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International Journal of Implant... Sep 2022To determine the clinical and radiological outcomes of hybrid-design- (HD) and bone-level (BL) implants for bar-retained mandibular implant-overdentures (IODs).
PURPOSE
To determine the clinical and radiological outcomes of hybrid-design- (HD) and bone-level (BL) implants for bar-retained mandibular implant-overdentures (IODs).
METHODS
For this retrospective study, edentulous patients who had received maxillary complete dentures and mandibular bar-retained IODs were invited for a follow-up assessment. Implant survival, implant success and health of peri-implant tissues were assessed on an implant level-based analysis. Patient-based parameters served to identify risk factors for peri-implant bone loss, presence of peri-implantitis and success.
RESULTS
Eighty patients (median age 72.72 [67.03; 78.81] years, 46 females) with 180 implants (median follow-up 12.01 [10.82; 21.04] years) were assessed. There was no difference concerning the rate of implant failure (p = 0.26), or peri-implantitis (p = 0.97) between HD and BL implants. Solely in one study group, there was the presence of peri-implant pus. Implant success was higher in BL implants with one group being notably higher than the comparing groups (p = 0.045). For bone loss, a width of keratinized mucosa (KM) ≤ 1 mm (p = 0.0006) and the presence of xerostomia (p = 0.09) were identified as risk factors. Smoking (p = 0.013) and a higher body mass index (BMI) (p = 0.03) were a risk factor for peri-implantitis. As risk factors for reduced implant success, a small width of KM (p = 0.003) and the presence of xerostomia (p = 0.007) were identified.
CONCLUSIONS
For mandibular bar-retained IODs, both BL and HD implants are mostly successful. A minimum of 1 mm KM around implants and normal salivary flow are relevant factors for implant success and stable peri-implant bone levels. Smoking and a high BMI are potential risk factors for peri-implantitis.
Topics: Aged; Dental Prosthesis, Implant-Supported; Denture, Overlay; Female; Follow-Up Studies; Humans; Jaw, Edentulous; Peri-Implantitis; Retrospective Studies; Xerostomia
PubMed: 36149544
DOI: 10.1186/s40729-022-00439-x -
Cureus May 2023Cleft lip/palate is a common birth defect globally, and the impact of this condition on the dental health of affected individuals can be profound. During intricate...
Cleft lip/palate is a common birth defect globally, and the impact of this condition on the dental health of affected individuals can be profound. During intricate rehabilitation of cleft lip and palate patients, the final phase is achieved with definitive prosthodontic treatment. Prosthodontic rehabilitation is often necessary due to missing teeth and the alveolar ridge, malocclusion, residual defects, and the discrepancy between maxillary and mandibular arches. This article presents a case report of a young female patient with residual post-surgical cleft palatal defect having a mobile anterior segment with missing lateral incisors rehabilitated by a cast partial denture. The prosthesis utilized provided improvements in the patient's speech and esthetics but at a low level of cost and ongoing maintenance.
PubMed: 37265910
DOI: 10.7759/cureus.38364 -
The Journal of Prosthetic Dentistry Oct 2023Long-term reports on 2-implant-retained overdentures having metal frameworks and bars containing distal attachments are scarce.
STATEMENT OF PROBLEM
Long-term reports on 2-implant-retained overdentures having metal frameworks and bars containing distal attachments are scarce.
PURPOSE
The purpose of this retrospective study was to evaluate prosthetic complications with 2-implant-retained mandibular overdentures with metal frameworks having either screw- or cement-retained cantilevered bars with distal attachments.
MATERIAL AND METHODS
Seventy-three edentulous study participants who had been treated with mandibular overdentures with 2 implants were included. The parameters assessed were acrylic resin fractures (base fracture, fracture at midline), debonding of teeth, opposing prosthesis fracture, need for relining or rebasing, abutment and bar screw loosening and fracture, ball or bar attachment or clip wear, fracture or detachment, bar fracture, and implant loss. Statistical analysis was performed by using the Mann-Whitney U test as the data were not normally distributed. The categorical variables between the groups were analyzed by using the Fisher exact test (α=.05).
RESULTS
Twenty-seven prostheses had a cement-retained bar, and 46 bars were screw-retained. Of 73 overdentures, 68 were metal-reinforced. The mean observation time was 5.9 years with a range between 2 and 12 years. The most common complication was wear of the Rhein 83 polymer attachment followed by bar screw loosening. The cumulative survival rate for overdentures was 91.9% at 6.8 years. The service life of cement-retained prostheses was significantly longer (P<.05). Bar, resin base, and mid-line fractures were only seen with cement-retained prostheses. The number of times an attachment change was required did not differ between cement- and screw-retained bars. Of 191 implants, 3 were lost, and the cumulative survival rate was 93.5% at 7.5 years. No significant difference was found between retention types in terms of implant loss (P>.05).
CONCLUSIONS
Based on the participant population observed, the survival rates of 2-implant-retained mandibular overdentures and their implants in the medium term were high. Wear of the polymer attachment was commonly seen. Overdentures with cement-retained bars had bar or acrylic resin fractures. Mandibular 2-implant-retained overdentures with a screw-retained bar containing bilateral distal attachments had fewer prosthetic complications and high implant survival in the medium term.
Topics: Humans; Retrospective Studies; Denture, Overlay; Jaw, Edentulous; Dental Prosthesis, Implant-Supported; Dental Implants; Mandible; Acrylic Resins; Polymers; Denture Retention
PubMed: 34998584
DOI: 10.1016/j.prosdent.2021.11.016 -
JPMA. the Journal of the Pakistan... Jan 2021This case report is of a 31-year-old female who presented with splinted and faulty metalloceramic prosthesis on maxillary anterior teeth, which was responsible for...
This case report is of a 31-year-old female who presented with splinted and faulty metalloceramic prosthesis on maxillary anterior teeth, which was responsible for localised periodontal disease and poor aesthetics. At multiple sites the ceramic had chipped off and the prosthesis colour did not match with the adjacent healthy teeth. A multidisciplinary approach of endodontics, periodontics and prosthodontics was employed for this case. The treatment plan consisted of removing the faulty prosthesis, endodontic retreatment of inadequately root-treated teeth and endodontics in the other coronally prepared abutment teeth. Crown lengthening surgery was performed for the correction of periodontal pockets and high smile line and maintenance of an adequate biological width. After periodontal healing, all-ceramic individual crowns were placed on the maxillary anterior teeth along with a three-unit all-ceramic bridge for the replacement of the left upper maxillary first premolar. The final results were aesthetically pleasing with good marginal fit. The patient was extremely satisfied with the outcome as all her concerns were addressed. It is, therefore, advisable to consider placing individual crowns rather than multiunit splinted prosthesis whenever possible.
Topics: Adult; Bicuspid; Ceramics; Crowns; Esthetics; Female; Humans; Open Bite
PubMed: 33484547
DOI: 10.47391/JPMA.860 -
Journal of Indian Prosthodontic Society Dec 2014The preservation of remaining root structure and alveolar bone covering them with denture has been used since many years. Tooth-retained overdentures transfer occlusal...
The preservation of remaining root structure and alveolar bone covering them with denture has been used since many years. Tooth-retained overdentures transfer occlusal forces to the alveolar bone through the periodontal ligament of the retained tooth roots and thereby prevent bone resorption. Applications of magnets in overdenture technique has been widely used in dentistry in the field of prosthodontics, as they can be manufactured in small dimensions as retentive devices for complete denture, removable partial dentures, obturators and maxillofacial prosthesis. This article presents a simple and efficient method of fabrication of mandibular over denture retained by magnets in a patient whose mandibular residual ridge is severely resorbed with few remaining teeth and maxillary conventional removable partial denture. Mandibular over denture retained by magnets assembly consist of magnet and coping with keeper on remaining tooth structure to rehabilitate the patient since magnetic attachments can provide support, stability and retention.
PubMed: 26199541
DOI: 10.1007/s13191-012-0194-x -
Stomatologija 2008Implant loading time is considered to influence the treatment outcomes. Number of experimental studies have shown that implant loading up to 3 months can produce equally... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Implant loading time is considered to influence the treatment outcomes. Number of experimental studies have shown that implant loading up to 3 months can produce equally satisfactory results. However, research results in this area are not consistent. The purpose of the study was to investigate the influence of conventional and early loading of two-implant supported mandibular overdentures on treatment outcomes.
METHODS
The articles from 1985 to 2007 in English related to the topic were identified. Totally 221 (214 online and 7 printed) primary articles were detected. Eight articles were selected for data extraction. Implant survival and success rates, periimplant parameters, prosthetic maintenance and patient satisfaction were considered.
RESULTS
Implant success rate ranged from 83% to 100% in conventional loading group and from 71% to 100% in early loading group. During the first year in conventional group, the marginal bone loss ranged from 0.35 to 0.91 mm, during the second year--from zero to 0.2 mm, whereas in early loading group these intervals were 0.12-1 mm and 0-0.15 mm, respectively. Comparing averaged probing depth values at different time periods, it could be noticed that around conventionally loaded implants probing depth slightly decreased (from 1.62 mm to 1.56 mm), while around early loaded implants--increased from 1.7 mm to 1.82 mm.
CONCLUSIONS
Considering implant success rates and peri-implant parameters early loading protocol produces equal outcomes as with conventional loading. More well designed studies are needed to further substantiate the early loading protocol.
Topics: Dental Abutments; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Complete, Lower; Denture, Overlay; Humans; Mandible; Patient Satisfaction; Periodontal Diseases; Survival Analysis; Treatment Outcome
PubMed: 18708737
DOI: No ID Found -
Journal of Prosthodontic Research Jul 2022To evaluate the effect of overdenture (OD) attachment type and the number of implants supporting mandibular ODs on peri-implant health. (Meta-Analysis)
Meta-Analysis
PURPOSE
To evaluate the effect of overdenture (OD) attachment type and the number of implants supporting mandibular ODs on peri-implant health.
STUDY SELECTION
From inception to October 2020, electronic databases (Medline/PubMed, Embase, Cochrane Library, and Scopus) were systematically searched. The outcomes of interest were marginal bone loss (MBL), pocket probing depth (PPD), plaque index, bleeding index, and implant survival rate. Bayesian network meta-analysis was performed using the GeMTC package supported by R. The weighted mean difference and 95% credible interval were estimated.
RESULTS
Twenty-eight studies with a total of 1166 participants who received 2666 dental implants were included. Except for 4 bar and 4 telescopic, which showed a statistically lower MBL than the 2 locator, all other interventions showed insignificant differences in MBL (P > 0.05). The difference in periodontal probing depth was not statistically significant when comparing the different groups. The pooled implant survival rates of the different interventions ranged from 88.9% to 100%. The rank probability test showed that 4 bar and 4 telescopic had the lowest MBL, 2 magnet and 2 bar had the highest PI, whereas 4 locator showed the least PPD.
CONCLUSION
Except for 4 implants+bar, or telescopic, and 4 locator that, respectively, showed less MBL and PPD compared to some interventions, it seemed that different attachment types and number of implants supporting mandibular ODs have no clear superiority over the other in terms of peri-implant health outcomes.
Topics: Bayes Theorem; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Humans; Jaw, Edentulous; Mandible; Network Meta-Analysis
PubMed: 34588403
DOI: 10.2186/jpr.JPR_D_21_00073 -
Clinical Oral Investigations Jul 2021Due to the partly strongly differing results in the literature, the aim of the present study was to investigate a possible deformation of the mandible during mouth...
OBJECTIVES
Due to the partly strongly differing results in the literature, the aim of the present study was to investigate a possible deformation of the mandible during mouth opening using an intraoral scanner (IOS) and a conventional impression for comparison with a reference aid.
MATERIALS AND METHODS
Four steel spheres were reversibly luted in the mandibular (n = 50) with a metallic reference aid at maximum mouth opening (MMO). Two digital impressions (Trios3), at MMO and at slightly mouth opening SMO and a conventional impression (Impregum), were taken as the measuring accuracy of the reference structure was already known. Difference between MMO-SMO for digital impressions and deviations between digital and conventional (SMO) were calculated. Furthermore, the angle between the normal vectors of two constructed planes was measured. Statistical analysis was performed with SPSS25.
RESULTS
Deviations for linear distances ranged from -1 ± 3 μm up to 17 ± 78 μm (digital impressions, MMO-SMO), from 19 ± 16 μm up to 132 ± 90 μm (digital impressions, SMO), and from 28 ± 17 μm up to 60 ± 52 μm (conventional impressions, SMO). There were no significant differences for digital impressions (MMO-SMO), and there were significant differences between the conventional and digital impressions at SMO.
CONCLUSIONS
Based on the results of the present study, no mandibular deformation could be detected during mouth opening with regard to the digital impressions. The results were rather within the measuring tolerance of the intraoral scanner.
CLINICAL RELEVANCE
Based on the present study, no deformation of the mandibular during mouth opening could be observed at the level previously assumed. Therewith related, dental techniques related to a possible mandibular deformation therefore should be reconsidered.
Topics: Computer-Aided Design; Dental Arch; Dental Impression Materials; Dental Impression Technique; Imaging, Three-Dimensional; Mandible; Models, Dental
PubMed: 33442777
DOI: 10.1007/s00784-021-03777-z -
Revista de Saude Publica Aug 2019To conduct a cost-effectiveness analysis of alternatives for rehabilitation treatment of mandibular edentulism in the context of the Brazilian Unified Health System...
OBJECTIVE
To conduct a cost-effectiveness analysis of alternatives for rehabilitation treatment of mandibular edentulism in the context of the Brazilian Unified Health System (implant-supported total dental prosthesis versus conventional total dental prosthesis).
METHODS
A Markov model was developed to capture long-term clinical and economic outcomes. The model's population was comprised of a hypothetical cohort of 1,000,000 patients, aged 55 years, with total mandibular edentulism and without medical contraindications for performing surgical procedures. The adopted analysis perspective was that of the Brazilian Unified Health System. Based on the proposed model, we calculated cost - in BRL, and effectiveness - measured by quality-adjusted prosthesis year (QAPY). The time horizon of the analysis was 20 years.
RESULTS
Considering a 5% discount in costs and effects, the incremental cost-effectiveness ratio of implant-supported total dental prostheses compared to conventional total dental prosthesis (BRL 464.22/QAPY) was lower than the willingness to pay threshold adopted in the model (BRL 3,050.00/QAPY).
CONCLUSIONS
The results of this economic analysis showed that the rehabilitation of mandibular edentulous patients by implant-supported total prosthesis is very cost-effective when compared to conventional complete prosthesis, considering the cost-effectiveness limits employed.
Topics: Brazil; Cost-Benefit Analysis; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Partial, Fixed; Humans; Middle Aged; Mouth, Edentulous; National Health Programs
PubMed: 31432931
DOI: 10.11606/s1518-8787.2019053001066 -
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