Rehabilitation of the edentulous mandible with implant-supported overdentures on telescopic abutments and immediate loading. A controlled prospective clinical study

Comparison of perceived masticatory ability in completely edentulous patients treated with thermoplastic complete denture versus single implant-retained mandibular overdenture: a single-center prospective observational study

Background

This study aimed to compare the perceived masticatory ability (PrMA) in completely edentulous patients (EDPs) with thermoplastic conventional complete dentures (CDs) versus single implant-retained mandibular overdentures.

Methods

The current study was conducted in the outpatient Prosthodontic Clinic, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt. PrMA was evaluated in 45 completely edentulous patients (46% males, mean age 50.4 ± 4.7 years). Each patient received a thermoplastic PMMA complete denture (Polyan IC TM Bredent GmbH & Co.KG, Germany). The PrMA was evaluated at one-month and six-month intervals of denture use. An immediate loading single implant was placed into the mid-symphyseal for each patient, and the denture was adjusted. Subsequently, the PrMA was reevaluated after one month and six months. The data were collected and statistically analyzed using the SPSS@V25 to assess the changes in PrMA.

Results

The PrMA demonstrated improvement after six months of thermoplastic conventional denture use. However, this improvement was not statistically significant (p = 0.405). In addition, the PrMA showed a substantial increase following a single implant placement at one and six months (p < 0.001) of the overdenture use compared to the conventional denture. The PrMA insignificantly improved (p = 0.397) after six months of the single implant retained overdenture use.

Discussion

The study's findings indicate that using immediate loading single implant-retained mandibular overdentures significantly improved PrMA in completely edentulous patients.

Advanced method of rehabilitating edentulous Jaws: A review of telescopic denture

BACKGROUND

Edentulism conducts to a recognized impairment of oral function with both aesthetic and psychological changes. These patients suffer from a multiplicity of problems with their dentures, such as insufficient stability, retention and pain during mastication. The rehabilitation of a part edentulous patient can be established using a wide range of prosthetic treatment options. The overdenture treatment uses a removable total denture that overlies retained teeth, tooth roots, or dental implants. In the literature it was shown that patients with removable overdentures supported and retained either by tooth roots or implants have more predictable prosthodontic outcomes.

OBJECTIVE

The aim of this review is to provide an overview on the overdenture with a focus on the tooth-supported telescopic overdenture.

METHODS

The literature research was performed in the Scopus, Web of Science, and Pubmed electronic databases. Document type was limited to papers written in English, without time restrictions. The Review was recorded in the international PROSPERO (International Prospective Register of Systematic Reviews) database with the following number CRD42022326415.

RESULTS

A total of 256 articles published were found from electronic searches, Two independent reviewers carried out the screening and the selection process for the studies. First, duplicate citations were eliminated. Then, the two Authors independently screened the retrieved articles by title and abstract of each citation to determine its suitability for inclusion. Finally, 13 full-text articles satisfied the inclusion criteria.

CONCLUSION

Prostheses supported by Frictional telescopic crowns offer an effective treatment alternative for patients with Severely reduced dentitions who do not want implant treatment or complete dentures.

Evaluation of Stress Distribution on all-on-four Concept and Conventional Implant Designs: 3D Finite Element Analysis

Background/Aim: The objective of this study was to evaluate the stress distribution on implants and supporting bone tissue in All-on-Four and conventional designs in edentulous mandible by using 3D finite element analysis.

Material and Methods: The different five models were designed according to All-on-Four concept and conventional implant placement designs. While the first two models were involved in All-on-Four concept with two long implants, the remaining models were designed by conventional approaches with three implants in different location and length. After the modelling procedures, a load of masticatory force was applied and the stresses were evaluated.

Results: It has been observed that principal stresses in both cortical and spongious bone tissue were concentrated in models of All-on-Four design. Less principal stress levels were found in models of conventional design. Similarly, von Mises stress values on implant surfaces were found to be higher in All-on-Four concept.

Conclusions: In severely resorbed mandible, the use of conventional implant placement is recommended. Although All-on-Four design seems to be a reasonable alternative for edentulous mandible, evidence-based results of this approach should be supported by long-term follow-up studies.

Immediate vs conventional loading of mandibular overdentures: A comprehensive systematic review and meta-analysis of randomized controlled trials

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.

Selective Laser Sintering versus Selective Laser Melting and Computer Aided Design - Computer Aided Manufacturing in Double Crowns Retention

Purpose This in vitro study aimed at ascertaining the retention forces for telescopic crowns fabricated with Selective Laser Manufacturing (SLM) and Selective Laser Sintering (SLS) additive technologies, and Computer Aided Design - Computer Aided Manufacturing (CAD-CAM) subtractive technology, by using suitable materials for each.Materials and Methods Full-factorial design was employed for experimental testing, considering the following three factors: (a) inner crown material ‒ technology (zirconia ‒ CAD-CAM; metal-alloy ‒ SLS; metal-alloy ‒ SLM); (b) tooth type (canine or molar); (c) wet vs. dry conditions (i.e. either with or without artificial saliva). The roughness of the inner crowns was analyzed through atomic force microscopy. Three-way analysis of variance (ANOVA) was applied for statistical analysis, followed by Tukey's post-hoc comparisons between the crown types.Results The retention force mean values were between 3.8 N (dry, SLM) and 14.8 N (artificial saliva, SLS), with statistically significant (p<0.001) differences between the three types of inner crowns and interaction with the tooth type. No significant interaction was found between crown or tooth types and the wet vs. dry testing conditions. The zirconia crowns' retention force was significantly (p<0.001) higher compared to similar SLM crowns, with 95% CI (3.62; 5.55) N for the differences. Zirconia was significantly (p<0.001) less retentive compared to similar SLS crowns, with 95% CI (-5.99; -4.06) N for the differences. The roughness decrease and subsequent loss of retention force was the largest in zirconia.Conclusions The SLS inner crowns showed the best retention, followed by zirconia and SLM inner crows.