Search

Objective: This prospective study is part of a randomised clinical trial and reports the changes in masticatory performance (MP) and bite force, and explores their influential factors, 1 year after the provision of mandibular overdentures retained by four titanium–zirconium mini implants. Methods: Edentulous patients received conventional complete dentures, followed by placement of four mini implants (Straumann® Mini Implant System) in the anterior mandible and converting the conventional prosthesis into a mandibular overdenture. Treatment protocols were randomised using a 2×2 factorial design combining different surgical (flapped vs. flapless) and loading (immediate vs. delayed) protocols. MP was assessed using a two‐colour mixing ability test and a colorimetric analysis to measure the level of colour mixing (Variance of Hue–VoH). Maximum voluntary bite force (MBF) was measured by a digital gnathodynamometer in the posterior and anterior regions. Sex, age, surgical and loading protocols and ridge morphology were tested as independent variables. MP and MBF tests were performed at baseline (pre‐treatment) and the 3‐, 6‐ and 12‐month after implant loading. Descriptive statistics, independent t‐test, and linear mixed‐effect model (LMM) regression were used for data analysis. Results: Seventy‐four participants were assessed and 73 completed the 1‐year follow‐up. Statistically significant improvements in functional parameters were observed in all follow‐up periods compared to baseline (p <.001). The flapless protocol was associated with higher improvement in MP at the 3‐month follow‐up (p =.004), while less resorbed ridges were associated with better MP (p =.038) and higher MBF (p <.001). Conclusion: The mandibular overdenture protocol using four titanium–zirconium mini implants was effective in improving MP and MBF of edentulous patients, compared to pre‐treatment values. The findings also suggest that improvements in chewing function and bite force are impacted by clinical factors since better outcomes were observed for flapless surgeries and less resorbed edentulous ridges. CLINICAL TRIAL REGISTRATION: ClinicalTrials.Gov ID NCT04760457. [ABSTRACT FROM AUTHOR]

Objective: To report the 1‐year implant survival/success and peri‐implant outcomes of mandibular overdentures retained by four titanium‐zirconium mini implants (Straumann® Mini Implant System), and to assess how surgery and loading protocols influence these outcomes. Materials and Methods: A 2 × 2 factorial randomized clinical trial (RCT) tested the combined effects of two loading protocols (immediate or delayed) and two surgical approaches (flapless or flapped) on the success/survival of the mini implants, and peri‐implant parameters (plaque, bleeding, sulcus depth, gingival position, and marginal bone loss). Outcomes were assessed up to 1‐year after loading, and generalized estimating equations (GEEs) were used to analyze longitudinal and within‐patient clustered data. Results: Two hundred and ninety‐six implants were placed in 74 patients. The implant survival/success rates after 1 year were 100%, and no major biological complications were observed. After 1‐year, descriptive data suggest no noticeable changes in plaque scores, whilst a reduction in bleeding scores at the 6‐month and 1‐year follow‐ups compared to baseline. Good longitudinal stability was observed for the probing depth and gingival margin height measures. Overall mean marginal bone loss was 0.68 (±0.68) mm after 3 months and 0.89 (±0.75) mm after 1‐year. The flapless protocol showed better results on soft tissue stability and health but a slightly higher risk for marginal bone loss. Conclusion: The results of this RCT suggest that mandibular overdentures retained by this novel mini implant system represent a safe and predictable treatment option as confirmed by implant survival/success and peri‐implant outcomes, even when flapless surgery and immediate loading protocols are adopted. [ABSTRACT FROM AUTHOR]

Background: Several complete denture wearers have major complaints and may be benefitted from implant treatment. However, the factors that shape the demand for and utilization of implants need further investigation. Objective: The aim was to evaluate edentulous patient's willingness to accept or refuse the offer and provision of implant‐retained treatment. Methods: As part of a clinical trial, edentulous subjects were offered a mandibular overdenture retained by four mini‐implants opposing a conventional maxillary denture. Treatment was offered without any financial costs for the patients. Patients' level of interest in receiving treatment was assessed using a 5‐point Likert scale, and they were asked to respond to a list of reasons that led to their decision to accept or refuse implants. Those who refused implants received conventional prosthodontic interventions as required, and those who accepted implant treatment underwent surgical planning and implant placement. Results: Of 175 eligible subjects, 147 accepted the offer of treatment and were invited to take part in the study (69.4% women, mean age 67.4 ± 10.0 years). Overall, 111 patients (75.5%) expressed a positive intention to undergo implant treatment at the initial contact. Implant treatment was performed for 56.3% (9/16) of those who answered 'probably yes' about their level of interest in implant treatment on the Likert scale, and 69.6% (64/92) of 'certainly yes' (p <.001). Older subjects were less likely to receive implants (OR = 0.93; p =.036), whilst those with a positive intention towards implants (OR = 3.15; p =.001), those previously treated by the dental team (OR = 7.89; p <.001), and who actively demanded implants (OR = 18.1; p <.001) were more likely to accept treatment. Improved chewing was the most common reason for accepting implants, whilst fear of surgery was the most reported reason for refusal. Conclusion: Refusal of implants was high among edentate patients even when financial costs were removed. Patients' initial attitude towards acceptance is a key factor in the demand for and uptake of implant therapy. [ABSTRACT FROM AUTHOR]