Parafunctional Habits Research Articles

Temporomandibular treatments are significantly efficient in improving otologic symptoms

Symptoms of temporomandibular disorders (TMD) could be present as otologic symptoms like earache and dizziness in some patients. In most cases, these symptoms are not recognized because otolaryngologists fail to diagnose TMD as a source of the problem. This investigation was conducted to evaluate the effect of TMD treatments on the otologic symptoms which after taking history and clinical examinations seemed to be related to TMD. In the present study, the patients who were complaining of otalgia, ear fullness, tinnitus, hearing loss, and dizziness were evaluated by an ear fellow. Forty patients who had no known otologic or other primary causes to explain their symptoms, were referred to the orofacial pain clinic with the possible diagnosis of TMD. If the diagnosis was confirmed by an orofacial pain specialist, a combination of TMD treatments was administered to each case and the patients were followed up. The results showed that following implementation of treatment protocols for TMD, more than 50% of the patients reported complete or partial recovery in the second follow-up (p < 0.05). The most common otologic symptom of the referred cases was earache, and the most common associated complaint was neck pain. All the patients had one or more parafunctional habits. This study showed that TMD treatments were significantly efficient in improving otologic symptoms partially or completely and the authors concluded that for the patients with otolaryngologic unexplained symptoms, an overhaul examination is needed to assess TMD as a possible cause of the patient complaint. It is recommended that in cases with unexplained otologic symptoms, otolaryngologists care more about the neck trigger points (TP) and ask about the patient’s parafunctional habits. Otolaryngologists and dentists need to be aware of the risk of developing otologic symptoms caused by these habits or cervical TPs.

Tooth wear: intrinsic and extrinsic mechanical factors

Tooth wear, the progressive loss of dental hard tissue not caused by decay or trauma, is a multi-faceted phenomenon with implications for oral health and aesthetics. This article provides a comprehensive overview of both intrinsic and extrinsic mechanical factors contributing to tooth wear. Intrinsic mechanical wear from direct tooth-to-tooth contact leading to attrition, such as in bruxism, and extrinsic mechanical wear resulting from external actions, such as parafunctional habits including biting nails, chewing on pens, or the consumption of rough food elements and the use of overly abrasive dental products and aggressive toothbrushing, leading to abrasion. CPD/Clinical Relevance: Understanding the complex relationship between intrinsic and extrinsic mechanical factors is essential for clinicians to provide holistic dental care.

Study Regarding the Monitoring of Nocturnal Bruxism in Children and Adolescents Using Bruxoff Device.

Bruxism is a parafunctional activity represented by the gnashing and clenching of one's teeth. The aim of this study was to determine the utility of screening and monitoring with a Bruxoff device during nocturnal bruxism in 51 children and adolescents (36 with bruxism and 15 without bruxism) by assessing the variations in the intensity and duration of parafunctional activity in each patient. Bruxoff measurements were recorded for at least 60 min for three consecutive nights for each subject. All the parameters recorded using Bruxoff in the control and the study groups showed a statistically significant difference (p < 0.05). The differences found by comparing the values recorded in the male and female study groups are significant for heart rate, the number of masseter muscle contractions during one night, and mixed contractions. The Bruxoff device proved to be important in diagnosing patients with bruxism in our practice.

Impact of Personality Trait of Emotional Stability on Oral Parafunctional Habits

OBJECTIVES To find the impact of emotional stability on oral parafunctional habits. METHODOLOGY A Cross-sectional descriptive study was conducted at the College of Dentistry, Sharif Medical and Dental College, Lahore, over five months, from July to November 2021. Data was collected using a medical questionnaire and a ten-item personality inventory scale (TIPI). The medical questionnaire comprised two sections with 11 items. The first section had six demographic statements, including age, gender, marital status, occupation, educational level and medical condition. The second section consisted of a pre-validated parafunctional habits questionnaire. RESULTSThere was a non-significant difference in the scores of the personality trait of emotional stability across categories of oral parafunctional habits of nail-biting (p=0.093), tooth grinding (p=0.192), tooth clenching (p=0.055), biting on hard objects (p=0.17) and chewing gum (p=0.116). CONCLUSION Emotional stability was most prevalent in individuals who denied having the habit of nail-biting, teeth grinding, tooth clenching and biting hard objects but neither agreed nor disagreed with having the habit of chewing gum.

The impact of occlusal forces on the longevity of restorations

The longevity of dental restorations like fillings, crowns, and bridges is critically influenced by occlusal forces exerted during biting and chewing. These forces vary among individuals based on diet, masticatory habits, and the structural soundness of the dental arch and can range from 11 to over 450 Newtons, depending on circumstances. The choice of restorative material is important for withstanding these forces. While amalgam is durable, modern dentistry has shifted towards aesthetic restoratives such as composite resins and ceramics. However, these materials respond differently to occlusal forces. Ceramics might fracture under excess load, whereas composite resins resist wear but can degrade over time due to other factors. Precision in restoration is crucial to preventing undue occlusal forces that might lead to restoration failure. Tools like T-scan assist in this precision. The manner and distribution of occlusal forces, along with the health of the periodontal ligament, are critical for restoration durability. Bruxism, a parafunctional habit, can significantly impact restorations, necessitating protective measures like occlusal splints and patient education. The interplay of occlusal forces and the chosen restorative material greatly affects the success and lifespan of dental restorations.

PRÁCTICAS DE SALUD BUCAL DURANTE LOS PRIMEROS 1000 DÍAS DE VIDA: REVISIÓN DE LA LITERATURA

Objective: To conduct a bibliographic literature review on current good practices in oral health during the first 1000 days of life, encompassing the gestation period and the initial two years of the child. Materials and methods: A scientific literature review was conducted in February and March 2022, utilizing the Pubmed and Scopus databases. The inclusion criteria encompassed original articles and systematic reviews (with or without meta-analysis) published between 2016 and 2022. Search strategies incorporating English keywords derived from MeSH were employed. Additionally, the grey literature was reviewed to define some key concepts. Results: 72 scientific articles, and four references from the grey literature (one clinical practice guide and three reports) were selected. The identified themes were categorized as follows: good oral hygiene practices, good feeding practices for pregnant women and infants, parafunctional habits, and dental visits. Based on the findings, the key recommendations for promoting good oral health practices during this crucial period include the use of fluoride toothpaste for oral hygiene once teeth erupt, avoidance of free sugar consumption, encouragement of breastfeeding over bottle-feeding, and early dental visits before birth. Conclusion: Good oral health practices during the first 1000 days of life significantly impact the child’s oral and general health, necessitating preventive measures starting from gestation, with a focus on oral hygiene and nutrition. The collaborative efforts of a multidisciplinary healthcare team during pregnancy and the initial two years of life are vital for enhancing both oral and general health outcomes for the population.

Cheiloscopy patterns in individuals with and without parafunctional oral habits: A cross-sectional observation pilot study.

Lip prints are unique and have potential for use as a human identifier. The purpose of this study was to observe possible cheiloscopy differences of individuals with and without parafunctional oral habits such as smoking, vaping, playing a wind instrument or using an asthma inhaler. This IRB approved blinded cross-sectional observation pilot study collected lip prints from 66 individuals, three of which were excluded. Participants cleansed their lips, then lipstick was applied to the vermillion zones of the upper and lower lips. Adhesive tape was applied to the lips and prints were transferred to white bond paper for viewing purposes. Each set of included lip prints was divided into quadrants and dichotomized into a group of those with an oral parafunctional habit or with no such habits. Each quadrant sample was then manually analysed and classed according to the gold standard Suzuki and Tsuchihashi system. A total of 252 dichotomized lip print quadrants (with habits n = 76, 30.2%, and without habits n = 176, 69.8%) were analysed. Type II patterns were the most common for examined quadrant samples; however, no statistically significant differences (Pearson's chi-squared test, p = 0.366) were observed between pattern classifications of samples with and without parafunctional oral habits. There is no statistically significant difference of lip print patterns between individuals with and without parafunctional oral habits. Further research on populational variations is needed for cheiloscopy to aid in human identifications.

Etiology, Diagnosis and Treatment of Bruxism in Children: A Review of the Literature

Bruxism, a parafunctional habit often linked to stress, anxiety, or medical conditions, causes various symptoms such as jaw pain, headaches, tooth wear and potentially temporomandibular joint disorders. While bruxism is prevalent in children, the literature remains unclear on its characteristics in this age group, prompting further review and investigation. The prevalence and onset of bruxism in children varies greatly between different studies and populations, with rates ranging from 6.5% to 88% and while most studies do not report a significant difference between boys and girls, some have found higher rates in one gender or the other. Bruxism has multiple causative factors including dental malocclusion, temporomandibular joint problems, emotional and psychological disorders, sleep disorders, nutritional deficiencies, medical problems, stress and heredity. However, the correlations between these factors and bruxism are multifactorial and sometimes contradictory. Bruxism diagnosis relies on patient history, clinical examination and diagnostic criteria, with polysomnography for nocturnal cases and BiteStrip® devices as alternatives, while diagnosing children presents challenges due to the lack of valid diagnostic means and the inadvisability of polysomnography. The recognition of stressors and application of psychological stress reduction methods have also been found to have a significant effect in reducing or eliminating the signs of bruxism in children. Treatment approaches for childhood bruxism vary and may include dental information, correction of malocclusion, occlusal splints, drugs and psychological methods. The use of hard occlusal splints has been found to prevent dental wear and reduce the frequency of bruxism in some studies, but further research is needed. The aim of this review is to summarize the characteristics of bruxism in childhood.

Advanced Dental Rehabilitation in Case of Severe Tooth Wear Caused by Gastroesophageal Reflux Disease and Bruxism During COVID-19 Pandemia: A Case Report

Stomatological manifestations of psychosomatic diseases can be associated, culminating in advanced oral alterations. These psychosomatic changes have also increased during the COVID-19 pandemic. In this perspective, parafunctional habits, such as bruxism and clenching, and gastro-oesophageal reflux disease can develop major dental destruction. Thus, various types of treatment are required in the rehabilitation of these patients. The purpose of this article is to present the case of a patient who developed severe tooth wear due to the association between gastro-oesophageal reflux disease and bruxism, during the COVID-19 pandemic. The patient was treated with a bite raising, direct composite restorations and removable prostheses.

3D comparative evaluation and correlation of condylar morphology in bruxers and non-bruxers.

Parafunctional habits like bruxism may have a deleterious effect on the temporomandibular joint. It can lead to the alteration of condylar morphology which can further lead to temporomandibular joint disorders. The early three-dimensional evaluation may help detect morphological changes in the condyle and reduce the risk of developing temporomandibular disorders. It will also help to make patients aware of the condition and encourage prompt treatment of parafunctional habits. To do a 3-Dimensional comparative evaluation and correlation of condylar morphology in bruxers and non-bruxers. 90 patients with parafunctional habits will be evaluated on cone beam computed tomography in two groups (control group, study group) of 45 each, for alteration in condylar morphology based on the suggested classification. Results will be formulated based on the classification of condylar morphology. Evaluation of condylar morphology will be done on cone beam computed Tomography based on the amount of variation in condylar morphology in bruxers as compared to non-bruxers. Thorough clinical examination and early evaluation of condylar morphology on cone beam computed tomography will help early detection of changes in the morphology of condyle and prompt treatment to reduce the risk of development of temporomandibular disorders.

Bruxism in children: What do we know? Narrative Review of the current evidence.

Bruxism is a repetitive masticatory muscles activity whose definition is being thoroughly reviewed in recent years. As in adults, two different forms of bruxism exist in children, namely awake and sleep bruxism. Scarcity of data, however,still persists about paediatric bruxism and no clear consensus has been developed. Therefore, the current review overviews the literature on bruxism in children tries to outline the state of art about this condition METHODS: Bruxism affects from 5% to 50% of the worldwide paediatric population. Sleep disturbances, parafunctional habits and psycho-social factors emerged to be the most likely associated factors with paediatric bruxism. Bruxism is characterised by several signs and symptoms variously combined, such as tooth wear and fractures, teeth impressions on soft tissues, temporomandibular disorders, headaches, behavioural and sleep disorders. About diagnosis, the most reliable tool in children remains the report of teeth grinding by parents or caregivers which must be accompanied by oral interview and accurate clinical examination. Electromyography and sleep polysomnography, albeit suitable in the diagnostic process, are not easy-to-use in children and are not strongly recommended. Currently, no evidence exists to support any kind of therapeutic options for bruxism in children. Management should be based on the identification of the underlying condition and conservative approaches are recommendable. Notwithstanding the high prevalence, several aspects need to be further assessed in paediatric bruxism. Parental reports are still the most suitable diagnostic tool and conservative approaches are recommended in the management. Bruxism should be considered through a biopsychosocial model, and sleep, personality traits, stress and headaches are the factors towards whom research questions must be addressed to improve diagnosis and management.

Evaluation and Co-Relation of Temporomandibular Disorders Concerning Dental Anomalies in Adolescents and Early Adulthood

Temporomandibular joint disorder (TMD) is a complex, multi-factorial etiology. TMDs in the pediatric populationmay go unreported in most cases and can negatively impact their quality of life and their learning ability. To evaluate andcorrelate parafunctional habits in the causation of temporomandibular disorder in adolescents and early adulthood. 340 subjectswith adolescents and early adulthood from 6-18 years were included in the present study. Detailed parameters relevant to TMJdisorder, including the clinical examination findings, were recorded in the structured case sheet. Further, these subjects werecategorized into symptomatic and asymptomatic TMDs. Of the 340 study population, 194 (57%) were identified as suffering fromTMD. A significant difference was recorded in diet practice and oral habits with the patients suffering from TMDs (p&lt;0.05).There was a significant difference in the habits of symptomatic patients. A high prevalence of TMDs in adolescents and earlyadulthood was found in women with bruxism and nail-biting oral habits. Active screening of children with various predisposingfactors is recommended to aid in the early recognition and treatment of TMDs.

Risk factors for orthodontic fixed retention failure: A retrospective controlled study.

: To investigate the potential correlation between fixed orthodontic retention failure and several patient- and treatment-related factors. : Patients finishing treatment with fixed appliances between 2016 and 2017 were retrospectively included in this study. Those not showing fixed retention failure were considered as control group. Patients with fixed retention failure were considered as the experimental group. Additionally, patients with failure of fixed retainers in the period of June 2019 to March 2021 were prospectively identified and included in the experimental group. The location of the first retention failure, sex, pretreatment dental occlusion, facial characteristics, posttreatment dental occlusion, treatment approach and presence of oral habits were compared between groups before and after treatment separately by using a Fisher exact test and a Mann-Whitney U test. : 206 patients with fixed retention failure were included, 169 in the mandibular and 74 in the maxillary jaws. Significant correlations were observed between retention failure in the mandibular jaws and mandibular arch length discrepancy (P = 0.010), post-treatment growth pattern (P = 0.041), nail biting (P < 0.001) and abnormal tongue function (P = 0.002). Retention failure in the maxillary jaws was more frequent in patients with IPR in the mandibular jaws (P = 0.005) and abnormal tongue function (P = 0.021). : This study suggests a correlation between fixed retention failure and parafunctional habits, such as nail biting and abnormal tongue function. Prospective studies with larger study populations could further confirm these results.

Bruxism, parafunctional oral habits and oral motor problems in children with spastic cerebral palsy: A cross-sectional study.

Individuals with spastic cerebral palsy are more predisposed to parafunctional oral activities and oral motor problems because of spasticity. The aim of the study was to evaluate the relationship between the gross motor function classification system score (GMFCS), age, bruxism, parafunctional oral habits and oral motor problems in children with cerebral palsy. This cross-sectional study included 63 children with spastic cerebral palsy, aged 3-18 years, with developmental disabilities. The relationship between parentally reported bruxism, parafunctional oral activity rates, oral motor problems, and GMFCS was analysed. The prevalence of bruxism was 52.4%, and the rate decreased as age increased. There was a greater likelihood of bruxism in individuals with tongue thrust (OR [95% CI] = 8.15 [1.4-47.3]) and swallowing problems (OR [95% CI] = 5.78 [1.3-24.68]). In children with spastic cerebral palsy, bruxism and the rate of parafunctional oral habits were high, thus affecting oral motor activities. A relationship was found between oral motor problems and increased GMFCS levels, but no relationship was found between bruxism and GMFCS levels. Children with spastic cerebral palsy who display tongue thrust or swallowing problems have an increased likelihood of presenting with bruxism.

The use of esthetic-functional space maintainer in pediatric dentistry: a case report

The use of space maintainers in deciduous and mixed dentition is of significant importance as it helps prevent the development of malocclusions, including those resulting from early tooth loss, by preserving the necessary space for the eruption of permanent teeth. This study aims to report a clinical case of a 10-year-old female patient. The patient presented at the Pediatric Dental Clinic of the School of Dentistry at UFAM with the main complaint of dissatisfaction with her smile. During the anamnesis, the mother reported trauma to elements 51 and 61, and the clinical examination revealed prolonged retention of these elements and malocclusion. After the extraction of the retained elements due to delayed eruption of permanent teeth, the fabrication of a space maintainer appliance was indicated for esthetic and preventive purposes. A Hawley Plate was used for this purpose, and an acrylic tooth was added for esthetic purposes. After a 5-month period of appliance use, the central and lateral incisors erupted naturally in the mouth. This treatment approach resulted in the maintenance of the upper arch perimeter, providing the necessary space for permanent teeth to erupt, thereby preventing dental inclinations and space loss, avoiding the onset of deleterious oral and parafunctional habits, future complex malocclusions, and ensuring the patient’s aesthetic well-being.

Prevalence of Bruxism in Down Syndrome Patients: A Systematic Review and Metanalysis.

Bruxism is a parafunctional activity characterized by grinding or clenching of teeth and is a common oral health concern in individuals with Down syndrome (DS). Understanding the prevalence of bruxism in this population is crucial for developing effective management strategies. This systematic review and meta-analysis is aimed to investigate the prevalence of bruxism among individuals with DS and explore its association with other oral health issues; METHODS: A comprehensive search was conducted across multiple electronic databases to identify relevant studies. Cross-sectional and observational studies were included. Data on bruxism prevalence and associated factors were extracted, and a meta-analysis was performed using both fixed and random-effects models of MedCalc software. Heterogeneity among studies was assessed using I2 statistics. New Castle - Ottawa scale was used to evaluate methodological quality of the included studies RESULTS: Eight studies met the predefined inclusion criteria and were included in the analysis. Seven studies used a questionnaire to assess bruxism. The pooled proportion estimate for occurrence of Down's syndrome across the included studies was found to be 0.33 (95% CI: 0.22-0.45) as per the RE model and 0.35(95% CI: 0.31-0.450) as per FE model in the quantitative analysis. All studies exhibited good methodological quality CONCLUSION: This systematic review and meta-analysis provide evidence of a significant prevalence of bruxism among individuals with Down syndrome. The findings highlight the association of bruxism with other oral health issues and specific chromosomal abnormalities. Comprehensive oral health assessments, including diagnostic procedures like PSG, are essential for addressing the unique oral health needs of individuals with DS. Further studies are recommended with a valid tool for the diagnosis. Early interventions and management strategies need to be tailored to this population, considering the multifaceted nature of oral health concerns in individuals with DS.

Problematic media use is associated with poor oral health in Turkish school-age children: a pilot cross-sectional study

ObjectivesIn the recent years, problematic media use (PMU) has become a serious health concern for children. The precisely defined effects of PMU on children’s oral health are unknown. It was aimed to investigate the relationship between the PMU and oral health and oral habits in school-age children.MethodsIn this cross-sectional study, mothers and their healthy children aged 6–11 years who applied to pediatric dentistry outpatient clinic were enrolled. PMU was assessed using the parent-reported Problematic Media Use Measure Short Form (PMUM-SF). PMUM-SF scores were divided into 3 groups from the lowest to the highest tertile. Multivariable logistic regressions for PMU (moderate-high vs. low) were used to predict the odds of having good and parafunctional oral habits, poor oral hygiene, gingivitis and caries.ResultsTotally 153 mother–child pairs participated in this study. Plaque index, gingival index, ICDAS-II (International Caries Detection and Evaluation System), DMFT and DMFS [decayed (D), missing (M), filled (F) tooth (T) /surfaces (S)] scores were significantly higher in children with moderate-high PMU (P < 0.05). After adjusting for potential confounders, moderate-high PMU decreased the probability of good oral habit of daily toothbrushing [Odds (95% CI) = 0.43 (0.20–0.94)] while it increased the risk of oral parafunctional habit of object sucking/biting [Odds (95% CI) = 3.34 (1.27–8.74)]. Moderate-high PMU increased the risk of moderate-severe gingivitis, moderate-extensive caries and the presence of DMFT [Odds (95% CI) = 2.13 (1.01–4.50); 4.54 (1.11–18.54) and 2.16 (1.07–4.36), respectively].ConclusionsTurkish school-age children with a remarkable PMU were significantly more likely to have poor oral health and exhibit oral parafunctional habits Oral health screening seems to be needed for Turkish children experiencing PMU.

Clinical Relevance of Dental Parameters and Symptoms in Patients Suffering from TMD and Tinnitus and a Randomised Trial Measuring Symptom Relief after Using a Relaxation Device

Aim: Tinnitus is a common symptom in dental patients presenting with Temporomandibular Disorders (TMD). In this study, 66 patients were examined and underlying variations in dental appearance, jaw position, jaw joint health, radiographic findings, and symptoms were recorded. The patients were randomly placed into either an intervention or a control group to assess the effectiveness of a relaxation device aiming to reduce tinnitus. Method: 100 patients referred for TMD problems and suffering from tinnitus were asked to participate in the study. 66 patients completed two questionnaires before the first consultation with a specialist in orofacial pain and function and 46 of them completed the randomised trial. Results: TMD patients most likely to be suffering from tinnitus had experienced stress, felt tension in the jaw or presented with neck problems. Clinical dental examinations revealed that these patients displayed a deep bite, had a click or scrape sound from their jaw joints and/or had parafunctional habits (grinding or clenching their teeth). Patients in the relaxation device group reported significant improvement at p&lt;0.01 compared with control group after 4 months treatment. Conclusion: This study presents general clinical signs and criteria that also non-dental medical professionals can use as a guide for referring tinnitus patients for specialist dental care. Patients under stress who are clenching or grinding their teeth, have missing teeth, midline shift and experience sounds from their jaw joints could benefit from examination by a dental specialist and the use of a relaxation device.

Correlation between Functional Magnetic Resonance and Symptomatologic Examination in Adult Patients with Myofascial Pain Syndrome of the Masticatory Muscles

Myofascial pain syndrome is the most common cause of TMD, characterised by trigger points of skeletal muscles in the masticatory region. Patients with myofascial pain suffer from orofacial pain and headaches. Parafunctional activity such as unconscious teeth clenching predisposes a higher possibility of developing myofascial pain. We report the results of a prospective study of 10 patients with a myofascial pain diagnosis related to TMD who underwent treatment with passive aligners and biofeedback exercise. All patients underwent pain assessment (visual analogic scale and muscular palpation test), measurement of masseters thickness with Dolphin Imaging Software, nuclear magnetic resonance of the temporomandibular joint, and functional nuclear magnetic resonance of the brain before and after gnathological treatment. The same patients underwent pain assessment (VAS and palpation test) for the entire duration of their treatment. This study aimed to assess if the results obtained with the therapy were repeatable using functional magnetic resonance imaging. This enabled us to correlate a subjective datum (pain) to an objective one (variation in the functional connectivity of the networks correlated to pain perception). According to the pain assessment, the treatment considerably reduced the pain in 9 out of 10 patients. Furthermore, the functional nuclear magnetic resonance of the brain showed similar modifications in the cerebral pain and default mode networks in these nine patients. The change in the masseter muscle dimensions was not correlated with the modification of pain. Statistical analysis was performed to evaluate the effects of treatment on VAS and trigger point stimulation and on the length and width of the masseter muscle. Linear regression analysis was used to assess a correlation between the modification of the masseter muscle dimension and the amendment of VAS. A paired t-test was used to evaluate statistically significant differences in the connectivity of brain areas of the DMN and the pain network. Our results suggest that the proper treatment of myofascial pain can reduce pain and consistently modify the functional activation of the cerebral pain and default mode networks. Overall, the treatment was repeatable because brain network changes were homogeneous in all patients and did not relate to the intracapsular TMJ condition but only to pain symptoms.

Hybrid Prosthesis versus Overdenture: Effect of BioHPP Prosthetic Design Rehabilitating Edentulous Mandible.

To compare the BioHPP (biocompatible high-performance polymer) as a substructure for the hybrid prosthesis versus the BioHPP bar supporting and retaining implant overdenture by radiographic evaluation to identify bone height alteration around the implants and to evaluate satisfaction based on visual analoge scale questionnaire. Ill-fitting mandibular dentures were chosen for 14 fully edentulous male patients with adequate dental hygiene, enough interarch space, and free of systemic diseases and parafunctional habits. Patients who received new dentures (CDs) were randomly allocated into each group using computer software, and four interforaminal implants were inserted in parallel using a surgical guide. Three months after osseointegration, the patients received either CAD-CAM BioHPP framework hybrid prosthesis (Group I) or BioHPP bar supported and retained overdenture (Group II). Using digital preapical radiography, the bone loss is evaluated 6, 12, and 18 months after insertion. The subjective patient evaluation was done using a questionnaire based on the VAS includes five points for chewing, comfort, esthetics, speech, oral hygiene, and general satisfaction. The overall marginal bone loss (MBL) revealed that Group I (hybrid prosthesis) was more than Group II (bar overdenture) at all intervals in the anterior and posterior implants' mesial and distal surfaces. The patient satisfaction survey results showed that, after 18 months, the difference was statistically not significant between them all (P > 0.05) except for the comfort (for the overdenture group, 4.43 ± 0.53 while the fixed hybrid was 5.00 ± 0.00). BioHPP framework material is an alternative material for implant rehabilitation of edentulous mandible with minimal MBL in BioHPP bar overdenture compared to BioHPP hybrid prosthesis.