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The Journal of Prosthetic Dentistry Apr 2020Changes in the intraoral condition immediately after implant placement and in patients using fixed prosthetic appliances with implant abutments cause problems that...
STATEMENT OF PROBLEM
Changes in the intraoral condition immediately after implant placement and in patients using fixed prosthetic appliances with implant abutments cause problems that require the use of an easily adjustable implant-supported overdenture system.
PURPOSE
The purpose of this in vitro study was to develop a simulated implant-supported overdenture attachment system by using healing screws for the patrix and a silicone resilient denture liner for the matrix and to investigate the initial retention force, time-course changes, and allowable range of the angle between attachments.
MATERIAL AND METHODS
Tests on the retention force and allowable range of the angle were performed. Attachments using tissue-level healing screws (height: 2.0 and 3.0 mm) for the patrix and a silicone resilient denture liner for the matrix were prepared. In the retention force measurement test, the frequency of insertion and removal was set at 3 per day to simulate a 4-month relief period. The joined attachment model was pulled apart, and the maximum traction (N) required to remove it was defined as the retention force. The retention force was measured every 90 times (representing the number of insertions and removals per month). To test the allowable angle range, 2 patrices were used. The angle between the 2 patrices was set at 0, 10, 20, and 30 degrees, and the angular limit for joining with the matrix was measured. The initial retention force of the healing screw attachments was compared with that of a polymeric O-ring by using 1-way layout ANOVA followed by the Bonferroni test (α=.05). To analyze time-course changes in the 2 types of healing screw attachments, the retention force before insertion and removal was compared with that after repeated insertions and removals for each simulated period using 1-way layout ANOVA followed by the Dunnett test (α=.05).
RESULTS
The initial retention force of the 2.0- and 3.0-mm healing screws was 2.4 ±0.1 and 2.6 ±0.2 N. After repeating insertions and removals to simulate use for 4 months, the retention force of the 2.0- and 3.0-mm healing screws was 1.8 ±0.2 and 2.2 ±0.1 N, respectively, both showing significant differences from the initial retention force (P<.05). The allowable angle range test revealed that insertion and removal of the healing screws was possible up to 30 degrees.
CONCLUSIONS
Under the conditions of this in vitro study, repeated insertion and removal attenuated the retention force but was still equivalent to the retention force of the O-ring. The allowable range of the angle between patrices for insertion and removal was up to 30 degrees.
Topics: Bone Screws; Dental Implants; Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Denture Liners; Denture Retention; Denture, Overlay; Humans; Silicones
PubMed: 31383531
DOI: 10.1016/j.prosdent.2019.05.006 -
Journal of the Mechanical Behavior of... Jul 2021To measure the pressure distribution on the oral mucosa in vitro by comparing the pressure distributions under a complete denture and that of an implant overdenture.
PURPOSE
To measure the pressure distribution on the oral mucosa in vitro by comparing the pressure distributions under a complete denture and that of an implant overdenture.
MATERIALS AND METHOD
Anatomically accurate models and conventional Class I complete denture (CD) were produced and subjected to cyclic loading using a 100 N vertical centric and unilateral masticatory load with the universal testing machine (Instron 3369). Four miniature pressure sensors were positioned at four different locations in the intaglio surface of the denture and recorded pressure at 100 Hz frequency measured during a 10-cycle load at 1 Hz. Testing was repeated in different clinical combinations; CD vs. single implant overdentures (1-IOD), CD vs. two, three and four implant overdentures (2-IOD, 3-IOD vs. 4-IOD). The pressure profile (kPa) of complete dentures were measured and compared to the implant overdenture combinations. Collected data was statically analysed using SPSS and one-way analysis of variance.
RESULTS
The highest mean pressure was observed in CD group, with the mean mandible buccal ridge pressure value of 212.82 kPa ± 136.9 due to its surface area. There were no statistically significant differences between the group combinations (p = 0.146) but between various locations in the mean pressure recorded across the five denture/overdenture combinations.
CONCLUSION
CD experienced large pressure values on mandibular denture. 1-IOD demonstrated the most pressure in comparison to CD where with an increase in the number of implants used, it transformed the denture from being pure-borne mucosa to an implant overdenture, providing support and distributing the pressure amongst the implants.
Topics: Dental Implants; Denture, Overlay; Humans; Mandible; Mucous Membrane
PubMed: 33894527
DOI: 10.1016/j.jmbbm.2021.104531 -
Zhonghua Kou Qiang Yi Xue Za Zhi =... Dec 2021Many randomized controlled clinical trials have reported that implant overdentures provided edentulous people with better retention, stability, and masticatory... (Review)
Review
Many randomized controlled clinical trials have reported that implant overdentures provided edentulous people with better retention, stability, and masticatory performance than conventional complete dentures did. The design of implant overdentures for edentulous jaws should be based on comprehensive consideration of factors such as anatomic structure, alveolar bone resorption, inter-arch distance, choice of implant number/distribution and suprastructure. During the clinical procedure, timing of attachment connection, choice of impression technique, methods of maxilla-mandibular relationship registration, wax-up try-in, and prostheses delivery should be determined according to the type of implant overdentures. The appropriate choices and conduction of the above-mentioned procedures can guarantee the long-term success of the prostheses. This review elaborates on the clinical significance, treatment design, key steps in clinical procedure of implant overdenture, and summarizes follow-up and maintenance following denture delivery.
Topics: Denture, Overlay; Humans
PubMed: 34915647
DOI: 10.3760/cma.j.cn112144-20210925-00434 -
The Journal of Prosthetic Dentistry Oct 2022Patients with ectodermal dysplasia are characterized by anodontia or oligodontia. How their challenging prosthodontic rehabilitation might be optimized is unclear. (Clinical Trial)
Clinical Trial
STATEMENT OF PROBLEM
Patients with ectodermal dysplasia are characterized by anodontia or oligodontia. How their challenging prosthodontic rehabilitation might be optimized is unclear.
PURPOSE
The purpose of this crossover study was to evaluate the effect of resilient denture liner versus acrylic resin copings in complete overdentures for patients with ectodermal dysplasia. Outcome measures included patient satisfaction, retention, and periodontal health of the abutment tooth.
MATERIAL AND METHODS
Ten partially edentulous participants diagnosed with ectodermal dysplasia were recruited from the Faculty of Dentistry, Cairo University, Egypt, and enrolled in this crossover clinical trial. All participants received acrylic resin coping-retained maxillary complete overdentures (group N, stage 1). The acrylic resin copings were then replaced by a resilient denture liner (group S, stage 2). Patient satisfaction, retention, and periodontal health parameters were evaluated 1 week and 3 months after the completion of each stage. Patient satisfaction was assessed with a validated, reliable questionnaire. The results of the periodontal probing depths were tested with repeated measures ANOVA followed by the Bonferroni correction for pairwise comparisons. Tooth mobility, patient satisfaction, retention, and gingival index were tested by using the Wilcoxon signed ranked test. Ordinal data as the sixth and seventh domains of patient satisfaction were tested by using the McNemar test for paired comparisons (α=.05).
RESULTS
Three months after overdenture delivery, a statistically significant difference was found between the groups regarding retention (P=.025), probing depth (P<.001), and gingival index (P=.011) favoring the acrylic resin coping-retained overdentures. Results of tooth mobility (P=.035), overall attitude (P=.041), ease of eating (P=.023), denture comfort (P=.024), and degree of teasing (P=.038) on wearing the denture showed a statistically significant difference between the groups, favoring the resilient denture liner.
CONCLUSIONS
In children with oligodontia and ectodermal dysplasia, the resilient denture liner-retained maxillary complete overdenture enhanced patient satisfaction and tooth mobility of anterior teeth, while minimally jeopardizing the periodontal condition of the abutment teeth.
Topics: Child; Humans; Denture Retention; Denture Liners; Cross-Over Studies; Acrylic Resins; Dental Prosthesis, Implant-Supported; Tooth Mobility; Personal Satisfaction; Dental Implants; Patient Satisfaction; Denture, Overlay; Ectodermal Dysplasia
PubMed: 33674122
DOI: 10.1016/j.prosdent.2020.09.049 -
The International Journal of... 2021To report changes in denture satisfaction and oral health-related quality of life (OHRQoL) in edentulous patients treated with two-implant mandibular overdentures (IODs)... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
To report changes in denture satisfaction and oral health-related quality of life (OHRQoL) in edentulous patients treated with two-implant mandibular overdentures (IODs) over a follow-up of 8 to 10 years.
MATERIALS AND METHODS
This is a follow-up of a previous study carried out between 1997 and 2005. The patients were originally randomly divided into one group receiving IODs and another group who had their conventional mandibular dentures relined (RCD group). The RCD group was offered and received IODs at the 2-year follow-up. The participants completed a self-administered questionnaire containing demographics, 15 variables related to denture satisfaction, and 20 questions from the Oral Health Impact Profile (OHIP-20). Changes over time were analyzed using multilevel linear models for denture satisfaction and multilevel ordinal regression analyses for OHIP-20 variables. Comparisons between groups were analyzed using Mann-Whitney U test for ordinal and t test for metric data.
RESULTS
Disregarding patients who passed away during follow-up, the 29 responders represented a response rate of 76%. The degree of denture satisfaction and the OHIP-20 scores remained high and stable in the IOD group over the 10-year observation period for all but one variable. The same factors showed only a modest improvement in the RCD group for the first 2 years; however, during the subsequent 8 years of the observation period (after receiving IODs), denture satisfaction and OHIP-20 scores improved to the same level as the original IOD group.
CONCLUSION
The positive effect on denture satisfaction and OHRQoL of edentulous patients treated with two-implant mandibular overdentures remained unchanged 8 to 10 years after treatment.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Complete, Lower; Denture, Overlay; Follow-Up Studies; Humans; Mandible; Oral Health; Patient Satisfaction; Personal Satisfaction; Quality of Life
PubMed: 33616561
DOI: 10.11607/ijp.7521 -
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 -
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 -
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