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BMC Oral Health Nov 2023Attachment material is one of the contributing factors to the degree of wear of the attachment components in mandibular implant-retained overdentures. The purpose of...
Quantitative and qualitative assessment of the wear pattern of two attachment systems of dissimilar materials for mandibular implant-retained overdentures: an in-vitro study.
BACKGROUND
Attachment material is one of the contributing factors to the degree of wear of the attachment components in mandibular implant-retained overdentures. The purpose of this in vitro study was to compare the wear behavior of 2 different attachment systems of dissimilar materials in mandibular implant-retained overdentures by qualitative and quantitative methods.
METHODS
Two attachment systems of different materials were utilized (n = 16); Titach (Dental Evolutions Inc, Beverly Hills, CA, USA) with a titanium-to-titanium interface and Locator R-Tx (Zest Anchors Inc, Escondido, CA, USA) with a titanium-to-nylon interface. One thousand cycles of overdenture insertion and removal simulating 1-year clinical use were performed. All matrices were removed from the overdentures and all patrices were unscrewed from the implants for wear assessment quantitively using a stereomicroscope and qualitatively using a scanning electron microscope. Data were analyzed by using an independent sample t test.
RESULTS
After cyclic loading, stereomicroscopic findings showed that the Titach group had statistically significant higher wear value than the Locator R-Tx group (p < 0.001). Moreover, scanning electron microscopy images showed noticeable abrasion in Titach patrix at the area of highest convexity. However, the Locator R-Tx matrix displayed an apparent tear of rubber inserts.
CONCLUSIONS
Titach attachment with the titanium-to-titanium interface revealed more wear than Locator R-Tx attachment with the titanium-to-nylon interface. Thus, the type of attachment material influences the degree of wear of the attachment components.
Topics: Humans; Denture, Overlay; Titanium; Nylons; Dental Prosthesis, Implant-Supported; Denture Retention; Dental Materials; Mandible; Dental Implants; Dental Stress Analysis
PubMed: 38036982
DOI: 10.1186/s12903-023-03693-6 -
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 -
The International Journal of... Apr 2024To investigate the long-term predictability of simplifying mandibular overdenture treatment using single-stage surgery and immediate prosthetic loading of a single...
PURPOSE
To investigate the long-term predictability of simplifying mandibular overdenture treatment using single-stage surgery and immediate prosthetic loading of a single implant to provide a more affordable treatment option.
MATERIALS AND METHODS
A total of 29 patients with a mean age of 68 years with problematic mandibular dentures were treated. A single implant (Brånemark System Mklll TiUnite, Nobel Biocare) was placed into the mandibular midline for primary stability. A ball attachment was placed, and the retentive cap was incorporated into the existing denture. The patients were recalled at 3 and 12 months and at 3, 5, 10, and 15 years. Clinical assessments, radiographs, and resonance frequency analysis were recorded. All complications, failures, maintenance, and reasons for failure to follow-up were noted. Visual analog scale (VAS) questionnaires were used to record patient satisfaction (ANOVA; P < .05).
RESULTS
One implant did not achieve sufficient primary stability to be immediately loaded and was treated with a two-stage delayed loading protocol. Of the 28 patients receiving immediately loaded implants, 14 patients were available for follow-up at 15 years. Implant survival remained at 100% throughout the study. Patient satisfaction was high, with a significant increase in all comfort and functional parameters (P values ranged from < .001 to .07) throughout the 15-year period.
CONCLUSIONS
These 15-year results indicate that immediate loading of a single oxidized surface implant used to retain a mucosa-borne overdenture is a safe, reliable, and cost-effective treatment with high levels of patient satisfaction long term.
Topics: Humans; Denture, Overlay; Aged; Prospective Studies; Dental Prosthesis, Implant-Supported; Follow-Up Studies; Immediate Dental Implant Loading; Female; Male; Mandible; Middle Aged; Patient Satisfaction; Denture Retention; Denture, Complete, Lower; Treatment Outcome; Dental Implants, Single-Tooth; Aged, 80 and over
PubMed: 37988425
DOI: 10.11607/ijp.8404 -
The Journal of Prosthetic Dentistry Feb 2024The 2-implant mandibular overdenture (2IMO) is a popular treatment for patients with mandibular edentulism. However, information on the influence of implant positions on...
STATEMENT OF PROBLEM
The 2-implant mandibular overdenture (2IMO) is a popular treatment for patients with mandibular edentulism. However, information on the influence of implant positions on crestal strain is lacking.
PURPOSE
The purpose of this in vitro study was to evaluate the crestal strain around 2 implants to support mandibular overdentures when placed at different positions.
MATERIAL AND METHODS
Edentulous mandibles were 3-dimensionally (3D) designed separately with 2 holes for implant placement at similar distances of 5, 10, 15, and 20 mm from the midline, resulting in 4 study conditions. The complete denture models were 3D designed and printed from digital imaging and communications in medicine (DICOM) images after scanning the patient's denture. Two 4.3×12-mm dummy implants were placed in the preplanned holes. Two linear strain gauges were attached on the crest of the mesial and distal side of each implant (CH1, CH2, CH3, and CH4) and connected to a computer to record the electrical signals. Male LOCATOR attachments were attached, the mucosal layer simulated, and the denture picked up with pink female nylon caps. A unilateral and bilateral force of 100 N was maintained for 10 seconds for each model in a universal testing machine while recording the maximum strains in the DCS-100A KYOWA computer software program. Data were analyzed by using 1-way analysis of variance, the Tukey post hoc test, and the paired t test (α=.05).
RESULTS
Under bilateral loading, the strain values indicated a trend with increasing distance between the implants with both right and left distal strain gauges (CH4 and CH1). The negative (-ve) values indicated the compressive force, and the positive (+ve) values indicated the tensile force being applied on the strain gauges. The strain values for CH4 ranged between -166.08 for the 5-mm and -251.58 for the 20-mm position; and for CH1 between -168.08 for the 5-mm and -297.83 for the 20-mm position. The remaining 2 mesial strain gauges for all 4 implant positions remained lower than for CH4 and CH1. Under unilateral-right loading, only the right-side distal strain gauge CH4 indicated the increasing trend in the strain values with -147.5 for the 5-mm, -157.17 for the 10-mm, -209.33 for the 15-mm, and -234.75 for the 20 mm position. The remaining 3 strain gauges CH3, CH2, and CH1 ranged between -28.33 and -107.17. For each position for both implants, significantly higher (P<.05) strain values were observed on the distal strain gauge channels CH4 and CH1 than on the mesial channels CH3 and CH2 under bilateral loading and on the right side under unilateral loading.
CONCLUSIONS
Peri-implant crestal strains in the 2IMO increased by increasing the distance of the implants from the midline. The stress values progressively increased from 5 to 10 mm to 15 to 20 mm from midline, represented as lateral incisor, canine, and premolar positions. The distal side of the implants exhibits higher strains than the mesial side of the implants.
Topics: Humans; Female; Male; Dental Implants; Denture, Overlay; Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Mandible; Printing, Three-Dimensional; Denture Retention
PubMed: 37985307
DOI: 10.1016/j.prosdent.2023.10.023 -
European Journal of Medical Research Nov 2023This study aims to evaluate the digitally designed ball attachment housing in its initial retentive force and after 2 years of simulated clinical use and to compare it...
PURPOSE
This study aims to evaluate the digitally designed ball attachment housing in its initial retentive force and after 2 years of simulated clinical use and to compare it with the regular nylon ball attachment housing.
MATERIALS AND METHODS
Twenty implants with their corresponding ball abutments (diameter 4.5 × 4.0 mm) were inserted in resin blocks. They were divided into two groups. In Group I, ten ball abutments each received their corresponding conventional attachment with nylon rings. In Group II, ten ball abutments received the novel CAD-CAM polyetheretherketone ball attachment housing. A universal testing machine was used to measure the retention force. The achieved maximum values of retention force were recorded at the beginning of the study (initial retention) and after 2 years of artificial ageing (2000 cycles of insertion and removal). Results were statistically analyzed using an independent sample T test.
RESULTS
The PEEK attachment housing showed high retention forces (25.12 ± 0.99 N) compared to the conventional attachment with a nylon ring (15.76 ± 0.93 N) in the initial dislodgement test. There was a statistically significant difference in mean retention at the initial retention test and after 2 years of stimulated usage between the two studied groups, p = 0.000.
CONCLUSIONS
Within the limitations of this study, the novel CAD-CAM-PEEK attachment showed high retention characteristics compared to the conventional attachment with nylon rings, initially and after simulated long-term use.
Topics: Humans; Housing; Nylons; Denture Retention; Denture, Overlay; Materials Testing; Polyethylene Glycols; Ketones; Computer-Aided Design
PubMed: 37968756
DOI: 10.1186/s40001-023-01498-5 -
The Journal of Prosthetic Dentistry Nov 2023Custom-made angled LOCATOR abutments have been used to compensate for the angulation of implants placed to support removable prostheses; however, their retention forces...
STATEMENT OF PROBLEM
Custom-made angled LOCATOR abutments have been used to compensate for the angulation of implants placed to support removable prostheses; however, their retention forces and the impact of mastication loading on retention have yet to be well addressed.
PURPOSE
The purpose of this in vitro study was to evaluate the retention force of custom-made LOCATOR abutments for implants placed at 0-, 15-, and 30-degree angulations with prefabricated abutments and to investigate the effect of mastication load on retention.
MATERIAL AND METHODS
Implant analogs were placed at the first molars of 40 maxillary typodonts, and 40 LOCATOR abutments were fabricated. Twenty implant analogs were placed at 0 degrees, 10 of which received prefabricated LOCATOR abutments and 10 of which received custom abutments. The remaining 20 implant analogs were placed at 15- and 30-degree angulations (n=10), and custom LOCATOR abutments were fabricated on them. A denture analog was digitally designed and manufactured from polymethyl methacrylate (PMMA) billets. Metal housings were then picked up using PMMA. The specimens were subjected to 2 rounds of 120 000 cycles of mastication loading. Retention force was assessed before and after each round of mastication loading using a universal testing machine. The wear of nylon inserts before and after mastication loading was accessed with a digital stereomicroscope. A 2-way ANOVA followed by the Tukey HSD test was used to determine the impacts of LOCATOR abutment type and times of mastication loading on the retention forces of the denture base (α=.05).
RESULTS
No significant difference in retention forces was found between prefabricated LOCATOR and custom abutments (placed at 0-, 15-, and 30-degree angulations) regardless of mastication loading (P>.05). The retentive force values of all groups increased significantly after the first round of mastication loading and decreased significantly to the initial level after the second round of mastication loading (P<.05).
CONCLUSIONS
Mastication loading impacted the retention force of both prefabricated and custom LOCATOR abutments; however, no significant difference in retention forces was found among various types of abutments.
Topics: Dental Implants; Denture Retention; Mastication; Polymethyl Methacrylate; Dental Prosthesis, Implant-Supported; Denture, Overlay; Dental Stress Analysis; Dental Abutments
PubMed: 37953027
DOI: 10.1016/j.prosdent.2023.07.033 -
Journal of Prosthodontics : Official... Apr 2024Single implant retained mandibular overdenture treatment has been shown to be a minimally invasive, satisfactory, and cost-effective option for edentulous individuals....
PURPOSE
Single implant retained mandibular overdenture treatment has been shown to be a minimally invasive, satisfactory, and cost-effective option for edentulous individuals. However, the impact of implant diameter and length on stress distribution at the implant, bone, and other components in this treatment approach remains unclear. The purpose of this 3D finite element analysis was to evaluate the effect of implant length and diameter on equivalent von Mises stress and strain distribution in single implant retained overdentures at bone, implant, and prosthetic components.
MATERIALS AND METHODS
Nine models were constructed according to implant lengths (L) (8, 10, 12 mm) and diameters (D) (3.3, 4.1, 4.8 mm). The implants were positioned axially, in the midline of the mandible. A 3D model of the edentulous mandible was created from a computed tomography image. A single implant, abutment with insert PEEK and a housing, acrylic denture, and Co-Cr framework were modeled separately. In the ANSYS software program, occlusal loads were applied as 150 N, bilaterally vertical direction, or unilaterally oblique direction to the first molar. Minimum principal stress values were evaluated for bone and equivalent von Mises stress and strain values were evaluated for implant and prosthetic components.
RESULTS
Von Mises stress values for vertical load increased at implant, housing, and insert PEEK for all groups when the length of the implant increased. When oblique load was applied, 3.3 mm diameter implant groups showed maximum von Mises stress values for implants, cortical bone, cancellous bone, and housing among all groups. A minimum stress level for implant was found in D4.1/L8 group. Regarding the insert PEEK, strain values were found to be higher as the diameter of the implant increased both for vertical and oblique loads. Cortical bone showed higher minimum principal stress values as compared to cancellous bone under both loading conditions.
CONCLUSIONS
The 3.3 mm diameter implant groups exhibited the highest von Mises stress and strain values for both loading conditions at the implant. The diameter of the implant had a greater impact on stress and strain levels at the implant site compared to length. For vertical loading, stress value increased at implant, housing, and PEEK when the length of the implant increased.
Topics: Humans; Dental Implants; Denture, Overlay; Finite Element Analysis; Dental Prosthesis, Implant-Supported; Mandible; Dental Stress Analysis; Stress, Mechanical; Biomechanical Phenomena; Benzophenones; Polymers
PubMed: 37950537
DOI: 10.1111/jopr.13795 -
Nigerian Journal of Clinical Practice Oct 2023Implant-supported overdentures are well-known and widely accepted treatment modality to increase retention which is a crucial factor for determining patient...
Biomechanical behavior of carbon fiber-reinforced polyetheretherketone as a dental implant material in implant-supported overdenture under mandibular trauma: A finite element analysis study.
CONTEXT
Implant-supported overdentures are well-known and widely accepted treatment modality to increase retention which is a crucial factor for determining patient satisfaction. The placement of two implants in the anterior region can be selected as a first-line treatment in patients with the atrophic mandibular ridge.
AIMS
The purpose of this research was to assess the biomechanical effects of carbon fiber-reinforced polyetheretherketone (CFR-PEEK) implant-supported overdenture in the event of 2,000 N forefront trauma to an atrophic edentulous mandible by using the finite element analysis method.
MATERIALS AND METHODS
Three types of mandible models were simulated; the first one was an edentulous atrophic mandible model; in the second model, 3.5 × 11.5 mm CFR-PEEK implants; and in the third model, 4.3 × 11.5 mm CFR-PEEK implants were positioned in the region of the lateral incisor of the identical edentulous atrophic mandible.
RESULTS
Maximum Von Misses stresses 979.261 MPa, 1,454.69 MPa, and 1,940.71 MPa and maximum principal stresses 1,112.74 MPa, 1,249.88 MPa, and 1,251.33 MPa have been detected at the condylar neck area and minimum principal stresses - 1,203.38 MPa, -1,503.21 MPa, and - 1,990.34 MPa have been recorded at the symphysis and corpus regions from M1 to M3, respectively. In addition, the M2 and M3 models showed low-stress distributions around the implant-bone interface, particularly where the implants were in contact with cancellous bone.
CONCLUSIONS
The results showed that the insertion of different diameters of CFR-PEEK implants led to low and homogenous stress distribution all around the implant-bone interface and stresses transferred directly to the condylar neck areas. Therefore, it was observed that CRF-PEEK implants did not change the basic behavior of the mandibula in response to frontal stresses.
Topics: Humans; Carbon Fiber; Denture, Overlay; Dental Implants; Finite Element Analysis; Mandible; Polyethylene Glycols; Ketones; Dental Materials; Dental Stress Analysis; Dental Prosthesis, Implant-Supported
PubMed: 37929532
DOI: 10.4103/njcp.njcp_239_23 -
Clinical Implant Dentistry and Related... Feb 2024This study aimed to evaluate the clinical outcomes and patient satisfaction of 4-implant-assisted maxillary overdentures using two different designs. (Randomized Controlled Trial)
Randomized Controlled Trial
Vertical versus angled immediately loaded implants for assisting maxillary overdentures with locator attachments: A preliminary results of one-year randomized clinical trial.
OBJECTIVES
This study aimed to evaluate the clinical outcomes and patient satisfaction of 4-implant-assisted maxillary overdentures using two different designs.
MATERIALS AND METHODS
Thirty edentulous participants received four implants in the maxillary ridge. The patients were randomly divided into two equal groups: (1) the control (CG, Vertical) group (n = 15); participants received four vertical implants with straight locator attachments to retain maxillary overdentures, and (2) the study (SG, Angled) group (n = 15); participants received four angled implants with angled locator attachments to retain maxillary overdentures. Peri-implant tissue health [Plaque (PL) and gingival (GI) indices, pocket depth (PD), implant stability (ISQ) and crestal bone loss (CBL)] were evaluated after denture insertion (T0), 6 (T6), and 12 (T12) months after insertion. Patient satisfaction was evaluated using a visual analog scale (VAS) after 12 months.
RESULTS
The survival rates were 96.7% and 95% for the control and study groups respectively. PL, GI, and PD increased significantly in both groups with the passage of time. No significant difference in PL, GI, PD, and ISQ was noted between groups at all observation times. CG showed higher CBL than SG at T12. For the VAS results, there was no significant difference between groups. SG recorded significantly higher satisfaction regarding comfort with maxillary and mandibular dentures, retention of mandibular dentures, oral hygiene, the ability to chew hard food, and occlusion than CG.
CONCLUSION
Within the limitations of this study, angled implants with angled locator attachments may be recommended to retain maxillary overdentures opposing intact dentition or fixed restoration as it was associated with improvements of several parameters of peri-implant tissue health and patient satisfaction compared to vertical implants with straight locator attachments.
Topics: Humans; Dental Implants; Denture, Overlay; Jaw, Edentulous; Denture Retention; Patient Satisfaction; Dental Plaque; Mandible; Dental Prosthesis, Implant-Supported
PubMed: 37926953
DOI: 10.1111/cid.13291 -
Journal of Dentistry Mar 2024The aim of the present study was to assess the long-term course of OHRQoL and the impact of the loading protocol in patients receiving a single mandibular implant... (Randomized Controlled Trial)
Randomized Controlled Trial
Impact of loading protocol of a mandibular single implant-supported complete denture on oral health-related quality of life over a period of 5 years: A randomized controlled trial.
OBJECTIVES
The aim of the present study was to assess the long-term course of OHRQoL and the impact of the loading protocol in patients receiving a single mandibular implant supporting a complete denture over a period of five years.
METHODS
In this multicenter RCT, a total of 158 edentulous patients were initially included and were randomly allocated immediately after placement of a mandibular midline implant to either immediate loading (IL) or to conventional loading (CL) with submerged healing. The assessment of OHRQoL was performed with the 49-item Oral Health Impact Profile (OHIP) at baseline and 1, 4, 12, 24, and 60 months after loading. At 5-year follow-up, 100 patients (mean age: 69.2 years; 45.0% female) with completed OHIP were available for analyses. A mixed-effects model with patients as random effect and an unstructured covariance matrix was developed to address repeated outcome measurement.
RESULTS
The OHRQoL improved substantially after loading, indicated by a decrease of mean OHIP summary scores from 51.0 points at baseline, by 14.2 (95%-CI: 9.4 - 19.1; p<0.001) points to 37.2 points at 1-month follow-up, and by continuous improvement to 20.4 OHIP points at final follow-up. Considering constant treatment effects, the loading protocol had no significant effect on OHIP scores (-3.7, 95%-CI: -9.4 - 2.2; p = 0.204). Time effect was statistically significant with -0.21 (95%-CI: -0.28 - -0.15; p<0.001) points per month.
CONCLUSION
Both the immediate and conventional loading of a single mandibular midline implant supporting a complete denture offer long-lasting high levels of OHRQoL, with no significant or clinically relevant long-term differences.
CLINICAL SIGNIFICANCE
The study firstly presents long-term data for OHRQoL by investigating the loading protocol of single mandibular implant-supported complete dentures. Since immediate loading has been associated with a reduced implant survival rate for this concept, information on patient benefits is essential for evidence-based decision making.
Topics: Aged; Female; Humans; Male; Dental Prosthesis, Implant-Supported; Denture, Complete; Denture, Overlay; Mandible; Mouth, Edentulous; Multicenter Studies as Topic; Patient Satisfaction; Quality of Life; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 37926424
DOI: 10.1016/j.jdent.2023.104769