Overdenture Patients Research Articles

Nocturnal wearing of complete dentures and obstructive sleep apnea: A meta-analysis

Statement of Problem: Improvement in outcomes of obstructive sleep apnea (OSA) could answer the question of whether nocturnal wearing of removable complete dentures is beneficial. Purpose: To evaluate the available literature that compares nocturnal wearing of removable complete dentures or overdentures in patients diagnosed with OSA on the Apnea–Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), quality of sleep (Pittsburgh Sleep Quality Index [PSQI]) and other outcomes. Methods: Registration of the proposed protocol was done in an open-source registry. Databases (Medline, Embase, and Cochrane Central Register of Controlled Trials) were searched until August 2024. All the reports were screened by reading the abstracts and full texts by two independent reviewers and conflicts were resolved by the third reviewer in Covidence. Data extraction and risk of bias assessment as per the Risk of Bias 1.0 tool (RoB 1.0) were done in Covidence. Mean difference and risk ratios were used as effect measures for continuous and dichotomous outcomes. Statistical analysis was performed using a fixed effect model. The certainty of evidence was judged by the GRADE approach. Results: Out of 2428 available reports, three randomized controlled trials were included for statistical analyses involving a total of 123 participants. The pooled estimate for AHI showed no evidence of any difference with and without nocturnal wear of removable complete dentures (MD: 2.88; 95% confidence interval [CI]: 0.94 to 6.70; 246 participants). No evidence of any difference was found for PSQI (MD: 0.20; 95% CI: -0.97 to 1.37; 138 participants) and for ESS (MD: 0.20; 95% CI: -1.60 to 1.20; 138 participants). Conclusion: The review found insufficient evidence to judge that nocturnal wearing of removable complete dentures was effective in patients with OSA measured by Apnea Hypopnea Index, PSQI, and Epworth sleepiness scale.

Interdisciplinary Rehabilitation of Overdenture Patients: A Case Report

Interdisciplinary Rehabilitation of Overdenture Patients: A Case Report

Synergistic effect of nicotine on different implant platform design in implant-assisted mandibular overdenture, 1- Year clinical and radiographic study

Background In implant therapy, peri-implant bone loss has been noticed mainly in the first year after prosthesis insertion. This bone loss can sometimes jeopardize the outcome of the treatment. Different implant platform designs are widely used in implant dentistry; however, its influence on the health of the surrounding soft tissues and marginal bone level alterations in implant-assisted overdentures particularly in smoker patients, remains inconclusive. The purpose of this study will be to evaluate the effect of nicotine on different implant platform designs in complete mandibular implant-assisted overdenture patient. Materials and methods Ten male smoker patients were selected for this study. Split mouth study design will be used in this study where, Group I represented the right side of the patients’ mandibular interforamenal region restored with platform-switched implant and Group II represented the left side of the patients’ mandibular interforamenal region restored with nonplatform swithched implants. The patients received complete mandibular assisted overdenture with O-ring attachment. Clinical and Radiographic evaluations were carried out for every patient at regular recall visits at the time of insertion, 6, and 12 months. At the end of the study, all implants of both groups were successfully osseointegrated. The data of this study were collected, tabulated, and statistically analyzed by IBM-SPSS statistics software (Independent T-test Samples). Result There were insignificant differences between both groups regarding plaque index (PI), bleeding index (BI), pocket depth (PD) and stability of the implants. Radiographically, there were significant differences in the mandibular bone density at the bone implant interface and marginal bone loss between both groups. Group I implant represented less marginal bone loss and higher bone density than Group II implants. Conclusion In smoker patient Platform-Switched dental implant is the implant of choice to control marginal bone loss around implants.

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.

Prosthetic Oral Rehabilitation with CAD/CAM Suprastructures in Patients with Severe Tissue Deficits: A Case Series.

This article presents the outcomes of prosthetic oral rehabilitation using CAD/CAM telescopic bar overdentures in patients with oral cancer (n = 3), severe facial trauma (n = 2), or various syndromes (n = 1), all suffering from severe tissue deficits and requiring complex and comprehensive oral rehabilitation. The aim was to assess the durability and functionality of implant-retained prosthetic structures, ensuring easy oral hygiene and minimizing specialized follow-up needs. The data for this study were sourced from a retrospective cohort at Helsinki University Hospital. The prosthetic reconstruction encompassed the Atlantis 2in1 and the Createch removable telescopic systems. Thus, 40 implants were placed (4 to 7 per patient), with prosthetic structures in the maxilla (n = 4 patients), in the mandible (n = 1), and in both jaws (n = 1). Two patients experienced no complications, two patients had part of the acrylic resin break, and one patient experienced loosening of the bar structure. All complications associated with prosthetic structures were successfully managed, and none of the implants were lost. The follow-up time ranged from 7 to 126 months. This rehabilitation is proved to be an effective solution for patients with complex oral conditions, facilitating both functional restoration and ease of maintenance. These findings underscore the importance of individualized treatment approaches in cases of tissue deficits.

Histomorphometric Analysis of Flaplessly Placed and Early Loaded One-Piece Mini Dental Implants in Overdenture Patients.

Mini dental implants (MDIs) are an affordable alternative for overdentures in medically compromised patients with reduced bone volume. This human study reports the histomorphometric analysis of early loaded and flaplessly placed tapered, one-piece MDIs (ILZ, Southern Implants; Sa: 1.5 μm) after 7 to 11 months in function. Patients agreed to have an additional MDI placed and removed for evaluation. MDI stability was assessed via Periotest prior to implant removal. Histologic sections of four mandibular and three maxillary MDIs with surrounding bone were processed, and the bone-to-implant contact (BIC) was analyzed. At retrieval, the MDIs were in function for more than 6 months, were clinically healthy, and had mean probing pocket depths of 1.4 mm and 1.6 mm in the maxilla and mandible, respectively. Periotest values were < 5.5, indicating clinical stability. Most of the screw threads were filled with bone and revealed an intimate BIC, without any signs of intervening fibrous tissue layer. In both arches, the mean BIC was 68.5%. Large osteocytes could be identified in the calcified tissue, indicative of mature peri-implant bone. It can be concluded that MDIs, when loaded within 2 weeks in either arch, provide proper clinical stability and high BIC after 6 months.

Evaluation of crestal bone loss around implants at different time periods in mandibular implant overdenture patients

Background and Aim: Crestal bone loss around dental implants is an inadvertent phenomenon. Many clinical measures have been proposed for this dilemma. This study was conducted to evaluate the crestal bone loss around implants at different time periods in mandibular implant overdenture patients. The study was completed in one year follow up timing. Materials &amp; Methods: Total 15 patients were selected for implant overdenture rehabilitation therapy including male and female patients. Complete dentures were fabricated by standard manner and delivered. Two implants were placed in each patient bilaterally. Group I consist of the implants placed in the right side of mandible while and Group II consist of implants placed in the left side of mandible. The mesial, distal, buccal and lingual bone level around the dental implants was evaluated in detail by advanced radiographic technique CBCT. These CBCT assessments were performed after 3 months, 6 months, 9 months and 12 months timings. P value less than 0.05 was considered significant (p&lt; 0.05). Statistical Analysis and Results: Statistical analysis was conducted by using statistical software Statistical Package for the Social Sciences.

Prosthetic complications and maintenance of different attachments used to stabilize mandibular 2-implant overdentures in patients with atrophied ridges. A 5-year randomized controlled clinical trial.

This randomized clinical trial aimed to evaluate prosthetic complications and maintenance of different attachments used to stabilize mandibular 2-implant overdentures in patients with atrophied ridges. Ninety edentulous patients with a maladaptive capacity of wearing conventional dentures due to mandibular ridge atrophy received 2-implants in the canine regions using computer-guided surgery. The patients were randomly assigned into three groups; (1) Bar group: overdentures were connected to the implants with bar/clip attachments, (2) Telescopic group: overdentures were connected to the implants using a resilient telescopic attachment, and (3) Stud group: overdentures were connected to the implants with resilient stud (Locator) attachments. Prosthetic complications of attachments, mandibular overdentures, and maxillary dentures, and soft tissue complications of mandibular overdentures and maxillary dentures were evaluated 1 year (T1), 3 years (T3), and 5 years (T5) after denture insertion. The majority of prosthetic and soft tissue complications for all groups occurred in the first year. The most frequent prosthetic complication was wear/distortion of retentive components of locator and telescopic attachments and activation of clips of bar attachment. The bar group showed the highest incidence of overdenture relines, fractures, hyperplasia, maxillary denture mucositis, and soreness. The telescopic group showed the highest incidence of screw loosening, teeth wear/fracture, maxillary denture relines, fractures, teeth wear, teeth separation, and flappy ridges. The stud group recorded the highest incidence of wear and replacement of retentive components. For 2-implant overdentures in patients with atrophied mandibles, bar attachments showed the highest incidence of complications related to mandibular overdentures, telescopic attachments showed the highest incidence of complications related to maxillary dentures, and stud attachments showed the highest incidence of complications related to the attachment components.

Evaluation of the Effects of Attachment Type and Implant Number on Life Quality of Implant-Supported Mandibular Overdenture Prosthesis Patients

Objective: The current study aimed to evaluate the life quality of implant-assisted mandibular overdenture patients who have had additional implant applications and were rehabilitated with ball or bar attachment. Material and Methods: 53 patients who came to Van Yüzüncü Yil University, Faculty of Dentistry, Prosthodontics Clinic for implant-supported mandibular overdenture treatment between 2019 and 2021 were included in this prospective clinical study (32 females, 30 males; mean age: 64.03; age range: 33-90). The patients were called back for the study precisely one year after prosthetic loading of their implants. Implant-supported mandibular overdenture prosthesis patients diverged into six groups: splinted two implants (bar attachment), single two implants (ball attachment), splinted three implants (bar attachment), single three implants (ball attachment), splinted four implants (bar attachment) and single four implants (ball attachment). And they asked for completing the Turkish version of the OHIP-14 questionnaire. Results: Ball attachment was used in 45.28% of the participants, a mandibular overdenture design supported by a bar attachment was preferred in 54.72%. Kruskal-Wallis test results indicated that the number of implants had a statistically significant effect only on functional limitation and psychological disability among the seven OHIP-14 categories evaluated (p=0.018, p=0.009). Accordingly, the average functional limitation score in individuals with four implants was 4.44 ± 1.89. Conclusion: We found that there are a positive correlation between the number of implants and the patient's life quality; however, it can be concluded that attachment type does not significantly affect the scores of the life quality

Comparing the functional efficiency of tooth-supported overdentures and implant-supported overdentures in patients requiring oral rehabilitation: A systematic review

Comparing the functional efficiency of tooth-supported overdentures and implant-supported overdentures in patients requiring oral rehabilitation: A systematic review

Bar versus resilient stud anchors used for immediately loaded 2 implants assisting overdentures in patients with history of periodontitis. One-year randomized controlled clinical study.

Bar versus resilient stud anchors used for immediately loaded 2 implants assisting overdentures in patients with history of periodontitis. One-year randomized controlled clinical study.

One-year prospective study on single short (7-mm) implant overdentures in patients with severely resorbed mandibles.

This prospective study aimed to assess the effectiveness of using a single short implant to retain a single-implant mandibular overdenture (SIMO) in participants with severely atrophic edentulous mandibles. The study sample included 18 edentulous participants with severely resorbed mandibular ridges and limited bone height in the symphyseal region sufficient for the insertion of a 7.0-mm-height implant. First, patients received new conventional dentures or had their dentures relined, followed by the insertion of a 3.75x7mm morse-taper implant, and the incorporation of a stud-type attachment and a nylon retentive insert after a 3-month healing period. Implant stability quotient (ISQ) was measured at baseline and after 3 and 12months. Patient-reported outcomes (satisfaction with the dentures and oral health-related quality of life) were assessed before implant placement and at the 3-, 6-, and 12-month follow-ups. Clinical-radiographic outcomes and the incidence of prosthodontic events were assessed throughout the follow-up period. The implant survival rate was 100%. ISQ increased from baseline (72.7±6.6) to the 3-month (82.0±3.3) and 1-year (85.4±2.9) follow-ups (p<.001). After 1year, satisfaction with the mandibular prosthesis increased significantly, and the overall OHIP-Edent score decreased by 79.2%. No effects were found for the maxillary denture (p=.420). Due to dissatisfaction with treatment, two participants (11.1%) required additional implants after the 1-year follow-up and were considered as prosthodontic failures. Single-implant mandibular overdenture retained by a short implant showed favorable outcomes after 1year. Further studies with larger samples and longer follow-up periods are needed to confirm the findings of this single-group prospective study. The present study was registered at the Brazilian Clinical Trials Registry (REBEC), identifier RBR-7p2xmg. The trial registry occurred during the study execution, and its final approval was delayed because of several formatting adequacies required by the platform REBEC.

General health of patients receiving an implant-retained overdenture. A cross-sectional study

Although ample research has been done on implant-retained overdentures, little is known about the age, health aspects and socio-economic status of patients receiving an implant-retained overdenture for the first time. Therefore, a big data study was set up, in cooperation with Vektis (a Dutch national database for all insured and claimed healthcare), with the aim of investigating the aspects mentioned earlier in patients who received implant-retained overdentures between 2009 and 2016. The study showed that these overdentures were predominantly made for the lower jaw, using a bar attachment system. It also showed they were mainly used for relatively young (55- to 75-year-olds) and healthy patients. It was concluded that relatively few implants are placed to support implant-retained overdentures in patients over 85 years of age and in those with diabetes mellitus, although neither are contraindicated.

Biologic and prosthetic complications with two versus four mini-implants supporting mandibular overdentures in patients with knife edge ridges. One-year results of randomized controlled clinical trial

the aim of clinical trial was to evaluate biologic and prosthetic complications with two versus four mini-implants supporting mandibular overdentures in patients with knife edge ridges. Twelve edentulous participants (6 men and 6 women, mean age =58.47 years) were randomly assigned into 2 groups; Group 1(control); included six participants who received four mini dental implants equally distributed in the interforaminal area of the mandible. Group 2 (study); included six participants who received two mini dental implants the canine area of the mandible. For both groups mandibular dentures were connected to the implants by O-ring attachments. The incidence biologic and prosthetic complications (related to the implants/attachments and to the overdentures) were measured from base line 12 months after overdenture insertion and compared between groups. Results: The implant survival rate, peri-implantitis, pocket depth >3mm, bone loss >1mm, separation of the metal housing from the denture base, teeth fracture, overdenture fracture, and denture relinings did not significantly differ between groups. The 4-implant group showed significant higher pain, edema, peri-implant mucositis, teeth wear, and denture border adjustments than the two implant group. The 2-implant group showed significant higher abutment bending /fracture, O/ring wear/ distortion, and O/ring damage/replacement than the 4-implant group 2 mini-implants may be a suitable alternative to 4-mini-implants when used to retain mandibular overdentures as it was associated with reduced pain, edema, peri-implant mucositis, teeth wear, and denture border adjustments. However, 2-mini-implants are associated with increased prosthetic complications related to attachments as abutment bending /fracture, O/ring wear/ distortion, and O/ring damage/replacement.

Evaluation of Oral Health Related Quality of Life in Different Telescopic Two-implant Supported Mandibular Overdenture

AIM: The purpose of the study was to evaluate patient’s oral health related quality of life using oral health impact profile (OHIP14) in rigid and non-rigid telescopic two-implant supported mandibular overdenture patients. METHODS: Twelve completely edentulous patients received two mandibular interforaminal implants to retain telescopic overdenture opposed by maxillary complete denture. Group I (six patients) had rigid telescopic connection and Group II (six patients) received non-rigid telescopic attachments. OHIP14 questionnaire was translated in Arabic and orally asked the patients, answers were collected soon after denture insertion and use (within 1 week), 6 and 12 months after using the overdenture to assess patient’s quality of life. RESULTS: There was no statistical significant difference regarding quality of life using OHIP14 questionnair between the two groups. CONCLUSION: Telescopic two-implant mandibular overdenture showed high quality of life, great satisfaction, and acceptance among patients; regardless to the type of attachments rigid or non-rigid.

Evaluation of Changes in the Mechanical Properties of O-Ring in One Piece and Two Piece Ball Retained Implant Supported Overdentures: A Three-Year Retrospective Study.

The O-rings in ball retained overdentures deteriorate with time and need replacement to restore the retentive quality. We evaluated retrospectively the mechanical properties of O-rings after 3 years in function in 1 and 2-piece implant-supported overdentures. The O-rings were retrieved from one-piece (Myriad snap, Equinox-Straumann, 3.3 × 13 mm) and 2-piece (Neo Biotech, 3.3 × 13 mm) implant-supported overdenture patients. A total of 16 pairs of matrices were tested for wear, type of damage, and elasticity using Pin on Disc method, USB Digital Camera in 30× zoom and Universal Tensile Machine, respectively. The statistical analysis for independent groups were done with the Mann-Whitney U test. Assessment of used O-rings showed 84% more wear in the 2-piece system with an abrasive type of damage while 46% wear in the 1-piece system with a compressive type of damage. The O-rings in 1-piece system showed increase in elongation and maximum displacement to 2% and 7%, respectively, whereas the 2-piece system showed decrease in elongation and maximum displacement by 13% and 6%, respectively. In 1-piece system, the loss of retention was more with slow wear rate, and in 2-piece system, the wear resistance of O-rings decreased due to increased stiffness. Further studies to evaluate the changes in O-ring with increased sample size and at interval 1 year will pave way for insight into the progressive changes in the mechanical properties of an O-ring.

Immediate vs Conventional Loading of Mandibular Overdentures: A Comprehensive Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Clinicians treating overdenture patients need to know if immediate loading and conventional loading results in similar outcomes. This study aimed to perform a systematic literature search of studies comparing immediate and conventional loading of mandibular overdentures irrespective of the number of implants and conduct a meta-analysis of implant failure and marginal bone loss (MBL). A literature search of PubMed, ScienceDirect, Ovoid, Springer, and Google Scholar databases was performed for randomized controlled trials (RCTs) comparing immediate vs conventional loading of mandibular overdentures. The primary outcome was implant failure and the secondary outcome was marginal bine loss (MBL). A descriptive analysis was performed for other outcomes. Thirteen trials were included. Only one trial compared the immediate and delayed loading of single implant-supported overdenture. Seven trials used 2 implants, 1 trial used 3 implants while 4 trials used 4 implants. Meta-analysis indicated no statistically significant difference in implant failure and MBL between immediate and conventional loading of 2- and 4-implant supported overdentures. Descriptive analysis indicated no difference in peri-implant tissue indices, implant stability, and quality of life outcomes between the 2 loading protocols. There may be no difference in implant failure and MBL with immediate loading or conventional loading of 2- and 4-implant supported mandibular overdentures. Literature review indicates that there may be no difference in peri-implant tissue indices, implant stability, and quality of life outcomes between the 2 loading protocols. The overall quality of evidence is moderate. Further, adequately powered RCTs are required to strengthen the evidence.

A 5-Year Retrospective Study Evaluating Periodontal Health and Oral Health-Related Quality of Life of Implant-Supported Overdentures With Locator and Magnetic Attachments.

This study compared peri-implant vertical bone loss, the periodontal index, prosthodontic maintenance requirements and oral health-related quality of life (OHQoL) of patients using mandibular implant-supported overdentures with 2 different attachment systems after an average of 5 years of use. Sixteen mandibular overdenture patients with magnet attachments (group 3), 24 with implant-supported mandibular overdentures with Locator attachments (group 2), and 25 conventional complete denture patients (group 1) were included in the study. The existing at least 5 years old dentures of all patients were evaluated for prosthodontic maintenance by the same prosthodontist and the patients were administered the oral health impact profile-14-Turkish version (OHIP-TR-14) questionnaire. Peri-implant tissue health was evaluated clinically in terms of plaque scores, bleeding scores, probing depth, and gingival index. Radiographic evaluation was performed in terms of peri-implant vertical bone loss. Radiographic evaluations were performed 5 years after overdenture insertion. There were no statistically significant differences between the groups in terms of total OHIP-TR-14 scores (P > .05). Although the average vertical bone resorption measured in group 2 at the end of 5 years was 1.38 mm, there was an average vertical bone loss of 1.45 mm in group 3, but this difference was not statistically significant (P > .05). Among the periodontal health indicators, there were no statistically significant differences in the mean values for periodontal indexes. According to results of the study, there were no differences in peri-implant vertical bone loss in groups 2 and 3, in periodontal health in mandibular overdentures with groups 2 and 3, or between total OHIP-TR-14 scores of patients in all groups.

Postimplantation radiation therapy in head and neck cancer patients: Literature review.

There is no recommendation regarding the timing for implant surgery in patients with head and neck cancer (HNC) who require postoperative radiation therapy (RT). This systematic review focused on the literature about the outcomes of implants placed during ablative surgery in patients with HNC who underwent postoperative RT. Implants placed after radiation therapy and implants placed in reconstructed jaws were excluded. Four comparative studies involving 755 native mandible primary implants were analyzed. The survival rate with postimplantation RT was 89.6% vs 98.6% in patients with no additional radiation. The overall success of implant-retained overdenture in patients with RT performed postimplantation was 67.4% vs 93.1% in patients with implant surgery that was carried out 1 year after the completion of radiation therapy. Only five cases of osteoradionecrosis (ORN) of the jaw were reported. The outcomes for implant survival rates appear to be positive for irradiated implants.

Long term satisfaction and biological complications in overdenture patients non participating in a maintenance program

Long term satisfaction and biological complications in overdenture patients non participating in a maintenance program