Implant-supported Removable Prostheses Research Articles

Effect of bar designs on peri implant tissues health in implant-supported removable prostheses: a systematic review

Different characteristics of bars (cross-sectional shape, diameter, distal extension etc.) lead to different biomechanical behavior (retention and stress) with implants and peri-implant tissues.Aim: To evaluate the impact of implant-supported removable prostheses bar designs in fully edentulous arch (in the maxilla and/or mandibula), with 4 implants or more, on the peri-implant soft and hard tissues.Two reviewers searched for observational studies, RCT and in vitro studies, published on five main databases and three from the grey literature, without restrictions on November 2023.Of the 3049 selected articles, four met the inclusion criteria. Four RCT evaluated peri-implant health tissues in full edentulous arches with 4 or 6 implants rehabilitated with implant bar overdentures. One prospective study with 5 years follow-up evaluated the success/survival rate of implants and implant bar overdentures. Overall, 261 subjects were enrolled in our systematic review with 1176 implants. Overdentures’ survival rate was 100%. There was a trend that plaque indices and gingival indices were low in all of the studies, however no statistical analysis was done due to the lack of information.Due to the lack of information in the included studies, we cannot confirm if bar characteristics affect the peri-implant tissues health.

Is the implant-retained overdenture a solution to improve the patient quality of life?

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.

Maxillary overdenture on three implants retained by low-profile stud attachments - A prospective cohort study.

Clinical 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. To restore individuals with an edentate maxilla with a metal-reinforced removable prosthesis without palatal coverage retained by low-profile stud attachments on three implants. The 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). Thirty-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. The 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.

Prosthetic failures in dental implant therapy.

Both fixed and removable implant‐supported prostheses are well‐established methods for replacing missing teeth in partially or fully edentulous patients. Numerous systematic reviews have been performed in recent years to evaluate the survival and complication rates of implant‐retained fixed dental prostheses and implant‐retained overdentures, displaying high 5‐year survival rates ranging from 97.1% for fixed dental prostheses to 95%‐100% for implant‐retained overdentures. However, the survival rates only represent the prostheses remaining in use for a defined follow‐up time, and do not account for the potential prosthetic complications that may have arisen and influence the general success of the implant treatment. The most common technical complications of fixed implant‐retained single crowns are crown fracture, fractures of ceramic implant abutments, and esthetic problems. The predominant technical complication at multiple‐unit, implant‐retained fixed dental prostheses is fracture/chipping of the veneering ceramic. Reported technical complications for implant‐retained overdentures are overdenture fracture or chipping of the veneer materials, whereas mechanical complications include implant fracture, attachment failure, and attachment housing or insert complications. To reduce the risk of such failures, a comprehensive pretreatment diagnostic work‐up is essential, including defining the prosthetic goal with the aid of a wax‐up or set‐up and the associated ideal, prosthetically oriented three‐dimensional implant position. Furthermore, selection of the ideal type of prosthesis, including the respective implant components and materials, is important for clinical long‐term treatment success.

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

Statement of problemInformation on the epidemiology and etiopathology of peri-implant diseases in reference to prostheses is sparse. PurposeThe purpose of this retrospective clinical study was to analyze the prevalence and risk of peri-implant diseases based on the type of prosthesis. Material and methodsA total of 274 implants in 106 patients were evaluated by clinical and radiological examination. Peri-implant mucositis was defined by bleeding on probing, whereas peri-implantitis was defined by additional bone loss ≥1.5 mm since seating of the definitive prosthesis. Prosthetic design and anamnestic risk factors were assessed in a regression analysis, whereas clinical and radiological differences between the prosthesis groups were compared by the Pearson chi-squared test (α=.05 for all procedures). ResultsThe median observation period was 18 years. Seventy-two implants were restored with single crowns, 138 implants with fixed partial dentures, and 64 implants with removable prostheses. Peri-implant mucositis was diagnosed more often in implants supporting fixed partial dentures (42.8%), whereas peri-implantitis was found more frequently in implants supporting removable prostheses (31.3%) (overall distribution pattern: P<.001). The type of prosthetic restoration was confirmed to be an independent prognostic risk factor regarding peri-implant diseases (P=.005). Additionally, increased bone loss was found with implant-supported removable prostheses, regardless of peri-implantitis (P<.001). ConclusionsThe type of prosthetic restoration was identified as an independent risk factor for the development of peri-implant diseases. Particularly, implants supporting double crown-retained removable prostheses might be at risk.

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

Introduction: Loss of mandibular continuity, jaw deviation, extensive freely movable soft tissues, and difficulty in mastication, swallowing, and speech are the re-sults of hemi-mandibulectomy, which adversely affect the patients’ quality of life. Management of such patients by fixed or removable prostheses is a complex and chal-lenging approach as the type of prosthesis is a determinant factor in successful reha-bilitation. Case Presentation: The present report describes prosthetic rehabilitation of two pa-tients who underwent hemi-mandibulectomy due to osteosarcoma. After clinical and paraclinical evaluations and multidisciplinary consultations, it was decided to use implant-supported removable overdenture with stud attachments and an open-structure framework for them. Results: Jaw reconstruction and dental rehabilitation of hemi-mandibulectomy patients are complicated procedures. However, with regard to developments in dental science, the clinicians have different options to fulfill the esthetic and functional demands of such patients. The current paper showed that implant-supported removable prostheses with stud attachments can successfully re-habilitate the hemi-mandibulectomy defects when the interocclusal space is limited and achieving the implants’ parallelism is a challenge due to the nature of hemi-mandibulectomy procedure.

Rationale for a novel attachment system for implant-supported overdentures.

To quantify the effect of support stiffness on the retention forces of telescopic crowns and to evaluate a prototype attachment system incorporating a nickel-titanium element. In the first part of the study, telescopic crowns were fabricated employing standard laboratory procedures. For six combinations of telescopic crowns, the separation force was determined while varying the stiffness of their supporting implants. In the second study part, an in vitro mandibular model with three interforaminal implants was equipped with strain gauges and extensometers. Two prostheses either employing cylindrical telescopic crowns or prototype attachments were fabricated and statically loaded on the model using either the midline or the left canine or both canine implants for support while strain in the peri-implant area and prosthesis displacement were recorded. Statistical analysis of both study parts was based on pairwise comparisons with the level of significance set at α = .05. With one exception (P = .161), for each assembly of two telescopic crowns, the separating force was always dependent on the stiffness of the supporting implants. With 3 exceptions out of a total of 14 comparisons for peri-implant strain and prosthesis displacement, the use of the prototype attachments always led to significantly lower mean values compared to the use of cylindrical telescopes (P < .00). The individual retention force of telescopic crowns on implants should be set at a lower level compared to telescopic crowns on natural abutments. Incorporating a nickel-titanium element into attachment systems for implant-supported removable prostheses reduces peri-implant strain and may facilitate the use of telescopic crowns.

Transition of a Misch removable prosthesis-5 to a fixed prosthesis-3: From a removable to a fixed complete denture

An implant-supported denture is used when a person does not have any teeth in the jaw but has enough bone to support implants. Treatment options can be broadly divided into the fixed implant-supported prosthesis and removable implant-supported prosthesis (overdenture). However, when such completely edentulous patients who are already rehabilitated using removable implant-supported overdentures report for a fixed prosthesis, then it becomes a challenging situation. This article describes the challenges involved in the transition of one such patient rehabilitated previously using a RP-5 prosthesis to a fixed FP-3 prosthesis.

Comparison of Success Rate and Radiological Bone Loss in Patients with Mini-Implant versus Conventional-Sized Implant Removable Prostheses: A Meta-Analysis

Background: The objective of this meta-analysis was to assess whether mini-implants have added benefit in terms of implants success rate and average bone loss over conventional-sized implants after one year of follow-up. Methods: An electronic search of randomized clinical trials was conducted in MEDLINE (via PubMed), Cochrane Central Register of Clinical Trials (CENTRAL) and Web of Science for studies including complete or partial edentulous patients requiring two or four mini-implants or conventional/ standard-sized implants in the maxilla or mandible for implant-supported removable prostheses who completed 12 months of follow-up. Results: The search provided 194 unique articles which were screened for title and abstract. Screening generated 12 articles which went through full-text analysis using eligibility criteria, and 4 articles were included for meta-analysis. Meta-analysis of these studies indicated a non-significant difference in the success rate between the two interventions (OR = 1.69 [0.74, 3.85; p = 0.21]). Bone loss estimates resulted in a significant bone reduction (Mean Difference = -0.74 [-0.95, -0.53; p - with two conventional-sized implants, the estimates were non-significant (Mean Difference = -0.24 [-0.69, 0.20; p = 0.29]). Conclusion: The current evidence does not provide solid evidence of the benefits of one intervention over the other. More studies with follow-up times of 10 and more years are needed as current studies have described the short-term outcomes.

Hygiene Recall in Diabetic and Nondiabetic Patients: A Periodic Prognostic Factor in the Protection Against Peri-Implantitis?

Diabetes mellitus is associated with an increased risk of poor outcomes with dental implant placement. This study aims to identify if frequency of hygiene visits is a protective factor for the development of peri-implantitis in diabetic patients. A retrospective cohort design was conducted on patients presenting for dental implant placement at the Philadelphia Veterans Affairs (VA) Medical Center from 2006 to 2012. The primary predictor variable was hygiene frequency, recorded as either infrequent, annual (7-12month recall), or biannual (≤6-month recall). The number of months between implant placement and the presence of peri-implantitis was the primary outcome (time-to-peri-implantitis) variable, which was assessed on a subject level and adjusted for clustered, correlated multiple implants on the same subject. Additional variables were greater than or equal to 60years of age, male gender, smokers, short implant length, diabetes, uncontrolled diabetes, and removable prostheses. Descriptive, univariate, and Cox proportional hazards regression statistics were computed to measure associations with peri-implantitis with P≤.05 used to define statistical significance. The study sample was composed of 286 patients. In total, 748 implants were placed. Subjects greater than or equal to 60years of age were 2 times more likely to develop peri-implantitis (hazards ratio (HR)=2.015, 95% Cl (0.985-4.119), P=.0549). Subjects receiving implant-supported removable prostheses were 2.3 times more likely to develop peri-implantitis (HR=2.315, 95% CI (1.006-5.327), P=.0485). With each hygiene visit, patients' risk of developing peri-implantitis decreased 20% (HR=0.805, 95% Cl (0.394-1.647), P=.5528). In addition, diabetic patients were 49% more likely to develop peri-implantitis (HR=1.491, 95% CI (0.758-2.936), P=.2475) than nondiabetic patients. Diabetic patients may be at increased risk for the development of peri-implantitis and an increased frequency of hygiene visits may reduce peri-implant diseases.

Effects of dental implant treatment on sleep quality in edentulous older people: A prospective cohort study.

Background Edentulism and sleep disturbances are commonly seen among older people and cause serious negative effects on their daily lives. Edentulism can induce sleep problems by changing maxillo-mandibular anatomy and surrounding soft tissues. The effect of the treatment of complete edentulism on sleep disturbances is not sufficiently understood. The purpose of this cohort study is to detect how different treatment options affect sleep quality, daytime fatigue and sleep disorder breathing in totally edentulous elderly people. Material and Methods Ninety-six individulas (50 male and 46 female) participated in this prospective cohort study. The patients were non-randomly assigned to three groups, fixed implant-supported prostheses (FP), removable implant-supported prostheses (RP) and conventional total prostheses (CP). The Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS) and the STOP-Bang questionnaire were calculated before (T0) and one year after (T1) their prosthetic rehabilitations. Results Although there was no statistically significant difference between groups in terms of mean PSQI (p=0.524), ESS (p=0.410) and STOP-Bang (p=0.697) scores at T0, there was a significant difference between groups in terms of mean PSQI (p=0.011), ESS (p=0.030) and STOP-Bang (p=0.024) scores at T1. The FP group, when compared to CP group was associated with significantly better scores in the PSQI (Δ = -3.399, 95% CI= -4.612 to -2.187), ESS (Δ = -1.663, 95% CI= -3.149 to -0.176) and STOP-Bang (Δ = -0.994, 95% CI= -1.592 to -0.397). Conclusions Within the limitations of this study FP was associated with a positive influence on sleep disturbances. Randomized controlled trials will be needed to provide reliable inference on this association. Key words:Dental implant, edentulism, older people, sleep disturbances.

Evaluation of complications in implant-supported locator retained removable dentures: 24 Months Retrospective Study

Aim: The purpose is to evaluate the complications that occur in implanted locator supported removable dentures for 2 years clinically and radiologically.Materials and methods: Study between the years of 2014-2019, was performed on 121 patients who underwent 284 dental implants and came to their controls at the 12th and 24th months. Patients included in the retrospective study were 52 men and 69 women. Complications detected in the first 24 months after the implant supported prosthesis applied; relining and rebasing, loss of retention (housing removal, wear of the retaining clip) and fracture in the base of prosthesis were recorded and evaluated. Data were analyzed using One‐way ANOVA and Tukey's HSD tests. A P value of &amp;lt; 0.05 was considered statistically significant.Results: In implant-supported removable prostheses, there are significant differences were found between the increasing complication rates at 12th and 24th months (p &amp;lt;0.05). The most common complication at the end of 24th month in overdenture prosthesis with implant supported locator holder applied to the maxilla and mandible, respectively; relining of prosthesis (11.57%), rebasing of prosthesis (6.6%), loss of retention (5.79%) and prosthetic base fracture (4.13%).Conclusion: Based on the data analyzed in our study, removable prostheses showed different types and frequency of complications. Treatment of implant-supported overdenture prostheses, routine control of the prostheses is important.

Supportive Implant Therapy (SIT): A Prospective 10-Year Study of Patient Compliance Rates and Impacting Factors.

The main objective of this study is to present patient compliance rates and influential factors for regular attendance in a systematic implant aftercare program (Supportive Implant Therapy; SIT) within a 10-year observation period. From 2005 to 2008, we identified 233 patients with 524 implants and implant-supported restorations at the study center. They had been instructed to attend an SIT program with 3-month recall intervals. A 2019 clinical prospective cohort study on 10-year compliance rates was performed. Data were assessed yearly in regression analyses to identify influential factors. Noncompliance rates increased during the period (4.8%, year 1; 39.7%, year 10). Total noncompliance was observed in four patients (1.7%) with 10 implants. “Age,” “Gender,” “Diabetes”, and “Surgical case complexity” showed no correlation with patient compliance. “Smoking” and “Cardiovascular diseases” significantly influenced patients in one of ten years, while “Number of implants per patient”, “Type of implant-supported prostheses”, and “Pre-existing experience in a prophylaxis program” reached significance after several years. When patients with implant-supported restorations are strongly recommended and frequently remotivated to comply with an SIT program with 3-month recall, an approximately 60% compliance rate after 10 years is achievable. Previous prophylaxis program experience, increased number of implants per patient, and removable implant-supported prostheses may be strong influential factors for increased patient compliance.

The effect of smoking on the marginal bone loss around implant-supported prostheses

INTRODUCTIONImplantology has led to several changes in the planning process involved in the application of dental prostheses to diminish bone level changes along the margins of dental implants. However, the relationship between smoking and marginal bone loss around dental implants, supporting both fixed and removable prostheses has not been investigated. We hypothesize that the design of different prostheses alter the effects of smoking, which consequently affects the amount of supporting alveolar bone.METHODSIn this study, we included 137 implants in the ‘implant-supported fixed prostheses’ (ISFP) group (31 smokers, 106 non-smokers) and 94 implants (21 smokers, 73 non-smokers) in the ‘implant-supported removable prostheses’ (ISRP) group. The corresponding patients were examined in routine recall sessions conducted at 6, 12 and 24 months after the placement of the dental prostheses. The recorded clinical periodontal parameters were the presence/ absence of a plaque index, bleeding index, and the probing depths. These periodontal parameters were assessed in conjunction with marginal bone level measurements. Comparative bone level measurements were obtained from radiographical images at ×20 magnification using the CorelDraw 11.0 software program. Statistical analysis was performed using the SPSS Statistical Software version 21.0.RESULTSThe overall clinical parameters were found to be poorer in smokers than in non-smokers (p<0.05). In all the groups, time-dependent bone loss was observed. However, among the patients with ISRPs, smokers were associated with significantly greater marginal bone loss compared to patients with ISFPs (p<0.05).CONCLUSIONSIn smokers with dental ISRPs, the marginal bone loss rates are likely to reach critical levels. Therefore, after the placement of prostheses, strict recall periods with a dental professional should be observed, and their guidance should be implemented in order to monitor the health of the bones around the implants.

THE IMPACT OF IMPLANT NUMBER ON CLINICAL AND RADIOGRAPHIC OUTCOMES OF IMPLANT-SUPPORTED MAXILLARY OVERDENTURE WITH LOCATOR ATTACHMENTS: 2-YEARS OUTCOMES

Statement of problem: Patient perspectives on the treatment options for maxillary edentulism, which debate include fixed or removable implant-supported prostheses, may help eliminate current uncertainty as to the best choice of treatment plan.Purpose: This study intended to evaluate the impact of implant number placed in fully edentulous maxilla on the clinical as well as the radiographic outcomes of implant-supported maxillary overdentures with locator attachments over two years of investigation. Materials & methods: For this clinical research study held between May 2015 and May 2017, twenty-four fully edentulous patients received new maxillary and mandibular complete dentures prior to implant placement. After common denture delivery modifications, every patient was instructed to use the denture in a conservative manner for three months, with a follow-up appointment every two week. During this period, arrangements for implant placement were processed. Following the three months of adaptation; patients were randomly categorized into two main groups: In the first group (of twelve patients), every patient received six implants in the maxilla (three in each quadrant) utilizing a pre-fabricated computer-aided surgical stent. In the second group (of twelve patients), every patient received four implants in the maxilla (two in each quadrant) utilizing a pre-fabricated computer-aided surgical stent. After six months of implants placement (to ensure complete implants osseointegration), patients of the two groups had completed the procedures of fabricating Implant-supported maxillary overdenture with locator attachment. the clinical & the radiographic outcomes of the Implants supporting the overdentures had been calibrated at time of implants insertion, 6 months, 12 months, 18 months and 24 months respectively. Noting that: Forcemeter measurements started at the time of overdenture insertion Not at the time of implants insertion (i.e. only four readings were obtained). Results: Repeated measures ANOVA test was used to study the changes by time inside each group as well as to compare between the two groups. Moreover, Student’s t-test was used to compare between quantities of bone loss or improvement in the two groups. Those studies exhibited that; there was a statistically significant difference in clinical & radiographic outcomes between the two groups of study throughout the investigation period.Conclusion: Maxillary Overdentures supported by six implants exhibited a more reliable and better treatment option than those supported by only four implants, in terms of clinical as well as radiographic outcomes.Keywords: Overdenture, Edentulism, Clinical outcome, Implant Number, Maxillary Denture, Locators.CLINICAL IMPLICATIONSCompletely edentulous patients often have problems with their complete dentures; a treatment modality of using four to six implants to support a maxillary overdenture has been proposed to improve the retention as well as the stability of the maxillary denture, in addition to preserving the residual alveolar bone.

Diş, Kemik ve Yumuşak Doku Kaybı Olan Travma Hastalarında Alternatif Prostodontik Rehabilitasyon

Acquired defects typically result from traumatic injuries such as falls, motor vehicle accidents, gunshot injuries or radiation injuries. Those maxillofacial defects resulting from motor vehicle accidents in particular often involve various soft and hard-tissue injuries such as fractures or avulsions of the maxillary or mandibular teeth or fractures of the temporomandibular joints. For a patient suffering such injuries, the retention and stabilization of a prosthesis that contributes to the patient's physical and psychological well-being are often difficult to achieve due to the nature of the moveable tissue beds involved and the resulting lack of support from the remaining teeth and bones. This clinical report describes the treatments of two partially edentulous patients with traumatic injuries that resulted from motor vehicle accidents. The prosthetic rehabilitations were accomplished through the manufacture of (1) a mandibular prosthesis with an extracoronal bar attachment, and (2) a maxillary implant-supported removable prosthesis.

Quality of life assessment of implant-retained overdentures and fixed metal-acrylic resin prostheses in patients with marginal mandibulectomy

Statement of problemSeveral factors affect the prosthetic outcome of patients with mandibular defects. However, it is questionable whether fixed or removable implant-supported prostheses meet the expectations and satisfaction of the patients. The perspectives of these patients are important in managing the prosthetic treatment strategies. PurposeThe purpose of this prospective clinical study was to evaluate the satisfaction and oral health-related quality of life of patients with marginal mandibulectomies with implant-retained overdentures and fixed metal-acrylic resin prostheses. Material and methodsTwenty-two participants with marginal mandibulectomies were included in the study. They completed an oral health impact profile questionnaire designed for patients with edentulism (OHIP-Edent) for the assessment of quality of life and visual analog scales (VASs) to validate their general satisfaction before treatment. Ten participants received 4 implant-retained fixed metal-acrylic resin prostheses, whereas 12 participants were treated with 2 implant-supported overdentures. Six months after delivery of their prostheses, the participants completed the OHIP-Edent questionnaire and VAS again. For the statistical analyses, Student t tests together with descriptive statistics (mean, standard deviation, frequency) were used in the 2 intergroup parameter comparisons that showed normal distribution. The Mann-Whitney U test and Kruskal-Wallis test were used for intergroup comparisons, and the Wilcoxon signed rank test was used for intragroup comparisons. ResultsCompared with pretreatment mean values, a statistically significant (P<.05) decrease in mean scores of all OHIP-Edent values and an increase in VAS scores were found in both groups. After patients were treated, their OHIP-Edent values in the group with an overdenture prosthesis were higher than those in the group with a fixed metal-acrylic resin prosthesis (P<.05). ConclusionsThese results demonstrate that implant-retained overdentures and fixed metal-acrylic resin prostheses provide better function and, thus, oral health-related quality of life for patients with marginal mandibulectomies.

Implant-supported Overdenture

ABSTRACT Edentulous patients often experience problems with their mandi­bular complete dentures. Patients with the resorbed mandibular ridge often complain of lack of stability and retention of the mandibular denture, together with a decreased chewing ability. While implant-supported fixed prosthesis offers many advantages, they are very expensive and not indicated in many conditions. Implant-supported removable prosthesis can be a choice of treatment in such cases. This clinical report describes a method to rehabilitate a patient with resorbed mandibular ridge with implant-supported overdenture. How to cite this article Kadam KS, Dange SP, Mahale K, Khalikar SA, Khalikar A. Implant-supported Overdenture. Int J Oral Implantol Clin Res 2017;8(1):22-25.

Peri-implant bone loss of dental implants with platform-switching design after 5 years of loading: a cross-sectional study.

The aim of this cross-sectional study was to estimate bone loss of implants with platform-switching design and analyze possible risk indicators after 5 years of loading in a multi-centered private practice network. Peri-implant bone loss was measured radiographically as the distance from the implant shoulder to the mesial and distal alveolar crest, respectively. Risk factor analysis for marginal bone loss included type of implant prosthetic treatment concept and dental status of the opposite arch. A total of 316 implants in 98 study patients after 5 years of loading were examined. The overall mean value for radiographic bone loss was 1.02 mm (SD ± 1.25 mm, 95% CI 0.90- 1.14). Correlation analyses indicated a strong association of peri-implant bone loss > 2 mm for removable implant-retained prostheses with an odds ratio of 53.8. The 5-year-results of the study show clinically acceptable values of mean bone loss after 5 years of loading. Implant-supported removable prostheses seem to be a strong co-factor for extensive bone level changes compared to fixed reconstructions. However, these results have to be considered for evaluation of the included special cohort under private dental office conditions.

Implant-supported Overdenture using Resilient Reliner

Fixed and removable implant-supported prostheses successfully address problems associated with complete dentures in edentulous mandibles. Implant-supported overdenture (IOD) improves retention, stability, function, proprioception, and comfort. This case report depicts step-by-step procedure for fabrication of IOD with castable bar and modified resilient reliner. The bar was fabricated from readily available castable bar system, and resilient silicone-based relining was done by using a pickup impression at the time of trial. The shortcomings of direct technique are overcome by this procedure. It is a relatively simple and easy technique to produce an accurate prosthesis and devoid of wear and tear of elastic components.