Implant-retained Overdentures Research Articles

Can Different Impression Techniques Affect the Chewing Efficiency of Mandibular Implant-Retained Overdentures?

Several impression techniques and theories have been developed for implant-retained overdentures, each with its own set of advantages and limitations. This study aimed to assess the chewing efficiency of mandibular implant-retained overdentures fabricated using three distinct impression techniques (mucofunctional, selective, and minimal pressure impression techniques). Twenty-six patients with complete edentulism free from any oral or systemic disease were selected to participate in the study. Three complete mandibular implant-retained overdentures were constructed for each patient, and grouped into three groups according to the impression technique employed in overdenture construction; Group A: Patients were treated by mandibular implant-retained overdenture fabricated using mucofunctional impression technique; Group B: Patients were treated by mandibular implant-retained overdenture fabricated using selective pressure impression technique; Group C: Patients were treated by mandibular implant-retained overdenture fabricated using minimal pressure impression technique. Chewing efficiency was evaluated for each patient with the implant-retained mandibular overdenture after three months of prosthesis insertion as an adaptation period. The data were collected, tabulated, and statistically analyzed. Results indicated that mandibular implant-retained overdentures made using the mucofunctional impression technique showed higher mean values of chewing efficiency parameters than mandibular overdentures made using selective and minimal pressure impression techniques. Within the limitations of this study, it can be concluded that the mucofunctional impression technique may be effective in improving the chewing efficiency of mandibular implant-retained overdentures more than minimal or selective pressure impression techniques.

Clinical and Radiographic Comparison Between Mandibular Implant Surveyed Crowns Retained Removable Partial Denture Versus Mandibular Implant Retained Overdenture

Clinical and Radiographic Comparison Between Mandibular Implant Surveyed Crowns Retained Removable Partial Denture Versus Mandibular Implant Retained Overdenture

Quantitative and qualitative assessment of the wear pattern of two attachment systems of dissimilar materials for mandibular implant-retained overdentures: an in-vitro study

BackgroundAttachment material is one of the contributing factors to the degree of wear of the attachment components in mandibular implant-retained overdentures. The purpose of this in vitro study was to compare the wear behavior of 2 different attachment systems of dissimilar materials in mandibular implant-retained overdentures by qualitative and quantitative methods.MethodsTwo attachment systems of different materials were utilized (n = 16); Titach (Dental Evolutions Inc, Beverly Hills, CA, USA) with a titanium-to-titanium interface and Locator R-Tx (Zest Anchors Inc, Escondido, CA, USA) with a titanium-to-nylon interface. One thousand cycles of overdenture insertion and removal simulating 1-year clinical use were performed. All matrices were removed from the overdentures and all patrices were unscrewed from the implants for wear assessment quantitively using a stereomicroscope and qualitatively using a scanning electron microscope. Data were analyzed by using an independent sample t test.ResultsAfter cyclic loading, stereomicroscopic findings showed that the Titach group had statistically significant higher wear value than the Locator R-Tx group (p < 0.001). Moreover, scanning electron microscopy images showed noticeable abrasion in Titach patrix at the area of highest convexity. However, the Locator R-Tx matrix displayed an apparent tear of rubber inserts.ConclusionsTitach attachment with the titanium-to-titanium interface revealed more wear than Locator R-Tx attachment with the titanium-to-nylon interface. Thus, the type of attachment material influences the degree of wear of the attachment components.

An overview of implant overdenture attachment systems

Implant-retained overdentures have revolutionized dental prosthetics, addressing the limitations of traditional removable dentures. These overdentures rely on attachment systems to anchor them to dental implants or abutments, improving stability, retention, and functionality. Common attachment systems include locator attachments, bar attachments, magnets, Hader clips, ERA attachments, telescopic crowns, and OT equator attachments. Each offers unique benefits and retention levels. Implant survival rates are influenced by various factors, including attachment type, but overall, attachment choice may not be the primary determinant of implant success. Attachment systems that evenly distribute forces, like bar attachments, contribute to implant stability. Marginal bone loss can affect implant stability and is influenced by attachment systems. Precision attachments, such as telescopic crowns, have shown reduced marginal bone loss in practice. Soft tissue complications, including inflammation and mucositis, vary by attachment but can be managed with proper oral hygiene. Retention, crucial for function, varies with attachment type and implant number. More implants generally improve retention, although it may decrease over time. Bar attachments typically provide superior retention. Maintenance is essential, with some debate over whether bar or stud designs entail more upkeep. Patient satisfaction is high with both bar and ball attachments, while magnets may pose retention issues. The choice of attachment depends on patient needs and clinical factors, with regular follow-up and maintenance essential for long-term success.

Evaluation of Retention and Wear of Ball and Socket and Locator Attachment for Implant Retained Overdenture (an in-vitro Study)

Evaluation of Retention and Wear of Ball and Socket and Locator Attachment for Implant Retained Overdenture (an in-vitro Study)

Influence of aging of PEEK attachment inserts on the pull-off force of implant-retained overdentures - A laboratory study.

The aim of the current study is to investigate the influence of mechanical stress as well as cleaning agents on the performance of various polyether ether ketone (PEEK) inserts for implant-retained overdentures (IOD). Three different standard PEEK inserts were subjected to rapid artificial aging through storage in chemical denture cleaning agents (acetic acid, sodium hypochlorite, or sparkling denture cleaner) as well as demineralized water. The pre-aged PEEK inserts were then placed in unilateral IOD and subjected to 200,000 chewing loads (5 kg ~ 50 N), with 5000 thermal cycles (5/55°C), and 1100 removal/insertion cycles (vertical movement 2 mm). For all the PEEK inserts, the retention forces decreased significantly with an increasing number of mechanical load cycles and after exposure to all the cleaning agents. PEEK inserts aged by exposure to chemical cleaning agents showed a significantly higher decline in retention force than the inserts stored in water. Confocal laser scanning microscopy indicated that the decline in retention force might be caused by wear on the internal insert surface in contact with the patrix. Within the limitations of this study, it can be concluded that the application of chemical cleaning agents accelerates the decline in the retention forces of PEEK retentive inserts in IODs.

Comparative Evaluation of Survival Rates and Marginal Bone Levels of Nonsplinted Immediately Loaded Interforaminal Mandibular Implant-Retained Overdentures: A Randomized Controlled Clinical Trial with 5-Year Results.

Τo evaluate and compare the marginal bone loss (MBL), survival rates, and periodontal parameters of immediately loaded implants with either Dolder bar or Locator attachments placed in the interforaminal region of edentulous mandibles. A total of included 19 patients with edentulous mandibles each received two implants in the interforaminal area of the symphysis. Randomly allocated Dolder bar or Locator attachments were then attached immediately, and both clips and a framework were fastened to the denture by the dental laboratory within 24 hours. A total of 28 subjects with 56 implants were treated in accordance with the immediate-loading study protocol. Of these, 9 patients were lost to follow-up; 1 patient reported a serious illness and 8 patients moved and couldn't be reached. The 19 subjects not lost to follow-up (11 women and 8 men; average age: 68 years) were included. Every patient received either two Locator abutments and were assigned to group A (7 patients; 36.8%) or two multiunit abutments and were assigned to group B (12 patients; 63.2%). No implant failure was detected for either group, and therefore the survival rate for both groups was 100% after 5 years. After 5 years without any symptoms, 2 implants from group A and 7 implants from group B showed > 2 mm of MBL, which makes the group A success rate 85.7% and the group B success rate 70.8%. Modified sulcular bleeding index (mSBI) did not differ significantly at any of the measurement intervals. However, the modified plaque index (mPI) of group B was significantly higher than group A at the 60-month follow-up. It can be concluded that either splinting or not splinting the immediately loaded interforaminal implants to retain mandibular overdentures (OVDs) does not affect marginal bone levels after 5 years and immediate loading of nonsplinted implants with Locator attachments can be safely preferred to retain mandibular OVDs.

Immediate versus conventional loading of mandibular implant-retained overdentures: a 3-year follow-up of a randomized controlled trial.

There is a scarcity of randomized clinical trials (RCT) that report medium- and long-term results and a lack of consensus in the literature on the predictability of immediately loaded unsplinted narrow diameter implants supporting mandibular overdentures. This RCT compared the performance of conventional (CL) and immediate loading (IL) of mandibular overdentures retained by two narrow-diameter implants for 3years. Patients from an RCT treated with CL or IL were invited to attend to 2- and 3-year follow-ups. Clinical, radiographic, functional, and oral health-related quality of life parameters were evaluated. Prosthetic maintenance events, biological complications, and success and survival rates were also recorded. The data were tested by multilevel mixed-effects linear regression analysis and chi-squared tests. The 1-year survival rates of 90% in the CL group and 85% in the IL group were maintained as no implants were lost between 1 and 3years. The marginal bone loss (MBL) in the IL group was significantly lower after year 3 (-0.04; p < 0.01). Significant changes were found only for the intra-group comparisons in the third year of function: (i) CL and IL presented similar progression of implant stability, MBL, and posterior bone area resorption; (ii) while CL started deteriorating of masticatory function, IL still exhibited functional evolution and (iii) oral comfort domain in the CL and pain domain in the IL were improved. Although IL experienced the lowest MBL after 3years, the outcomes showed that both loading protocols result in predictable medium-term rehabilitation when monitored annually. It can be expected that in the third year of function, patients with immediate loading may present more complaints related to general performance even with acceptable masticatory function and self-reported improvements in oral comfort.

Removable complete denture with a metal base: Integration of digital design and conventional fabrication techniques.

Digitally-designed removable complete dentures are typically composed of a resin denture base without a metal framework. However, metal denture bases are preferable as resin bases are more susceptible to fracture. Therefore, this article introduces a unique technique that integrates computer-aided design (CAD) and conventional resin processing for the fabrication of removable complete dentures with a metal framework. A maxillary complete denture with a metal base and a mandibular implant-retained overdenture reinforced with a metal framework were fabricated. The dentures were designed using CAD software and a tooth library. The denture bases were milled from wax disks, and artificial teeth were placed to complete the wax dentures. The metal frameworks were also designed using CAD software and produced via casting of printed resin patterns. Finally, conventional denture processing techniques were applied to obtain dentures with metal frameworks. A digitally designed, removable complete denture with a metal base can be successfully fabricated using the described technique, which merges digital design and conventional methods. This article demonstrates the feasibility and potential advantages of this innovative approach in denture fabrication. The presented technique provides the following advantages: digital design features, precise space above implant overdenture attachments for a metal framework, convenience of esthetic evaluation with printed trial dentures, long-term data storage and duplication, reliable bond between the artificial teeth and denture base, and enhanced strength of the removable complete denture due to the metal reinforcement.

Survival Rate of Sandblasted, Large Grit, Acid-Etched (SLA) versus Laser-Treated Implants in Completely Edentulous Patients Rehabilitated with Mandibular Implant-Retained Overdentures: A Split-Mouth Study

Survival Rate of Sandblasted, Large Grit, Acid-Etched (SLA) versus Laser-Treated Implants in Completely Edentulous Patients Rehabilitated with Mandibular Implant-Retained Overdentures: A Split-Mouth Study

Comparison of the Quality of Life Among the Immediate Loading Implant Overdentures Using the Single and the Double Implants: An Original Study.

In edentulous individuals, single implant-retained mandibular overdentures are an effective substitute for double implant-retained overdentures. In this current research, the oral health-related quality of life (OHRQoL) was assessed for the immediate loading overdenture using the implants. The comparisons are drawn between the single and double implants. Forty subjects received single and double implants for the placement of the mandibular overdentures. Within a week days of implant insertion, they were loaded with overdentures. Using the Oral Health Impact Profile-14 (OHIP-14) questionnaire, the OHRQoL was measured before treatment, one month following treatment, and 12 months thereafter. In both the single implant and double implant groups, participants' mean OHIP-14 scores decreased statistically significantly for the different timelines. For the single implant group, the baseline total mean OHIP-14 score was 14.33, and for double implants, it was 19.15. Following therapy, it decreased to 8.55 in the single implant group and 9.48 for the double implant group at one month, and at 12 months, it further decreased to 3.25 in the single implant group while it was 5.15 in the double implant group. Single and double implants increase the QoL for older subjects who are edentulous at the 1-month and 1-year recall points. When two implants are used by older individuals, the single implant might offer an equivalent quality of life.

Revitalizing Worn-Out Overdenture Attachments in One-Piece Implant Cases using Silicone Matrix System: A Case Report

The case report discusses the use of a silicone matrix system for salvaging worn-out overdenture attachments in one-piece implant cases. It highlights the effectiveness of this technique and presents a detailed case study. One-piece or single-piece implant systems, where the intraosseous and abutment portions with the stud attachments consist of one unit, do not allow changing the worn-out abutment individually if required, thus ruling out any further use of implant and abutment once the attachment component faces extensive irreversible wearing. The ‘Retention. Sil’ – an additional curing elastomeric material in salvaging worn-out attachments of one-piece implants, emphasizes the revitalization process and effective use as an attachment for implant-retained overdenture, thereby extending the clinical use of one-piece implants and avoiding extensive invasive procedures in geriatric patients.

Stress Generated in Bone with Different Configurations of Implants and Attachments in a Mandibular Implant-retained Overdenture: A Finite Element Analysis

Stress Generated in Bone with Different Configurations of Implants and Attachments in a Mandibular Implant-retained Overdenture: A Finite Element Analysis

Effect of Occlusal Scheme in All on 4 Implant Retained Overdenture on Occlusal Fore Analysis Using T-Scan

Effect of Occlusal Scheme in All on 4 Implant Retained Overdenture on Occlusal Fore Analysis Using T-Scan

Efficacy of adjunct photodynamic therapy on Candida growth and oral health quality of life in denture stomatitis patients with type 2 diabetes mellitus wearing implant-retained overdentures: A randomized clinical study

AimThe aim of the present clinical trial was to study the efficacy of combined miconazole and PDT in the improvement of quality of life and levels of Candida species in chronic hyperglycemic patients with denture stomatitis (DS). MethodsOne hundred patients were randomly divided into five groups; 20 each in the miconazole, PDT, miconazole+ PDT, CHX and distilled water groups. Methylene blue mediated irradiation was conducted using 600 nm diode laser with power, energy density and radiance as 100 mW, 3527 mW/cm2 and 9 J, respectively. Patients were advised to apply 2.5 ml of 2% topical miconazole four times a day. The existence of Candida spp. was detected by means of microbiological culture technique. Candida colony counts from the palates and dentures surfaces, quantified as colony forming unit (CFU)/mL were evaluated at baseline, end of 14 days, 28 days and 60 days. Oral health related quality of life was assessed with the help of a questionnaire. ResultsThe quality of life showed significant improvement in the group where combination treatment was executed. The overall CFU/mL values were greater in the dentures in comparison to those from the palates of the patients of all the five groups. During all time periods of the study, the CFU/mL values obtained from combination treatment group showed significant differences. Candida albicans was the most predominant yeast. ConclusionThis study showed the effectiveness of methylene blue- PDT in combination with miconazole in improving oral health related quality of life and significantly reducing Candida CFU counts to resolve palatal inflammation in diabetic individuals with implant-supported complete dentures.

Fatigue Resistance of Two Different Materials Used as Retentive Attachments in Implant Supported Overdenture after Immersion in Denture Cleansing Solution: An In Vitro Comparative Study

Aim: This in vitro study compared the fatigue resistance of two polymeric materials (Nylon and Polytetrafluoroethylene (PTFE)) used as retentive attachments in implant-retained overdentures after immersion in denture cleansing solution. Materials and Methods: A total of 24 samples (N=24), of which 12 capsule-shaped samples of commercially available nylon material from ADIN dental implants, India, and similar sized and shaped 12 PTFE (medical grade) capsules custom fabricated from AAA Industries, Mumbai was obtained. Six samples of each material were immersed in distilled water and six samples in Clinsodent denture cleanser, simulating an 8–h daily immersion of the denture for a period of 2 years. After completion of the immersion protocol, samples were subjected to 2900 fatigue cycles using the Universal Testing Machine (UTM), simulating 4 cycles per day of removal and insertion of the overdenture for a duration of 2 years. Before and after immersion, the wear of the samples was assessed for internal and external diameter changes using the Sipcon Inspection System. The statistical analysis of the obtained results was tested by applying the paired-t test, Fisher analysis of variance, and Tukey’s honest significant difference test, with a probability value less than 0.05 used as statistically significant. Results: Statistically significant differences were observed after immersion in denture cleanser for nylon and PTFE. The greatest fatigue for ID, IHL, and IVL was demonstrated in nylon immersed in Clinsodent at p = .000. ED and EHL of PTFE in distilled water showed greater deformation than others ( p = .000). Conclusion: PTFE attachments have shown better fatigue resistance after immersion in Clinsodent denture cleanser. Nylon material immersed in distilled water as well as in Clinsodent cleanser showed greater deformation after fatigue cycles.

Lithium disilicate occlusal surfaces on acrylic resin denture teeth in a mandibular implant-retained overdenture opposed by a maxillary removable complete denture: A clinical report

Decreased masticatory efficiency, loss of vertical dimension of occlusion, and loss of maxillomandibular relationships are common in relation to the wear experienced by the artificial teeth in removable complete dentures and implant-retained overdentures. To prevent early surface loss, the occlusal surfaces of acrylic resin denture teeth were replaced with adhesively luted lithium disilicate onlays in this patient’s prostheses.

Influence of Denture Cleansers on the Retention Loss of Attachment Systems Retained Implant Overdenture.

This study aimed to evaluate the effects of different denture cleansing solutions (DCSs) on the retention of Locator and Locator R-Tx attachment systems of implant retained overdentures (IRO). Two part acrylic resin blocks were fabricated, upper part contained metal housing and plastic inserts and lower part contained implant analogs and abutments. Eighty pink plastic inserts (40/attachment, 10/solution) were immersed in Corega, Fittydent, sodium hypochlorite, and water for a time simulating upto 1-year of clinical usage. Acrylic blocks were held on a universal testing machine for a pull-out test to record the dislodgement force. Measurements were conducted after 6 months (T1) and 12 months (T2). One-way ANOVA followed by Tukey's HSD test was used to analyze the results (α = 0.05). For both attachments, retention significantly decreased after immersion in different solutions at T2 (P < 0.001). Locator R-Tx attachment in NaOCl showed a significant decrease in retention compared with other solutions at T1. At T2, there was a significant decrease in retention for all DCS compared with water (P < 0.001). Locator R-TX showed higher retention values per solution compared to Locator attachment (P < 0.001). In terms of retention loss %, NaOCl recorded the highest (61.87%) loss, followed by Corega (55.54%) and Fittydent (43.13%), whereas water demonstrated the best retention (16.13%) in both groups. Locator R-TX has better retention with different DCS immersion. The loss of retention varied with different types of DCS and NaOCl recorded the highest retention loss. Therefore, denture cleanser selection must be guided by the type of IRO attachment.

Evaluation of Different Fabrication Techniques for Reinforcement of Mandibular Implant-Retained Overdentures

Purpose: This study was performed to evaluate the effect of PEEK reinforced mandibular implant overdenture, in comparison with metal reinforced mandibular implant overdenture on bone height. Subjects and methods: Fourteen completely edentulous patients were selected with ages ranging from 50-70 years. All the patients received two implants in the inter-foraminal area of the mandible and maxillary complete dentures, then they were divided into two groups: group (I) seven patients received PEEK reinforced mandibular implant overdentures, group (II) seven patients received metal reinforced mandibular implant overdentures. The overdentures were functionally loaded after three months of implant insertion and retained with the implants using ball and socket attachments. Evaluation of crestal bone height changes around the implants and in the distal aspect of the ridge was done by CBCT at the time of denture insertion, 6 and 12 months. Results: The results revealed that there was a statistically significant decrease in amount of crestal bone loss in PEEK group than in metal group after 6 and 12 months. The results also showed that, there was non significant difference when comparing the changes in the distal bone height after 6 months then, there was a statistically significant decrease in amount of distal bone loss in PEEK group than in metal group after 12 months. Conclusion: PEEK reinforced implant overdentures have better results than those reinforced with metal, as they recorded favorable radiographic outcomes after one year of overdenture insertion regarding crestal and distal bone height changes.

Evaluation of Different Fabrication Techniques for Reinforcement of Mandibular Implant-Retained Overdentures

Purpose: This study was performed to evaluate the effect of PEEK reinforced mandibular implant overdenture, in comparison with metal reinforced mandibular implant overdenture on bone height. Subjects and methods: Fourteen completely edentulous patients were selected with ages ranging from 50-70 years. All the patients received two implants in the inter-foraminal area of the mandible and maxillary complete dentures, then they were divided into two groups: group (I) seven patients received PEEK reinforced mandibular implant overdentures, group (II) seven patients received metal reinforced mandibular implant overdentures. The overdentures were functionally loaded after three months of implant insertion and retained with the implants using ball and socket attachments. Evaluation of crestal bone height changes around the implants and in the distal aspect of the ridge was done by CBCT at the time of denture insertion, 6 and 12 months. Results: The results revealed that there was a statistically significant decrease in amount of crestal bone loss in PEEK group than in metal group after 6 and 12 months. The results also showed that, there was non significant difference when comparing the changes in the distal bone height after 6 months then, there was a statistically significant decrease in amount of distal bone loss in PEEK group than in metal group after 12 months. Conclusion: PEEK reinforced implant overdentures have better results than those reinforced with metal, as they recorded favorable radiographic outcomes after one year of overdenture insertion regarding crestal and distal bone height changes.