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: ANIL Sukumaran[Show abstract] [Hide abstract]
ABSTRACT: Purpose. Nowadays, the advancements in direct metal laser sintering (DMLS) technology allow the fabrication of titanium dental implants. The aim of this study was to evaluate implant survival, complications, and peri-implant marginal bone loss of DMLS implants used to support bar-retained maxillary overdentures. Materials and Methods. Over a 2-year period, 120 implants were placed in the maxilla of 30 patients (18 males, 12 females) to support bar-retained maxillary overdentures (ODs). Each OD was supported by 4 implants splinted by a rigid cobalt-chrome bar. At each annual follow-up session, clinical and radiographic parameters were assessed. The outcome measures were implant failure, biological and prosthetic complications, and peri-implant marginal bone loss (distance between the implant shoulder and the first visible bone-to-implant contact, DIB). Results. The 3-year implant survival rate was 97.4% (implant-based) and 92.9% (patient-based). Three implants failed. The incidence of biological complication was 3.5% (implant-based) and 7.1% (patient-based). The incidence of prosthetic complication was 17.8% (patient-based). No detrimental effects on marginal bone level were evidenced. Conclusions. The use of 4 DMLS titanium implants to support bar-retained maxillary ODs seems to represent a safe and successful procedure. Long-term clinical studies on a larger sample of patients are needed to confirm these results.International Journal of Dentistry 12/2014; 252343:9.
- [Show abstract] [Hide abstract]
ABSTRACT: Objectives: Bone loss around dental implants is generally measured by monitoring changes in marginal bone level using radiographs. After the first year after implantation an implant should have less than 0.2 mm annual loss of marginal bone level to satisfy the criteria of success. However, the process of measuring marginal bone level on radiographs has a precision of 0.2 mm (or more) due to variations in exposure geometry, exposure time, and observer perception. Therefore the value of the annual loss may vary considerably, especially when short intervals are considered. This study investigates how the way annual bone loss is calculated affects the success rate of dental implants. Material and methods: Panoramic radiographs of 82 implant patients with an average follow-up of 10.4 years were analyzed. Marginal bone levels near the implants were indicated by one observer. The annual loss of marginal bone level was determined according to four different calculation methods. Results: The methods yielded succes rates of 9%, 45%, 81%, and 89%. Conclusions: The succes rate of dental implants measured on radiographs greatly depends on the details of the calculation method. Without rigorous standardisation annual bone loss and implant succes rate are not well defined.Dento-maxillo-facial radiology. Supplement 07/2014;
- [Show abstract] [Hide abstract]
ABSTRACT: Background. Only a few studies have dealt with immediately loaded, unsplinted mini-implants supporting ball attachment-retained mandibular overdentures (ODs). The aim of this study was to evaluate treatment outcomes of ball attachment-retained mandibular ODs supported by one-piece, unsplinted, immediately loaded, direct metal laser sintering (DMLS) mini-implants. Methods. Over a 4-year period (2009-2012), all patients referred to the Dental Clinic, University of Varese, and to a private practice for treatment with mandibular ODs were considered for inclusion in this study. Each patient received three or four DMLS mini-implants. Immediately after implant placement, a mandibular OD was connected to the implants. At each annual follow-up session, clinical and radiographic parameters were assessed: the outcome measures were implant failures, peri-implant marginal bone loss, and complications. Statistical analysis was conducted using a life-table analysis. Results. A total of 231 one-piece DMLS mini-implants were inserted in 62 patients. After four years of loading, six implants failed, giving an overall cumulative survival rate of 96.9%. The mean distance between the implant shoulder and the first visible bone-to-implant contact (DIB) was 0.38 mm (± 0.25) and 0.62 mm (± 0.20) at the 1- and 4 -year follow-up examinations, respectively. An incidence of 6.0% of biological complications was reported; prosthetic complications were more frequent (12.9%). Conclusion. Within the limits of this study, it can be concluded that the immediate loading of one-piece, unsplinted, DMLS titanium mini-implants by means of ball attachment-supported mandibular ODs is a successful treatment procedure. Long-term follow-up studies are needed to confirm these results.Journal of Periodontology 10/2014; · 2.40 Impact Factor