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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 -
JDR Clinical and Translational Research Jan 2024Single-implant mandibular overdentures (SIMOs) are one of the least invasive implant treatments for edentulism. The new Novaloc attachment system can improve the... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Single-implant mandibular overdentures (SIMOs) are one of the least invasive implant treatments for edentulism. The new Novaloc attachment system can improve the clinical performance of implant-retained overdentures but has not been tested for SIMOs.
OBJECTIVES
To compare Novaloc and a gold standard system (Locator) for SIMOs in an edentate elderly population in terms of patient-reported outcomes and device- and treatment-related complications.
METHODS
In this single-center crossover randomized clinical trial (RCT), 10 edentulous participants received an implant in the lower midline and had their lower complete dentures converted to SIMOs. The participants received each attachment system for 3 mo in a randomized order, followed by measurement of patient satisfaction and oral health-related quality of life via the McGill Denture Satisfaction Questionnaire and the Oral Health Impact Profile for Edentulous People questionnaire, respectively. Complications were registered throughout the RCT. Patients were interviewed for their experiences with SIMOs and preference for one of the attachment systems. Quantitative analysis employed mixed linear models and chi-square tests (α = 0.05), whereas interview data underwent thematic analysis and, in turn, integration into quantitative data (mixed methods explanatory design).
RESULTS
All 10 randomized participants completed the trial. Mean ± SD general satisfaction was 92% ± 8% with Novaloc versus 85% ± 13% with Locator (mean difference, 9%; 95% CI, 1% to 17%). For specific McGill Denture Satisfaction Questionnaire items, only denture stability was significantly increased for Novaloc. Seven participants preferred Novaloc over Locator at the end of the RCT (chi-square, = 0.045). No difference was found between the attachments in terms of oral health-related quality of life based on the Oral Health Impact Profile for Edentulous People and complications. Thematic analysis revealed high patient satisfaction with SIMOs, with denture stability the main criterion for their satisfaction and attachment preference.
CONCLUSION
Among elderly edentulous patients wearing SIMOs, Novaloc led to increased patient satisfaction and preference. Better patient-perceived denture stability may explain this result. The attachment systems exhibited similar short-term maintenance needs.
TRIAL REGISTRATION
ClinicalTrials.gov: NCT03126942 (first registered on April 13, 2017). Secondary identifiers: A03-M07-17A (McGill University, Institutional Review Board) and 2018-3873 (McGill University Health Centre, Research Ethics Board).
KNOWLEDGE TRANSFER STATEMENT
The results of this mixed methods study can be used by clinicians when choosing which attachment system to use for SIMOs. Results suggest that edentulous patients prefer attachments with a better-defined seating position, such as that of the Novaloc system, as opposed to the nylon matrix on metallic abutment of the Locator system.
Topics: Aged; Humans; Denture, Complete; Denture, Overlay; Jaw, Edentulous; Mandible; Patient Satisfaction; Cross-Over Studies
PubMed: 36127832
DOI: 10.1177/23800844221124083 -
Gerodontology Dec 2022To report on the use of a mandibular 3-implant overdenture with a novel implant distribution opposing a maxillary complete denture for the rehabilitation of an older...
OBJECTIVE
To report on the use of a mandibular 3-implant overdenture with a novel implant distribution opposing a maxillary complete denture for the rehabilitation of an older edentulous patient.
BACKGROUND
The use of oral implants with attachment systems of various numbers and designs to support removable partial and complete dentures is well documented with success and predictability.
MATERIALS AND METHODS
An older edentulous patient with a mandibular implant-assisted removable partial denture was presented with failing remaining dentition. Teeth were extracted and a single midsymphyseal implant was placed. A mandibular overdenture on three implants with ball attachments in a tripod distribution was constructed to oppose a new maxillary complete denture made using a modified impression technique.
RESULTS
Over 2 years of follow-up, no significant biological or mechanical complications were reported, and denture retention and stability remained optimum.
CONCLUSION
Mandibular overdentures on three implants with ball attachments in a tripod distribution, opposing a maxillary complete denture, could be an alternative treatment option for the older edentulous patients.
Topics: Humans; Denture, Overlay; Denture Retention; Dental Prosthesis, Implant-Supported; Dental Implants; Mandible; Mouth, Edentulous; Denture, Complete, Lower
PubMed: 36218242
DOI: 10.1111/ger.12615 -
The Journal of Prosthetic Dentistry Apr 2022This report describes a digital workflow for the fabrication of a complete maxillary denture opposing an implant-retained overdenture. This procedure provides a...
This report describes a digital workflow for the fabrication of a complete maxillary denture opposing an implant-retained overdenture. This procedure provides a predictable and accurate 3-visit technique to digitally scan and articulate edentulous ridges, avoiding the discomfort associated with analog impression making. Wax rims were applied to intraorally relined plastic edentulous stock trays. The occlusal relationship was registered at the appropriate vertical dimension of occlusion by using these tray and rim assemblies. The digital laboratory scanning of the relined tray and rim assemblies resulted in accurate virtual articulation of the digital edentulous intraoral scans. The removable restorations were digitally designed, milled, and delivered, and the clinical and laboratory steps are described.
Topics: Computer-Aided Design; Denture, Complete; Denture, Overlay; Humans; Mouth, Edentulous; Workflow
PubMed: 33549339
DOI: 10.1016/j.prosdent.2020.12.024 -
Nutrients Mar 2023Tooth loss may affect food ingestion and, consequently, nutrition intake. The neuroimaging literature using functional magnetic resonance imaging (fMRI) was reviewed to... (Review)
Review
Tooth loss may affect food ingestion and, consequently, nutrition intake. The neuroimaging literature using functional magnetic resonance imaging (fMRI) was reviewed to summarize the changes in brain functions in response to denture rehabilitation in patients with partial or complete edentulous dentition. Overall, this review covered nine fMRI studies on denture rehabilitation. Eight recruited complete edentulous patients, whereas one recruited partially edentulous patients. The risk-of-bias assessment revealed concerns regarding all nine studies. Due to the heterogeneity of the studies and the lack of brain coordinates reported, a meta-analysis could not be conducted, and this review could only summarize the findings without statistical validation. The evidence from jaw-clenching studies suggested that implant-supported fixed dentures could be the best option, as compared to implant-supported overdentures and complete dentures, as it was associated with higher brain activity levels in various brain regions, including those corresponding to the primary sensory (postcentral gyrus) and motor cortices (precentral gyrus). Gum-chewing studies indicated that perhaps the medial and middle frontal gyri were associated with food comminuting and food mixing, which could be improved by the full replacement of the dental arch, instead of only partial replacement. All the fMRI studies described the functional neuroplasticity of the patients undergoing denture rehabilitation and suggested that certain rehabilitation options were more beneficial in restoring masticatory functions, as well as their associated brain activity levels.
Topics: Humans; Adult; Magnetic Resonance Imaging; Denture, Complete; Mouth, Edentulous; Denture, Overlay; Neuronal Plasticity; Mastication
PubMed: 37049418
DOI: 10.3390/nu15071577 -
The Journal of Prosthetic Dentistry Nov 2022Previous studies on single-implant mandibular overdentures have reported favorable results for clinical and patient-reported outcomes. However, information from longer...
STATEMENT OF PROBLEM
Previous studies on single-implant mandibular overdentures have reported favorable results for clinical and patient-reported outcomes. However, information from longer term clinical studies is lacking.
PURPOSE
The purpose of this clinical study was to assess clinical, radiographic, and patient-reported outcomes of edentulous individuals rehabilitated with single-implant mandibular overdentures after a 5-year follow-up.
MATERIAL AND METHODS
A prospective clinical study was performed including completely edentulous individuals who received new conventional complete dentures and then an external hexagon implant in the mandibular midline region, followed by the incorporation of a retention system (O-ring/ball attachment; Neodent). Data collection occurred at baseline and 3, 6, 12, 24, and 60 months after implant loading. Assessed outcomes included implant stability, peri-implant soft tissue condition, peri-implant marginal bone level, satisfaction with the prostheses, and oral health-related quality of life (OHRQoL). Clinical maintenance events were also recorded. Descriptive statistics, incidence rates, Wilcoxon Signed Ranks test, and Generalized Estimating Equation regression were used for data analysis (α=.05).
RESULTS
Thirty of 34 eligible participants attended the 5-year follow-up visit, mean ±standard deviation age was 68.1 ±7.8 years, and 70% were women. The overall implant survival rate was 88.9%. After 5 years, the OHRQoL showed statistically significant improvement for all evaluation periods compared with baseline (P<.001). Regarding satisfaction with the mandibular denture, a significant increase was found between all evaluation periods compared with baseline in terms of comfort, stability, and ability to masticate (P<.001). Implant stability significantly increased (P=.003), and a mean bone loss of 1.46 mm was observed compared with baseline measures. The most frequent maintenance event was replacement of the O-ring matrix (n=80). Twenty-one midline fractures of the overdenture occurred in 14 study participants. No significant changes in peri-implant soft tissue conditions were observed.
CONCLUSIONS
A single-implant mandibular overdenture effectively maintained the positive effect of the intervention on oral health-related quality of life and patient satisfaction, stable peri-implant condition, and acceptable rates of prosthetic events.
Topics: Humans; Female; Middle Aged; Aged; Male; Denture, Overlay; Quality of Life; Prospective Studies; Follow-Up Studies; Dental Prosthesis, Implant-Supported; Dental Implants; Mandible; Patient Reported Outcome Measures; Patient Satisfaction; Denture Retention
PubMed: 33640091
DOI: 10.1016/j.prosdent.2021.01.007 -
Clinical and Experimental Rheumatology Dec 2023To prospectively investigate patient-reported outcomes and clinical performance of implant supported overdentures in edentulous Sjögren's disease (SjD) patients...
OBJECTIVES
To prospectively investigate patient-reported outcomes and clinical performance of implant supported overdentures in edentulous Sjögren's disease (SjD) patients compared to subjects without SjD.
METHODS
51 implants were placed in 12 patients with SjD and 50 implants in 12 non-SjD patients to support overdentures. Clinical performance, marginal bone-level changes, patient satisfaction and oral health related quality of life (OHRQoL) were assessed at 1 (T1), 6 (T6), 12 (T12) and 18 (T18) months after placement of the overdenture. Patient satisfaction, ability to chew and OHRQoL were assessed with validated questionnaires. Marginal bone-level changes were measured on standardised dental radiographs. Clinical parameters included implant and overdenture survival, plaque, bleeding and gingival indices, and probing depth.
RESULTS
OHRQoL in patients with SjD improved significantly after placement of implant supported overdentures at all measuring moments compared to baseline (p<0.05). Nevertheless, ability to chew tough and hard food was significantly better for non-SjD patients at all timepoints after placement of an implant supported overdenture (p<0.05). Implant survival at T18 was 100% in the patients with SjD and 98% in the non-SS group. Mean marginal bone loss at T18 did not differ between patients with SjD and non-SS patients, 1.12±0.74 mm and 1.43±1.66 mm, respectively (p=0.58). Clinical performance was good with no differences between the groups for all outcome measures (p>0.05).
CONCLUSIONS
Implant-supported overdentures have a positive effect on OHRQoL and dental implants can be successfully applied in edentulous patients with SjD with nearly similar outcomes as in non-SjD subjects.
Topics: Humans; Denture, Overlay; Quality of Life; Prospective Studies; Patient Satisfaction; Dental Prosthesis, Implant-Supported
PubMed: 38019170
DOI: 10.55563/clinexprheumatol/cryfka -
Contemporary Clinical Dentistry 2022This clinical report describes the oral rehabilitation with a mandibular overdenture retained by telescopic crowns and ball attachments on semierupted permanent teeth...
This clinical report describes the oral rehabilitation with a mandibular overdenture retained by telescopic crowns and ball attachments on semierupted permanent teeth with a 5-year follow-up. A female patient used an old complete denture in the maxilla and was willing to extract her remaining mandibular teeth to have new dentures. The treatment included preservation of semierupted premolars because of the high surgical risk for mandibular fracture and paresthesia, a new maxillary complete denture, and a mandibular overdenture supported by combined telescopic crowns and ball attachments. The prosthetic rehabilitation restored function and esthetics with high patient satisfaction after 5 years in function.
PubMed: 36213847
DOI: 10.4103/ccd.ccd_240_21 -
Clinical Implant Dentistry and Related... Dec 2020Little is known on the effect of varying implant diameters, especially with mini implants (ie, less than 3 mm in diameter), on oral health-related quality of life...
BACKGROUND
Little is known on the effect of varying implant diameters, especially with mini implants (ie, less than 3 mm in diameter), on oral health-related quality of life (OHrQoL).
PURPOSE
To compare OHrQoL and satisfaction in patients with mandibular overdentures immediately retained by either two conventional or two mini-implants.
MATERIALS AND METHODS
Edentulous patients receiving immediately loaded overdentures retained by Locators on either two conventional diameter (4.1 mm) or two mini (2.9 mm or less) implants were selected based on available buccal-lingual ridge width in the intraforaminal area. Two questionnaires were used (Oral Health Impact Profile-14 [OHIP-14]; and Denture Satisfaction Questionnaire [DSQ]) to determine OHrQoL and overall denture satisfaction. Questionnaires were filled out at six different time points up to a 1-year follow-up. Mann-Whitney U test was used for group comparisons. Friedman and Wilcoxon tests were used to identify changes within group along the time points. Correlation between OHIP-14 and DSQ was assessed with Spearman test.
RESULTS
A total of 48 patients were analyzed and equally distributed to each group. The conventional group presented a significantly smaller change of OHIP functional score from the baseline to the first week of follow-up after surgery (P = .017). In addition, total DSQ scores were significantly higher for the conventional group at 12 weeks (P = .022) and there was a significant difference between groups in satisfaction with mandibular prosthesis at 24 weeks (P = .034). Correlation between OHIP-14 and DSQ was not significant (P > .05). Individual results of each group (ie, within group analysis) over all assessed time points revealed a significant OHrQoL (P = .001 for conventional, P = .006 for mini-implants) and satisfaction (P < .001 for both groups) improvement in both groups.
CONCLUSION
Mandibular overdentures retained by two conventional or mini-implants lead to a significant and comparable improvements in OHrQoL and satisfaction over a 1-year follow-up.
Topics: Cohort Studies; Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Overlay; Humans; Jaw, Edentulous; Mandible; Patient Satisfaction; Quality of Life
PubMed: 33073516
DOI: 10.1111/cid.12955