Maxillary Implant-supported Overdenture Research Articles

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.

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.

Biomechanical Analysis of Palateless Splinted and Unsplinted Maxillary Implant-Supported Overdentures: A Three-Dimensional Finite Element Analysis.

The objective of this study was to compare the distribution of stress in the maxillary bone, dental implants, and prosthetic components supporting implant-supported maxillary overdentures with partial palatal coverage, in both splinted and unsplinted designs. Two models of maxillary overdentures were designed using the Exocad Dental CAD program, which included cancellous and cortical bone. The complete denture design and abutments (locator abutments in the unsplinted and Hader bar with Vertix attachments placed distally in the splinted variant) were also designed. The denture material was PEEK (Polyetheretherketone), and the method used to analyze patient-specific 3D X-ray scans was 3D QCT/FEA (three-dimensional quantitative computed tomography-based finite element analysis). Loading was divided into three load cases, in the frontal region (both incisors of the denture) and distal region (both molars and first premolar of the denture). The forces applied were 150 N with an oblique component with a buccal inclination of 35° in the frontal region, and 600 N with a buccal inclination of 5° (molars) or solely vertical (premolar) in the distal region. The model with locator abutments showed higher stresses in all load cases in both analyzed implant variants and in the maxilla. The differences in stress distribution between the splinted and unsplinted variants were more significant in the distal region. According to the results of the present study, the amount of stress in bone tissue and dental implant parts was smaller in the splinted, bar-retained variant. The findings of this study can be useful in selecting the appropriate prosthetic design for implant-supported maxillary overdentures with partial palatal coverage.

Maxillary Overdenture Implant Survival Rate and Prosthetic Complications: An Observational Study

Background: Edentulism is a serious public health problem since it is a physical defect that has been associated with significant impairments in self-esteem, communication, nutrition, and perceptions of appearance. This study aimed to evaluate the survival rate and prosthetic complications of implant-supported overdentures in the edentulous upper jaw. Methods: This prospective study was carried out at Banasree Dental and German Dental implant surgery centers from December 2011 to December 2021 where 78 patients were included in this study and evaluated clinically and radiographically. A total of 20 patients were excluded as they did not agree to or maintain the follow-up schedule. After this procedure, 58 patients (24 male and 34 female) were evaluated for this study. Results: The mean age of the patients was 61.3± 6.8 years whereas the 24 (41.4%) were male. The total survival rate of implants was 94.8% at the 5-year follow-up and 92.2% at the 10-year follow-up. In the 3.0 mm diameter implants, the lowest survival rate was 70.6% at the 5-year follow-up and 52.9% at the 10-year follow-up, whereas in the 3.8 mm diameter implants it was 95.1% and 93.4%, in the 4.2 mm diameter implants it was 97.8% and 96.7%, and in the 4.6 mm diameter implants it was 94.8% and 92.2%, respectively. Most of the 29 implants had prosthetic tooth fractures, followed by 18 premature wear of gaskets, 15 prosthesis loosening/shedding, 9 damaged prosthesis flanges, 4 damaged baskets, and 3 implants with screw loosening. Conclusion: It is concluded that implant-supported maxillary overdentures have a high rate of survival and are a safe and reliable treatment option. But it's obvious that biological and mechanical complications arise frequently and that they become more common over time.

Axial and Non-axial Retention Forces of Milled Titanium Bar Versus Locator-Milled Titanium Bar Attachments in Implant-Supported Maxillary Overdenture: An In Vitro Study

Axial and Non-axial Retention Forces of Milled Titanium Bar Versus Locator-Milled Titanium Bar Attachments in Implant-Supported Maxillary Overdenture: An In Vitro Study

Angled ball and locator attachments for immediate loaded inclined implants used to retain maxillary overdentures: A cross over study of patient satisfaction and oral health related quality of life.

The aim of this was to compare the influence of two different angulated abutment designs on patient satisfaction, oral health-related quality of life, and prosthetic aspects of implant-supported maxillary overdentures. For this cross-over study, 18 patients with completely edentulous maxillary ridges opposing implant-retained mandibular overdentures received 4 implants between the maxillary sinuses using computer-guided surgery. The anterior implants were installed at canine/lateral incisor areas and inclined 15° labially. The posterior implants were inserted just anterior to the maxillary sinuses and inclined 15o distally. Eight patients received maxillary overdentures retained by angled ball attachment (ball overdenture [BOD]) and angled locator attachment in random order. After 6months, patients indicated satisfaction with their prosthesis using a visual analog scale (VAS), and oral health impact profile (OHIP-14). Moreover, postinsertion prosthodontic maintenance and complications were recorded for both attachments. Comparisons of patient satisfaction and prosthetic complications between groups were performed using the Wilcoxon matched-pairs test and the McNemar test, respectively. Locator overdenture (LOD) recorded significantly higher scores than the BOD group regarding all the VAS questions except for ease of cleaning (p < 0.007). LOD recorded significantly higher patient satisfaction regarding the pronunciation of sounds (p=0.009), painful aching (p=0.018), feeling tense (p=0.011), unsatisfactory diet (p=0.013), irritability with people (p=0.005), and life in general (p=0.004). The most common complications were matrix activation/renewal (n=34). BOD showed a significantly higher incidence of attachment loosening (p=0.002), and teeth fracture (p=0.049) than LOD. LOD showed a significantly higher incidence of attachment wear and replacement than BOD (p <0.001). There was no difference between groups regarding soft tissue complications. Within the limitations of this study, and in terms of improved patient-centered outcomes, angled locator attachments are recommended to retain maxillary implant overdentures opposed by implant retained mandibular overdentures at it was associated with increased patient satisfaction and oral health-related quality of life than angled ball attachments. However, locator attachment was associated with more postinsertion prosthodontic maintenance than ball attachment.

Case Series on the Long-Term Effect of Three Different Types of Maxillary Implant-Supported Overdentures on Clinical Outcomes and Complications.

(1) Long-term data on maxillary implant overdentures (IODs) are scarce. This case series evaluated three types of IODs supported by six, four or three implants (Anyridge®, Mega’Gen Implant Co., Ltd., Daegu, South-Korea), after 3–5 years in function. (2) A total of 31 patients, with 132 implants, were non-randomly allocated based on available bone or financial limitations. IOD-6 received a telescopic overdenture; IOD-4 a bar; and IOD-3, non-connected implants with locator abutments. Implant survival, bone level changes, probing pocket depth (PPD), plaque index, bleeding on probing (BOP), and technical, biological and aesthetic complications were registered. Impact of suprastructures on bone loss and PPD was analyzed using mixed-effect linear regression models. Differences between groups were analyzed using the ANOVA test for BOP, and Kruskal Wallis test for complications. (3) In total, 23 patients participated in the follow-up (9 female, 14 male), with average age of 62.2 years; 7, 11 and 5 patients in IOD-6, IOD-4 and IOD-3, respectively. Implant survival after 4.4 years on average, was 98% in total; 100%, 97.8% and 93.3% for IOD-6, IOD-4 and IOD-3, respectively. Mean bone loss corresponded to 0.68 mm (SD 1.06, range −4.57–1.51), 0.39 mm (SD 1.06, range −3.6–2.43), and 1.42 mm (SD 1.68, range −5.11–0.74) for IOD-6, IOD-4 and IOD-3, respectively. A statistically significant difference was seen in bone level when comparing IOD-6 to IOD-3 (p = 0.044), and IOD-4 to IOD-3 (p = 0.018). Mean PPD was 3.8 mm (SD: 0.69; range 2.5–5.3), 3.5 mm (SD 0.59; range 2.33–5), and 3.2 mm (SD 0.56; range 2–4) for IOD-6, IOD-4 and IOD-3, respectively, and differed significantly between IOD-6 and IOD-3 (p = 0.029). Incidence of peri-implantitis was 1%. No differences were seen for complications between groups. (4) Maxillary IOD supported by four to six implants is the most reliable treatment regarding implant survival and peri-implant health. More research is needed in the clinical outcomes, in particular the peri-implant health, and complications of maxillary IODs, especially with a reduced number of implants.

Incidence of peri-implant mucositis and peri-implantitis in patients with a maxillary overdenture: A sub-analysis of two prospective studies with a 10-year follow-up period.

BackgroundThough studies on maxillary overdentures show satisfying results on implant survival, patient‐related outcomes and prosthetic complications, the epidemiology of peri‐implant diseases in this specific group of patients has hardly been reported. While the general patient‐level prevalence of peri‐implant mucositis and peri‐implantitis are estimated at ~45% and ~20%, respectively, the risk of developing these diseases within a specific period is less clear. To fully appreciate the epidemiology of peri‐implant diseases, more long‐term data on incidence of peri‐implant diseases are needed.PurposeThe purpose of this sub‐analysis of two prospective studies was to assess the incidence of peri‐implant mucositis and peri‐implantitis in fully edentulous patients with implant‐retained maxillary overdentures during a 10‐year follow‐up period.Materials and MethodsOne hundred and sixteen patients treated with implant‐supported maxillary overdentures were available from two clinical trials. Data on biological complications, clinical and radiographical parameters were collected for 106 patients at 5‐year, for 82 patients at 10‐year follow‐up. The incidence was calculated following the consensus of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions. Extent and severity then were calculated to enable an appropriate epidemiological description of peri‐implantitis.ResultsThe patient‐level incidence of peri‐implant mucositis was 37.7% after 5 years and 64.6% after 10 years whereas the patient‐level incidence of peri‐implantitis was 10.4% after 5 years and 19.5% after 10 years. After 10 years, the extent of peri‐implant mucositis and peri‐implantitis is 52.8% and 43.8%, respectively. In terms of severity, 26.5% of all affected implants suffered from >3 mm bone loss and 17.6% of all affected implants was lost.ConclusionThree of five fully edentulous patients with implant‐supported maxillary overdentures experience peri‐implant mucositis after 10 years. Peri‐implantitis occurs in one of five patients after 10 years. In spite of these incidence rates, implant survival remains high.

Implant and prosthesis failure rates with implant-supported maxillary overdentures: a systematic review.

To assess the clinical outcomes of maxillary overdentures supported by dental implants by conducting a literature review. An electronic search was undertaken in March 2019. Eligibility criteria included publications reporting cases of implant-supported maxillary overdentures with follow-up information. A total of 131 publications were included (1,478 overdentures supported by 6,681 implants). The mean number of attachments per overdenture was 3.8 ± 1.2 (range: 1 to 9), and a bar-clip system was used in about half of the cases. The prostheses were followed up for a mean of 47.9 ± 32.8 (range 1: to 240) months. A total of 401 implants (6.0%) failed in 219 patients (14.8%), and 55 prostheses (3.7%) failed at a mean of 40.2 ± 53.2 (6 to 240) months after placement. Most of the failures happened within the first year after placement for both implants (52.1%) and prostheses (41.8%). Patients with fewer implants per prosthesis presented higher prosthesis failure rates than patients with more implants per prosthesis. The cumulative survival rate for dental implants after 19 years was 70.4%, and for implant-supported maxillary overdentures was 79.8%. Presence of palatal coverage and/or metallic structure/reinforcement does not seem to have an influence on failure rate. Of the most commonly used attachment systems, the ball/O-ring and the Ceka were the ones with the highest rates of patients having at least one implant failure. Most of the prosthesis failures were due to loss of implants, and the first year was the most critical period for failures. The number of dental implants placed per patient seemed to have an impact on the occurrence of overdenture failure.

Cost-Effectiveness of Maxillary Implant-Supported Overdentures Compared to Complete Dentures and Implant-Supported Fixed Dental Prostheses-A Systematic Review

Purpose: Implant-supported restorations are well-documented treatments from a clinical perspective. Analysis of their cost-effectiveness is however limited, especially for implant-supported overdentures. The objective of this systematic review was to assess the literature on cost-effectiveness regarding maxillary implant-supported overdentures compared to complete dentures and fixed implant-supported restorations.

How many implants are necessary to stabilise an implant-supported maxillary overdenture?

Data sources Pubmed and EMBASE databases were searched from 2000 to 2017 and complemented by manual searching of the references of reviews and the full-text articles assessed for inclusion.Study selection The inclusion criteria were: (i) Randomised clinical trials (RCT), prospective or retrospective studies, and case series or case reports including at least ten totally edentulous patients rehabilitated with maxillary implant-supported overdenture; (ii) analysed one of the following outcomes: survival rate of the implants, survival rate of the overdenture and patient-reported results; (iii) had at least two years of follow-up; (iv) and were written in English language.Data extraction and synthesis The data extraction was performed by two independent reviewers. The comparison of the analysed outcomes was performed by nonparametric Fisher Test for unpaired data according to the number of implants and to the splinting technique. A meta-analysis was performed for the odds ratio (OR) for implant failure between four splinted implants and more than four splinted implants.Results Twenty-eight studies were included in the systematic review. The survival rate of implants appeared to be higher when at least four implants were placed to support the overdenture, compared to less than four implants. The survival rate of overdentures and the patient satisfaction were not influenced by the number of implants.The metanalysis could only be performed to compare the implant survival rate of a four splinted implants group and more than 4 splinted implants group, without significant differences between both groups (OR = 0.39; 95 % CI: 0.14, 1.14; p = 0.09).Conclusions Although the placement of at least four implants to support a maxillary overdenture seems to report higher implant survival rates, further studies are needed to confirm this conclusion. No differences were found for overdenture survival rates or patient satisfaction according to the number of implants.

A Comparative Study Between Telescopic and Ball and Socket Attachments Used for Maxillary Implant Supported Single Dentures

Purpose: This study was conducted to compare between maxillary implant-supported overdentures retained by telescopic and ball and socket regarding retention. Material and Methods: seven male patients had completely edentulous maxilla free from any systemic disease that might affect bone metabolism was selected to participate in this study. Each patient received four dental implants in the edentulous maxilla using computer guided surgical stent. Implants had enough antero-posterior spread so that load can be distributed equally. Once the implant osseointegration appears to be satisfactory, the maxillary four implants were loaded with two different attachments as follow; Group I: All patients received maxillary single denture retained with ball and socket attachments and used it for three months. Group II: After a wash up period of two weeks, all patients received another newly constructed maxillary single denture retained with telescopic attachments and used it for another three months. Retention of both groups was measured using universal testing machine. The assessment was made at time of insertion, one month and three months follow-up period. Results: Group II showed higher retention values compared to Group I. Conclusion: ball and socket attachment as well as telescopic attachment showed decrease in retention but telescopic attachment revealed a higher score than ball attachment due to frictional retention.

Maxillary implant-supported overdenture with magnetic attachment using healing abutment: A case report

Maxillary implant-supported overdenture with magnetic attachment using healing abutment: A case report

Effects of attachment type and palatal coverage on oral perception and patient satisfaction in maxillary implant-supported complete denture patients.

The effect of oral rehabilitation on the oral perception of implant-supported overdenture patients is a concern. This study evaluated the effects of the attachment type and palatal coverage on oral perception and patient satisfaction in maxillary implant-supported complete denture patients. The correlation between oral perceptual ability (OPA) and patient satisfaction in three groups was investigated. Group I consisted of dentate individuals (n = 40), Group II consisted of maxillary implant-supported complete denture patients with bar attachments and palatal coverage (n = 12), and Group III of maxillary implant-supported complete denture patients with magnetic attachments and palatal coverage (n = 14). In addition, implant-supported maxillary overdentures with bar attachments, with (Group II; n = 12) and without (Group IV; n = 18) palatal coverage, were examined in terms of patient satisfaction and OPA. The relationship between OPA and patient satisfaction was assessed with the Turkish version of the Oral Health Impact Profile-14 (OHIP-TR-14) satisfaction survey. To compare oral sensory function among the groups, tactile awareness and pressure awareness were assessed. There was no significant difference in OHIP-TR-14 scores between Groups II and III. In addition, there was no correlation between oral tactile function and patient satisfaction in Groups II and III. For patients with maxillary bar-retained implant-supported overdentures, palatal coverage did not affect the correlation between OPA and patient satisfaction, lateral pressure threshold, or tactile thickness threshold. According to the results of the study, whether maxillary implant-supported overdentures were made with a bar- or magnetic-type retainer, and whether bar-retained implant-supported overdentures had an open or closed palate did not affect the correlation between patient satisfaction and oral perception.

Mechanical Study of Optimal Implant Position for Maxillary Implant-Supported Overdentures Using Three-Dimensional Simulation Software.

The purpose of this study was to determine the optimal positioning of implants for maxillary implant-supported overdentures (MIODs) using finite element analysis (FEA). Three-dimensional (3D) finite element models were built incorporating the maxilla, mucous membrane, removable denture, and artificial teeth using FEA software. Four models were prepared: one without an implant; one with two implants in the region of the lateral incisor; one with two implants in the first premolar region; and one with four implants in the lateral incisor and first premolar regions. Occlusal load was applied to the model, and denture displacement and the distribution of stress in the surrounding bone and mucous membrane were observed and measured. The maximum equivalent stresses to the bone and mucous membrane were highest in the premolar and anterior areas, respectively. Stress to the bone was concentrated around the implants, whereas stress in the mucous membrane was concentrated along the posterior margin. Denture displacement in the anterior direction was highest in the model without implants, while denture displacement in the posterior direction was less affected by the presence of implants. Overall, denture displacement in the four-implant model was smaller than that in the other models. Implant angle affected the stress distribution, with highest stress to the bone when the implant was positioned in a palatal direction and highest stress to the mucous membrane when placed mesially. However, implant angle had little impact on denture displacement, with almost the same stress for implants at all tested angles. Optimal implant position can stabilize overdentures and reduce stress to the bone and mucous membrane. Stress is reduced when implants are inserted in the premolar area and when the direction of the implant is perpendicular to the occlusal plane.

Does the retention system influence the stability of implant-supported maxillary overdentures? A comparison with fixed and conventional dentures

PurposeThe purpose of this in vitro study was to compare the stability of removable implant-supported maxillary overdentures with fixed complete dentures and conventional dentures. MethodsFour types of complete dentures were tested: conventional complete dentures; overdentures retained by a male resilient attachment system; overdentures retained by a combination of clip bar and attachment system; and fixed complete dentures. Each group was placed in the posterior and anterior region and the stability was recorded by measuring the vertical displacement of the prosthesis. ResultsThere was a difference in the vertical movement of the prosthesis according to the type of system. The results showed that the behavior of the overdenture retained by a combination of a clip bar and attachment system is comparable with the stabilization of an implant-retained fixed complete denture. ConclusionsOverdentures retained by a combination of a clip bar and attachment presented better stability and retention capacity under our experimental conditions, close to that of the positive control (fixed complete denture), with the advantages of removable overdentures.

Retention and Stability of Rigid Telescopic and Milled Bar Attachments for Implant-Supported Maxillary Overdentures: An In Vitro Study.

This study aimed to evaluate and compare the retention and stability of rigid telescopic and milled bar attachments for implant-supported maxillary overdentures. An acrylic resin model of the edentulous maxilla without alveolar undercuts was fabricated, and four implants were inserted in the canine and second premolar areas of the model. Two experimental overdentures were constructed and connected to the model with either rigid telescopic (RTA) or milled bar (MBA) attachments. Resistance of overdentures to axial and nonaxial (anterior, posterior, and lateral) dislodging forces was measured to represent retention and stability, respectively. Measurements were made at the beginning of the study (initial retention) and after 540 cycles of denture insertion and removal (retention after wear simulation). After wear simulation, MBAs recorded significantly higher retention (P < .001) and stability against anterior dislodging (P < .001) than RTAs. RTAs recorded significantly higher stability against posterior (P = .022) and lateral (P < .001) dislodging than MBAs. Initial stability of RTA against anterior (P < .001) and posterior (P < .001) dislodging was significantly higher than stability after wear simulation. Retention of RTAs (P = .020) and stability of MBAs against posterior (P = .038) and lateral (P = .020) dislodging after wear simulation were significantly higher than initial values. MBA was associated with increased retention of maxillary implant overdentures compared with RTA, while RTA was associated with increased stability compared with MBA.

Maxillary Implant-Supported Over-Denture, Role of Attachment Selection on Treatment Success Rate: A Literature Review

Objectives Maxillary implant-supported over-denture is a suitable treatment where conventional denture cannot be used. Few studies are available on maxillary over-denture while more are available on mandibular over-denture with no literature referring to attachment selection in maxillary over-dentures. The objective of this literature review was to see attachment selection strategies in maxillary over-denture and its effect on success rate several successes contributing factors were noted including survival rate, marginal bone loss, soft tissue problems, fracture, and retention of maxillary over-denture. Methods This review study was conducted on available article discussing maxillary implant over-denture. An online comprehensive search was performed on PubMed, Scopus, ScienceDirect, and Google Scholar is using the following key words “implant supported over-denture” and “attachments” from 2000 to 2016, with total 78 articles being obtained. Results Studies including the attachment selection and maxillary implant over-denture were prioritized. Articles that were not peer reviewed were excluded. In total 78 articles were included for initial evaluation among which, with only 35 articles were judged as related to maxillary Over-denture topic and used for evaluation and report. Conclusion Based on the reviewed articles result, the attachments type has a profound effect on the overall success rate. The number and position of implants and corresponding soft tissue are also influenced by attachment selection.

Stress Distribution in Splinted and Unsplinted Implant-Supported Maxillary Overdentures: A 3D Finite Element Analysis.

This study was accomplished to assess the biomechanical state of splinting in implant-supported maxillary overdentures. Two models of maxillary overdentures were designed in SolidWorks 2011. The first model included 4 separate implants and ball abutments, whereas the second one included 4 splinted implants connected with a bar. Evaluation was performed in ANSYS Workbench software with 200 N load applied at the molar-premolar region, bilaterally. The maximum equivalent stress and strain (von Mises) was recorded and analyzed along a path between the implants in the crestal bone and the prosthetic attachments. First model presented higher values of strain in prosthetic attachment and higher values of von Mises stress in crestal bone. The second model presented higher stress concentration in the gingival tissue of premolar area (near the bar), whereas the peak stress values were reported within the most distal part of the soft tissue support of the prosthesis in the first model (unsplinted). Splinting maxillary overdentures implants is associated with significant lower stress levels in the surrounding bone tissue.

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.