Long-term outcomes of three types of implant-supported mandibular overdentures in smokers
ABSTRACT The aim of the study was to compare the differences in the long-term clinical and radiologic effects for three different treatment strategies with implant-supported overdentures in the edentulous mandible, with a special emphasis on smoking.
In a randomized- controlled clinical trial, 110 edentulous patients participated. Thirty-six patients were treated with an overdenture supported by two implants with ball attachments (2IBA), 37 patients with an overdenture supported by two implants with a bar (2ISB) and 37 patients with an overdenture supported by four implants with a triple bar (4ITB). After a mean evaluation period of 8.3 years, the clinical and radiographic parameters were evaluated.
Ninety-four out of the original 110 patients (=85%) were evaluated. In the 2IBA group, the plaque index was significantly lower (vs. 2ISB, P=0.013; vs. 4ITB, P=0.001) than in the other groups, but there was no correlation with the other peri-implant parameters. In the 4ITB group, the marginal bone loss was significantly higher than that in the two implant groups. The maximal probing depth was correlated with peri-implant bone loss (P=0.011). Smoking almost doubled marginal bone loss irrespective of the treatment strategy chosen.
Patients with two implants show less marginal bone loss than those with four implants. Smoking is a risk factor for the survival of dental implants in the long run.
- SourceAvailable from: Ann-Marie Roos-Jansåker
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- "Prospective cohort/5 years " Evaluate clinically and radiographically immediate implants " 22/68 Mucositis: PPD ≥4 mm+ BoP Peri-implantitis: PPD ≥4 mm+BoP+ " significant bone loss " Implants: 20 % (P) Implants: 5.8 % (P) Comment: " Implants placed with the immediate protocol demonstrated a higher tendency to crestal bone loss and periimplantitis " NS Table 1 (continued) References Study design/follow-up Aim Sample size (patients/implants) Disease definition Prevalence (P) of mucositis Prevalence (P)/incidence (I) of peri-implantitis Stoker et al. 2012  Prospective RCT/8.3 years " Compare the differences in the long-term clinical and radiologic effects for three different treatment strategies with implant-supported overdentures in the edentulous mandible, with a special emphasis on smoking " 94/256 No clear definition (clinical signs of inflammation not recorded) Patients: 5 % (P) Implants: 5 % (P) Comment: " smoking almost doubled marginal bone loss " Östman et al. 2012  "
ABSTRACT: This narrative review focuses on the current understanding of the definition and prevalence of peri-implantitis. A MEDLINE (PubMed) search over the past 3 years was performed using keywords related to the definition and prevalence of peri-implantitis. Additional literature retrieved from reference lists, review articles, and consensus reports were used. Definition of peri-implantitis is heterogeneous due to the various thresholds of bone loss and pocket depths used, creating a discrepancy in the prevalence figures. The prevalence of peri-implant mucositis varied between 19 and 65 %, whereas the prevalence of peri-implantitis ranged from 10 to 40 %. A consensus has been reached that the definition of peri-implantitis should be clinical signs of inflammation (bleeding on probing) and/or suppuration, in combination with progressive bone loss. In addition, we strongly recommend that measurement of the bone loss in relation to the implant length would further classify the case as mild, moderate, or severe peri-implantitis.12/2014; 1(4). DOI:10.1007/s40496-014-0031-x
- Peri-Implant Tissue Remodeling: Scientific Background and Clinical Implications, 1 edited by Luigi Canullo, Roberto Cocchetto, Ignazio Loi, 01/2012: chapter Factors Affecting Peri-Implant Bone Remodeling; Quintessence Publishing.
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ABSTRACT: OBJECTIVE: Moderately rough, surfaced implants are widely used. Nevertheless data on long-term soft and hard tissue parameters are still conflicting. The purpose of this study was to evaluate peri-implant bone level and soft tissue integration of anodized vs. turned surfaced implants in the anterior mandible after a mean functional loading time of 85 months. METHODS: Of 114 edentulous patients invited for follow-up, 41,2% were available for recall. Forty-seven patients with a mean age of 71 ± 9 years (14 men and 33 women) received 188 dental implants; All patients were edentulous and prosthetic rehabilitation was carried out by a bar-retained overdenture. Radiographic peri-implant bone level was assessed twice at baseline and recall. Clinical examination contained peri-implant sounding (PPD, BoP) and indexing oral hygiene (mPI). RESULTS: From baseline up to 85 months two patients experienced implant loss (four implants), which corresponds to an overall-survival rate of 97.9%. No significant differences were found between implant surfaces concerning the clinical parameters, such as plaque, calculus, bleeding on probing and pocket probing depth. The moderately rough surfaced implants showed significantly less decrease in peri-implant bone level (1.53 ± 0.25 mm) than turned surfaced implants (2.42 ± 0.34 mm) (P = 0.036). The interaction between the position of the implant and surface topography (P = 0.037) as well as the site at the implant (P = 0.004) had a significant influence on bone level changes. CONCLUSION: Both surface topographies with bar-supported overdentures have excellent long-term clinical outcomes. Moreover, a moderately roughened, anodized surface has beneficial effects in the anterior lower jaw.Clinical Oral Implants Research 05/2012; 24(9). DOI:10.1111/j.1600-0501.2012.02498.x · 3.12 Impact Factor