Abstract

Objectives To compare the changes in implant stability for the nonsubmerged (NS) and submerged (S) protocols for the single implant retained mandibular overdenture using ball attachment throughout a 24-month follow-up. Materials and Methods Eighty completely edentulous patients were seeking to improve retention of their lower complete denture by installing a single implant in the midline of the completely edentulous mandible. At the day of implant installation, patients were randomized into 2 groups using sealed envelopes: the nonsubmerged (NS) and submerged (S) group. After a 3-month healing period, all patients were randomized using sealed envelopes into ball attachment and CM-LOC attachment. The Periotest readings (PTV) was recorded using the Periotest M device and was recorded every 3 months for the first year and then annually in the second year. The scope of this clinical trial focused only on results of the ball attachment. The Mann–Whitney U test was used for comparison between study groups for independent samples. Two-sided p values less than 0.05 was considered statistically significant. Results There was no statistically significant difference in the mean change in PTV reading between the NS and S group at the different follow-up intervals. Initially, at the day of pickup (baseline) and 3-month follow-up, the mean PTV reading for the NS was greater than that of the S group (−4.471 ± 1.489, −4.391 ± 1.4727 (p=0.913)), while the S group has shown a greater improvement in PTV than the NS group after 6-month follow-up and continued throughout the 24-month follow-up (−5.730 ± 1.7804, −50855 ± 1.2581 (p=1)). Conclusion Both the nonsubmerged and the submerged healing protocol have shown reliable Periotest readings using ball attachment for a single implant retained overdenture. The submerged group has resulted in a greater improvement in Periotest readings after the 12- and 24-month follow-up period when compared to the nonsubmerged group although this improvement was not statistically significant.

Highlights

  • Branemark first introduced the successful outcomes of the submerged surgical procedure in implant dentistry [1]. e submerged surgical protocol would enhance the process of new bone formation and remodeling by utilizing a two-stage surgical procedure, which first includes implant installation in the underlying bone and a secondary-stage surgery after a period of osseointegartion [2]. e two-stage surgical protocol has proven to have good short- and long-term outcomes [3,4,5]

  • Osseointegration has proven to be successfully achieved through a single-stage “nonsubmerged surgical protocol,” in which implants and the healing abutment are exposed in the oral cavity during the period of osseointegration [6, 7]. e nonsubmerged surgical protocol offers several advantages when compared to the submerged surgical protocol as it requires only a single-stage surgery which is more cost effective [8], it is more convenient to the patients reducing postoperative complications, and there is no microgap at the alveolar bone crest level [9]

  • In the first 6 months from baseline, the change in mean Periotests values (PTVs) readings was slightly greater in the NS group than that in the S group, while after 12 months and 24 months, the change in PTV readings was greater in the S group than that in the NS group showing the greatest improvement at 12-month follow-up (−0.454 ± 1.6525, −1.775 ± 1.6637 (p 0.064)) (Table 4 and Figure 6)

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Summary

Objectives

To compare the changes in implant stability for the nonsubmerged (NS) and submerged (S) protocols for the single implant retained mandibular overdenture using ball attachment throughout a 24-month follow-up. At the day of implant installation, patients were randomized into 2 groups using sealed envelopes: the nonsubmerged (NS) and submerged (S) group. Ere was no statistically significant difference in the mean change in PTV reading between the NS and S group at the different follow-up intervals. Both the nonsubmerged and the submerged healing protocol have shown reliable Periotest readings using ball attachment for a single implant retained overdenture. E submerged group has resulted in a greater improvement in Periotest readings after the 12- and 24-month follow-up period when compared to the nonsubmerged group this improvement was not statistically significant Both the nonsubmerged and the submerged healing protocol have shown reliable Periotest readings using ball attachment for a single implant retained overdenture. e submerged group has resulted in a greater improvement in Periotest readings after the 12- and 24-month follow-up period when compared to the nonsubmerged group this improvement was not statistically significant

Introduction
Intervention
Discussion
Conclusions
Conflicts of Interest

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