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International Journal of Implant... Feb 2021This randomized clinical trial aimed to evaluate the marginal bone loss and peri-implant aspects in patients with mandibular overdentures retained by one or two implants... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
This randomized clinical trial aimed to evaluate the marginal bone loss and peri-implant aspects in patients with mandibular overdentures retained by one or two implants and assess patient satisfaction, prosthesis-related clinical outcomes, and masticatory efficiency.
METHODS
Patients from the School of Dentistry of the University of Passo Fundo (UPF) with lower conventional complete dentures dissatisfied with prosthetic retention were selected. Eighteen patients were analyzed and divided into randomized treatment groups: GA, installation of one implant in the midline of the mandibular symphysis (8 patients), and GB, installation of two implants in the lower canine region (10 patients). Implant survival and prosthetic maintenance were assessed by clinical and radiographic examinations performed 6 months after implant placement and 3 months after loading. Finally, the masticatory efficiency of the prostheses was evaluated with the QoLIP-10 (Quality of Life with Implant-Prostheses) questionnaire, and the degree of patient satisfaction used the visual analog scale (VAS).
RESULTS
Regarding the esthetic satisfaction of the patients, there was no statistical difference between the two groups studied (p = 0.680). Patients who received two implants presented easier chewing (p = 0.049) and a lower average number of prosthesis maintenance. There was no difference between the groups regarding peri-implant bone resorption 3 months after the use of prostheses.
CONCLUSIONS
The use of two dental implants showed higher masticatory ability and lower need for maintenance appointments when compared with one implant in mandibular overdentures but did not affect peri-implant aspects and patient satisfaction. The treatment using one implant was effective for the aspects evaluated, but further clinical studies are required on the subject.
Topics: Dental Implants; Denture, Overlay; Follow-Up Studies; Humans; Personal Satisfaction; Quality of Life
PubMed: 33569757
DOI: 10.1186/s40729-020-00286-8 -
Journal of Personalized Medicine May 2023Alloplastic temporomandibular joint (TMJ) replacement is a well-established procedure in maxillo-facial surgery. However, the surgical management of large excision in...
Extended Complex Temporomandibular Joint Reconstructions Exploiting Virtual Surgical Planning, Navigation Assistance, and Custom-Made Prosthesis: A Comprehensive Protocol and Workflow.
BACKGROUND
Alloplastic temporomandibular joint (TMJ) replacement is a well-established procedure in maxillo-facial surgery. However, the surgical management of large excision in this area requires complex reconstruction beyond the standard TMJ prosthesis.
OBJECTIVE
This study aims to describe the design and the consequential application of a protocol which involves the use of computer-assisted surgery tools to best face complex TMJ reconstruction (TMJR). Preoperative accurate study of every single case and intraoperative check of the surgical act are nowadays essential to perform such delicate surgical procedures.
MATERIALS AND METHODS
The study is a retrospective and single institution case series. The various processes of the management and planning of extended TMJ reconstruction (eTMJR) are extensively described, from the preoperative clinical evaluation, imaging acquisition protocols and virtual surgical planning (VSP), focusing also on the intraoperative transfer of VSP using navigation and surgical guides.
RESULTS
We included nine patients with different pathologies which were candidates for eTMJR. Overall, the application of our protocol and workflow permitted the reduction of complications and pain, and the improvement of the maximum interincisal opening (MIO) of the patients, restoring patients' masticatory function and esthetics.
CONCLUSIONS
The eTMJR should be considered as a safe and reliable surgical management modality in selected patients with large temporomandibular joint and skull base (TMJ-SB) lesions. An accurate preoperative protocol and workflow is essential to perform such insidious and complex reconstruction. However, more extensive studies on this type of device have to be conducted in order to validate its real usefulness and indications.
PubMed: 37373920
DOI: 10.3390/jpm13060931 -
Australian Dental Journal Jun 2018This retrospective cohort study reviewed dental implant treatment completed at the Adelaide Dental Hospital over a 20-year period.
BACKGROUND
This retrospective cohort study reviewed dental implant treatment completed at the Adelaide Dental Hospital over a 20-year period.
METHODS
The database of implant treatment completed between 1996 and 2015 was analysed for patient, implant, prosthesis and operator specifics together with known implant status.
RESULTS
Three hundred and twenty patients (mean age, 51.50 years) were treated with 527 implants. One hundred and eighty-four female patients received 296 implants and 136 males received 231 implants. Three hundred implants were restored with single crowns, 147 implants were restored with 63 mandibular implant overdentures, five implants were restored with two maxillary implant overdentures and 67 implants were restored with 20 full-arch fixed prostheses. The overall known implant survival rate was 87.67%. Mandibular implant overdentures had a risk of implant failure four times that of single implant-retained crowns that was statistically significant (P = 0.0100).
CONCLUSIONS
Implant treatment completed in this public sector clinic using finite resources and a defined system of patient and restorative selection criteria demonstrated a high known implant survival rate. Utilizing a structured and maintained patient recall protocol, it would be ideal to investigate further parameters of interest, particularly those that could improve treatment delivery and longevity.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Australia; Crowns; Dental Clinics; Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture, Overlay; Female; Humans; Male; Mandible; Maxilla; Middle Aged; Registries; Retrospective Studies; Treatment Outcome; Young Adult
PubMed: 29396995
DOI: 10.1111/adj.12598 -
Clinical and Experimental Dental... Apr 2024Guided implant systems can be used as a training approach for placing implants. This in vitro prospective randomized pilot study evaluated the learning progression and... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
Guided implant systems can be used as a training approach for placing implants. This in vitro prospective randomized pilot study evaluated the learning progression and skill development in freehand placement of two implants supporting a three-unit fixed prosthesis on a simulation model among novice operators.
MATERIAL AND METHODS
Four senior dental students with no prior implant placement experience participated in the study. As a baseline, each student placed two mandibular and two maxillary implants by freehand technique on a simulation model. Sixteen consecutive guided placements using a static guide, dynamic navigation, and template-based guide followed totaling 32 guided implant placements into maxillary and mandibular models. Freehand implant placements before and after the various guided navigation attempts were compared to assess their impact on freehand skill. Metrics compared included surgical time, horizontal, vertical, and angulation discrepancies between the planned and placed implant positions measured on superimposed CBCT scans and analyzed with repeated measures regression with Tukey's adjusted pairwise comparisons (α = .05).
RESULTS
Before training with guided techniques, the average baseline freehand implant placement took 10.2 min and decreased to 8.2 after training but this difference was not statistically significant (p = .1670) There was marginal evidence of a significant difference in the 3D apex deviation with an average improvement of 0.89 mm (95% CI: -0.38, 2.16, p = .1120); and marginal evidence of a significant improvement in the overall angle with an average improvement of 3.74° (95% CI: -1.00, 8.48, p = .0869) between baseline and final freehand placement attempts.
CONCLUSIONS
Within the limitations of this pilot study, guided implant placement experiences did not significantly benefit or hinder freehand placement skills. Dental students should be exposed to various placement techniques to prepare them for clinical practice and allow them to make informed decisions on the best technique based on their skills and a given clinical scenario.
Topics: Humans; Dental Implants; Pilot Projects; Prospective Studies; Surgery, Computer-Assisted; Dental Implantation, Endosseous
PubMed: 38506282
DOI: 10.1002/cre2.878 -
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 -
Tzu Chi Medical Journal 2021Many authors' have advocated a minimum of two implants to support a mandibular overdenture, but financial restraints specifically among the geriatric population in...
OBJECTIVES
Many authors' have advocated a minimum of two implants to support a mandibular overdenture, but financial restraints specifically among the geriatric population in developing countries made this treatment plan economically difficult. Hence, this study was planned to assess the symphyseal (midline) single implant-assisted complete overdenture for patient satisfaction and masticatory performance.
MATERIALS AND METHODS
In this clinical study, 12 edentulous first-time denture wearers underwent placement of a single implant in the mandibular symphyseal region. After 1 week, new complete dentures were fabricated and delivered to the patients. Post 3 months, the denture was fixed with a nylon cap-ball attachment to the anchor implant. Patients were questioned about comparison in the level of satisfaction and complaint before loading the implant (control group) and after 1 week, 1 month, and 3 months. The implant-assisted overdenture was fabricated with the help of a questionnaire. Masticatory performance was calculated with the help of a bite force measuring device at the same time intervals. SPSS 17.0 statistical software was used to analyze the data.
RESULTS
It was found that single implant anchorage of the mandibular complete denture resulted in a significant increase ( < 0.05) in patient's subjective satisfaction and a decrease ( < 0.05) in complaints at the end of 3 months. There was a significant ( < 0.01) increase in bite force in implant overdenture after 3 months (5.459 kgf) as compared to that of the complete denture (3.406 kgf).
CONCLUSION
Single implant-assisted overdenture can be an appropriate treatment modality to treat edentulousness in the geriatric population. It insinuates the remarkable improvement of prosthesis function and oral comfort with minor surgical procedures.
PubMed: 34760639
DOI: 10.4103/tcmj.tcmj_242_20 -
Clinical Oral Investigations May 2024The aim of this multi-center pilot study was to assess the viability and feasibility of a novel treatment concept - the canine-positioned single implant mandibular...
OBJECTIVES
The aim of this multi-center pilot study was to assess the viability and feasibility of a novel treatment concept - the canine-positioned single implant mandibular overdenture (c-SIMO), with the single implant placed on the patient's preferred chewing side instead of the midline.
MATERIALS AND METHODS
Participants received a single implant in the canine region of their preferred chewing side, based on an Asymmetry Index observed during mastication. The pre-existing mandibular denture was transformed into a c-SIMO on a spherical attachment. The primary outcome was oral health-related quality of life (OHRQoL), measured with GOHAI and OHIP-EDENT. Secondary outcomes included denture satisfaction index (DSI), chewing efficiency (CE), maximum bite force (MBF), implant survival and success, and prosthetic maintenance. Data analysis included descriptive statistics and bivariate comparison tests.
RESULTS
Fifteen participants received the c-SIMO treatment (mean age: 69.9 ± 7.0). Implant success and survival rates were 100% at 1 year. Patient-reported outcome measures improved significantly compared to pre-treatment values (OHIP-EDENT: p = 0.001; DSI: p = 0.001; GOHAI: p = 0.002). Masticatory outcomes also improved significantly (CE: p = 0.001; overall MBF: p = 0.005). Post-implant, MBF was significantly higher in the ipsilateral side compared to the contralateral side at 2 weeks (p = 0.019) and 3 months (p = 0.015), but no longer at T3 (p = 0.730). Common prosthodontic events included denture base adjustments (n = 17) and matrix activation (n = 9).
CONCLUSIONS
This pilot study concludes that c-SIMO is a promising treatment option, and a potential alternative to the single midline implant overdenture.
CLINICAL RELEVANCE
The novel treatment concept of a canine-positioned single implant mandibular overdenture could be a viable treatment alternative to the midline positioning.
Topics: Humans; Denture, Overlay; Pilot Projects; Aged; Male; Female; Feasibility Studies; Dental Prosthesis, Implant-Supported; Quality of Life; Mastication; Cuspid; Dental Implants, Single-Tooth; Patient Satisfaction; Middle Aged; Mandible; Denture Design
PubMed: 38772987
DOI: 10.1007/s00784-024-05723-1 -
Proceedings of the Royal Society of... Jun 1974
Topics: Adult; Aged; Ameloblastoma; Chondrosarcoma; Humans; Ilium; Male; Mandible; Mandibular Neoplasms; Mandibular Prosthesis; Skin Transplantation; Surgery, Plastic; Transplantation, Autologous
PubMed: 4604724
DOI: No ID Found -
The Journal of Advanced Prosthodontics Nov 2012The aim of this systematic review is to address treatment outcomes of Mandibular implant overdentures relative to implant survival rate, maintenance and complications,...
PURPOSE
The aim of this systematic review is to address treatment outcomes of Mandibular implant overdentures relative to implant survival rate, maintenance and complications, and patient satisfaction.
MATERIALS AND METHODS
A systematic literature search was conducted by a PubMed search strategy and hand-searching of relevant journals from included studies. Randomized Clinical Trials (RCT) and comparative clinical trial studies on mandibular implant overdentures until August, 2010 were selected. Eleven studies from 1098 studies were finally selected and data were analyzed relative to number of implants.
RESULTS
Six studies presented the data of the implant survival rate which ranged from 95% to 100% for 2 and 4 implant group and from 81.8% to 96.1% for 1 and 2 implant group. One study, which statistically compared implant survival rate showed no significant differences relative to the number of implants. The most common type of prosthetic maintenance and complications were replacement or reattaching of loose clips for 2 and 4 implant group, and denture repair due to the fracture around an implant for 1 and 2 implant groups. Most studies showed no significant differences in the rate of prosthetic maintenance and complication, and patient satisfaction regardless the number of implants.
CONCLUSION
The implant survival rate of mandibular overdentures is high regardless of the number of implants. Denture maintenance is likely not inflenced substantially by the number of implants and patient satisfaction is typically high again regardless os the number of implants.
PubMed: 23236572
DOI: 10.4047/jap.2012.4.4.204 -
Journal of Indian Prosthodontic Society Jun 2013The association between dental occlusion and mandibular condyle/fossa relation has long been debated and still remains one of the most controversial issues in...
The association between dental occlusion and mandibular condyle/fossa relation has long been debated and still remains one of the most controversial issues in Prosthodontics. The aim of the study was to evaluate the effect of two different tooth forms on the condyle/fossa relation recorded during jaw relation process. Twenty edentulous patients were selected with good neuromuscular control. For each patient two pairs of dentures were fabricated with anatomic teeth and semi-anatomic teeth. Condylar position was recorded using a digital volume tomography (DVT) following the process of jaw relation (following extra oral tracing). Subsequent laboratory remounting, the denture insertion was done and DVTs were taken again for both the dentures separately. Two methods were used to evaluate the condyle/fossa relation viz. (1) Zhang's method (2) Brewka's method. The obtained values were then subjected to statistical analysis. The statistical significance was set as at 0.05 %. The mandibular concentricity were analysed during the process of jaw relation and after the insertion of dentures with the two different tooth forms. Statistical analysis indicated that no statistically significant difference of the influence of different posterior tooth forms on the condyle/fossa relation recorded during jaw relation (p < 0.05). Thus within limitations of this study it was concluded that the condyle/fossa relation established during jaw relation does not change with the change in posterior tooth form used.
PubMed: 24431715
DOI: 10.1007/s13191-013-0260-z