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Ye M, Liu W, Cheng S, Yan L. Immediate vs conventional loading of mandibular overdentures: A comprehensive systematic review and meta-analysis of randomized controlled trials. J ORAL IMPLANTOL 2020; 48:64-73. [PMID: 33206979 DOI: 10.1563/aaid-joi-d-20-00265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
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 two implants, one trial used three implants while four trials used four implants. Meta-analysis indicated no statistically significant difference in implant failure and MBL between immediate and conventional loading of two-implant and four-implant supported overdentures. Descriptive analysis indicated no difference in peri-implant tissue indices, implant stability, and quality of life outcomes between the two loading protocols.There may be no difference in implant failure and MBL with immediate loading or conventional loading of two and four-implant supported mandibular overdentures. Literature review indicates that there may be no difference in peri-implant tissue indices, implant stability, and QoL outcomes between the two loading protocols. The overall quality of evidence is moderate. Further, adequately powered RCTs are required to strengthen the evidence.
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Affiliation(s)
- Mingfu Ye
- Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment Department of Oral Implantology No. 1309, Lvling Road CHINA Xiamen Fujian 361008 Department of Oral Implantology, Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment
| | - Wenjun Liu
- Department of Oral Implantology, Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment
| | - Shaolong Cheng
- Department of Oral Implantology, Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment
| | - Lihui Yan
- Department of Oral Implantology, Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment
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Immediate or delayed loading protocols for two-implant mandibular overdentures: A systematic review and meta-analysis of randomized controlled trials. J Prosthet Dent 2020; 126:742-748. [PMID: 33139056 DOI: 10.1016/j.prosdent.2020.09.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/29/2020] [Accepted: 09/29/2020] [Indexed: 12/12/2022]
Abstract
STATEMENT OF PROBLEM The immediate loading protocol for 2-implant mandibular overdentures has been widely reported. Nevertheless, the clinical effects reported in different articles are quite different. PURPOSE The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to compare the clinical effects of immediate and delayed loading of 2-implant mandibular overdentures. MATERIAL AND METHODS The review followed the guidelines of Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). PubMed, Cochrane Library, Web of Science, Embase, Scopus, ScienceDirect, CBM, CNKI, and Wan Fang databases were searched electronically for RCTs published before March 25, 2020. Two authors independently conducted literature screening, quality assessment, and data extraction. The outcomes of interest were implant failure rate, marginal bone loss (MBL), implant stability quotient (ISQ), periotest value (PTV), and patient satisfaction. RESULTS A total of 2498 unduplicated records were identified. After full-text analysis, 7 eligible RCTs were included. All studies were followed for at least 12 months, and the meta-analysis was based on this. The meta-analysis showed that the implant failure rate in the immediate group was higher than that in the delayed group, but there was no statistically significant difference (I2=0%; n=7; risk difference [RD]=0.03; 95% confidence interval [CI]=-0.01 to 0.08). The difference of MBL between immediate and delayed loading was not significant (I2=88%; n=6; mean difference [MD]=-0.04; 95% CI=-0.16 to 0.24). Because of the limited articles reporting on ISQ, PTV, and patient satisfaction, no quantitative analysis was conducted for these outcomes. CONCLUSIONS Although the implant failure rate was more likely to favor the delayed group, available evidence indicates no statistical difference in implant failure and marginal bone loss between immediate and delayed loading protocols.
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Song SY, Kang KH, Lee JY, Shin SW. Effects of type of magnet attachment and implant angulation in two implant overdenture models. J Adv Prosthodont 2020; 12:33-37. [PMID: 32128084 PMCID: PMC7040452 DOI: 10.4047/jap.2020.12.1.33] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The purpose of this study is to evaluate the effects of type of magnet attachment and implant angulation in two implant overdenture models. MATERIALS AND METHODS Magnet attachments used in this study were flat and dome types (MGT5515, MGT5520D, Dentium Co., Seoul, Korea). Two implants with keepers were inserted in the resin blocks at a distance of 24 mm. For the first model, the implants were parallel to the vertical and perpendicular to the horizontal; for the second model, both were angulated 5 degrees to the mesial; for the third model, both were angulated 10 degrees toward the mesial. The retentive force was measured in both vertical and lateral directions. Statistical analyses were performed using SPSS software version 22.0 (α=.05). RESULTS The flat type magnet attachment showed the highest lateral retentive force in the 20° divergent group (P<.05) and the dome type magnet attachment showed the highest lateral retentive force in the parallel group (P<.05). The vertical and lateral retentive force of the dome type magnet attachment was greater than that of the flat type magnet attachment in every direction (P<.05). CONCLUSION Within the limitations of this study, the dome shape magnet attachment can resist vertical and lateral retentive force more superiorly than the flat type magnet attachment, regardless of angle, in the mandibular two implant model.
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Affiliation(s)
- So-Yeon Song
- Department of Biomedical Science, Graduate School of Korea University, Institute for Clinical Dental Research, Korea University Medical Center, Seoul, Republic of Korea
| | - Kyeong-Hwan Kang
- Department of Prosthodontics, Institute for Clinical Dental Research, Korea University Medical Center, Korea University, Seoul, Republic of Korea
| | - Jeong-Yol Lee
- Institute for Clinical Dental Research, Guro Hospital, Korea University Medical Center, Seoul, Republic of Korea
| | - Sang-Wan Shin
- Institute for Clinical Dental Research, Korea University Medical Center, Seoul, Republic of Korea
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He Y, Hasan I, Keilig L, Fischer D, Ziegler L, Abboud M, Wahl G, Bourauel C. Biomechanical characteristics of immediately loaded and osseointegration dental implants inserted into Sika deer antler. Med Eng Phys 2018; 59:8-14. [PMID: 30017665 DOI: 10.1016/j.medengphy.2018.04.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 03/13/2018] [Accepted: 04/16/2018] [Indexed: 10/28/2022]
Abstract
This study aimed to compare biomechanical characteristics of immediately loaded (IL) and osseointegrated (OS) dental implants inserted into Sika deer antler and lay a foundation for developing an alternative animal model for dental implants studies. Two implants per antler were inserted. One implant was loaded immediately via a self-developed loading device; the other was submerged and unloaded as control. IL implants were harvested after different loading periods. The unloaded implants were collected after OS and the shedding of antler. Specimens were scanned by µCT scanner and finite element models were generated. A vertical force of 10 N was applied on the implant. The mean values of maximum displacements, stresses and strains were compared. The results showed that the density of antler tissue around the implants dramatically increased as the loading time increased. After shedding the antler, 3 pairs of antlers were collected and the density of antler tissue remained in a similar value in all specimens. The maximum values of displacement and stresses in implant and stresses and strains in antler tissue were significantly different among OS models. In one antler, all the biomechanical parameters of IL model were significantly higher than those of OS model of the same animal (P < 0.05) and wider distributions were obtained from IL model. It can be concluded that implants inserted into Sika deer antler might not disturb the growth and calcification process of antler and the use of Sika deer antler model is a promising alternative for implant studies that does not require animal sacrifice.
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Affiliation(s)
- Yun He
- Orofacial Reconstruction and Regeneration Laboratory, Department of Oral and Maxillofacial Surgery, the Hospital of Stomatology, Southwest Medical University, Luzhou, China; Oral Technology, Dental School, University of Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany
| | - Istabrak Hasan
- Oral Technology, Dental School, University of Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany; Department of Prosthetic Dentistry, Preclinical Education and Materials Science, Dental School, University of Bonn, Bonn, Germany.
| | - Ludger Keilig
- Oral Technology, Dental School, University of Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany; Department of Prosthetic Dentistry, Preclinical Education and Materials Science, Dental School, University of Bonn, Bonn, Germany
| | - Dominik Fischer
- Raptor Center and Wildlife Parc Hellenthal, Hellenthal, Germany; Clinic for Birds, Reptiles, Amphibians and Fish, Veterinary Faculty, Justus Liebig University Giessen, Giessen, Germany
| | - Luisa Ziegler
- Clinic for Birds, Reptiles, Amphibians and Fish, Veterinary Faculty, Justus Liebig University Giessen, Giessen, Germany
| | - Markus Abboud
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, 1104 Westchester Hall, Stony Brook, New York
| | - Gerhard Wahl
- Department of Oral Surgery, Dental School, University of Bonn, Bonn, Germany
| | - Christoph Bourauel
- Oral Technology, Dental School, University of Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany
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Locator® versus ceramic/electroplated double-crown attachments: a prospective study on the intraindividual comparison of implant-supported mandibular prostheses. Clin Oral Investig 2018; 23:763-770. [PMID: 29779182 DOI: 10.1007/s00784-018-2491-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 05/07/2018] [Indexed: 10/16/2022]
Abstract
OBJECTIVES Implant-supported overdentures are an established dental treatment mode. The aim of this prospective study was and interindividual comparison of patient satisfaction with restorations retained by a prefabricated and thus inexpensive attachment system (Locator®) or with a technologically complex and thus expensive attachment system (ceramic/electroplated double crowns) with similar retentive performance. MATERIALS AND METHODS Twelve patients received a Locator and a double-crown prosthesis in a crossover study for test periods of 3 months each. The main target parameter was the patient's final decision in favor of one of the two prosthesis types. RESULTS After completing both test phases, seven patients opted for the Locator prosthesis and five patients opted for the double-crown prosthesis. CONCLUSION Given the predominant lack of statistically significant differences, the two types of prostheses can be described as equivalent. A recommendation in favor of the Locator prosthesis can be motivated by its lower cost. CLINICAL RELEVANCE The results of the study show that the more cost-effective variant was comparable to the more expensive double-crown prosthesis under the conditions prevailing in the study. Depending on the indication, this may influence the decision-making process in daily clinical practice and support the clinician's patient information and consultation efforts.
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Helmy MHED, Alqutaibi AY, El-Ella AA, Shawky AF. Effect of implant loading protocols on failure and marginal bone loss with unsplinted two-implant-supported mandibular overdentures: systematic review and meta-analysis. Int J Oral Maxillofac Surg 2018; 47:642-650. [PMID: 29146396 DOI: 10.1016/j.ijom.2017.10.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 10/21/2017] [Accepted: 10/31/2017] [Indexed: 10/18/2022]
Abstract
The aim of this study was to compare implant failure and radiographic bone level changes with different loading protocols for unsplinted two-implant-supported mandibular overdentures. An electronic search of two databases (PubMed, Cochrane Library) was performed, without language restriction, to identify randomized controlled trials (RCTs) comparing immediate or early versus conventional dental implant loading protocols for unsplinted two-implant-supported mandibular overdentures. Data were extracted independently by two reviewers. The Cochrane tool was used to assess the quality of included studies. A meta-analysis was performed. Eight RCTs were identified, seven of which were included; one trial was excluded because related outcomes were not measured. Four of the seven studies were considered to have a high risk of bias and three an unclear risk. Meta-analysis revealed no difference between immediate versus conventional or early versus conventional implant loading protocols regarding implant failure (risk difference (RD) -0.02, 95% confidence interval (CI) -0.13 to 0.10; RD 0.09, 95% CI -0.03 to 0.20) or marginal bone loss (mean difference (MD) 0.09, 95% CI -0.10 to 0.28; MD -0.05, 95% CI -0.12 to 0.02) for implants supporting mandibular overdentures. These findings should be interpreted with great caution given the serious numerical limitations of the studies included.
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Affiliation(s)
- M H E-D Helmy
- Department of Prosthodontics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt; Department Prosthodontics, Faculty of Dentistry, Assuit University, Assuit, Egypt
| | - A Y Alqutaibi
- Faculty of Oral and Dental Medicine, Ibb University, Ibb, Yemen; Department of Prosthodontics, Faculty of Dentistry, Ahram Canadian University, Cairo, Egypt.
| | - A A El-Ella
- Department of Prosthodontics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
| | - A F Shawky
- Removable Prosthodontics Department, Faculty of Dentistry, Beni Suef University, Beni Suef, Egypt
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Raza FB, Vaidyanathan AK, Veeravalli PT, Ravishankar S, Ali AS. Analysis of crestal bone loss around single piece ball attachment implant placed bilaterally in canine region and wear of O-ring in implant supported overdenture: Three year follow-up. Clin Implant Dent Relat Res 2018; 20:403-409. [PMID: 29508911 DOI: 10.1111/cid.12594] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 01/21/2018] [Accepted: 01/24/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Single piece implant in fixed prosthesis is widely been evaluated, however, long term evaluation of crestal bone loss and the wear of O-ring in single piece ball attachment implant supported overdenture is yet to be evaluated PURPOSE: The present article evaluates the crestal bone loss around single piece ball attachment implants placed bilaterally in the canine region and the wear of O-ring in implant supported overdenture over a period of three years. MATERIALS AND METHODS Twelve completely edentulous patients between the age group of 55-65 years were selected. Two 3.3 mm × 13 mm myriad snap fit implants were placed in the mandibular interforaminal region. All the implants were conventionally loaded at three months after surgical placement. Intra-oral periapical radiographs were made and crestal bone loss was measured at the end of one year and three years. The elasticity and wear of O-Ring was assessed after three years of usage. RESULTS The crestal bone loss showed no significant difference between the first and third year after implant placement. The mean bone loss at the end of third year was 1.5 mm. Analysis of O-ring for change in the elasticity showed reduction in displacement and a significant increase in maximum displacement and elongation. The area of O-ring and yield stress did not show any changes from the standard value. Compression set damage was observed in the O-ring at the end of three years. CONCLUSIONS The present study shows that the bilateral single piece implant supported overdenture has a success rate equivalent to the two piece implant supported overdenture and is a viable treatment option.
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Affiliation(s)
- Fathima Banu Raza
- Department of Prosthodontics, Faculty of Dental Science, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
| | - Anand Kumar Vaidyanathan
- Department of Prosthodontics, Faculty of Dental Science, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
| | | | - Subhiksha Ravishankar
- Department of Prosthodontics, Faculty of Dental Science, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
| | - Aashique S Ali
- Department of Prosthodontics, Faculty of Dental Science, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
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Reda KM, El-Torky IR, El-Gendy MN. In vitro retention force measurement for three different attachment systems for implant-retained overdenture. J Indian Prosthodont Soc 2016; 16:380-385. [PMID: 27746603 PMCID: PMC5062134 DOI: 10.4103/0972-4052.191284] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM The aim of this study is to compare the retention force of three different types of overdenture attachment systems used in implant-retained mandibular complete overdentures. MATERIALS AND METHODS Twenty-one similar acrylic resin blocks were prepared and divided into three study groups: Group A (snap attachment) - 10 specimens, Group B (locator attachment) - 1 specimen, and Group C (syncone attachment) - 10 specimens. A single rectangular heat cure acrylic resin block with two implant analogs 22 mm apart was used with all specimens. Each specimen was subjected to 5500 cycles of insertion and removal in the presence of artificial saliva, representing 5 years of usage. Retention was measured three times for each specimen using universal testing machine. Data were analyzed using one-way and two-way analysis of variance at 95% level of confidence. RESULTS Locator attachment group (Group B) showed the greatest retention level throughout the study, followed by snap attachment (Group A), and syncone attachment (Group C) showed the lowest retention level. CONCLUSION Regardless of the initial retention level of overdenture attachment, gradual loss of retention values is inevitable. However, the rate of retention loss in overdenture attachments is higher in types which comprised plastic parts within their components, rather than those totally made up of noble metals.
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Affiliation(s)
- Kareem Mohammed Reda
- Department of Prosthodontics, Menoufia University Hospitals, Shibin al Kawm, Menoufia Governorate, Egypt
| | | | - Mohamed Nabeel El-Gendy
- Department of Prosthodontics, Faculty of Dentistry, Tanta University, Tanta, Gharbia Governorate, Egypt
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Comparison of patient-reported outcomes between immediately and conventionally loaded mandibular two-implant overdentures: A preliminary study. J Prosthodont Res 2016; 60:185-92. [DOI: 10.1016/j.jpor.2015.12.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 12/14/2015] [Accepted: 12/28/2015] [Indexed: 11/18/2022]
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Abstract
This article reviews relevant dental literature to answer some frequent questions related to evidence-based implantology. There are hundreds of implant systems on the market, but the majority lack clinical documentation. Recommended number of implants for full-arch fixed prostheses is four or five in the mandible but at least six in the maxilla. Less expensive implant-retained overdentures make implant treatment available to a greater portion of edentulous subjects. Mandibular overdentures on two implants, and even one implant, have shown excellent long-term outcomes. In the maxilla, less than four implants are not recommended for good results. Single implant restorations have good prognosis, but placement of the implant should be postponed until adulthood. Osseointegrated implants have revolutionized clinical dentistry. However, in a global perspective, implants make up only a small part of all prosthodontic treatment. Knowledge and skill in conventional prosthodontics must be maintained as it will remain the most common part of the specialty.
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Affiliation(s)
- Gunnar E Carlsson
- Department of Prosthetic Dentistry/Dental Materials Science, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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