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Journal of the American Dental... Aug 2019Management of the full and partially edentulous arch requires an understanding regarding the amount of vertical and horizontal restorative space that is needed for...
BACKGROUND
Management of the full and partially edentulous arch requires an understanding regarding the amount of vertical and horizontal restorative space that is needed for different types of dental implant prostheses. Failure to design a prosthetic construct without considering space issues can result in a rehabilitation with diminished stability, poor esthetics, and inadequate contours. Therefore, available restorative volume must be computed before initiating therapy to ensure proper prosthesis design.
TYPES OF STUDIES REVIEWED
The authors searched the dental literature for articles that addressed space requirements for different types of dental implant prostheses and found a few on this subject.
RESULTS
The dental literature indicates there is a 3-dimensional hierarchy of restorative space necessary for different types of implant constructs. The minimum amount of vertical space required for implant prostheses is as follows: fixed screw-retained (implant level): 4 through 5 millimeters; fixed screw-retained (abutment level): 7.5 mm; fixed cement-retained: 7 through 8 mm; unsplinted overdenture: 7mm; bar overdenture: 11 mm; and fixed screw-retained hybrid: 15mm. These dimensions represent the minimal amount of vertical rehabilitative space that can accommodate the above implant prostheses. With respect to horizontal space, computations are needed to account for the discrepancy between an implant and tooth position.
CONCLUSIONS AND PRACTICAL IMPLICATIONS
Restorative spaces for each type of prostheses are restoration specific and should be considered during treatment planning to facilitate proper case selection and enhance patient satisfaction.
Topics: Dental Implantation; Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture, Overlay; Humans
PubMed: 31352966
DOI: 10.1016/j.adaj.2019.04.015 -
Journal of Oral Science Oct 2021The recent literature on maxillary implant overdenture (IOD) was reviewed in order to clarify its predictability and establish treatment guidelines. Electronic searches... (Review)
Review
The recent literature on maxillary implant overdenture (IOD) was reviewed in order to clarify its predictability and establish treatment guidelines. Electronic searches were performed using PubMed, and articles about maxillary IOD written after 1990 were reviewed, focusing on the following items: I. implant survival rate, II. maxillary IOD survival rate, III. number of implants, IV. attachment type, V. follow-up period, VI. implant system, and VII. opposing dentition. The review revealed an implant survival rate of 61-100% and an overdenture survival rate of 72.4-100%. The attachments used included bars, balls, locators, and telescope crowns. The minimum and maximum observation periods were 12 months and 120 months, respectively, and the number of implants used for supporting IOD ranged from 2 to 8. At present, there is no strong evidence to indicate that maxillary IOD is clearly superior for all the items examined. However, the existing data indicate that maxillary IOD has almost the same therapeutic effect as fixed implant superstructures, and is a treatment option that can be actively adopted for patients in whom fixed superstructures cannot be applied for various reasons.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Overlay; Humans; Maxilla
PubMed: 34408111
DOI: 10.2334/josnusd.21-0087 -
Journal of Indian Prosthodontic Society 2021This systematic review aimed to compare different attachment systems used in mandibular implant supported overdentures by assessing outcomes such as prosthodontic... (Meta-Analysis)
Meta-Analysis Review
AIM
This systematic review aimed to compare different attachment systems used in mandibular implant supported overdentures by assessing outcomes such as prosthodontic maintenance and complication, peri implant tissue changes, retention, and patient satisfaction for optimum selection of attachment system.
SETTINGS AND DESIGN
This systematic review conducted following Preferred Reporting Items for the Systematic Review and Meta Analysis (PRISMA) guidelines.
MATERIALS AND METHODS
A systematic electronic literature search was conducted through PubMed, The Cochrane Central Register of Controlled Trials (Central), and Science direct. A hand search was also performed for individual journals and reference lists of selected studies. Randomized controlled clinical trials and crossover clinical trials from 2010 to 2020 with follow up of more than 1 year were included. The Cochrane Collaboration's tool was used for assessing the risk of bias of included studies.
STATISTICAL ANALYSIS USED
The statistical meta analysis was performed using Review Manager (RevMan) [computer program]. Version 5.4. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboation, 2020.
RESULTS
Six studies that met the inclusion criteria possess the low risk of bias with follow up of more than 1 year were included in this systematic review. Out of four outcomes, meta analysis was performed for prosthodontic maintenance and peri implant tissue changes. Due to the limited availability of data, retention and patient satisfaction were reviewed systematically without meta analysis. The result of meta analysis for ball versus magnet attachment showed statistically significant differences in prosthodontic complications and maintenance, and ball attachment reported fewer complications than the locator attachment (risk ratio [RR] =0.55, confidence interval [CI] =95%, P = 0.03). Peri implant tissue changes were analyzed in the included studies as probing depth and marginal bone loss. The result of meta analysis for probing depth showed no statistically significant difference between bar versus telescopic type of attachment (RR = 0.20, CI = 95%, P = 0.74). The meta analysis results for marginal bone loss showed no statistically significant difference between bar versus telescopic type of attachment (mean difference = 0.35, CI = 95%, P = 0.10).
CONCLUSION
It can be concluded from the current review that bar attachment provided the most superior retention. The telescopic attachment system not only showed the most favorable patient's satisfaction but also reported the least peri implant mucosal changes. The ball attachment system is a favorable choice for limited inter arch space and parallel implant placement.
Topics: Cross-Over Studies; Denture, Overlay; Humans; Jaw, Edentulous; Mandible; Patient Satisfaction
PubMed: 34810359
DOI: 10.4103/jips.jips_158_21 -
Primary Dental Journal Sep 2020Whilst increasing numbers of older people retain natural teeth, a sizable proportion of older people are still edentate. Replacement of missing teeth is important for...
Whilst increasing numbers of older people retain natural teeth, a sizable proportion of older people are still edentate. Replacement of missing teeth is important for function, aesthetics and to facilitate social interactions. The process of providing oral rehabilitation for edentate older adults can be challenging, but clinicians can utilise a number of treatment options including removable or implant retained prostheses. In this article, complete denture construction will be described using both conventional and copy denture techniques. Recent innovations in the process for constructing complete dentures using computer aided design and manufacturing (CAD-CAM) techniques will also be discussed. Dental implants can be used to help retain removable complete prostheses for edentate patients and the use of implant-retained overdentures is presented as a treatment alternative.
Topics: Aged; Aged, 80 and over; Computer-Aided Design; Dental Prosthesis, Implant-Supported; Denture, Complete; Denture, Overlay; Humans
PubMed: 32940588
DOI: 10.1177/2050168420943410 -
Journal of Oral Science Oct 2022The purpose of this review is to search for complications of dental implant superstructures and consider the issues involved. This narrative review was performed by... (Review)
Review
The purpose of this review is to search for complications of dental implant superstructures and consider the issues involved. This narrative review was performed by searching through PubMed databases and review articles that were published after 1990. Misfitting of the superstructure can result in loosening of screws, reduced preload, and in some cases, significant stress around the implant. External connection modalities and single implant prostheses have been reported to have more loose or broken abutment screws. In addition, when zirconia abutment was used for platform shifting, the rate of fracture of the abutment was considered to be high. Additionally, it was reported that men were significantly at an increased risk of abutment fracture. As for the retention mechanism of implant overdenture, stud attachment (Locator type) should receive more attention to wear and damage of retention parts than other attachments. The causes of the complications of implant superstructures have not been clarified in some cases, and further verification is required. Verification of complications is considered important to obtain a long-term prognosis for superstructures of implants. It will be necessary to further verify complications of implants in the future.
Topics: Dental Abutments; Dental Implants; Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Denture, Overlay; Humans; Male
PubMed: 35989295
DOI: 10.2334/josnusd.21-0534 -
Evidence-based Dentistry Sep 2022Design The research was a retrospective cohort study evaluating a study which performed routine control sessions to assess bone loss around the dental implant over five... (Review)
Review
Design The research was a retrospective cohort study evaluating a study which performed routine control sessions to assess bone loss around the dental implant over five years and 12 and 24 months, after their prosthetic restorations.Aim The study aimed to evaluate patients' dental implant marginal bone loss after oral rehabilitation with bar and locator retainers and their possible complications.Methods A study of 114 patients who had received 283 dental implants from 2013-2018 was conducted. Two follow-up recall sessions were conducted, one at 12 months and one at 24 months, after dentures were placed. Intraoral and extraoral examinations were also conducted in addition to clinical assessments. The patients' prostheses were assessed for occlusion, tissue health and soft-tissue continuity, complaints, implant success rates and marginal bone loss, in addition to prosthetic complications, at follow-up sessions.Results In this study, 94 patients were fitted with implant-supported removable prostheses on locator attachments on both arches and 20 were fitted with removable prostheses using bar attachments. After evaluating the location of the implant, the number of days after implantation and the type of retainer in all patients, both groups showed a significant amount of marginal bone loss in the 12th and 24th months. The presence of complications was significantly associated with both prosthesis types at month 24 (p >0.05). When the relation between the position of the denture and the presence of complications at month 12 was evaluated, 36% of the complications were observed in the maxilla and 21.3% in the mandible. There was no significant difference associated between denture location and complication presence at month 24 (p >0.05).Conclusions Even though complications do not affect marginal bone loss, a patient's failure to maintain adequate oral hygiene results in marginal bone loss. Therefore, it appears that regular post-treatment prosthesis inspections are essential. If the requirements resulting from these inspections are satisfied, future complications may be prevented.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture Retention; Denture, Overlay; Follow-Up Studies; Humans; Jaw, Edentulous; Quality of Life; Retrospective Studies; Treatment Outcome
PubMed: 36151291
DOI: 10.1038/s41432-022-0817-y -
British Dental Journal Jul 2021The ability to provide high-quality complete dentures is a key skill for the GDP. The increasing prevalence and utilisation of implant-supported overdentures has opened...
The ability to provide high-quality complete dentures is a key skill for the GDP. The increasing prevalence and utilisation of implant-supported overdentures has opened the possibility of a wide variety of treatment options to support patient care, while also creating the need for primary care practitioners to have a greater awareness of commonly used prosthetic attachments.A thorough understanding of the advantages and disadvantages of implant-supported overdentures is essential to ensuring appropriate treatment planning, consent and maintenance. This two-part series explores various aspects of implant-supported overdentures including assessment of the patient, treatment planning, different attachment systems and maintenance requirements.Part one will explore availability of implants in the NHS, the commonly available implant attachment systems, including their relative advantages and disadvantages.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Overlay; Humans; Mandible
PubMed: 34302089
DOI: 10.1038/s41415-021-3224-4 -
British Dental Journal Aug 2021The ability to provide high-quality complete dentures is a key skill for the general dental practitioner. The introduction of new implant attachments and dental...
The ability to provide high-quality complete dentures is a key skill for the general dental practitioner. The introduction of new implant attachments and dental technologies has opened the possibility of a wide variety of treatment options when considering implant-supported overdentures (ISODs).A thorough understanding of the advantages and disadvantages of ISODs is essential to ensuring appropriate treatment planning, consent and maintenance. Part one of this paper discussed the role of ISODs and the different attachment systems available. This second part will explore the relevant treatment planning considerations and maintenance requirements.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Dentists; Denture Retention; Denture, Overlay; Humans; Mandible; Professional Role
PubMed: 34385644
DOI: 10.1038/s41415-021-3278-3 -
The Journal of Prosthetic Dentistry Dec 2022Prosthetic rehabilitation, especially with removable complete dentures (CDs), can contribute to speech problems, although the prevalence of the problem is unclear. (Review)
Review
STATEMENT OF PROBLEM
Prosthetic rehabilitation, especially with removable complete dentures (CDs), can contribute to speech problems, although the prevalence of the problem is unclear.
PURPOSE
The purpose of this systematic review was to examine the influence of implant-supported fixed complete dentures (FCDs), implant-supported overdentures, and removable CDs on speech articulation disorders in patients with at least 1 completely edentulous jaw.
MATERIAL AND METHODS
This study was prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in the International Prospective Register of Systematic Reviews (CRD42020182705). The PubMed/Medline, Embase, Web of Science, Scopus, Latin American and Caribbean Health Sciences, Brazilian Clinical Trials Registry, and Cochrane Library databases were searched through April 2020 to identify clinical trials comparing maxillary and/or mandibular implant-supported dentures with removable CD use in terms of speech articulation in participants with at least 1 completely edentulous jaw. The risk of bias of selected studies was assessed with the Joanna Briggs Institute critical appraisal tools, and the quality of evidence was tested by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
RESULTS
Initially, 2586 articles were identified, and their titles and abstracts were read. Sixteen articles were read in full, and 8 studies (4 paired clinical trials and 4 cross-sectional studies) were included in this review. In total, 290 prosthesis users aged 29 to 90 years, approximately 44 of whom had hearing difficulties, were included. Four studies had a low risk of bias, and 4 studies had a high risk of bias. Distortions of the /s/ phoneme were observed more often in the first 6 months of maxillary FCD use than with removable CD use. Speech articulation did not differ between mandibular FCD and removable CD users. The quality of evidence for speech articulation disorders was low.
CONCLUSIONS
Given the low quality of evidence on speech articulation disorders, further research on speech articulation disorders in prosthesis wearers is needed.
Topics: Humans; Dental Prosthesis, Implant-Supported; Speech; Cross-Sectional Studies; Dental Implants; Denture, Complete; Denture, Overlay; Jaw, Edentulous; Articulation Disorders; Patient Satisfaction
PubMed: 33865562
DOI: 10.1016/j.prosdent.2021.03.006 -
The Journal of Prosthetic Dentistry Nov 2023Standard-diameter dental implants are not always applicable because of anatomic limitations of the residual ridge. Thus, mini-implants have been increasingly used and... (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Standard-diameter dental implants are not always applicable because of anatomic limitations of the residual ridge. Thus, mini-implants have been increasingly used and offer an alternative. However, data regarding prosthetic complications, maintenance factors, and clinical outcomes are limited.
PURPOSE
The purpose of this systematic review and meta-analysis was to compare prosthetic complications and maintenance events and clinical outcomes in residual ridges rehabilitated with mandibular implant overdentures (IODs) by using standard implants or mini-implants.
MATERIAL AND METHODS
Nine electronic databases were searched. Quantitative analyses to measure the risk ratio (RR) and standardized mean difference (SMD) were applied. Those methods were used to assess prosthetic complications and maintenance events (abutment adjustments, replacement of retentive element, occlusal adjustment, and overdenture fracture) and clinical outcomes related to postoperative pain, probing depth (PD), plaque index (PI), marginal bone loss (MBL), and implant survival rate.
RESULTS
Altogether, 7 publications were selected. Mini-implants presented reduced abutment adjustments (RR 0.23 [0.07, 0.73], P=.01), replacement of retentive element (RR 0.41 [0.31, 0.54], P<.001), occlusal adjustment (RR 0.53 [0.31, 0.91], P=.02), and overdenture fracture (RR 0.46 [0.23, 0.94], P=.03) compared with standard implants. Additionally, mini-implants presented lower values for PI at 6 months (SMD -0.27 [-0.47, -0.08], P=.006) and 12 months (SMD -0.25 [-0.46, -0.05], P=.01). No additional tangible differences were noted.
CONCLUSIONS
Mini-implants might be an alternative choice based on the number of prosthetic complications and maintenance events. This was also confirmed by the comparable clinical data between standard implants and mini-implants.
Topics: Humans; Dental Implants; Denture, Overlay; Dental Prosthesis, Implant-Supported; Alveolar Bone Loss; Mandible
PubMed: 35120735
DOI: 10.1016/j.prosdent.2021.11.010