Oral Reconstruction of Hemi-Mandibulectomy Patients by Implant Overdenture: Report of Two Cases

Prevalence and risk of peri-implant diseases based on the type of prosthetic restoration: A retrospective study after 17 to 23 years

Rehabilitation of a mandibulotomy/onlay/graft-reconstructed mandible using a milled bar and a tooth- and implant-supported removable dental prosthesis: A clinical report

BackgroundClinical data are needed on long‐term outcomes of removable implant‐supported prostheses in the fully edentulous maxilla as a function of the number of implants, effects of the attachment system and other clinical variables.ObjectiveTo restore individuals with an edentate maxilla with a metal‐reinforced removable prosthesis without palatal coverage retained by low‐profile stud attachments on three implants.MethodsThe regional ethics committee approved a prospective cohort study that included all consecutive patients treated in a private speciality clinic. Primary outcomes were patients reported, that is denture satisfaction scale and oral health‐related quality of life – OHIP‐20. Secondary outcomes were implant‐ (bone loss, implant complications and peri‐implant conditions) and prosthesis‐related (prosthesis complications, maintenance needs and mucosa condition).ResultsThirty‐two study participants were recruited between March 2007 and October 2016 and followed for a minimum of five years. According to Kruskal–Wallis tests, the OHIP‐20 and Denture Satisfaction Scale questionnaire pre‐treatment scores differed significantly. After an average of 6.7 years, peri‐implant bone loss of more than 2 mm was observed on 17% of all implants, while no or minor bone loss was seen on 38%. The estimated success of implants was 0.95 at 168 months. The estimated success of the prosthesis, that is no adverse events or need for any repairs, was 0.55 at 156 months.ConclusionThe positive findings in the current clinical study strengthen the notion that for many individuals with an edentulous maxilla, a removable prosthesis retained by three implants fitted with low‐profile stud‐attachment is a reliable technical solution.

This cross-sectional study aimed to quantify the impact of implant-related complications on perceived pain, functional impairment, concern, quality of life (QoL) and confidence which were the study's primary outcomes. Patients were recruited in five centres over 19 months. They completed a structured ad hoc questionnaire scoring pain, chewing ability, concern, QoL and confidence in future implant treatment. Some potential independent variables were also recorded. The data were analysed descriptively and with a multiple-stepwise regression model for correlations of the five primary variables with the other data. The sample consisted of 408 patients, with prosthesis mobility being the most common complication (40.7%). Most patients (79.2%) consulted because of a complication, while 20.8% were asymptomatic and consulted regularly. Pain was correlated with symptoms at consultation and in biological/mixed complications (p < .001; R2 = 44.8%). Chewing impairment with implant loss, prosthesis fracture and removable implant-supported or total prostheses (p < .001; R2 = 42.8%); patient concern was correlated with the clinical symptoms and removable implant-supported prostheses (p < .001; R2 = 36.1%); impact on QoL was correlated with implant loss, prosthesis fracture and removable implant-supported prostheses (p < .001; R2 = 41.1%). Patient confidence was relatively independent and only impact on quality of life significantly influenced it (r = 0.73). Implant-related complications moderately impaired patients' perceptions of pain, chewing ability, concern and QoL. Nevertheless, complications only slightly reduced their confidence in future implant treatment.

To evaluate patient satisfaction and prosthetic complications of maxillary conventional dentures and implant overdentures opposing mandibular implant overdentures with different attachments. A total of 60 patients with maxillary conventional dentures (maxillary CD) and mandibular two-implant overdentures received four implants in the maxilla. The implants were connected to the maxillary overdentures with a stud attachment (maxillary OD). The participants were classified into three groups according to the type of mandibular overdenture attachment: bar overdentures (BOD, n = 20), resilient telescopic overdentures (TOD, n = 20), and resilient stud/Locator overdentures (LOD, n = 20). Patient satisfaction (using a visual analog scale [VAS] and oral health-related quality of life (OHRQoL)] and prosthetic/soft tissue complications were evaluated for maxillary CD and maxillary OD after 1 year of insertion. LOD showed higher VAS and oral health impact profile (OHIP-14) scores with maxillary CD and maxillary OD than BOD and TOD except for ease of chewing (VAS) and satisfactory diet (OHIP-7). For maxillary CD, TOD showed a significantly higher frequency of prosthetic and soft tissue complications than BOD and LOD. For all groups, maxillary OD showed significantly higher patient satisfaction regarding VAS and OHIP-14 scores, and lower prosthetic and soft tissue complications than the maxillary CD. Locator-retained maxillary overdentures opposing mandibular implant overdentures improved patient satisfaction and reduced prosthetic complications compared to conventional maxillary dentures. Such overdentures are best opposed by Locator-retained mandibular overdentures, as they increase patient satisfaction and reduce prosthetic and soft tissue complications compared to the bar and telescopic attachments.

A questionnaire was sent to U.S. dental laboratories to evaluate the level of communication between dentists and laboratory technicians and to determine trends in procedures and materials used in fixed and removable implant restorations. Dental laboratories were randomly chosen from the National Association of Dental Laboratories for each of the 50 states. The questionnaire was mailed to the laboratory directors for 199 dental laboratories. One hundred fourteen dental laboratories returned the survey, yielding a response rate of 57%. Of those laboratories, 37 indicated that they did not participate in the fabrication of fixed implant restorations, yielding a response rate of 39%. Forty-two dental laboratories indicated that they did not participate in the fabrication of implant-retained overdenture prostheses, yielding a response rate of 36%. Results from this survey show inadequate communication by dentists in completing work authorization forms. Custom trays are used more frequently for implant-retained overdenture impressions and stock trays for impressions of fixed implant prostheses. Poly(vinyl siloxane) is the material most commonly used for both fixed and removable implant-supported prostheses. Two implants with stud attachments are used more widely than those with bar attachments for implant-retained overdentures. Most laboratories working on implant prosthodontic cases report inadequate communication between the laboratory and dentists related to materials and techniques used in fabrication of implant restorations.

Background: Implant overdentures with stud attachments are a popular choice for edentulous patients due to their enhanced retention, stability, and patient satisfaction.However, the fatigue resistance of different stud attachment systems may vary based on mechanical wear over time.Additionally, the type of denture base material used may influence the performance of these attachments.This in vitro study aims to evaluate and compare the fatigue resistance of various implant overdenture stud attachments in combination with different denture base materials.Materials and Methods: Three types of stud attachments were tested: Locator, Ball, and Magnetic attachments.Each attachment was paired with three different denture base materials: heat-cured polymethyl methacrylate (PMMA), injection-molded resin, and nylon-based flexible resin.A total of 45 samples were fabricated (15 samples for each type of attachment).Fatigue testing was conducted using a cyclic loading machine, simulating mastication forces (50 N) for 50,000 cycles at 1.5 Hz frequency.Retention force (N) was measured before and after fatigue loading using a universal testing machine.Data were analyzed using one-way ANOVA and post-hoc Tukey's test, with a significance level set at p < 0.05.Results: The initial retention force for Locator attachments was 35 N, Ball attachments 30 N, and Magnetic attachments 20 N.After fatigue loading, Locator attachments retained 85% of their initial force, Ball attachments 75%, and Magnetic attachments 60%.Denture bases made of PMMA showed the highest retention stability (90% retention post-loading), followed by injection-molded resin (80%) and nylon-based flexible resin (65%).Statistically significant differences were observed among the different attachment types and denture base materials (p < 0.01).Conclusion: Locator attachments demonstrated superior fatigue resistance compared to Ball and Magnetic attachments, making them a preferable choice for long-term use.PMMA as a denture base material exhibited the highest retention stability, suggesting that it may enhance the longevity of stud attachments in implant overdentures.These findings provide useful insights for clinicians in selecting attachment systems and denture base materials for optimal performance.

To determine the overall success of dental implants placed in geriatric patients. Dental implants were placed in 47 geriatric patients who were 79 or more years of age at the time of the procedure. The study group was composed of 27 men and 20 women, with a median age of 89 years and a range of 79 to 99 years of age at the time of implant surgery. A total of 73 dental implants were placed in the maxilla and 87 dental implants placed in the mandible. All implants were restored with fixed implant-supported prostheses or removable implant-supported prostheses. Eleven of the patients underwent maxillary sinus augmentation with porous hydroxyapatite and platelet-rich plasma. Seven patients had their implants immediately loaded. A total of 160 dental implants were placed in the 47 geriatric patients. One hundred fifty-nine integrated successfully. In the case of the failed implant, the site was grafted and another implant was placed 5 months subsequent to the initial failure. This replacement implant integrated and has been in function for 6 months. The survival rate for dental implants placed in the maxilla was 99% and in the mandible was 100% in our geriatric population. Treatment with dental implants can be predictable and safe for the rapidly growing geriatric population. Geriatric patients who are medically stable are suitable candidates for osseointegrated implant surgery, which facilitates oral function, comfort, and quality of life. A review of the 47 geriatric patients treated supports the conclusion that dental implants can be successfully placed and restored with fixed implant-supported or removable implant-supported prostheses.

The purpose of this study was to compare patient satisfaction and oral health-related quality of life (OHRQoL) among fully edentulous patients treated with either fixed implant-supported prostheses (FP), removable implant-supported prostheses (RP), or complete dentures (CD). Eighty-six patients - 29 FP, 27 RP, and 30 CD patients - participated in this study. The survey was conducted using face-to-face interviews with a questionnaire that included a patient satisfaction scale and Oral Health Impact Profile (OHIP-14). We measured patient satisfaction after prosthetic treatments and OHRQoL before and after the treatments. After prosthetic treatments, OHRQoL increased in all three groups (P<0.05). The FP and RP groups showed no significant difference in patient satisfaction and OHRQoL, and both groups showed greater improvement compared with the CD group. Specifically, the OHRQoL dimensions of functional limitation, physical pain, psychological discomfort, and psychological disability in the FP group, and functional limitation in the RP group, improved greatly in comparison with the CD group (P<0.05). Although further research is still needed, prosthetic treatments may provide superior OHRQoL for fully edentulous patients. In particular, both the FP and RP treatments provided significantly greater improvement of OHRQoL and patient satisfaction than the CD treatment. Reliable information of OHRQoL and patient satisfaction helps experts and patients choose the best prosthetic treatment option.

Several attachment systems for implant-supported removable dental prostheses (ISRDPs) are currently available. The bar attachment option includes cast or milled alloyed male and female parts. Replaceable slide attachments made from elastic materials can be inserted into the female part of the bar to counter loss of friction that develops due to wear. Another approach involves milling the female part from organic thermoplastic polymers. In the present case history report, an edentulous maxilla was restored with a digitally fabricated ISRDP with the female part of the bar milled from polyether ether ketone (PEEK) polymerized into a zirconia framework.

Design The research was a retrospective cohort study evaluating a study which performed routine control sessions to assess bone loss around the dental implant over five years and 12 and 24 months, after their prosthetic restorations.Aim The study aimed to evaluate patients' dental implant marginal bone loss after oral rehabilitation with bar and locator retainers and their possible complications.Methods A study of 114 patients who had received 283 dental implants from 2013-2018 was conducted. Two follow-up recall sessions were conducted, one at 12 months and one at 24 months, after dentures were placed. Intraoral and extraoral examinations were also conducted in addition to clinical assessments. The patients' prostheses were assessed for occlusion, tissue health and soft-tissue continuity, complaints, implant success rates and marginal bone loss, in addition to prosthetic complications, at follow-up sessions.Results In this study, 94 patients were fitted with implant-supported removable prostheses on locator attachments on both arches and 20 were fitted with removable prostheses using bar attachments. After evaluating the location of the implant, the number of days after implantation and the type of retainer in all patients, both groups showed a significant amount of marginal bone loss in the 12th and 24th months. The presence of complications was significantly associated with both prosthesis types at month 24 (p >0.05). When the relation between the position of the denture and the presence of complications at month 12 was evaluated, 36% of the complications were observed in the maxilla and 21.3% in the mandible. There was no significant difference associated between denture location and complication presence at month 24 (p >0.05).Conclusions Even though complications do not affect marginal bone loss, a patient's failure to maintain adequate oral hygiene results in marginal bone loss. Therefore, it appears that regular post-treatment prosthesis inspections are essential. If the requirements resulting from these inspections are satisfied, future complications may be prevented.

ABSTRACTAim:This study aimed to evaluate the relationship between oral health and quality of life in removable prosthesis users.Materials and Methods:An investigative cross-sectional study was designed, and 200 participants were considered based on calculations from the studies in the past. The Oral Health Impact Profile (OHIP)-14 survey comprises two parts in the study. Questions related to sociodemographic factors that documented age, gender, and type of removable prosthesis were included in the initial part of survey. Questions related to impact of oral health on quality of life make up the latter part of the survey. The answers ranged from “Definitely no” to “Definitely yes” for every item on a scale having 5 points. The likely range of scores is from 14 to 70. Data were analyzed by using the Statistical Package for the Social Sciences (SPSS) software program, version 20.0 for Windows. A value of P < 0.05 was considered statistically significant.Results:A survey evaluating the relationship between oral health and quality of life was adequately completed by 200 participants. Of these, 18 (22%) were women and 154 (78%) were men. The parameters such as gender, age, and the relationship between oral health and quality of life did not show significant difference either within groups or between the groups. The enrolled participants were wearing different dental prostheses such as complete dentures (CDs) in both upper (U) jaw and lower (L) jaw (19%), U jaw (3%), L jaw (4%) and removable prostheses in both jaws (30%), U jaw (24%) and L jaw (20%). No statistically significant differences were seen between them. The scores for oral health-related quality of life (OHRQoL) were associated positively with removable prosthesis score (r = 0.122) and were statistically significant.Conclusion:This study concluded that the use of removable prosthesis may positively impact OHRQoL. The period of usage of removable dentures was the highly significant parameter affecting patient gratification, whereas the practice of using removable prostheses was the highly significant parameter affecting the relationship between oral health and quality of life.

The aim of this study was to evaluate structural changes in peri-implant trabecular bone in patients with fixed and removable implant-supported prostheses over an average five-year period using panoramic radiography. Two consecutive panoramic images, one taken before implant placement and the other an average of five years after prosthodontic loading, of a total of 60 mandibular implants with either fixed or removable prostheses were included in the study. Measurements included fractal dimension, bone area fraction, and mean gray value of three peri-implant regions (mesial, distal, apical) and three control regions (inferior to the mental foramen, angle, and condyle). The paired samples t-test was used for statistical analysis (p<0.05). In patients with fixed prostheses, significant reductions in bone area fraction and mean gray value were observed after loading. Conversely, patients using removable implant-supported prosthesis exhibited increased fractal dimension values. Control regions in both groups exhibited age-related declines in bone area fraction and mean gray value over the five-year period. Our results demonstrated that fractal dimension is a useful method for monitoring structural bone alterations around implants with removable prostheses during post-loading follow-up periods. In addition to functional forces, long-term peri-implant bone remodeling may also be influenced by aging.

Influence of a removable prosthesis on oral health-related quality of life and mastication in elders with Parkinson disease

Patient-reported outcome measures and clinical performance of implant-retained mandibular overdentures with stud and ball attachments: A systematic review and meta-analysis