-
The Journal of Craniofacial SurgeryThis study aims to investigate the bone remodelling and resorption in immediate implantation and restoration of clinical implant-supported overdentures.
OBJECTIVE
This study aims to investigate the bone remodelling and resorption in immediate implantation and restoration of clinical implant-supported overdentures.
MATERIALS AND METHODS
Six adult domestic dogs were divided into 2 groups: In the experimental group, 6 implants were immediately placed in each mandible, the distal end implants were inclined distal to the long axis of the tooth at an angle of 30 degrees, and restored immediately. As the control group, the animals underwent immediate implant placement with single denture restoration, respectively, nontilting and tilting at 30 degrees in the long axis of the tooth. The osseointegration index (OI) and rate of bone ingrowth fraction were measured, and the peri-implant bone remodelling was observed. The marginal bone loss was measured in the slices of bone-implant and analyzed.
RESULTS
New bone regenerated and had remodelled in each group. The experimental group had no statistically significant differences, when compared with other groups, except the tilted implant control group, in terms of the OI and bone ingrowth fraction.
CONCLUSION
Obvious bone absorption did not statistically significantly occur in implant-supported overdenture of immediate implant placement and function with satisfactory new bone and OI.
Topics: Animals; Dogs; Dental Implants; Denture, Overlay; Dental Implantation, Endosseous; Osseointegration; Immediate Dental Implant Loading; Dental Prosthesis, Implant-Supported; Mandible; Alveolar Bone Loss; Follow-Up Studies
PubMed: 35946812
DOI: 10.1097/SCS.0000000000008877 -
Journal of Dentistry Dec 2022To compare the degree of satisfaction (SD) and the impact on oral health-related quality of life (OHRQoL) of edentulous patients treated with conventional complete... (Randomized Controlled Trial)
Randomized Controlled Trial
Impact of the extension of the anterior-posterior spread on quality of life and satisfaction of patients treated with implant-retained mandibular overdentures - a randomized clinical trial.
OBJECTIVES
To compare the degree of satisfaction (SD) and the impact on oral health-related quality of life (OHRQoL) of edentulous patients treated with conventional complete dentures (CCDs) and mandibular overdentures (IODs) with a short anteroposterior spread (S-APS) or a large antero-posterior spread (L-APS).
MATERIALS AND METHODS
Edentulous patients were treated with CCDs and subsequently randomly allocated to receive a bar clip mandibular overdenture retained by 2 interforaminal implants (Control) or 4 (Test: 2 additional implants distal to the mental foramen). The Oral Health Impact Profile Edent questionnaire (OHIP-20E) and the Visual Analogue Scale (VAS) were applied at a mean follow-up of 38.5 months to assess the impact on OHRQoL and DS, respectively. Comparisons between the type of prosthesis and the extension of the AP spread were made with Student's t test for paired samples and for independent samples, respectively, at a significance level of 5%.
RESULTS
The IODs had significantly lower OHRQoL values in the dimensions "functional limitation" (p=0.03), "physical pain" (p=0.02), "psychological discomfort" (p<0.01), "disability physical" (p<0.01) and "general score" (p<0.01) (n=20 patients). The IODs presented DS values significantly for "aesthetics" (p=0.04), "stability" (p=0.03), "masticatory capacity" (p<0.01), "function" (p<0.01) and "oral condition" (p=0.03). The S-APS group (control) resulted in significantly lower values in the dimensions "physical pain" (p<0.01) and "general score" (p<0.01) and no domain with statistical difference in the VAS scale.
CONCLUSIONS
IODs significantly improved OHRQoL and DS. The increase in AP spread did not result in benefits for the patient's OHRQOL and DS in this clinical study. (Study Protocol Number: 1.452.492) CLINICAL SIGNIFICANCE: Implantology has experienced in the last 20 years a permanent evolution that aim at increasing predictability and improving long-term clinical performance. Placement of short implants distally to the mental foramen, for instance, and the resulting increase of the anterior-posterior spread, is a promising approach and is worthy of investigation.
Topics: Humans; Denture, Overlay; Quality of Life; Personal Satisfaction; Dental Prosthesis, Implant-Supported; Dental Implants; Patient Satisfaction; Esthetics, Dental; Mouth, Edentulous; Pain
PubMed: 36414990
DOI: 10.1016/j.jdent.2022.104346 -
The Journal of Prosthetic Dentistry Feb 2021The clinical performance of implant-retained overdentures (IODs) with plastic bar clips made of different materials in the same design and dimensions may vary according...
STATEMENT OF PROBLEM
The clinical performance of implant-retained overdentures (IODs) with plastic bar clips made of different materials in the same design and dimensions may vary according to the patient's daily home care procedures. However, information about the effects of denture cleaning solutions on the retention of Hader bar clips is lacking.
PURPOSE
The purpose of this in vitro study was to evaluate the retention of Hader bar clips made of different polymers after being soaked in denture cleaning solutions.
MATERIAL AND METHODS
Ninety Hader bar clips made of polyamide (PA, n=30), polytetrafluoroethylene (PTFE, n=30), and polyetherketoneketone (PEKK, n=30) materials were tested. Two multiunit abutments were screwed onto the implant analogs and embedded into an acrylic resin block in a standardized position. The digital scanning of the abutments was acquired, and the bar patrix of each material system milled from a cobalt-chromium (Co-Cr) alloy disk by using computer-aided design and computer-aided manufacturing (CAD-CAM). After the milled bar patrices were screwed onto abutments and the metal housings of the bar clips were embedded into acrylic resin blocks, they were connected passively at the same angulation to a universal testing machine. The initial retention values of all Hader bar clips were measured, and each material system was divided into 3 subgroups (n=10) before soaking in the cleaning solutions: distilled water (DW), 5% sodium hypochlorite (NaOCl), or sodium bicarbonate-sodium perborate (SBSP). Each material was soaked for the equivalent of 3 months of clinical use. The final retention values of each Hader bar clip were measured. The data were statistically analyzed by using a 2-way analysis of variance (ANOVA), the Tukey honestly significant difference (HSD) test, and the paired sample t test (α=.05).
RESULTS
The 2-way ANOVA showed that the denture cleaning solution, the clip material, and their interactions led to significantly different retention values (P<.001). A decrease was observed for the retention values of all test groups after soaking in the cleaning solutions (P<.05). No retention was observed for the PTFE clips after soaking in the 5% NaOCI solution.
CONCLUSIONS
The denture cleaning solutions negatively affected the retention of Hader bar clips, regardless of the type of solution and clip material. The 5% NaOCI solution not only decreased the retention of PTFE clips but also completely degraded it. It is recommended that 5% NaOCI solution be avoided for the daily care of IODs with PTFE clips.
Topics: Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Denture Retention; Denture, Overlay; Humans; Surgical Instruments
PubMed: 33198989
DOI: 10.1016/j.prosdent.2020.09.026 -
The Journal of Prosthetic Dentistry Jun 2022A systematic review of the effect of different overdenture attachments with different loading protocols on peri-implant health is lacking. (Meta-Analysis)
Meta-Analysis Review
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.
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.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Humans; Immediate Dental Implant Loading; Jaw, Edentulous; Mandible; Network Meta-Analysis; Treatment Outcome
PubMed: 33546861
DOI: 10.1016/j.prosdent.2020.12.016 -
Journal of Prosthodontics : Official... Oct 2023The aim of this systematic review was to compare treatment outcomes in terms of implant survival rate, marginal bone loss, and patient-reported outcome measures (PROMs)... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The aim of this systematic review was to compare treatment outcomes in terms of implant survival rate, marginal bone loss, and patient-reported outcome measures (PROMs) between narrow-diameter implants and regular-diameter implants (RDIs) for mandibular implant overdentures (MIOs).
METHODS
This study was based on the methodology adapted as per Cochrane. Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and Scopus were searched for pertinent studies published by July 22, 2022. Outcome parameters included in this meta-analysis were implant survival rate, marginal bone loss, visual analogue scale score for patient satisfaction, and value of oral health impact profile.
RESULTS
A total of 782 non-duplicate articles and 83 clinical study registrations were identified from database and hand searches, of which 26 were eligible for full-text searches. Finally, 12 publications reporting on 8 independent studies were included in this review. In the meta-analysis, implant survival rate and marginal bone loss did not significantly differ between narrow-diameter implants and RDIs. Regarding RDIs, narrow-diameter implants were associated with significantly better outcomes in general patient satisfaction and oral health-related quality of life than RDIs for mandibular overdentures.
CONCLUSIONS
Narrow-diameter implants have competitive treatment outcomes compared to RDIs in terms of implant survival rate, marginal bone loss, and PROMs. [Correction added on July 21, 2023, after first online publication: The abbreviation RDIs was changed to PROMs in the preceding sentence.] Thus, narrow-diameter implants might be an alternative treatment option for MIOs in situations with limited alveolar bone volume.
Topics: Humans; Dental Implants; Quality of Life; Denture, Overlay; Dental Prosthesis, Implant-Supported; Treatment Outcome; Mandible; Alveolar Bone Loss
PubMed: 37365991
DOI: 10.1111/jopr.13726 -
The Journal of Contemporary Dental... Jan 2020This study aimed to evaluate and compare the effect of locator attachment and ball and socket (BS) attachment on the peri-implant and periabutment supporting structures... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
This study aimed to evaluate and compare the effect of locator attachment and ball and socket (BS) attachment on the peri-implant and periabutment supporting structures on clinical pocket depth and gingival index in cases of limited interarch spaces in mandibular Kennedy class I implant-supported removable partial overdentures.
MATERIALS AND METHODS
A comparative clinical trial was conducted among twenty partially edentulous patients aged 30-60 years. The study participants were randomly divided into two study groups based on the attachment system used: group I - locator attachment, and group II - BS attachment. Two implants were positioned in the 1st or 2nd molar area following the two-stage surgical protocol. Evaluation of the peri-implant and periabutment supporting structures was done at the time of overdenture insertion and after 6, 12, and 18 months by measuring the pocket depth and gingival index. Inter- and intragroup comparisons were done using independent-samples test and paired-sample test respectively. < 0.05 was considered statistically significant.
RESULTS
It was observed that there was a statistically significant increase in the pocket depth around the implant as well as the abutment in both groups at 6, 12, and 18 months when compared to baseline. Intergroup comparison for pocket depth and gingival index revealed nonsignificant results. However, the values were higher in the BS group.
CONCLUSION
The locator attachment group had lower, though statistically not significant, pocket depth and gingival index scores around both the dental implant and the natural abutment as compared with the BS attachment.
CLINICAL SIGNIFICANCE
Gingival health surrounding dental implant attachments is very crucial for the long-term success of dental implant, this could help the clinician to select the proper design for implant attachment underneath the over denture prosthesis.
Topics: Adult; Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Overlay; Humans; Mandible; Middle Aged
PubMed: 32381804
DOI: No ID Found -
Clinical Implant Dentistry and Related... Dec 2023Maxillary implant overdenture therapy is a good treatment option for treating patients experiencing problems with their conventional maxillary denture. Retaining the... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Maxillary implant overdenture therapy is a good treatment option for treating patients experiencing problems with their conventional maxillary denture. Retaining the overdenture with four implants and a bar attachment system serves as the current gold standard. However, there is a demand for less costly and less invasive treatment options. The aim of this randomized controlled trial was to compare marginal bone level change (MBLC), implant and overdenture survival, clinical, masticatory, and patient-related outcomes (PROMs) of maxillary implant overdentures with either two or four implants and a bar attachment system.
MATERIALS AND METHODS
Forty edentulous participants were randomly allocated to two groups (n = 20), to receive either two or four implants in the maxilla. After healing, all the participants received an implant overdenture retained by a bar attachment system. All the participants were evaluated 1 and 12 months after overdenture placement. The primary outcome was MBLC. Secondary outcomes were implant and overdenture survival, clinical, masticatory, and PROMs. The outcomes were analyzed using parametric and non-parametric tests.
RESULTS
MBLC was -0.03 mm in the 2-implant group and -0.16 mm in the 4-implant group (p = 0.21). Implant survival was 83.3% in the 2-implant group and 94.4% in the 4-implant group (p = 0.03). The median pocket depth change and clinical outcomes were low, and masticatory performance along with PROMs improved in both groups and did not differ significantly between them.
CONCLUSION
Maxillary 4-implant overdentures perform better than maxillary 2-implant overdentures with a bar attachment system in terms of implant and overdenture survival and therefore remains the gold standard. However, both overdentures perform similarly in terms of MBLC, clinical, masticatory, and PROMs.
Topics: Humans; Denture, Overlay; Dental Implants; Jaw, Edentulous; Maxilla; Dental Prosthesis, Implant-Supported; Mouth, Edentulous; Denture Retention
PubMed: 37563860
DOI: 10.1111/cid.13262 -
Journal of Prosthodontics : Official... May 2021This technical report describes a workflow to fabricate an implant overdenture via digital duplication of an interim complete removable dental prosthesis and additive...
This technical report describes a workflow to fabricate an implant overdenture via digital duplication of an interim complete removable dental prosthesis and additive manufacturing (3D printing). An edentulous patient was provided with an interim maxillary denture after implant placement. After 4 months of healing, the existing interim denture was scanned, duplicated via 3D printing, and used to make the final impression, record the maxillomandibular interocclusal relationship, and transfer the esthetic information to the definitive implant overdenture. The framework of the implant overdenture was digitally designed and manufactured using a direct metal printing (DMP) system. This digital duplication workflow facilitated the implant overdenture fabrication with favorable clinical outcomes.
Topics: Computer-Aided Design; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Esthetics, Dental; Humans; Printing, Three-Dimensional
PubMed: 32656819
DOI: 10.1111/jopr.13225 -
Journal of Indian Prosthodontic Society 2022Mandibular overdenture is suspected to fracture, especially in the midline and anterior region due to low surface area of coverage and minimum acrylic thickness in...
Mandibular overdenture is suspected to fracture, especially in the midline and anterior region due to low surface area of coverage and minimum acrylic thickness in addition to attachments pickup holes that weakens the denture. Dentures used to be conventionally reinforced with metal meshwork which cannot be done in a digital workflow. This in vitro report introduces a novel approach of digital overdenture reinforcement using computer-aided design, computer-aided manufacturing, and rapid prototyping technologies. This novel approach provided digital reinforced, stable, and well-adapted overdenture with accurate and easy attachment pickup. Digital reinforced denture has fewer clinical steps with fewer laboratory complications. The newly developed overdenture fabrication techniques have the ability to change the conventional clinical and laboratory workflow from analog to digital. Which grantee standardization of the outcome on both research and clinical work.
Topics: Denture Retention; Dental Prosthesis, Implant-Supported; Dental Implants; Denture, Overlay; Mandible
PubMed: 36511033
DOI: 10.4103/jips.jips_514_21 -
The Journal of Prosthetic Dentistry Feb 2024Evidence regarding the retention system for a mandibular overdenture is important for treatment planning. However, the clinical performance of stud and ball attachments... (Meta-Analysis)
Meta-Analysis Review
Patient-reported outcome measures and clinical performance of implant-retained mandibular overdentures with stud and ball attachments: A systematic review and meta-analysis.
STATEMENT OF PROBLEM
Evidence regarding the retention system for a mandibular overdenture is important for treatment planning. However, the clinical performance of stud and ball attachments for mandibular overdenture retainers is unclear.
PURPOSE
The purpose of this systematic review and meta-analysis was to compare the clinical performance and self-reported patient outcomes of ball and stud attachments as mandibular overdenture retainers.
MATERIAL AND METHODS
Randomized (RCTs) and nonrandomized (N-RCTs) controlled clinical trials were selected based on the eligibility criteria. The risk of bias was assessed by using the Cochrane Collaboration Tools, and the certainty of the evidence (COE) by using the grades of recommendation, assessment, development, and evaluation (GRADE) workshop approach. Meta-analyses according to the follow-up period were performed for implant survival, prosthetic maintenance and complications, bleeding on probing (BoP), marginal bone loss (MBL), satisfaction, and oral health-related quality of life (OHRQoL).
RESULTS
Thirteen RCTs and 4 N-RCTs were included. Twelve studies presented a high risk of bias. The stud demonstrated a lower risk ratio (RR) (P<.001) for maintenance and complications concerning the need for matrix activation (RR 7.12 [2.65, 19.15]) (very low COE) and new overdentures (RR 2.47 [1.02, 5.96]) (moderate COE), ranging from 1 to 5 years of follow-up. Mean difference (MD) for MBL after 1 (MD 0.40 [0.28, 0.52]; P<.001) and 5 years (MD 0.18 [0.16, 0.20]; P<.001) was higher for ball attachments than that for stud (very low COE) attachments. Stud attachments also improved satisfaction (P<.001) when compared with ball attachments (very low COE). Implant survival rate (high COE), BoP (very low COE), and OHRQoL (low COE) were similar for the attachments.
CONCLUSIONS
Stud and ball attachments are clinically appropriate options as mandibular overdenture retainers and are capable of restoring OHRQoL. Nevertheless, the stud showed greater improvement in satisfaction and less prosthetic aftercare and MBL.
Topics: Humans; Denture, Overlay; Quality of Life; Dental Prosthesis, Implant-Supported; Denture Retention; Dental Implants; Mandible; Patient Reported Outcome Measures
PubMed: 35931572
DOI: 10.1016/j.prosdent.2022.02.006