Patient satisfaction and crestal bone changes with one-piece and two-piece single implant-retained mandibular overdenture: A randomized controlled clinical study

PURPOSE

The present study was done to assess patient satisfaction and crestal bone changes with one-piece and two-piece single implant-retained mandibular overdentures (SIMOs).

METHODS

The participants included in Group 1 (n=12) received one-piece SIMOs; the participants in Group 2 (n=12) received two-piece SIMOs.Scheduled follow-ups were done at 1 month and 1 year after implant placement. Patient satisfaction and crestal bone changes were evaluated. The data obtained were analyzed statistically with independent Student t-test.

RESULTS

Visual analogue scale (VAS) score for patient satisfaction with one-piece and two-piece SIMOs were statistically significant at 1-year of follow-up. The patient satisfaction level on the VAS score increased (38.1 to 51.1) with group one-piece SIMOs and two-piece SIMOs (36.6 to 46.8) at baseline to 1 month (P=0.13). The patient satisfaction level increased (38.1 to 56.6) with group one-piece SIMOs and two-piece SIMOs (36.6 to 52.2) at baseline to 1 year (P=0.03). At the 1 year follow-ups, group 1 had mean crestal bone loss of 0.80 ± 0.49 mm and group 2 had 1.24 ± 0.90 mm (P=0.16). Crestal bone loss was greater in the two-piece SIMOs group at 1 month and 1 year follow-ups, but statistically it was insignificant.

CONCLUSIONS

One-piece SIMOs seemed to be a viable treatment option with increased patient satisfaction on a VAS. Crestal bone loss was greater in the patients with two-piece SIMOs during follow-up. One-piece SIMOs was comparatively simple with less invasive procedures and needed fewer components,so considerable number of patients requiring implant retained dentures could be benefited.

Biological mechanisms underlying complications related to implant site preparation

Implant site preparation is a critical stage of implant surgery that may underpin various complications related to implant surgery. This review discusses the latest available scientific information on risk factors related to implant site preparation. The role of the drilling process in relation to the density of the available alveolar bone, the effects of insertion torque on peri-implant osseous healing, and implant-related variables such as macrodesign and implant-abutment connection are all factors that can influence implant success. Novel information that links osteotomy characteristics (including methods to improve implant initial stability, the impact of drilling speed, and increase of the implant insertion torque modifying the bone-implant interface) with the appropriate instrumentation techniques will be discussed, as well as interactions at the bone-biomaterial interface that may lead to biologic complications mediated by implant dissolution products.

Crestal Bone Changes and Patient Satisfaction with Single Implant-Retained Mandibular Overdentures with Dalla Bona and Locator Attachments with Immediate Loading Protocols. A Randomized Controlled Clinical Study

PURPOSE

There is no enough evidence present on the success of single implant-retained mandibular overdentures (SIMO) with Dalla Bona and Locator attachments. This study aims to compare crestal bone loss and patient satisfaction with SIMO with Dalla Bona and Locator attachment following immediate loading protocols.

MATERIAL AND METHODS

Twelve patients included in Group 1 received immediate SIMO with Dalla Bona attachments, and another twelve patients in Group 2 received immediate SIMO with Locator attachments in the mid symphyseal region. The follow-up was scheduled at 6 and 12 months after implant placement. The patient satisfaction with the denture was evaluated with the visual analog scale (VAS) score. The data obtained were statistically analyzed with the independent student t-test for intergroup comparison and repeated measures of ANOVA followed by Bonferroni's Post hoc analysis for intragroup comparison of mean crestal bone loss at a different time interval.

RESULTS

Ten patients each in both the groups were available for follow-up. Crestal bone loss at 6 months follow-up for Dalla Bona group was 0.42 ± 0.10 mm on the mesial side and 0.43 ± 0.14 mm on the distal side and at 1 year 1.54 ± 0.16 mm on the mesial side and 1.66 ± 0.13 mm on the distal side. The mean crestal bone loss at 6 months follow-up for Locator group was 0.48 ± 0.16 mm on the mesial side and 0.45 ± 0.11 mm on the distal side and at 1 year was 1.71 ± 0.22 mm on mesial side and 1.74 ± 0.28 mm on the distal side. There was difference in bone loss at 6 months (mesial: 0.06 mm, p = 0.327; distal:0.02 mm; p = 0.726) and at 1 year (mesial: 0.17 mm, p = 0.063; distal: 0.08 mm; p = 0.423) in between two groups but the difference was statistically insignificant. There was a significant difference found in the VAS score for patient satisfaction with SIMO with Dalla Bona attachments and Locator attachments at 6 months (54.2 vs. 51.8, p = 0.005) and 1 year (60.6 vs. 55.2, p = 0.005).

CONCLUSIONS

Patient satisfaction with SIMO with Dalla Bona attachments was higher during the follow-up. SIMO with Dalla Bona attachments had less crestal bone loss and less prosthetic complications when compared to Locator attachments, although the difference in the bone loss was statistically insignificant.

A systematic review and meta-analysis of the attachments used in implant-supported overdentures

AIM

To evaluate the survival rate, tissue response, and patient satisfaction of different attachments used in implant overdenture.

SETTINGS AND DESIGN

Systematic Review and Meta-analysis.

MATERIALS AND METHODS

Electronic search of peer-review articles published between 2001 and 2019 assessing the attachments used for implant-supported overdentures was done according to PRISMA Guidelies. The review evaluated sixteen articles related to survival of the attachments, the reaction of the soft and hard tissues along with repair and maintenance of the attachments, and overall performance of the overdenture attachments.

STATISTICAL ANALYSIS USED

There is statistically significant heterogeneity (Q =374.7403, df = 15, and P < 0.0001). The statistics of fixed-effect model reported an MD of - 0.0880 (95% CI = -0.1536; 0.0225).

RESULT

The review evaluated the 16 articles that met with the inclusion and search criteria. The studies were the combination of bar and ball attachments and their subtypes, magnetic and bar attachments, and locator in combination with other attachments. The meta-analysis of combined 16 studies reported acceptable heterogeneity among 16 studies (I 2 = 96%) and reported to be statistically significant (P < 0.01).

CONCLUSION

The survival rate of attachments was in the range of 95.8%-97.5% for bar, 96.2%-100% for ball, 90%-92% for magnet and locator attachments were in the range of 97% after a mean follow-up period of 3 years. The bar attachments reported moderate tissue reaction in the form of mucosal changes, gingival inflammation, and bone resorption. The locator attachments require higher maintenance and repair. The magnetic attachments produce higher bone resorption and readily displace under functional force. Patient satisfaction and compliance was higher for ball, locator, and bar attachments as well as low for magnetic attachment. Thus, the ball and locator attachments excellently perform in terms of survival rate, tissue response, and patient satisfaction.

Primary stability of narrow-diameter dental implants with a multiple condensing thread design placed in bone with and without osteotomes: An in vitro study

BACKGROUND

The authors hypothesized that there is no difference in the primary stability (PS) of multiple condensing thread design (MCTD) implants placed in simulated type-IV bone with and without using osteotomes.

PURPOSE

This in vitro study assessed the PS of narrow-diameter dental implants with MCTD placed in simulated soft (type-IV) bone with and without using osteotomes.

MATERIALS AND METHODS

Sixty MCT-designed implants (diameter: 3.0 mm; length: 11.5 mm) were placed using 800 rpm drilling speed in cellular rigid polyurethane foam bone-blocks that simulated type-IV bone. Prior to placement, the implants were divided into three groups (20 implants per group) depending upon the protocol used for osteotomy preparation-Group-1: Conventional drilling (CD); Group-2: CD followed by osseous condensation using a chisel-shaped tapered osteotome with maximum diameter of 3 mm; and Group-3: CD followed by osseous condensation using a cylindrical osteotome with maximum diameter of 3 mm. Abutments were connected to all implants and PS was recorded using resonance frequency analysis (RFA) and the periotest (PTV). Group comparisons were performed using analysis and Bonferroni post-hoc adjustment tests. Level of significance was set at P < .05.

RESULTS

There was no statistically significant difference in the RFA values for the MCT-designed implants placed in groups 1, 2, and 3 (59.85 ± 0.72, 59.67 ± 0.76 and 59.42 ± 0.92, respectively). There was no statistically significant difference in the PTV values for MCT-designed implants in groups 1, 2, and 3 (1.655 ± 0.82, 1.405 ± 0.57, and 1.078 ± 0.63, respectively).

CONCLUSION

The MCTD implants with narrow diameters have a high PS in artificial soft bone in vitro. Due to the condensation effect of the thread design, there is no need for additional condensation of the peri-osteotomy bone in order to improve implant stability.

Crestal bone-level changes and patient satisfaction with mandibular overdentures retained by one or two implants with immediate loading protocols: A randomized controlled clinical study

STATEMENT OF PROBLEM

Single-implant-retained overdentures are an alternative treatment option for an edentulous mandible. However, evaluation of their clinical performance with an immediate loading protocol is lacking.

PURPOSE

The purpose of this prospective randomized controlled clinical study was to evaluate crest bone-level changes and patient satisfaction with mandibular overdentures retained by 1 or 2 titanium-zirconium (Ti-Zr) implants with immediate loading protocols after 1 year.

MATERIAL AND METHODS

Thirty-six Ti-Zr implants were placed in 24 participants (single central implant in 12 participants and 2 interforaminal implants in 11 participants) by a single operator. LOCATOR attachments were used to retain the mandibular overdentures with an immediate loading protocol, and observations were made at 1 month and 1 year. Changes to the crestal bone level were evaluated with digital periapical radiographs. A 100-mm visual analog scale (VAS) was used to evaluate patient satisfaction. The Mann-Whitney U test was used to analyze the data.

RESULTS

At 1 month, the mean crestal bone loss was 0.23 mm in the 2-implant group (n=22) and 0.39 mm (P=.181) in the single-implant group (n=11). At 1 year, the bone loss was 0.67 mm in the 2-implant group and 0.88 mm (P=.248) in the single-implant group. The mean VAS score for patient satisfaction level increased from 38.3% to 49.7% for single-implant participants and from 40.5% to 54.8% for 2-implant participants 1 month after implant placement (P=.250) and from 38.3% to 54.5% for single-implant participants and from 40.5% to 58.9% for 2-implant participants after 1 year (P=.341).

CONCLUSIONS

Single-implant-retained mandibular overdentures with an immediate loading protocol may represent a viable treatment option considering crestal bone-level changes and patient satisfaction compared with 2-implant-retained mandibular overdentures after 1 year of follow-up.