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Yang F, Liu D, Yin W, Yuan C, Hu Y, Xu J, Yang Y, Tang J, Chen J. Three-dimensional finite element analysis of the biomechanical behaviour of different dental implants under immediate loading during three masticatory cycles. Heliyon 2024; 10:e32616. [PMID: 38961961 PMCID: PMC11219977 DOI: 10.1016/j.heliyon.2024.e32616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 06/05/2024] [Accepted: 06/06/2024] [Indexed: 07/05/2024] Open
Abstract
The study aimed to evaluate the impact of varying modulus of elasticity (MOE) values of dental implants on the deformation and von Mises stress distribution in implant systems and peri-implant bone tissues under dynamic cyclic loading. The implant-bone interface was characterised as frictional contact, and the initial stress was induced using the interference fit method to effectively develop a finite element model for an immediately loaded implant-supported denture. Using the Ansys Workbench 2021 R2 software, an analysis was conducted to examine the deformation and von Mises stress experienced by the implant-supported dentures, peri-implant bone tissue, and implants under dynamic loading across three simulated masticatory cycles. These findings were subsequently evaluated through a comparative analysis. The suprastructures showed varying degrees of maximum deformation across zirconia (Zr), titanium (Ti), low-MOE-Ti, and polyetheretherketone (PEEK) implant systems, registering values of 103.1 μm, 125.68 μm, 169.52 μm, and 844.06 μm, respectively. The Zr implant system demonstrated the lowest values for both maximum deformation and von Mises stress (14.96 μm, 86.71 MPa) in cortical bone. As the MOE increased, the maximum deformation in cancellous bone decreased. The PEEK implant system exhibited the highest maximum von Mises stress (59.12 MPa), whereas the Ti implant system exhibited the lowest stress (22.48 MPa). Elevating the MOE resulted in reductions in both maximum deformation and maximum von Mises stress experienced by the implant. Based on this research, adjusting the MOE of the implant emerged as a viable approach to effectively modify the biomechanical characteristics of the implant system. The Zr implant system demonstrated the least maximum von Mises stress and deformation, presenting a more favourable quality for preserving the stability of the implant-bone interface under immediate loading.
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Affiliation(s)
- Feng Yang
- School and Hospital of Stomatology, Fujian Medical University, Fujian, China
- School of Stomatology, Xuzhou Medical University, Jiangsu, China
- Department of Stomatology, The Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Dianbin Liu
- School of Stomatology, Xuzhou Medical University, Jiangsu, China
| | - Wenjie Yin
- School of Stomatology, Xuzhou Medical University, Jiangsu, China
| | - Changyong Yuan
- School of Stomatology, Xuzhou Medical University, Jiangsu, China
| | - Yiming Hu
- School of Stomatology, Xuzhou Medical University, Jiangsu, China
| | - Jiaqi Xu
- School of Stomatology, Xuzhou Medical University, Jiangsu, China
| | - Yunfan Yang
- School of Stomatology, Xuzhou Medical University, Jiangsu, China
| | - Jianteng Tang
- School of Stomatology, Xuzhou Medical University, Jiangsu, China
| | - Jiang Chen
- School and Hospital of Stomatology, Fujian Medical University, Fujian, China
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Maniewicz S, Curado TFF, Srinivasan M, Leles CR, Müller F. Mandibular overdenture with a single implant in the canine region (c-SIMO): a feasibility study. Clin Oral Investig 2024; 28:330. [PMID: 38772987 PMCID: PMC11108892 DOI: 10.1007/s00784-024-05723-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/13/2024] [Indexed: 05/23/2024]
Abstract
OBJECTIVES The aim of this multi-center pilot study was to assess the viability and feasibility of a novel treatment concept - the canine-positioned single implant mandibular overdenture (c-SIMO), with the single implant placed on the patient's preferred chewing side instead of the midline. MATERIALS AND METHODS Participants received a single implant in the canine region of their preferred chewing side, based on an Asymmetry Index observed during mastication. The pre-existing mandibular denture was transformed into a c-SIMO on a spherical attachment. The primary outcome was oral health-related quality of life (OHRQoL), measured with GOHAI and OHIP-EDENT. Secondary outcomes included denture satisfaction index (DSI), chewing efficiency (CE), maximum bite force (MBF), implant survival and success, and prosthetic maintenance. Data analysis included descriptive statistics and bivariate comparison tests. RESULTS Fifteen participants received the c-SIMO treatment (mean age: 69.9 ± 7.0). Implant success and survival rates were 100% at 1 year. Patient-reported outcome measures improved significantly compared to pre-treatment values (OHIP-EDENT: p = 0.001; DSI: p = 0.001; GOHAI: p = 0.002). Masticatory outcomes also improved significantly (CE: p = 0.001; overall MBF: p = 0.005). Post-implant, MBF was significantly higher in the ipsilateral side compared to the contralateral side at 2 weeks (p = 0.019) and 3 months (p = 0.015), but no longer at T3 (p = 0.730). Common prosthodontic events included denture base adjustments (n = 17) and matrix activation (n = 9). CONCLUSIONS This pilot study concludes that c-SIMO is a promising treatment option, and a potential alternative to the single midline implant overdenture. CLINICAL RELEVANCE The novel treatment concept of a canine-positioned single implant mandibular overdenture could be a viable treatment alternative to the midline positioning.
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Affiliation(s)
- Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.
| | | | - Murali Srinivasan
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
- Clinic of General-, Special Care and Geriatric Dentistry, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Cláudio Rodrigues Leles
- Department of Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Brazil
- Clinic of General-, Special Care and Geriatric Dentistry, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Thônex, Switzerland
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Ribeiro AKC, Costa RTF, Vasconcelos BCDE, de Moraes SLD, Carreiro ADFP, Pellizzer EP. Patient-reported outcome measures and prosthetic events in implant-supported mandibular overdenture patients after immediate versus delayed loading: A systematic review and meta-analysis. J Prosthet Dent 2024; 131:833-840. [PMID: 35501187 DOI: 10.1016/j.prosdent.2022.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 03/14/2022] [Accepted: 03/14/2022] [Indexed: 11/22/2022]
Abstract
STATEMENT OF PROBLEM Immediately loaded mandibular overdentures are clinically acceptable treatment options that have gained popularity because their use shortens the treatment duration. However, whether the immediate loading of dental implants can match the prosthetic events, satisfaction, and quality of life of delayed loading is still unclear. PURPOSE The purpose of this systematic review and meta-analysis was to compare the prosthetic events, satisfaction, and quality of life of immediate versus delayed loading implants in patients rehabilitated with mandibular overdentures. MATERIAL AND METHODS This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was registered at The International Prospective Register of Systematic Reviews (PROSPERO) (CRD42021258187). Electronic searches were carried out by 2 independent reviewers in the PubMed/MEDLINE, Cochrane Library, and Web of Science databases up to May 2021. Only randomized clinical trials and prospective studies with at least 10 participants that compared immediate versus delayed loading were selected. A meta-analysis was performed by using the RevMan 5 software program for complications and maintenance outcomes. RESULTS Seven articles were included in the qualitative analysis, and 4 were included in the quantitative analysis. The meta-analysis demonstrated no significant difference between immediate and delayed loading for prosthetic complications (RR=1.71; 95% CI=0.67-4.37; I2=85%, P=.27) or maintenance (RR=1.92, 95% CI=0.44-8.28; I2=94%, P=.38). CONCLUSIONS Although the prosthetic complications and maintenance were more likely to favor the delayed loading group, available evidence showed no statistical difference for prosthetic complications and maintenance between immediate loading and delayed loading in mandibular overdentures.
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Affiliation(s)
- Anne Kaline Claudino Ribeiro
- PhD student, Department of Dentistry, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Rayanna Thayse Florêncio Costa
- PhD student, Division of Oral Rehabilitation, Faculty of Dentistry, University of Pernambuco (UPE), Recife, Pernambuco, Brazil
| | | | - Sandra Lúcia Dantas de Moraes
- Associate Professor, Division of Oral Rehabilitation, Faculty of Dentistry, University of Pernambuco (UPE), Recife, Pernambuco, Brazil
| | | | - Eduardo Piza Pellizzer
- Full Professor, Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
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Maniewicz S, Curado TFF, McKenna G, Leles CR, Müller F. Single lateral implant for mandibular overdentures as a fallback solution or a viable treatment alternative: Four case reports. J Prosthodont 2024. [PMID: 38512962 DOI: 10.1111/jopr.13841] [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: 07/05/2023] [Accepted: 03/01/2024] [Indexed: 03/23/2024] Open
Abstract
This report of four clinical cases aims to illustrate the use of a lateral implant as a solution for implant overdentures in the mandible in different clinical situations. The first two cases describe the clinical situations of patients wearing two-implant mandibular overdentures until the failure of one of the implants, one due to implant loss and the other due to a fracture of an abutment screw, and how the conditions were managed. The third case illustrates the placement of a single implant to retain an overdenture, where a midline implant, as originally planned, was not feasible due to anatomic reasons. The final case describes the use of a lateral implant to support and retain a single-implant mandibular overdenture. The four cases demonstrate that a single lateral implant can be utilized as sole retention in cases of a failing contra-lateral implant and as an alternative to a single implant in the midline.
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Affiliation(s)
- Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | | | - Gerald McKenna
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Cláudio Rodrigues Leles
- Department of Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Thônex, Switzerland
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Waltenberger L, Reissmann DR, Blender S, Fritzer E, Heydecke G, Kappel S, Mundt T, Schierholz CV, Stiesch M, Wolfart S, Yazigi C, Kern M, Passia N. Impact of loading protocol of a mandibular single implant-supported complete denture on oral health-related quality of life over a period of 5 years: A randomized controlled trial. J Dent 2024; 142:104769. [PMID: 37926424 DOI: 10.1016/j.jdent.2023.104769] [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: 09/27/2023] [Revised: 10/27/2023] [Accepted: 10/29/2023] [Indexed: 11/07/2023] Open
Abstract
OBJECTIVES The aim of the present study was to assess the long-term course of OHRQoL and the impact of the loading protocol in patients receiving a single mandibular implant supporting a complete denture over a period of five years. METHODS In this multicenter RCT, a total of 158 edentulous patients were initially included and were randomly allocated immediately after placement of a mandibular midline implant to either immediate loading (IL) or to conventional loading (CL) with submerged healing. The assessment of OHRQoL was performed with the 49-item Oral Health Impact Profile (OHIP) at baseline and 1, 4, 12, 24, and 60 months after loading. At 5-year follow-up, 100 patients (mean age: 69.2 years; 45.0% female) with completed OHIP were available for analyses. A mixed-effects model with patients as random effect and an unstructured covariance matrix was developed to address repeated outcome measurement. RESULTS The OHRQoL improved substantially after loading, indicated by a decrease of mean OHIP summary scores from 51.0 points at baseline, by 14.2 (95%-CI: 9.4 - 19.1; p<0.001) points to 37.2 points at 1-month follow-up, and by continuous improvement to 20.4 OHIP points at final follow-up. Considering constant treatment effects, the loading protocol had no significant effect on OHIP scores (-3.7, 95%-CI: -9.4 - 2.2; p = 0.204). Time effect was statistically significant with -0.21 (95%-CI: -0.28 - -0.15; p<0.001) points per month. CONCLUSION Both the immediate and conventional loading of a single mandibular midline implant supporting a complete denture offer long-lasting high levels of OHRQoL, with no significant or clinically relevant long-term differences. CLINICAL SIGNIFICANCE The study firstly presents long-term data for OHRQoL by investigating the loading protocol of single mandibular implant-supported complete dentures. Since immediate loading has been associated with a reduced implant survival rate for this concept, information on patient benefits is essential for evidence-based decision making.
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Affiliation(s)
- L Waltenberger
- Department of Prosthodontics and Biomaterials, Centre for Implantology, RWTH Aachen University Hospital, Aachen, Germany.
| | - D R Reissmann
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Freiburg, Freiburg, Germany; Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Blender
- Center of Dentistry, Department of Prosthetic Dentistry, Ulm University Hospital, Ulm, Germany
| | - E Fritzer
- Center for Clinical Studies, University Hospital Schleswig-Holstein, Kiel University, Kiel, Germany
| | - G Heydecke
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Kappel
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - T Mundt
- Department of Prosthodontics, Gerodontology and Biomaterials, Greifswald University Hospital, Greifswald, Germany
| | - C V Schierholz
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Freiburg, Freiburg, Germany
| | - M Stiesch
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover, Germany
| | - S Wolfart
- Department of Prosthodontics and Biomaterials, Centre for Implantology, RWTH Aachen University Hospital, Aachen, Germany
| | - C Yazigi
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Germany
| | - M Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Germany
| | - N Passia
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Germany; Department of Prosthetic Dentistry, Faculty of Medicine Carl Gustav Carus, TU Dresden, Germany
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Reissmann DR, Schimmel M, Kraus D, Stoilov M, Srinivasan M, Enkling N. IMPACT OF LOADING PROTOCOL OF 2-IMPLANT BAR-RETAINED MANDIBULAR OVERDENTURES ON ORAL HEALTH-RELATED QUALITY OF LIFE: A RANDOMIZED CONTROLLED TRIAL. J Evid Based Dent Pract 2023; 23:101891. [PMID: 37689447 DOI: 10.1016/j.jebdp.2023.101891] [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: 08/04/2022] [Revised: 04/10/2023] [Accepted: 05/10/2023] [Indexed: 09/11/2023]
Abstract
OBJECTIVES Aim was to assess whether immediate loading (IL) is more effective than delayed loading (DL) for 2-implant bar-retained mandibular overdentures in terms of oral health-related quality of life (OHRQoL) improvement over a period of 24-month. METHODS In this randomized controlled trial, 32 edentulous patients (mean age: 65.7 ± 10.6 years, 50.0% female) were included. Potential participants had to be unsatisfied with the retention of their current mandibular complete denture and demanded implant treatment for inclusion in the study. OHRQoL was assessed with the 49-item Oral Health Impact Profile (OHIP) at baseline before treatment and 1, 3, 6, 12, and 24 months after implant loading and insertion of implant-retained bars for overdenture support. A mixed-effects model with patients as random effect and an unstructured covariance matrix was developed to address repeated outcome measurement. RESULTS Patients' OHRQoL impairment at baseline was substantial indicated by mean OHIP summary score of 45.1 points. OHIP summary scores decreased substantially from baseline to 1-month follow-up to a mean of 33.5 points (P = .020). OHRQoL further improved during study period indicated by OHIP summary score of 25.7 points at 24-month follow-up. Raw treatment effects (IL vs. DL) ranged from -1.2 OHIP points for 12-month follow-up to 5.8 OHIP points for 24-month follow-up. Assuming constant treatment and time effects, treatment effect was small and not statistically significant (-0.7 OHIP points; P= .918). CONCLUSION A 2-implant bar-retained mandibular overdentures substantially improves OHRQoL over a period of at least 24 months. There seems to be no significant effect of implant loading protocol.
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Affiliation(s)
- Daniel R Reissmann
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Freiburg, Freiburg, Germany; Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
| | - Dominik Kraus
- Department of Prosthodontics, Preclinical Education and Dental Material Science, University of Bonn, Bonn, Germany
| | - Milan Stoilov
- Department of Prosthodontics, Preclinical Education and Dental Material Science, University of Bonn, Bonn, Germany
| | - 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 of Geneva, Geneva, Switzerland
| | - Norbert Enkling
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Prosthodontics, Preclinical Education and Dental Material Science, University of Bonn, Bonn, Germany
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Marginal Bone Loss and Treatment Complications with Mandibular Overdentures Retained by Two Immediate or Conventionally Loaded Implants—A Randomized Clinical Trial. PROSTHESIS 2023. [DOI: 10.3390/prosthesis5010022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
This study aimed to assess marginal bone loss and complication rates of mandibular overdentures retained on two implants with conventional and immediate loading protocols. Twenty edentulous patients were treated with mandibular two-implant-retained overdentures and new complete maxillary dentures. In one half of the sample, the implants were loaded immediately by VulkanLoc® abutments. In the counterpart group, these abutments were connected to the implants two months after implant placement (conventional protocol). Treatment outcomes were evaluated at 2, 6, and 12 months after implant placement. According to the pre- and post-insertion radiographs, there was a mean marginal bone loss of 0.25–0.59 mm (CI 95%) after 13.4 ± 2.1 months of follow-up. There were no significant differences between groups. The failure rate (percentage of implants failing per year) was slightly higher in the conventional loading group (14.0 ± 32.7%) than in the immediate loading group (8.3 ± 18.0%). The findings of the present study suggested that there were no differences in marginal bone loss observed at one year for immediately loaded implants (0.40–0.39 mm) versus conventionally loaded implants (0.44- 0.36 mm) placed for the retention of mandibular overdentures. There were no differences in primary and secondary stability of immediately loaded versus conventional implants; however, in the conventional loading group, stability increased significantly between implant placement compared at both 6 and 12 months post-placement.
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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.
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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
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Passia N, Ali S, Behrendt C, Fritzer E, Kohal RJ, Luthardt RG, Maltzahn NFV, Rädel M, Reissmann DR, Schwindling FS, Wolfart S, Kern M. Single mandibular implant study - chewing efficiency - 5-year results from a randomized clinical trial using two different implant loading protocols. J Prosthodont Res 2022; 66:610-617. [PMID: 35197416 DOI: 10.2186/jpr.jpr_d_21_00216] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To investigate the chewing efficiency of edentulous patients wearing complete dentures, treated with a single implant in the mandible, placed underneath the existing mandibular dentures, using two different loading protocols (immediate loading or conventional loading), over an observation period of 5 years. METHODS One-hundred and fifty-eight (158) edentulous seniors aged 60-89 years received an implant in the midline of the lower jaw and were randomized either to the immediate loaded group A (n=81) or the conventional loaded group B (n=77). Chewing efficiency was obtained before treatment, one month after implant placement during the submerged healing phase (only group B) and 1, 4, 12, 24 and 60 months after implant loading. RESULTS After 5 years, chewing tests from 89 patients (45 in the immediate loading group and 44 in the conventional loading group) were available for every recall visit and thus statistically analyzed. The chewing efficiency increased over time in both groups. A significant increase was observed up to 4 months after loading (p≤0.05). Later, chewing efficiency further increased, but not significantly. Between the two loading protocols, chewing efficiency did not differ significantly (p>0.05) at any follow-up investigation. CONCLUSION A single mandibular implant placed underneath existing mandibular dentures improves chewing efficiency of edentulous patients significantly over an observation period of 5 years, irrespective of the loading protocol.
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Affiliation(s)
- Nicole Passia
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Germany.,Department of Prosthetic Dentistry, Faculty of Medicine Carl Gustav Carus, TU Dresden, Germany
| | - Shurouk Ali
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Germany
| | - Christoph Behrendt
- Department of Prosthodontics, Gerodontology and Biomaterials, Greifswald University Hospital, Germany
| | - Elfriede Fritzer
- Center for Clinical Studies, Christian-Albrechts University at Kiel, Germany
| | - Ralf Joachim Kohal
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic dentistry, Faculty of Medicine, University of Freiburg, Germany
| | - Ralph G Luthardt
- Center of Dentistry, Department of Prosthetic Dentistry, Ulm University Hospital, Germany
| | | | - Michael Rädel
- Department of Prosthetic Dentistry, Faculty of Medicine Carl Gustav Carus, TU Dresden, Germany
| | - Daniel R Reissmann
- Center for Dental and Oral Medicine, Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Germany
| | | | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Medical Faculty, RWTH Aachen University, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Germany
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10
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Kashyap S, Mittal S, Sharma N, Sukhija U, Kamra M, Gupta N. Evaluation of patient satisfaction and masticatory performance in mandible single implant-assisted overdenture. Tzu Chi Med J 2021; 33:406-411. [PMID: 34760639 PMCID: PMC8532589 DOI: 10.4103/tcmj.tcmj_242_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/19/2020] [Accepted: 02/01/2021] [Indexed: 11/04/2022] Open
Abstract
Objectives Many authors' have advocated a minimum of two implants to support a mandibular overdenture, but financial restraints specifically among the geriatric population in developing countries made this treatment plan economically difficult. Hence, this study was planned to assess the symphyseal (midline) single implant-assisted complete overdenture for patient satisfaction and masticatory performance. Materials and Methods In this clinical study, 12 edentulous first-time denture wearers underwent placement of a single implant in the mandibular symphyseal region. After 1 week, new complete dentures were fabricated and delivered to the patients. Post 3 months, the denture was fixed with a nylon cap-ball attachment to the anchor implant. Patients were questioned about comparison in the level of satisfaction and complaint before loading the implant (control group) and after 1 week, 1 month, and 3 months. The implant-assisted overdenture was fabricated with the help of a questionnaire. Masticatory performance was calculated with the help of a bite force measuring device at the same time intervals. SPSS 17.0 statistical software was used to analyze the data. Results It was found that single implant anchorage of the mandibular complete denture resulted in a significant increase (P < 0.05) in patient's subjective satisfaction and a decrease (P < 0.05) in complaints at the end of 3 months. There was a significant (P < 0.01) increase in bite force in implant overdenture after 3 months (5.459 kgf) as compared to that of the complete denture (3.406 kgf). Conclusion Single implant-assisted overdenture can be an appropriate treatment modality to treat edentulousness in the geriatric population. It insinuates the remarkable improvement of prosthesis function and oral comfort with minor surgical procedures.
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Affiliation(s)
- Swati Kashyap
- Department of Prosthodontics, MM College of Dental Sciences and Research, Mullana, Haryana, India
| | - Sanjeev Mittal
- Department of Prosthodontics, MM College of Dental Sciences and Research, Mullana, Haryana, India
| | - Navneet Sharma
- Department of Prosthodontics, MM College of Dental Sciences and Research, Mullana, Haryana, India
| | - Urvashi Sukhija
- Department of Prosthodontics, MM College of Dental Sciences and Research, Mullana, Haryana, India
| | - Mohit Kamra
- Department of Prosthodontics, MM College of Dental Sciences and Research, Mullana, Haryana, India
| | - Nitika Gupta
- Department of Prosthodontics, MM College of Dental Sciences and Research, Mullana, Haryana, India
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Gaballa OA, Hamed HAEF, Fayyad AE, Rahhal MM. Overdentures Supported by Mini or Conventional Implants-effect on Patient Satisfaction and Bone Resorption Rates. A Randomized Clinical Trial. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM: The aim of the study was to assess the difference between patient satisfaction and bone height changes of mini-implant supported overdentures in comparison with conventional implant after bone expansion technique.
METHODS: This randomized clinical trial contains 36 edentulous participants with thin mandibular ridges randomly divided to receive 2 mini-implants, or 2 conventional implants after ridge splitting, both treatments were done in the inter-forminal area of the anterior mandible. Then, the patients received mandibular overdentures with ball and socket attachments. At base line, after 6 and 12 months of loading the implants, patients’ satisfaction was evaluated using visual analog scale, in addition to bone height changes using Soredex DIGORA Optime Classic software.
RESULTS: There was statistically significant difference in the overall satisfaction between the mini-implants and the conventional implants group; the amount of bone height changes in the mini-implant group was statistically significant less than the conventional implant group at base line, 6 and 12 months.
CONCLUSION: Treatment with two mini-implants provides high level of satisfaction and less bone height changes in a follow-up period of 12 months in comparison to conventional implants after ridge expansion.
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Nogueira TE, Silva JR, Nascimento LN, Cardoso JB, Srinivasan M, McKenna G, Leles CR. Immediately loaded single-implant mandibular overdentures compared to conventional complete dentures: A cost-effectiveness analysis. J Dent 2021; 115:103846. [PMID: 34637892 DOI: 10.1016/j.jdent.2021.103846] [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: 06/26/2021] [Revised: 09/14/2021] [Accepted: 09/30/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND In recent years, the single-implant mandibular overdenture (SIMO) has been proposed as an alternative to more complex overdenture designs as a simplified implant intervention for edentulous patients. OBJECTIVE The aim of this study was to run a cost-effectiveness analysis alongside a randomized clinical trial comparing the SIMO and the conventional complete denture (CCD) treatment. Imediately loaded external hexagon implant and ball attachment were used for the overdenture goup. Direct costs related to therapies were identified and valuated throughout a 1-year period after delivery, in Brazilian currency (R$) and converted into international dollars (I$) using purchase power parity exchange rates. Treatment effectiveness was measured using the OHIP-Edent and satisfaction scores for calculation of incremental cost-effectiveness ratios (ICER). RESULTS Outcomes were assessed at the 1-year follow-up for 65 patients (CCD=34; SIMO=31). Overall OHIP-Edent and satisfaction scores improved significantly in the SIMO group, while remained unchanged in the CCD group. The mean overall costs were R$1,179.04 (I$590.99) for the CCD group and R$2,127.91 (I$1,068.20) for the SIMO group - 80.7% incremental cost for SIMO. The ICER calculation for SIMO treatment showed a mean cost of I$48.20 for 1-point reduction in OHIP-Edent scores, and I$12.56 for 1-point increase in satisfaction score. CONCLUSIONS Findings support the effectiveness of this simplified and low-cost implant intervention for edentulous patients. SIMO also seems a cost-effective alternative to the CCD and the relatively low incremental cost may potentially increase the utilization of dental implants among older subjects, especially those with limited financial resources. CLINICAL SIGNIFICANCE The immediately loaded single-implant mandibular overdenture was superior to the conventional complete denture in terms of patient-reported outcome measures at a low incremental cost.
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Affiliation(s)
| | | | | | | | - Murali Srinivasan
- Clinic of General, Special Care, and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Gerald McKenna
- Centre for Public Health, Queen's University, School of Medicine Dentistry & Biomedical Sciences, Institute of Clinical Science, Belfast, United Kingdom
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13
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Gibreel M, Lassila LV, Närhi TO, Perea-Lowery L, Vallittu PK. Midline denture base strains of glass fiber-reinforced single implant-supported overdentures. J Prosthet Dent 2021; 126:407-412. [DOI: 10.1016/j.prosdent.2020.05.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 02/03/2023]
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14
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Gibreel M, Sameh A, Hegazy S, Närhi TO, Vallittu PK, Perea-Lowery L. Effect of specific retention biomaterials for ball attachment on the biomechanical response of single implant-supported overdenture: A finite element analysis. J Mech Behav Biomed Mater 2021; 122:104653. [PMID: 34229172 DOI: 10.1016/j.jmbbm.2021.104653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/03/2021] [Accepted: 06/16/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE The purpose of this finite element analysis (FEA) was to evaluate the effect of specific retention biomaterials with different elastic modulus on the biomechanical response to the axial and off-axial biting loads of a mandibular midline single implant-supported overdenture (SIO) model. METHODS Five 3-dimensional (3D) finite element models of an edentulous mandible with SIO were designed as follows: model M with a titanium retentive element for ball attachment, model P with a PEEK retentive element, model S with a silicone resilient liner retentive element, model T with a thermoplastic acrylic resin retentive element made from a CAD-CAM material, and model A with a polyacetal resin retentive element. Posterior bilateral vertical load (PV) at the 1st molar areas and anterior oblique load (AO) at the incisal edge of the mandibular central incisors at a 30-degree angle of 100 N were applied. Stress values were recorded. RESULTS Stress values were higher for all models under (AO) loading than under (PV) loading. Model M recorded the highest stress values on the implant, its components, cortical, and cancellous bone under both loading conditions. Under (AO) loading condition, the ball abutment von Mises stress value in model S was almost 7 times lower than that of model M (19 and 130 MPa respectively) and the other 3 models (P, T, and A) (119, 121, and 120 MPa respectively). However, model S recorded the highest value of denture base stress at the attachment area. CONCLUSIONS The elastic modulus of retention materials can affect stresses generated on the implant overdenture components and supporting structures.
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Affiliation(s)
- Mona Gibreel
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku, Turku, Finland.
| | - Ahmed Sameh
- Production Engineering Dept., Faculty of Engineering, Mansoura University, Mansoura, Egypt
| | - Salah Hegazy
- Professor and Chair of Department of Prosthodontics, Faculty of Dentistry, Mansoura University, Egypt
| | - Timo O Närhi
- Department of Prosthetic Dentistry, and Stomatognathic Physiology, University of Turku, Turku, Finland; and City of Turku, Welfare Division, Turku, Finland
| | - Pekka K Vallittu
- Professor, and Chair of Biomaterials Science Department, University of Turku, Turku, Finland; and City of Turku, Welfare Division, Turku, Finland
| | - Leila Perea-Lowery
- Department of Biomaterials Science, Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku, Turku, Finland
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15
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Borges GA, Costa RC, Nagay BE, Magno MB, Maia LC, Barão VAR, Mesquita MF. Long-term outcomes of different loading protocols for implant-supported mandibular overdentures: A systematic review and meta-analysis. J Prosthet Dent 2021; 125:732-745. [DOI: 10.1016/j.prosdent.2020.04.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 12/17/2022]
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16
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Huang X, Bai J, Liu X, Meng Z, Shang Y, Jiao T, Chen G, Deng J. Scientometric Analysis of Dental Implant Research over the Past 10 Years and Future Research Trends. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6634055. [PMID: 33954187 PMCID: PMC8057884 DOI: 10.1155/2021/6634055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 02/28/2021] [Accepted: 03/30/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND We conducted a bibliometrics analysis to explore the recent trends in dental implant research which could help researchers have a clear grasp of the relevant research hotspots and prospects. Material and Methods. Altogether, 15,770 articles on dental implants, from January 1, 2010, to October 31, 2019, were selected from the Web of Science Core Collection. We used BICOMB software to extract the high-frequency MeSH terms and construct binary and coword matrices. gCLUTO software was used for biclustering and visual analysis, Ucinet 6 software for social network analysis, SCIMAT software for strategic diagram building, Citespace 5.5 software to form timeline visualization, and VOSviewer software, eventually, for bibliometrics cocitation network. RESULTS Altogether, 72 high-frequency keywords were extracted from the selected articles and 4 clusters and 7 subcategories were identified through biclustering analysis in the dental implant research field. The use of the strategic diagram also enabled us to find the research hotspot and development trends. CONCLUSIONS The survival rate of dental implants and subsequent restoration have always been the core focus of research. Sinus floor elevation and guided bone regeneration are worthy of constant exploration owing to their reliability. With continuous improvement in technology, immediate loading could become a future research hot spot.
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Affiliation(s)
- Xin Huang
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Tianjin Medical University, Tianjin, China
| | - Jin Bai
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Tianjin Medical University, Tianjin, China
| | - Xu Liu
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Tianjin Medical University, Tianjin, China
| | - Zhaosong Meng
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Tianjin Medical University, Tianjin, China
| | - Yuli Shang
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Tianjin Medical University, Tianjin, China
| | - Tiejun Jiao
- Department of Oral Implantology, Stomatological Hospital of Tianjin Medical University, Tianjin, China
| | - Gang Chen
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Tianjin Medical University, Tianjin, China
| | - Jiayin Deng
- Department of Periodontics, Stomatological Hospital of Tianjin Medical University, Tianjin, China
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17
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de Resende GP, Jordão LMR, de Souza JAC, Schimmel M, Leles CR. Single versus two-implant mandibular overdentures using early-loaded titanium-zirconium implants with hydrophilic surface and ball attachments: 1-year randomized clinical trial. Clin Oral Implants Res 2021; 32:359-368. [PMID: 33417279 DOI: 10.1111/clr.13707] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 12/22/2020] [Accepted: 01/03/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This randomized clinical trial aimed to compare the outcomes of the mandibular overdenture retained by one (1-IOD) or two (2-IOD) implants. MATERIALS AND METHODS Participants received new complete dentures, were assessed at baseline and randomly assigned to groups. Early loaded single midline implant (1-IOD) or two implants in the canine regions bilaterally (2-IOD). Ball attachments were used for overdenture retention. Post-treatment outcomes (6- and 12-month follow-ups) included patient satisfaction, oral health-related quality of life measures, and chewing function. Data analysis included within- and between-group comparisons, and Generalized Estimating Equations. Both superiority and non-inferiority hypotheses were tested. RESULTS Forty-seven participants were included (1-IOD = 23; 2-IOD = 24). Significant improvements in OHIP-Edent were observed after insertion of new dentures and at the 1-year follow-up compared with baseline. No differences were found between the 1- and 2-IOD groups for the OHIP-Edent and QoLFAST scores. Patient satisfaction with the mandibular denture improved significantly from baseline to the 6-month follow-up and remained unaltered until 1 year, with no differences between groups. The magnitudes of treatment effect sizes were moderate to large for patient-reported outcomes. Progressive improvement in chewing function occurred in both groups. Non-inferiority testing based on a 15% non-inferiority margin showed inconclusive results for patient-reported outcomes, whilst chewing function in the 1-IOD group was concluded to be not inferior to the 2-IOD group. CONCLUSIONS Results support the use of both 1- and 2-IOD. The 1-IOD was also an acceptable alternative to the 2-IOD as a secondary option for the treatment of the edentulous mandible.
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Affiliation(s)
| | | | | | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
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18
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Kern M, Behrendt C, Fritzer E, Kohal RJ, Luthardt RG, Maltzahn NFV, Rädel M, Reissmann DR, Schwindling FS, Wolfart S, Passia N. 5-year randomized multicenter clinical trial on single dental implants placed in the midline of the edentulous mandible. Clin Oral Implants Res 2020; 32:212-221. [PMID: 33258136 DOI: 10.1111/clr.13692] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This multicenter randomized controlled clinical trial was conducted to investigate whether the loading protocol of single dental implants placed in the midline of edentulous mandibles will influence the implant survival or prosthetic maintenance. MATERIALS AND METHODS In total, 158 patients were randomly assigned either to the immediate loading group (n = 81) or to the delayed loading group (n = 77). All implants were loaded with an overdenture retained by a ball attachment. RESULTS After 5 years, 102 patients attended the follow-up investigation. Immediately loaded single implants in the midline of the edentulous mandible revealed a statistically significant lower survival rate than implants loaded conventionally over an observation period of 5 years. In the immediate loading group, 9 implants failed within the first three months of implant loading. No further implant loss was recorded for this group. Two implants failed in the delayed loading group, whereas one implant had to be removed during second-stage surgery and the second five years after implant loading. Non-inferiority of the survival rate of the midline implant of the immediate loading group, compared with the delayed loading group, could not be shown (p = .79, CI immediate loading: 74.9%; 100.0%, CI delayed loading: 73.0%; 100.0%). The observed difference in implant survival between the two treatment groups over time was statistically significant. CONCLUSIONS The results of the present study indicate that immediate loading of a single mandibular implant in the edentulous mandible should be considered only in exceptional cases.
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Affiliation(s)
- Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University at Kiel, Kiel, Germany
| | - Christoph Behrendt
- Department of Prosthodontics, Gerodontology and Biomaterials, Greifswald University Hospital, Greifswald, Germany
| | - Elfriede Fritzer
- Center for Clinical Studies, University Hospital Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Ralf J Kohal
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center - University Hospital Freiburg, Freiburg, Germany
| | - Ralph G Luthardt
- Center of Dentistry, Department of Prosthetic Dentistry, Ulm University Hospital, Ulm, Germany
| | - Nadine Frfr V Maltzahn
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover, Germany
| | - Michael Rädel
- Faculty of Medicine Carl Gustav Carus, TU Desden, Dresden, Germany
| | - Daniel R Reissmann
- Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Nicole Passia
- Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University at Kiel, Kiel, Germany.,Universitätsklinikum Schleswig-Holstein - Campus Kiel
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19
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A prospective cohort on the incidence of fractures in single-implant mandibular overdentures. J Dent 2020; 103:103521. [DOI: 10.1016/j.jdent.2020.103521] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/07/2020] [Accepted: 10/31/2020] [Indexed: 12/18/2022] Open
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20
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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.
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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
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21
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Pinheiro MA, Meira IA, Magno MB, Maia LC, Rodrigues Garcia RC. Masticatory function improvement with the use of mandibular single-implant overdentures in edentulous subjects: a systematic literature review. MINERVA STOMATOLOGICA 2020; 69:256-268. [PMID: 32945635 DOI: 10.23736/s0026-4970.20.04327-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION In this systematic review, several masticatory function parameters assessed during mandibular single-implant overdenture (SIO) use were compared to pre- SIO placement values in edentulous patients with aim of contributing to a consensus regarding denture treatment options. EVIDENCE ACQUISITION This study was registered a priori in the PROSPERO database (CRD42018106567). Two independent reviewers carried out electronic searches in eight databases, without language or time frame limitations, to collate clinical studies comparing masticatory function of edentulous patients before versus after SIO installation with the implant placed on the mandibular midline. Risk of bias was assessed with a before-and-after tool and evidence certainty level was evaluated with the Grading of Recommendations Assessment, Development and Evaluation program. EVIDENCE SYNTHESIS Eleven studies were included in this review (1 prospective, 3 crossover trials, 4 randomized clinical trials, 2 paired clinical trials, and 1 pilot). Enrolled patients were mostly over 60 years old; all patients were using conventional complete dentures (CD) prior to SIO installation. Masticatory performance, masticatory efficiency, bite force, and muscle activity were improved after the SIO placement compared to during mandibular CD use. Mandibular movement and masticatory ability data were inconclusive. Most of the studies had low risk of bias, but all had very low certainly level ratings due to methodological heterogeneity. CONCLUSIONS Placement of SIO improves masticatory function, as reflected mostly by masticatory performance and efficiency data, relative to CD use. Further studies comparing dental rehabilitation options, including SIOs, are needed to improve the quality of evidence in the literature.
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Affiliation(s)
- Mayara A Pinheiro
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Ingrid A Meira
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Marcela B Magno
- Department of Paediatric Dentistry and Orthodontic, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucianne C Maia
- Department of Paediatric Dentistry and Orthodontic, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Renata C Rodrigues Garcia
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil -
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22
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Pardal-Peláez B, Flores-Fraile J, Pardal-Refoyo JL, Montero J. Implant loss and crestal bone loss in immediate versus delayed load in edentulous mandibles: A systematic review and meta-analysis. J Prosthet Dent 2020; 125:437-444. [PMID: 32276823 DOI: 10.1016/j.prosdent.2020.01.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 10/24/2022]
Abstract
STATEMENT OF PROBLEM The current trend is to shorten the loading times of dental implants. However, information about the risk of early loss of implants that have been loaded immediately is scant if compared with data available for those conventionally loaded. PURPOSE The purpose of this systematic review and meta-analysis was to study immediate (IL) and delayed loading (DL) protocols in edentulous mandibles to determine whether differences exist in implant success and crestal bone loss and to evaluate these possible differences in relation to the type of prosthesis and the splinting of the implants. MATERIAL AND METHODS The literature review was conducted in PubMed, Scopus, and the Cochrane Library. Nine randomized clinical trials were included. RESULTS The result of a meta-analysis of implant loss before 1 year was 2.63 (95% CI: 1.22, 5.68), favoring the DL control group, while the outcome for crestal bone loss at the observation year was 0.42 (95% CI: -0.35, 1.20), with a tendency toward reduced bone loss for DL. CONCLUSIONS The risk of early loss in the IL group was higher than that in the DL group. For removable prostheses and nonsplinted implants, DL was preferred. The quality of scientific evidence significantly favors DL.
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Affiliation(s)
- Beatriz Pardal-Peláez
- Associate Professor, Department of Surgery, Faculty of Medicine, Dental Clinic, University of Salamanca, Salamanca, Spain.
| | - Javier Flores-Fraile
- Associate Professor, Department of Surgery, Faculty of Medicine, Dental Clinic, University of Salamanca, Salamanca, Spain
| | - José Luis Pardal-Refoyo
- Honorary Collaborating Professor, Faculty of Medicine, IBSAL (Salamanca Biomedical Research Institute) Member, University Assistance Complex of Salamanca, Salamanca, Spain
| | - Javier Montero
- Lecturer of Stomatological Prosthesis, Faculty of Medicine, Dental Clinic, University of Salamanca, Salamanca, Spain
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Enkling N, Moazzin R, Geers G, Kokoschka S, Abou-Ayash S, Schimmel M. Clinical outcomes and bone-level alterations around one-piece mini dental implants retaining mandibular overdentures: 5-year follow-up of a prospective cohort study. Clin Oral Implants Res 2020; 31:549-556. [PMID: 32096255 DOI: 10.1111/clr.13591] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 02/11/2020] [Accepted: 02/15/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To report on the clinical outcomes of one-piece mini dental implants (MDIs) retaining mandibular implant overdentures (IODs), including marginal bone-level alterations (ΔMBLs), clinical peri-implant parameters, and technical- and biological complications during a 5-year follow-up. The null hypothesis was that ΔMBLs would be equal in subjects older than 65 years relative to younger subjects. MATERIALS AND METHODS Four 1.8-mm diameter one-piece MDIs with ball attachments were placed in the interforaminal region of 20 edentulous subjects. The existing complete dentures were converted to IODs. Standardized radiographs of each implant were taken at implant placement (baseline) and during the five-year follow-up. ΔMBLs and potential influencing factors were evaluated, and peri-implant parameters, and biological and technical complications were recorded. RESULTS The implant and prosthetic survival rates were both 100%. IODs fractured in seven participants. The overall mean ΔMBL after 5 years was -1.18 mm (standard deviation: 0.79 mm). ΔMBLs per month were most pronounced within the first 3 months after implant placement. ΔMBLs were not influenced by the implant location, the presence of keratinized mucosa, or gender. However, ΔMBLs were significantly smaller in subjects older than 65 years (p = .007). CONCLUSIONS One-piece MDIs retaining mandibular IODs with O-ring attachments are a predictable treatment option, providing stable peri-implant bone and soft tissue conditions over a mid-term follow-up. Incorporating a metal reinforcement can prevent denture fracturing when converting a complete denture into an IOD. The presence of keratinized mucosa does not necessarily lead to decreased bone-level changes. Advanced age might be beneficial in terms of peri-implant bone stability.
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Affiliation(s)
- Norbert Enkling
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland.,Department of Prosthodontics, Preclinical Education and Dental Materials Science, University of Bonn, Bonn, Switzerland
| | - Rim Moazzin
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | - Gregor Geers
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | - Stephanie Kokoschka
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
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Asami M, Kanazawa M, Lam TV, Thu KM, Sato D, Minakuchi S. Preliminary study of clinical outcomes for single implant-retained mandibular overdentures. J Oral Sci 2020; 62:98-102. [PMID: 31996534 DOI: 10.2334/josnusd.19-0079] [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] [Indexed: 11/01/2022]
Abstract
This study evaluated marginal bone loss and prosthetic complications associated with single implant-retained mandibular overdentures (1-IODs) with locator attachments. The 1-IOD was placed in the mandibular midline by using a conventional loading protocol in 22 patients with an edentulous mandible. Marginal bone loss at the start of loading and 12 months postoperatively was assessed by radiographic and crestal bone evaluation. The crestal bone was defined as the distance between the customized abutment shoulder and the top of the bone, as indicated by probing. In addition, implant stability quotient and prosthetic complications were recorded. The cumulative implant survival rate was 95.5%. Median implant stability quotient remained greater than 80, and median radiographic bone loss was 0.56 mm. Crestal measurement showed a median crestal bone loss of 0.16, 0.43, 0.39, and 0.52 mm on the buccal, right, lingual, and left sides, respectively. Both radiographic and crestal bone loss values significantly differed between the start of implant loading and 12 months postoperatively (except on the buccal and lingual sides; P < 0.05). The need to replace the nylon insert was the most common complication. Conventional loading of a 1-IOD with a locator attachment resulted in a high survival rate, good implant stability, and acceptable marginal bone loss.
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Affiliation(s)
- Mari Asami
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Manabu Kanazawa
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Thuy V Lam
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Khaing M Thu
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Daisuke Sato
- Department of Implant Dentistry, School of Dentistry, Showa University
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
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25
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Passia N, Oberbillig F, Goulioumis V, Naumova EA, Kern M, Arnold W. Three-Dimensional Reconstruction of the Genial Spinal Canal. Clin Anat 2019; 33:1102-1108. [PMID: 31688952 DOI: 10.1002/ca.23512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 10/17/2019] [Accepted: 10/26/2019] [Indexed: 01/01/2023]
Abstract
The aim of this anatomical study was to investigate the genial spinal canal histologically and to reconstruct it three-dimensionally to improve understanding of its anatomy and to reveal any differences between dentate and edentulous specimens. Two tissue blocks from the mandible between the left and right second incisors, one dentate and one edentulous, were fixed in 4.5% formaldehyde, decalcified and embedded in paraffin. Serial histological sections were prepared, stained with Azan and examined microscopically. Additionally, three-dimensional models of the blocks were reconstructed using microphotographs of the sections. The genial spinal canal in the dentate specimen contained a neurovascular bundle, which branched into a nerve innervating the incisor and a neurovascular bundle, whereas that in the edentulous specimen contained some nerves for vestibular gingival innervation and a vascular bundle. The results suggest differences in the genial spinal canal between dentate and edentulous mandibles. Further research is needed to confirm this finding. Clin. Anat., 33:1102-1108, 2020. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Nicole Passia
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany
| | - Franziska Oberbillig
- Department of Biological and Material Sciences in Dentistry, Faculty of Health, School of Dentistry, Witten/Herdecke University, Witten, Germany
| | - Vlasios Goulioumis
- Department of Operative and Preventive Dentistry, Faculty of Health, School of Dentistry, Witten/Herdecke University, Witten, Germany
| | - Ella A Naumova
- Department of Biological and Material Sciences in Dentistry, Faculty of Health, School of Dentistry, Witten/Herdecke University, Witten, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany
| | - Wolfgang Arnold
- Department of Biological and Material Sciences in Dentistry, Faculty of Health, School of Dentistry, Witten/Herdecke University, Witten, Germany
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Abstract
Edentulism, defined as the complete loss of all dentition, is a worldwide phenomenon. Edentulism occurs because of biologic disease processes, such as dental caries, periodontal diseases, trauma, and oral cancer. Edentulism is accompanied by several comorbidities that can significantly influence an individual. Although the rate of edentulism is declining, the number of edentulous patients continues to rise because of the increase in population. The management of edentulous patient has been addressed since the early days of dentistry. This article describes complete dentures and their maintenance, and advanced technology in complete dentures, and in implant-retained and implant-supported prosthesis.
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Affiliation(s)
- Damian J Lee
- Advanced Prosthodontics Program, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, 305 West 12th Avenue, Room 2039L, Columbus, OH 43210, USA.
| | - Paola C Saponaro
- Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, 305 West 12th Avenue, Room 3005Q, Columbus, OH 43210, USA
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27
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Ten-year clinical outcome of single implant-retained mandibular overdentures—A prospective pilot study. J Dent 2019; 82:63-65. [DOI: 10.1016/j.jdent.2019.01.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 01/18/2019] [Accepted: 01/21/2019] [Indexed: 12/17/2022] Open
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Ewers R. The incisal foramen as a means of insertion for one of three ultra-short implants to support a prosthesis for a severely atrophic maxilla - A short-term report. Heliyon 2019; 4:e01034. [PMID: 30603683 PMCID: PMC6310776 DOI: 10.1016/j.heliyon.2018.e01034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/20/2018] [Accepted: 12/06/2018] [Indexed: 11/29/2022] Open
Abstract
As a continuation of our prospective cohort study for a total of 18 patients with 72 implants in severely atrophic maxillae corresponding to Cawood and Howell class V and VI (1988) [1] with four 4.0 × 5.0 mm ultrashort locking taper implants Ewers et al., 2018 [2], we now present a prospective cohort study with a total of 9 patients. The special feature of this newly modified study is the reduction of the number of implants to only three 4.0 × 5.0 mm or 4.5 × 6.0 mm or 5.0 × 6.0 mm calcium phosphate-coated Bicon Integra CP implants. Reducing the number of implants is possible by inserting the middle implant into the incisal foramen and the nasopalatine canal. All patients were restored with metal-free prostheses made of a glass fiber-reinforced hybrid resin material. Neither were any implants lost during the observation period, nor did any patient experience any sensory alteration due to the placement of an implant into the nasopalatine canal. Three implants were sufficient in all patients to stabilize their 12-unit prosthesis.
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Affiliation(s)
- Rolf Ewers
- Hospital of Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- CMF Implant Institute Vienna, Schumanngasse 15, 1180, Vienna, Austria1
- Corresponding author.
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Nogueira TE, Aguiar FMO, Esfandiari S, Leles CR. Effectiveness of immediately loaded single-implant mandibular overdentures versus mandibular complete dentures: A 1-year follow-up of a randomized clinical trial. J Dent 2018; 77:43-50. [DOI: 10.1016/j.jdent.2018.07.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/04/2018] [Accepted: 07/09/2018] [Indexed: 11/30/2022] Open
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Gu M, Lv L, Du F, Niu T, Chen T, Xia D, Wang S, Zhao X, Liu J, Liu Y, Xiong C, Zhou Y. Effects of thermal treatment on the adhesion strength and osteoinductive activity of single-layer graphene sheets on titanium substrates. Sci Rep 2018; 8:8141. [PMID: 29802306 PMCID: PMC5970187 DOI: 10.1038/s41598-018-26551-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 05/09/2018] [Indexed: 01/22/2023] Open
Abstract
In recent years, dental implants have become the preferred approach for the restoration of missing teeth. At present, most dental implants are made of pure titanium, and are affected by peri-implantitis and bone resorption, which usually start from the implant neck, due to the complex environment in this region. To address these issues, in this study we modified the surface of titanium (Ti) implants to exploit the antibacterial and osteoinductive effects of single-layer graphene sheets. Chemical vapor deposition (CVD)-grown single-layer graphene sheets were transferred to titanium discs, and a method for improving the adhesion strength of graphene on Ti was developed due to compromised adhesion strength between graphene and titanium surface. A thermal treatment of 2 h at 160 °C was found to enhance the adhesion strength of graphene on Ti to facilitate clinical transformation. Graphene coatings of Ti enhanced cell adhesion and osteogenic differentiation, and imparted antibacterial activity to Ti substrate; these favorable effects were not affected by the thermal treatment. In summary, the present study elucidated the effects of a thermal treatment on the adhesion strength and osteoinductive activity of single-layer graphene sheets on titanium substrates.
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Affiliation(s)
- Ming Gu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun Avenue South, Beijing, 100081, PR China
| | - Longwei Lv
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun Avenue South, Beijing, 100081, PR China
| | - Feng Du
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, 100871, PR China
| | - Tianxiao Niu
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, 100871, PR China
| | - Tong Chen
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun Avenue South, Beijing, 100081, PR China
| | - Dandan Xia
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun Avenue South, Beijing, 100081, PR China
| | - Siyi Wang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun Avenue South, Beijing, 100081, PR China
| | - Xiao Zhao
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun Avenue South, Beijing, 100081, PR China
| | - Jianzhang Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun Avenue South, Beijing, 100081, PR China
| | - Yunsong Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun Avenue South, Beijing, 100081, PR China. .,National Engineering Laboratory for Digital and Material Technology of Stomatology, National Clinical Research Center for Oral Disease, Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, PR China.
| | - Chunyang Xiong
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, 100871, PR China
| | - Yongsheng Zhou
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun Avenue South, Beijing, 100081, PR China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, National Clinical Research Center for Oral Disease, Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, PR China
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31
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Antunes JLF, Domaneschi C, Lemos CA. Noninferiority trials in oral medicine. Oral Dis 2018; 25:357-362. [PMID: 29766614 DOI: 10.1111/odi.12892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 05/09/2018] [Indexed: 11/28/2022]
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Kanazawa M, Tanoue M, Miyayasu A, Takeshita S, Sato D, Asami M, Lam TV, Thu KM, Oda K, Komagamine Y, Minakuchi S, Feine J. The patient general satisfaction of mandibular single-implant overdentures and conventional complete dentures: Study protocol for a randomized crossover trial. Medicine (Baltimore) 2018; 97:e10721. [PMID: 29768340 PMCID: PMC5976348 DOI: 10.1097/md.0000000000010721] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Mandibular overdentures retained by a single implant placed in the midline of edentulous mandible have been reported to be more comfortable and function better than complete dentures. Although single-implant overdentures are still more costly than conventional complete dentures, there are a few studies which investigated whether mandibular single-implant overdentures are superior to complete dentures when patient general satisfaction is compared. The aim of this study is to assess patient general satisfaction with mandibular single-implant overdentures and complete dentures. METHODS This study is a randomized crossover trial to compare mandibular single-implant overdentures and complete dentures in edentulous individuals. Participant recruitment is ongoing at the time of this submission. Twenty-two participants will be recruited. New mandibular complete dentures will be fabricated. A single implant will be placed in the midline of the edentulous mandible. The mucosal surface of the complete denture around the implant will be relieved for 3 months. The participants will then be randomly allocated into 2 groups according to the order of the interventions; group 1 will receive single-implant overdentures first and will wear them for 2 months, followed by complete dentures for 2 months. Group 2 will receive the same treatments in a reverse order. After experiencing the 2 interventions, the participants will choose one of the mandibular prostheses, and yearly follow-up visits are planned for 5 years. The primary outcome of this trial is patient ratings of general satisfaction on 100 mm visual analog scales. Assessments of the prostheses and oral health-related quality of life will also be recorded as patient-reported outcomes. The secondary outcomes are cost and time for treatment. Masticatory efficiency and cognitive capacity will also be recorded. Furthermore, qualitative research will be performed to investigate the factors associated with success of these mandibular denture types. Clinical outcomes, such as implant survival rate, marginal bone loss, and prosthodontic complications, will also be recorded. DISCUSSION The results of this randomized crossover trial will clarify whether mandibular single implants and overdentures for edentulous individuals provide better patient general satisfaction when compared to conventional complete dentures. TRIAL REGISTRATION This clinical trial was registered at the University Hospital Medical Information Network (UMIN) Center (UMIN000017883).
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Affiliation(s)
- Manabu Kanazawa
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Mariko Tanoue
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Anna Miyayasu
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Shin Takeshita
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Daisuke Sato
- Implant Center, Showa University Dental Hospital, Tokyo, Japan
| | - Mari Asami
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Thuy Vo Lam
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Khaing Myat Thu
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Ken Oda
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Yuriko Komagamine
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Shunsuke Minakuchi
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Jocelyne Feine
- Oral Health and Society Division, Faculty of Dentistry, McGill University, Quebec, Canada
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33
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Raes F, Eccellente T, Lenzi C, Ortolani M, Luongo G, Mangano C, Mangano F. Immediate functional loading of single implants: a multicenter study with 4 years of follow-up. J Dent Res Dent Clin Dent Prospects 2018; 12:26-37. [PMID: 29732018 PMCID: PMC5928471 DOI: 10.15171/joddd.2018.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 03/11/2018] [Indexed: 11/19/2022] Open
Abstract
Background. In the current scientific literature there are only few studies on the immediate functional loading of single implants. The aim of the present present study was to evaluate the 4-year survival rate, complication rate and peri-implant marginal bone loss (PIMBL) of immediately loaded single implants inserted in healed ridges and fresh post-extraction sites.
Methods. Six centers were involved in this prospective study. The surgical and prosthetic protocol was defined in detail, before the start of recruiting patients. Recruitment of patients and performance of surgeries took place between February 2012 and February 2013. Criteria for inclusion were single-tooth gaps in healed ridges and fresh post-extraction sockets. All the fixtures (Anyridge®, Megagen Corporation, Gyeongbuk, South Korea) were functionally loaded immediately after insertion and followed for a period of 4 years. Outcome measures were implant survival, complications and PIMBL.
Results. Forty-six patients (18‒73 years of age) were selected. In total, 57 fixtures were placed (10 in fresh post-extraction sockets). After 4 years of functional loading, only one fixture was lost; therefore, high survival rates (97.6% patient-based; 98.1% implant-based) were reported. In addition, a limited incidence of biologic (4.8% patient-based; 3.8% implant-based) and prosthetic (9.7% patient-based; 7.6% implant-based) complications was reported. The overall 4-year PIMBL amounted to 0.38±0.21 mm (healed ridges: 0.4±0.21 mm; fresh post-extraction sockets: 0.33±0.20 mm).
Conclusion. Loading single implants immediately seems to be a highly successful treatment modality. However, long-term data are needed to confirm these positive outcomes.
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Affiliation(s)
- Filiep Raes
- Professor, Department of Periodontology and Oral Implantology, University of Ghent, Belgium
| | | | | | | | - Giuseppe Luongo
- Professor, Department of Oral and Maxillofacial Surgery, Dental School, University of Naples, Italy
| | - Carlo Mangano
- Professor, Department of Dental Sciences, University Vita Salute San Raffaele, Milan, Italy
| | - Francesco Mangano
- Lecturer, Department of Surgical and Morphological Science, Dental School, University of Varese, Italy
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