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Debbarma L. Restoring Oral Health: Implant-Supported Full-Mouth Rehabilitation for an Edentulous Patient. Cureus 2024; 16:e66732. [PMID: 39268280 PMCID: PMC11391092 DOI: 10.7759/cureus.66732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2024] [Indexed: 09/15/2024] Open
Abstract
Edentulism, the loss of all the natural teeth, significantly impacts a patient's functional, aesthetic, and psychological well-being. Traditional dentures often fail to provide the required stability and functionality. Implant-supported full-mouth rehabilitation has emerged as an advanced solution, leveraging strategically placed dental implants to support fixed prostheses that mimic natural teeth in appearance and function. This case report details the comprehensive treatment of a 78-year-old male patient with complete edentulism, utilizing six implants in both the maxillary and mandibular arches. Following a five-month healing period, a series of precise prosthetic procedures, including abutment-level impressions, custom tray fabrication, and implant-level impressions, were performed to ensure optimal fit and functionality. The final prostheses provided significant improvements in masticatory efficiency, speech, and overall quality of life. The report underscores the transformative potential of implant-supported rehabilitation, highlighting high success rates, patient satisfaction, and the multifaceted benefits of restoring oral function and aesthetics with advanced dental technologies.
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Affiliation(s)
- Lisa Debbarma
- Prosthodontics, Rajasthan University of Health Sciences College of Dental Sciences, Jaipur, IND
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2
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Possebon APDR, Schuster AJ, Chagas-Júnior OL, Pinto LDR, Faot F. Immediate versus conventional loading of mandibular implant-retained overdentures: a 3-year follow-up of a randomized controlled trial. Clin Oral Investig 2023; 27:5935-5946. [PMID: 37612525 DOI: 10.1007/s00784-023-05205-w] [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: 10/01/2022] [Accepted: 08/11/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVES There is a scarcity of randomized clinical trials (RCT) that report medium- and long-term results and a lack of consensus in the literature on the predictability of immediately loaded unsplinted narrow diameter implants supporting mandibular overdentures. This RCT compared the performance of conventional (CL) and immediate loading (IL) of mandibular overdentures retained by two narrow-diameter implants for 3 years. MATERIALS AND METHODS Patients from an RCT treated with CL or IL were invited to attend to 2- and 3-year follow-ups. Clinical, radiographic, functional, and oral health-related quality of life parameters were evaluated. Prosthetic maintenance events, biological complications, and success and survival rates were also recorded. The data were tested by multilevel mixed-effects linear regression analysis and chi-squared tests. RESULTS The 1-year survival rates of 90% in the CL group and 85% in the IL group were maintained as no implants were lost between 1 and 3 years. The marginal bone loss (MBL) in the IL group was significantly lower after year 3 (-0.04; p < 0.01). Significant changes were found only for the intra-group comparisons in the third year of function: (i) CL and IL presented similar progression of implant stability, MBL, and posterior bone area resorption; (ii) while CL started deteriorating of masticatory function, IL still exhibited functional evolution and (iii) oral comfort domain in the CL and pain domain in the IL were improved. CONCLUSION Although IL experienced the lowest MBL after 3 years, the outcomes showed that both loading protocols result in predictable medium-term rehabilitation when monitored annually. CLINICAL RELEVANCE It can be expected that in the third year of function, patients with immediate loading may present more complaints related to general performance even with acceptable masticatory function and self-reported improvements in oral comfort.
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Affiliation(s)
- Anna Paula da Rosa Possebon
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Alessandra Julie Schuster
- School of Dentistry, Federal University of Pelotas, Gonçalves Chaves Street 457, Pelotas, RS, 96015-560, Brazil
| | - Otacílio Luiz Chagas-Júnior
- Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Luciana de Rezende Pinto
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Fernanda Faot
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil.
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3
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Chappuis-Chocano AP, Venante HS, da Costa RMB, Pordeus MD, Marcillo-Toala OO, Santiago JF, Porto VC. A systematic review and meta-analysis of the clinical performance of implant-supported overdentures retained by CAD-CAM bars. J Appl Oral Sci 2023; 31:e20230054. [PMID: 37646715 PMCID: PMC10501751 DOI: 10.1590/1678-7757-2023-0054] [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: 02/24/2023] [Revised: 06/07/2023] [Accepted: 07/10/2023] [Indexed: 09/01/2023] Open
Abstract
Currently, there is no consensus on the indications and clinical performance of implant-supported overdentures (IODs) involving computer-aided design and manufacturing (CAD-CAM) bars. OBJECTIVE To evaluate the performance of IODs involving CAD-CAM bars. METHODOLOGY A comprehensive search of studies published until May 2023 was conducted in many databases, including PubMed/MEDLINE, Web of Science, Cochrane Library, and SciELO, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The population, intervention, comparison, outcome (PICO) question was: "How do IODs retained by bars fabricated by CAD-CAM technology perform in daily clinical practice?" The meta-analysis included clinical studies based on effect size and a two-tailed null test with a 95% confidence interval (CI). RESULTS Ten studies were included in the meta-analysis. Among them, nine reported a 100% implant survival rate for all CAD-CAM milled bars. Complications were reported in two studies with CAD/CAM-milled titanium bars, and one study reported more fractures in soldered gold bars used in maxillary rehabilitation. However, no fractures were observed in IODs retained by PEEK and zirconia bars. According to six studies, biological complications, including peri-implantitis, were minimal in the BioHPP and PEEK bar groups, while no cases were reported in the titanium or zirconia bar groups. CAD-CAM-milled zirconia bars had higher plaque and bleeding indices compared with titanium bars, as evidenced by findings from five studies. All four studies that evaluated Oral Health Impact Profile (OHIP) scores showed a positive effect of IODs retained by CAD-CAM milled titanium bars on quality of life. Patient satisfaction and acceptance by prosthodontists were significantly high, according to the results of five studies. CONCLUSION Overdentures retained with CAD-CAM milled titanium bars show great potential for use in daily clinical practice. Moreover, patient and practitioner satisfaction was very high when this method was used.
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Affiliation(s)
- Ana Paula Chappuis-Chocano
- Universidade de São PauloFaculdade de Odontologia de BauruBauruSão PauloBrasilUniversidade de São Paulo, Faculdade de Odontologia de Bauru, Bauru, São Paulo, Brasil.
| | - Helena Sandrini Venante
- Universidade de São PauloFaculdade de Odontologia de BauruBauruSão PauloBrasilUniversidade de São Paulo, Faculdade de Odontologia de Bauru, Bauru, São Paulo, Brasil.
| | - Rodrigo Moreira Bringel da Costa
- Universidade de São PauloFaculdade de Odontologia de BauruBauruSão PauloBrasilUniversidade de São Paulo, Faculdade de Odontologia de Bauru, Bauru, São Paulo, Brasil.
| | - Mariana Domingues Pordeus
- Universidade de São PauloFaculdade de Odontologia de BauruBauruSão PauloBrasilUniversidade de São Paulo, Faculdade de Odontologia de Bauru, Bauru, São Paulo, Brasil.
| | - Oscar Oswaldo Marcillo-Toala
- Universidad de Especialidades Espíritu SantoSamborondónEcuadorUniversidad de Especialidades Espíritu Santo (UEES), Samborondón, Ecuador.
| | - Joel Ferreira Santiago
- Universidade de São PauloFaculdade de Odontologia de BauruBauruSão PauloBrasilUniversidade de São Paulo, Faculdade de Odontologia de Bauru, Bauru, São Paulo, Brasil.
| | - Vinícius Carvalho Porto
- Universidade de São PauloFaculdade de Odontologia de BauruBauruSão PauloBrasilUniversidade de São Paulo, Faculdade de Odontologia de Bauru, Bauru, São Paulo, Brasil.
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Tallarico M, Fiorillo L, Montanari M, Scrascia R, Cristache CM, Ferrari E, Casucci A, Xhanari E, Lupi SM, Ieria I, Baldoni E, Rodriguez y Baena R, Cervino G. One-Year Multicenter Randomised Controlled Trial Comparing OT Equator® and Locator Attachments to Retain an Early Loaded Implant Overdenture on Two Implants. Int J Biomater 2023; 2023:2745262. [PMID: 37457392 PMCID: PMC10348852 DOI: 10.1155/2023/2745262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 06/06/2022] [Accepted: 06/27/2023] [Indexed: 07/18/2023] Open
Abstract
This investigation aimed to compare the effectiveness of the OT Equator® (Rhein, Bologna, Italy) and the Locator attachment systems used to retain early loaded implant-retained overdentures. This study was designed as a multicenter randomised controlled trial of parallel groups. After implant placement, the patients were randomised to receive OT Equator® attachments in the test group or Locator attachments in the control group. The outcome measures were implant and prosthetic success and survival rates, any biological and technical complication, marginal bone loss, patients' satisfaction, and periodontal parameters. Overall, 42 patients were consecutively enrolled and treated. One implant was lost in the control group, while no implants were lost in the test group. No prostheses failed in both groups. Only a few complications were experienced in both groups. The main was represented by loss of retention of the attachments (retentive caps). The OT Equator® attachment showed statistically lower periodontal parameters. In conclusion, both attachment systems were suitable for overdenture implant retention.
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Affiliation(s)
| | - Luca Fiorillo
- School of Dentistry, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Messina 98125, Italy
- School of Dentistry, Aldent University, Tirana 1001, Albania
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, Naples 80121, Italy
- Department of Prosthodontics, Dr D. Y. Patil Dental College and Hospital, Dr D. Y. Patil Vidyapeeth, Pimpri, Pune 411018, India
| | | | | | - Corina Marilena Cristache
- Faculty of Midwifery and Medical Assisting, “Carol Davila” University of Medicine and Pharmacy, Bucharest 020021, Romania
| | | | | | - Erta Xhanari
- School of Dentistry, Aldent University, Tirana 1001, Albania
| | | | | | | | | | - Gabriele Cervino
- School of Dentistry, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Messina 98125, Italy
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5
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Gupta N, Bansal R, Shukla NK. The effect of ball versus locator attachment system on the performance of implant supported overdenture: A systematic review. J Oral Biol Craniofac Res 2023; 13:44-55. [PMID: 36406295 PMCID: PMC9673099 DOI: 10.1016/j.jobcr.2022.11.001] [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: 05/07/2022] [Revised: 09/07/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Abstract
Objective This systematic review was aimed to compare ball and locator attachment system on the basis of clinical and biomechanical performance of implant supported overdenture as well as biological and patient related outcomes. Material and methods Open and free electronic and manual searches were performed in digital databases including MEDLINE via PubMed, the Cochrane Database of Clinical Trials, and Scopus along with some other reliable sources. From the 667 retrieved records, 11 full-text controlled trials were included in this study. Risk of bias was assessed according to RoB 2.0 except for one RCT (economic evaluation), only assessed by CASP checklist. Results From the 11 retrieved studies, total 183 locator and 219 ball attachments were identified in 452 subjects of 30 yrs-95 yrs of age. Studies provided data about prosthodontic complications or maintenance (replacement or the activation of matrix and patrix part, loss of retention, fracture and relining of the prosthesis, fracture of the attachment and the survival probability), oral health impact profile, soft tissue parameters and periodontal complications, marginal bone loss, patient related outcome and cost of the attachment systems. Only 5 studies were assessed at low risk bias, while other 6 at moderate to high risk of bias. Conclusion Locator attachment system show lesser complications including loss of retention and lower maintenance appointments, lesser soft tissue, and periodontal complications than the ball attachment. Ball is better in terms of cost effectiveness. In other related outcomes, no significant differences were noted between ball and locator attachment.
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Affiliation(s)
- Nimmi Gupta
- Dpt. of Prosthodontics, Faculty of Dental Sciences, IMS, Banaras Hindu University, India
| | - Rajesh Bansal
- Dpt. of Prosthodontics, Faculty of Dental Sciences, IMS, Banaras Hindu University, India
| | - Neeteesh K. Shukla
- Dpt. of Orthodontics, Faculty of Dental Sciences, IMS, Banaras Hindu University, India
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6
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Grande F, Pozzan MC, Marconato R, Mollica F, Catapano S. Evaluation of Load Distribution in a Mandibular Model with Four Implants Depending on the Number of Prosthetic Screws Used for OT-Bridge System: A Finite Element Analysis (FEA). MATERIALS (BASEL, SWITZERLAND) 2022; 15:ma15227963. [PMID: 36431449 PMCID: PMC9699052 DOI: 10.3390/ma15227963] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/09/2022] [Accepted: 11/09/2022] [Indexed: 05/28/2023]
Abstract
In full-arch implant rehabilitations, when the anterior screw abutment channel compromises the aesthetic of the patient, the OT-Bridge system used with its Seeger rings may provide the necessary retention of the prosthesis. However, no studies have evaluated the forces generated at the Seeger level during loading. This Finite Element Analysis aims to investigate the mechanical behavior of Seeger rings in a mandibular model with four implants and an OT-Bridge system, used without one or two anterior prosthetic screws. A 400 N unilateral load was virtually applied on a 7 mm distal cantilever. Two different variables were considered: the constraint conditions using two or three screws instead of four and the three different framework materials (fiberglass reinforced resin, cobalt-chrome, TiAl6V4). The FEA analysis exhibited tensile and compressive forces on the Seeger closest to the loading point. With the resin framework, a tension force on abutment 3.3 generates a displacement from 5 to 10 times greater than that respectively expressed in metal framework materials. In a full-arch rehabilitation with four implants, the case with three prosthetic screws seems to be a safer and more predictable configuration instead of two. Considering the stress value exhibited and the mechanical properties of the Seeger, the presence of only two prosthetic screws could lead to permanent deformation of the Seeger in the screwless abutment closest to the loading point.
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Affiliation(s)
- Francesco Grande
- Department of Prosthodontics, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Via Nizza, 230, 10126 Torino, Italy
| | - Mario Cesare Pozzan
- Department of Prosthodontics, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy
| | - Raul Marconato
- Department of Prosthodontics, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy
| | - Francesco Mollica
- Department of Engineering, University of Ferrara, 44121 Ferrara, Italy
| | - Santo Catapano
- Department of Prosthodontics, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy
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7
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Gibreel M, Perea-Lowery L, Lassila L, Vallittu PK. Mechanical Properties Evaluation of Three Different Materials for Implant Supported Overdenture: An In-Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:6858. [PMID: 36234196 PMCID: PMC9572462 DOI: 10.3390/ma15196858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/07/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
Aim: the aim of this study was to compare the flexural strength and elastic modulus of three-dimensionally (3D) printed, conventional heat-cured, and high-impact implant-supported overdenture materials specimens. Materials and Methods: Thirty implant-supported overdenture materials specimens (bar-shaped, 65.0 × 10.2 × 5.1 ± 0.2 mm3) with one central hole were fabricated using 3D-printed, heat-cured conventional, and high-impact denture base resins (n = 10/group). Autopolymerizing acrylic resin was used to attach titanium matrix housings to the central holes of the specimens. A three-point bending test was conducted using a universal testing machine and a model analog with a crosshead speed of 5 mm/min. The indicative flexural strength and elastic modulus were recorded. Data were statistically analyzed using analysis of variance (ANOVA) and the Tukey tests at α = 0.05. Results: One-way ANOVA revealed a significant effect of denture base material on the flexural strength (p < 0.001) but not on the elastic modulus (p = 0.451) of the evaluated materials. The flexural strength of the 3D-printed specimens (95.99 ± 9.87 MPa) was significantly higher than the conventional (77.18 ± 9.69 MPa; p < 0.001) and high-impact ones (82.74 ± 7.73 MPa; p = 0.002). Conclusions: The maximum flexural strength was observed in the 3D-printed implant-supported overdenture material specimens, which might indicate their suitability as an alternative to the conventionally fabricated ones. Flexural strength and elastic modulus of conventional and high-impact heat-cured implant-supported overdenture materials specimens were comparable.
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Affiliation(s)
- Mona Gibreel
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku, 20520 Turku, Finland
| | - Leila Perea-Lowery
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku, 20520 Turku, Finland
| | - Lippo Lassila
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku, 20520 Turku, Finland
| | - Pekka K. Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku, 20520 Turku, Finland
- City of Turku Welfare Division, Oral Health Care, Puolalankatu 5, 20101 Turku, Finland
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Kamonkhantikul K, Homsiang W, Arksornnukit M. Brushing effect on the retentive force of retentive inserts in three denture attachments: An in vitro study. J Prosthet Dent 2022; 128:487.e1-487.e12. [DOI: 10.1016/j.prosdent.2022.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 11/28/2022]
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9
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Ikbal LK, Duygu K, Ravza E, Zeynep K, Kerem K. A 5-Year Retrospective Study Evaluating Periodontal Health and Oral Health-Related Quality of Life of Implant-Supported Overdentures With Locator and Magnetic Attachments. J ORAL IMPLANTOL 2021; 47:303-309. [PMID: 32870316 DOI: 10.1563/aaid-joi-d-20-00064] [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] [Indexed: 11/22/2022]
Abstract
This study compared peri-implant vertical bone loss, the periodontal index, prosthodontic maintenance requirements and oral health-related quality of life (OHQoL) of patients using mandibular implant-supported overdentures with 2 different attachment systems after an average of 5 years of use. Sixteen mandibular overdenture patients with magnet attachments (group 3), 24 with implant-supported mandibular overdentures with Locator attachments (group 2), and 25 conventional complete denture patients (group 1) were included in the study. The existing at least 5 years old dentures of all patients were evaluated for prosthodontic maintenance by the same prosthodontist and the patients were administered the oral health impact profile-14-Turkish version (OHIP-TR-14) questionnaire. Peri-implant tissue health was evaluated clinically in terms of plaque scores, bleeding scores, probing depth, and gingival index. Radiographic evaluation was performed in terms of peri-implant vertical bone loss. Radiographic evaluations were performed 5 years after overdenture insertion. There were no statistically significant differences between the groups in terms of total OHIP-TR-14 scores (P > .05). Although the average vertical bone resorption measured in group 2 at the end of 5 years was 1.38 mm, there was an average vertical bone loss of 1.45 mm in group 3, but this difference was not statistically significant (P > .05). Among the periodontal health indicators, there were no statistically significant differences in the mean values for periodontal indexes. According to results of the study, there were no differences in peri-implant vertical bone loss in groups 2 and 3, in periodontal health in mandibular overdentures with groups 2 and 3, or between total OHIP-TR-14 scores of patients in all groups.
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Affiliation(s)
| | - Kilic Duygu
- Department of Periodontology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Eraslan Ravza
- Department of Periodontology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey.,Ortoperio Dental Clinic, Kayseri, Turkey
| | - Karacalar Zeynep
- Department of Prosthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Kilic Kerem
- Department of Prosthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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Acampora R, Montanari M, Scrascia R, Ferrari E, Pasi M, Cervino G, Meloni SM, Lumbau AI, Xhanari E, Koshovari A, Tallarico M. 1-Year Evaluation of OT Bridge Abutments for Immediately Loaded Maxillary Fixed Restorations: A Multicenter Study. Eur J Dent 2021; 15:290-294. [PMID: 33622005 PMCID: PMC8195625 DOI: 10.1055/s-0040-1716632] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective
Preliminary data on survival and success rates of immediately loaded, maxillary, screw-retained, implant-supported, fixed restorations delivered on narrow and low-profile OT Equator abutments (OT Bridge, Rhein’83) were evaluated.
Materials and Methods
This retrospective study evaluated data collected from patients rehabilitated with OT Bridge prosthetic concept between November 2017 and February 2019 in six different centers. Outcome measures were implant and prosthetic survival rates, biological and technical complications, marginal bone loss (MBL), oral health impact profile (OHIP), bleeding on probing, and plaque index.
Results
A total of 76 implants were inserted in 14 patients. Patients were followed for a mean period of 15.8 months (range = 12–24). All the patients receive OT Equator (Rhein'83) as intermediate abutments. One year after loading, one implant failed (1.3%). None of the prosthesis failed. One prosthetic complication was experienced in one patient. Three out of 76 implants were connected to the prosthetic framework using only the Seeger system, without screw. Difference in OHIP values was statistically significant (71.9 ± 8.5;
p
= 0.000). One year after loading, MBL was 0.21 ± 0.11 mm and
p-
value was 0.000. One year after loading, 8.7% of the examined implant sites present positive bleeding on probing, while 6.4% of the implant sites presented plaque.
Conclusion
The OT Equator abutments (Rhein'83) showed successful results when used to support maxillary fixed dental prosthesis delivered on four to six implants. High implant and prosthetic survival rates, very low complications, high patient satisfaction, and good biological parameters, including only 0.2 mm of bone remodeling were experienced one year after function. Further studies are needed to confirm these preliminary results.
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Affiliation(s)
| | | | | | | | - Massimo Pasi
- Department of Dental, CLMOPD Ateneo Vita-Salute San Raffaele, Milan, Italy
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, School of Dentistry, University of Messina, Policlinico G. Martino, Via Consolare Valeria, Messina, Italy
| | - Silvio Mario Meloni
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Aurea Immacolata Lumbau
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Erta Xhanari
- Departament of Implantology and Prosthetic Aspects, Master of Science in Dentistry Program, Aldent University, Tirana, Albania
| | - Alba Koshovari
- Departament of Implantology and Prosthetic Aspects, Master of Science in Dentistry Program, Aldent University, Tirana, Albania
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11
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Aldhohrah T, Mashrah MA, Wang Y. Effect of 2-implant mandibular overdenture with different attachments and loading protocols on peri-implant health and prosthetic complications: A systematic review and network meta-analysis. J Prosthet Dent 2021; 127:832-844. [PMID: 33546861 DOI: 10.1016/j.prosdent.2020.12.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/17/2020] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Abstract
STATEMENT OF PROBLEM A systematic review of the effect of different overdenture attachments with different loading protocols on peri-implant health is lacking. PURPOSE The purpose of this systematic review and network meta-analysis was to evaluate the effect of different overdenture attachments with delayed or immediately loaded 2-implant-retained mandibular overdentures on peri-implant tissue health. MATERIAL AND METHODS A comprehensive search of the PubMed, EMBASE, and Cochrane library was conducted to identify eligible randomized controlled trials (RCTs). The outcomes were marginal bone loss, probing depth, plaque index, bleeding on probing, implant survival rate, and prosthetic complications. The Bayesian network meta-analysis accompanied by a random effect model and 95% credible intervals was calculated. RESULTS Sixteen RCT (n=599 participants receiving 1198 dental implants) were included. Five common overdenture attachment systems with delayed or immediate loading were compared. The difference in marginal bone loss and probing depth was not statistically significant when comparing different overdenture attachments with different loading protocols. The rank probability test showed that bar+ immediate loading ranked highest (63.8%) in terms of marginal bone loss, whereas ball+ delayed loading (73.3%) ranked highest in terms of probing depth. The implant survival rate was 100% for the LOCATOR+ delayed loading, resilient telescopic+ delayed loading, and magnet+ immediate loading; however, bar+ delayed loading, ball+ delayed loading, magnet+ delayed loading, LOCATOR+ immediate loading, ball+ immediate loading, and bar+ immediate loading had survival rates of 99.1%, 98.8%, 96.0%, 94.7%, 93.1%, and 91.2%, respectively. CONCLUSIONS All types of overdenture attachment with immediate loading or delayed loading had a similar effect on peri-implant health. Bar+ immediate loading was associated with the least marginal bone loss, whereas ball+ delayed loading showed the least probing depth.
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Affiliation(s)
- Taghrid Aldhohrah
- Postgraduate student, Department of Prosthodontic, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University and Guangdong Key Laboratory of Stomatology, Guangzhou, Guangdong, PR China
| | - Mubarak Ahmed Mashrah
- Assistant professor, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, PR China
| | - Yan Wang
- Professor, Department of Prosthodontic, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University and Guangdong Key Laboratory of Stomatology, Guangzhou, Guangdong, PR China.
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12
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Comparative Analysis of the Stability of Prosthetic Screws under Cyclic Loading in Implant Prosthodontics: An In Vitro Study. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11020622] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background: To compare the loss of preload in absence of loading and after a fixed number of cyclic loadings on 7-mm distal cantilever in two different connection systems using all-on-four prosthetic model. Methods: Two equal models of an edentulous mandible rehabilitated with all-on-four technique with two types of abutment system (MUA and OT-Bridge) supporting a hybrid prosthesis, were used. Initial torque values of the prosthetic fixing screw, after ten minutes from initial screw tightening and after 400,000 repeated loadings were registered using a mechanical torque gauge. Differences between initial and final torque values were reported for each anchoring system and the two systems were finally compared. Results: No statistically significant differences regarding the loss of preload between MUA and OT-Bridge system were found after 400,000 cyclic loadings; however, in MUA system it was found between anterior and posterior implant screws. A significant difference in preload loss was found only for MUA system comparing the initial screw torque to that measured after 10 min from the tightening in absence of cyclic loadings. Conclusions: Within the limits of the present study, MUA and OT-Bridge may be considered reliable prosthetic anchoring systems able to tolerate repeated cyclic occlusal loads on distal cantilever in all-on-four rehabilitation model without any significant loss of preload in screw tightening.
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Alfarsi MA, Shaik S. Four narrow dental implants and conventionally cast bar-supported removable hybrid acrylic complete denture as a therapeutic modality for terminal dentition. Clin Case Rep 2021; 9:326-336. [PMID: 33489180 PMCID: PMC7813059 DOI: 10.1002/ccr3.3525] [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: 08/07/2020] [Revised: 10/09/2020] [Accepted: 10/19/2020] [Indexed: 12/03/2022] Open
Abstract
The report portrays four narrow implants and cast bar-supported removable hybrid acrylic complete dentures and other terminal dentition treatment options in the maxilla. The therapeutic module could be efficient and satisfactory to patients.
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Affiliation(s)
- Mohammed A. Alfarsi
- Deptartment of Prosthetic DentistryCollege of DentistryKing Khalid UniversityAbhaSaudi Arabia
| | - Sharaz Shaik
- Deptartment of Prosthetic DentistryCollege of DentistryKing Khalid UniversityAbhaSaudi Arabia
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A One-Year, Multicenter, Retrospective Evaluation of Narrow and Low-Profile Abutments Used to Rehabilitate Complete Edentulous Lower Arches: The OT Bridge Concept. PROSTHESIS 2020. [DOI: 10.3390/prosthesis2040033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Purpose: To evaluate preliminary data on survival and success rates of immediately loaded, screw-retained, restorations delivered on lower arches using narrow and low-profile OT Equator abutments. Methods: This retrospective study analyzed data of patients rehabilitated with OT Bridge (fixed prosthetic system built on OT Equator) prosthetic concept from November 2017 to February 2019 in five different centers. Outcome measures were implant and prosthetic survival rates, biological and technical complications, marginal bone loss (MBL), oral health impact profile (OHIP), bleeding on probing, and plaque index. Results: A total of 60 implants were inserted in 12 patients. Patients were followed for a mean period of 15.8 months (range 12–24). All the patients received OT Equator as intermediate abutments. Four out of 60 implants were connected to the prosthetic framework using only the Seeger system, without a screw. One year after loading, three implants failed (implant survival rate of 95.0%) in two patients. No prosthesis failed and no major biological and technical complications were experienced. One year after initial loading, the marginal bone level was 0.32 ± 0.2 mm. The OHIP before treatment was 87.7 ± 6.0. One year after treatment, OHIP was 23.6 ± 1.2. The difference was statistically significant (64.1 ± 7.2; p = 0.0000). One year after loading, 8.9% of the examined implant sites present positive bleeding on probing, while 5.8% of the implant sites presented plaque. Conclusions: The OT Equator abutments showed successful results when used to support mandible fixed dental prosthesis delivered on 4–6 implants. Whole prosthetic survival and success rates, high patient satisfaction, and good biological parameters were experienced one year after function. Further prospective studies are needed to confirm these preliminary results.
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Clinical Versatility of the Facility-Equator Implant System as Mandibular Overdenture Retainers. Case Rep Dent 2020; 2020:8823547. [PMID: 33312740 PMCID: PMC7719493 DOI: 10.1155/2020/8823547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 11/17/2022] Open
Abstract
The use of mandibular overdentures (MO) for the rehabilitation of totally edentulous individuals with limited bone availability is widespread and has proven clinical success. Narrow diameter implants (NDI) are available on the market as MO retainers to solve problems related to limited bone availability and bone thickness, providing a low-cost, minimally invasive treatment option. This technique evolved over the years, and changes frequently involved the number of implants used as MO retainers, as the adoption of a smaller number of implants can generate biomechanical disadvantages, contributing to the increased stress in peri-implant tissues, which may accelerate marginal bone loss (MBL), in addition to reducing masticatory capacity and satisfaction with rehabilitation. Some studies pointed out that the use of 3 or more implants as MO retainers improves the biomechanics. Thus, the objective of this study was to report 3 different clinical cases where 3 or more NDI were adopted to retain mandibular overdentures in association with diverse loading protocols: (i) 3 implants adopting conventional loading, (ii) 4 implants using progressive loading, and (iii) 4 implants with hybrid loading. The case with 4 implants and progressive loading showed a slight worsening of masticatory function at 1 year, in addition to a more pronounced MBL compared to other cases, but with improvements in satisfaction and oral health-related quality of life. Thus, NDI can be used as MO retainers with predictability and clinical success, using different numbers of implants and loading protocols.
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Schmidt MB, Rauch A, Schwarzer M, Lethaus B, Hahnel S. Combination of Digital and Conventional Workflows in the CAD/CAM-Fabrication of an Implant-Supported Overdenture. MATERIALS 2020; 13:ma13173688. [PMID: 32825488 PMCID: PMC7503874 DOI: 10.3390/ma13173688] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/09/2020] [Accepted: 08/18/2020] [Indexed: 01/19/2023]
Abstract
Completely digital workflows for the fabrication of implant-supported removable restorations are not yet common in clinical dental practice. The aim of the current case report is to illustrate a reliable and comfortable workflow that reasonably merges conventional and digital workflows for the CAD/CAM-fabrication of implant-supported overdentures. The 53-year old patient was supplied with a digitally processed complete denture in the upper jaw and, simultaneously, with an overdenture supported by four interforaminal implants in the lower jaw. The overdenture included a completely digitally processed and manufactured alloy framework that had been fabricated by selective laser sintering. The case report indicates that digital manufacturing processes for extensive and complex removable restorations are possible. However, as it is currently not yet possible to digitally obtain functional impressions, future developments and innovations might focus on that issue.
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Affiliation(s)
- Michael Benno Schmidt
- Clinic for Prosthodontics and Dental Materials Science, University of Leipzig, 04103 Leipzig, Germany; (A.R.); (S.H.)
- Correspondence:
| | - Angelika Rauch
- Clinic for Prosthodontics and Dental Materials Science, University of Leipzig, 04103 Leipzig, Germany; (A.R.); (S.H.)
| | - Marcus Schwarzer
- Flemming Dental Tec GmbH, Dental Technology Center, 04317 Leipzig, Germany;
| | - Bernd Lethaus
- Clinic for Oral and Maxillofacial Surgery, University of Leipzig, 04103 Leipzig, Germany;
| | - Sebastian Hahnel
- Clinic for Prosthodontics and Dental Materials Science, University of Leipzig, 04103 Leipzig, Germany; (A.R.); (S.H.)
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Implant-Supported Prosthetic Therapy of an Edentulous Patient: Clinical and Technical Aspects. PROSTHESIS 2020. [DOI: 10.3390/prosthesis2030013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The purpose of this article is to show how to implement an implant-supported prosthetic overdenture using a digital workflow. Esthetic previewing using a specific software, guided-surgery, construction of the prosthesis, and the esthetic finalization are described in this article. Patients suffering from severe loss of bone and soft tissue volume could benefit from the construction of an overdenture prosthesis as a feasible therapeutic choice for functional and esthetic issues of the patient.
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Fiorillo L, Cervino G, Russo D, Itro A, Laino L, Cicciù M. Transcortical bone capillary vessels network: implication on the maxillofacial district. ACTA ACUST UNITED AC 2020; 69:309-316. [PMID: 32407058 DOI: 10.23736/s0026-4970.20.04294-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The field of medicine takes steps forward every day. Although some aspects of our organism seem clear, scientific discoveries also affect fields such as anatomy. Recently, transcortical vessels (TCVs) have been debated, although it was thought that cortical bones were not interested by these structures. This would upset some concepts of oral surgery, maxillofacial surgery, periodontics and implantology. EVIDENCE ACQUSITION In this study an analysis of the literature on this topic was carried out, and it is proposed to understand the possible implications of TCVs to the oral health. EVIDENCE SYNTHESIS Being a current topic, the aim of the study is to promote research in this field, leading to the evidence of these anatomical structures in the maxillofacial district. This study is of a prospective type, there are no other results that speak of these vessels in the maxillofacial district, waiting for a histological study. CONCLUSIONS The purpose of the study, therefore, is to shed light on this topic, so that the research could move in this direction.
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Affiliation(s)
- Luca Fiorillo
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, Messina, Italy.,Department of Biomedical and Surgical and Biomedical Sciences, Naples University, Naples, Italy
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, Messina, Italy
| | - Diana Russo
- Department of Biomedical and Surgical and Biomedical Sciences, Naples University, Naples, Italy
| | - Annalisa Itro
- Department of Biomedical and Surgical and Biomedical Sciences, Naples University, Naples, Italy
| | - Luigi Laino
- Department of Biomedical and Surgical and Biomedical Sciences, Naples University, Naples, Italy
| | - Marco Cicciù
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, Messina, Italy -
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Gandhi PV, Kalsekar BG, Patil AA, Kandi NS. A low-profile universal attachment system with housing welded to metal reinforcement framework to retain mandibular implant overdenture: A clinical report. J Indian Prosthodont Soc 2019; 19:374-378. [PMID: 31649448 PMCID: PMC6803799 DOI: 10.4103/jips.jips_129_19] [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: 04/02/2019] [Revised: 05/29/2019] [Accepted: 09/11/2019] [Indexed: 11/04/2022] Open
Abstract
Literature has proved that implant-retained overdenture is one of the best prosthetic options in the rehabilitation of complete edentulism. Tissue-supported implant-retained overdentures have been an appropriate treatment modality for atrophic mandibular ridges. In this case report, the patient presented with Class I maxillomandibular relationship and Class II Prosthodontic Diagnostic Index. The patient was concerned about esthetics as well as the retention of the lower denture. Taking into consideration the above concerns, an implant-retained mandibular overdenture was the chosen treatment modality. There are numerous attachment systems that have been used to improve the retention, stability, and support of implant-retained overdenture. Every attachment system has its own set of advantages. The OT Equator is a new line of low-profile attachment which is a radically modified OT-CAP Normo. The rationale for using this attachment is that it is considered the smallest attachment system available with the least overall dimension. It is a resilient and self-aligning attachment system which can be used in limited inter-arch space situation. OT equator derives its name from the OT Dental Laboratory (Bologna, Italy) used as a brand name. Considering these advantages, this was the chosen attachment and proved beneficial in terms of both patient satisfaction and the overall success of the treatment.
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Affiliation(s)
- Paresh Vasant Gandhi
- Department of Prosthodontics and Crown and Bridge, Bharati Vidyapeeth Deemed University Dental College and Hospital, Pune, Maharashtra, India
| | - Bhagyashree Gurunath Kalsekar
- Department of Prosthodontics and Crown and Bridge, Bharati Vidyapeeth Deemed University Dental College and Hospital, Pune, Maharashtra, India
| | - Abhijit Ashok Patil
- Department of Prosthodontics and Crown and Bridge, Bharati Vidyapeeth Deemed University Dental College and Hospital, Pune, Maharashtra, India
| | - Nikita Shirish Kandi
- Department of Prosthodontics and Crown and Bridge, Bharati Vidyapeeth Deemed University Dental College and Hospital, Pune, Maharashtra, India
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Ortensi L, Martinolli M, Borromeo C, Ceruso FM, Gargari M, Xhanari E, Tallarico M. Effectiveness of Ball Attachment Systems in Implant Retained- and Supported-Overdentures: A Three- to Five-Year Retrospective Examination. Dent J (Basel) 2019; 7:dj7030084. [PMID: 31480546 PMCID: PMC6784476 DOI: 10.3390/dj7030084] [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: 06/19/2019] [Revised: 07/31/2019] [Accepted: 08/14/2019] [Indexed: 02/03/2023] Open
Abstract
Purpose: To evaluate implant and prosthetic survival rates, complications, patient satisfaction, and biological outcomes of patients rehabilitated with a ball attachment system for implant retained- and supported-overdentures (IOV), which was in function for 3 to 5 years. Methods: This retrospective study evaluated data collected from patients treated between April 2001 and May 2018 with IOV on splinted and non-splinted implants and a ball attachment system. Patients were followed for 36 to 206 months (mean follow-up was 128.1 ± 51.9 months). Data were collected at the 3- and 5-year follow-up examination. Outcome measures were implant and prosthetic survival rates, technical complications, marginal bone loss (MBL), oral health impact profile (OHIP), and periodontal parameters (bleeding on probing and plaque index). Results: A total of 46 patients (16 males and 30 females) with 124 implants were included in this study. Twenty-five implant-retained overdentures were delivered on 53 unsplinted implants, while the other 21 patients received an implant-supported overdentures and the implants were splinted. At the five-year follow-up examination, one implant and one prosthesis failed in the unsplinted group, resulting in a cumulative survival rate of 97.8% at the patient level. Two minor technical complications were experienced. Conclusions: Implant overdenture retained or supported by ball attachment systems showed high implant and prosthetic survival and success rates. A low number of complications, high patient satisfaction, and successful biological parameters were experienced in the mid-term follow-up. Data need to be confirmed by further randomized trials.
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Affiliation(s)
| | | | | | | | - Marco Gargari
- Department of Clinical Science and Translational Medicine, University of Rome, Tor Vergata, 00100 Rome, Italy
| | - Erta Xhanari
- Department of Implantology and Prosthetic Aspects, Aldent University, 1001 Tirana, Albania
- Private Practice, 1001 Tirana, Albania
| | - Marco Tallarico
- Department of Implantology and Prosthetic Aspects, Aldent University, 1001 Tirana, Albania
- Private Practice, 00151 Rome, Italy
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