A Clinical Retrospective Study of Distal Extension Removable Partial Denture with Implant Surveyed Bridge or Stud Type Attachment

Implant-assisted removable partial dentures: Part II. a systematic review of the effects of implant position on the biomechanical behavior

PURPOSE

This systematic review aimed to evaluate the effects of implant placement sites on the biomechanical behavior of implant-assisted removable partial dentures (IARPDs) using finite element analysis (FEA).

STUDY SELECTION

Two reviewers independently conducted manual searches of the PubMed, Scopus, and ProQuest databases for articles investigating implant location in IARPDs using FEA, according to the 2020 Systematic Reviews and Meta-analyses statement. Studies published in English up to August 1, 2022, were included in the analysis based on the critical question.

RESULTS

Seven articles meeting the inclusion criteria were systematically reviewed. Six studies investigated mandibular Kennedy Class I and one study investigated mandibular Kennedy Class II. Implant placement reduced the displacement and stress distribution of the IARPD components, including dental implants and abutment teeth, regardless of the Kennedy Class type and dental implant placement site. Most of the included studies showed that, based on the biomechanical behavior, the molar region, rather than the premolar region, is the preferred implant placement site. None of the selected studies investigated the maxillary Kennedy Class I and II.

CONCLUSIONS

Based on the FEA regarding mandibular IARPDs, we concluded that implant placement in both the premolar and molar regions improves the biomechanical behaviors of IARPD components, regardless of the Kennedy Class. Implant placement in the molar region results in more suitable biomechanical behaviors compared with implant placement in the premolar region in Kennedy Class I. No conclusion was reached for Kennedy Class II due to the lack of relevant studies.

Implant-assisted removable partial dentures: Part I. a scoping review of clinical applications

PURPOSE

This scoping review aimed to systematically map research regarding implant-assisted removable partial dentures (IARPDs), and identify existing gaps in knowledge.

STUDY SELECTION

Two reviewers independently conducted a search of the MEDLINE-PubMed and Scopus databases according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) extension for Scoping Review and included articles published in English up to August 31, 2022, including human studies, reviews, and in vitro studies. Expert opinions, animal studies, and clinical studies involving complete overdentures were excluded, and ten aspects for establishing the treatment strategy for IARPDs were examined.

RESULTS

One hundred and twelve articles were chosen. There were two treatment modalities: IARPDs retained by implant- and tooth-supported surveyed single crowns (SCs) or fixed partial dentures (FPDs). In IARPDs retained by tooth-supported surveyed SCs or FPDs, the survival rate of dental implants for IARPDs was relatively higher with a wide range of marginal bone loss and many complications, but with improved functional performance, oral health-related quality of life, and patient satisfaction. There were limited data on survival or success rates and designs of IARPDs, attachment selections, length and diameter, inclination, placement sites, and loading protocols of implants, regardless of prosthetic types. There was limited information on maxillary IARPDs except for survival rates of implants.

CONCLUSIONS

Although IARPDs could become a useful treatment strategy, there is limited scientific consensus with gaps in knowledge about their use. Additional well-designed clinical and in vitro studies are necessary to scientifically establish IARPDs as definitive prostheses in implant dentistry.

Marginal Bone Loss around Implant-Retaining Overdentures versus Implant-Supported Fixed Prostheses 12-Month Follow-Up: A Retrospective Study

Few studies have compared marginal bone loss (MBL) around implant-retaining overdentures (IODs) vs. implant-supported fixed prostheses (FPs). This study evaluated the mean MBL and radiographic bone-implant interface contact (r-BIIC) around IODs and implant-supported FPs. We also investigated osseointegration and MBL around non-submerged dental implants. We measured the changes between the MBL in the mesial and distal sites immediately after prosthetic delivery and after one year. The mean MBL and its changes in the IOD group were significantly higher. The mean percentage of r-BIIC was significantly higher in the FP group. MBL and its changes in males were significantly higher in the IOD group. The percentage of r-BIIC was significantly higher in the FP group. MBL in the lower site in the IOD group was significantly higher. Regarding MBL, the location of the implant was the only significant factor in the IOD group, while gender was the only significant predictor in the FP group. Regarding the r-BIIC percentage, gender was a significant factor in the FP group. We concluded that non-submerged dental implants restored with FPs and IODs maintained stable bone remodeling one year after prosthetic delivery.

Clinical and radiographic evaluations of implants as surveyed crowns for Class I removable partial dentures: A retrospective study

PURPOSE

The purpose of this study was to evaluate survival rates and marginal bone loss (MBL) of implants in IC-RPDs.

MATERIALS AND METHODS

Seventy implants were placed and used as surveyed crowns in 30 RPDs. The survival rates and MBL around implants based on multiple variables, e.g., position, sex, age, opposing dentitions, splinting, type of used retainer, and first year bone loss, were analyzed. Patient reported outcome measures (PROMs) regarding functional/esthetic improvement after IC-RPD treatment, and complications were also inspected.

RESULTS

The 100% implant survival rates were observed, and 60 of those implants showed MBL levels less than 1.5 mm. No significant differences in MBL of implants were observed between implant positions (maxilla vs. mandible; P = .341) and type of used retainers (P = .630). The implant MBL of greater than 0.5 mm at 1 year showed significantly higher MBL after that (P < .001). Splinted implant surveyed crowns showed lower MBL in the maxilla (splinted vs. non-splinted; P = .037). There were significant esthetic/functional improvements observed after treatment, but there were no significant differences in esthetic results based on implant position (maxilla vs. mandible). Implants in mandible showed significantly greater improvement in function than implants in the maxilla (P = .002). Prosthetic complication of IC-RPD was not observed frequently. However, 2 abutment teeth among 60 were failed. The bone loss of abutment teeth was lower than MBL of implants in IC-RPDs (P = .001).

CONCLUSION

Class I RPD connected to residual teeth and strategically positioned implants as surveyed crowns can be a viable treatment modality.

Influence of direct prostheses on the condition of the alveolar processes during dental implantation

OBJECTIVE

The purpose of this article is to study of the processes accompanying osseointegration of the dental implants using various plate prostheses as temporary constructions, as well as to compare the dynamics of changes in the state of the jaw alveolar processes.

MATERIALS AND METHODS

The effect of dentures on the condition of the alveolar processes was studied in all patients according to the technique developed by L. Chulak on the 7th, 14th, 30th day and in 3, 6 months. To verify the results, the degree of atrophy of the alveolar processes was also determined by the second method the authors have chosen at the same time as indicated above.

RESULTS

The measurement results confirm linear changes in the height of the alveolar processes of the jaws with a decrease in the tissues of the prosthetic area. Throughout the duration of the examination, atrophy of the tissues of the alveolar processes is observed. Judging by the results obtained during the patients' study, it can be concluded that when applied as a temporary prosthesis with a dental delayed implantation of a partial denture made of polypropylene, the results of the state of the hard tissues of the mandible alveolar process show a better adaptation of the mucous membrane and slowing of atrophy of the jaw alveolar processes with this type of prosthetics.

Clinical Performance of Implant Crown Retained Removable Partial Dentures for Mandibular Edentulism-A Retrospective Study

The studies on implant-crown-retained removable partial dentures (IC-RPDs) for edentulism are scarce. The purpose of this study was to evaluate survival rates and marginal bone loss (MBL) of IC-RPDs compared to implant overdentures (IODs) in mandibular edentulism. Variables that influenced survival and marginal bone loss (MBL) of implants in both treatment modalities were analyzed and the functional/esthetic satisfaction of patients as well as prosthetic complications were also observed. Eighteen IC-RPDs with a total of 60 implant-supported survey crowns and 24 IODs with a total 94 implants retained with magnet attachments were observed. After a median observation period of 46.6 months (up to 149 months), we observed 98.3% implant survival rates for IC-RPDs and 92.5% for IODs. Kaplan–Meier survival curves based on the treatment modality showed that, at 96 months, cumulative survival rates were 98.3% in IC-RPD and 83.1% in IOD. For implant survival rates, no statistical differences were observed according to age, sex, opposing dentition, or implant positions (p = 0.515, 0.666, 0.201, 0.749, respectively). The implant MBL measurements for IC-RPD and IOD groups at the final recall check were 0.93 ± 1.22 mm and 2.12 ± 2.09 mm, respectively. Additionally, there were no significant differences between groups (p = 0.554). The implants with peri-implantitis at year 1 showed significantly higher MBL at final check-up (p < 0.001). The MBL of implants showed significant differences based on age (p = 0.008) and opposing dentition (p = 0.003). No significant differences of implant MBL were observed for the position of placed implants (p = 0.621) or sex (p = 0.666). Patient-reported outcome measures (PROMs) on functional and esthetic satisfaction were significantly improved after IC-RPD or IOD treatment (p < 0.001). The most frequent prosthetic complication of IC-RPD was clasp loosening, while for IOD group, it was attachment dislodgement. Within the limitations of this retrospective study, we concluded that IC-RPDs could be considered as a viable treatment option for edentulous patients who need few fixed abutments for satisfaction.

New Rehabilitation Concept for Maxillary Edentulism: A Clinical Retrospective Study of Implant Crown Retained Removable Partial Dentures

There have been no studies of implant-crown-retained removable partial dentures (IC-RPD) for the treatment of maxillary edentulism. The purpose of this study was to perform clinical and radiographic evaluations of implants in IC-RPD compared to implant overdentures (IOD) in maxillary edentulous patients. Twenty IC-RPDs with 74 splinted implant crowns and 18 IODs with 71 implants retained with magnet attachments were observed in 38 patients. We statistically analyzed survival rates and marginal bone loss (MBL) of implants based on multiple variables including first year pathologic condition, location of placed implant, age, and sex in both treatments. Patient reported oral measurements (PROMs) regarding functional/esthetic improvement after IC-RPD or IOD treatments and prosthetic complications were also statistically analyzed. After a median observation period of 47.1 months (up to 147 months), we observed 97.3% implant survival rates for IC-RPD and 70.4% for IOD (p < 0.001). Among variables, first year pathologic condition (p < 0.001) and sex (p = 0.027) influenced implant survival rates. The MBL of implants for IC-RPD and IOD groups at the final check-up were 1.12 ± 1.19 mm and 3.31 ± 1.71 mm, respectively (p < 0.001). In both groups, patients with peri-implantitis (p < 0.001) and patients older than 65 years (p = 0.029) showed significantly higher implant MBL regardless of treatment modality. Functional and esthetic satisfaction were significantly improved (p < 0.001) after both treatments. The IOD group showed more frequent prosthetic complications compared to the IC-RPD group. Within the limitations of a retrospective study, we concluded that RPD with few splinted implant crowns is a feasible alternative treatment modality for maxillary edentulous patients with anatomical limitations.

Survival rate and clinical evaluation of the implants in implant assisted removable partial dentures: surveyed crown and overdenture

PURPOSE

The purpose of this study was to investigate survival rates of the implants used in implant assisted removable partial dentures (IARPDs).

MATERIALS AND METHODS

The study was conducted on 21 patients who were treated with IARPDs. The mean follow-up period for IARPD patients ranged from 12 to 185 months (mean 47.9 months). A total of 58 implants were used for IARPDs in two different modalities: 41 for surveyed crowns and 17 for overdentures. The survival of implants was determined by clinical and radiographic evaluations considering relevant factors: location, RPD classification, opposing dentition, splinting, and implant diameter.

RESULTS

The survival rate of total 58 implants was 93.1%: 95.1% for implants supporting surveyed crowns and 88.2% for implants used in overdentures. Considering only the implants supporting surveyed crown, regular diameter implants showed a higher survival rate than narrow or wide diameter implants.

CONCLUSION

The survival rate of the implants used in IARPDs was 93.1% (surveyed crown: 95.1%, overdenture: 88.2%).

Retrospective clinical evaluation of implant-assisted removable partial dentures combined with implant surveyed prostheses

STATEMENT OF PROBLEM

Implant-assisted removable partial dentures (IARPDs) have been proposed as a treatment option for partially edentulous patients. However, evidence regarding the outcome of implant-assisted removable partial dentures with implant surveyed prostheses is limited.

PURPOSE

The purpose of this retrospective clinical study was to evaluate the clinical status and complications of IARPDs combined with implant surveyed prostheses in terms of clinical tissue condition, marginal bone resorption, and prosthetic complications.

MATERIAL AND METHODS

Patients treated with IARPDs combined with implant surveyed prostheses who had worn an IARPD for at least 12 months were included. Twenty-four participants (25 prostheses, 12 maxillary, and 13 mandibular) were evaluated, with 80 implants used as abutments for IARPDs. The average follow-up period was 27.6 months, and the maximum follow-up was 78 months. Implant cumulative survival rate, marginal bone resorption, probing depth, peri-implant inflammation, bleeding, plaque, calculus, and complications were evaluated.

RESULTS

No implant failure occurred, and all implants functioned without clinical mobility. Mean marginal bone resorption of implants at 1 year after loading was 0.77 ±0.63 mm, and mean probing depth was 3.4 ±0.1 mm. No patient developed peri-implantitis, and no implant failed. Two clasp fractures, 1 rest fracture, 1 decementation, and 1 fracture of porcelain on an implant surveyed prosthesis were detected at 12 months after loading.

CONCLUSIONS

Well-planned IARPDs using implant surveyed prostheses were clinically successful. Longitudinal and systematic clinical studies are necessary to confirm these results.