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PubMed2006

A randomized controlled trial of implant-retained mandibular overdentures.

Evidence from randomized clinical trials of implant-retained overdentures is very limited at the present time. The aim of this study was to compare implant-retained mandibular overdentures and conventional complete dentures in a randomized controlled trial (RCT). Our a priori hypothesis was that implant-retained mandibular overdentures would be significantly better than conventional complete dentures. Edentulous patients (n = 118) were randomly allocated to either an Implant Group (n = 62) or a Denture Group (n = 56). Patients completed the Oral Health Impact Profile (OHIP) and a denture satisfaction scale pre-treatment and three months post-treatment. Upon completion of treatment, both groups reported improvement (p < 0.001, Wilcoxon Ranks Sum test) in oral-health-related quality of life and denture satisfaction. There were no significant post-treatment differences between the groups, but a treatment effect may be masked by application of "intention to treat" analysis. The OHIP change scores were significantly greater for patients receiving implants than for those who refused them.

Age Factors↗
PubMed1996

The edentulous predicament. II: The longitudinal effectiveness of implant-supported overdentures.

Fifty consecutive completely edentulous patients who were unable to wear their complete dentures took part in this prospective longitudinal study. After providing initial optimization treatment of patients' existing prostheses, prosthodontists conducting the study prescribed osseointegrated implant-supported removable overdentures for 45 of the 50 patients. The remaining five underwent ongoing attempts at optimizing their complete dentures. This article details the results of treatment for the 50 patients over a period of three to 13 years.

Adult↗
PubMed2004

Immediate functional load of mandibular implant overdentures: a surgical and prosthodontic rationale of 2 implant modalities.

Classic guidelines in osseointegration for root-form dental implants include a long healing period, during which functional load should be avoided. However, the long healing period might impose an intolerable situation on some patients, especially in the completely edentulous situation. Subperiosteal dental implant guidelines demonstrate that the implant upon insertion can be put into immediate function and be restored with the final prosthesis soon after surgery. Studies on immediately functional loaded implant-supported prostheses in patients who are completely edentulous have been reported, exhibiting high success rates comparable with conventionally loaded implants. This article describes the surgical and prosthodontic procedure for the immediately functional loaded mandibular implant overdentures in 2 different dentalimplant modalities, as well as its clinical rationale.

Dental Implantation, Endosseous↗
PubMed1999

The role of the dental technician in fabricating the single-stage implant prosthesis.

With the initiation of the concept of osseointegration, the use of dental implants has become a predictable and frequently used addition to comprehensive planning and treatment of edentulous patients. Implantology poses challenges for the dental laboratory not present in any other existing specialty. Single-stage implant surgery represents such an innovation.

Dental Abutments↗
PubMed2002

Immediate implant loading: a case report.

The therapeutic goal of implant dentistry is not merely tooth replacement but total oral rehabilitation. Considering dental implants as a treatment option can provide patients with positive, long-term results. Implants have developed into a viable alternative to conventional prosthetic reconstruction of edentulous areas. They provide excellent support for fixed or fixed detachable appliances, which increases function compared with conventional complete dentures. Implant dentistry has gone through many phases over the years. Modern technology and design allows us to predictably place our dental implants in immediate extraction sites and often load the implants at the time of placement. Single tooth-by-tooth reconstruction provides easy access for the patient to floss and clean the areas compared with the relative difficulty in maintenance when crowns are splinted. This case study demonstrates full maxillary and partial mandibular reconstruction using dental implants. The implants were surgically placed immediately after extractions and loaded using a stable roundhouse composite temporary bridge. Following osseointegration, the implants were permanently restored with individual crowns.

Aged↗
PubMed2002

The masticatory efficiency of mandibular implant-supported overdentures as compared with tooth-supported overdentures and complete dentures.

This study assesses the comparative masticatory efficiency (CME) of mandibular implant-supported overdentures (ISOs) to tooth-supported overdentures (TSOs) and complete dentures (CDs). Three groups of patients in equal numbers were evaluated by assessing chewing efficiency, and the results were correlated with tracings of mandibular excursion (ME) and electromyographic (EMG) computerized analysis. CME was measured by utilizing standardized portions of 2 food staples with fixed masticatory sequencing. In a following session, utilizing the same fixed masticatory sequence, tracings of ME and EMG of the masseter and temporal muscles were recorded and analyzed. The results revealed that the ISO provided the greatest degree of efficiency, followed by the TSO and then the CD group. CME is more correlated to ME and less correlated to EMG.

Adult↗
PubMed1998

Case report: Complications of rehabilitation using osseointegrated implants--tardive dyskinesia.

The oral rehabilitation of patients using osseointegrated dental implants is a well established treatment modality. However complications can arise during the provision of treatment. This case report describes the management of a patient exhibiting tardive dyskinesia with an implant stabilised mandibular overdenture. Complications of the treatment and their resolution are discussed.

Aged↗
PubMedDate not supplied

Maxillary changes under complete dentures opposing mandibular implant-supported fixed prostheses.

PURPOSE: The aim of this study was to determine whether a condition similar to Combination Syndrome occurs in patients rehabilitated with a maxillary complete denture opposing a mandibular implant-supported fixed prosthesis. MATERIALS AND METHODS: Standardized clinical procedures measured fit, occlusal integrity, and bone loss in the anterior maxilla in 11 edentulous subjects meeting these requirements, from the patient pool of the Implant Centre, United Dental Hospital, Sydney. RESULTS: A mean annual loss of 0.17 mm in the anterior maxillary ridge height was not statistically significant (P > 0.05). However, increased pressure in the anterior maxillary ridge during occlusion and loss of posterior occlusal contacts in retruded position were noted on one or both sides in all subjects. CONCLUSION: Loss of posterior occlusion could not be related to anterior maxillary bone loss. However, to maintain the integrity of the prostheses and their supporting structures, it is important to schedule periodic recall appointments for review of the occlusion.

Aged↗
PubMedDate not supplied

A six-year follow-up study of maxillary overdentures on osseointegrated implants.

This study comprised a clinical and radiological examination of two groups of 14 patients receiving overdentures of the same design on osseointegrated implants. The mean follow-up period was 82 months and 35 months in the two groups the fixture success rate was 84% and 85% and the marginal bone loss 0.97 mm and 1.29 mm respectively. The follow-up of the two groups was guided by several clinical parameters and apart from the loss of fixtures and adjustments of the attachment system only a few complications were registered. The results show that this treatment method is a successful alternative in the treatment of the edentulous maxillae.

Aged↗
PubMedDate not supplied

Implant-retained mandibular overdentures with immediate loading: a prospective study of ITI implants.

A prospective study was conducted in which 21 patients received a mandibular implant-supported overdenture. Eighty-four ITI screw-type implants were placed in the interforaminal area of the mental symphysis (4 implants per patient). Immediately after implant placement, a U-shaped gold or titanium bar was fabricated and implants were loaded with an implant-retained overdenture. Of 21 patients treated, 19 were followed for a minimum of 25 months to a maximum of 60 months, with a mean follow-up of 37 months. Two patients dropped out during the follow-up. The overall failure rate of implants (according to Albrektsson criteria) was 4% (3/76 implants), but all implants, bars, and prostheses remained in function. Results from this study demonstrated that the success rate for immediately loaded mandibular implants is similar to that obtained in cases of delayed loading, after osseointegration has taken place. This method shortens dental rehabilitation time with relevant satisfaction for patients.

Aged↗
PubMed2000

[Mandibular atrophy and a screw-retained implant-supported prosthesis].

Prosthetic care for mandibular atrophy has raised many difficult problems, particularly in the most severe cases. The solution to most of these problems lies in the use of osteointegrated implants. Good results were obtained by using a small number of implants associated with adjustable overdenture prostheses or, alternatively, by using a larger number of implants (5 or 6) associated with a screw fixed prosthesis with posterior cantilever. Cantilever prostheses can provide support for the mental foramen zones and the posterior zones of the mandibular body where bone resorption is important after application of adjustable plates to the fibromucosa.

Aged↗
PubMed2000

Immediately loaded mandibular implant bar overdenture: a surgical and prosthodontic rationale.

Classical guidelines for osseointegration include a long healing time, during which functional load should be avoided. However, the long healing period might impose an intolerable situation on some patients, especially in the completely edentulous situation. Studies on immediately loaded implant-supported prostheses in completely edentulous patients have been reported, exhibiting high success rates comparable to conventionally loaded implants. This article describes the surgical and prosthodontic procedure for the immediately loaded mandibular implant bar overdenture as well as its clinical rationale.

Dental Implantation, Endosseous↗
PubMedDate not supplied

Implant-supported mandibular overdentures retained with ball or bar attachments: a randomized prospective 5-year study.

PURPOSE: The aim of the present study was to evaluate the periimplant conditions and the maintenance requirements for implant-supported overdentures in the mandible retained with ball or bar attachments during a 5-year period. MATERIALS AND METHODS: Twenty-six completely edentulous patients had two Astra Tech dental implants placed in the anterior part of the mandible. The denture attachment system for the patients was chosen randomly by drawing lots. Eleven patients drew the bar attachment system and fifteen patients drew the ball attachment system. Plaque Index, Gingival Index, and probing pocket depth were assessed around each implant. Periotest values were recorded, and periodically identical intraoral radiographs were obtained with a specially designed film-holding device. RESULTS: No implants were lost from baseline to the 5-year registration. The periimplant conditions were very healthy after 5 years. No significant differences of the periimplant variables were recorded between the bar and the ball groups. During the first year of function, significantly more complications/repairs were registered in the bar group than in the ball group. In the following years, no significant differences were registered. The mean frequency of complications/repairs per patient per year was 1.0 in the bar group and 0.6 in the ball group during the 5-year observation period. CONCLUSION: Two implants with ball or bar attachment supported an overdenture in the mandible for 5 years with a 100% survival rate. No differences in marginal bone loss or health of the periimplant mucosa were observed between bar and ball attachment, but the frequency of technical complications/repairs per patient was higher around bar than ball attachments.

Aged↗
PubMedDate not supplied

Oral rehabilitation with osseointegrated implants in a patient with oromandibular dystonia with blepharospasm (Brueghel's syndrome): a patient history.

Oromandibular dystonia with blepharospasm (also known as Brueghel's syndrome, Meige's syndrome, or idiopathic orofacial dystonia) is characterized by intense and involuntary spasms of the orofacial muscles, with a frequent loss of teeth and occlusal alterations that worsen the dystonic manifestations and cause mucosal lesions that can lead to complete edentulism. The history of a patient with oromandibular dystonia who was rehabilitated with mandibular overdentures supported by endosteal implants is presented. Oral rehabilitation with implant-supported overdentures improved the situation, despite serious problems with instability. Mandibular overdentures supported by endosteal implants were satisfactorily used to re-establish occlusion, ensuring prosthetic stability and improving the dynamics of the masticatory muscles.

Aged↗
PubMedDate not supplied

The symphyseal single-tooth implant for anchorage of a mandibular complete denture in geriatric patients: a clinical report.

Little information exists to define the minimum number of implants required for sufficient anchorage of mandibular overdentures. To date, 2 implants placed in the interforaminal region have been considered the minimum. The aim of this study was to examine whether a single symphyseal implant would suffice for adequate anchorage of a mandibular complete denture in elderly patients (octogenarians), and whether this surgically, prosthetically, and financially simple concept would also satisfy patients needing replacement of the mandibular dentition. Nine patients with a mean age of 82.2 years underwent placement of a single symphyseal endosseous implant and anchorage of a complete denture using a ball attachment. Standardized recall examinations, including patient response and inspections of the peri-implant soft tissue and bone conditions, were carried out at 3- to 6-month intervals for a period of 1 1/2 years. It was found that anchorage with a single implant led to both a significant improvement in patients' subjective satisfaction (P < .01) and a significant reduction in reported symptoms (P < .01). During the observation phase, pocket depth and bone resorption initially increased around implants but stabilized after the sixth month. Denture management (placement and removal) also improved during the recall period (P < .01). The results of this study indicate that oral rehabilitation by mandibular complete dentures anchored on a single implant can be considered an economical therapeutic alternative to a conventional mandibular complete denture for very old (octogenarian) patients.

Aged↗
PubMedDate not supplied

Oral health impact on daily performance in patients with implant-stabilized overdentures and patients with conventional complete dentures.

This cohort study (n = 83) investigated whether patients with implant-stabilized overdentures would demonstrate less impact on daily life, would have less difficulty in the mastication of different types of food, and would generally be more satisfied than patients with conventional complete dentures. The groups were comparable for gender, age of dentures, and duration of edentulism. The patients were interviewed using a questionnaire, which included the Oral Impacts on Daily Performances (OIDP) sociodental indicator. Patients with implant-stabilized overdentures were more satisfied with the comfort of their dentures, could eat a wide range of food items with less difficulty, and experienced less impact on daily life than patients with conventional complete dentures. The findings of this study support the need to consider implant-stabilized overdentures in the treatment of edentulous patients.

Activities of Daily Living↗

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