimental studies and about the choice of materials for manufacture of implants and at the ways of processing of their surface are necessary.
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Affiliation(s)
- I V Maiborodin
- Institute of Chemical Biology and Fundamental Medicine, Russian Academy of Science, Siberian Branch, Novosibirsk, Russia
| | - A A Shevela
- International Center of Implantology of iDent, Novosibirsk, Russia
| | - M S Toder
- International Center of Implantology of iDent, Novosibirsk, Russia
| | - A I Shevela
- Institute of Chemical Biology and Fundamental Medicine, Russian Academy of Science, Siberian Branch, Novosibirsk, Russia
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Marcello-Machado RM, Faot F, Schuster AJ, Bielemann AM, Nascimento GG, Del Bel Cury AA. How fast can treatment with overdentures improve the masticatory function and OHRQoL of atrophic edentulous patients? A 1-year longitudinal clinical study. Clin Oral Implants Res 2017; 29:215-226. [PMID: 29218786 DOI: 10.1111/clr.13101] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this prospective clinical study was to evaluate the masticatory function (MF) and subjective perception of patients with poor denture-bearing tissue in relation to change and the time required to identify an improvement in these parameters after rehabilitation with mandibular overdentures (MO) by two narrow-diameter two-piece implants. MATERIAL AND METHODS Twenty-three edentulous patients were selected for MO installation. The masticatory function (MF) was evaluated with the masticatory performance (MP) and swallowing threshold (ST) tests. In the MP test, each volunteer was instructed to masticate a portion of Optocal (standardized artificial test food) for 40 masticatory cycles. During the swallowing threshold test, the patients were instructed to chew a new portion of Optocal cubes until they felt the desire to swallow. The MF tests were performed while complete denture (CD) wearers (baseline) and 1, 3, 6, and 12 months after MO loading. In addition, the subjective perception was assessed through the questionnaires Dental Impact on Daily Living (DIDL), Geriatric Oral Health Assessment Index (GOHAI), and Oral Health Impact Profile in Edentulous (OHIP- EDENT) at the baseline and 3, 6, and 12 months after MO loading. RESULTS A significant improvement in masticatory function (p < .05) was observed already in the first month of loading. Three months after MO loading, a significant improvement (p < .05) was found in the subjective perception of patients. The effect size indicates that the MO had the greatest impact on the domains related to function and comfort of all questionnaires and in relation to psychosocial domain of the GOHAI. The level of patient satisfaction increased significantly after the MO loading and reached >90% satisfied patients at 12 months. CONCLUSION The MO improved both the MF of the patient and their oral health-related quality of life and satisfaction regarding the prosthesis in a short time period.
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Affiliation(s)
| | - Fernanda Faot
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Alessandra Julie Schuster
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Amália Machado Bielemann
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | - Altair Antoninha Del Bel Cury
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
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Marcello-Machado RM, Faot F, Schuster AJ, Nascimento GG, Del Bel Cury AA. Mini-implants and narrow diameter implants as mandibular overdenture retainers: A systematic review and meta-analysis of clinical and radiographic outcomes. J Oral Rehabil 2017; 45:161-183. [DOI: 10.1111/joor.12585] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2017] [Indexed: 02/07/2023]
Affiliation(s)
- R. M. Marcello-Machado
- Department of Prosthodontics and Periodontology; Piracicaba Dental School, State University of Campinas Piracicaba; SP Brazil
| | - F. Faot
- Department of Restorative Dentistry; School of Dentistry; Federal University of Pelotas; Pelotas RS Brazil
| | - A. J. Schuster
- Graduate Program in Dentistry; School of Dentistry; Federal University of Pelotas; Pelotas RS Brazil
| | - G. G. Nascimento
- Department of Dentistry and Oral Health; Aarhus University; Aarhus Denmark
| | - A. A. Del Bel Cury
- Department of Prosthodontics and Periodontology; Piracicaba Dental School; State University of Campinas; Piracicaba Brazil
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Batisse C, Bonnet G, Veyrune JL, Nicolas E, Bessadet M. Predictive Parameters of Oral Health Quality of Life in Complete Mandibular Denture Wearers Stabilized by Mini-Implants: A Two-Year Follow-Up Study. MATERIALS 2017; 10:ma10101197. [PMID: 29048334 PMCID: PMC5667003 DOI: 10.3390/ma10101197] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 10/03/2017] [Accepted: 10/10/2017] [Indexed: 11/26/2022]
Abstract
The frequent instability of mandibular removable complete dentures affects patient Oral Health Related Quality of Life (OHRQoL). An innovative therapeutic strategy used to improve stability involves placing four symphyseal mini-implants. This study was aimed at assessing OHRQoL over time in subjects in which mini-implants were placed and exploring if certain parameters could predict the evolution of their OHRQoL. The Quality of life of subjects with dentures was assessed using the Geriatric Oral Health Assessment Index (GOHAI) before (T0), 2–6 months (T1), twelve months (T2) and twenty-four or more months (T3) after mini-implant setting. Age, gender and chewing ability were tested as explanatory variables for the change in OHRQoL with time. Thirteen women and six men were included (mean age: 69 ± 10 years). After mini-implant placement, mean GOHAI scores at T1, T2 and T3 increased significantly (p < 0.001). The GOHAI-Add mean score was not affected by age or gender. Baseline chewing ability impacted the “functional” and “pain and discomfort” fields of the mean GOHAI scores (p < 0.05). The OHRQoL was quickly improved after mini-implant placement in complete denture wearers and then stabilized over time. Baseline chewing ability can be used as a predictive parameter of OHRQoL.
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Affiliation(s)
- Cindy Batisse
- Université Clermont Auvergne, CROC EA4847, BP 10448, F-63000 Clermont-Ferrand, France; CHU de Clermont-Ferrand, Service d'Odontologie, F-63000 Clermont-Ferrand, France.
| | - Guillaume Bonnet
- Université Clermont Auvergne, CROC EA4847, BP 10448, F-63000 Clermont-Ferrand, France; CHU de Clermont-Ferrand, Service d'Odontologie, F-63000 Clermont-Ferrand, France.
| | - Jean-Luc Veyrune
- Université Clermont Auvergne, CROC EA4847, BP 10448, F-63000 Clermont-Ferrand, France; CHU de Clermont-Ferrand, Service d'Odontologie, F-63000 Clermont-Ferrand, France.
| | - Emmanuel Nicolas
- Université Clermont Auvergne, CROC EA4847, BP 10448, F-63000 Clermont-Ferrand, France; CHU de Clermont-Ferrand, Service d'Odontologie, F-63000 Clermont-Ferrand, France.
| | - Marion Bessadet
- Université Clermont Auvergne, CROC EA4847, BP 10448, F-63000 Clermont-Ferrand, France; CHU de Clermont-Ferrand, Service d'Odontologie, F-63000 Clermont-Ferrand, France.
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Kim Y. Mini Implant–Retained Complete Overdenture Can be an Alternative Treatment Option for Selected Patients. J Evid Based Dent Pract 2017; 17:116-118. [DOI: 10.1016/j.jebdp.2017.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Jawad S, Barclay C, Whittaker W, Tickle M, Walsh T. A pilot randomised controlled trial evaluating mini and conventional implant retained dentures on the function and quality of life of patients with an edentulous mandible. BMC Oral Health 2017; 17:53. [PMID: 28202072 PMCID: PMC5310054 DOI: 10.1186/s12903-017-0333-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 01/06/2017] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Total tooth loss (edentulism) can be a debilitating condition, impacting on ability to chew, speak and interact with others. The most common treatment is with complete removable dentures, which may be successful, but in the lower jaw, bone resorption that worsens over time makes denture-wearing difficult. Two dental implants in the mandible to retain the lower denture has been advocated as the gold standard of treatment, but has not been universally provided due largely to financial constraints and also patient fear. Mini implants (MI) are cheaper and less invasive than conventional implants (CI), but may not have equivalent longevity. Therefore, it is unknown whether they represent a cost-effective treatment modality over time. The aim of this pilot randomised controlled trial was to assess the feasibility of carrying out a trial on this cohort of patients, and to inform the study design of a large multicentre trial. METHODS Forty-six patients were randomly allocated to receive either two mini implants or two conventional implants in the mandible to retain their lower dentures. Quality of life (QoL) questionnaires, pain and anxiety scores, and an objective "gummy jelly" chewing test were carried out at multiple timepoints, along with detailed health economics information. Implants were placed one-stage, and an early loading protocol was utilised. Patients were reviewed 8 weeks post-placement, and finally at 6 months. Implant failure, recruitment and retention rates were recorded and analysed. RESULTS The pilot study demonstrated that it is possible to recruit, randomise and retain edentulous (mainly elderly) patients for an implant trial. We recruited to target and retention rates were acceptable. The large number of questionnaires was onerous for participants to complete, but the distribution of scores and feedback from participants helped inform the choice of primary and secondary outcomes in a full trial. The chewing test was time-consuming and inconsistent. Implant failure rate was low (1/46). The data on indirect costs gathered at every visit was viewed as repetitive and unnecessary, as there was little or no change between visits. CONCLUSIONS The pilot study has shown that acceptable recruitment and retention rates are achievable in this population of patients for this intervention. The results provide valuable information for selection of outcome variables and sample size calculations for future trials. TRIAL REGISTRATION (ISRCTN): 87342238 Trial registration date: 05/07/2013.
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Affiliation(s)
- Sarra Jawad
- Department of Restorative Dentistry, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester, M15 6FH, UK.
| | - Craig Barclay
- Department of Restorative Dentistry, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester, M15 6FH, UK
| | - William Whittaker
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, UK
| | - Martin Tickle
- Division of Dentistry, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Tanya Walsh
- Division of Dentistry, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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Lemos CAA, Verri FR, Batista VEDS, Júnior JFS, Mello CC, Pellizzer EP. Complete overdentures retained by mini implants: A systematic review. J Dent 2017; 57:4-13. [DOI: 10.1016/j.jdent.2016.11.009] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 10/31/2016] [Accepted: 11/21/2016] [Indexed: 12/21/2022] Open
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El Osta N, El Osta L, Moukaddem F, Papazian T, Saad R, Hennequin M, Rabbaa Khabbaz L. Impact of implant-supported prostheses on nutritional status and oral health perception in edentulous patients. Clin Nutr ESPEN 2017; 18:49-54. [PMID: 29132738 DOI: 10.1016/j.clnesp.2017.01.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 11/20/2016] [Accepted: 01/09/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND & AIMS Improvement of nutritional status and perception of oral health are supposed to be different with complete conventional denture or implant-supported fixed or removable prostheses. Since no study has been conducted in Lebanon, the aim of our study was to assess the nutritional status and oral heath related quality of life (OHRQoL) in totally edentulous patients after treatment with complete denture or implant supported-prostheses. MATERIAL AND METHODS This was an observational clinical prospective study. A convenient sample of Lebanese people aged 60 years or more was selected between September 2013 and July 2015 from the Departments of removable and fixed prosthesis at Saint-Joseph University of Beirut. The treatment options included complete denture, implant-supported complete denture and implant-supported fixed prostheses. Nutritional status and OHRQoL were assessed with the Mini-Nutritional Assessment Index (MNA) and the Geriatric Oral Health Assessment Index (GOHAI) respectively at Baseline (first visit before treatment), 2-3 weeks after treatment (t1), 3 months (t2) and 6 months (t3) after treatment. RESULTS Fifty-one participants (mean age: 69.39 ± 7.164 years) were included. The results have shown an improvement over time in nutritional status and OHRQoL for all treatment groups. However, 2-3 weeks after treatment the number of participants at risk of malnutrition was higher with complete removable denture, intermediate with implant-supported complete denture and lower with implant-supported fixed prostheses (p-value = 0.049). Moreover, the mean GOHAI score was significantly lower over time with complete removable denture compared to implant-supported prostheses (p-value <0.05). CONCLUSION Our study has shown an enhancement in the quality of life and the nutritional status for implant supported-prostheses compared to conventional removable dentures. Therefore, it is fundamental that dentists communicate with their patients about implant treatment to understand their expectations, to explain the outcomes and achieve the desired clinical result.
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Affiliation(s)
- Nada El Osta
- Department of Public Health, Faculty of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon; Department of Prosthodontics, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon; Clermont University, University of Auvergne, EA 4847, Centre de Recherche en Odontologie Clinique, BP 10448, F-63000 Clermont-Ferrand, France.
| | - Lana El Osta
- Department of Public Health, Faculty of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Farah Moukaddem
- Department of Prosthodontics, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Tatiana Papazian
- Department of Nutrition, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Robert Saad
- Public Health, Private Practice, Beirut, Lebanon
| | - Martine Hennequin
- Clermont University, University of Auvergne, EA 4847, Centre de Recherche en Odontologie Clinique, BP 10448, F-63000 Clermont-Ferrand, France
| | - Lydia Rabbaa Khabbaz
- Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de Qualité des Médicaments, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
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Temizel S, Heinemann F, Dirk C, Bourauel C, Hasan I. Clinical and radiological investigations of mandibular overdentures supported by conventional or mini-dental implants: A 2-year prospective follow-up study. J Prosthet Dent 2016; 117:239-246.e2. [PMID: 27671375 DOI: 10.1016/j.prosdent.2016.07.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 06/30/2016] [Accepted: 07/01/2016] [Indexed: 11/20/2022]
Abstract
STATEMENT OF PROBLEM Conventional dental implants are not applicable in the mandibular interforaminal region if bone volume is limited. Mini-dental implants offer an alternative means of supporting mandibular overdentures in a narrow residual ridge, without additional surgery. PURPOSE The purpose of this nonrandomized clinical trial was to compare the ability of mini-dental implants with that of conventional dental implants in supporting mandibular overdentures during a 2-year clinical follow-up. Bone quality, bone resorption, implant stability, and oral health were assessed radiographically. MATERIAL AND METHODS A total of 32 participants with edentulism were included. Twenty-two participants (99 implants) received 4 to 5 mini-dental implants (diameter: 1.8-2.4 mm; length: 13-15 mm, study group), and 10 participants (35 implants) received 2 to 4 conventional dental implants (diameter: 3.3-3.7 mm; length: 11-13 mm, control group). The selection of the participants in the study or control group was based on the available bone volume in the mandible. The selection was not randomized. The density of cortical bone thickness was measured in Hounsfield units (HU) from computed tomography data, and patients were followed for 2 years. The participants were examined 3, 6, 12, and 24 months after surgery. Primary stability immediately after the insertion of dental implants (Periotest), secondary stability 6 months after implantation, modified plaque, bleeding on probing indices, and probing depth were measured and analyzed statistically (α=.05). RESULTS The mean HU value 6 months after implantation in the participants who received mini-dental implants was significantly (P=.035) higher (1250 HU) than that in the participants who received conventional dental implants (1100 HU). The probing depths around the conventional dental implants (1.6 and 1.8 mm, respectively) were significantly higher than those around the mini-dental implants (1.3 and 1.2 mm, respectively) 12 and 24 months after surgery, respectively (P<.001). The mean primary and secondary stability values for conventional dental implants were -4.0 and -4.9, respectively. The primary and secondary stability values for the mini-dental implants were -0.3 and -1.4, respectively. The Periotest values of the primary (measured immediately after implant insertion) and secondary implant stabilities (measured 6 months after implant insertion) were significantly higher for the conventional dental implants than for the mini-dental implants (P<.001). CONCLUSIONS Based on this 2-year clinical trial, patients receiving mini-dental implants had clinical outcomes similar to those of patients receiving conventional dental implants to support overdenture prostheses.
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Affiliation(s)
- Sonay Temizel
- Dental student, Endowed Chair of Oral Technology, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Friedhelm Heinemann
- Research Associate Professor, Department of Prosthodontics, Gerodontology and Biomaterials, University of Greifswald, Greifswald, Germany
| | - Cornelius Dirk
- Doctoral student, Endowed Chair of Oral Technology, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Christoph Bourauel
- Professor, Endowed Chair of Oral Technology, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Istabrak Hasan
- Senior researcher, Department of Prosthetic Dentistry, Preclinical Education and Materials Science, Dental School, Rheinische Friedrich-Wilhelms University, Bonn, Germany.
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Early Loaded Single Implant Reinforced Mandibular Overdenture. Case Rep Dent 2016; 2016:4213753. [PMID: 27403350 PMCID: PMC4923555 DOI: 10.1155/2016/4213753] [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] [Received: 03/18/2016] [Accepted: 05/26/2016] [Indexed: 11/18/2022] Open
Abstract
Rehabilitating atrophied mandible with two-implant supported denture is a common treatment modality for implant retained removable overdenture in mandible. This paper aims to design a treatment modality where single implant reinforced overdenture is fabricated for a severely atrophied mandibular ridge with early loading protocol. Results of studies have shown that a single implant mandibular overdenture significantly increases the satisfaction and quality of life of patients with edentulism. Midline fracture of the prosthesis is the most common complication related to single implant and two-implant retained mandibular overdentures. To manage such complication, a thin metal mesh is used to reinforce the overdenture and also to make the prostheses lighter and cost effective as compared to conventional cast metal framework.
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Batisse C, Bonnet G, Bessadet M, Veyrune J, Hennequin M, Peyron M, Nicolas E. Stabilization of mandibular complete dentures by four mini implants: Impact on masticatory function. J Dent 2016; 50:43-50. [DOI: 10.1016/j.jdent.2016.04.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 04/28/2016] [Accepted: 04/30/2016] [Indexed: 10/21/2022] Open
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ELSYAD MA, ELHDDAD AA, KHIRALLAH AS. The effect of implant diameter on strain around implants retaining a mandibular overdenture with Locator attachments: An in vitro study. Dent Mater J 2016; 35:938-945. [DOI: 10.4012/dmj.2016-181] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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