Abstract
Purpose: The aim of this study was to compare the clinical and radiographical outcomes of two loading protocols of mandibular overdentures supported by two unsplinted implants. Materials and methods: Twenty completely edentulous patients were included in the study. Patients were categorized in two groups each containing 10 patients. In group A, patients received at least two implants in symphysis areas inserted after a minimal flap reflection, and 2 months after implant placement, a mandibular complete denture was connected to the implants using ball attachments. In second group, prosthesis was loaded immediately after placing the implants in symphysis areas without any flap reflection. Patients were examined at 1, 12, 24 and 48 weeks after loading. At postoperative visits, occlusion was checked and the need for any prosthesis maintenance was recorded. Mobility of the implants, radiolucency around the implant and amount of crestal bone loss was checked and measured for both groups during the checkup sessions. Also any prosthetic problems were recorded. Results: After 12 months of loading, in both group no implant failure was reported and the survival rate was 100% in immediate and delay loading groups. Average of bone resorption in control group at the end of study was 0.84 ± 0.05 mm and in the test group was 0.84 ± 0.03 mm. In all patients after every 6 months the plastic O-rings were changed due to frictional wearing. In test group, in three patients the mandibular denture fractured, while, in control group it happened in two patients. In the test group, two patients experienced unbearable pain, while, in the control group seven patients experienced unbearable pain and they needed analgesics. None of the patients in test group experienced edema, swelling and discomfort after surgery due to flapless surgery, while in the control group four patients experienced edema and swelling after surgery. Conclusion: The results of this study suggest that immediate loading of two implants supporting mandibular overdenture has outcomes comparable with conventional loading protocols. This clinical approach offers good stability and comfort while keeping high implant success rate.
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