Abstract
Objectives/Aims:The primary aim of this retrospective pilot study was to evaluate the clinical outcome of overdentures on four non-splinted maxillary implants compared to the mandible using locator attachments and secondly to assess patient's opinion of the treatment.Materials and Methods:The treatment protocol used here is summarised as a single-stage surgical approach followed by immediate loading (same day in 12 of 17 patients) of a removable prosthesis in the maxilla and mandible. Most of the implants were installed into fresh extraction sockets. Clinical outcomes were evaluated in 68 southern implants, straight (non co-axis) or angulated (co-axis) in 17 patients. Patients were examined by independent examiners at an average follow-up of 14.5 months after implant placement.Results:Outcomes measured were implant survival, bone loss, bleeding on probing, probing pocket depths and plaque score in addition to quality of life measured with OHIP-14 questionnaires. An overall implant survival of 100% was achieved. The mean marginal bone level (mm) over the entire cohort of 66 measured implants was (1.4 mm; range, 0–5.5). A significant difference (P=0.01) was found between bone level, from implant head to bone contact in the maxilla (M, 0.9 mm; s.d., 1.1; range, 0–4) and the mandible (M, 1.7; s.d., 1.0; range, 0–5.5). The marginal bone-to-implant head distance with the angulated co-axis implants was 1.9 mm (s.d., 1.5; range, 0–5.5) compared to non co-axis, mean 1.2 mm (s.d., 1.1; range, 0–4) (P=0.01). The OHIP-14 overall mean was 3.3 (out of a maximum of 56).Conclusion:The implant survival was 100% and the patients benefited from the overdenture treatment on four non-connected implants. The extremely low OHIP-14 indicated a very high level of patient satisfaction following treatment. The results of this study merit further long-term investigation to fully investigate the success of immediately loading implants in the maxilla as well as cost-benefit.
Highlights
Dental implants yield an above 95% survival in long-term studies under most treatment indications
The clinical outcome of implant-supported overdentures is very successful in the mandible under delayed and immediate loading conditions and two implants are considered the standard of care.[1]
Sadowsky and Zitzmann[2] recently carried out a systematic review of 23 publications relating to 20 cohort studies looking at maxillary implant overdentures
Summary
Dental implants yield an above 95% survival in long-term studies under most treatment indications. A recent systematic review indicated that the number of studies providing information on overdentures in the maxilla is rather limited.[2] Machined surface implants yield high failure rates and often four–six implants are suggested to support a splinted reconstruction. Sadowsky and Zitzmann[2] recently carried out a systematic review of 23 publications relating to 20 cohort studies looking at maxillary implant overdentures. They concluded that four–six implants are widely applied in successful cohort studies and found no distinct evidence that implant splinting with a bar is superior to single attachments in terms of implant survival, in general splinted and solitary anchorage systems are both advocated. The success of non-axially loaded implants as a technique to overcome the problem of bone resorption in the posterior maxilla has been described in some detail.[3]
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