The original Brånemark protocol for dental implant treatment was based on submerged healing prior to loading. In recent years, immediate/early functional loading has been reported to be possible with high success for various indications including two splinted mandibular implants supporting an overdenture. However, there are a limited number of studies regarding the early loading protocol for two unsplinted mandibular implants supporting an overdenture.
A total of 26 edentulous patients were treated with two unsplinted dental implants supporting mandibular overdentures. All implants were placed in the canine regions of each mandible according to the one-stage surgery. For the test group, overdentures were connected 1 week after surgery, and for the control group, overdentures were connected 3 months after surgery. Peri-implant parameters were recorded 1, 6, 12, 18, and 24 months after surgery. Marginal bone levels were evaluated at implant placement and after 6, 12, 18, and 24 months. Clinical stability measurements were performed at surgery, and after 3, 6, 12, 18, and 24 months.
No implant from either group was lost during 2 years. Clinical peri-implant parameters, clinical implant stability measurements, and marginal bone resorptions showed no statistically significant differences between the two groups during 24 months.
The results of this clinical trial suggest that the early loading approach of two dental implants supporting a mandibular overdenture does not jeopardize peri-implant soft tissue health, marginal bone resorption, and implant stability.
"Insertion torque, tapping, tactile sense, MM device, and RFA are some of the methods used to evaluate primary stability (Meredith et al. 1997, 1998; Sennerby & Meredith 1998; Turkyilmaz et al. 2006a, 2006b). Peri-implant clinical parameters, marginal bone levels around implants, and RFA measurements are non-invasive methods that can be used for routine periodical evaluations of dental implants (Schwartz-Arad et al. 2005; Tozum et al. 2005; Turkyilmaz et al. 2006a, 2006b). "
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to evaluate short-term bone level and stability/mobility measurement alterations at platform switched (PS) and standard platform (SP) implants placed in mandibular premolar/molar regions using a single-stage protocol.
Sixteen PS and 16 SP implants restorated with fixed prosthesis were included. Standard implant dimensions were used for both implant systems. After 3 months of osseointegration, implants were connected to abutments and final restorations were performed. Marginal bone loss was measured by standardized periapical radiographs. Implant stability/mobility was determined by resonance frequency analysis (RFA) and mobility measuring (MM) device values. Peri-implant parameters were evaluated with clinical periodontal indices and all parameters were assessed at baseline, 1, 3, and 6 months after the surgery.
After 6 months, all implants showed uneventful healing. Radiographic evaluation showed a mean bone loss of 0.72 mm for PS and 0.56 mm for SP implants, and there were no significant differences between implant types. At 6 months, mean implant stability quotient (ISQ) values were 73.38 and 77 for PS and SP implants, respectively. Mean MM values were -4.75 for PS and -6.38 for SP implants. Mean MM values were lower for SP implants compared to PS implants at all time points. No significant differences were detected between implant types according to clinical peri-implant parameters.
The micro-gap at crestal level which immediately exposed to the oral cavity in non-submerged two part implants seems to have adverse influence on the marginal bone level.
"The following benefits of an immediately loaded implant-supported prosthesis in edentulous patients are reduced surgical and prosthetic visits along with improved function and patient's comfort, as for a functional prosthesis delivered immediately after surgery.4,5 Immediate loading of mandibular overdenture supported by 2 to 4 implants connected with a gold bar appears as a very promising treatment modality similar to delayed loading protocol.6,7 Ball, magnet and bar attachments have been commonly used to retain implant-supported overdenture over the last several decades. "
[Show abstract][Hide abstract] ABSTRACT: Despite the greater retention and low maintenance of bar attachment system, the longer clinical time and increased number of visits were the assignments to overcome in bar attachment system. This case report describes SFI-Bar® (Cendres et Métaux, Biel/Bienne, Switzerland) to be solve those problems. A 65-year-old female, who had severely absorbed mandible, hoped to wear a stable mandibular denture without pain. As soon as two implants were placed on mandible, a tube bar was connected to two adaptors connected to each implant. The length of the tube bar was adjusted considering inter implant distance, and reconnected to the adaptors. Finally a female part was seated beneath the denture. This case report showed that a satisfactory clinical result was achieved by delivering bar overdenture immediately after implant placement without laboratory procedure.
The journal of advanced prosthodontics 03/2011; 3(1):47-50. DOI:10.4047/jap.2011.3.1.47 · 0.64 Impact Factor
"Recent studies indicate comparable success rates and patient satisfaction for immediate loading protocols with splinted and unsplinted implants in the edentulous jaw (Payne et al. 2001, 2002; Raghoebar et al. 2003; Chiapasco 2004; Naert et al. 2004; Turkyilmaz et al. 2006). Therefore, immediate functional loading of unsplinted implants with overdentures may become more widespread as a simplified and efficient treatment option for edentulous patients (Kawai & Taylor 2007). "
[Show abstract][Hide abstract] ABSTRACT: When used with dental implants advantages of the magnetic attachments include control of load transmitted to implants, improvements in stability, support and retention for the prosthesis, and the relative ease of prostheses fabrication. Clinically, the use of sterilized components is required, and this may be problematic as magnetic alloys are sensitive to temperature. The purpose of this study was to evaluate the influence of autoclave sterilization on the maximum retentive forces and characteristic curves for magnetic attachments recommended for use with dental implants.
Eleven SmCo and NeFeB implant magnetic attachments were evaluated as provided by the respective manufacturers. Implant magnetic abutment and the corresponding denture magnet (n=5 magnet pairs) were tested before and after standardized autoclave sterilization (10 min at 134 degrees C). Each magnet pair was tested 10 times in a calibrated universal testing machine using a non-magnetic test device (s=40 mm, v=20 mm/min). Results were recorded electronically and statistically analyzed using t-test and ANOVA (Welch and Brown-Forsythe test; P<0.05).
After autoclave sterilization all magnetic pairs produced lower (though statistically insignificant) overall retention forces compared with the untreated pairs. After sterilization mean maximum retentive forces (SD) ranged from 5.65 (0.33) to 1.41 (0.07) N. The characteristic force-displacement curves of the tested magnetic systems showed differences among the single products.
Autoclave sterilization caused a non-significant reduction in retentive force of 0.04-14.6% when compared with the unsterilized magnet pairs. There were differences between the tested magnetic pairs for both the initial breakaway forces and the characteristic force-displacement curves. Within the limitations of this study all tested magnetic attachments were sterilized in an autoclave without significant change of retention properties. Nevertheless magnetic implant abutments should be sterilized with caution to reduce the risk of alterations of the retention properties.
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