MATERIAL AND METHODS: In this prospective study, 20 IFPP (mean age 47.0; SD 12.9 years) and 28 ISOD (mean age 61.5; SD 9.1 years) patients received 2 mandibular implants. Metal ceramic nonsplinted fixed prostheses were provided in IFPP group, while in ISOD group, the mandibular overdentures were retained by nonsplinted attachments. Patients rated their oral health-related quality of life using OHIP-14 Malaysian version at baseline (T0), 2-3 months (T1) and 1 year (T2) postimplant treatment. Mean OHIP-14 for total and domain scores between groups and intervals was analysed using repeated-measures ANOVA and t-test. Mann-Whitney and Wilcoxon signed-rank tests were used for the comparison of mean score change and effect size, while the association between pre- and post-treatment scores was determined using multivariate linear regression modelling.
RESULTS: The total OHIP and domain scores before implant treatment were significantly higher (lower OHRQoL) in IFPP than in ISOD groups, except for physical pain where this domain showed similar impact in both groups. Postimplant scores between groups at T1 and T2 showed no significant difference. The mean score changes at T0-T1 and T0-T2 for total OHIP-14 and domains were significantly greater in IFPP except in the domains of physical pain and disability which showed no difference. Large effect size (ES) was observed for total OHIP-14 in IFPP while moderate in ISOD. Improved OHRQoL was dependent on the treatment group and pretreatment score.
CONCLUSION: Improvement in OHRQoL occurred following both mandibular implant-supported overdentures and implant fixed partial prostheses.
BACKGROUND: Literature lacks information on various unsplinted attachment systems and their effect on peri-implant tissue health. A focus question (as per PICOS) was set as follows: Does one particular unsplinted attachment system (I) compared with another (C) results in better peri-implant outcomes (O) in two implant-retained mandibular overdentures (P) using randomized controlled trials (RCTs) (S)? The literature search was conducted in the PubMed, MEDLINE and Cochrane Central Register of Controlled Trials (CENTRAL) databases between January 2011 and December 2021. The keywords used were "denture, overlay," "denture," "overlay" AND "dental prosthesis, implant supported," "dental implants," "dental implant abutment design" AND "jaw, edentulous," "mouth, edentulous" AND "mandible." Only RCTs on two implant-retained mandibular overdentures using unsplinted attachment systems measuring peri-implant tissue outcomes with minimum 1-year follow-up were selected. In total, 224 studies were identified in initial search, and 25 were shortlisted for full-text evaluation. Four studies were included for systematic review upon considering inclusion and exclusion criteria. The risk of bias was evaluated using Cochrane Risk of Bias Tool 2.0 (RoB 2.0).
REVIEW RESULTS: A total of 41 patients received ball attachments (in 3 studies), 36 patients received low-profile attachments (in 3 studies), 16 patients received magnet attachments (in 1 study), and 13 patients received telescopic attachments (in 1 study). All four studies used standard sized implants, however, differed in implant manufacturers. Two studies which compared ball attachments low-profile attachments revealed-similar peri-implant tissue health parameters but differed in crestal bone-level changes. One study compared ball with telescopic attachments and revealed similar results in crestal bone-level changes and all four peri-implant tissue health parameters. Single study compared magnets with low-profile attachments and shown lesser bone loss with magnet attachments. Single study was judged to have low risk of bias, single with some concerns, and remaining two to have high risk of bias.
CONCLUSION: Gingival index and bleeding index of the patients were not influenced by any of the unsplinted overdenture attachment (stud, magnet, telescopic) system. Inconclusive results found among the studies evaluated comparing crestal bone loss and plaque index.
CLINICAL SIGNIFICANCE: This review manuscript has simplified comparative analysis of different unsplinted attachment systems used in two implant mandibular overdentures to help clinicians choose correct system in such situation.
PURPOSE: The purpose of this prospective randomized controlled clinical study was to evaluate crest bone-level changes and patient satisfaction with mandibular overdentures retained by 1 or 2 titanium-zirconium (Ti-Zr) implants with immediate loading protocols after 1 year.
MATERIAL AND METHODS: Thirty-six Ti-Zr implants were placed in 24 participants (single central implant in 12 participants and 2 interforaminal implants in 11 participants) by a single operator. LOCATOR attachments were used to retain the mandibular overdentures with an immediate loading protocol, and observations were made at 1 month and 1 year. Changes to the crestal bone level were evaluated with digital periapical radiographs. A 100-mm visual analog scale (VAS) was used to evaluate patient satisfaction. The Mann-Whitney U test was used to analyze the data.
RESULTS: At 1 month, the mean crestal bone loss was 0.23 mm in the 2-implant group (n=22) and 0.39 mm (P=.181) in the single-implant group (n=11). At 1 year, the bone loss was 0.67 mm in the 2-implant group and 0.88 mm (P=.248) in the single-implant group. The mean VAS score for patient satisfaction level increased from 38.3% to 49.7% for single-implant participants and from 40.5% to 54.8% for 2-implant participants 1 month after implant placement (P=.250) and from 38.3% to 54.5% for single-implant participants and from 40.5% to 58.9% for 2-implant participants after 1 year (P=.341).
CONCLUSIONS: Single-implant-retained mandibular overdentures with an immediate loading protocol may represent a viable treatment option considering crestal bone-level changes and patient satisfaction compared with 2-implant-retained mandibular overdentures after 1 year of follow-up.
Method: Maxillary CBCT images of two-hundred-and-fifty-seven consecutive patients (163 men, 94 women, mean age 42 years) were analyzed. Samples were later divided into dentate (n = 142) and posteriorly edentulous (n = 115) jaws. Using both alveolar ridge and tooth location as reference points, the distance and diameter of IA were assessed.
Result: The IA was seen in 63.7% of all sinuses with 68.2% in dentate and 62.4% in edentulous. Mean distance and diameter of IA across the posterior tooth locations were 17.9 ± 3.0 mm and 1.4 ± 0.5 mm (dentate) and 15.1 ± 3.0 mm and 1.0 ± 0.5 mm (posteriorly edentulous), respectively. In each sample, there were no significant differences in distance-alveolar ridge and no significant correlations in diameter-tooth location. A statistically significant Pearson coefficient correlation between diameter and distance in dentate state was observed (r = -0.6).
Conclusion: This study reveals that dentate maxillary jaws present larger diameters as compared to posteriorly edentulous jaws, although the IA course remains the same. As these canal structures contain neurovascular bundles with diameters that may be large enough to cause clinically substantial complications, a thorough pre-surgical planning is therefore highly advisable.
PURPOSE: The purpose of this clinical study was to evaluate the safe distance in the interforaminal region of the mandible measured from the genial tubercle level for implant osteotomy in a Chinese-Malaysian population.
MATERIAL AND METHODS: A total of 201 Digital Imaging and Communications in Medicine (DICOM) files were selected for the study from the CBCTs of dentate or edentulous Chinese-Malaysian adult patients with ongoing or completed treatments. Measurements were made with implant planning software. The anatomy of the whole mandible was assessed in the coronal cross-sectional, horizontal view and in panoramic view. Measurements were obtained in millimeters on one side by locating and marking a genial tubercle and then marking the mesial margin of the mental foramen and the anterior loop of the inferior alveolar nerve. The corresponding points of these landmarks were identified on the crest of the mandibular ridge to measure the linear distances. All the measurement steps were repeated on the other side. The linear distance of 2 mm was deducted from the total distance between the genial tubercle and the anterior loop separately for left and right side measurements to identify the safe zone. The mixed 2-way analysis of variance (ANOVA) test was used to analyze side and sex-related variations.
RESULTS: The mean safe zone measured at the crestal level from the genial tubercle site on the left side of the mandible was 21.12 mm and 21.67 mm on the right side. A statistically significant (P