1
|
Omeish N, Bessou L, Carra MC, Tavernier B, Porporatti AL. Effect of bar designs on peri implant tissues health in implant-supported removable prostheses: a systematic review. BMC Oral Health 2024; 24:138. [PMID: 38281916 PMCID: PMC10822188 DOI: 10.1186/s12903-024-03915-5] [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: 08/25/2023] [Accepted: 01/19/2024] [Indexed: 01/30/2024] Open
Abstract
Different characteristics of bars (cross-sectional shape, diameter, distal extension etc.) lead to different biomechanical behavior (retention and stress) with implants and peri-implant tissues.Aim: To evaluate the impact of implant-supported removable prostheses bar designs in fully edentulous arch (in the maxilla and/or mandibula), with 4 implants or more, on the peri-implant soft and hard tissues.Two reviewers searched for observational studies, RCT and in vitro studies, published on five main databases and three from the grey literature, without restrictions on November 2023.Of the 3049 selected articles, four met the inclusion criteria. Four RCT evaluated peri-implant health tissues in full edentulous arches with 4 or 6 implants rehabilitated with implant bar overdentures. One prospective study with 5 years follow-up evaluated the success/survival rate of implants and implant bar overdentures. Overall, 261 subjects were enrolled in our systematic review with 1176 implants. Overdentures' survival rate was 100%. There was a trend that plaque indices and gingival indices were low in all of the studies, however no statistical analysis was done due to the lack of information.Due to the lack of information in the included studies, we cannot confirm if bar characteristics affect the peri-implant tissues health.
Collapse
Affiliation(s)
- Nadine Omeish
- Université Paris Cité and Service of Odontology, Rothschild Hospital, Paris, France.
| | - Laure Bessou
- Université Paris Cité and Service of Odontology, Rothschild Hospital, Paris, France
| | - Maria-Clotilde Carra
- Université Paris Cité and Service of Odontology, Rothschild Hospital, Paris, France
- Population-based Epidemiologic Cohorts Unit, Inserm, Villejuif, UMS 011, France
| | - Bruno Tavernier
- Université Paris Cité and Service of Odontology, Rothschild Hospital, Paris, France
- Unité de Recherche Biomatériaux Innovants et Interfaces - URB2i - UR4462, Paris, France
| | - André Luís Porporatti
- Service of Odontology, Rothschild Hospital, Paris, France
- Laboratoire de Neurobiologie Oro-Faciale, Paris, France
| |
Collapse
|
2
|
Ciftci G, Somay SD, Ozcan I, Ozcelik TB, Yilmaz B. Prosthetic complications with mandibular bar-retained implant overdentures having distal attachments and metal frameworks: A 2- to 12-year retrospective analysis. J Prosthet Dent 2023; 130:573-580. [PMID: 34998584 DOI: 10.1016/j.prosdent.2021.11.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 11/09/2021] [Accepted: 11/09/2021] [Indexed: 10/19/2022]
Abstract
STATEMENT OF PROBLEM Long-term reports on 2-implant-retained overdentures having metal frameworks and bars containing distal attachments are scarce. PURPOSE The purpose of this retrospective study was to evaluate prosthetic complications with 2-implant-retained mandibular overdentures with metal frameworks having either screw- or cement-retained cantilevered bars with distal attachments. MATERIAL AND METHODS Seventy-three edentulous study participants who had been treated with mandibular overdentures with 2 implants were included. The parameters assessed were acrylic resin fractures (base fracture, fracture at midline), debonding of teeth, opposing prosthesis fracture, need for relining or rebasing, abutment and bar screw loosening and fracture, ball or bar attachment or clip wear, fracture or detachment, bar fracture, and implant loss. Statistical analysis was performed by using the Mann-Whitney U test as the data were not normally distributed. The categorical variables between the groups were analyzed by using the Fisher exact test (α=.05). RESULTS Twenty-seven prostheses had a cement-retained bar, and 46 bars were screw-retained. Of 73 overdentures, 68 were metal-reinforced. The mean observation time was 5.9 years with a range between 2 and 12 years. The most common complication was wear of the Rhein 83 polymer attachment followed by bar screw loosening. The cumulative survival rate for overdentures was 91.9% at 6.8 years. The service life of cement-retained prostheses was significantly longer (P<.05). Bar, resin base, and mid-line fractures were only seen with cement-retained prostheses. The number of times an attachment change was required did not differ between cement- and screw-retained bars. Of 191 implants, 3 were lost, and the cumulative survival rate was 93.5% at 7.5 years. No significant difference was found between retention types in terms of implant loss (P>.05). CONCLUSIONS Based on the participant population observed, the survival rates of 2-implant-retained mandibular overdentures and their implants in the medium term were high. Wear of the polymer attachment was commonly seen. Overdentures with cement-retained bars had bar or acrylic resin fractures. Mandibular 2-implant-retained overdentures with a screw-retained bar containing bilateral distal attachments had fewer prosthetic complications and high implant survival in the medium term.
Collapse
Affiliation(s)
- Gozde Ciftci
- Postdoctoral Fellow, Baskent University, Faculty of Dentistry, Department of Prosthodontics, Ankara, Turkey
| | - Suphi Deniz Somay
- Postdoctoral Fellow, Baskent University, Faculty of Dentistry, Department of Prosthodontics, Ankara, Turkey
| | - Işıl Ozcan
- Postdoctoral Fellow, Baskent University, Faculty of Dentistry, Department of Prosthodontics, Ankara, Turkey
| | - Tuncer Burak Ozcelik
- Professor, Baskent University, Faculty of Dentistry, Department of Prosthodontics, Ankara, Turkey
| | - Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio.
| |
Collapse
|
3
|
Srinivasan M, Kamnoedboon P, Angst L, Müller F. Oral function in completely edentulous patients rehabilitated with implant-supported dental prostheses: A systematic review and meta-analysis. Clin Oral Implants Res 2023; 34 Suppl 26:196-239. [PMID: 37750517 DOI: 10.1111/clr.14068] [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: 10/28/2022] [Revised: 03/10/2023] [Accepted: 03/30/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES This review evaluated the effects of rehabilitation with implant-supported prostheses on the oral function of completely edentulous adults. MATERIALS AND METHODS Systematic literature searches were performed to identify records reporting on oral function in completely edentulous adults rehabilitated with implant-supported prostheses. Meta-analyses were performed on various outcomes including bite force, masticatory performance, muscle activity, mandibular movement/chewing pattern, and salivary flow. RESULTS 5507 records were identified. Thirty studies qualified for data extraction and analysis. The kappa (𝛋) for the search and identification strategy ranged between 0.50 and 1.00. Meta-analysis was performed grouping the studies by outcomes and split by time points of 6-12 months, 12-36 months, and >36 months after implant therapy. The meta-analyses revealed a significant improvement in oral function of completely edentulous adults after rehabilitation with implant-supported prostheses at 6-12 months (Z = -4.895, p < .001; 95% CI: -0.703, -0.301; τ2 = .609; Q = 114.953, df = 17, p < .001; I2 = 85.2%), at 12-36 months (Z = -4.886, p < .001; 95% CI: -0.580, -0.248; τ2 = .908; Q = 280.611, df = 35, p < .001; I2 = 87.5%) and at more than 36 months (Z = -9.108, p < .001; 95% CI: -1.472, -0.951; τ2 = .019; Q = 7.918, df = 7, p = .340; I2 = 11.6%). The included studies demonstrated a low to moderate risk of bias. CONCLUSIONS This systematic review concluded that the oral function of completely edentate adults significantly improved with implant-supported/retained prostheses, even when only one jaw received implant therapy. Therefore, implant therapy should be promoted for edentulous adults to alleviate the shortcomings of conventional complete removable dental prostheses.
Collapse
Affiliation(s)
- Murali Srinivasan
- Clinic of General-, Special Care, and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Porawit Kamnoedboon
- Clinic of General-, Special Care, and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Lea Angst
- Clinic of General-, Special Care, and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|
4
|
Ye Z, Ye H, Jiang Z, Wu S, Feng Z, Liu H, Wang X, Lan R, Lin X, Ding C, Zhang Q, Ding X, Wu L. Influence of Different Implant Designs on Replacement of Four Teeth of The Posterior Free-end Edentulism: Three-dimensional Finite Element Analysis and Clinic Case Validation. Ann Anat 2023:152111. [PMID: 37247761 DOI: 10.1016/j.aanat.2023.152111] [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: 11/11/2022] [Revised: 03/15/2023] [Accepted: 05/15/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND With periodontal disease having an increasing incidence, mandibular free-end edentulism caused by periodontitis is clinically more common. Finite element analysis and clinical case reports were used to evaluate the influence of different designs on the load distribution of implant prosthesis in mandibular posterior free-end edentulism. METHOD A finite element model of a mandible with posterior free-end edentulism was established. Considering the implant position and selection of single crown repair or splint repair, four designs were conducted including model A: 3435×37(four-unit fixed bridge supported by three implants, implant positions were 34, 35, 37); model B: 34,35×37, (34: a single implant crown) (35×37: three-unit fixed bridge supported by two implants, implant positions were 35, 37); model C: 34×3637(four-unit fixed bridge supported by three implants, implant positions were 34, 36, 37); and model D: 34×36, 37(37: a single implant crown)(34×36: three-unit fixed bridge supported by two implants, implant positions were 34, 36). Stress distribution and the Von Mises stress value of the implants, the crown and the bone around the implants were analyzed at vertical and 45° inclined load. RESULTS Stress in the cortical bone was mainly concentrated around the implant neck, and maximum Von Mises stress (MVMS) of the four models was 11.6-16.1MPa at vertical load and 61.74-96.49MPa at 45° inclined load. Stress in the cancellous bone was concentrated around the implant base, and MVMS of four models was 3.075-3.899MPa at vertical load and 5.021-6.165MPa at 45° inclined load. Stress of the restoration crowns was mainly concentrated in the connector of the bridge, and MVMS of four models was 23.38-26.28MPa at vertical load and 53.14-56.35MPa at 45° inclined load. Stress of the implant interface was mainly concentrated on the surface of the smaller implants near the bridge, and MVMS of four models was 21.12-33.25MPa at vertical load and 83.73-138.7MPa at 45° inclined load. CONCLUSION There was favorable stress distribution of the four models at vertical load and 45° inclined load. Design of a three-unit fixed bridge combined with a partial crown may be an available option for devising patient treatment plans with mandibular free-end edentulism.
Collapse
Affiliation(s)
- Zhangyan Ye
- Department of Stomatology, Pingyang Hospital Affiliated of Wenzhou Medical University(The People's Hospital of Pingyang), Wenzhou, 325400 Zhejiang; P.R. China; Institute of Digitized Medicine and Intelligent Technology, Wenzhou Medical University, Wenzhou, 325015 Zhejiang; P.R. China.
| | - Hao Ye
- Institute of Digitized Medicine and Intelligent Technology, Wenzhou Medical University, Wenzhou, 325015 Zhejiang; P.R. China.
| | - Zhengting Jiang
- Department of Stomatology, The first affiliated hospital of Wenzhou Medical University, Wenzhou, 325015 Zhejiang; P.R. China
| | - Suwen Wu
- Department of Stomatology, Pingyang Hospital Affiliated of Wenzhou Medical University(The People's Hospital of Pingyang), Wenzhou, 325400 Zhejiang; P.R. China
| | - Zhongqiang Feng
- Department of Stomatology, Pingyang Hospital Affiliated of Wenzhou Medical University(The People's Hospital of Pingyang), Wenzhou, 325400 Zhejiang; P.R. China
| | - Hongwen Liu
- Institute of Digitized Medicine and Intelligent Technology, Wenzhou Medical University, Wenzhou, 325015 Zhejiang; P.R. China
| | - Xinyi Wang
- Institute of Digitized Medicine and Intelligent Technology, Wenzhou Medical University, Wenzhou, 325015 Zhejiang; P.R. China
| | - Ruotian Lan
- Institute of Digitized Medicine and Intelligent Technology, Wenzhou Medical University, Wenzhou, 325015 Zhejiang; P.R. China
| | - Xinyi Lin
- Institute of Digitized Medicine and Intelligent Technology, Wenzhou Medical University, Wenzhou, 325015 Zhejiang; P.R. China
| | - Chenlu Ding
- Institute of Digitized Medicine and Intelligent Technology, Wenzhou Medical University, Wenzhou, 325015 Zhejiang; P.R. China
| | - Qi Zhang
- Institute of Digitized Medicine and Intelligent Technology, Wenzhou Medical University, Wenzhou, 325015 Zhejiang; P.R. China
| | - Xi Ding
- Department of Stomatology, The first affiliated hospital of Wenzhou Medical University, Wenzhou, 325015 Zhejiang; P.R. China.
| | - Lijun Wu
- Institute of Digitized Medicine and Intelligent Technology, Wenzhou Medical University, Wenzhou, 325015 Zhejiang; P.R. China.
| |
Collapse
|
5
|
de Resende GP, de Menezes EEG, Maniewicz S, Srinivasan M, Leles CR. Prosthodontic outcomes of mandibular overdenture treatment with one or two implants: 4-year results of a randomized clinical trial. Clin Oral Implants Res 2023; 34:233-242. [PMID: 36692124 DOI: 10.1111/clr.14036] [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: 08/01/2022] [Revised: 12/29/2022] [Accepted: 01/12/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To assess the incidence of prosthodontic maintenance events and complications during 4 years of follow-up after mandibular overdenture treatment with one or two implants. METHODS Participants received one or two implants inserted in the midline (1-IOD group) or the lateral incisor-canine area bilaterally (2-IOD group). Implants were loaded with an early loading protocol after 3 weeks. Programmed recall visits were scheduled at the 6-, 12-, 36-, and 48-month follow-ups and nonprogrammed visits in case of prosthodontic complaints. The type of maintenance was registered, and the final treatment outcome was classified as successful, surviving, unknown, dead, repair, or retreatment. RESULTS Forty-seven participants, mean age 65.4 ± 8.6, 74.5% female, were included (1-IOD = 23; 2-IOD = 24) and 44 completed the 4-year follow-up. A total of 159 prosthodontic maintenance events occurred and 89 in unscheduled visits. The most common event was the need for minor modifications of the denture base due to sore spots in the oral mucosa (n = 56 in 31 patients), matrix activation (n = 54 in 34 patients), and overdenture fracture (n = 25 in 18 patients). A "successful" or "surviving" outcome could be attributed to 57.5% of cases, whereas 38.3% needed repair. No significant differences in the incidence of prosthodontic events or treatment outcomes were found between the two groups. CONCLUSIONS Findings show that 1-IODs perform similar to 2-IODs when considering the incidence of fractures and the need for prosthodontic maintenance, including adjustments of the overdenture and the attachment system.
Collapse
Affiliation(s)
| | | | - Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Murali Srinivasan
- Clinic of General, Special Care, and Geriatric Dentistry, Centre of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Cláudio Rodrigues Leles
- Department of Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Brazil
| |
Collapse
|
6
|
Padhye NM, Shirsekar VU, Rakhangi RS, Chalakuzhy PM, Joshi AV. Three-dimensional assessment of the mandibular lingual foramina with implications for surgical and implant therapy: A multicentre cross-sectional study. J Oral Biol Craniofac Res 2023; 13:186-190. [PMID: 36688146 PMCID: PMC9852479 DOI: 10.1016/j.jobcr.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 12/25/2022] [Accepted: 01/05/2023] [Indexed: 01/07/2023] Open
Abstract
Treatment planning for dental implants in the anterior mandible is often complicated by the presence of vascular structures. The aim of our study was to investigate the prevalence, location and morphology of the mandibular lingual foramen (LF) through cone beam computed tomography (CBCT) scans and contribute to its anatomical knowledge in an Indian population. A total of 400 mandibular anterior CBCT scans from 4 centers were included in this retrospective analysis. The vertical distance from alveolar crest (Hcre) and inferior border of mandible (Hinf) to the LF, horizontal distance from lingual canal to labial cortical plate (LC-CP), length of the lingual canal (LLC) and diameter of the LF were measured. Data was analysed using Wilcoxon signed rank test and compared between median and lateral LF. 14 (3.5%) scans were excluded due to non-visualization of LF. A lateral LF was detected in 149 scans (38.6%), predominantly in the canine region (61.7%). Hcre was significantly higher for median LF (16.35 ± 4.59 mm) than lateral LF (12.94 ± 3.92 mm) (p < 0.001), while Hinf did not show significant difference between median (11.38 ± 3.62 mm) and lateral (12.94 ± 3.92 mm) LF (p = 0.0032). The LC-CP, LLC and diameter of LF averaged at 5.05 ± 1.76 mm, 6.26 ± 1.82 mm and 0.88 ± 0.72 mm respectively. The LF can be visualized in CBCT scans with a prevalence of 96.5%. This study stresses on the need for a CBCT, prior to surgeries in anterior mandible to avoid excessive bleeding episodes.
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
Impact of the extension of the anterior-posterior spread on quality of life and satisfaction of patients treated with implant-retained mandibular overdentures - a randomized clinical trial. J Dent 2022; 127:104346. [PMID: 36414990 DOI: 10.1016/j.jdent.2022.104346] [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: 02/24/2022] [Revised: 10/02/2022] [Accepted: 10/16/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To compare the degree of satisfaction (SD) and the impact on oral health-related quality of life (OHRQoL) of edentulous patients treated with conventional complete dentures (CCDs) and mandibular overdentures (IODs) with a short anteroposterior spread (S-APS) or a large antero-posterior spread (L-APS). MATERIALS AND METHODS Edentulous patients were treated with CCDs and subsequently randomly allocated to receive a bar clip mandibular overdenture retained by 2 interforaminal implants (Control) or 4 (Test: 2 additional implants distal to the mental foramen). The Oral Health Impact Profile Edent questionnaire (OHIP-20E) and the Visual Analogue Scale (VAS) were applied at a mean follow-up of 38.5 months to assess the impact on OHRQoL and DS, respectively. Comparisons between the type of prosthesis and the extension of the AP spread were made with Student's t test for paired samples and for independent samples, respectively, at a significance level of 5%. RESULTS The IODs had significantly lower OHRQoL values in the dimensions "functional limitation" (p=0.03), "physical pain" (p=0.02), "psychological discomfort" (p<0.01), "disability physical" (p<0.01) and "general score" (p<0.01) (n=20 patients). The IODs presented DS values significantly for "aesthetics" (p=0.04), "stability" (p=0.03), "masticatory capacity" (p<0.01), "function" (p<0.01) and "oral condition" (p=0.03). The S-APS group (control) resulted in significantly lower values in the dimensions "physical pain" (p<0.01) and "general score" (p<0.01) and no domain with statistical difference in the VAS scale. CONCLUSIONS IODs significantly improved OHRQoL and DS. The increase in AP spread did not result in benefits for the patient's OHRQOL and DS in this clinical study. (Study Protocol Number: 1.452.492) CLINICAL SIGNIFICANCE: Implantology has experienced in the last 20 years a permanent evolution that aim at increasing predictability and improving long-term clinical performance. Placement of short implants distally to the mental foramen, for instance, and the resulting increase of the anterior-posterior spread, is a promising approach and is worthy of investigation.
Collapse
|
9
|
Alshenaiber R, Barclay C, Silikas N. The Effect of Number and Distribution of Mini Dental Implants on Overdenture Stability: An In Vitro Study. MATERIALS 2022; 15:ma15092988. [PMID: 35591322 PMCID: PMC9104554 DOI: 10.3390/ma15092988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/09/2022] [Accepted: 04/16/2022] [Indexed: 02/05/2023]
Abstract
The rotational movement of mini dental implants (MDIs) overdenture disturbs the function of the prosthesis. Many dentists place more MDIs to improve the overdenture stability; however, the influence of the MDIs number and distribution on the overdenture resistance to para-axial dislodgment has not been investigated. Seven resin models simulating atrophic mandibles housed twenty MDIs placed according to seven arrangements. Acrylic overdentures were fabricated for each cast and were dislodged five times in lateral, anterior and posterior directions, and the peak load dislodgment was measured. Each overdenture underwent 540 axial removal/placement cycles. The para-axial dislodgments were measured again, and data were compared. Dislodgment force values were measured in all directions, and the data were analysed using analysis of variance ANOVA and post hoc (p < 0.05). After six months of simulated placement/removal, increasing the MDI number showed a difference in resistance to para-axial dislodgment. The distribution affected the resistance to dislodgment in some directions. The inter-implant distance of 27 mm provided better resistance to posterior dislodgment than placing two MDIs close together at 19 mm. The placement of three MDIs at any distribution showed no significant difference except for resistance to posterior dislodgment. FourMDIs placed at any distribution showed a significant difference in all groups in all tested directions. The resistance to the para-axial dislodgment of MDI overdenture could improve with the increasing MDIs number and careful planning of MDI distribution.
Collapse
Affiliation(s)
- Rafif Alshenaiber
- Division of Dentistry, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK;
- Prosthetic Dental Sciences Department, College of Dentistry, Prince Sattam Bin Abdulaziz University, AlKharj 16278, Saudi Arabia
- Correspondence: ; Tel.: +44-7477426007
| | - Craig Barclay
- Restorative Dentistry, University of Manchester Dental Hospital, Manchester M15 6FH, UK;
| | - Nick Silikas
- Division of Dentistry, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK;
| |
Collapse
|
10
|
Bi Y, Aldhohrah T, Mashrah MA, Su Y, Yang Z, Guo X, Ge L, Wang L. Effects of attachment type and number of dental implants supporting mandibular overdenture on peri-implant health: A systematic review and network meta-analysis. J Prosthodont Res 2021; 66:357-373. [PMID: 34588403 DOI: 10.2186/jpr.jpr_d_21_00073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To evaluate the effect of overdenture (OD) attachment type and the number of implants supporting mandibular ODs on peri-implant health. STUDY SELECTION From inception to October 2020, electronic databases (Medline/PubMed, Embase, Cochrane Library, and Scopus) were systematically searched. The outcomes of interest were marginal bone loss (MBL), pocket probing depth (PPD), plaque index, bleeding index, and implant survival rate. Bayesian network meta-analysis was performed using the GeMTC package supported by R. The weighted mean difference and 95% credible interval were estimated. RESULTS Twenty-eight studies with a total of 1166 participants who received 2666 dental implants were included. Except for 4 bar and 4 telescopic, which showed a statistically lower MBL than the 2 locator, all other interventions showed insignificant differences in MBL (P > 0.05). The difference in periodontal probing depth was not statistically significant when comparing the different groups. The pooled implant survival rates of the different interventions ranged from 88.9% to 100%. The rank probability test showed that 4 bar and 4 telescopic had the lowest MBL, 2 magnet and 2 bar had the highest PI, whereas 4 locator showed the least PPD. CONCLUSIONS Except for 4 implants+bar, or telescopic, and 4 locator that, respectively, showed less MBL and PPD compared to some interventions, it seemed that different attachment types and number of implants supporting mandibular ODs have no clear superiority over the other in terms of peri-implant health outcomes.
Collapse
Affiliation(s)
- Ye Bi
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Taghrid Aldhohrah
- Department of Prosthodontic, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Mubarak Ahmed Mashrah
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yucheng Su
- Department of Dental Implantology of Peking Union Medical College Hospital, Beijing, China
| | - Zhe Yang
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xueqi Guo
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Linhu Ge
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Liping Wang
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| |
Collapse
|
11
|
Fonteyne E, Matthys C, Bruneel L, Becue L, De Bruyn H, Van Lierde K. Articulation, oral function, and quality of life in patients treated with implant overdentures in the mandible: A prospective study. Clin Implant Dent Relat Res 2021; 23:388-399. [PMID: 33615684 DOI: 10.1111/cid.12989] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 01/13/2021] [Accepted: 01/15/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Modifications of facial and oral structures affect aesthetic appearance, orofacial functions, and have impact on quality of life. PURPOSE This study determined alterations of articulation, oromyofunctional behavior, and Oral Health Related Quality of Life (OHRQoL) in patients replacing complete removable dentures by implant retained overdentures in the mandible. MATERIALS AND METHODS Twenty-one fully edentulous patients received mandibular overdenture retained on a bar connecting two titanium dental implants. Patients were evaluated after receiving a new set of fully removable dentures (stage 1), after surgery during provisionalization on healing abutments (stage 2), and after final connection to the bar (stage 3). Assessments were taken by speech therapists and included evaluation of: articulation (picture naming and reading); oromyofunctional behavior; OHRQoL (OHIP-14 questionnaire), and overall satisfaction and speech (VAS). To measure changes over time, Wilcoxon matched-pairs signed-rank-test and McNemar test was used. RESULTS There was no significant impact of the treatment on speech nor on the results of oromyofunction. In stage 1, patients had different kinds of articulation errors (mean:1.21) which evolved to 0.71 and 0.67. In stage 3, especially problems with the /s/ sound are seen in 37% (7/19) of the participants. Results of OHRQoL and satisfaction reveal that the average of satisfaction with oral health evolved from 67% to 63% and finally 78%. OHIP-14 total score was 17.4/56 in stage 1, remained unchanged in stage 2 and evolved in stage 3 to 9.8/56 (P: .010). This indicates improvement. Satisfaction with speech evolved significantly from 68% pretreatment to 82% in stage 3 (P: .013). CONCLUSION Despite existing articulation and oromyofunctional disorders after treatment, people are very satisfied with their OHRQoL and their speech. Impact of mandibular denture wearing on OHRQoL declines once connected. It's important to inform patients that speech and oromyofunctional disorders may occur during treatment where especially the /s/ sound is vulnerable.
Collapse
Affiliation(s)
- Ester Fonteyne
- Faculty of Medicine and Health Sciences, Department of Oral Health Sciences, Section Periodontology and Oral Implantology, Ghent University, Ghent, Belgium.,Department of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Carine Matthys
- Faculty of Medicine and Health Sciences, Department of Oral Health Sciences, Clinic for Removable Prosthodontics, Ghent University, Ghent, Belgium
| | - Laura Bruneel
- Faculty of Medicine and Health Sciences, Department of Speech, Language, and Hearing Sciences, Ghent University, Ghent, Belgium
| | - Laurence Becue
- Faculty of Medicine and Health Sciences, Department of Oral Health Sciences, Section Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Hugo De Bruyn
- Faculty of Medicine and Health Sciences, Department of Oral Health Sciences, Section Periodontology and Oral Implantology, Ghent University, Ghent, Belgium.,Department of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Kristiane Van Lierde
- Faculty of Medicine and Health Sciences, Department of Speech, Language, and Hearing Sciences, Ghent University, Ghent, Belgium.,Department of Communication, University of Pretoria, Pretoria, South Africa
| |
Collapse
|
12
|
Ye M, Liu W, Cheng S, Yan L. Immediate vs conventional loading of mandibular overdentures: A comprehensive systematic review and meta-analysis of randomized controlled trials. J ORAL IMPLANTOL 2020; 48:64-73. [PMID: 33206979 DOI: 10.1563/aaid-joi-d-20-00265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Clinicians treating overdenture patients need to know if immediate loading and conventional loading results in similar outcomes. This study aimed to perform a systematic literature search of studies comparing immediate and conventional loading of mandibular overdentures irrespective of the number of implants and conduct a meta-analysis of implant failure and marginal bone loss (MBL). A literature search of PubMed, ScienceDirect, Ovoid, Springer, and Google Scholar databases was performed for randomized controlled trials (RCTs) comparing immediate vs conventional loading of mandibular overdentures. The primary outcome was implant failure and the secondary outcome was marginal bine loss (MBL). A descriptive analysis was performed for other outcomes. Thirteen trials were included. Only one trial compared the immediate and delayed loading of single implant-supported overdenture. Seven trials used two implants, one trial used three implants while four trials used four implants. Meta-analysis indicated no statistically significant difference in implant failure and MBL between immediate and conventional loading of two-implant and four-implant supported overdentures. Descriptive analysis indicated no difference in peri-implant tissue indices, implant stability, and quality of life outcomes between the two loading protocols.There may be no difference in implant failure and MBL with immediate loading or conventional loading of two and four-implant supported mandibular overdentures. Literature review indicates that there may be no difference in peri-implant tissue indices, implant stability, and QoL outcomes between the two loading protocols. The overall quality of evidence is moderate. Further, adequately powered RCTs are required to strengthen the evidence.
Collapse
Affiliation(s)
- Mingfu Ye
- Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment Department of Oral Implantology No. 1309, Lvling Road CHINA Xiamen Fujian 361008 Department of Oral Implantology, Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment
| | - Wenjun Liu
- Department of Oral Implantology, Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment
| | - Shaolong Cheng
- Department of Oral Implantology, Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment
| | - Lihui Yan
- Department of Oral Implantology, Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment
| |
Collapse
|
13
|
Baskaradoss JK, Geevarghese A, Baig MR. Peri-implant mucosal response to implant-supported overdentures: A systematic review and meta-analysis. Gerodontology 2020; 38:27-40. [PMID: 33164257 DOI: 10.1111/ger.12505] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 09/20/2020] [Accepted: 10/17/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To systematically review and evaluate the effects of different types of attachments, implant numbers and loading protocols on the peri-implant mucosa of implant-supported overdentures (ISODs). BACKGROUND The impact of peri-implant tissue health on the ISOD treatment outcome is unclear, and current evidence is inadequate on this aspect. MATERIALS AND METHODS A systematic literature search for randomised controlled trials or prospective studies was conducted in indexed databases from 1995 to April 2020. The focused question was as follows: How does the peri-implant mucosa respond to implant-supported or implant-tissue-supported complete overdentures based on different types of attachments, implant numbers, and loading protocols, in terms of clinical outcomes achieved [plaque index (PI), gingival index (GI), probing pocket depth (PD) and bleeding index (BI)]? A random- or fixed-effects model was applied to measure the significance of standardised mean differences (SMD) of PD between the groups. RESULTS Seventeen studies met the eligibility criteria. The SMD for PD between splinted/bar and unsplinted/stud attachments was 0.10 mm (95% CI: -0.27 to 0.47; P = .60) and between 2- and 4-implant groups was 0.15 mm (95% CI: -0.16 to 0.45; P = .34), which were not statistically significant. Significant difference (P = .003) was observed between immediate/early loading and delayed loading (SMD = 0.46 mm [95% CI: 0.16 to 0.75]). CONCLUSIONS Probing depth for the immediate loaded implants was significantly higher than for the delayed loading group. No attachment type, implant number or loading protocol seemed to have a clear advantage over the other, in terms of other peri-implant mucosal outcome measures.
Collapse
Affiliation(s)
- Jagan Kumar Baskaradoss
- Division of Dental Public Health, Department of Developmental and Preventive Sciences, Faculty of Dentistry, Kuwait University, Safat, Kuwait
| | - Amrita Geevarghese
- Dental Public Health, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, CA, USA
| | - Mirza Rustum Baig
- Division of Prosthodontics, Department of Restorative Sciences, Faculty of Dentistry, Kuwait University, Safat, Kuwait
| |
Collapse
|
14
|
Sipahi C, Ezmek B. An Alternative Incorporation Technique for Minimizing Complications in Attachment-Retained Implant Mandibular Overdentures: Technical Report. J Prosthodont 2020; 29:814-817. [PMID: 33150997 DOI: 10.1111/jopr.13279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2020] [Indexed: 11/29/2022] Open
Abstract
The present technical report aimed to display an alternative incorporation method for ball/stud attachments in mandibular implant overdentures (MIO) to prevent or minimize metal housing debonding and attachment malpositioning. Precoating of metal housings with auto-polymerizing acrylic resin (AAR) and fabrication of straight AAR bars onto metal housings for optimal parallelism were used as new techniques. The glossy flat surfaces of metal housings (matrices) were sandblasted and precoated with a thin layer of AAR in the laboratory. Straight acrylic resin bars (3 cm long and 3 mm in diameter) were obtained and attached to these flat metal housing surfaces using a surveyor. The metal housings carrying the AAR bars were then placed intraorally onto ball/stud attachments, accurately positioned parallel to each other, and perpendicular to the long axes of implants and bound to the MIO with AAR.
Collapse
Affiliation(s)
- Cumhur Sipahi
- Department of Prosthodontics, Gulhane Faculty of Dentistry, Health Sciences University, Ankara, Turkey
| | - Bahadır Ezmek
- Department of Prosthodontics, Gulhane Faculty of Dentistry, Health Sciences University, Ankara, Turkey
| |
Collapse
|
15
|
Schmidt MB, Rauch A, Schwarzer M, Lethaus B, Hahnel S. Combination of Digital and Conventional Workflows in the CAD/CAM-Fabrication of an Implant-Supported Overdenture. MATERIALS 2020; 13:ma13173688. [PMID: 32825488 PMCID: PMC7503874 DOI: 10.3390/ma13173688] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/09/2020] [Accepted: 08/18/2020] [Indexed: 01/19/2023]
Abstract
Completely digital workflows for the fabrication of implant-supported removable restorations are not yet common in clinical dental practice. The aim of the current case report is to illustrate a reliable and comfortable workflow that reasonably merges conventional and digital workflows for the CAD/CAM-fabrication of implant-supported overdentures. The 53-year old patient was supplied with a digitally processed complete denture in the upper jaw and, simultaneously, with an overdenture supported by four interforaminal implants in the lower jaw. The overdenture included a completely digitally processed and manufactured alloy framework that had been fabricated by selective laser sintering. The case report indicates that digital manufacturing processes for extensive and complex removable restorations are possible. However, as it is currently not yet possible to digitally obtain functional impressions, future developments and innovations might focus on that issue.
Collapse
Affiliation(s)
- Michael Benno Schmidt
- Clinic for Prosthodontics and Dental Materials Science, University of Leipzig, 04103 Leipzig, Germany; (A.R.); (S.H.)
- Correspondence:
| | - Angelika Rauch
- Clinic for Prosthodontics and Dental Materials Science, University of Leipzig, 04103 Leipzig, Germany; (A.R.); (S.H.)
| | - Marcus Schwarzer
- Flemming Dental Tec GmbH, Dental Technology Center, 04317 Leipzig, Germany;
| | - Bernd Lethaus
- Clinic for Oral and Maxillofacial Surgery, University of Leipzig, 04103 Leipzig, Germany;
| | - Sebastian Hahnel
- Clinic for Prosthodontics and Dental Materials Science, University of Leipzig, 04103 Leipzig, Germany; (A.R.); (S.H.)
| |
Collapse
|
16
|
An X, Chui Z, Yang HW, Choi BH. Digital workflow for fabricating an overdenture by using an implant surgical template and intraoral scanner. J Prosthet Dent 2020; 123:675-679. [DOI: 10.1016/j.prosdent.2019.04.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 04/19/2019] [Accepted: 04/19/2019] [Indexed: 10/26/2022]
|
17
|
Gehrke P, Dinkel J, Fischer C, Schmenger K, Sader R. Surface Roughness and Necessity of Manual Refinishing Requirements of CAD/CAM-Manufactured Titanium and Cobalt-Chrome Bars – A Pilot Study. Open Dent J 2019. [DOI: 10.2174/1874210601913010316] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Due to their increased precision, CAD/CAM generated bars (Computer-Aided Design/ Computer-Aided Manufacturing) are increasingly utilized in implant prosthodontics. For optimal clinical results, surface morphology should promote the integration of soft tissue while minimizing plaque and bacterial retention.
Objective:
Despite their clinical use, only limited information on the biological and clinical surface quality of CAD/CAM milled bars is available. The aim of the study was therefore to characterize the surface topography of bars of different manufacturers based on the profilometric analysis and the need for manual post-processing in the laboratory.
Methods:
A custom mandibular edentulous cast with four anterior implants was used as a reference cast and reproduced eight times. On each reproduction cast, corresponding scan flags were positioned and digitized. Acrylic 3D printed bar frameworks were produced and sent to the respective production center along with the digital files of the CAD bars for milling. In the course of profilometric analysis, all bars were examined in three critical Regions of Interest (ROI): Transmucosal, labial, basal. Sa and Ra values of each construction were determined. To evaluate the necessary refinishing time eight dental technicians macroscopically evaluated the bars by performing a subjective visual inspection. Kruskal-Wallis H-tests and Tukey and Kramer's post hoc tests were applied to detect differences between the samples.
Results:
After profilometric examination, three specimens (Dentsply Sirona: ZDC; Straumann: ZST; CAMLOG: ZCC) demonstrated surface roughness values in the biological acceptable range (Sa 0.2-0.4 μm) in the transmucosal region and provided optimal conditions for a reliable soft tissue adaptation. The Ra measurements revealed values beyond the acceptable threshold in the transmucosal region for three bars (Straumann: ZST; Dentsply Sirona: ZDC; Amann Girrbach: LAC). Four bars (LAC: Amann Girrbach; ZBC: BEGO; Datron: LDC & LDT; Zirkonzahn: ZZC) needed undesirable extensive manual rework. The evaluation of quality and time for manual post-processing by dental technicians confirmed the measurement-based ranking of the bars.
Conclusion:
It is desirable to define a clear roughness threshold for the clinical acceptance of transmucosal CAD/CAM generated surfaces. Clinical studies with profilometric data could help to further improve the surface quality of CAD/CAM milled bars and reduce the need for manual reworking time and effort.
Collapse
|
18
|
Fonteyne E, Van Doorne L, Becue L, Matthys C, Bronckhorst E, De Bruyn H. Speech evaluation during maxillary mini-dental implant overdenture treatment: A prospective study. J Oral Rehabil 2019; 46:1151-1160. [PMID: 31271663 PMCID: PMC6899632 DOI: 10.1111/joor.12852] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/11/2019] [Accepted: 07/01/2019] [Indexed: 12/27/2022]
Abstract
Large proportions of patients are edentulous and wear removable dentures leading to reduced functional comfort and less oral health‐related quality of life. Satisfaction with the oral situation after implantation depends on the outcome in eating comfort, speech comfort and aesthetics. Modification in form and location of the teeth may affect speech. The aim of this study is to determine speech, oromyofunctional behaviour, satisfaction with the treatment and the impact on quality of life of the horse‐shoe overdenture retained by mini‐dental implants (MDIs) in the maxilla. This prospective multicentre cohort study included 32 patients for treatment. 5 to 6 implants were placed, traumatically piercing the mucosa. Patients were evaluated three times during treatment (pre‐operatively with conventional prosthesis including full palatal coverage (CD), post‐operatively with provisionally relined CD and with horse‐shoe overdenture on MDI). The assessment included a phonetic evaluation, examination of oromyofunctional behaviour, evaluation of the impact on quality of life (OHIP‐14) and a rating of satisfaction with the treatment and speech on a visual analogue scale. Several speech sounds are found to be disturbed before treatment. In the next two stages of the treatment, the number of speech issues decreases. In the final stage, ten people show minor speech problems, especially with the /s/ sound. In this stage, seven people still present with oromyofunctional problems, especially whistling problems. In this last stage, people are very satisfied with the treatment (83%) and with speech (84%). The impact on quality of life is low (8.23/56).
Collapse
Affiliation(s)
- Ester Fonteyne
- Department of Oral Health Sciences, Section Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Luc Van Doorne
- Department of Oral Health Sciences, Section Maxillo-Facial Surgery, Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | | | - Carine Matthys
- Clinic for Removable Prosthodontics, Faculty of Medicine and Health Sciences, Dental School, Ghent University, Ghent, Belgium
| | - Ewald Bronckhorst
- Department of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hugo De Bruyn
- Department of Dentistry, Periodontology Dental School Ghent, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
19
|
Srinivasan M, Kalberer N, Maniewicz S, Müller F. Implant overdentures retained by self-aligning stud-type attachments: A clinical report. J Prosthet Dent 2019; 123:6-14. [PMID: 31113663 DOI: 10.1016/j.prosdent.2019.03.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 03/07/2019] [Accepted: 03/07/2019] [Indexed: 11/24/2022]
Abstract
The functionality of a new overdenture attachment (LOCATOR R-Tx) was described for different clinical situations: a conventional mandibular implant overdenture (IOD) retained by 2 implants, a straightforward chairside maintenance procedure for replacing a worn LOCATOR (Legacy) attachment with the new LOCATOR R-Tx, and a complex clinical situation with nonideal implant positions with compromised parallelism. The LOCATOR R-Tx is an advance on the existing LOCATOR Legacy attachment and has an improved abutment head design with a more durable surface coating to prevent attachment wear and thereby reduce frequency of maintenance.
Collapse
Affiliation(s)
- Murali Srinivasan
- Privat-docent, Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland; Professor and Head, Clinic for General, Special Care, and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Nicole Kalberer
- Research and Teaching Assistant, Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Sabrina Maniewicz
- Research and Teaching Assistant, Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Frauke Müller
- Professor and Chair, Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland; Professor, Service of Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals of Geneva, Thônex, Switzerland.
| |
Collapse
|
20
|
Implant-supported overdentures with different clinical configurations: Mechanical resistance using a numerical approach. J Prosthet Dent 2019; 121:546.e1-546.e10. [PMID: 30711289 DOI: 10.1016/j.prosdent.2018.09.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 09/24/2018] [Accepted: 09/24/2018] [Indexed: 11/24/2022]
Abstract
STATEMENT OF PROBLEM Implant-supported overdentures (IODs) are a treatment option for patients with complete edentulism. However, this treatment increases the possibilities of peri-implant complications, characterized by inflammation or partial loss of surrounding hard and soft tissues. PURPOSE The purpose of this finite element analysis study was to evaluate the mechanical performance of different bar-IOD designs under different clinical configurations by comparing the stress and strain distribution on the bone during secondary stabilization. MATERIAL AND METHODS A finite element model of the mandible representing a patient with complete edentulism was developed. Different designs of bar-IODs were modeled and compared. The parameters studied were the material properties (cobalt-chromium, zirconium dioxide, titanium grade 5, and titanium grade 4), diameter and bar-IOD cross-sectional shape, tilt of the posterior implants (30 degrees), presence of a distal extension cantilever in the bar-IODs (12 mm), and number of implants (4 or 6). Two different mastication loading conditions were analyzed. One- and 2-way ANOVAs and the Tukey honestly significant differences post hoc test (α=.05) were used to determine the significant von Mises stress and strain values in the bone. RESULTS The 4 materials tested in the bar-IOD did not have a significant mechanical effect on the bone (P<.05). A smaller diameter and structure of the bar-IOD led to significantly higher bone stress (P<.001). A distal extension cantilever led to an increased stress concentration (model M1 versus model M3: P<.001), which reached 50% in the event of tilting of the posterior implants (model M2 versus model M4: P<.001). Tilting of the posterior implants alone, without extension, had a nonsignificant effect (model M3 versus model M4: P=.999). Model M5 supported with 6 implants reduces the stress transferred to the bone compared with model M3 supported with 4 implants (P<.05). CONCLUSIONS Distal extensions in bar-IODs, the tilt of the posterior implants, and the low amount of material in the cross-sectional area in the bar-IOD were the most influential parameters on the mechanical resistance of dental implants in the mandibular bone.
Collapse
|
21
|
Kourtis S, Madianos P, Patras M, Andrikopoulou E. Rehabilitation of the edentulous mandible with implant-supported overdentures on telescopic abutments and immediate loading. A controlled prospective clinical study. J ESTHET RESTOR DENT 2018; 30:369-377. [PMID: 30113126 DOI: 10.1111/jerd.12406] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 05/13/2018] [Indexed: 11/29/2022]
Abstract
The rehabilitation of the edentulous mandible with implant-supported overdentures is an established clinical procedure but immediate loading of implants supporting mandibular overdentures has not been equally documented. AIM The aim of this prospective clinical study was to evaluate the rehabilitation of the edentulous mandible with immediate loading and implant-supported overdentures. MATERIALS AND METHODS 10 patients were restored with immediate loading of the implants and 5 with delayed loading. The treatment planning included placement of four implants in the interforaminal area of the mandible. Prefabricated titanium abutments with 4 degrees of conical inclination were fixed on the implants and the telescoping conical caps were connected to the base of the mandibular denture. Bone loss was assessed by comparison of panoramic x-rays at baseline 3, 6, and 36 months by visual observation from clinicians. RESULTS A total of 60 implants were restored, 40 with immediate and 20 with delayed loading. The follow-up period ranged from 4 to 10 years with 72 months mean observation time. Prosthetic complications appeared with low frequency and no implant loss occurred during the follow-up period. No statistical significance was observed in the bone loss in the cervical area of the immediate and late loaded implants. CLINICAL SIGNIFICANCE The rehabilitation of the edentulous mandible with implant-supported overdentures and telescopic copings is a viable clinical solutions with multiple clinical advantages both for the clinician and the patient. . Immediate loading can be applied in cases where increased initial stability can be achieved. More extended long-term clinical studies with increased number of patients and implants are needed, however, to verify the efficacy of the treatment method.
Collapse
Affiliation(s)
- Stefanos Kourtis
- Department of Prosthodontics, National and Kapodistrian University of Athens, Athens, Greece
| | - Phoebus Madianos
- Department of Periodontics, National and Kapodistrian University of Athens, Athens, Greece
| | - Michael Patras
- Department of Prosthodontics, National and Kapodistrian University of Athens, Athens, Greece
| | - Efstathia Andrikopoulou
- Department of Prosthodontics, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
22
|
Al-Harbi FA. Mandibular Implant-supported Overdentures: Prosthetic Overview. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2017; 6:2-7. [PMID: 30787808 PMCID: PMC6196685 DOI: 10.4103/sjmms.sjmms_101_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Implant-supported overdentures are becoming the treatment of choice for the completely edentulous mandible. They significantly improve the quality of life in edentulous patients. For this review article, the literature was searched to identify pertinent studies. No meta-analysis was conducted because of high heterogeneity within the literature. Accordingly, in this review article, the author provides an update on implant-supported mandible overdentures with regard to the number of implants, type of loading, stress-strain distribution, mode of implant-to-denture attachment, occlusal considerations and complications.
Collapse
Affiliation(s)
- Fahad A Al-Harbi
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| |
Collapse
|
23
|
Melo LAD, Souza MBCD, Barbosa GAS, Carreiro ADFP. Peri-Implant Bone Loss of External Hexagon and Morse Taper in Patients Wearing Immediately Loaded Overdentures. Braz Dent J 2017; 28:694-698. [PMID: 29211123 DOI: 10.1590/0103-6440201701577] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 07/27/2017] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to evaluate the peri-implant bone loss of External Hexagon (EH) and Morse Taper (MT) implants in patients wearing immediately loaded mandibular overdentures during a 1-year follow-up. This is a non-randomized controlled clinical trial including 18 MT and 22 EH implants. Periapical radiographs were taken after overdentures insertion and following 1 year. The peri-implant bone loss was assessed through digitalization and analysis of the radiographs in the software Corel DRAW X7. For this, measurement from implant platform to residual ridge at mesial and distal surfaces of each implant was conducted. The results showed high success rate in the groups EH (100%) and MT (94.4%). For peri-implant bone levels, it was found significant difference between the groups (p=0.032) and greater bone loss was observed in the group EH. In general, bone loss was 0.85mm (±0.82) for EH and 0.10mm (±1.0) for MT. It was concluded that greater bone loss occurred in the group EH in comparison to the group MT after a 1-year follow-up.
Collapse
Affiliation(s)
- Laércio Almeida de Melo
- Department of Dentistry, UFRN - Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | | | | | | |
Collapse
|
24
|
Quality of Life of Implant-Supported Overdenture and Conventional Complete Denture in Restoring the Edentulous Mandible. IMPLANT DENT 2017; 26:945-950. [DOI: 10.1097/id.0000000000000668] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
25
|
Stilwell C. Mandibular Implant Overdentures: Treatment and Medico-Legal Considerations. Prim Dent J 2017; 6:28-35. [PMID: 29258637 DOI: 10.1308/205016817822230265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The concept of a two-implant overdenture as the minimum standard of care or first choice treatment for the edentulous mandible was first proposed in 2002 and has since been backed by an overwhelming body of evidence supporting greater patient satisfaction and improved quality of life. This article examines the implant overdenture concept and its various options and discusses best practice from both the patient's and a medico-legal standpoint.
Collapse
|
26
|
Pisani M, Bedos C, da Silva CHL, Fromentin O, de Albuquerque RF. A Qualitative Study on Patients' Perceptions of Two Types of Attachments for Implant Overdentures. J ORAL IMPLANTOL 2017; 43:476-481. [PMID: 29090984 DOI: 10.1563/aaid-joi-d-17-00166] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this qualitative study was to gain a deeper understanding of patient perceptions of wearing implant-retained overdentures with ball-shaped or cylindrical attachment systems. Twenty-two wearers of implant-supported overdentures participated in this qualitative study based on a randomized crossover clinical trial that aimed to compare a cylindrical attachment and a ball attachment. In phase I of the study, group A experienced ball attachments (n = 11) and group B Locator attachments (n = 11) for 1 year. Afterward, in phase II, the attachments were changed; group A received Locator attachments and group B received ball attachments. One week after the attachment's replacement, semistructured individual interviews were conducted. All interviews were audiotaped and transcribed. The analysis was guided by thematic content analysis. Most of the patients from both groups preferred the attachment they received in phase II, regardless the type. A major theme raised by the participants to justify their preference between the attachment types was prosthesis retention/stability, sometimes considered as a positive and other times as a negative factor. Other themes were also explored: oral function, pain, hygiene, previous experiences, confidence on the dentist's work, and esthetic. Aspects related to the retention/stability of the overdentures are the main concerns associated with the perceptions of most patients treated with implant overdentures regardless of the type of attachment. Adequate retention level should be identified and adjusted on an individual basis and maintained overtime as possible. Therefore, follow-up appointments should be planned for readjustment of the attachment's retention. Overretention should be avoided.
Collapse
Affiliation(s)
- Marina Pisani
- 1 Department of Dental Materials and Prosthodontics, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Christophe Bedos
- 2 Oral Health and Society Research Unit, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Cláudia Helena Lovato da Silva
- 1 Department of Dental Materials and Prosthodontics, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Olivier Fromentin
- 3 UFR of Odontology, Rothschild Hospital (AP-HP), Sorbonne Paris Cité University, Paris, France
| | - Rubens F de Albuquerque
- 1 Department of Dental Materials and Prosthodontics, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
27
|
Sivaramakrishnan G, Sridharan K. Comparison of implant supported mandibular overdentures and conventional dentures on quality of life: a systematic review and meta-analysis of randomized controlled studies. Aust Dent J 2017; 61:482-488. [PMID: 26836981 DOI: 10.1111/adj.12416] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Conventional complete dentures and implant supported overdentures are commonly used by dentists to treat completely edentulous mandibular arches. There have been problems associated with retention and stability while treating completely edentulous mandibular arches compared to maxillary arches. Many factors have been attributed to this, primarily focusing on the decreased area available for support and increased resorption. Implant supported overdentures have increased the treatment options for resorbed ridges, especially the mandible. However, no reports have proved the superiority of one treatment option over the other, especially in terms of patient-centric outcome measures such as the Oral Health Impact Profile (OHIP). Hence, this meta-analysis was conducted. METHODS A literature search of Medline (via PubMed), the Cochrane Central Register of Clinical Trials (CENTRAL) and the Database of Abstracts of Reviews of Effects (DARE) was performed. The reviewers screened titles, abstracts and performed full-text screening of eligible studies. The references from these studies were further screened for additional relevant studies. A random effects model was applied to measure the significance of the per cent mean difference in OHIP scale improvement between implant and conventional dentures. The Cochrane Risk of Bias Tool was applied to assess the selection, ascertainment and selective reporting biases. RESULTS Five studies were reviewed and identified. Results of 441 patients (228 implant and 213 conventional) were pooled for analysis of primary outcome and other secondary outcomes. A forest plot of total OHIP scores and for secondary outcomes were obtained between the interventions. Results of 441 patients (228 implant and 213 conventional) were pooled for analysis of primary outcome with a mean difference [95% confidence interval] in the score of -30.72[-48.39, -13.05]; mean difference [95% confidence interval] in the score of -26.45[-43.56, -9.35] for functional limitation; -29.16[-60.89, 2.56] for physical pain; -77.61[-154.63, -0.60] for psychological discomfort; -33.70[-47.96, -19.44] for physical disability; -41.17[-55.93, -26.40] for psychological disability; -17.27[-29.44, 5.10] for social disability; and -28.45[-33.97, -22.92] for handicap. A statistically significant difference favouring the implant group was obtained except for physical pain. CONCLUSIONS The implant overdenture group performed better in regard to patient satisfaction as measured using the OHIP questionnaire. Further studies are required to identify superiority between the two treatment options.
Collapse
Affiliation(s)
| | - K Sridharan
- Department of Health Sciences, Fiji National University, Suva, Fiji
| |
Collapse
|
28
|
Bishti S, Lautensack J, Türp JC, Wolfart S. Does professional experience save teeth? A survey among prosthodontists. Clin Oral Investig 2017; 22:1001-1008. [PMID: 28730455 DOI: 10.1007/s00784-017-2180-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 07/10/2017] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The aim of this study is to investigate the effect of clinical experience and educational background on clinical decision-making of dentists presented with two prosthodontic cases. METHODS A questionnaire-based survey was performed among 66 prosthodontists who were divided into two groups. The first group included clinicians from Belgium, Germany, and the Netherlands covering a wide spectrum of dental experience. The second (specialized) group consisted of German dentists performing their last module of a 3-year postgraduate master program in prosthodontics. Two patient scenarios of different complexities were presented to the participants who were asked to make an educated choice among seven therapeutic options. RESULTS Sixty-six dentists participated. For case #1, 22 therapeutic suggestions were offered within the international group (variation 54%), while 17 options were chosen in the specialized group (variation 68%). For case #2, five (variation 12%) and four (variation 16%) different therapeutic options were planned in the groups, respectively. Treatment planning in combination with implants was clearly preferred by dentists with an experience of 20 years or less. Conversely, participants with more experience favored more conventional treatments. All differences were statistically significant (p < 0.05). CONCLUSION Clinicians' experience and educational background had a clinically relevant influence on decision-making and treatment planning. A clear preference for implant-free therapies was noted for dentists with more than two decades of professional experience. CLINICAL SIGNIFICANCE In complex cases, clinicians with more than 20 years of professional experience tend to save questionable teeth rather than to resort to implants. This interindividual variation might less likely occur when more external evidence is taken into account during the decision-making process.
Collapse
Affiliation(s)
- Shaza Bishti
- Department of Prosthodontics and Biomaterials, Medical Faculty, RWTH Aachen University, Pauwelstrasse 30, 52074, Aachen, Germany.
| | - Julia Lautensack
- Department of Prosthodontics and Biomaterials, Medical Faculty, RWTH Aachen University, Pauwelstrasse 30, 52074, Aachen, Germany
| | - Jens C Türp
- Department of Reconstructive Dentistry and Temporomandibular Disorders, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Medical Faculty, RWTH Aachen University, Pauwelstrasse 30, 52074, Aachen, Germany
| |
Collapse
|
29
|
Corsalini M, Di Venere D, Stefanachi G, Muci G, Palminteri A, Laforgia A, Pettini F. Maxillary Overdenture Retained with an Implant Support CAD-CAM Bar: A 4 Years Follow Up Case. Open Dent J 2017; 11:247-256. [PMID: 28659995 PMCID: PMC5470066 DOI: 10.2174/1874210601711010247] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 02/27/2017] [Accepted: 03/28/2017] [Indexed: 02/05/2023] Open
Abstract
Introduction: Oral rehabilitation with overdenture on implants of upper jaw must be taken into consideration a variety of anatomical and biomechanical issues. It is possible to provide for rehabilitation with two or more implants, in different positions, solidarizing them with a bar. Materials & Methods: The present study involved a patient rehabilitated with 4 Xive implants (Friadent GmbH, Mannheim, Germany) solidarized with a titanium bar crafted with CAD-CAM technology for maximal comfort, precision and structural lightness. Results & Discussion: The follow-up was 54 months, with an implant survival of 100%. Based on our clinical evidence, bars engineered with CAD-CAM technology are promising in terms of precision and comfort despite higher costs.
Collapse
Affiliation(s)
- Massimo Corsalini
- Interdisciplinary Department of Medicine, Dental School, University of Bari, Bari, Italy
| | - Daniela Di Venere
- Interdisciplinary Department of Medicine, Dental School, University of Bari, Bari, Italy
| | - Gianluca Stefanachi
- Interdisciplinary Department of Medicine, Dental School, University of Bari, Bari, Italy
| | - Giovannino Muci
- Interdisciplinary Department of Medicine, Dental School, University of Bari, Bari, Italy
| | - Andrea Palminteri
- Interdisciplinary Department of Medicine, Dental School, University of Bari, Bari, Italy
| | - Alessandra Laforgia
- Interdisciplinary Department of Medicine, Dental School, University of Bari, Bari, Italy
| | - Francesco Pettini
- Interdisciplinary Department of Medicine, Dental School, University of Bari, Bari, Italy
| |
Collapse
|
30
|
Dimililer G, Kücükkurt S, Cetiner S. Biomechanical effects of implant number and diameter on stress distributions in maxillary implant-supported overdentures. J Prosthet Dent 2017; 119:244-249.e6. [PMID: 28552286 DOI: 10.1016/j.prosdent.2017.03.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 03/21/2017] [Accepted: 03/22/2017] [Indexed: 10/19/2022]
Abstract
STATEMENT OF PROBLEM Implant-supported overdentures (ISOs) are considered a good alternative to conventional removable dentures. However, varying rates of failure have been reported in some clinical studies. Excessive stress on surrounding tissues is one of the possible causes of implant failure. As stress is transmitted to the bone through the implant, careful planning, correct number of implants, and implant positioning are keys to ensuring appropriate stress distribution. However, research of the optimal number of implants necessary to support a maxillary ISO is insufficient. PURPOSE The purpose of this in vitro finite element study was to determine the optimal implant location, number, and diameter to support a maxillary ISO. MATERIAL AND METHODS Three-dimensional models of an atrophic maxilla, dental implants, and ball attachments were modeled, and different loading conditions were applied to simulate realistic conditions. Six models with different numbers and diameters of implants, including mini-dental implants and differently located implants, were formed, and stress values were compared by implementing a finite element analysis. RESULTS The study showed that, as the implant number increased, decreased stress values were observed in peri-implant bone and implants in the maxillary ISO prosthesis. However, changes in implant diameter had no significant effect on stresses. CONCLUSIONS Increasing the implant diameter was not advantageous; the use of mini-dental implants may be a viable alternative method. However, using 4 implants for maxillary ISOs is indicated.
Collapse
Affiliation(s)
- Gizem Dimililer
- Doctoral student, Graduate Oral and Maxillofacial Surgeon, Gazi University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Ankara, Turkey
| | - Sercan Kücükkurt
- Assistant Professor, Istanbul Aydın University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Istanbul, Turkey.
| | - Sedat Cetiner
- Professor, Gazi University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Ankara, Turkey
| |
Collapse
|
31
|
ELsyad MA, Shaheen NH, Ashmawy TM. Long-term clinical and prosthetic outcomes of soft liner and clip attachments for bar/implant overdentures: a randomised controlled clinical trial. J Oral Rehabil 2017; 44:472-480. [PMID: 28258636 DOI: 10.1111/joor.12500] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2017] [Indexed: 11/29/2022]
Abstract
Long-term clinical and prosthetic outcomes of soft liner attachments for bar/implant overdentures were not sufficiently investigated. The aim of this trial was to evaluate clinical and prosthetic outcomes of resilient liner and clip attachments for bar/implant-retained mandibular overdenture after 7 years. Thirty edentulous male participants received two implants in the canine areas of the mandible. Three months later, implants were splinted with a resilient bar. Mandibular overdentures were connected to the bars with either clip (CR group, n = 15) or resilient liner (RR group, n = 15) attachments. Plaque index (PI), gingival index (GI), probing depth (PD), vertical bone loss (VBL), horizontal bone loss (HBLO) and prosthetic complications (PCs) were evaluated at denture delivery (T0), 6 (T6m ), 12 (T1), 24 (T2), 36 (T3), 48 (T4), 60 (T5), 72 (T6) and 84 (T7) months after insertion. PI and GI increased significantly with time for CR and decreased significantly for RR (P < 0·001). PD increased at T1 (CR) and T6 m (RR) and then decreased thereafter (P < 0·05). VBL increased significantly with time in both groups (P < 0·005). HBLO increased at T2 (CR) and T1 (RR) and then decreased thereafter. CR recorded significant higher PI, GI, PD, VBLO and HBLO compared to RR at all observation times (P < 0·042). The survival rates were 96·6% and 100% for CR and RR after 7 years. The most common PCs for CR and RR were clip wears and separation of the resilient liner from the denture base, respectively. Within the limitations of this study, resilient liner attachments are recommended for bar/implant-retained mandibular overdentures than clip attachments in terms of peri-implant tissue health and prosthetic complications after 7 years.
Collapse
Affiliation(s)
- M A ELsyad
- Department of Removable Prosthodontics, Faculty of Dentistry, University of Mansoura, Eldakahlia, Egypt
| | - N H Shaheen
- Department of Removable Prosthodontics, College of Oral and Dental Surgery, Misr University for Science and Technology, Cairo, Egypt
| | - T M Ashmawy
- Department of Maxillofacial Prosthodontics, National Cancer Institute, Cairo University, Cairo, Egypt
| |
Collapse
|
32
|
Kronstrom M, Carlsson GE. An International Survey among Prosthodontists of the Use of Mandibular Implant-Supported Dental Prostheses. J Prosthodont 2017; 28:e622-e626. [PMID: 28314082 DOI: 10.1111/jopr.12603] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2017] [Indexed: 01/12/2023] Open
Abstract
PURPOSE To evaluate the use of implant-supported overdentures (IOD) and implant-supported fixed dental prostheses (IFDP) in patients with edentulous mandibles among international prosthodontists. MATERIALS AND METHODS A questionnaire was sent by e-mail to all clinically active prosthodontists in the International College of Prosthodontists with questions related to implant treatment of the edentulous mandible performed in 2015. RESULTS One hundred and sixteen prosthodontists from 33 countries responded to the questionnaire. The vast majority of the responding prosthodontists was faculty or worked in private practice, and the great majority had performed treatment with mandibular implant-supported dental prostheses; however, two thirds of the respondents reported that <20% of the implant patients in their clinic had received treatment related to edentulous mandibles. The majority reported using 2 implants (84%), while 13% used 4 for overdenture retention. There were great variations regarding retention systems used for mandibular IODs; the most common was individual Locator attachments. Cost was considered the most common reason to choose mandibular IOD, There was a wide variation of materials used for mandibular IFDPs. The most common combination included milled titanium frameworks and acrylic resin teeth. CONCLUSIONS This survey, completed by 116 prosthodontists from 33 countries, showed that implant treatment for edentulous mandibles is common, but there was great variation among the respondents regarding amount of treatments performed, design, and materials used for the implant prostheses.
Collapse
Affiliation(s)
- Mats Kronstrom
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, WA
| | - Gunnar E Carlsson
- Department of Prosthetic Dentistry/Dental Materials Science, University of Gothenburg, Göteborg, Sweden
| |
Collapse
|
33
|
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.
Collapse
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
| |
Collapse
|
34
|
Pozzi A, Tallarico M, Moy PK. Four-implant overdenture fully supported by a CAD-CAM titanium bar: A single-cohort prospective 1-year preliminary study. J Prosthet Dent 2016; 116:516-523. [PMID: 27160781 DOI: 10.1016/j.prosdent.2016.03.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 03/20/2016] [Accepted: 03/21/2016] [Indexed: 01/31/2023]
Abstract
STATEMENT OF PROBLEM In patients with an altered skeletal maxillomandibular relationship and bone resorption, the rehabilitation of edentulous jaws by combining 4 implants, 2 straight medially and 2 tilted distally, may be preferred to avoid a bone augmentation procedure. PURPOSE The purpose of this single cohort 1-year prospective study was to evaluate the clinical performance of a 4-implant overdenture fully supported by a computer-aided designed and computer-aided manufactured (CAD-CAM) titanium bar. MATERIAL AND METHODS This single cohort prospective study included edentulous participants rehabilitated with a 4-implant overdenture in 1 of the 2 jaws. The outcomes were implant and prosthetic survival and success rates, any biologic and technical complications, periimplant marginal bone loss, changes in the oral health impact profile (OHIP), bleeding on probing, and the plaque index. RESULTS Eighteen participants received 72 implants. One year after implant placement, no implants or prosthesis had failed, and no biologic or technical complications had been observed. At the 1-year follow-up, the mean marginal bone loss was 0.29 ±0.16 mm. The OHIP summary scores demonstrated a significant improvement in oral health-related quality of life. At the 1-year follow-up, positive bleeding was found in 2 participants (11.1%) around 3 implants (4.1%). Three participants (16.6%), accounting for 5 implants (6.9%), showed a slight amount of plaque. CONCLUSIONS A 4-implant overdenture supported by a CAD-CAM titanium bar may be a reliable option for the treatment of the edentulous mandible and maxilla over a 1-year period. Oral health-related quality of life significantly improved in all treated participants.
Collapse
Affiliation(s)
- Alessandro Pozzi
- Interim Chair, Oral Surgery and Implant Dentistry, Marche Polytechnic University, Ancona, Italy.
| | - Marco Tallarico
- Lecturer, University of Sassari, Surgical, Micro-Surgical and Medical Science Department, Sassari, Italy
| | - Peter K Moy
- Chair and Director, Implant Dentistry and the Dental Implant Center at UCLA, University of California, Los Angeles, Calif
| |
Collapse
|
35
|
Li K, Xin H, Zhao Y, Zhang Z, Wu Y. Remodeling of the Mandibular Bone Induced by Overdentures Supported by Different Numbers of Implants. J Biomech Eng 2016; 138:051003. [DOI: 10.1115/1.4032937] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Indexed: 11/08/2022]
Abstract
The objective of this study was to investigate the process of mandibular bone remodeling induced by implant-supported overdentures. computed tomography (CT) images were collected from edentulous patients to reconstruct the geometry of the mandibular bone and overdentures supported by implants. Based on the theory of strain energy density (SED), bone remodeling models were established using the user material subroutine (UMAT) in abaqus. The stress distribution in the mandible and bone density change was investigated to determine the effect of implant number on the remodeling of the mandibular bone. The results indicated that the areas where high Mises stress values were observed were mainly situated around the implants. The stress was concentrated in the distal neck region of the distal-most implants. With an increased number of implants, the biting force applied on the dentures was almost all taken up by implants. The stress and bone density in peri-implant bone increased. When the stress reached the threshold of remodeling, the bone density began to decrease. In the posterior mandible area, the stress was well distributed but increased with decreased implant numbers. Changes in bone density were not observed in this area. The computational results were consistent with the clinical data. The results demonstrate that the risk of bone resorption around the distal-most implants increases with increased numbers of implants and that the occlusal force applied to overdentures should be adjusted to be distributed more in the distal areas of the mandible.
Collapse
Affiliation(s)
- Kai Li
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, Stomatology School, Fourth Military Medical University, 145 Changle Xi Road, Xi'an 710032, China e-mail:
| | - Haitao Xin
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, Stomatology School, Fourth Military Medical University, 145 Changle Xi Road, Xi'an 710032, China e-mail:
| | - Yanfang Zhao
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, Stomatology School, Fourth Military Medical University, 145 Changle Xi Road, Xi'an 710032, China e-mail:
| | - Zhiyuan Zhang
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, Stomatology School, Fourth Military Medical University, 145 Changle Xi Road, Xi'an 710032, China e-mail:
| | - Yulu Wu
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, Stomatology School, Fourth Military Medical University, 145 Changle Xi Road, Xi'an 710032, China e-mail:
| |
Collapse
|
36
|
Srinivasan M, Makarov NA, Herrmann FR, Müller F. Implant survival in 1- versus 2-implant mandibular overdentures: a systematic review and meta-analysis. Clin Oral Implants Res 2016; 27:63-72. [PMID: 25350235 DOI: 10.1111/clr.12513] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2014] [Indexed: 12/19/2022]
Abstract
OBJECTIVE This systematic review was performed to compare the survival of 1- vs. 2-implant overdentures (IODs) in the edentulous mandible. MATERIALS AND METHODS Manual and electronic database (PubMed, EMBASE and CENTRAL) searches were performed to identify scientific articles, published in English, reporting on mandibular IODs utilizing unsplinted attachments. Studies were included if they were prospective human studies reporting on two-piece microrough surface implants with a diameter ≥3 mm. Data were extracted by two independent investigators, and an overall inter-investigator kappa score was calculated. A meta-analysis was performed on the included comparative studies. RESULTS The search shortlisted 30 prospective studies for data extraction and statistical analysis. The included studies comprised of only two randomized controlled trials (RCTs) comparing 1- vs. 2-IODs, and a further 28 prospective studies. The kappa score calculated was between 0.86 and 1 for the various parameters. One RCT favored 1-IODs (RD: 0.08, 95% CI: 0.01, 0.14) while the other favored 2-IODs (RD:-0.04, 95% CI: -0.27, 0.19). However, the overall random effects model did not reveal a significant risk difference (RD) for implant failure between the two interventions (I(2) = 36.6%, P = 0.209; RD: 0.05, 95% CI: -0.07, 0.18). CONCLUSIONS The results of this meta-analysis conclude that the postloading implant survival of 1-IODs is not significantly different from 2-IODs. However, the existing scientific evidence in the literature in terms of prospective comparative studies is scarce. Hence, before recommending the 1-IOD as a treatment modality, long-term observations are needed and a larger range of functional, prosthodontic, and patient-centered outcome measures should be considered.
Collapse
Affiliation(s)
- Murali Srinivasan
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Nikolay A Makarov
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - François R Herrmann
- Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals of Geneva, Thônex, Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
- Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals of Geneva, Thônex, Switzerland
| |
Collapse
|
37
|
Visser A, Stellingsma C, Raghoebar GM, Meijer HJ, Vissink A. A 15-Year Comparative Prospective Study of Surgical and Prosthetic Care and Aftercare of Overdenture Treatment in the Atrophied Mandible: Augmentation Versus Nonaugmentation. Clin Implant Dent Relat Res 2015; 18:1218-1226. [PMID: 26676082 DOI: 10.1111/cid.12386] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Different treatment strategies for the atrophied mandible are described in literature. The need for long term care and aftercare for these strategies is sparsely described, however. PURPOSE To prospectively assess the need for prosthetic and surgical care and aftercare of two implant treatment strategies for the atrophied mandible. MATERIALS AND METHODS Forty edentulous elderly patients were randomly assigned according to a balanced allocation method to a treatment strategy: dental implants in combination with an augmentation procedure versus a nonaugmentation procedure. All surgical and prosthetic care and aftercare were scored from the first visit until 15 years after implant placement. RESULTS Twenty elderly patients completed the 15-year follow-up. As expected, the augmentation group needed significantly more surgical time than the nonaugmentation group (338 vs 145 minutes), but the need for prosthetic care and surgical/prosthetic aftercare was comparable. Implant survival was lower in augmented mandibles (88.7% vs 98.7%, p < .05). Aftercare mainly consisted of routine inspections; the need for prosthetic adjustments was minor. Surgical aftercare was hardly needed. CONCLUSION The only difference in the need for surgical and prosthetic (after) care was the extra time needed for performing augmentation surgery and the higher risk on implant loss in augmented mandibles. Otherwise, the need for care and aftercare was of the same magnitude. Thus, when applicable, nonaugmentation surgery is preferred as no general anesthesia is needed and the morbidity is low.
Collapse
Affiliation(s)
- Anita Visser
- University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, University of Groningen, Groningen, The Netherlands
| | - Cornelis Stellingsma
- University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, University of Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, University of Groningen, Groningen, The Netherlands
| | - Henny Ja Meijer
- University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, Department of Fixed and Removable Prosthodontics, University of Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
38
|
Boven GC, Meijer HJA, Slot W, Vissink A, Raghoebar GM. Does a large dehiscent implant surface at placement affect the 5-year treatment outcome? An assessment of implants placed to support a maxillary overdenture. J Craniomaxillofac Surg 2015; 43:1758-62. [PMID: 26427618 DOI: 10.1016/j.jcms.2015.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 08/05/2015] [Accepted: 08/12/2015] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to assess the 5-year clinical and radiographic outcome of implants with a dehiscent surface at implant placement. A total of 26 consecutive patients (mean age 61.6 years; SD 8.0 years) with at least one implant with a dehiscent implant surface of ≥ two thirds of the implant length on the labial side were included. All implants were placed to support a maxillary overdenture. The implants were placed with adequate primary stability and the dehiscent surface was covered with autologous bone, inorganic bovine bone and a resorbable membrane. Outcome measures were soft tissue conditions, change of radiographic marginal bone level and implant survival. Baseline data (at loading, T0) were compared with 1-year (T1) and 5-year (T5) post loading data. Of the 116 implants, 40 implants had no dehiscence, 16 had a buccal dehiscence < two thirds of the implant length, and 60 implants had a dehiscence ≥ two thirds. The peri-implant tissues were healthy and 5-year marginal bone changes were well within normal limits (-0.4 mm; range: -0.8 to -0.1). One implant was lost during the osseointegration period. Even when implants are placed with a dehiscence ≥ two thirds of the buccal implant surface, favorable 5-year peri-implant health can be achieved provided these dehiscences are covered with autologous bone, inorganic bone and a resorbable membrane, and there is good initial stability of the implants.
Collapse
Affiliation(s)
- G C Boven
- University of Groningen, University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, Groningen, The Netherlands.
| | - H J A Meijer
- University of Groningen, University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Dental School, Department of Fixed and Removable Prosthodontics, Groningen, The Netherlands
| | - W Slot
- University of Groningen, University Medical Center Groningen, Dental School, Department of Fixed and Removable Prosthodontics, Groningen, The Netherlands
| | - A Vissink
- University of Groningen, University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, Groningen, The Netherlands
| | - G M Raghoebar
- University of Groningen, University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, Groningen, The Netherlands
| |
Collapse
|
39
|
Korfage A, Raghoebar GM, Arends S, Meiners PM, Visser A, Kroese FGM, Bootsma H, Vissink A. Dental Implants in Patients with Sjögren's Syndrome. Clin Implant Dent Relat Res 2015; 18:937-945. [DOI: 10.1111/cid.12376] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Anke Korfage
- Department of Oral and Maxillofacial Surgery; University of Groningen, University Medical Center Groningen; Groningen The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery; University of Groningen, University Medical Center Groningen; Groningen The Netherlands
| | - Suzanne Arends
- Department of Rheumatology and Clinical Immunology; University of Groningen, University Medical Center Groningen; Groningen The Netherlands
| | - Petra M Meiners
- Department of Oral and Maxillofacial Surgery; University of Groningen, University Medical Center Groningen; Groningen The Netherlands
| | - Anita Visser
- Department of Oral and Maxillofacial Surgery; University of Groningen, University Medical Center Groningen; Groningen The Netherlands
| | - Frans GM Kroese
- Department of Oral and Maxillofacial Surgery; University of Groningen, University Medical Center Groningen; Groningen The Netherlands
- Department of Rheumatology and Clinical Immunology; University of Groningen, University Medical Center Groningen; Groningen The Netherlands
| | - Hendrika Bootsma
- Department of Rheumatology and Clinical Immunology; University of Groningen, University Medical Center Groningen; Groningen The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery; University of Groningen, University Medical Center Groningen; Groningen The Netherlands
| |
Collapse
|
40
|
De Bruyn H, Raes S, Matthys C, Cosyn J. The current use of patient-centered/reported outcomes in implant dentistry: a systematic review. Clin Oral Implants Res 2015; 26 Suppl 11:45-56. [DOI: 10.1111/clr.12634] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2015] [Indexed: 02/06/2023]
Affiliation(s)
- Hugo De Bruyn
- Department of Periodontology and Oral Implantology; Faculty of Medicine and Health Sciences; Dental School; Ghent University; Ghent Belgium
- Department of Prosthodontics; Faculty of Odontology; Malmö University; Malmö Sweden
| | - Stefanie Raes
- Department of Periodontology and Oral Implantology; Faculty of Medicine and Health Sciences; Dental School; Ghent University; Ghent Belgium
| | - Carine Matthys
- Department of Periodontology and Oral Implantology; Faculty of Medicine and Health Sciences; Dental School; Ghent University; Ghent Belgium
| | - Jan Cosyn
- Department of Periodontology and Oral Implantology; Faculty of Medicine and Health Sciences; Dental School; Ghent University; Ghent Belgium
- Department of Periodontology and Oral Implantology; Faculty of Medicine and Pharmacy; Dental Medicine; Vrije Universiteit Brussel (VUB); Brussels Belgium
| |
Collapse
|
41
|
Rinke S, Rasing H, Gersdorff N, Buergers R, Roediger M. Implant-supported overdentures with different bar designs: A retrospective evaluation after 5-19 years of clinical function. J Adv Prosthodont 2015; 7:338-43. [PMID: 26330982 PMCID: PMC4551791 DOI: 10.4047/jap.2015.7.4.338] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 07/29/2015] [Accepted: 08/05/2015] [Indexed: 11/18/2022] Open
Abstract
PURPOSE This retrospective study evaluated the outcome of implant-retained overdentures (IODs) after 5-19 years of clinical function. MATERIALS AND METHODS A retrospective analysis of patient files was performed referring to 27 patients who received 36 IODs with 3 different bar designs (group A=prefabricated round bars, n=7; group B=one-piece anterior milled bars, n=20; and group C=two bilaterally placed milled bars, n=9) in the mandible (n=24) and/or in the maxilla (n=12). The analysis focused on the survival and success rates (according to Kaplan-Meier) of the implants and prostheses. Technical complication rates for each type of restoration were analyzed and compared via one-way ANOVA and the Chi-squared test. The prevalence of peri-implantitis (radiographic bone loss ≥3.5 mm) was evaluated by digital analysis of panoramic radiographs taken post-operative (baseline) and after 5-19 years of clinical function (follow-up). RESULTS The mean observational time was 7.3 years. The survival rates of the prostheses and implants were 100% and 97.7%, respectively. Technical complications occurred more frequently in group A (mean: 3.5 during observational time) than in the other two groups (B: 0.8; C: 1.0). However, this difference was not statistically significant (P=0.58). Peri-implantitis was diagnosed for 12.4% of the implants in 37% of the patients. CONCLUSION Bar-retained IODs are an adequate treatment option for edentulous jaws. These restorations may exhibit high implant/prosthesis survival rates (>97%), and a limited incidence of technical complications after a mean observational period of >7 years. Nevertheless, peri-implantitis was identified as a frequent and serious biological complication for this type of reconstruction.
Collapse
Affiliation(s)
- Sven Rinke
- Department of Prosthodontics, Georg-August-University, Goettingen, Germany. ; Private Practice, Hanau, Germany
| | - Hajo Rasing
- Department of Prosthodontics, Georg-August-University, Goettingen, Germany
| | - Nikolaus Gersdorff
- Department of Prosthodontics, Georg-August-University, Goettingen, Germany
| | - Ralf Buergers
- Department of Prosthodontics, Georg-August-University, Goettingen, Germany
| | - Matthias Roediger
- Department of Prosthodontics, Georg-August-University, Goettingen, Germany
| |
Collapse
|
42
|
Kern JS, Kern T, Wolfart S, Heussen N. A systematic review and meta-analysis of removable and fixed implant-supported prostheses in edentulous jaws: post-loading implant loss. Clin Oral Implants Res 2015; 27:174-95. [PMID: 25664612 PMCID: PMC5024059 DOI: 10.1111/clr.12531] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2014] [Indexed: 11/30/2022]
Abstract
Objectives The aim of this systematic review was to analyze post‐loading implant loss for implant‐supported prostheses in edentulous jaws, regarding a potential impact of implant location (maxilla vs. mandible), implant number per patient, type of prosthesis (removable vs. fixed), and type of attachment system (screw‐retained, ball vs. bar vs. telescopic crown). Material and methods A systematic literature search for randomized‐controlled trials (RCTs) or prospective studies was conducted within PubMed, Cochrane Library, and Embase. Quality assessment of the included studies was carried out, and the review was structured according to PRISMA. Implant loss and corresponding 3‐ and 5‐year survival rates were estimated by means of a Poisson regression model with total exposure time as offset. Results After title, abstract, and full‐text screening, 54 studies were included for qualitative analyses. Estimated 5‐year survival rates of implants were 97.9% [95% CI 97.4; 98.4] in the maxilla and 98.9% [95% CI 98.7; 99.1] in the mandible. Corresponding implant loss rates per 100 implant years were significantly higher in the maxilla (0.42 [95% CI 0.33; 0.53] vs. 0.22 [95% CI 0.17; 0.27]; P = 0.0001). Implant loss rates for fixed restorations were significantly lower compared to removable restorations (0.23 [95% CI 0.18; 0.29] vs. 0.35 [95% CI 0.28; 0.44]; P = 0.0148). Four implants and a fixed restoration in the mandible resulted in significantly higher implant loss rates compared to five or more implants with a fixed restoration. The analysis of one implant and a mandibular overdenture also revealed higher implant loss rates than an overdenture on two implants. The same (lower implant number = higher implant loss rate) applied when comparing 2 vs. 4 implants and a mandibular overdenture. Implant loss rates for maxillary overdentures on <4 implants were significantly higher than for four implants (7.22 [95% CI 5.41; 9.64] vs. 2.31 [1.56; 3.42]; P < 0.0001). Conclusions Implant location, type of restoration, and implant number do have an influence on the estimated implant loss rate. Consistent reporting of clinical studies is necessary and high‐quality studies are needed to confirm the present results.
Collapse
Affiliation(s)
- Jaana-Sophia Kern
- Department of Prosthodontics and Biomaterials, Center for Implantology, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Thomas Kern
- Department of Prosthodontics and Biomaterials, Center for Implantology, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Center for Implantology, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Nicole Heussen
- Department of Medical Statistics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| |
Collapse
|
43
|
Berardini M, Di Iorio E. Overdenture mandibolare su due impianti: una valida alternativa nella riabilitazione dell’edentulismo totale. DENTAL CADMOS 2015. [DOI: 10.1016/s0011-8524(15)30007-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
44
|
Korfage A, Raghoebar GM, Slater JJH, Roodenburg JL, Witjes MJ, Vissink A, Reintsema H. Overdentures on primary mandibular implants in patients with oral cancer: a follow-up study over 14 years. Br J Oral Maxillofac Surg 2014; 52:798-805. [DOI: 10.1016/j.bjoms.2014.05.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 05/26/2014] [Indexed: 11/16/2022]
|
45
|
Boven GC, Raghoebar GM, Vissink A, Meijer HJA. Improving masticatory performance, bite force, nutritional state and patient's satisfaction with implant overdentures: a systematic review of the literature. J Oral Rehabil 2014; 42:220-33. [PMID: 25307515 DOI: 10.1111/joor.12241] [Citation(s) in RCA: 129] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2014] [Indexed: 11/29/2022]
Abstract
Oral function with removable dentures is improved when dental implants are used for support. A variety of methods is used to measure change in masticatory performance, bite force, patient's satisfaction and nutritional state. A systematic review describing the outcome of the various methods to assess patients' appreciation has not been reported. The objective is to systematically review the literature on the possible methods to measure change in masticatory performance, bite force, patient's satisfaction and nutritional state of patients with removable dentures and to describe the outcome of these. Medline, Embase and The Cochrane Central Register of Controlled Trials were searched (last search July 1, 2014). The search was completed by hand to identify eligible studies. Two reviewers independently assessed the articles. Articles should be written in English. Study design should be prospective. The outcome should be any assessment of function/satisfaction before and at least 1 year after treatment. Study population should consist of fully edentulous subjects. Treatment should be placement of any kind of root-form implant(s) to support a mandibular and/or maxillary overdenture. Fifty-three of 920 found articles fulfilled the inclusion criteria. A variety of methods was used to measure oral function; mostly follow-up was 1 year. Most studies included mandibular overdentures, three studies included maxillary overdentures. Implant-supported dentures were accompanied by high patient's satisfaction with regard to denture comfort, but this high satisfaction was not always accompanied by improvement in general quality of life (QoL) and/or health-related QoL. Bite force improved, masseter thickness increased and muscle activity in rest decreased. Patients could chew better and eat more tough foods. No changes were seen in dietary intake, BMI and blood markers. Improvements reported after 1 year apparently decreased slightly with time, at least on the long run. Treating complete denture wearers with implants to support their denture improves their chewing efficiency, increases maximum bite force and clearly improves satisfaction. The effect on QoL is uncertain, and there is no effect on nutritional state.
Collapse
Affiliation(s)
- G C Boven
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | | | | |
Collapse
|
46
|
Koyano K, Esaki D. Occlusion on oral implants: current clinical guidelines. J Oral Rehabil 2014; 42:153-61. [PMID: 25284468 DOI: 10.1111/joor.12239] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2014] [Indexed: 11/28/2022]
Abstract
Proper implant occlusion is essential for adequate oral function and the prevention of adverse consequences, such as implant overloading. Dental implants are thought to be more prone to occlusal overloading than natural teeth because of the loss of the periodontal ligament, which provides shock absorption and periodontal mechanoreceptors, which provide tactile sensitivity and proprioceptive motion feedback. Although many guidelines and theories on implant occlusion have been proposed, few have provided strong supportive evidence. Thus, we performed a narrative literature review to ascertain the influence of implant occlusion on the occurrence of complications of implant treatment and discuss the clinical considerations focused on the overloading factors at present. The search terms were 'dental implant', 'dental implantation', 'dental occlusion' and 'dental prosthesis'. The inclusion criteria were literature published in English up to September 2013. Randomised controlled trials (RCTs), prospective cohort studies and case-control studies with at least 20 cases and 12 months follow-up interval were included. Based on the selected literature, this review explores factors related to the implant prosthesis (cantilever, crown/implant ratio, premature contact, occlusal scheme, implant-abutment connection, splinting implants and tooth-implant connection) and other considerations, such as the number, diameter, length and angulation of implants. Over 700 abstracts were reviewed, from which more than 30 manuscripts were included. We found insufficient evidence to establish firm clinical guidelines for implant occlusion. To discuss the ideal occlusion for implants, further well-designed RCTs are required in the future.
Collapse
Affiliation(s)
- K Koyano
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | | |
Collapse
|
47
|
Mandibular 2-Implant Overdentures Improve Oral Health-related Quality of Life More Than Conventional Dentures, But There Are Cultural Differences. J Evid Based Dent Pract 2014; 14:133-5. [DOI: 10.1016/j.jebdp.2014.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
48
|
Implant-Retained Overdentures for Young Children With Severe Oligodontia: A Series of Four Cases. J Oral Maxillofac Surg 2014; 72:1684-90. [DOI: 10.1016/j.joms.2014.04.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 04/28/2014] [Indexed: 11/21/2022]
|
49
|
Emami E, Michaud PL, Sallaleh I, Feine JS. Implant-assisted complete prostheses. Periodontol 2000 2014; 66:119-31. [DOI: 10.1111/prd.12041] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2013] [Indexed: 11/28/2022]
|
50
|
Carlsson GE. Implant and root supported overdentures - a literature review and some data on bone loss in edentulous jaws. J Adv Prosthodont 2014; 6:245-52. [PMID: 25177466 PMCID: PMC4146723 DOI: 10.4047/jap.2014.6.4.245] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 08/05/2014] [Accepted: 08/08/2014] [Indexed: 12/17/2022] Open
Abstract
PURPOSE To present a literature review on implant overdentures after a brief survey of bone loss after extraction of all teeth. MATERIALS AND METHODS Papers on alveolar bone loss and implant overdentures have been studied for a narrative review. RESULTS Bone loss of the alveolar process after tooth extraction occurs with great individual variation, impossible to predict at the time of extraction. The simplest way to prevent bone loss is to avoid extraction of all teeth. To keep a few teeth and use them or their roots for a tooth or root-supported overdenture substantially reduces bone loss. Jaws with implant-supported prostheses show less bone loss than jaws with conventional dentures. Mandibular 2-implant overdentures provide patients with better outcomes than do conventional dentures, regarding satisfaction, chewing ability and oral-health-related quality of life. There is no strong evidence for the superiority of one overdenture retention-system over the others regarding patient satisfaction, survival, peri-implant bone loss and relevant clinical factors. Mandibular single midline implant overdentures have shown promising results but long-term results are not yet available. For a maxillary overdenture 4 to 6 implants splinted with a bar provide high survival both for implants and overdenture. CONCLUSION In edentulous mandibles, 2-implant overdentures provide excellent long-term success and survival, including patient satisfaction and improved oral functions. To further reduce the costs a single midline implant overdenture can be a promising option. In the maxilla, overdentures supported on 4 to 6 implants splinted with a bar have demonstrated good functional results.
Collapse
Affiliation(s)
- Gunnar E Carlsson
- Department of Prosthetic Dentistry/Dental Materials Science, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Sweden
| |
Collapse
|