Implant-supported Overdentures Research Articles

All-On-4 Implant with Hybrid Prosthesis Opposing Implant Supported Overdenture- A Case Report

Implant-supported prosthetic solutions have revolutionized the field of dental rehabilitation, particularly for patients with extensive edentulism or failing dentition. Among these, the All-on-4 implant technique has gained popularity due to its ability to provide and aesthetic restoration with fewer implants and reduced surgical complexity. However, challenges such as insufficient bone volume or poor bone quality in the edentulous maxilla or mandible may necessitate alternative approaches to ensure long-term success and patient satisfaction. One such approach involves the integration of a hybrid prosthesis with All-on-4 implant concept opposing an implant-supported overdenture. This hybrid solution combines the stability and support of dental implants with the comfort and versatility of removable prostheses, offering a balance between fixed and removable options. Key aspects covered include the selection of appropriate candidates for this treatment modality, diagnostic imaging techniques for precise implant placement, surgical protocols for achieving optimal osseointegration and soft tissue management, prosthetic fabrication processes including material selection and occlusal considerations, postoperative care and maintenance strategies to ensure long-term success. Through a comprehensive examination of current literature, clinical case studies, and expert opinions, this case report aims to provide clinicians with valuable insights into the rationale, planning, execution, and outcomes of utilizing a hybrid prosthesis with All-on-4 implant concept opposing an implant-supported overdenture. By understanding the indications, advantages, limitations, and clinical nuances of this treatment approach, dental professionals can effectively address the diverse needs and preferences of edentulous or near-edentulous patients, ultimately improving their quality of life and oral health outcomes. Keywords: All-on-4 implants, hybrid prosthesis, implant-supported overdenture, prosthetic rehabilitation, bone quality, patient satisfaction.

Risk factors for implant-supported overdenture failures: A systematic review

Aim: Implant-supported overdenture presents failures. To minimize and avoid the occurrence of implant and prosthetic complications, a number of considerations must be taken into account. This systematic review aimed to point out variables associated with failure rates of implant-supported overdenture. Settings and Design: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were implemented during carrying out this systematic review. Materials and Method: An automatic electronic literature search of peer-review articles was conducted on the MEDLINE database by querying its PubMed portal, the Cochrane Library and LILACS in addition to a complementary manual search. Clinical trial (CT), Randomized controlled trial (RCT) and Observational study (OS) from 2018 to 2023 were included. Two examiners, independently, selected studies based on the inclusion criteria and recorded the extracted data. The risk of bias of the included studies was evaluated via the Cochrane Collaboration's tool. Results: After the screening and eligibility assessment stages, the inclusion criteria allowed to retain 20 articles: 13 RCT, one prospective CT, three prospective studies, two retrospective studies and one cross-sectional OS. The synthesis of the articles allowed to deduct that the failures of the implant-supported overdenture are variable and related to several factors such as the general condition of the patient, the edentulous arch, the number of implants and the loading protocol, which can be considered to minimize them. Conclusion: Aptitude of the dentist and regular follow-up as well as intense patient care can minimize implant-retained overdenture failure rate. In spite of this, this denture remains the best solution suitable for most patients and providing them with comfort, satisfaction and improved quality of life.

Case Series on Implant Supported Overdenture Prosthesis

The biggest problem of patients with total edentulism is the lack of retention and stabilization of their dentures and the insufficient chewing function. In these patients, implant-supported prosthetic treatment approaches provide function, phonation and aesthetic expectations. . In this case series, the rehabilitation of two patients with 4 implants in the maxilla and 2 implants in the mandible with different implant-supported overdenture prosthesis planning is described.

Immediate versus Non-immediate Loading Protocols for Reduced-diameter Implants Supporting Overdentures: A Systematic Review and Meta-analysis.

This systematic review aimed to compare the influence of immediate and non-immediate loading protocols on overdentures retained by reduced-diameter implants(≦3.5mm). Electronic databases, including MEDLINE (via PubMed), Embase and the Cochrane Central Register of Controlled Trials were searched for randomized controlled trials (RCTs) comparing clinical outcomes of immediately and nonimmediately loaded reduced-diameter implants supported overdentures. The risk of bias within and across the studies and the certainty of evidence were assessed by RoB 2.0 and GRADE, respectively. Sensitivity analysis was performed by eliminating studies at high risk of bias, and repeating the data synthesis employing the randomeffect model. Subgroup analyses were conducted based on the implant diameter and the length of follow-up. Six RCTs with 255 patients were included in this systematic review. The meta-analyses found similar implant survival rates between immediate and nonimmediate loaded implants in mini implant (RR=0.98; 95% CI=0.95, 1.01; p=0.12) and narrow implant subgroups (RR=0.99, 95% CI=0.94, 1.03, p =0.56), as well as in short-term (RR=0.98, 95% CI=0.97, 1.00, p =0.11) and long-term (RR=0.97, 95% CI=0.93, 1.01, p =0.09) follow-up subgroups. Additionally, marginal bone loss (MBL) showed no statistically significant difference between the loading protocols in the subgroup of long-term follow-up (MD=0.03; 95%CI=-0.16, 0.23; p=0.74). Three RCTs investigating peri-implant parameters found relatively higher modified plaque index and probing depth in reduced-diameter implant under immediate loading. Compared with non-immediate loading, the immediately loading protocol can achieve comparable survival rates and MBL in reduced-diameter implant retained overdentures.

Masticatory function in edentulous patients wearing implant overdentures after graftless maxillary sinus membrane elevation.

Graftless sinus floor augmentation shows good results in bone gain, radiology and implant survival. Clinically, this technique can be recommended as an alternative to conventional procedures using augmentation materials. This study aims to assess masticatory performance, masticatory ability and patient satisfaction after graftless sinus floor augmentation. The study group consisted of patients who had received a graftless sinus lift procedure in a split-mouth design and was compared to patients with maxillary implant-supported overdentures without augmentation and a natural dentition group. To assess objective masticatory performance, the mixing ability test was performed. Three questionnaires were used to assess patient reported outcomes related to mastication and patient satisfaction. Each group included ten patients. Both the graftless sinus lift group and the edentulous control group had a worse masticatory performance compared to the natural dentition group. Masticatory ability, measured by patient reported outcomes, was not different between the graftless sinus floor augmentation group and implant-retained overdentures group without augmentation, but the natural dentition group showed better results. Thereby, the better the masticatory performance in patients with a graftless sinus membrane elevation the better the patient satisfaction for 'prosthesis', 'appearance of prostheses', 'speech' and 'mastication and eating'. Patients with implant-supported overdentures show inferior masticatory function compared to those with natural dentition. There were no significant differences in masticatory performance between patients with implant-retained overdentures, with or without graftless augmentation. The decision on the preferred procedure should consider additional factors such as anatomical, surgical-technical aspects and patient's preferences.

Patients’ Satisfaction with Mandibular Overdentures Retained Using Mini-Implants: An Up-to-16-Year Cross-Sectional Study

Background: Patients with edentulism often have an impaired functional, phonetic, and esthetic status, resulting in poor quality of life; hence, the mandibular overdenture has been considered the standard implant treatment for such patients. Therefore, this study aimed to assess the effectiveness of mandibular overdentures retained using mini-implants on patient-reported satisfaction and their long-term survival. Methods: We searched patients’ medical records for eligible subjects, screening and inviting patients who received a mandibular overdenture anchored on mini-implants over ten years ago. We used a numerical rating scale from 0 (the worst) to 10 (the best) to assess four aspects: comfort, retention, chewing ability, and speaking ability before and after having mini-implants. We carried out Kaplan–Meier analysis to assess their survival. Results: Forty-eight elderly patients who were medically compromised and had a mandibular overdenture anchored on four permucosal mini-implants were included. All patient-reported satisfaction (comfort, retention, chewing ability, and speaking ability) was significantly improved after supporting mandibular overdentures with mini-implants (p-values < 0.05), with retention and chewing ability being the most substantially improved. The 10- and 15-year mini-implant survival rates were both 97.9%. Conclusions: Mandibular overdentures with mini-implants can be considered a valid and practical alternative to conventional implant-supported overdentures in patients with atrophic ridges, medically compromised, and the elderly.

A retrospective study of occlusal reconstruction in patients with old jaw fractures and dentition defects

PurposeThis study evaluated the methods and clinical effects of multidisciplinary collaborative treatment for occlusal reconstruction in patients with old jaw fractures and dentition defects. MethodsPatients with old jaw fractures and dentition defects who underwent occlusal reconstruction at the Third Affiliated Hospital of Air Force Military Medical University from January 2018 to December 2022 were enrolled. Clinical treatment was classified into 3 phases. In phase I, techniques such as orthognathic surgery, microsurgery, and distraction osteogenesis were employed to reconstruct the correct three-dimensional (3D) jaw position relationship. In phase II, bone augmentation and soft tissue management techniques were utilized to address insufficient alveolar bone mass and poor gingival soft tissue conditions. In phase III, implant-supported overdentures or fixed dentures were used for occlusal reconstruction. A summary of treatment methods, clinical efficacy evaluation, comparative analysis of imageological examinations, and satisfaction questionnaire survey were utilized to evaluate the therapeutic efficacy in patients with traumatic old jaw fractures and dentition defects. All data are summarized using the arithmetic mean and standard deviation and compared using independent sample t-tests. ResultsIn 15 patients with old jaw fractures and dentition defects (an average age of 32 years, ranging from 18 to 53 years), there were 7 cases of malocclusion of single maxillary fracture, 6 of malocclusion of single mandible fracture, and 2 of malocclusion of both maxillary and mandible fractures. There were 5 patients with single maxillary dentition defects, 2 with single mandibular dentition defects, and 8 with both maxillary and mandibular dentition defects. To reconstruct the correct 3D jaw positional relationship, 5 patients underwent Le Fort I osteotomy of the maxilla, 3 underwent bilateral sagittal split ramus osteotomy of the mandible, 4 underwent open reduction and internal fixation for old jaw fractures, 3 underwent temporomandibular joint surgery, and 4 underwent distraction osteogenesis. All patients underwent jawbone augmentation, of whom 4 patients underwent a free composite vascularized bone flap (26.66%) and the remaining patients underwent local alveolar bone augmentation. Free gingival graft and connective tissue graft were the main methods for soft tissue augmentation (73.33%).The 15 patients received 81 implants, of whom 11 patients received implant-supported fixed dentures and 4 received implant-supported removable dentures. The survival rate of all implants was 93.82%. The final imageological examination of 15 patients confirmed that the malocclusion was corrected, and the clinical treatment ultimately achieved occlusal function reconstruction. The patient satisfaction questionnaire survey showed that they were satisfied with the efficacy, phonetics, aesthetics, and comfort after treatment. ConclusionOcclusal reconstruction of old jaw fractures and dentition defects requires a phased sequential comprehensive treatment, consisting of 3D spatial jaw correction, alveolar bone augmentation and soft tissue augmentation, and implant-supported occlusal reconstruction, achieving satisfactory clinical therapeutic efficacy.

Occlusal equilibration and muscle activity in fixed versus removable mandibular implant supported overdenture

ObjectivesSingle denture rehabilitated patients have negative appraisals regarding oral function, mostly associated by stability and retention issues regarding mandibular prosthetics. Therefore, this study assessed patients’ occlusal equilibration, muscle activity, and oral health-related quality of life (OHRQoL) receiving milled removable or fixed mandibular implant retained prostheses.Materials and methodsTwenty-two edentulous mandibular ridges patients were randomly distributed into two groups based on the definitive prosthesis received. Group I: Removable mandibular implant-supported overdenture, Group II: Implant retained fixed prosthesis. Occlusal equilibration was evaluated utilizing Occlusense, muscle activity via Electromyograph (EMG) at delivery, after one, and three months. The OHRQoL was evaluated by Oral Health Impact Profile questionnaire (OHIP-19) before delivery and after follow-ups. Data were collected, tabulated, and analyzed, utilizing independent t-test and One-way ANOVA followed Tukey`s post-hoc test. Significance level set at P ≤ 0.05.ResultsGroups I &II showed significant improvement in occlusal equilibration, muscle activity and OHRQoL. Group II demonstrated significantly higher improvement than group I in occlusal equilibration associated with muscle activity after 1 month, and in functional limitations domain in OHRQoL questionnaire after 3 months.ConclusionImplant retained mandibular prosthesis showed improvement in occlusal equilibration, muscle activity, and OHRQoL regardless of prosthesis type employed. Fixed implant-supported prosthesis revealed better outcomes than removable mandibular implant-supported overdenture concerning occlusal equilibration, muscle activity, and OHRQoL regarding functional limitations.Clinical relevanceImplant retained mandibular prosthesis is one of best treatment options for single mandibular completely edentulous patients, as dental implants improved occlusal equilibration, muscle activity, and OHRQoL.

Unveiling denture-induced oral lesions: A comprehensive study on classification and pain assessment.

Denture-induced oral Lesions (DIOLs) often manifests shortly after the placement or adjustment of new or realigned dentures, frequently resulting in severe pain and discomfort. This study aimed to classify DIOLs placing a particular emphasis on assessing the associated pain. A prospective case study was conducted involving 126 patients who were fitted with a total of 193 dentures of various types at the Hadassah School of Dental Medicine. All patients underwent comprehensive intra-oral examinations within 1-8 weeks following denture delivery, completed symptom questionnaires and had their medical records reviewed. Key variables documented included age, gender, overall health status, denture type, and a detailed description of the DIOLs. The description encompassed factors such as lesion location, shape, colour, size, border characteristics, ulcerative appearance, membrane coverage, 3D morphology (elevated, immersed and flat) and patient-reported Verbal Pain Score (VPS) when touching the DIOLs, when wearing the denture, and when not wearing the denture. Notably, 25.4% of denture wearers required no adjustments, while 14.4% necessitated more than three revisions. A majority (71.8%) of DIOLs cases were associated with mandibular complete dentures, primarily situated on the alveolar ridge. The mean VPS indicated a pain intensity of 7 ± 2.1, with temporary dentures in both jaws causing the most discomfort. Implant-supported overdentures were particularly painful when placed in the mandible. Additionally, VPS scores were higher among older individuals and those with prior prosthetic experiences. A significant correlation was observed between pain intensity and presence of chronic health condition (0.036). This study revealed distinct characteristics of DIOLs and highlighted the multifactorial nature of pain experienced following the development of DIOLs. Insights into the influence of patient and denture characteristics on DIOLs and pain intensity can guide healthcare professionals in optimising patient comfort and satisfaction.

Rate of Residual Ridge Resorption in Complete Denture Wearers – A Narrative Review

The aim of the present narrative review was to gather the available information on overdentures in order to find an answer to the question, "Does overdenture affect residual ridge resorption?" The study also identifies the elements that affect the rate of residual ridge resorption in individuals who wear overdentures. Search strategy application, inclusion and exclusion criteria definition, and study selection for findings summarization were all part of the approach. Each author collected the literature from the database on their own, and the application of the exclusion criteria resulted in seven literatures. When taken as a whole, the studies show how complicated a combination of variables, such as prosthetic support type, implant presence, and length of edentulism, influence alterations in the bone of edentulous individuals. Compared to conventional complete dentures, implant-supported overdentures—especially those with several implants—seem to be associated with decreased bone resorption. All of the reviewed study findings highlight how important it is to utilise prosthetics, how occlusal pressures and implant use affect bone alterations in an individual's edentulous maxilla and mandible. The results deepen our knowledge of the challenges associated with caring for edentulous patients and emphasise the need for personalised treatment plans based on a range of patient-specific variables as well as ongoing investigation to better understand and treat residual ridge resorption in denture wearers.

Finite Element Analysis of Stress Distributions for Mandibular Dental Implant-Supported Overdentures with Magnetic Attachments in Osteoporotic and Normal Bone.

To compare the biomechanical responses of a normal mandible to an osteoporotic mandible with two-implant-supported magnetic attachments. A 3D finite-element model of a two-implant-supported mandibular overdenture with magnetic attachments was developed, and normal and osteoporotic bone samples were prepared. Four types of load were applied to the overdenture in each model: 100 N vertical and oblique loads on the right first molar, and a 100 N vertical load on the right canine and incisors. Biomechanical behaviors of the peri-implant bone, implant, and mucosa were recorded. Maximum equivalent stresses and elastic strains were analyzed. Equivalent elastic strain in osteoporotic cortical and cancellous bone was 9% to 71% and was 142% and 207% greater than in normal cortical bone, respectively. Equivalent elastic strain in the first molar oblique loading condition was 101% to 190% greater than in the first molar vertical loading condition. Osteoporotic cancellous bone was weaker and less resistant to deformation than normal bone, and oblique loading was more harmful than vertical loading.

Single Implant-Retained Mandibular Overdentures: A Literature Review.

The absence of teeth, known as edentulism, poses considerable obstacles in prosthodontic care and greatly affects a person's well-being. Conventional complete dentures frequently lead to problems like instability and insufficient retention, especially in the lower jaw. Fortunately, the introduction of dental implants has transformed the way we approach edentulous patients, as they now offer support and enhanced retention for removable prostheses, thus revolutionizing their treatment. While a consensus exists on using two implants for retaining mandibular overdentures, the associated cost may be prohibitive for economically disadvantaged individuals. As a solution, the concept of single implant-retained mandibular overdentures has emerged, catering to individuals with limited financial resources and complete tooth loss. This review explores the efficacy and suitability of the single implant overdenture approach, along with an overview of treatment options for edentulous patients, including traditional dentures, tooth-supported overdentures, and implant-supported overdentures. The preservation of bone, improvements in functional abilities, and psychological benefits associated with overdentures are discussed. Moreover, various classifications and prosthetic options for implant overdentures, specifically for mandibular cases, are presented. This literature review aims to provide a comprehensive understanding of possible treatment options and focus on the single implant-retained mandibular overdenture approach and its implications in prosthodontic rehabilitation for edentulous patients.

An In Vitro Study to Evaluate Retention of Ball and Locator Attachments in Straight and Angulated Implant-supported Overdenture

An In Vitro Study to Evaluate Retention of Ball and Locator Attachments in Straight and Angulated Implant-supported Overdenture

Assessment of peri-implant bone stress distribution with the effect of attachment type and implant location using finite element analysis.

The objective of the current research was to evaluate how stress is distributed in the peri-implant bone of a mandibular overdenture with implants placed asymmetrically to the midline. A 26-year-old male's mandible, with missing teeth, was examined using computed tomography (CT) scanning. Two implants were inserted at right angles to the occlusal plane, in the positions of the right canine and left lateral incisor of the mandible, with an internal connection. Two types of attachments (bar and ball) were designed. To simulate the clinical condition, anterior (on central incisors) and bilateral posterior (on premolars and molars) loadings were applied. The stress distribution was assessed using finite element analysis (FEA). The lateral incisor level implant was found to have the highest maximum principal stress (about 33 MPa) in both models in the anterior loading condition. However, in both models, the canine-level implant revealed more stress values (about 22 MPa) in the posterior loading condition. In mandibular implant-supported overdentures, when implants were placed asymmetrically to the midline, one acted as a fulcrum and sustained more occlusal load. The bar attachment system did not reveal superior results in terms of stress distribution compared to the ball attachment.

Conventional maxillary denture versus maxillary implant-supported overdenture opposing mandibular implant-supported overdenture: Patient's satisfaction.

This study sought to determine the impact of age, gender, and use of maxillary implant-supported overdenture (UISOD) versus conventional denture (CMD) opposing mandibular implant-supported overdenture (LISOD) and the number of years the patient has used their prosthesis on the ratings of satisfaction. This study aimed to assess the long-term influence of different factors on patients'satisfaction with LISODs needing a maxillary prosthesis, helping dentists choose a treatment pathway that leads to a higher satisfaction rate. This cross-sectional study included 84 participants. They were treated with LISOD opposing either CMD or UISOD from 2015 to 2020. They were all eligible to participate in the study. An oral health impact profile (OHIP-14) questionnaire was given to each patient and filled out by them. OHIP-14 scores were gathered and went under statistical analysis with PASS-11 software to determine the relationship between patients'satisfaction with the scores. Age and gender had no significant influence on how satisfied patients were. Patients with maxillary overdentures showed more satisfaction than the CMD group (p < .05). Moreover, patients'satisfaction decreased with increasing years of prostheses usage (p < .05). This study demonstrated that satisfaction is related to the type of maxillary prosthesis (conventional or implant-supported) used opposing LISODs and the number of years the patient had used the prostheses.

Retention Evaluation of Implant-Supported Mandibular Overdenture Using Two Different Attachment Systems: An in Vitro Study

Objective: The purpose of this in vitro study was to evaluate the retentive behavior of implant-supported overdenture using two different attachment systems (locator and milled bar-clip attachment system).&#x0D; Methods: Six edentulous mandibular models were fabricated from cold‑cure PMMA; the denture-bearing area of the acrylic resin model was covered by an approximately 1.5 mm thick silicone resilient liner to simulate mucosa. The Study models were divided into three groups: Model A (locator), Model B (milled bar-clip attachment system without extension), and Model C (milled bar-clip attachment system with 1cm extension). However, for each study model, a complete mandibular denture was constructed. Anterior, posterior, and central dislodging forces were measured by digital force gauge at the beginning of the study (Initial retention) and after 540 courses of consecutive pulling and inserting the prosthesis (final retention), which was to simulate six months of overdenture use assuming three daily removals and insertions for oral hygiene practice.&#x0D; Results: There were statistically significant differences in retention between the group models, and milled bar-clips attachment systems revealed the highest retentive capacity. However, after six months of simulated use, there was a significant retention loss; retention of Model B recorded the highest percentage loss of 55.1%, while Model A recorded the most minor retention loss of 24%. &#x0D; Conclusions: The bar and clip attachment system offered higher retentive values than the locator attachment system. However, the retention loss was correlated to the particular attachment system, and the bar–clip attachment systems had the highest percent of retention loss. In contrast, the locator attachments were associated with acceptable retention, simplicity, and minimal retention.

Accuracy of Selective Laser Melted Bar Retaining Mandibular Implant-Assisted Overdenture: An In Vitro Comparison of Different Impression Materials and Techniques.

This study aimed to assess the accuracy of the marginal fit of 2 implant-supported overdenture bars fabricated with selective laser melting technology, using polyvinyl siloxane and vinyl siloxane ether impression materials and different impression techniques. Two implants with multi-unit abutments were inserted in a 3D-printed mandibular model and used as a reference model, then duplicated into a stone cast to fabricate custom trays for obtaining impressions with polyvinyl siloxane and vinyl siloxane ether impression materials, using both open and closed-tray techniques. This resulted in a total of 4 groups, each with 8 specimens. The impressions were poured and scanned, and 32 cobalt-chromium bars were fabricated using selective laser melting technology. Each bar was screwed onto one abutment of the reference model, and a standardized digital periapical radiograph of the opposite unscrewed side was taken; this process was repeated to the other abutment. The vertical misfit was measured at 3 predetermined positions on the unscrewed side, and 6 values per bar were recorded. The mean gap distance was measured, and the data were subjected to statistical analysis; the present study found that the open-tray technique with vinyl polyether siloxane impression material may offer improved accuracy for obtaining impressions for 2 implant-supported bars. The open-tray technique groups also showed better marginal fit than the closed-tray groups. However, further clinical research is required to confirm these findings.

Biomechanical behavior of carbon fiber-reinforced polyetheretherketone as a dental implant material in implant-supported overdenture under mandibular trauma: A finite element analysis study.

Implant-supported overdentures are well-known and widely accepted treatment modality to increase retention which is a crucial factor for determining patient satisfaction. The placement of two implants in the anterior region can be selected as a first-line treatment in patients with the atrophic mandibular ridge. The purpose of this research was to assess the biomechanical effects of carbon fiber-reinforced polyetheretherketone (CFR-PEEK) implant-supported overdenture in the event of 2,000 N forefront trauma to an atrophic edentulous mandible by using the finite element analysis method. Three types of mandible models were simulated; the first one was an edentulous atrophic mandible model; in the second model, 3.5 × 11.5 mm CFR-PEEK implants; and in the third model, 4.3 × 11.5 mm CFR-PEEK implants were positioned in the region of the lateral incisor of the identical edentulous atrophic mandible. Maximum Von Misses stresses 979.261 MPa, 1,454.69 MPa, and 1,940.71 MPa and maximum principal stresses 1,112.74 MPa, 1,249.88 MPa, and 1,251.33 MPa have been detected at the condylar neck area and minimum principal stresses - 1,203.38 MPa, -1,503.21 MPa, and - 1,990.34 MPa have been recorded at the symphysis and corpus regions from M1 to M3, respectively. In addition, the M2 and M3 models showed low-stress distributions around the implant-bone interface, particularly where the implants were in contact with cancellous bone. The results showed that the insertion of different diameters of CFR-PEEK implants led to low and homogenous stress distribution all around the implant-bone interface and stresses transferred directly to the condylar neck areas. Therefore, it was observed that CRF-PEEK implants did not change the basic behavior of the mandibula in response to frontal stresses.

Effectiveness of a polycaprolactone scaffold combined with platelet-rich fibrin as guided tissue regeneration materials for preserving an implant-supported overdenture

ObjectivesThis study aimed to assess the effectiveness of ridge preservation using a polycaprolactone (PCL) scaffold combined with platelet-rich fibrin (PRF) to promote bone regeneration before implantation. Materials and MethodsThis prospective study was conducted at Al-Azhar University in Egypt. It included 30 participants requiring the extraction of their last mandibular premolar before constructing an implant-supported overdenture. The participants were divided into three groups: Group A was treated with a PCL scaffold and PRF as ridge preservative materials, Group B was treated with PRF alone, and Group C (control) was treated with no preservative material. Bone samples were collected for histomorphometric analysis at implant placement. ResultsThe participants’ mean age was 65.3 ± 4.27 years, and 18 (60%) were male. Postoperative alveolar bone lengths differed significantly between Groups A and B (P = 0.001). However, alveolar bone width changes did not differ significantly among groups. In contrast, the postoperative bone density and loss differed significantly among groups (P = 0.001). ConclusionCombining two ridge preservation techniques (PCL and PRF) enhanced participants’ alveolar bone remodelling by decreasing its resorption and maintaining its width.

Reliability of Cone Beam Computed Tomography in Predicting Implant Treatment Outcomes in Edentulous Patients.

Since the development of CBCT has been utilized in dentistry, the images of the CBCT can assist the surgeon to evaluate the anatomy carefully. Despite the value of radiology evaluation, implant procedures may require additional consideration rather than only evaluating the anatomical factors. The purpose of this study is to evaluate the predictability of using CBCT alone to plan for implant placement in edentulous patients digitally. CBCT images were analyzed by clinicians, measuring the maxillary and mandibular ridge heights and widths digitally of four predetermined implant sites in the maxillary and two selected implant sites in the mandibular arches of 91 patients planning for implant-supported overdenture. A total of 47 patients out of the 91 had completed implant placement on the edentulous ridge, contributing to 55 upper and/or lower arches (136 dental implants). Both predictabilities are low, implying that CBCT planning for implant placement on the edentulous ridge is not a good index and is insufficient to predict the surgical procedures as a solo method. The findings of this study indicate that digital planning by CBCT is insufficient to serve as an individual tool to predict implant procedures. Further information and evaluation must be considered for implant placement in the edentulous ridge.