Abstract
Serious consequences of long-term complete denture wearing may be extreme residual ridge atrophy and a reduced area of keratinized oral mucosa of a denture-bearing area. This paper presents five clinical cases of extreme mandibular ridge atrophy, rehabilitated by means of mandibular overdentures retained by short mini dental implants. The patients had a reduced mandibular bone volume in the interforaminal region, bone height less than 10 mm, and buccolingual bone width less than 4 mm. In order to avoid bone augmentation, patients received four short mini dental implants (MDIs) (6 or 8 mm long; 2.0 or 2.5 mm wide) for the support of mandibular overdentures, which is a new rehabilitation option. After insertion, the MDIs were early loaded with new mandibular overdentures reinforced with the CoCr framework. The patients have been wearing their overdentures for 2 years. One MDI broke during insertion and a new one was added. One patient lost one MDI but successfully continued to wear the overdenture retained by the remaining three MDIs. Mean marginal bone loss (MBL) was 0.20 ± 0.19 mm. Patients significantly improved their OHRQoL and chewing function by reducing the summary scores of the OHIP-14 and the chewing function questionnaires. The improvements remained unchanged throughout the observation period.
Highlights
Complete edentulism can be described as an irreversible condition that decreases oral health-related quality of life with consequences on chewing efficiency, nutrition, and general health
During insertion one mini dental implant fractured due to an insertion torque > 45 N/cm and was left as a sleeping implant in the bone, while an additional mini dental implants (MDIs) was inserted for proper denture retention (Figure 4(a))
Grades her mandibular overdenture retained by the three remaining short MDIs (Figure 6(b))
Summary
Complete edentulism can be described as an irreversible condition that decreases oral health-related quality of life with consequences on chewing efficiency, nutrition, and general health. Mandibular ridge atrophy can sometimes be so advanced that the mandibular height in the interforaminal region may be less than 10 mm (class D or E according to Lekholm and Zarb [9]), accompanied with a reduced buccolingual width and exposed inferior alveolar nerve under oral mucosa In such cases, it is almost impossible to make a stable and wellfunctioning mandibular CD. It is almost impossible to make a stable and wellfunctioning mandibular CD Such a condition of extreme bone atrophy leads to chewing difficulties, pain, and sore spots within the denture-bearing area, resulting in poor oral health-related quality of life (OHRQoL). One recent study revealed that flapless placement of MDIs caused significantly less pain than the insertion of SSIs [15] In this clinical study, we treated patients who had reduced buccolingual width and reduced mandibular height (
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