Home About us Contact
|
Home About us Contact | ||
|
|
||
Overdentures
Kinds of Overdentures Terms modified by Overdentures Selected AbstractsImplant-Supported Obturator Overdenture for Extensive Maxillary Resection Patient: A Clinical ReportJOURNAL OF PROSTHODONTICS, Issue 3 2010Cláudio Rodrigues Leles DDS Abstract This clinical report presents an implant-retained obturator overdenture solution for a Prosthodontic Diagnostic Index Class IV maxillectomy patient with a large oronasal communication and severe facial asymmetry, loss of upper lip and midfacial support, severe impairment of mastication, deglutition, phonetics, and speech intelligibility. Due to insufficient bone support to provide satisfactory zygomaticus implant anchorage, conventional implants were placed in the body of the left zygomatic arch and in the right maxillary tuberosity. Using a modified impression technique, a cobalt-chromium alloy framework with three overdenture attachments was constructed to retain a complete maxillary obturator. Patient-reported functional and quality of life measure outcomes were dramatically improved after treatment and at the two-year follow-up. [source] Influence of Attachment Systems on Load Transfer of an Implant-Assisted Maxillary OverdentureJOURNAL OF PROSTHODONTICS, Issue 4 2004Mete I. Fanuscu DDS Purpose: This photoelastic study compared the load transfer characteristics of 2 retention mechanisms in an implant-assisted overdenture prosthesis. Materials and Methods: Four implants were incorporated into a photoelastic model of a moderately resorbed edentulous human maxilla. Two retention mechanisms were studied by changing components on the same model and the palateless overdenture. The retention mechanisms studied were bar splint with anterior clip and distal resilient attachments, and solitary ball/O-ring attachments. Loads, ranging from 1.4 to 14.4 kg, were applied to the palatal incline of central incisors and buccal incline of premolars with and without balancing contacts. Stresses developed around all the implants under each loading condition were photographed in the field of a circular polariscope. Results: With both retention mechanisms, protrusive and laterotrusive loads without balancing contacts caused instability of the overdenture, producing minimal stress around the implants in the supporting structure. High intensity stresses indicating intrusion of the posterior implants were noted when the bar/distal resilient attachment overdenture had balancing contacts for protrusive and laterotrusive loads. The posterior implants of ball/O-ring attachment overdenture exhibited high intensity stresses indicating not only intrusion, but also bending, when the occlusion was balanced. Conclusions: Balanced occlusion was required in both retention mechanisms for stability of the implant-assisted overdenture when clinically acceptable loads were applied. The protrusive and laterotrusive loads were not distributed equitably in either mechanism, since highest stresses occurred at the posterior implants. [source] Immediate Loading of Two Implants Supporting a Ball Attachment-Retained Mandibular Overdenture: A Prospective Clinical StudyCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2007Riccardo 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 OverdentureCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2002Douglas 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] Implant overdentures for edentulous elders: study of patient preferenceGERODONTOLOGY, Issue 1 2009Shahrokh Esfandiari Background:, Studies show that elders wearing implant overdentures have improved nutrition and quality of life. However, upfront costs of this therapy are high, and the income of elderly edentulous populations is low. Objectives:, This study was designed (i) to measure the preferences of edentulous patients for mandibular two-implant overdentures using Willingness-To-Pay (WTP) and Willingness-To-Accept (WTA), (ii) to assess the effect of long-term financing on WTP and (iii) to assess the desired role of health care plans in financing dental prostheses. Methods:, Edentulous elders (68,79 years; n = 36) wearing maxillary dentures and either a mandibular conventional denture (CD, n = 13) or a two-implant overdenture with ball attachments (IOD, n = 23) participated in this study. All had received their prostheses 2 years previously, as part of a randomised clinical trial. A three-part questionnaire was completed during a 20-min interview with a trained researcher. Results:, Forty-six per cent (6/13) of the CD wearers and 70% (16/23) of the IOD wearers were willing to pay three times more than the current cost of conventional dentures for implant prostheses. These percentages were increased to 77% (CD) and 96% (IOD) if participants could pay for implant overdentures in monthly instalments. Eighty-six per cent (31/36) of all participants in both groups (21/23 IOD; 10/13 CD) thought that the government should cover at least some of the cost of implant overdentures. Conclusions:, This study shows that, the majority of elderly edentate individuals who have not experienced mandibular two-implant overdenture therapy are willing to pay the cost, particularly when payment can be made in monthly instalments. [source] Accelerated rehabilitation of an edentulous patient with an implant retained dental prosthesis: a case reportGERODONTOLOGY, Issue 3 2007Gerald McKenna This case report details the successful rehabilitation of an edentulous patient using a complete upper prosthesis and a lower implant retained overdenture. The provision of care was split between a specialist centre and a primary care setting. This approach reduced inconvenience to the patient. Modern surgical and prosthodontic techniques also reduced the total delivery time. After initial consultation a new set of complete dentures was prescribed with changes in design to the originals. The patient was also planned for placement of two mandibular implants to stabilise and retain the mandibular denture. The first line of treatment involved provision of a new set of dentures constructed by the patient's general dental practitioner. Dental implants were then placed in a specialist centre and the patient returned to the dental practice for attachment of the lower denture to the dental implants. The benefits and success of mandibular implant retained dentures are well documented. With delivery of the overdenture, the patient reported increased satisfaction with his prostheses which allowed him to eat a greater range of foods and enabled him to feel confident when speaking and socialising. [source] Mandibular overdentures supported by two Brånemark, IMZ or ITI implants: a ten-year prospective randomized studyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2009Henny 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 (IMZ Relative effectiveness of powered and manual toothbrushes in elderly patients with implant-supported mandibular overdenturesJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2002A. 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 MaxillaJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 4 2002DGDP(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] Effect of magnetic attachment with stress breaker on lateral stress to abutment tooth under overdenture,JOURNAL OF ORAL REHABILITATION, Issue 10 2004T. Gonda summary, Recently, a newly developed magnetic attachment with stress breaker was used in retentive components in overdentures. Excessive lateral stress has a more harmful effect on natural teeth than axial stress, and the magnetic attachment with stress breaker is expected to reduce lateral forces on abutment teeth and protect it teeth from excessive stress. However, the properties of this retainer have not yet been determined experimentally. This study compares the lateral forces on abutment teeth for three retainers under loading on the denture base in a model study. A mandibular simulation model is constructed to measure lateral stress. Three types of retentive devices are attached to the canine root. These devices include the conventional root coping, the conventional magnetic attachment and the new magnetic attachment with stress breaker. For each retentive device, load is generated on the occlusal table of the model overdenture, and the lateral stress on the canine root and the displacement of the overdenture measured. The magnetic attachment with stress breaker does not displace the denture and exhibits lower lateral stress in the canine root than conventional root coping and magnetic attachments. [source] Influence of the thickness of the resin palatal vault on the closest speaking space with complete denturesJOURNAL OF ORAL REHABILITATION, Issue 10 2001G. Schierano The closest speaking space (CSS) has been considered stable over time, and therefore useful to determine the vertical dimension of occlusion (VDO) in edentulous patients. Clemençon affirms that, in complete denture wearers, CSS is not constant but depends on the thickness of the resin palatal vault, and that is the air volume needed to pronounce words to remain constant. The aim of this study was to evaluate Clemençon hypothesis in a group of edentulous patients rehabilitated with traditional maxillary denture and mandibular implant anchored overdenture. The CSS was determined by means of a kinematics method using the Elite System® at 30, 60, 90, 180, 360 days from delivery. The CSS was assessed twice at each stage: with the unmodified denture and a second time after thickening the resin palatal vault by 2 mm with a calibrated wax layer. The CSS after thickening the resin palatal vault was wider. The wider CSS observed can be because of oro-sensory feedback excited by contact between tongue and palatal vault. As hypothesized by Clemençon thickening the resin palatal vault could be a useful procedure to increase the VDO, in cases in which it is too low from the aesthetic stand point. [source] Influence of Attachment Systems on Load Transfer of an Implant-Assisted Maxillary OverdentureJOURNAL OF PROSTHODONTICS, Issue 4 2004Mete I. Fanuscu DDS Purpose: This photoelastic study compared the load transfer characteristics of 2 retention mechanisms in an implant-assisted overdenture prosthesis. Materials and Methods: Four implants were incorporated into a photoelastic model of a moderately resorbed edentulous human maxilla. Two retention mechanisms were studied by changing components on the same model and the palateless overdenture. The retention mechanisms studied were bar splint with anterior clip and distal resilient attachments, and solitary ball/O-ring attachments. Loads, ranging from 1.4 to 14.4 kg, were applied to the palatal incline of central incisors and buccal incline of premolars with and without balancing contacts. Stresses developed around all the implants under each loading condition were photographed in the field of a circular polariscope. Results: With both retention mechanisms, protrusive and laterotrusive loads without balancing contacts caused instability of the overdenture, producing minimal stress around the implants in the supporting structure. High intensity stresses indicating intrusion of the posterior implants were noted when the bar/distal resilient attachment overdenture had balancing contacts for protrusive and laterotrusive loads. The posterior implants of ball/O-ring attachment overdenture exhibited high intensity stresses indicating not only intrusion, but also bending, when the occlusion was balanced. Conclusions: Balanced occlusion was required in both retention mechanisms for stability of the implant-assisted overdenture when clinically acceptable loads were applied. The protrusive and laterotrusive loads were not distributed equitably in either mechanism, since highest stresses occurred at the posterior implants. [source] Immediate Loading of Two Implants Supporting a Ball Attachment-Retained Mandibular Overdenture: A Prospective Clinical StudyCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2007Riccardo 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] Report of a Case Receiving Full-Arch Rehabilitation in Both Jaws Using Immediate Implant Loading Protocols: A 1-Year Resonance Frequency Analysis Follow-UpCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2006Michael Portmann DDS ABSTRACT Background:, Immediate occlusal implant loading has been documented as a viable treatment option for various indications. However, documentations related to full-arch rehabilitation are usually limited to treatment of one jaw at a time, thereby leaving the opposing dentition unchanged. Furthermore, clinical documentation using traditional, well-accepted measuring techniques may not be adequate when it comes to short-term evaluation of the success or failure of implants subjected to immediate occlusal loading. Purpose:, The purpose of this case report is to (1) present an implant stability follow-up of a patient receiving an immediate, implant-supported full-arch rehabilitation in both jaws and (2) evaluate the patient's acceptance of this rehabilitation. Materials and Methods:, A 68-year-old patient scheduled for implant treatment was selected for an immediate implant loading protocol in both jaws. During two surgical events 3 weeks apart, eight maxillary and four mandibular Brånemark System® Mk IV TiUniteTM fixtures (Nobel Biocare AB, Göteborg, Sweden) were inserted and subsequently used to immediately support a cross-arch fixed prosthesis in the maxilla and a bar-retained overdenture in the mandible. Implant stability was recorded from the day of surgery periodically during a 1-year follow-up using resonance frequency analysis (RFA). Results:, At the 1-year follow-up, based on clinical, RFA, and radiographic evaluations, all implants and the reconstructions were classified as successful. All maxillary implants showed a decrease in the implant stability quotient (ISQ) value from the measurement at the time of surgery to the first follow-up, whereas two of four mandibular implants revealed an initial drop in stability. Irrespective of a specific ISQ level measured at implant surgery (ISQ range 53,74) and despite an initial decrease in stability, measurements recorded at the 12-month follow-up indicated similar stability levels for all maxillary implants (ISQ range 64,68) or the group of mandibular implants (ISQ range 72,75) but with a higher ISQ level for mandibular implants. Furthermore, the patient's acceptance of the immediate full-arch rehabilitation in both jaws was high. Conclusions:, The present case report demonstrates that a slightly staged approach for full-arch rehabilitation in both jaws using immediate implant loading protocols is a realistic treatment option. Furthermore, RFA follow-up indicates that immediately occlusally loaded implants placed in reduced bone quality and quantity are more prone to loose stability in the early healing period compared with implants placed in dense bone quality. [source] Ten-Year Results of a Prospective Study Using Porous-Surfaced Dental Implants and a Mandibular OverdentureCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2002Douglas 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 trialCLINICAL ORAL IMPLANTS RESEARCH, Issue 9 2010Anke 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] Long-term, retrospective evaluation (implant and patient-centred outcome) of the two-implant-supported overdenture in the mandible.CLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2010Part 2: marginal bone loss Abstract Objective: In part 2 of this long-term, retrospective study on the two-implant-supported overdenture in the mandible, the annual marginal bone loss was evaluated in detail and parameters, with a significant effect on the annual bone loss, were verified. Material and methods: For all 495 patients with an overdenture in the mandible at least 5 years in function, data up to their last follow-up visit had been collected, including long-cone radiographs (taken at the abutment connection and after years 1, 3, 5, 8, 12 and 16 of loading) and probing data at their last evaluation. General information (medical history, implant data, report on surgery) was retrieved from the patient's file. Two hundred and forty-eight patients had been clinically examined recently. For the others, information on bone level and probing depths were retrieved from the patient's files, as all patients had been enrolled in our annual follow-up schedule. Results: The mean annual bone loss on a site level (without considering the first year of bone remodelling) after 3 years of loading was 0.08 mm/year (SD=0.22, n=1105), after 5 years of loading 0.07 mm/year (SD=0.14, n=892), after 8 years of loading 0.06 mm/year (SD=0.12, n=598), after 12 years 0.04 mm/year (SD=0.07, n=370) and 0.05 mm/year (SD=0.05, n=154) after 16 years of loading. Ongoing bone loss was seen in a number of implants (n=26) with the annual bone loss exceeding 0.2 mm. Some factors clearly showed a significant impact on bone loss: smoking (,10 cigarettes/day), GBR, the presence of dehiscence and bone quantity(the latter only during the first year). The probing data showed a favourable condition, with <1.2% of the approximal pockets being ,6 mm, and 4.1%=5 mm. Conclusions: The mean annual bone loss over the study period was <0.1 mm/year after the first year of loading. However, a small number (2.5%) of the implants showed continuing bone loss. To cite this article: Vercruyssen M, Quirynen M. Long-term, retrospective evaluation (implant and patient-centred outcome) of the two-implants-supported overdenture in the mandible. Part 2: marginal bone loss. Clin. Oral Impl. Res. 21, 2010; 466,472. doi: 10.1111/j.1600-0501.2009.01902.x [source] Resilient liner vs. clip attachment effect on peri-implant tissues of bar-implant-retained mandibular overdenture: a 1-year clinical and radiographical studyCLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2010Moustafa 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] An in vitro study of non-axial forces upon the retention of an O-ring attachmentCLINICAL ORAL IMPLANTS RESEARCH, Issue 12 2009Renata Cristina Silveira Rodrigues Abstract: Objective: The purpose of this study was to evaluate the retention force of an O-ring attachment system in different inclinations to the ideal path of insertion, using devices to compensate angulations. Material and methods: Two implants were inserted into an aluminum base, and ball attachments were screwed to implants. Cylinders with O-rings were placed on ball attachments and connected to the test device using positioners to compensate implant angulations (0°, 7°, and 14°). Plexiglass bases were used to simulate implant angulations. The base and the test device were positioned in a testing apparatus, which simulated insertion/removal of an overdenture. A total of 2900 cycles, simulating 2 years of overdenture use, were performed and 36 O-rings were tested. The force required for each cycle was recorded with computer software. Longitudinal sections of ball attachment,positioner,cylinder with O-rings of each angulation were obtained to analyze the relationship among them, and O-ring sections tested in each angulation were compared with an unused counterpart. A mixed linear model was used to analyze the data, and the comparison was performed by orthogonal contrasts (,=0.05). Results: At 0°, the retention force decreased significantly over time, and the retention force was significantly different in all comparisons, except from 12 to 18 months. When the implants were positioned at 7°, the retention force was statistically different at 0 and 24 months. At 14°, significant differences were found from 6 and 12 to 24 months. Conclusions: Within the limitations of this study, it was concluded that O-rings for implant/attachments perpendicular to the occlusal plane were adequately retentive over the first year and that the retentive capacity of O-ring was affected by implant inclinations despite the proposed positioners. [source] Successful outcome of splinted implants supporting a ,planned' maxillary overdenture: a retrospective evaluation and comparison with fixed full dental prosthesesCLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2009A. Sanna Abstract Objective: Whereas an overdenture concept is generally accepted for the mandible, the outcome of this therapy for the maxilla remains less documented. This retrospective analysis evaluated the peri-implant parameters of implants supporting a ,planned' overdenture in the maxilla, and compared these data with those of an age-matched control group, with a fixed full dental prosthesis. Material and methods: All patients with an implant-supported overdenture in the maxilla from the Leuven University Hospital (at least 12 months in function) were recalled for a thorough examination. Forty-four patients (162 implants, Brånemark type) could be enrolled. Results: The mean loading time was 9 years (range: >1 to >20 years). The cumulative survival rate after 10 years of function was 99.3% if four to six interconnected implants supported the overdenture, but only 85.7% in case two non-connected implants were used as support. The marginal bone level in the former group remained stable, with changes comparable with those observed for implants supporting fixed full dental prostheses. Conclusions: These results fully support the overdenture treatment concept for the maxilla, at least when ,4 splinted implants are used. [source] Comparison of early telescope loading of non-submerged ITI implants in irradiated and non-irradiated oral cancer patientsCLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2006Constantin Alexander Landes Abstract Objective: To compare early dental implant loading in irradiated and non-irradiated oral cancer patients in order to accelerate masticatory function improvement and quality of life. Patients and methods: One hundred and fourteen non-submerged interforaminal ITI implants were early loaded in 30 patients after 3 weeks in situ (telescoped overdenture). Nineteen patients received 72 implants (63%) after local irradiation; 11 non-irradiated patients received 42 implants (37%) with a 24-month follow-up. Results: At 24 month follow-up, one early failure had occurred in an irradiated patient (=99% functioning implants in situ). Peri-implant bleeding and plaque index were similarly high in both groups (40 to 68% average). The Results of other measured parameters were as follows (values for mean; irradiated; non-irradiated patients with respective standard deviations; significance of comparison): bone loss (0.9±0.9; 1.4±0.9; 0.4±0.5 mM; P<0.01); Periotest® score (,2.7±2.7; ,2.4±2.2; ,3.1±3.3; P<0.2); gingival recession (0.6±0.7 mM; 0.8±0.9 mM; 0.4±0.5 mM, P<0.02); and peri-implant probing depths (3±1.2; 2.6±0.6; 3.4±1.7 mM; P<0.002). Conclusion: The results suggest reliable non-submerged implantation and early loading. However, bone loss in irradiated mandibles, combined with higher average Periotest values and gingival recession in an oral environment of altered saliva quantity, quality, microflora and local scarring, requires extended follow-up. [source] Human ex vivo bone tissue strains around immediately loaded implants supporting maxillary overdenturesCLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2005vanç Akça Abstract Purpose: To evaluate ex vivo bone tissue strains around maxillary implants supporting immediately loaded bar-retained overdentures. Material and methods: Ninety degree two-element rosette strain gauges were bonded on the labial bone of four ITI® dental implants placed in the maxillary anterior region of four completely edentulous maxilla of fresh human cadavers. The installation torque value (ITV) of each implant was measured by a custom-made torque wrench and resonance frequency analyses (RFAs) were undertaken. A bar-retained overdenture was fabricated for each cadaver, and two miniature load cells were integrated in the first molar region of the overdentures for controlled loading experiments. Strain measurements were performed at a sample rate of 10 kHz and under a maximum load of 100 N, simultaneously monitored from a computer connected to a data acquisition system. Finally, removal torque values (RTVs) of the implants were measured. Results: RFA values did not mirror ITVs, while RTVs of implants were slightly lower than the ITVs. Any correlation could not be obtained between RFA values and ITVs or RTVs. Maximum strains around loaded implants ranged between ,100 and ,550 ,, under 25,100 N. The axial and lateral strain values of posterior implants of both sides were higher than those of anterior implants under all loads (P<0.05). Conclusion: Because occlusal forces in humans tend to decrease because of age-related factors, maximum strains around immediately loaded implants supporting maxillary overdentures fall within physiologic levels. Résumé Le but de cette étude a été d'évaluer les tensions du tissu osseux ex vivo autour d'implants maxillaires portant des prothèses amovibles retenues sur une barre placée immédiatement après l'insertion des implants. Deux jauges de force en rosette à 90° ont été attachées au côté lingual de l'os de quatre implants dentaires ITI® placés dans la région antérieure du maxillaire de quatre cadavres humains frais aux maxillaires édentées. La valeur du couple de torsion lors de l'installation (ITV) de chaque implant a été mesurée par un couple fabriqué et des analyses de fréquence de résonnance (RFA) ont été faites. Une prothèse retenue par une barre a été fabriquée pour chaque cadavre et deux cellules de charge miniatures ont été intégrées dans la région de la première molaire de ces prothèses pour les expériences de charge contrôlées. Les mesures de force ont été effectuées à un taux d'échantillonnage de 10 kHz et sous une charge maximale de 100 N, suivies simultanément par un ordinateur connectéà un système d'acquisition de données. Finalement les valeurs des couples de torsion à l'enlèvement (RTV) des implants ont été mesurées. Les valeurs RFA n'étaient pas en ligne avec les ITV tandis que les RTV des implants étaient légèrement inférieurs aux ITV. Aucune corrélation n'a pûêtre établie entre les valeurs RFA et ITV ou RTV. Les forces maximales autour des implants chargés s'étalaient de ,100 ,e à,550 ,e sous 25 N à 100 N. Les valeurs des forces axiales et latérales des implants postérieurs des deux côtés étaient supérieures à celles des implants antérieurs sous toutes les charges (P<0.05). Zusammenfassung Ziel: Es war das Ziel dieser Arbeit, an bis vor kurzem vitalen Knochengewebe Spannungen um Oberkieferimplantate zu untersuchen, welche sofortbelastete und stegverankerte Hybridprothesen tragen. Material und Methoden: Auf den labialen Knochen von vier ITI-Implantaten in der vorderen Region des zahnlosen Oberkiefers von vier frisch verstorbenen Menschen klebte man Dehnmessinstrumente an. Man mass den Wert der Eindrehkraft (ITV) jedes einzelnen Implantates mit einem handelsblichen Drehmomentschlssel und fhrte eine Resonanzfrequenzanalyse (RFA) durch. Man stellte fr jede Leiche eine stegverankerte Hybridprothese her und man baute in der Region der ersten Molaren zwei kleine Messgerte ein, die kontrollierte Belastungsexperimente erlaubten. Dehnmessungen fhrte man mit einer Frequenz von 10 kHz und einer maximalen Belastung von 100 N durch, simultan aufgezeichnet von einem mit dem Messsystem verbundenen Komputer. Schliesslich mass man auch die Krfte, die es brauchte um die Implantate wieder auszudrehen (RTV). Resultate: Die RFA wiederspiegelte die ITV-Werte nicht, whrenddem die RTV-Werte der Implantate geringfgig tiefer waren als die ITV-Werte. Man konnte weder zwischen der RFA, den ITV-Werten oder den RTV-Werten eine Korrelation herstellen. Die maximalen Dehnungen um die Implantate erreichte Werte zwischen ,100 E und ,550 E bei einer Belastung zwischen 25 N und 100 N. Die axialen und lateralen Dehnkrfte bei posterioren Implantaten waren unter smtlichen getesteten Belastungen beidseits grsser als diejenigen der anterioren Implantate (P<0.05). Resumen Propósito: Evaluar las tensiones del tejido óseo ex vivo alrededor de implantes maxilares soportando sobredentaduras retenidas por barras con carga inmediata. Material y Métodos: Se pegaron dos indicadores de tensión de roseta de dos elementos de 90° en el hueso labial de cuatro implantes dentales ITI® colocados en la región maxilar anterior de cuatro maxilares completamente edéntulos de cadáveres humanos frescos. Se midió el valor del torque de instalación (ITV) de cada implante por medio de una chicharra de torque hecha a medida y se llevó a cabo análisis de frecuencia de resonancia (RFA). Se fabricó una sobredentadura retenida por barras para cada cadáver y se integraron dos células miniatura de carga en la región del primer molar de las sobredentaduras para los experimentos de carga controlada. Se llevaron a cabo mediciones de la tensión a un índice de muestra de 10 kHz y bajo una carga máxima de 100 N, simultáneamente monitorizada desde un ordenador conectado a sistema de adquisición de datos. Finalmente, se midieron los valores del torque de remoción (RTV) de los implantes. Resultados: Los valores de RFA no se reflejaron en los ITVs, mientras que los RTVs de los implantes fueron ligeramente más bajos que los ITVs. No se pudieron obtener correlaciones entre los valores de RFA y los ITVs o RTVE. Las tensiones máximas alrededor de los implantes cargados variaron entre ,100 ,, y ,550 ,, bajo 25 N a 100 N. Los valores de las tensiones axiales y laterales de los implantes posteriores de ambos lados fueron mayores que aquellos implantes anteriores bajo todas las cargas (P<0.05). [source] The effect of maximum bite force on marginal bone loss in mandibular overdenture treatment: an in vivo studyCLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2005Frits Van Kampen Abstract: The impact of bite force on the marginal bone response around implants is a subject of debate. This study focused on the effect of maximum bite force on marginal bone levels in mandibular implant overdenture treatment. In addition, the effect of the sequence of 3 different loading conditions on marginal bone loss was evaluated in vivo. The patient population consisted of a group of 18 patients. They received 2 implants in the mandible and a new denture without attachments during the period of submerged implant healing. After second stage surgery, the denture was provided with a ball, magnet or bar-clip attachment. There was a transition of attachment type after 3 and 6 months of function. The sequence in which the attachments were used was randomised. Radiographic marginal bone loss was measured after the period of submerged implant healing and after 3, 6 and 9 months of functional implant loading. Maximum bite force measurements were obtained just prior to second stage surgery with the new denture without attachment. Bite force measurements were also obtained after 3, 6 and 9 months of loading with the implant-retained overdenture. The latter 3 values were averaged. The mean bone loss during the period of submerged healing and during functional loading was 1.7 mm (0.7 mm) and 1.3 mm (0.6 mm), respectively. A relationship between maximum bite force during the period of submerged healing or during the period of functional loading on the one hand and the amount of marginal bone loss on the other could not be demonstrated. The sequence in which the different attachment types were used did not influence the observed amount of marginal bone loss. Résumé L'impact des forces d'occlusion sur la réponse de l'os marginal autour d'implants est sujet à débat. Cette étude s'est centrée sur l'effet de la force d'occlusion maximale sur les niveaux d'os marginaux dans le traitement de prothèses mandibulaires sur implants. De plus l'effet de la séquence de trois conditions de mise en charge différentes sur la perte osseuse marginale a étéévaluée in vivo. Les patients étaient au nombre de douze. Ils avaient reçu deux implants dans la mandibule et une nouvelle prothèse sans attache durant la période de guérison lorsque les implants étaient enfouis. Après la deuxième chirurgie, la prothèse amovible a été utilisée avec une boule, un aimant ou une barre comme attache. Il y avait une transition du type d'attache après trois et six mois de mise en fonction. La séquence suivant laquelle les attaches étaient utilisées était effectuée au hasard. La perte osseuse marginale radiographique a été mesurée après la période de guérison des implants enfouis et après trois, six et neuf mois de mise en fonction. Les mesures de force d'occlusion maximale ont été obtenues juste avant la deuxième chirurgie avec la nouvelle prothèse sans attache. Les mesures de forces d'occlusion ont également été obtenues après trois, six et neuf mois de mise en charge lorsque les implants retenaient la prothèse. Les trois dernières valeurs ont été mélangées. Les pertes osseuses moyennes durant la période de guérison avec les implants enfouis et durant la charge de mise en fonction étaient respectivement de 1,7±0,7 mm et de 1,3±0,6 mm. Une relation entre la force d'occlusion maximale durant la période de guérison avec les implants enfouis ou durant la période de mise en charge fonctionnelle d'une part et la quantité de perte osseuse marginale d'autre part n'a pas pûêtre démontrée. La séquence dans laquelle les différents types d'attache ont été utilisés n'influençaient pas la quantité observée de perte osseuse marginale. Zusammenfassung Der Einfluss der Kaukraft auf die Reaktion des marginalen Knochens um Implantate wir immer wieder diskutiert. Diese Studie konzentrierte sich auf den Einfluss der maximalen Kaukraft auf das marginale Knochenniveau bei Unterkieferimplantaten und Hybridprothesen. Zusätzlich untersuchte man in vivo den Einfluss von drei Phasen mit unterschiedlichen Belastungstypen auf den marginalen Knochenverlust. Es handelte sich um eine Gruppe von 18 Probanden. Alle erhielten zwei Implantate im Unterkiefer und eine neue Prothese, während der submukösen Einheilphase der Implantate noch ohne Retentionselemente. Nach der chirurgischen Freilegung der Implantate fixierte man die Prothesen mit einem Kugelanker, einem Magneten oder einem Steg. Der Wechsel zum nächsten Retentionstyp erfolgte jeweils nach 3 bis 6 Monaten normaler Funktion der Prothesen. Die Abfolge, in welcher man die Retentionselemente einsetzte, wurde zufällig ausgewählt. Den radiologischen marginalen Knochenverlust mass man nach der submukösen Einheilphase der Implantate, sowie nach 3, 6 und 9 Monate einer funktionellen Implantatbelastung. Die maximale Kaukraft wurde genau vor der chirurgischen Freilegung der Implantate mit der neuen Prothese und ohne Attachments gemessen. Zusätzliche Messungen der Kaukraft erfolgten 3, 6 und 9 Monate nach funktioneller Belastung der implantatgetragenen Hybridprothesen. Die letzten drei Werte wurden gemittelt. Der mittlere Knochenverlust während der submukösen Einheilphase betrug 1.7 mm (0.7 mm) und während der funktionellen Belastung 1.3 mm (0.6 mm). Eine Beziehung zwischen der maximalen Kaukraft während der submukösen Einheilung oder während der funktionellen Belastung auf der einen Seite und dem marginalen Knochenverlust auf der anderen Seite konnte nicht gezeigt werden. Die Abfolge, in der die verschiedenen Retentionstypen verwendet wurden, beeinflusste das Ausmass des beobachteten marginalen Knochenverlustes nicht. Resumen El impacto de la fuerza de mordida sobre la respuesta del hueso marginal alrededor de los implantes es motivo de debate. Este estudio está enfocado sobre el efecto de la fuerza de máxima mordida en los niveles de hueso marginal en el tratamiento de sobredentadura mandibular implantosoportada. Además, se evaluó el efecto de la secuencia de 3 condiciones diferentes de carga sobre la pérdida de hueso marginal in vivo. La población de4 pacientes consistió en un grupo de 18 pacientes. Estos recibieron 2 implantes en la mandíbula y una nueva dentadura sin anclajes durante el periodo de cicatrización sumergida de los implantes. Tras la cirugía de segunda fase se suministró una dentadura con anclajes de bola, imanes o barra. Se realizó un cambio en el sistema de anclaje tras 3 y 6 meses en función. La secuencia en la que se emplearon los anclajes fue aleatoria. Se midió la pérdida de hueso marginal radiográfica tras un periodo de cicatrización sumergida y tras 3, 6 y 9 meses de carga funcional de los implantes con la sobredentadura implantosoportada. Los últimos 3 valores se promediaron. La pérdida de hueso media durante el periodo de cicatrización sumergida y durante la carga funcional fue de 1.7 mm (0.7 mm) y 1.3 mm (0.6 mm) respectivamente. No se pudo demostrar una relación entre la fuerza de máxima mordida durante el periodo de cicatrización sumergida o durante el periodo de carga funcional por un lado y la cantidad de pérdida de hueso marginal por otro. La secuencia en la que se emplearon los diferentes tipos de anclajes no influyó en la cantidad de la cantidad de pérdida de hueso marginal observado. [source] Mandibular overdentures supported by two or four endosseous implantsCLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2005A 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] Organization of the connective tissue barrier around long-term loaded implant abutments in manCLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2002Gianmario Schierano Abstract: The study aimed to investigate the connective tissue seal and the spatial organization of collagen fibers around long-term loaded implants in man. Block specimens containing smooth titanium implant abutments and the surrounding supracrestal connective tissue were obtained from patients rehabilitated for at least 1 year with implant-retained overdentures or implant-supported fixed prostheses and were histologically investigated. The histological features of the connective tissue around long-term loaded titanium abutments were specific: the tissue was rich in collagen fibers, organized in bundles, presenting a constant spatial arrangement, similar to that reported in animal studies. Circular fibers, the most numerous, were located externally, and longitudinal fibers internally. Radial fibers inserted on the abutment surface, similar to those of the periodontal system, were not observed in any case. No histological differences were found between tissue sampled around implants supporting a fixed restoration and those anchoring an overdenture. [source] Should edentulous patients be constrained to removable complete dentures?GERODONTOLOGY, Issue 1 2010The use of dental implants to improve the quality of life for edentulous patients doi:10.1111/j.1741-2358.2009.00294.x Should edentulous patients be constrained to removable complete dentures? The use of dental implants to improve the quality of life for edentulous patients Background:, Nowadays, there is some speculation among dental educators that the need for complete dentures will significantly decrease in the future and that training in their provision should be removed from the dental curriculum. Objective:, To sensitise the reader to the functional shortcomings of complete denture therapy in the edentulous patient and present restorative options including implants to improve edentulous quality of life in these patients. Methods:, Information retrieval followed a systematic approach using PubMed. English articles published from 1964 to 2008, in which the masticatory performance of patients with implant-supported dentures was assessed by objective methods and compared with performance with conventional dentures, were included. Results:, National epidemiological survey data suggested that the adult population in need of one or two complete dentures will increase from 35.4 million adults in 2000 to 37.9 million adults in 2020. Clinical studies have showed that the ratings of general satisfaction were significantly better in the patients treated with implant overdentures post-delivery compared with the complete denture users. In addition, the implant group gave significantly higher ratings on comfort, stability and ability to chew. Furthermore, patients who received mandibular implant overdentures had significantly fewer oral health-related quality of life problems than did the conventional group. Conclusion:, Implant-supported dentures including either complete overdentures or a hybrid prosthesis significantly improve the quality of life for edentulous patients compared with conventional removable complete dentures. Therefore, the contemporary dental practitioner should consider other options as well as conventional removable complete dentures to restore edentulous patients. [source] Oral health and oral implant status in edentulous patients with implant-supported dental prostheses who are receiving long-term nursing careGERODONTOLOGY, Issue 4 2009Rita Isaksson Aim:, The aim of this study was to investigate oral health and oral implant status in a group of edentulous patients receiving long-term residential or nursing care (LTC), all of whom had implant-supported fixed or removable dental prostheses. Material and methods:, A dental examination was performed on a total of 3310 patients receiving LTC and from this population 35 edentulous patients in whom dental implants had been placed formed the cohort for this study. All examinations were performed by a specialist in hospital dentistry and took place in the patients' own home environment. Oral health was assessed by means of a protocol which evaluated oral hygiene status, possible oral mucosal inflammation and oral mucosal friction levels. Any problems with the implant-supported prosthesis, implant mobility or other complications were also assessed. In addition, patients were asked about any oral symptoms and their usual oral hygiene procedures. Results:, About half of the subjects (17/35) were registered as having no/mild inflammation with 18 of 35 having moderate/severe inflammation. Twelve of the 35 patients had good/acceptable oral hygiene and 23 of 35 had poor/bad oral hygiene. Twenty-one of the 35 patients depended on help from the nursing personnel for their daily oral hygiene procedures. Obvious problems with food impaction were noted in 11 patients. A total of 229 implants had been placed in 43 jaws supporting 40 full arch-fixed prostheses and three implant-borne overdentures. There was no evidence of mobility or fractures of either the implants or the prostheses. Fifteen implants showed some exposed screw threads. Pus was exuding from one implant site and general peri-implant gingival hyperplasia was noted in two patients. Twenty-four patients were completely satisfied with the function and appearance of their implant-supported prostheses. Two patients were totally dissatisfied. Conclusion:, This study indicates that oral implant therapy can be considered as a treatment of choice in elderly patients, even if oral hygiene is sub-optimal. [source] Implant overdentures for edentulous elders: study of patient preferenceGERODONTOLOGY, Issue 1 2009Shahrokh Esfandiari Background:, Studies show that elders wearing implant overdentures have improved nutrition and quality of life. However, upfront costs of this therapy are high, and the income of elderly edentulous populations is low. Objectives:, This study was designed (i) to measure the preferences of edentulous patients for mandibular two-implant overdentures using Willingness-To-Pay (WTP) and Willingness-To-Accept (WTA), (ii) to assess the effect of long-term financing on WTP and (iii) to assess the desired role of health care plans in financing dental prostheses. Methods:, Edentulous elders (68,79 years; n = 36) wearing maxillary dentures and either a mandibular conventional denture (CD, n = 13) or a two-implant overdenture with ball attachments (IOD, n = 23) participated in this study. All had received their prostheses 2 years previously, as part of a randomised clinical trial. A three-part questionnaire was completed during a 20-min interview with a trained researcher. Results:, Forty-six per cent (6/13) of the CD wearers and 70% (16/23) of the IOD wearers were willing to pay three times more than the current cost of conventional dentures for implant prostheses. These percentages were increased to 77% (CD) and 96% (IOD) if participants could pay for implant overdentures in monthly instalments. Eighty-six per cent (31/36) of all participants in both groups (21/23 IOD; 10/13 CD) thought that the government should cover at least some of the cost of implant overdentures. Conclusions:, This study shows that, the majority of elderly edentate individuals who have not experienced mandibular two-implant overdenture therapy are willing to pay the cost, particularly when payment can be made in monthly instalments. [source] Responses of jawbone to pressure,GERODONTOLOGY, Issue 2 2004Gunnar E. Carlsson Objective:, To provide a literature review of bone resorption of edentulous jaws focusing on responses to pressure. Background:, After the extraction of all teeth in a jaw there is a continuous reduction of the residual ridge. The individual variation of bone resorption is great, and the aetiology is complex and not yet well understood. Materials and methods:, A search of the literature published up to May 2003 on bone resorption and pressure was performed using PubMed/Medline. Results:, Animal studies have demonstrated that excessive and constant pressure induces bone resorption. Recent experimental research has indicated that bone resorption is a pressure-regulated phenomenon with a lower threshold for continuous than for intermittent pressure. Clinical studies have suggested that residual ridge resorption is due more to the effects of denture wearing than to disuse atrophy. However, the results of leaving out dentures at night are not conclusive. Nor does the literature offer any strong evidence for the so-called combination syndrome, which has been described as a result of unfavourable loading. Clinical studies using multivariate analyses indicate that female gender and systemic factors may be of greater importance than oral and denture factors. Implant-supported prostheses have a bone preserving effect rather than the continuing resorption under complete dentures. Conclusions:, The best way to reduce bone resorption is to avoid total extraction, preserve a few teeth and fabricate overdentures. In edentulous jaws, placement of implant-supported prostheses will lead to less bone loss and may even promote bone growth. To increase our knowledge of residual ridge resorption extended experimental, clinical and statistical methods will be needed, preferably including collaboration between dental and medical researchers. [source] Impact of Human Genome Project on treatment of frail and edentulous patients,GERODONTOLOGY, Issue 1 2004Ichiro Nishimura Objective:, Because of ongoing increases in life expectancy and deferment of edentulousness to older age, dentists are facing a different challenge to satisfy elderly denture wearers with a higher prevalence of chronic diseases. This discussion introduces the Human Genome databases as novel and powerful resources to re-examine the core problems experienced by frail and edentulous patients. Background:, Recent studies demonstrated that mandibular implant overdentures do not necessarily increase masticatory function, perception and satisfaction in denture wearers with adequate edentulous residual ridges. It has been demonstrated that the rate of edentulous residual ridge resorption significantly varies among individuals. The prognosis and cost-effectiveness of denture treatment, with or without implants, may largely depend on how the edentulous ridge is maintained. However, reliable clinical methods permitting dentists to predict the long-term health of the edentulous residual ridge are lacking. Materials and methods:, With the completion of the Human Genome Project, the genomic sequence database from this multinational consortium will provide a unique resource to determine the genetic basis of similarity and diversity of humans. Results:, One base pair in every 100 to 300 base pairs of the genome sequence varies among humans, suggesting that genetic diagnosis using the single nucleotide polymorphisms (SNPs) may provide a novel opportunity to differentiate our edentulous patients. Conclusions:, Future dental service for the elderly will require a personalized care paradigm, using highly sensitive diagnostic technology such as SNP genomic analysis, for recommending the treatment with greatest potential benefit. [source]
| | |||||||||