The prosthodontic maintenance requirements of mandibular mucosa- and implant-supported overdentures

Department of Oral Rehabilitation, School of Dentistry, PO Box 647, University of Otago, Dunedin, New Zealand.
The International journal of prosthodontics (Impact Factor: 1.46). 01/2000; 13(3):238-43.
Source: PubMed

ABSTRACT This article presents a critical review of the literature on the prosthodontic maintenance requirements of mandibular mucosa- and implant-supported overdentures.
A search of the literature produced 35 papers pertaining to prospective and retrospective studies. The relationship of these prosthodontic maintenance requirements to the axis of rotation treatment concept was examined.
More often than not, 2 anterior mandibular implants either splinted (round or ovoid bars) or unsplinted (balls or magnets) have been used to evaluate this prosthodontic follow-up. Wide variation existed in the categories used for prosthodontic complications. Although principally related to alterations of overdenture contour and aspects of patrix and matrix maintenance, they also provide subjective information on relines and the rationale for avoiding overdenture fractures. These prosthodontic maintenance requirements undoubtedly have a direct impact on the time to retreatment of mandibular mucosa- and implant-supported overdentures.
There appears to be a need for a more uniform, standardized categorization with criteria for determining prosthodontic success, in terms of maintenance requirements and complications, for mandibular mucosa- and implant-supported overdentures. Controlled prospective evaluations of exact prosthodontic maintenance requirements of mandibular overdentures using different systems are lacking and encouraged. There is also an absence of prospective studies on such maintenance requirements of mandibular overdentures using multiple round bars on 3 or 4 implants.

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Available from: Alan G.T. Payne, Sep 27, 2015
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    • "Implant initial stabilization is an essential need for implant bone osseointegration. The immediate implant, in the present study, replaced the mandibular canines; because the mandibular canine area is the area of choice for most over-implant mandibular overdentures33 and also the single-rooted teeth have been the most frequent sites for immediate implants.34-36 "
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    ABSTRACT: To compare the changes in the occlusal vertical dimension, activity of masseter muscles and biting force after insertion of immediate denture constructed with conventional, tooth-supported and Implant-supported immediate mandibular complete denture. Patients were selected and treatment was carried out with all the three different concepts i.e, immediate denture constructed with conventional (Group A), tooth-supported (Group B) and Implant-supported (Group C) immediate mandibular complete dentures. Parameters of evaluation and comparison were occlusal vertical dimension measured by radiograph (at three different time intervals), Masseter muscle electromyographic (EMG) measurement by EMG analysis (at three different positions of jaws) and bite force measured by force transducer (at two different time intervals). The obtained data were statistically analyzed by using ANOVA-F test at 5% level of significance. If the F test was significant, Least Significant Difference test was performed to test further significant differences between variables. Comparison between mean differences in occlusal vertical dimension for tested groups showed that it was only statistically significant at 1 year after immediate dentures insertion. Comparison between mean differences in wavelet packet coefficients of the electromyographic signals of masseter muscles for tested groups was not significant at rest position, but significant at initial contact position and maximum voluntary clench position. Comparison between mean differences in maximum biting force for tested groups was not statistically significant at 5% level of significance. Immediate complete overdentures whether tooth or implant supported prosthesis is recommended than totally mucosal supported prosthesis.
    The journal of advanced prosthodontics 05/2012; 4(2):61-71. DOI:10.4047/jap.2012.4.2.61 · 0.64 Impact Factor
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    • "The consensus of many studies is that maintenance requirements are highest during the first year of service, and they are usually related to adjustments of contour, loosening or breakage of clips or ball matrices, corrosion of magnets, retention loss of clips and ball matrices and loosening of fixation screws of the bar or ball [14] [15] [16] [17]. As a patient functions with an implant-retained overdenture , loads are transmitted to the alveolar bone surrounding the implants [18]. "
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    ABSTRACT: The study aimed to evaluate the effect of different mucosa thickness and resiliency on stress distribution of implant-retained overdentures using a two-dimensional finite element analysis. Models were used in order to simulate two situations. In group A, model represented an edentulous mandible supporting an overdenture retained by two-splinted-implants connected with bar-clip system while in group B, model simulated an edentulous mandible supporting an overdenture retained by two-splinted-implants connected with bar-clip system associated with two-distally placed o'ring system. In each group, mucosa assumed three characteristics of thickness (1, 3 and 5 mm) in the resiliencies: hard, resilient and soft, respectively. Evaluation was performed on Ansys software. Group A showed higher stress values regardless of the mucosa characteristics. Overall, stress decreased at the supporting tissues as mucosa thickness and resiliency increased. Regarding supporting tissues, cortical bone showed the highest stress values. The use of bar-clip attachment system with distally placed o'ring attachment design optimized the stress distribution.
    Computer Methods and Programs in Biomedicine 10/2008; 92(2):213-23. DOI:10.1016/j.cmpb.2008.07.009 · 1.90 Impact Factor
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    ABSTRACT: The aim of this study was to ascertain whether simplifying mandibular overdenture treatment by using single-stage surgery and immediate prosthetic loading of a single implant will achieve acceptable implant success rates, functional improvement, and increased patient satisfaction. As part of this study, the Mk III Branemark implant with an oxidized surface was compared to the classic machined Mk III Branemark implant. Thirty-five patients (mean age: 68 years) with problematic mandibular dentures were treated. The primary complaints among the patients referred to the clinic for treatment were poor retention of the mandibular denture, instability, denture sores, and phonetic problems. Initially, patients were placed randomly into the "machined surface" or "oxidized surface" groups. A single implant was placed in the mandibular midline with high initial stability. A ball attachment was placed and the retentive cap incorporated into the existing denture. Reviews took place at 3, 12, and 36 months posttreatment. Clinical assessments, radiographs made with custom film holders, and stability measurements by both manual and resonance frequency analysis methods were recorded. All complications, failures, maintenance, and reasons for dropout were noted. Visual analog scale questionnaires were used to record patient satisfaction (analysis of variance: P < .05). Three of eight machined-surface implants failed, representing an unacceptably high failure rate (37.5%). The machined surface was therefore discontinued for this study. One machined and two oxidized-surface implants did not achieve sufficient primary stability to be immediately loaded, so they were treated with a two-stage delayed loading protocol. The 25 immediately loaded oxidized-surface implants were all classified as surviving at the 36-month recall. Patient satisfaction was very high with a significant increase in all comfort and functional parameters. Within the limitations of this study and research design, it appears that over a 3-year observation period, the immediately loaded single implant-retained mandibular overdenture, using an oxidized-surface implant and the existing prosthesis in a small group of prosthetically maladaptive patients, can provide a beneficial treatment outcome with a minimal financial outlay. Int J Prosthodont 2010;23:13-21.
    The International journal of prosthodontics 11/2009; 23(1):13-21. · 1.46 Impact Factor
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