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Dental and Medical Problems 2023The ball attachments and their O-rings used for the retention and stabilization of overdentures showed a decrease in retention as the number of cycles increased. This... (Review)
Review
The ball attachments and their O-rings used for the retention and stabilization of overdentures showed a decrease in retention as the number of cycles increased. This fact resulted in a decrease in the retention of the prosthesis. The purpose of this study was to evaluate the fatigue resistance of ball attachments through a systematic review. An electronic search was performed using the Cochrane Library, LILACS, PubMed, ScienceDirect, and Web of Science databases. The search was conducted based on the PICOS framework. The inclusion criteria involved in the search comprised research articles written in English and published between the years 2000 and 2020. In the final selection, 18 articles were included in the review. Most of these studies performed the fatigue retention tests using parallel implants without angles. However, some studies used different angles to analyze the fatigue retention values. With the passage of time, the wear results in deformation and, as a consequence, a decrease in the retention of most attachments, leading to treatment failure. The main factor to be considered is the loss of retention of these components and their low durability. The loss of retention is due to large extent to the materials used to manufacture the attachments and O-rings, the size and angulation of the implants, and the length of the prosthesis. Future research is needed to further elucidate the reasons for the failure of the attachments.
Topics: Humans; Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Overlay
PubMed: 37023344
DOI: 10.17219/dmp/146719 -
Journal of Oral Rehabilitation May 2023Several complete denture wearers have major complaints and may be benefitted from implant treatment. However, the factors that shape the demand for and utilization of...
BACKGROUND
Several complete denture wearers have major complaints and may be benefitted from implant treatment. However, the factors that shape the demand for and utilization of implants need further investigation.
OBJECTIVE
The aim was to evaluate edentulous patient's willingness to accept or refuse the offer and provision of implant-retained treatment.
METHODS
As part of a clinical trial, edentulous subjects were offered a mandibular overdenture retained by four mini-implants opposing a conventional maxillary denture. Treatment was offered without any financial costs for the patients. Patients' level of interest in receiving treatment was assessed using a 5-point Likert scale, and they were asked to respond to a list of reasons that led to their decision to accept or refuse implants. Those who refused implants received conventional prosthodontic interventions as required, and those who accepted implant treatment underwent surgical planning and implant placement.
RESULTS
Of 175 eligible subjects, 147 accepted the offer of treatment and were invited to take part in the study (69.4% women, mean age 67.4 ± 10.0 years). Overall, 111 patients (75.5%) expressed a positive intention to undergo implant treatment at the initial contact. Implant treatment was performed for 56.3% (9/16) of those who answered 'probably yes' about their level of interest in implant treatment on the Likert scale, and 69.6% (64/92) of 'certainly yes' (p < .001). Older subjects were less likely to receive implants (OR = 0.93; p = .036), whilst those with a positive intention towards implants (OR = 3.15; p = .001), those previously treated by the dental team (OR = 7.89; p < .001), and who actively demanded implants (OR = 18.1; p < .001) were more likely to accept treatment. Improved chewing was the most common reason for accepting implants, whilst fear of surgery was the most reported reason for refusal.
CONCLUSION
Refusal of implants was high among edentate patients even when financial costs were removed. Patients' initial attitude towards acceptance is a key factor in the demand for and uptake of implant therapy.
Topics: Humans; Female; Middle Aged; Aged; Male; Prospective Studies; Dental Implants; Patient Satisfaction; Denture, Overlay; Jaw, Edentulous; Mouth, Edentulous; Mandible; Dental Prosthesis, Implant-Supported; Denture Retention
PubMed: 36789570
DOI: 10.1111/joor.13429 -
Clinical Oral Implants Research Apr 2023The objective of this study was to assess, over a period of 5 years, implant prosthesis and patient-reported outcomes of complete dentures retained by four...
OBJECTIVES
The objective of this study was to assess, over a period of 5 years, implant prosthesis and patient-reported outcomes of complete dentures retained by four implant-supported attachments in the edentulous maxilla facing either natural teeth or fixed rehabilitation in the lower jaw.
MATERIALS AND METHODS
Implant, prosthodontic and patient-related outcomes were assessed in 30 patients at 1, 3 and 5 years. Prosthodontic survival, complications or maintenance events as well as implant survival were recorded. Patient-reported outcome measures (PROMs) were evaluated with the Oral Health Impact Profile (OHIP-20) questionnaire and a visual analogue scale (VAS) before implant placement (baseline) and during the follow-up period.
RESULTS
After 5 years, three patients dropped out, 21 implants failed, and four overdentures were replaced leading to a prosthesis survival rate of 85.2% (95% CI: 71.8%-98.6%) and an implant survival rate of 80.6% (95% CI: 73.1%-88.0%). Prosthodontic success rate decreased from 86.2% to 74% between the 1st and the 3rd year and reached 63% after 5 years. OHIP results improved significantly from baseline to 1 year (p < .0001) and to 3 years (p = .036), but, at 5 years, the improvement was no longer significant when compared to baseline (p = .12). The overall VAS score remained significantly higher up to 5 years (p < .001).
CONCLUSION
A substantial number of prosthetic complications and replacements occurred over the 5-year follow-up. After 5 years, the OHIP-20 deteriorated and reached again the baseline level. Nonetheless, the VAS results suggest significantly increased patient satisfaction after implant-supported retention was provided for the removable prostheses.
Topics: Humans; Maxilla; Dentition; Denture, Overlay; Denture Retention; Dental Implants; Jaw, Edentulous; Patient Satisfaction; Mandible; Dental Prosthesis, Implant-Supported
PubMed: 36692949
DOI: 10.1111/clr.14033 -
Journal of Indian Prosthodontic Society 2022The purpose of this study is to evaluate the retention effectiveness of Molloplast B as a female attachment compared to O rings' in implant supported overdentures. (Meta-Analysis)
Meta-Analysis
AIM
The purpose of this study is to evaluate the retention effectiveness of Molloplast B as a female attachment compared to O rings' in implant supported overdentures.
SETTINGS AND DESIGN
This systematic review and meta-analysis was evaluated using the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines.
MATERIALS AND METHODS
Sixteen female part models were divided into two groups: eight female parts made with O ring (Group A) and eight female parts made with Molloplast B (Group B). All of the models were soaked in artificial saliva for 24 h, then, their retention force was measured in Newton using a Universal mechanical testing machine, initially, after 500, after 1000, and after 1500 of loading and dislodging cycles.
STATISTICAL ANALYSIS USED
: The statistical analysis was conducted by using one way ANOVA test and Bonferroni test. SPSS Software (SPSS, Version 27, IBM Co., Chicago, IL, USA).
RESULTS
After 1500 loading and dislodging cycles, Group B has the highest mean retention force (4.09), followed by Group A, which has a mean retention force of 3.73.
CONCLUSION
Molloplast B with a 2.7 mm diameter ball attachment lost the least amount of retention force after 1500 loading and dislodging cycles.
Topics: Female; Humans; Denture Retention; Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Dental Implants; Denture, Overlay
PubMed: 36511057
DOI: 10.4103/jips.jips_43_22 -
Journal of Indian Prosthodontic Society 2022The aim of this study was to compare the function and coordination of masticatory muscles for patients with two implant-supported mandibular overdenture (ISOD) with that... (Clinical Trial)
Clinical Trial
A comparative study to evaluate surface electromyographic correlations of mandibular implant-supported overdentures to conventional complete dentures in edentulous patients: An study.
AIM
The aim of this study was to compare the function and coordination of masticatory muscles for patients with two implant-supported mandibular overdenture (ISOD) with that of conventional complete dentures (CCD) using surface electromyography (sEMG). The objectives were to assess the muscle activity (efficiency) and clinical outcome after the transition of CCD patients to ISOD.
SETTING AND DESIGN
This was a crossover study.
MATERIALS AND METHODS
This clinical trial was conducted in the department of prosthodontics. A total of 15 patients (nine males and six females) were assessed using sEMG. In each patient, a total of four surfaces were examined above the following muscles - right and left masseter and right and left temporalis muscles. The electromyography readings were recorded to assess muscle activity during Clenching, cotton roll clenching, and chewing. The readings were recorded first for CCD and then for ISOD (after installing attachments).
STATISTICAL ANALYSIS USED
Data analysis was done using independent t-test and one-way ANOVA.
RESULTS
Mean muscular activity of masseter during clenching, cotton roll clenching, and chewing for patients with ISOD (44.3 ± 11.2 μV, 41.1 ± 13.4 μV, and 45.2 ± 17.5 μV) was higher than CCD (26.0 ± 11.3 μV, 22.6 ± 9.7 μV, and 24.2 ± 9.5 μV). The mean muscular activity of temporalis during clenching, cotton roll clenching, and chewing was also higher with ISOD (47.9 ± 11.2 μV, 45.6 ± 11.9 μV, and 51.0 ± 14.4 μV) than CCD (31.0 ± 12.2 μV, 29.7 ± 15.3 μV and 31.9 ± 14.2 μV). No statistically significant result was found between masseter and temporalis muscle activity on both sides (P < 0.05), indicating symmetrical activity on both the sides.
CONCLUSION
Two-ISODs prove to be a better and efficient treatment modality in rehabilitating edentulous patients as it enhances retention and also increases masticatory muscle activity and chewing efficiency.
Topics: Female; Humans; Male; Cross-Over Studies; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Complete; Denture, Overlay; Mouth, Edentulous
PubMed: 36511054
DOI: 10.4103/jips.jips_368_21 -
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 -
International Journal of Implant... Dec 2022To assess the implant and prosthesis survival rates, the clinical, radiographical and patient-related outcome measures, and the masticatory performance of maxillary...
PURPOSE
To assess the implant and prosthesis survival rates, the clinical, radiographical and patient-related outcome measures, and the masticatory performance of maxillary overdentures supported by two implants in patients with an atrophic maxilla.
METHODS
In this case series, 15 consecutive patients who were eligible for maxillary implant overdenture therapy, but who had insufficient bone volume to place at least four implants and were unwilling to be treated with reconstructive surgery were asked to participate. After giving consent, participants received two implants in the maxilla under local anaesthesia. After 3 months of osseointegration, a maxillary overdenture with palatal coverage and solitary attachments was fabricated. Implant and overdenture survival, marginal bone level change, clinical outcome measures, masticatory performance and patient-related outcomes were evaluated at baseline and 1 year after overdenture placement.
RESULTS
Fourteen out of 15 participants completed the follow-up period of 12 months. Implant and overdenture survival rate were 89.3% and 85.7%, respectively. Change in marginal bone level (- 0.5 ± 0.7 mm), change in probing depth (0.0 ± 1.0 mm), and clinical outcomes were favourable. Masticatory performance and patient-related outcomes improved significantly compared to baseline. Complications were minimal.
CONCLUSIONS
Within the limitations of this study, it can be concluded that patients with extreme resorption of the maxilla that are unwilling to be treated with reconstructive surgery, benefit from two-implant maxillary overdentures retained by solitary attachments in terms of improved masticatory functioning and denture satisfaction. However, they have relatively high risk of implant loss.
TRIAL REGISTRATION
UMCG Trial Register (RR201900060), registered 22 January 2019.
Topics: Humans; Jaw, Edentulous; Denture Retention; Dental Prosthesis, Implant-Supported; Dental Implants; Denture, Overlay; Atrophy
PubMed: 36484878
DOI: 10.1186/s40729-022-00460-0 -
Journal of Prosthodontic Research Jul 2023We investigated and compared the stress distribution within one- and two-piece mini-implants for overdentures with three different attachments (ball, Locator, and...
PURPOSE
We investigated and compared the stress distribution within one- and two-piece mini-implants for overdentures with three different attachments (ball, Locator, and magnet) and two different diameters using three-dimensional finite element (3D FE) analysis and a monotonic bending test. The goal was to identify the most beneficial implant attachment system design for mini-implant overdentures with a lower risk of implant fracture.
METHODS
Twelve 3D FE models simulating a mandible segment with one- and two-piece mini-implants with different attachment systems, diameters, and overdentures were created using three-dimensional computer-aided design (CAD) software. Vertical and oblique forces (45° to the longitudinal axis of the implant) of 100 N were applied to the dentures. The stress distribution was analyzed. A bending test was performed on a mini-implant (Locator, 2.4 mm) using a testing machine to quantify the load at yield stress.
RESULTS
One-piece mini-implants showed lower maximum stress compared to two-piece mini-implants. Among the three designs, the magnet attachment systems showed the maximum stress. The maximum von Mises stress occurred at the neck of the implants, which was surrounded by cortical bone in all models, and under both loading conditions.
CONCLUSIONS
Focusing on the attachments and one- and two-piece designs of mini-implant overdentures using CAD models to reduce confounding factors affecting the stress distribution, we concluded that one-piece mini-implants tended to show lower stress compared to two-piece mini-implants. Mini-implant overdentures with Locator and ball attachments demonstrated lower stress within the implants compared to those with magnet attachments under vertical and oblique loading conditions.
Topics: Dental Implants; Stress, Mechanical; Finite Element Analysis; Denture, Overlay; Dental Prosthesis, Implant-Supported; Mandible; Dental Stress Analysis; Denture Retention
PubMed: 36372437
DOI: 10.2186/jpr.JPR_D_22_00108 -
Journal of Dentistry Dec 2022To evaluate the benefits of implant therapy for patients with diabetes, we compared (i) healthy, (ii) well controlled T2DM and (iii) poorly controlled T2DM patients, in...
OBJECTIVES
To evaluate the benefits of implant therapy for patients with diabetes, we compared (i) healthy, (ii) well controlled T2DM and (iii) poorly controlled T2DM patients, in terms of oral health-related quality of life (OHRQoL) and satisfaction with mandibular 2-implant overdentures over 12 months following restoration.
MATERIALS AND METHODS
This single-center, prospective, cohort study recruited 165 edentulous adults (HbA1c<12%) to receive two endosseous implants in the anterior mandible to support mandibular overdentures. Participants were enrolled as having T2DM or not, with T2DM participants divided according to HbA1c into well-controlled (<8.1%) and poorly controlled (≥ 8.1%) groups. Participants provided responses to the OHIP-20 (OHRQoL) and the McGill Denture Satisfaction Questionnaire, before implant therapy and 6 and 12 months after overdenture insertion using Locator attachments. HbA1c was measured at the same time points. The effect of groups and time was verified using generalized estimating equations (α=0.025).
RESULTS
At 12 months, 137 participants provided responses. The two diabetes groups showed improvements in OHRQoL to the same extent as the non-diabetic control group at both 6 and 12 months. Patient satisfaction showed similar improvements with no between-group differences and similar increases identified at 6 and 12 months. HbA1c was not affected by time or groups.
CONCLUSIONS
Dental implant therapy provided significant improvements in patient-perceived benefits of mandibular two-implant overdentures for T2DM individuals, which are similar to those found for healthy edentulous individuals. Importantly, those benefits extend to those individuals with poorly controlled glycaemia. The addition of 2-implant supported mandibular overdentures did not affect glycaemic status over 12 months following insertion.
CLINICAL SIGNIFICANCE
As risks for implant therapy relative to glycaemic status are better understood, this study documents that implant therapy may offer important benefits in QoL for T2DM patients independent of glycaemic status.
Topics: Humans; Denture, Overlay; Quality of Life; Prospective Studies; Jaw, Edentulous; Personal Satisfaction; Cohort Studies; Dental Prosthesis, Implant-Supported; Patient Satisfaction; Mouth, Edentulous; Mandible; Diabetes Mellitus, Type 2; Dental Implants; Denture Retention
PubMed: 36351489
DOI: 10.1016/j.jdent.2022.104357 -
Journal of Prosthodontic Research Jul 2023Purpose To compare the 5-year follow-up outcomes of maxillary overdentures retained by bars or solitary attachments.Methods Fifty consecutively selected fully edentulous... (Randomized Controlled Trial)
Randomized Controlled Trial
Purpose To compare the 5-year follow-up outcomes of maxillary overdentures retained by bars or solitary attachments.Methods Fifty consecutively selected fully edentulous patients experiencing problems with their conventional denture received four implants and were randomly allocated to receive a maxillary overdenture with either bar- or solitary attachment retention. Marginal bone level change (primary outcome), implant- and overdenture survival rate, clinical- and patient related outcome measures were recorded at baseline, and after 1 and 5 years. Biological and technical complications were recorded throughout the entire follow-up period.Results After 5 years, the mean marginal bone level change was higher in the solitary attachment group (-1.41±1.38mm, P=0.024) than in the bar group (-0.99±0.96mm). Also, fewer implants survived in the solitary attachment group (89.5%, P=0.027) than in the bar group (96.3%). The overdenture survival rate was 95.0% and 91.3% in the bar and solitary attachment group, respectively. Although the clinical and patient related outcomes were favourable and did not differ significantly between the groups, the peri-implantitis incidence was 25.8% in the solitary attachment group and 5.1% in the bar group. Any technical complications were minor.Conclusions In maxillary 4-implant overdenture therapy, the marginal bone level, implant survival rate and the number of complications are better with bar attachments than with solitary attachments. Both groups' clinical and patient related outcome measure scores were equal throughout the entire follow-up period.
Topics: Humans; Denture, Overlay; Mouth, Edentulous; Peri-Implantitis; Maxilla; Dental Prosthesis, Implant-Supported; Denture Retention; Jaw, Edentulous; Dental Implants
PubMed: 36261342
DOI: 10.2186/jpr.JPR_D_22_00076