Long-Term Prosthetic Aftercare of Mandibular Implant-Supported Overdenture

Abstract

Background: Two of the most popular resilient attachment systems for mandibular implant-supported overdenture (MISOD) are locator and ball attachments. The purpose of the present retrospective cohort study was to assess the long-term prosthetic aftercare and oral hygiene status in edentulous patients rehabilitated with MISOD. Materials and Methods: Forty-five consecutive patients were included (22, group A- ball vs. 23, group B- locator attachments). Attachment incorporation into the MISOD was conducted in a direct (chair-side) intraoral technique at the time of denture insertion. Routine follow-up included yearly visits. The number of visits requiring prosthetic aftercare, either during the follow-up or during the additional visit, was recorded. Outcome parameters included—prosthetic aftercare—the number of aftercare (primary outcome parameter) visits, and dental treatment received (pressure sores relief, liner changes due to loss of retention, loss of retention due to debris accumulation, denture repair—secondary outcome parameters); oral hygiene—gingival index (primary outcome parameter). Results: The mean follow-up of the entire study population was 84 ± 21 months, range 39–120 months. Statistical analysis revealed a lower need for prosthetic aftercare interventions in group A (p < 0.001). The mean number of visits dedicated to pressure sores relief (6.09 ± 1.04 vs. 3.03 ± 0.77, p < 0.001) and liner exchange due to loss of retention (5.6 ± 1.03 vs. 2.09 ± 1.04, p < 0.001), were significantly lower in group A. Debris (food/calculus) accumulation inside the attachment was noted only for the locator’s group (p < 0.001). No statistically significant differences between the groups were noted for denture repair (p = 0.318). Oral hygiene also exhibited statistically significant differences in favor of group A (2.3 ± 0.3 vs. 1.03 ± 0.2, p < 0.001). Conclusions: It can be concluded that using ball attachments for MISOD yields less need for aftercare treatments and improved oral hygiene status over the years.