The Prosthodontic Maintenance Requirements of Mandibular Mucosa- and Implant-Supported Overdentures: A Review of the Literature

University of the Witwatersrand, Johannesburg, Gauteng, South Africa
The International journal of prosthodontics (Impact Factor: 1.46). 05/2000; 13(3):238-43.
Source: PubMed


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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    • "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.
    Full-text · Article · May 2012 · The journal of advanced prosthodontics
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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.
    Full-text · Article · Oct 2008 · Computer Methods and Programs in Biomedicine
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    ABSTRACT: Implants have been designed to provide edentulous patients with fixed prostheses or overdentures. Recently, implant-supported fixed partial prostheses and single crowns have become successful treatment alternatives to removable and fixed partial dentures. However, few researchers have examined "removable partial dentures on implants and natural teeth". In this article, we report two patients fitted with "removable partial dentures on implants and natural teeth". The patients were satisfied with their dentures in terms of function and aesthetics. Regular follow-up visits revealed that the periodontal and peri-implant conditions were stable. There was no evidence of excessive intrusion or mobility of the teeth, nor were any visible changes in the bone levels of the natural teeth or implants noted on radiographs. Since the average duration of observation was about 38 months, further follow-up examinations are necessary to determine whether these dentures remain stable long-term.
    Full-text · Article · May 2007 · Chang Gung medical journal
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