Mandibular Overdentures (mandibular + overdenture)

Distribution by Scientific Domains


Selected Abstracts


Immediate Loading of Two Implants Supporting a Ball Attachment-Retained Mandibular Overdenture: A Prospective Clinical Study

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2007
Riccardo Marzola DDS
ABSTRACT Background:, A prospective clinical study was conducted to evaluate clinically and radiographically the performance of two implants immediately loaded supporting a ball attachment-retained mandibular overdenture. Materials and Methods:, Seventeen completely edentulous patients were included in the study. Each patient received two implants inserted after a minimal flap reflection and no vestibular extension in order to reduce the postoperative swelling and facilitate immediate prosthesis connection. After implant placement, a mandibular complete denture was connected to the implants using ball attachments of appropriate height according to the depth of the peri-implant tissue. Patients were asked not to remove the denture for 1 week. No limitations to chewing function were given. At implant placement, the maximum value of insertion torque was recorded. Patients were examined at 1, 2, 4, 12, and 52 weeks postsurgery. At postoperative visit, occlusion was checked and the need for any prosthesis maintenance was recorded. The radiographic bone level (RBL) change was measured on periapical radiographs at baseline and 12 months after loading. Results:, After 12 months of loading, no implant failure was reported and the survival rate was 100%. Average RBL change was 0.7 mm ± 0.5 mm. Of the 17 cases, two had major prosthetic complications and five patients required minor extra maintenance appointments. Conclusions:, The immediate loading of two implants by means of ball attachment-retained mandibular complete denture may be a predictable treatment option. This clinical approach offers increased stability and comfort, while keeping a high implant success rate. [source]


Ten-Year Results of a Prospective Study Using Porous-Surfaced Dental Implants and a Mandibular Overdenture

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2002
Douglas Deporter DDS
ABSTRACT Background: Numerous investigators have used osseointegrated dental implants as retention for mandibular overdentures, but few have reported 10-year outcomes or incorporated carefully standardized radiographs to document crestai bone loss. Purpose: The purpose of this study was to use a prospective clinical trial design to assess the performance of short sintered porous-surfaced dental implants with a mandibular complete overdenture when all patients in the trial had undergone 10 years of continuous function. Materials and Methods: Fifty-two fully edentulous patients, most with advanced alveolar ridge resorption, each received three free-standing Endopore implants (7,10 mm in length, mean length, 8.7 mm; Innova Corporation, Toronto, ON, Canada) in the mandibular symphysis region. After 10 weeks of submerged healing, these implants were used to support an overdenture. Carefully standardized radiographs, using a customized stainless steel filmholder attached to each implant and the x-ray tube, were collected at baseline, 3 months, 6 months, yearly to 5 years, and then again at 7 and 10 years. Results: Life table analysis revealed a 10-year implant survival of 92.7% and a mean annual bone loss after year 1 of 0.03 mm. Conclusion: Short free-standing dental implants with a sintered porous surface used for implant fixation are a predictable and effective means of retaining a mandibular overdenture in patients with advanced mandibular ridge resorption. [source]


Mandibular overdentures supported by two Brånemark, IMZ or ITI implants: a ten-year prospective randomized study

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2009
Henny J. A. Meijer
Abstract Objectives: The aim of this prospective comparative study was to evaluate the survival rate, condition of peri-implant tissues, patient satisfaction and surgical and prosthetic aftercare of the IMZ-implant system (two-stage cylinder type), the Brånemark-implant system (two-stage screw type) and the ITI-implant system (one-stage screw type) supporting a mandibular overdenture during a 10-year follow-up period. Materials and Methods: Three groups of 30 edentulous patients were treated with two endosseous implants in the interforaminal region of the mandible. Clinical and radiographic parameters were evaluated immediately after completion of the prosthetic treatment and after 1, 5 and 10 years of functional loading. Prosthetic and surgical aftercare was scored during the evaluation period, as well as patient satisfaction. Results: The 10-year survival rate was 93% for the IMZ group, 98% for the Brånemark group and 100% for the ITI group (IMZmandibular overdenture in the edentulous patient. After10 years, no relevant changes had developed between the three implant systems. [source]


Resilient liner vs. clip attachment effect on peri-implant tissues of bar-implant-retained mandibular overdenture: a 1-year clinical and radiographical study

CLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2010
Moustafa Abdou Elsyad
Abstract Purpose: The aim of this study was to compare between the effects of resilient liner and clip attachments of bar-implant-retained mandibular overdenture on peri-implant tissues. Materials and methods: In a randomized-controlled clinical trial, 30 edentulous male patients (mean age 62.5 years) were equally assigned to two groups. In each patient, two implants were inserted in the canine area of the mandible using a two-stage surgical protocol. After 3 months, the implants were connected with resilient bars. Mandibular overdentures were retained to the bars with either clips (group I) or silicone-resilient liners (group II). Peri-implant tissues were evaluated clinically (with regard to plaque scores, gingival scores and probing depths) and radiographically (with regard to peri-implant vertical and horizontal alveolar bone changes). Evaluations were performed at the time of overdenture insertion (T0), 6 months (T6) and 12 months (T12) after overdenture insertion. Results: After 12 months of using bar-implant-retained mandibular overdenture, the resilient liner attachment had significantly decreased peri-implant plaque score, gingival score, probing depth, vertical and horizontal bone loss when compared with the clip attachment. Conclusion: Within the limitations of this study, and in terms of peri-implant tissue health of bar-implant-retained mandibular overdenture, we recommend resilient liner rather than clip attachment. To cite this article: Elsyad MA, EL Shoukouki AH. Resilient liner vs. clip attachment effect on peri-implant tissues of bar-implant-retained mandibular overdenture: a 1-year clinical and radiographical study. Clin. Oral Impl. Res. 21, 2010; 473,480 doi: 10.1111/j.1600-0501.2009.01879.x [source]


Mandibular overdentures supported by two or four endosseous implants

CLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2005
A 5-year prospective study
Abstract Objective: The aim of this 5-year prospective comparative study was to evaluate treatment outcome (survival rate, condition of hard and soft peri-implant tissues, patient satisfaction, prosthetic and surgical aftercare) of mandibular overdentures supported by two or four implants. Material and methods: Sixty edentulous patients with a mandibular height between 12 and 18 mm participated. Thirty patients were treated with an overdenture supported by two IMZ implants (group A) and 30 patients were treated with an overdenture supported by four IMZ implants (group B). Standardised clinical and radiographic parameters were evaluated 6 weeks after completion of the prosthetic treatment and after 1, 2, 3, 4 and 5 years of functional loading. Prosthetic and surgical aftercare was scored during the evaluation period. Results: One implant was lost (group A) during the healing period. There were no significant differences with regard to any of the studied clinical or radiographic parameters of the peri-implant tissues between the groups. None of the patients reported sensory disturbances in the lip or chin region. No differences in satisfaction were observed between the groups. With regard to aftercare, there was a tendency of a greater need of prosthetic interventions in group A, while correction of soft-tissue problems was restricted to patients of group B. Conclusion: There is no difference in clinical and radiographical state of patients treated with an overdenture on two or four implants during a 5-year evaluation period. Patients of both groups were as satisfied with their overdentures. Résumé Le but de cette étude comparative et prospective de cinq années a été d'évaluer la guérison (taux de survie, condition des tissus paroïmplantaires mous et durs, satisfaction du patient, prothèse et chirurgie) de prothèses mandibulaires sur deux ou quatre implants. Soixante édentés avec une hauteur mandibulaire entre douze et 18 mm ont participé. Trente patients ont été traités avec une prothèse ancrées sur deux implants IMZ (groupe A) tandis que les trente autres ont été traités avec une prothèse ancrée sur quatre implants IMZ (groupe B). Les paramètres radiographiques et cliniques standards ont étéévalués six semaines après la mise en place de la prothèse et ensuite une, deux, trois, quatre et cinq années après la mise en charge fonctionnelle. Le suivi chirurgical et prothétique a étéévalué durant cette période. Un implant a été perdu dans le groupe A durant la période de guérison. Il n'y avait aucune différence significative en ce qui concerne aucun des paramètres radiographiques et cliniques étudiés des tissus paroïmplantaires entre les deux groupes. Aucun des patients n'a rapporté d'ennuis sensoriels au niveau de la lèvre ou du menton. Aucune différence dans la satisfaction n'a été observée entre les deux groupes. En ce qui concerne le maintien, une nécessité plus importante d'intervention au niveau des prothèses était constatée dans le groupe A tandis que la correction des problèmes des tissus mous n'a dûêtre effectuée que chez les patients du groupe B. Il n'y a donc aucune différence radiographique ou clinique chez les patients traités avec une prothèse ancrée sur deux ou quatre implants durant un suivi de cinq années. Les patients des deux groupes étaient autant satisfaits de leurs prothèses. Zusammenfassung Ziel: Das Ziel dieser prospektiven vergleichenden Studie über 5 Jahre war, das Behandlungsresultat (Ueberlebensrate, Zustand der peri-implantären Hart- und Weichgewebe, Patientenzufriedenheit, prothetische und chirurgische Nachsorge) von Hybridprothesen im Unterkiefer, welche von 2 oder 4 Implantaten getragen werden, zu untersuchen. Material und Methoden: An der Studie nahmen 60 zahnlose Patienten mit einer Unterkieferhöhe zwischen 12 und 18 mm teil. 30 Patienten wurden mit einer Hybridprothese getragen von 2 IMZ Implantaten versorgt (Gruppe A), und 30 Patienten erhielten eine Hybridprothese auf 4 IMZ Implantaten (Gruppe B). Standardisierte klinische und radiologische Parameter wurden 6 Wochen nach Eingliederung der Rekonstruktion und nach 1,2,3,4 und 5 Jahren funktioneller Belastung ausgewertet. Die prothetische und chirurgische Nachsorge wurde während der Beobachtungsperiode aufgezeichnet. Resultate: 1 Implantat ging während der Einheilphase verloren (Gruppe A). Es bestanden keine signifikanten Unterschiede in Bezug auf die untersuchten klinischen und radiologischen Parameter der peri-implantären Gewebe zwischen den zwei Gruppen. Keiner der Patienten beklagte Gefühlsstörungen im Bereich der Lippe oder des Kinns. Zwischen den zwei Gruppen bestanden keine Unterschiede bezüglich Zufriedenheit. Bei der Nachsorge bestand eine Tendenz eines grösseren Bedarfs an prothetischen Interventionen in Gruppe A, während Korrekturen von Weichteilproblemen auf Patienten der Gruppe B beschränkt waren. Schlussfolgerung: Es bestehen keine Unterschiede in den klinischen und radiologischen Befunden bei Patienten, welche für eine Beobachtungsperiode von 5 Jahren mit Hybridprothesen auf 2 oder 4 Implantaten versorgt worden waren. Die Patienten beider Gruppen waren mit ihren Hybridprothesen zufrieden. Resumen Objetivo: La intención de este estudio fue prospectivo comparativo de 5-años fue evaluar los resultados del tratamiento (índice de supervivencia, condiciones de los tejidos duros y blandos periimplantarios, satisfacción del paciente, mantenimiento postquirúrgico y postprotesico) de sobredentaduras mandibulares soportadas por 2 o 4 implantes. Material y Métodos: Participaron 60 pacientes edéntulos con una altura mandibular entre 12 y 18 mm. Se trataron 30 pacientes con una sobredentadura soportada por 2 implantes IMZ (grupo A) y 30 pacientes se trataron con una sobredentadura soportada por 4 implantes IMZ (grupo B). Se evaluaron parámetros clínicos y radiológicos a las 6 semanas tras conclusión del tratamiento protésico y tras 1, 2, 3, 4 y 5 años de carga funcional. Se tomó nota del mantenimiento prostético y quirúrgico durante el periodo de evaluación. Resultados: Se perdió un implante (grupo A) durante el periodo de cicatrización. No hubo diferencias significativas respecto a ninguno de los parámetros clínicos y radiográficos estudiados de los tejidos periimplantarios entre los grupos. Ninguno de los pacientes informó sobre molestias sensoriales en el labio o la región del mentón. No se observaron diferencias entre los grupos respecto a la satisfacción. Respecto al mantenimiento, hubo una tendencia a una mayor necesidad de intervenciones prostéticas en el grupo A, mientras que las correcciones en los tejidos blandos se circunscribieron al grupo B. Conclusiones: No hay diferencias en el estado clínico y radiográfico de los pacientes tratados con una sobredentadura en 2 o 4 implantes durante un periodo de evaluación de 5 años. Los pacientes de ambos grupos estaban satisfechos con sus sobredentaduras. [source]


Mandibular overdentures supported by two Brånemark, IMZ or ITI implants: a ten-year prospective randomized study

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2009
Henny J. A. Meijer
Abstract Objectives: The aim of this prospective comparative study was to evaluate the survival rate, condition of peri-implant tissues, patient satisfaction and surgical and prosthetic aftercare of the IMZ-implant system (two-stage cylinder type), the Brånemark-implant system (two-stage screw type) and the ITI-implant system (one-stage screw type) supporting a mandibular overdenture during a 10-year follow-up period. Materials and Methods: Three groups of 30 edentulous patients were treated with two endosseous implants in the interforaminal region of the mandible. Clinical and radiographic parameters were evaluated immediately after completion of the prosthetic treatment and after 1, 5 and 10 years of functional loading. Prosthetic and surgical aftercare was scored during the evaluation period, as well as patient satisfaction. Results: The 10-year survival rate was 93% for the IMZ group, 98% for the Brånemark group and 100% for the ITI group (IMZmandibular overdenture in the edentulous patient. After10 years, no relevant changes had developed between the three implant systems. [source]


Immediate Loading of Two Implants Supporting a Ball Attachment-Retained Mandibular Overdenture: A Prospective Clinical Study

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2007
Riccardo Marzola DDS
ABSTRACT Background:, A prospective clinical study was conducted to evaluate clinically and radiographically the performance of two implants immediately loaded supporting a ball attachment-retained mandibular overdenture. Materials and Methods:, Seventeen completely edentulous patients were included in the study. Each patient received two implants inserted after a minimal flap reflection and no vestibular extension in order to reduce the postoperative swelling and facilitate immediate prosthesis connection. After implant placement, a mandibular complete denture was connected to the implants using ball attachments of appropriate height according to the depth of the peri-implant tissue. Patients were asked not to remove the denture for 1 week. No limitations to chewing function were given. At implant placement, the maximum value of insertion torque was recorded. Patients were examined at 1, 2, 4, 12, and 52 weeks postsurgery. At postoperative visit, occlusion was checked and the need for any prosthesis maintenance was recorded. The radiographic bone level (RBL) change was measured on periapical radiographs at baseline and 12 months after loading. Results:, After 12 months of loading, no implant failure was reported and the survival rate was 100%. Average RBL change was 0.7 mm ± 0.5 mm. Of the 17 cases, two had major prosthetic complications and five patients required minor extra maintenance appointments. Conclusions:, The immediate loading of two implants by means of ball attachment-retained mandibular complete denture may be a predictable treatment option. This clinical approach offers increased stability and comfort, while keeping a high implant success rate. [source]


Ten-Year Results of a Prospective Study Using Porous-Surfaced Dental Implants and a Mandibular Overdenture

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2002
Douglas Deporter DDS
ABSTRACT Background: Numerous investigators have used osseointegrated dental implants as retention for mandibular overdentures, but few have reported 10-year outcomes or incorporated carefully standardized radiographs to document crestai bone loss. Purpose: The purpose of this study was to use a prospective clinical trial design to assess the performance of short sintered porous-surfaced dental implants with a mandibular complete overdenture when all patients in the trial had undergone 10 years of continuous function. Materials and Methods: Fifty-two fully edentulous patients, most with advanced alveolar ridge resorption, each received three free-standing Endopore implants (7,10 mm in length, mean length, 8.7 mm; Innova Corporation, Toronto, ON, Canada) in the mandibular symphysis region. After 10 weeks of submerged healing, these implants were used to support an overdenture. Carefully standardized radiographs, using a customized stainless steel filmholder attached to each implant and the x-ray tube, were collected at baseline, 3 months, 6 months, yearly to 5 years, and then again at 7 and 10 years. Results: Life table analysis revealed a 10-year implant survival of 92.7% and a mean annual bone loss after year 1 of 0.03 mm. Conclusion: Short free-standing dental implants with a sintered porous surface used for implant fixation are a predictable and effective means of retaining a mandibular overdenture in patients with advanced mandibular ridge resorption. [source]


Benefits of dental implants installed during ablative tumour surgery in oral cancer patients: a prospective 5-year clinical trial

CLINICAL ORAL IMPLANTS RESEARCH, Issue 9 2010
Anke Korfage
Abstract Objective: This prospective study assessed treatment outcome and patient satisfaction of oral cancer patients with a mandibular overdenture on implants up to 5 years after treatment. Materials and methods: At baseline, 50 consecutive edentulous oral cancer patients, in whom prosthetic problems were expected after oncological treatment, were evaluated by standardized questionnaires and clinical assessments. All implants were installed during ablative tumour surgery in native bone in the interforaminal area. About two-thirds of the patients (n=31) had radiotherapy post-surgery (dose >40 Gy in the interforaminal area). Results: At the 5-year evaluation, 26 patients had passed away and four patients had to be excluded from the analyses, because superstructures were not present, due to persistent local irritation (n=2), loss of three implants (n=1) and the impossibility of making an overdenture related to tumour and oncological surgery-driven anatomical limitations (n=1). In the remaining 20 patients, the prosthesis was still in function (76 implants). During the 5-year follow-up, total 14 implants were lost, 13 in irradiated bone (survival rate 89.4%, dose >40 Gy) and one in non-irradiated bone (survival rate 98.6%). Peri-implant tissues had a healthy appearance and remained healthy over time. Patients were satisfied with their dentures. Conclusions: It was concluded that oral cancer patients can benefit from implants installed during ablative surgery, with a high survival rate of the implants, a high percentage of rehabilitated patients and a high denture satisfaction up to 5 years after treatment. To cite this article: Korfage A, Schoen PJ, Raghoebar GM, Roodenburg JLN, Vissink A, Reintsema H. Benefits of dental implants installed during ablative tumour surgery in oral cancer patients: a prospective 5-year clinical trial. Clin. Oral Impl. Res. 21, 2010; 971,979. doi: 10.1111/j.1600-0501.2010.01930.x [source]


Resilient liner vs. clip attachment effect on peri-implant tissues of bar-implant-retained mandibular overdenture: a 1-year clinical and radiographical study

CLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2010
Moustafa Abdou Elsyad
Abstract Purpose: The aim of this study was to compare between the effects of resilient liner and clip attachments of bar-implant-retained mandibular overdenture on peri-implant tissues. Materials and methods: In a randomized-controlled clinical trial, 30 edentulous male patients (mean age 62.5 years) were equally assigned to two groups. In each patient, two implants were inserted in the canine area of the mandible using a two-stage surgical protocol. After 3 months, the implants were connected with resilient bars. Mandibular overdentures were retained to the bars with either clips (group I) or silicone-resilient liners (group II). Peri-implant tissues were evaluated clinically (with regard to plaque scores, gingival scores and probing depths) and radiographically (with regard to peri-implant vertical and horizontal alveolar bone changes). Evaluations were performed at the time of overdenture insertion (T0), 6 months (T6) and 12 months (T12) after overdenture insertion. Results: After 12 months of using bar-implant-retained mandibular overdenture, the resilient liner attachment had significantly decreased peri-implant plaque score, gingival score, probing depth, vertical and horizontal bone loss when compared with the clip attachment. Conclusion: Within the limitations of this study, and in terms of peri-implant tissue health of bar-implant-retained mandibular overdenture, we recommend resilient liner rather than clip attachment. To cite this article: Elsyad MA, EL Shoukouki AH. Resilient liner vs. clip attachment effect on peri-implant tissues of bar-implant-retained mandibular overdenture: a 1-year clinical and radiographical study. Clin. Oral Impl. Res. 21, 2010; 473,480 doi: 10.1111/j.1600-0501.2009.01879.x [source]


Relative effectiveness of powered and manual toothbrushes in elderly patients with implant-supported mandibular overdentures

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2002
A. Tawse-Smith
Abstract Aim: The aim of this study was to compare the clinical effectiveness of a powered toothbrush (Braun Oral-B Plaque Remover 3-D) and a manual soft toothbrush (Oral-B Squish-grip brush) for the control of supragingival plaque and soft tissue inflammation around implants supporting mandibular overdentures. Material and methods: The study sample involved 40 edentulous subjects, aged 55,80 years, having 2 unsplinted mandibular implants supporting a complete removable overdenture opposed by a maxillary complete denture. In this single-blinded, randomised, cross-over clinical trial, two 6-week experimental phases were separated by a 2-week wash-out period. 2 weeks prior to each experimental phase (pre-entry visits), implant abutments were polished to remove all plaque and a standardised instruction in the use of the toothbrush was given. Modified plaque and bleeding indices were recorded at the start and end of each experimental period. Mean index scores at each phase were analysed using paired t -test, and the mean number of sites showing a change in plaque or mucositis were compared using the Mann-Whitney U -test. Combined data from 2 different implant systems were considered after controlling for implant type. Results: Only minor changes in plaque and bleeding scores were observed following the two test periods. There were no statistically significant differences between the manual and powered toothbrushes. Conclusion: Manual and powered brushes were found to be of comparable efficacy with regard to improvement in peri-implant bleeding and plaque indices. Zusammenfassung Zielsetzung: Untersuchung der klinischen Effektivität einer elektrischen Zahnbürste (Braun Oral-B Plaque Remover 3-D) im Vergleich zu einer weichen Handzahnbürste (Oral-B Squish-grip brush) zur Kontrolle supragingivaler Plaque und Weichgewebsentzündung an Implantaten, die Unterkiefer-Totalprothesen tragen. Material und Methoden: Das Untersuchungskollektiv bestand aus 40 zahnlosen Patienten im Alter zwischen 55 und 80 Jahren, die 2 unverblockte Unterkiefer-Implantate zur Unterstützung einer Totalprothese aufwiesen. Der Oberkiefer war jeweils mit einer total schleimhautgetragenen Prothese versorgt. In dieser einfach verblindeten, randomisierten klinischen Cross-over-Studie wurden 2 6-wöchige experimentelle Phasen von einer 2-wöchigen Auswaschperiode unterbrochen. 2 Wochen vor jeder experimentellen Phase wurden die supragingivalen Implantatflächen von sämtlicher Plaque gereinigt und die Patienten erhielten eine Instruktion im Gebrauch der Zahnbürsten. Modifizierte Plaque- und Blutungsindizes wurden zu Beginn und am Ende jeder experimentellen Phase erhoben. Die Mittelwerte für die Indizes wurden mittels des paarigen t -Tests und die Zahl der Stellen, die eine Veränderung in Plaque und Mucositis aufwiesen, wurden durch den Mann-Whitney U -Test verglichen. Die Daten für 2 Implantatsysteme wurden zusammengefasst, nachdem der Einfluss des Implantatsystems überprüft worden war. Ergebnisse: Es wurden nur geringe Veränderungen der Plaque- und Blutungsindizes am Ende beider Testphasen beobachtet. Ein statistisch signifikanter Unterschied zwischen elektrischer und Handzahnbürste konnte nicht gezeigt werden. Schlussfolgerungen: Hand- und elektrische Zahnbürsten erwiesen sich als gleich effektiv für die Verbesserung periimplantärer Plaque- und Blutungsindizes. Résumé But: Le but de cette étude était de comparer l'efficacité clinique d'une brosse à dent électrique (Plaque remover 3D de Braun Oral B) et une brosse souple manuelle (squish grip d'oral B) pour le contrôle de la plaque supra-gingivale et l'inflammation des tissus mous autour d'implants supportant des overdentures mandibulaires. Matériaux et méthodes: L'échantillon étudié comprenait 40 sujets édentés, âgés de 55 à 80 ans, ayant 2 implants mandibulaires non reliés supportant une overdenture amovible complète et une prothèse maxillaire antagoniste complète. Dans cet essai clinique croisé en aveugle simple, randomisée, 2 phases expérimentales de 6 semaines encadraient une période d'arrêt de 2 semaines. 2 semaines avant chaque phase expérimentale, (visite de pré-entrée), les piliers implantaires étaient polis afin d'éliminer toute la plaque et des instructions standardisées d'utilisation de la brosse étaient données. On notait les indices, de saignement et de plaque modifié, au début et à la fin de chaque période expérimentale. Les notes d'indices moyens à chaque phase étaient analysées par le test t apparié et le nombre moyen de sites présentant une modification de la plaque ou de la mucosite était comparé par le test U de Mann Whitney. Les données combinées des 2 systèmes implantaires étaient considérées après cotrôle pour chaque type d'implant Résultats: De minimes modifications des notes de plaque et de saignement étaient observées après les deux périodes de test. Il n'y avait pas de différences statistiques significatives entre les brosses manuelles et électriques. Conclusion: Les brosses manuelles et électriques ont une efficacité comparable du point de vue de l'amélioration des indices de saignement et de plaque peri-implantaires. [source]


The Milled Bar-Retained Removable Bridge Implant-Supported Prosthesis: A Treatment Alternative for the Edentulous Maxilla

JOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 4 2002
DGDP(UK), PAUL A. TIPTON BDS
ABSTRACT Restoration of the edentulous jaw with dental implants can be achieved using either an implant-supported prosthesis, such as a fixed bridge, or an implant-retained prosthesis, such as a traditional overdenture. The implant-retained prostheses use edentulous ridges as primary stress-bearing regions, and through stress-breaking mechanisms, the implants are not loaded during function. However, the success rates of maxillary overdentures do not appear to be as good as for mandibular overdentures; this may be attributable to the adverse loading conditions, short implant length, poor quality of bone, number of implants used, flexible bar design, or poor treatment planning. Many articles have also described the numerous problems and multiple visits required in maintaining a traditional bar-retained overdenture restoration, often making it more expensive in the long term than a fixed restoration. The milled bar implant-supported prosthesis offers the benefits of both fixed and removable restorations. Its infrastructure provides the same rigidity as the fixed restoration, owing to the precise fit to the superstructure, which is removable, to promote adequate access for hygiene, yet it still provides lip support and maintains close contact with the soft tissues. These advantages enhance phonetics, esthetics, correct lip support, maintenance, and patient comfort. CLINICAL SIGNIFICANCE Restoring esthetics and function for the edentulous patient requires a multidiscipline approach for success. This article discusses the techniques for restoring function and esthetics for these patients, using a milled bar restoration supported and retained by dental implants. [source]


Clinical Outcome of Overdenture Treatment on Two Nonsubmerged and Nonsplinted Astra Tech MicrothreadÔ Implants

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2009
Hugo De Bruyn DDS
ABSTRACT Background: The use of two implants for mandibular overdenture stabilization improves the patients' comfort and well-being. This treatment could be more cost-effective if surgery and prosthetic treatment could be performed by one clinician in the normal setting of a dental clinic. Purpose: The aim of this retrospective clinical study was to describe implant success, restorative outcome, and the patients' opinion of mandibular overdenture treatment on two early-loaded, nonsplinted Astra Tech TiOblast MicrothreadÔ (Astra Tech Dental, Mölndal, Sweden) implants. Materials and Methods: Thirty-seven consecutive patients treated with implant-supported mandibular overdentures were invited for a clinical examination. Implant survival, marginal bone level, quality of implant and prosthetic treatment, and the patients' opinion by means of questionnaires were scored. Results: Thirty-four patients attended the examination. Two implants were lost in one patient and the failure rate for the total group of patients was 3%. As 8 of the 33 remaining patients were still in the provisional loading stage, they were not included in the final clinical and radiographic examination. Based on 25 patients and 50 implants with a mean follow-up of 18.8 months (range 4,33), implant positioning and occlusion/articulation scored perfect in 74 to 80% of the cases. Retention of the dentures was rated perfect in 80%, but 20% needed minor activation of the attachments, 20% showed signs of abrasion, and 20% had already been repaired. The average marginal bone level was 0.8 mm below the reference point. The mean pocket depth was 2.1 mm, and 54% of the peri-implant tissues were free of bleeding. The patients were appreciative of the work carried out by their dentist and they indicated a significant improvement in their well-being and quality of life. Conclusions: It can be concluded that the Astra Tech implant system was successfully used by the general dentist both surgically and prosthetically with minimal implant failures and prosthetic complications and that this led to high levels of patient appreciation and overall satisfaction. [source]


Early Functional Loading of Unsplinted Roughened Surface Implants with Mandibular Overdentures 2 Weeks after Surgery

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2003
Alan G.T. Payne BDS, FCD (SA), MDent
ABSTRACT Background: Before early functional loading of unsplinted implants with mandibular overdentures can become widespread, more clinical studies are needed to investigate the success of the approach. Purpose: To evaluate the success rates of two types of roughened titanium surface implants with early 2-week functional loading of paired mandibular interforaminal implants with overdentures. Materials and Methods: Random allocation divided 24 strictly selected edentulous participants into two groups, with each group to receive a different implant system (ITI Dental Implant System, Straumann AG, Waldenburg, Switzerland; or Southern Implant System, Southern Implants, Irene, South Africa). Two implants were placed in the anterior mandible of all participants using one-stage standardized surgical procedures. Previously constructed conventional mandibular dentures (opposing maxillary complete dentures) were temporarily relined and worn by the participants for the first 2 weeks; participants used a soft diet. Two weeks after implant surgery and following some mucosal healing, the mandibular dentures had the tissue conditioner removed and the appropriate matrices included for an unsplinted prosthodontic design. Results: No implant from either group was lost. Resonance frequency analysis (RFA) indicated higher primary stability at surgery for the Southern group than for the ITI group, with a statistically significant difference between the groups throughout the study period. The drop in RF values between surgery and 6 weeks was significant and was greater for the Southern group. RFA also indicated stabilized osseointegration between 6 to 12 and 12 to 52 weeks, with no participant showing any decrease in those values over time. Participants with type 3 bone showed a significant improvement in RF values between 12 and 52 weeks, eventually matching those of participants with type 2 bone. There were no significant differences in marginal bone loss, periimplant parameters, or prosthodontic maintenance between the groups over the study period. Conclusions: Using only strict patient selection criteria, 1-year follow-up data indicate that early functional loading of ITI and Southern implants with mandibular two-implant overdentures is possible as early as 2 weeks after implant surgery. [source]


Ten-Year Results of a Prospective Study Using Porous-Surfaced Dental Implants and a Mandibular Overdenture

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2002
Douglas Deporter DDS
ABSTRACT Background: Numerous investigators have used osseointegrated dental implants as retention for mandibular overdentures, but few have reported 10-year outcomes or incorporated carefully standardized radiographs to document crestai bone loss. Purpose: The purpose of this study was to use a prospective clinical trial design to assess the performance of short sintered porous-surfaced dental implants with a mandibular complete overdenture when all patients in the trial had undergone 10 years of continuous function. Materials and Methods: Fifty-two fully edentulous patients, most with advanced alveolar ridge resorption, each received three free-standing Endopore implants (7,10 mm in length, mean length, 8.7 mm; Innova Corporation, Toronto, ON, Canada) in the mandibular symphysis region. After 10 weeks of submerged healing, these implants were used to support an overdenture. Carefully standardized radiographs, using a customized stainless steel filmholder attached to each implant and the x-ray tube, were collected at baseline, 3 months, 6 months, yearly to 5 years, and then again at 7 and 10 years. Results: Life table analysis revealed a 10-year implant survival of 92.7% and a mean annual bone loss after year 1 of 0.03 mm. Conclusion: Short free-standing dental implants with a sintered porous surface used for implant fixation are a predictable and effective means of retaining a mandibular overdenture in patients with advanced mandibular ridge resorption. [source]


One-Stage Operative Procedure Using Two Different Implant Systems: A Prospective Study on Implant Overdentures in the Edentulous Mandible

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2001
Andrew Tawse-Smith DDS, Cert Perio (Göteborg)
ABSTRACT Background: Evidence-based reports are needed to support the application of a one-stage surgical protocol for unsplinted implants supporting mandibular overdentures. Purpose: To examine the feasibility and success of using two different dental implant systems (originally designed for two-stage operative technique) using a one-stage operative procedure in patients being rehabilitated with implant mandibular overdentures. Materials and Methods: The study sample involved 24 edentulous subjects (aged 55,80 yr) randomly allocated to two different implant systems, one with a machined titanium implant surface (Steri-Oss, Nobel Biocare, Göteborg, Sweden) and the other with a roughened titanium surface (Southern Implants, Ltd., Irene, South Africa). Two unsplinted implants to support implant overdentures were placed in the anterior mandible of all patients, using a standardized one-stage surgical and prosthodontic procedure. Primary stability and bicortical anchorage of the implants was mandatory before healing abutments were connected at the time of implant placement. Implant overdentures and their respective matrices were inserted following a standard 12-week healing period. Data relating to mobility tests, radiographs, and peri-implant parameters were documented at 12, 16, and 52 weeks after surgery. Results: A success rate of 95.8% for the Steri-Oss and 100% for the Southern Implants was found, without any statistically significant differences in the marginal bone loss. Significant changes in Periotest values were observed for both types between 12 and 52 weeks (p <.001). Minor changes were observed in the peri-implant parameters evaluated. Conclusions: These preliminary findings show a successful application of this one-stage approach for unsplinted implants supporting mandibular overdentures with Steri-Oss and Southern Implant Systems. [source]


One-Year Prospective Evaluation of the Early Loading of Unsplinted Conical Brånemark Fixtures with Mandibular Overdentures Immediately following Surgery

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2001
Alan G.T. Payne BDS, FCD(SA), MDent
ABSTRACT Background: Prospective evaluation of the early loading of unsplinted Branemark implants with mandibular over-dentures opposing conventional dentures is not evident in the implant-related literature. Purpose: To clinically evaluate progressive and early loading of 20 unsplinted conical Brånemark implants in edentulous mandibles with overdentures. Materials and Methods: Ten edentulous patients all had two conical Brånemark implants placed in the anterior mandible with mandatory primary stability with bicortical anchorage. Ball abutment connection was performed simultaneously. Previously constructed conventional mandibular dentures were temporarily relined with tissue conditioner postoperatively and worn with moderation for the first 2 weeks to allow progressive loading. Early loading of the implants followed after 2 weeks, with inclusion of the respective matrices in the mandibular dentures, using a definitive reline procedure. Results: All patients successfully functioned with their mandibular implant overdentures from 2 to 52 weeks postoperatively. Mean marginal bone loss was within established criteria for success:0.22 mm (SD = 0.48 mm) mesially and 0.30 mm (SD = 0.39 mm) distally on the conical implants. Mobility tests using the Periotest instrument became more negative, although not at statistically significant levels. Difficulties in the management of the peri-implant mucosa between surgery and loading at 2 weeks were observed in 40% of the patients. Conclusions: These preliminary 1-year results show that successful early loading of unsplinted conical Brånemark implants with mandibular overdentures is possible. [source]


Mandibular overdentures supported by two or four endosseous implants

CLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2005
A 5-year prospective study
Abstract Objective: The aim of this 5-year prospective comparative study was to evaluate treatment outcome (survival rate, condition of hard and soft peri-implant tissues, patient satisfaction, prosthetic and surgical aftercare) of mandibular overdentures supported by two or four implants. Material and methods: Sixty edentulous patients with a mandibular height between 12 and 18 mm participated. Thirty patients were treated with an overdenture supported by two IMZ implants (group A) and 30 patients were treated with an overdenture supported by four IMZ implants (group B). Standardised clinical and radiographic parameters were evaluated 6 weeks after completion of the prosthetic treatment and after 1, 2, 3, 4 and 5 years of functional loading. Prosthetic and surgical aftercare was scored during the evaluation period. Results: One implant was lost (group A) during the healing period. There were no significant differences with regard to any of the studied clinical or radiographic parameters of the peri-implant tissues between the groups. None of the patients reported sensory disturbances in the lip or chin region. No differences in satisfaction were observed between the groups. With regard to aftercare, there was a tendency of a greater need of prosthetic interventions in group A, while correction of soft-tissue problems was restricted to patients of group B. Conclusion: There is no difference in clinical and radiographical state of patients treated with an overdenture on two or four implants during a 5-year evaluation period. Patients of both groups were as satisfied with their overdentures. Résumé Le but de cette étude comparative et prospective de cinq années a été d'évaluer la guérison (taux de survie, condition des tissus paroïmplantaires mous et durs, satisfaction du patient, prothèse et chirurgie) de prothèses mandibulaires sur deux ou quatre implants. Soixante édentés avec une hauteur mandibulaire entre douze et 18 mm ont participé. Trente patients ont été traités avec une prothèse ancrées sur deux implants IMZ (groupe A) tandis que les trente autres ont été traités avec une prothèse ancrée sur quatre implants IMZ (groupe B). Les paramètres radiographiques et cliniques standards ont étéévalués six semaines après la mise en place de la prothèse et ensuite une, deux, trois, quatre et cinq années après la mise en charge fonctionnelle. Le suivi chirurgical et prothétique a étéévalué durant cette période. Un implant a été perdu dans le groupe A durant la période de guérison. Il n'y avait aucune différence significative en ce qui concerne aucun des paramètres radiographiques et cliniques étudiés des tissus paroïmplantaires entre les deux groupes. Aucun des patients n'a rapporté d'ennuis sensoriels au niveau de la lèvre ou du menton. Aucune différence dans la satisfaction n'a été observée entre les deux groupes. En ce qui concerne le maintien, une nécessité plus importante d'intervention au niveau des prothèses était constatée dans le groupe A tandis que la correction des problèmes des tissus mous n'a dûêtre effectuée que chez les patients du groupe B. Il n'y a donc aucune différence radiographique ou clinique chez les patients traités avec une prothèse ancrée sur deux ou quatre implants durant un suivi de cinq années. Les patients des deux groupes étaient autant satisfaits de leurs prothèses. Zusammenfassung Ziel: Das Ziel dieser prospektiven vergleichenden Studie über 5 Jahre war, das Behandlungsresultat (Ueberlebensrate, Zustand der peri-implantären Hart- und Weichgewebe, Patientenzufriedenheit, prothetische und chirurgische Nachsorge) von Hybridprothesen im Unterkiefer, welche von 2 oder 4 Implantaten getragen werden, zu untersuchen. Material und Methoden: An der Studie nahmen 60 zahnlose Patienten mit einer Unterkieferhöhe zwischen 12 und 18 mm teil. 30 Patienten wurden mit einer Hybridprothese getragen von 2 IMZ Implantaten versorgt (Gruppe A), und 30 Patienten erhielten eine Hybridprothese auf 4 IMZ Implantaten (Gruppe B). Standardisierte klinische und radiologische Parameter wurden 6 Wochen nach Eingliederung der Rekonstruktion und nach 1,2,3,4 und 5 Jahren funktioneller Belastung ausgewertet. Die prothetische und chirurgische Nachsorge wurde während der Beobachtungsperiode aufgezeichnet. Resultate: 1 Implantat ging während der Einheilphase verloren (Gruppe A). Es bestanden keine signifikanten Unterschiede in Bezug auf die untersuchten klinischen und radiologischen Parameter der peri-implantären Gewebe zwischen den zwei Gruppen. Keiner der Patienten beklagte Gefühlsstörungen im Bereich der Lippe oder des Kinns. Zwischen den zwei Gruppen bestanden keine Unterschiede bezüglich Zufriedenheit. Bei der Nachsorge bestand eine Tendenz eines grösseren Bedarfs an prothetischen Interventionen in Gruppe A, während Korrekturen von Weichteilproblemen auf Patienten der Gruppe B beschränkt waren. Schlussfolgerung: Es bestehen keine Unterschiede in den klinischen und radiologischen Befunden bei Patienten, welche für eine Beobachtungsperiode von 5 Jahren mit Hybridprothesen auf 2 oder 4 Implantaten versorgt worden waren. Die Patienten beider Gruppen waren mit ihren Hybridprothesen zufrieden. Resumen Objetivo: La intención de este estudio fue prospectivo comparativo de 5-años fue evaluar los resultados del tratamiento (índice de supervivencia, condiciones de los tejidos duros y blandos periimplantarios, satisfacción del paciente, mantenimiento postquirúrgico y postprotesico) de sobredentaduras mandibulares soportadas por 2 o 4 implantes. Material y Métodos: Participaron 60 pacientes edéntulos con una altura mandibular entre 12 y 18 mm. Se trataron 30 pacientes con una sobredentadura soportada por 2 implantes IMZ (grupo A) y 30 pacientes se trataron con una sobredentadura soportada por 4 implantes IMZ (grupo B). Se evaluaron parámetros clínicos y radiológicos a las 6 semanas tras conclusión del tratamiento protésico y tras 1, 2, 3, 4 y 5 años de carga funcional. Se tomó nota del mantenimiento prostético y quirúrgico durante el periodo de evaluación. Resultados: Se perdió un implante (grupo A) durante el periodo de cicatrización. No hubo diferencias significativas respecto a ninguno de los parámetros clínicos y radiográficos estudiados de los tejidos periimplantarios entre los grupos. Ninguno de los pacientes informó sobre molestias sensoriales en el labio o la región del mentón. No se observaron diferencias entre los grupos respecto a la satisfacción. Respecto al mantenimiento, hubo una tendencia a una mayor necesidad de intervenciones prostéticas en el grupo A, mientras que las correcciones en los tejidos blandos se circunscribieron al grupo B. Conclusiones: No hay diferencias en el estado clínico y radiográfico de los pacientes tratados con una sobredentadura en 2 o 4 implantes durante un periodo de evaluación de 5 años. Los pacientes de ambos grupos estaban satisfechos con sus sobredentaduras. [source]