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Purpose: To evaluate the precision and efficiency of a novel guide system for single implant placement in the mandibular symphyses and to evaluate whether the outcome is affected by the level of operator experience. Materials and Methods: A total of 90 implants were placed in three different mandibular cast types (Cawood and Howell class III, IV, and V). For each model, a complete denture was 3D printed. A polyether ether ketone rail with a guide sleeve was embedded in the middle of the denture. To determine the ideal implant position, the sleeve could be moved in a buccolingual direction. Adjustment of implant angulation was possible, and an angle correction of 0, 12, or 24 degrees was available. A total of 30 clinicians were divided into three groups: group 1 (experienced, n = 10), group 2 (beginner, n = 10), and group 3 (inexperienced, n = 10). Each clinician was asked to plan and perform a guided flapless implant placement in the mandibular symphysis. Two preoperative CBCT scans were taken; the first was to verify the planning, and the second was to adjust the planning if needed. Finally, a postoperative CBCT scan was taken to compare the planning to the final implant position. Results: Based on the first CBCT, the clinicians adjusted their planning by an average of 1.66 ± 1.65 mm coronally, 2.41 ± 2.44 mm apically, and by a mean angular correction of 6.08 ± 0.77 degrees. After implant placement, the mean deviation from the planned implant position was 0.87 ± 0.58 mm at the coronal aspect and 0.98 ± 0.64 mm at the apical aspect. The mean angular deviation was 6.05 ± 0.71 degrees. Overall, there were no significant differences in coronal and apical deviation (P > .05) based on the level of experience. In terms of angulation, a significant difference was found in both planning (P = .049) and placement (P = .038) between beginners and experienced clinicians. Conclusions: Guided implant placement of a single implant in the mandibular symphysis using a removable denture with guide sleeve had an acceptable level of accuracy. Clinicians with limited experience spent more time on the procedure, resulting in less angular deviation during implant planning and placement compared to experienced clinicians. [ABSTRACT FROM AUTHOR]

Purpose: The objective of the present systematic review and meta-analysis was to assess randomised controlled trials (RCTs) which assessed the efficacy of mini dental implants (MDIs) and standard-diameter implants (SDIs) in retaining mandibular overdentures (MO). Materials and Methods: The focused question was “Is there a difference in the mechanical stability between MDIs and SDIs in retaining MO?” Indexed databases were searched up to and including November 2023 using different keywords. Boolean operators were used during the search. The literature was searched in accordance with the PRISMA guidelines. The PICO characteristics were: patients (P) = individuals with complete mandibular dentures requiring dental implants; Intervention (I) = placement of MDIs under mandibular dentures; Control (C) = placement of SDIs under mandibular dentures; Outcome (O) = comparison of stability between MDIs and SDIs in supporting mandibular dentures. Only RCTs were included. Risk of bias (RoB) was assessed using the Cochrane RoB tool. Results: Five RCTs were included. The numbers of participants ranged between 45 and 120 edentulous individuals wearing complete mandibular dentures. The mean age of patients ranged between 59.5 ± 8.5 and 68.3 ± 8.5 years. The number of MDIs and SDIs ranged between 22 and 152 and 10 and 80 implants, respectively. The follow-up duration ranged between one week and 12 months. Three RCTs reported an improvement in the quality of life (QoL) of all patients after stabilisation of mandibular dentures using MDIs or SDIs. In one RCT, peri-implant soft tissue profiles were comparable between MDIs and SDIs at the 1-year follow-up. The implant survival rate was reported in two RCTs, which were from 89% to 98% and 99% to 100% for MDIs and SDIs, respectively. All RCTs had a low RoB. Conclusion: Mini dental implants represent a viable alternative to traditional standard-diameter implants when seeking optimal retention for mandibular overdentures. [ABSTRACT FROM AUTHOR]

Background: Mini dental implants (MDIs) are alternatives to support an overdenture when a standard diameter implant cannot be placed due to lack of bone volume. They reduce the need for invasive bone grafting and lower the barrier for treatment. Aim: This prospective study reports on implant and patient-centered outcomes of flaplessly placed, early loaded MDIs supporting horseshoe-shaped maxillary overdentures after 7 years of function. Materials and Methods: Patients with a CBCT-confirmed thin alveolar crest received 5–6 one-piece MDIs using mentally guided flapless surgery. The conventional denture was relined and MDIs were provisionally loaded within one week. After 6 months the non-splinted MDIs were actively loaded with a horseshoe overdenture. Implant and prosthetic survival, peri-implant health (PPD and BoP) and patient-related outcomes using OHIP-14 and Subjective Masticatory Evaluation were assessed after 7 years. Results: 185 MDIs were placed in 14 females and 17 males. During provisional loading, 32 MDIs were lost, and 17 replacements were required in 16 patients. In total, 170 out of 202 totally placed MDIs were supporting 29 overdentures after 6 months. Cumulative implant failure increased from 15.8% at the moment of active loading to 34.7% at 7 years. After 7 years, 76% of the initially placed overdentures remained functional, mean PPD was 3.48 (SD 0.86), BoP was 0.20 (SD 0.40) and peri-implantitis incidence was 0.9%. The total OHIP-14 was reduced from 21.3/56 (SD: 13.1) preoperatively to 15.6/56 (SD 12.8) at provisional loading (p > 0.1) and 7.3/56 (SD 6.7) at final loading (p = 0.006), and it remained unchanged up to 7 years at 6.57/56 (SD: 8.92) (p > 0.5). Conclusions: Maxillary MDIs provide an acceptable treatment option in patients with deficient bone volume that cannot or refuse to be treated with bone grafting. Despite one third of the MDIs being lost, remaining MDIs had good peri-implant health, prosthetic success was 71% and Oral Health Related Quality of Life was beyond expectations. [ABSTRACT FROM AUTHOR]

The article presents a budget impact analysis comparing the cost and efficiency of digital workflow versus conventional methods for implant-supported overdentures. Results from a study involving 36 edentulous patients showed that the digital approach led to a 14.2% reduction in initial costs, 41.1% decrease in treatment time, and 47.1% fewer treatment sessions. In the Netherlands, the 3D-IOD was found to be more cost-effective than the conventional C-IOD, potentially saving around 50 million euros annually. Overall, the digital workflow was shown to provide high-quality overdentures at lower costs, without compromising general health-related quality of life, benefiting both patients and healthcare systems. [Extracted from the article]

Objective: To assess the relative position of mini‐implants to retain a mandibular overdenture, according to the surgical protocol, technical and anatomical factors. Methods: Mandibular cone‐beam computed tomography (CBCT) scans were analyzed for 73 patients who received four one‐piece titanium‐zirconium mini‐implants. Drilling was performed using a 1.6 mm needle drill and a 2.2 mm Pilot Drill, according to the bone density with a surgical stent. Post‐insertion CBCT images in DICOM format were analyzed using the E‐Vol‐DX software with BAR filters. Divergence angle between implants and between implants and the overdenture path of insertion was measured using CliniView 10.2.6 software. Results: Divergence between implants ranged from 0° to 22.3° (mean = 4.2; SD = 3.7) in the lateral and from 0° to 26.2° (mean = 5.3; SD = 4.1) in the frontal projections (p <.001). Only 1 (0.2%) and 3 (0.7%) of the measurements were higher than 20° in the lateral and frontal views, respectively. The mean angulations between the implant and the path of insertion for the overdenture were 9.3° (SD = 7.5) and 4.0° (SD = 2.9) for the lateral and frontal views, respectively (p <.001). Regression analyses showed a significant association between the divergence of implants and the frontal view projection (p <.001), greater distance between the paired implants (p =.017), the flapped surgical protocol (p =.002), higher final insertion torque (p =.011), and deeper preparation with the needle drill (p <.001). Conclusions: The mini‐implants were placed with low divergence angles and satisfactory parallelism. Factors including shorter distances between the implants, higher density bone, and a flapless surgical approach all contributed positively to improved parallelism of the mini‐implants. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction Methods Results Conclusion Palateless overdentures (PLODs) provide advantages of improved taste perception and retention over conventional dentures. We aimed to evaluate 5‐year outcomes of four implant maxillary PLODs.In this prospective observational study, edentulous participants were enrolled. A new conventional maxillary denture was prepared followed by implant placement and insertion of four implant retained maxillary PLOD. Oral health quality of life was assessed using the 49‐item Oral Health Impact Profile (OHIP‐49) at multiple intervals over 5 years along with biological and mechanical outcomes.Nine patients were evaluated at year 5. The mean age was 68 years, and six of the nine patients were males. The cumulative survival rate of implants was 100% while the implant success rate was 86%. Nylon retentive replacement was the most common encountered complication noted approximately four times per patient over 5 years. From a mean OHIP‐49 severity score of 71.2 at baseline, severity scores decreased to 23.9 (p < 0.001) at year 1, denoting a clinically meaningful and statistically significant improvement in oral health quality of life. The lowered OHIP‐49 severity scores remained stable throughout 5 years of follow‐up.Four implant supported maxillary overdenture appears to have good patient perceived, biological and mechanical outcomes over 5 years. Fully powered studies are needed to replicate these findings. [ABSTRACT FROM AUTHOR]

Background: Limited data exist on the mid‐ to long‐term masticatory capacity of mandibular overdenture (IOD) wearers, particularly regarding the use of posterior implants to retention. Objectives: To periodically evaluate mastication of IOD wearers, comparing the effectiveness of two to four implants to retain the prosthesis. Methods: In a randomised controlled clinical trial, 20 complete edentulous patients (14 women), aged 51–84 years (mean age 69.1 ± 9.6), received new bimaxillary complete dentures (CD). After adaptation, baseline measurements of masticatory performance (X50) and swallowing threshold were conducted using the sieving method. Patients were then randomly assigned to groups: control (two intra‐foraminal regular implants) and experimental (two intra‐foraminal regular implants and two extra‐short posterior implants) (n = 10 each). After 4 months, implants were splinted, and a new mandibular IOD was fabricated with bar/clip retention. Mastication was reassessed after 6, 12, and 48 months, and data analysed with repeated measures ANOVA and Sidak's post hoc (α = 0.05). Results: Despite a loss of two patients per group, masticatory performance significantly improved after mandibular IOD installation (p =.031) in both groups (p =.670). A second improvement was observed after 6 months (p =.027), with no subsequent changes (p >.05). Swallowing threshold improvements were noted with IOD, and no discernible differences between groups were observed (p >.05). Conclusion: Masticatory function significantly improved after mandibular IOD installation, with the number of implants demonstrating minimal influence. Clinical Trial Registration: The present study was not registered in a public database, as mandated. It is important to note that the recommendation for registration was initiated in 2017 by the Committee of Medical Journal Editors, while patient inclusion in the research took place in 2016. Given that the data presented in this manuscript cover a follow‐up period of up to 4 years post‐surgical intervention, delayed registration was not feasible. [ABSTRACT FROM AUTHOR]

Objectives: Single midline implants in the edentulous mandible can be used to support existing complete dentures to improve patients’ satisfaction and masticatory efficiency. The impact on patients’ dietary habits and the influence of the loading protocol of the implants was the subject of this study. Materials and methods: In this prospective randomized clinical trial, edentulous patients with existing complete dentures in both jaws were treated with a single midline implant in the mandible. In group A, the implants were loaded immediately, in group B the loading was delayed after three months. Patients were asked to report on their nutritional intake before implant placement and 12, 24 and 60 months after loading using a standardized two-part questionnaire. Results: Nutritional intake regarding the frequency of consumption of the requested food items did not change significantly during the 60-months study period, regardless of the loading protocol. In contrast, the second part of the questionnaire revealed that after 60 months, there was a significant decrease in avoidance of food, that had a coarse and hard texture in both groups. This significant decrease was observable in the group A in the first 12 and 24 months and in the group B after 60 months. Conclusion: A change in the patients’ dietary habits due to the insertion of a single midline implant in the mandible to support the existing complete denture cannot be observed, independently to the loading protocol. Clinical relevance: Improving the chewing efficiency by single midline implants in the edentulous mandible does not lead to a change in dietary habits. [ABSTRACT FROM AUTHOR]

Aim: This is a report of the 5-year results of a two-group parallel randomized clinical trial comparing longitudinal implant stability, and clinical and radiographic peri-implant outcomes of mandibular overdentures retained by one (1-IOD group) or two (2-IOD group) implants. Methods: All participants received 4.1 mm diameter tissue-level implants (Straumann® Standard Plus – SLActive®, Institut Straumann AG), installed in the mandible midline (1-IOD; n = 23) or the lateral incisor-canine area bilaterally (2-IOD; n = 24), and loaded after 3 weeks. Implant Stability Quotient (ISQ) was measured using a resonance frequency device (Osstell® Mentor, Integration Diagnostics) at implant placement, after three weeks (loading), and at the 6-month, 1-, 3-, and 5-year follow-ups. Marginal bone loss and clinical implant outcomes (plaque, calculus, suppuration and bleeding) were assessed periodically up to 5 years after loading. Results: Only minor changes in marginal bone level were observed after 5 years (mean = 0.37; SD = 0.44 mm), and satisfactory and stable peri-implant parameters were observed throughout the 5-year follow-up. No significant differences between groups were found. Overall, the mean primary implant stability was considered high (> 70) for the two groups (1-IOD = 78.1 ± 4.5; 2-IOD = 78.0 ± 5.8). No noticeable changes were observed between implant insertion and loading. A marked increase was observed from insertion to the 6-month follow-up – the mean difference for the 1-IOD group was + 5.5 ± 5.5 (Effect size = 1.00), while for the 2-IOD group, the mean difference was + 6.0 ± 5.6 (Effect size = 1.08). No relevant changes were observed throughout the follow-up periods up to 5 years. Linear mixed-effect model regression showed no influence of the bone-related variables (p > 0.05) and the number of implants (p = 0.087), and a significant effect of the time variable (p < 0.001). Conclusion: Satisfactory peri-implant outcomes and stable secondary stability suggest good clinical performance and successful long-term osseointegration of the implants for single and two-implant mandibular overdentures. Using a single implant to retain a mandibular overdenture does not seem to result in detrimental implant loading over the five years of overdenture use. Clinical relevance: This study corroborates the use of a single implant to retain a mandibular denture. [ABSTRACT FROM AUTHOR]

Copyright of Fogorvosi Szemle is the property of Hungarian Dental Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Gerostomatology is a medical discipline dealing with the dental care of elderly patients. With advancing age, changes in tooth structure and tooth loss have a major impact not only on the oral health but also on general health. The loss of teeth in patients’ life leads to reduced chewing and swallowing ability which affects the digestive system. In addition, a less aesthetic appearance and difficulties in speech affect the psychological state of the individual and impair the quality of social life. Case report: 70-year-old female patient with gerostomatological factors affecting dental treatment. She was dissatisfied with her previous dental prosthesis made according to the dysgnath bite form, in particular mandibular prognathism. After professional oral hygiene treatment and restorative dental procedures the final prosthodontic treatment plan was an upper and lower telescopic overdenture. Facebow and an intraoral central bearing device were used to determine the centric relation position during the procedures. Summary: In developing societies, the role of dentists is increasingly valued in improving the quality of life of the elderly, whereas a well-functioning, aesthetic prosthodontic treatment has an impact on many aspects of our patients’ lives. Overdentures seem to be an ideal choice as a prosthodontic treatment, they meet the requirements of gerostomatology.

Purpose: To evaluate and compare the marginal bone loss (MBL), survival rates, and periodontal parameters of immediately loaded implants with either Dolder bar or Locator attachments placed in the interforaminal region of edentulous mandibles. Materials and Methods: A total of included 19 patients with edentulous mandibles each received two implants in the interforaminal area of the symphysis. Randomly allocated Dolder bar or Locator attachments were then attached immediately, and both clips and a framework were fastened to the denture by the dental laboratory within 24 hours. Results: A total of 28 subjects with 56 implants were treated in accordance with the immediate-loading study protocol. Of these, 9 patients were lost to follow-up; 1 patient reported a serious illness and 8 patients moved and couldn't be reached. The 19 subjects not lost to follow-up (11 women and 8 men; average age: 68 years) were included. Every patient received either two Locator abutments and were assigned to group A (7 patients; 36.8%) or two multiunit abutments and were assigned to group B (12 patients; 63.2%). No implant failure was detected for either group, and therefore the survival rate for both groups was 100% after 5 years. After 5 years without any symptoms, 2 implants from group A and 7 implants from group B showed > 2 mm of MBL, which makes the group A success rate 85.7% and the group B success rate 70.8%. Modified sulcular bleeding index (mSBI) did not differ significantly at any of the measurement intervals. However, the modified plaque index (mPI) of group B was significantly higher than group A at the 60-month follow-up. Conclusion: It can be concluded that either splinting or not splinting the immediately loaded interforaminal implants to retain mandibular overdentures (OVDs) does not affect marginal bone levels after 5 years and immediate loading of nonsplinted implants with Locator attachments can be safely preferred to retain mandibular OVDs. [ABSTRACT FROM AUTHOR]

Interim rehabilitation of edentulous patients is essential in implant prosthodontics. However, surgical augmentation may be required for patients with reduced bone density, which complicates the use of an interim prosthesis. This report describes the rehabilitation of an edentulous patient with an interim maxillary overdenture retained by short implants with individual attachments during the healing period of vertical and horizontal ridge augmentation. This technique increased the stability of the interim prosthesis even with shortened flanges to eliminate any pressure on the surgical site. This technique could also be used when immediate loading is not possible due to lack of primary stability of the implants placed for definitive fixed prostheses. [ABSTRACT FROM AUTHOR]

Abstract Background Hyoid bone is attached to the mandible, tongue, larynx, temporal bone, and cervical spine via different types of muscles or ligaments. The tongue, mandible, and hyoid system play a crucial role in swallowing function. This within subject study aimed to evaluate the impact of mandibular implant overdentures on the displacement of the hyoid bones during the swallowing process. Methods Twenty five healthy edentulous subjects were selected for participating in the study. New complete dentures were constructed for all the participants. Subsequently two dental implants were inserted in the canine regions of the participant’s mandibular arch. In order to retain the mandibular prosthesis in place, ball attachments were incorporated into the mandibular dentures to convert them into implant overdentures. Using 10 ml of thin liquid bolus, videofluoroscopy swallowing examination was performed in three different oral conditions: without complete dentures (WCD), with complete denture (CDs), and with a mandibular implant overdenture (IODs). ANOVA with Bonferroni test was used to analyze the data in order to determine how the hyoid displacement varied throughout different oral conditions. Results Compared to complete dentures, mandibular implant overdentures showed a significant decrease (P 0.05) between the two oral circumstances in terms of superior hyoid displacement or duration for hyoid maximum elevation (DOHME). There is no penetration or aspiration for both complete denture and implant overdenture oral conditions. Conclusion Implant retained overdentures have a positive effect on hyoid displacement during swallowing of thin liquid bolus consistency relative to conventional complete dentures. Trial registration Retrospectively registered (NCT06187181) 02/1/2024.

Background/purpose: This retrospective study assessed the risks and complications associated with dental implants after jaw surgery and radiotherapy for large defects, highlighting challenges for reconstructive surgeons and prosthetic dentists. Materials and methods: From 2002 to 2008, National Taiwan University's Department of Maxillofacial Surgery used preoperative stereolithographic models and microvascular flaps for mandibular reconstruction in 18 patients with defects from ameloblastoma or advanced gingival cancer. They received free fibular flap grafts, followed by 46 osseointegrated dental implants. Patient outcomes, monitored for up to 60 months, were assessed through clinical and radiographic evaluations of implant success. Results: The overall survival rate of dental implants following tumor surgery and radiotherapy was 84.8%. Seven implants failed due to peri-implantitis (3), tumor recurrence (2), and osteoradionecrosis (ORN) (2). The ameloblastoma group did not contribute to implant failure, with 4 implant failures in the stage III gingival cancer group, and 3 implant failures in the stage IV gingival cancer group. Conclusion: Following segmental mandibulectomy for mandible lesions, free fibular bone graft reconstruction restored mandible continuity, while subsequent dental implantation and overdenture fabrication restored occlusion and aesthetics for patients. Besides considering treatment strategies for ameloblastoma groups, similar approaches can be extended to oral cancer patients undergoing post-operative reconstruction. However, additional considerations (peri-implant soft tissue condition, tumor recurrence, ORN, etc.) are necessary for oral cancer patients predisposed to dental implant failure post-surgery.

Objective: this study aimed to digitally compare wear behavior and retention between PEEK and nylon retentive inserts used in locator-retained, mandibular implant overdentures when attachment design and size were standardized. Materials and methods: A total of sixty-four inserts (32 PEEK and 32 nylon inserts); were picked-up in implant overdentures. Overdentures of both groups were submerged in artificial saliva and mounted to chewing simulator. After 480,000 chewing cycles (equivalent to 2 years of clinical use) all inserts were scanned by scanning electron microscope (SEM), then all acquired images were digitally analyzed by software to detect and compare quantitative and qualitative changes of inserts in both groups. On the other hand, retention of both groups was measured by universal testing machine and the collected data was statistically analyzed using one-way Analysis of Variance (ANOVA) test with significance level set at P ≤ 0.05. Results: PEEK inserts showed significantly higher mean retentive values compared to the nylon inserts in the control group. Also, PEEK retentive inserts exhibited statistically lower mean wear values than the control group P ≥ 0.000. Qualitative investigation revealed significant and more pronounced changes in the surface roughness of nylon inserts compared to PEEK ones. Conclusions: Regarding retention, wear behavior and dimension stability, PEEK can be recommended as retentive insert material in cases of locator-retained mandibular implant overdentures. Clinical relevance: PEEK inserts offer enhanced retention, reduced wear, and greater dimensional stability over two years time interval. Clinically, this reduces prosthodontic maintenance and adjustments, improving patient satisfaction and long-term prosthetic success. [ABSTRACT FROM AUTHOR]

Objective: To evaluate clinical parameters that affect the performance of root‐supported overdentures (ROD) and to identify the possible factors that may affect it. Background: ROD still serve as an alternative and successful treatment plan nowadays for partially edentulous patients. Nonetheless, there is not yet conclusive evidence about their clinical evaluation. Materials and Methods: A search strategy was developed following a PIO (Population, Intervention, Outcome) framework including an electronic search in the following databases: PubMed, Cochrane Library and Scopus. The systematic search included only randomised controlled clinical trials (RCTs), published until January 2023 in English language and was performed by two independent reviewers. Quality assessment of the included studies was conducted according to the Cochrane Risk of Bias tool. Results: The final selection of studies included 11 RCTs. Clinically relevant variables derived from this search were: Complications, with caries being the most frequently reported, periodontal aspects and bone changes around abutment teeth. Additionally, methods and clinical suggestions for the maintenance of these restorations and patient‐related outcomes were assessed. According to the risk of bias assessment, nine studies were considered of high risk, whereas only 2 of low risk. A meta‐analysis was not feasible. Conclusion: Within the limitations of this systematic review, ROD remain a viable treatment plan, offering better denture stability and bone preservation around abutment teeth and high patient satisfaction. Thorough oral hygiene and regular follow‐ups are of utmost importance. Further well‐designed RCTs are necessary for firmer conclusions. [ABSTRACT FROM AUTHOR]

Background: Hyoid bone is attached to the mandible, tongue, larynx, temporal bone, and cervical spine via different types of muscles or ligaments. The tongue, mandible, and hyoid system play a crucial role in swallowing function. This within subject study aimed to evaluate the impact of mandibular implant overdentures on the displacement of the hyoid bones during the swallowing process. Methods: Twenty five healthy edentulous subjects were selected for participating in the study. New complete dentures were constructed for all the participants. Subsequently two dental implants were inserted in the canine regions of the participant's mandibular arch. In order to retain the mandibular prosthesis in place, ball attachments were incorporated into the mandibular dentures to convert them into implant overdentures. Using 10 ml of thin liquid bolus, videofluoroscopy swallowing examination was performed in three different oral conditions: without complete dentures (WCD), with complete denture (CDs), and with a mandibular implant overdenture (IODs). ANOVA with Bonferroni test was used to analyze the data in order to determine how the hyoid displacement varied throughout different oral conditions. Results: Compared to complete dentures, mandibular implant overdentures showed a significant decrease (P < 0.05) in both anterior hyoid displacement and duration of hyoid maximum anterior excursion (DOHMAE). However, there was a non-significant difference (P > 0.05) between the two oral circumstances in terms of superior hyoid displacement or duration for hyoid maximum elevation (DOHME). There is no penetration or aspiration for both complete denture and implant overdenture oral conditions. Conclusion: Implant retained overdentures have a positive effect on hyoid displacement during swallowing of thin liquid bolus consistency relative to conventional complete dentures. Trial registration: Retrospectively registered (NCT06187181) 02/1/2024. [ABSTRACT FROM AUTHOR]

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]

This retrospective study assessed the risks and complications associated with dental implants after jaw surgery and radiotherapy for large defects, highlighting challenges for reconstructive surgeons and prosthetic dentists. From 2002 to 2008, National Taiwan University's Department of Maxillofacial Surgery used preoperative stereolithographic models and microvascular flaps for mandibular reconstruction in 18 patients with defects from ameloblastoma or advanced gingival cancer. They received free fibular flap grafts, followed by 46 osseointegrated dental implants. Patient outcomes, monitored for up to 60 months, were assessed through clinical and radiographic evaluations of implant success. The overall survival rate of dental implants following tumor surgery and radiotherapy was 84.8%. Seven implants failed due to peri-implantitis (3), tumor recurrence (2), and osteoradionecrosis (ORN) (2). The ameloblastoma group did not contribute to implant failure, with 4 implant failures in the stage III gingival cancer group, and 3 implant failures in the stage IV gingival cancer group. Following segmental mandibulectomy for mandible lesions, free fibular bone graft reconstruction restored mandible continuity, while subsequent dental implantation and overdenture fabrication restored occlusion and aesthetics for patients. Besides considering treatment strategies for ameloblastoma groups, similar approaches can be extended to oral cancer patients undergoing post-operative reconstruction. However, additional considerations (peri-implant soft tissue condition, tumor recurrence, ORN, etc.) are necessary for oral cancer patients predisposed to dental implant failure post-surgery. [ABSTRACT FROM AUTHOR]

Background: This study aimed to compare the perceived masticatory ability (PrMA) in completely edentulous patients (EDPs) with thermoplastic conventional complete dentures (CDs) versus single implant-retained mandibular overdentures. Methods: The current study was conducted in the outpatient Prosthodontic Clinic, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt. PrMA was evaluated in 45 completely edentulous patients (46% males, mean age 50.4 ± 4.7 years). Each patient received a thermoplastic PMMA complete denture (Polyan IC TM Bredent GmbH & Co.KG, Germany). The PrMA was evaluated at one-month and six-month intervals of denture use. An immediate loading single implant was placed into the mid-symphyseal for each patient, and the denture was adjusted. Subsequently, the PrMA was reevaluated after one month and six months. The data were collected and statistically analyzed using the SPSS@V25 to assess the changes in PrMA. Results: The PrMA demonstrated improvement after six months of thermoplastic conventional denture use. However, this improvement was not statistically significant (p = 0.405). In addition, the PrMA showed a substantial increase following a single implant placement at one and six months (p < 0.001) of the overdenture use compared to the conventional denture. The PrMA insignificantly improved (p = 0.397) after six months of the single implant retained overdenture use. Discussion: The study's findings indicate that using immediate loading single implant-retained mandibular overdentures significantly improved PrMA in completely edentulous patients. [ABSTRACT FROM AUTHOR]

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Patient satisfaction and quality of life are integral to assessing oral health care quality. For many Americans still using conventional complete dentures (CDs) or implant-retained mandibular overdentures (IODs), it remains essential to consider improving their oral health outcomes and quality of life. Due to inexperienced student dentists providing dental care to dental school patients, patient grievances are generally considered a problem. Patient feedback and satisfaction have proven valuable resources for monitoring and improving patient safety. While CDs and IODs are the 2 leading treatment options for edentulism, more comparative studies in the literature need to compare their outcomes in a school setting. The research question that guided this comparative analysis was, "Is patient satisfaction and quality of life affected by the type of prostheses and provider?" A validated questionnaire was mailed to 520 individuals selected from records of patients who had received treatment for edentulous mandible at a student prosthodontic clinic at the University of Kentucky College of Dentistry from 2014 to 2016 with at least 1 year of follow-up time. A validated questionnaire for edentulous patients based on the Oral Health Impact Profile (OHIP-19) was used. In addition, information on patients' oral health-related quality of life, including questions related to the edentulous patients' satisfaction with their dentures, was collected. The response rate was 33% (N = 171). The study's findings confirm previous findings, suggesting that IODs may significantly impact oral health-related quality of life. Data show that 76% of the IOD group reported improvement in experience when using the implants to retain the mandibular denture. However, there were no statistically significant differences in the OHIP scores between overall CD and IOD patient groups. Males with IODs had lower physical pain, limitations, and disability scores than males with CD. However, females with IODs reported more significant concerns associated with a social disability and handicap domains. Comparing users who had experiences with both treatment options, this study discerned essential characteristics that contribute to increased patient satisfaction with IODs and identified significance in outcomes by gender. These findings guide prosthodontic practitioners' patient care practices and identify a continuing need to discuss CD and IOD treatment protocols within dental school curricula. [ABSTRACT FROM AUTHOR]

Purpose: Critically evaluate the existing literature and answer the question, "Does the dental implant/mini-implant design influence the stress distribution in prosthetic overdentures according to finite element analysis?". Methods: This systematic review was registered in the Open Science Framework (osf.io/2bquj) and followed the PRISMA protocols. The custom search strategy was applied to 4 databases. In vitro experimental studies that evaluated the influence of dental implant/mini-implant design on stress distribution in overdentures by FEM, without time and language restrictions, were included. The selection process was carried out in two stages by two reviewers independently. Risk of bias analysis was performed by a checklist of important parameters. Results: Sixty articles were evaluated by their title and abstract, four were selected for full reading, three were relevant, and nine were included by additional search. The 12 studies have a low risk of bias. The meta-analysis could not be performed due to the heterogeneity of the data (implant type, design variation, load intensity, and direction). Conclusion: It can be inferred from the evaluated literature that design modifications influence the stress distribution, but as the FEM presents limitations inherent to the in vitro study, clinical trials are necessary to infer the effectiveness of the modifications. It should be noted that there is no consensus on which is the best thread design and that implants with a very narrow diameter are subject to the highest stress concentration. [ABSTRACT FROM AUTHOR]

Purpose The goal of the current study is to evaluate the stress distribution when tilted implants and mini-implants are used to support a mandibular overdenture. Materials and Methods Three-dimensional (3D) finite element models of mandibular overdentures were established using four, axial, standard-sized implants (SA model), four standardsized implants with the mesial ones axial and the distal ones tilted (ST model) and four mini-implants (MA model) with Locator attachments. On each model, a 100 N load was applied to the overdenture in four different directions; bilateral vertical, unilateral vertical and oblique load on the posterior region, and a vertical load on the incisors. The stresses distributed at the peri-implant bone, implants, the prosthetic components, and the overdentures were evaluated. Results Non-axial posterior loading caused higher stress values in the implant and the prosthetic component than axial posterior loading. Lower stress values of the implant and the prosthetic component were observed in the ST model than SA model. The stress distribution in the overdenture at posterior loads were mostly observed around the implants. Conclusion Less prosthetic complications may be expected when the treatment option in the ST model is used. Fatigue fractures may occur around the implants in the overdentures, precautions are advised. [ABSTRACT FROM AUTHOR]

Key Clinical Message: A 64‐year‐old edentulous woman with a mandibular fracture received a subperiosteal implant for fracture fixation and dental rehabilitation. However, the ball abutments were submerged by the soft tissue because they were too short. Therefore, we designed a connector to lengthen the attachment and achieve adequate stability and retention for the overdenture. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

This study presents the first 10-year follow-up investigation of the implant survival and peri-implant outcomes of one-piece mini dental implants (MDIs) retaining mandibular implant overdentures (IODs), including marginal bone level alterations (ΔMBLs), clinical peri-implant parameters, and complications. Twenty participants with horizontally atrophied mandibles received complete dentures and four MDIs (diameter 1.8 mm) at baseline. The dentures were converted into IODs with O-ring attachments. The 10-year follow-up comprised a radiological assessment of ΔMBLs, peri-implant parameters, as well as biological and technical complications. Results from a 10-year follow-up of 14 participants showed a 100% implant survival rate for all 56 implants. The mean ΔMBL after 10 years was −1.12 ± 0.80 mm, with 49 implants classified as successful (ΔMBL < 2 mm) and 7 implants with satisfactory survival (ΔMBL 2–4 mm). Time after implant placement significantly influenced ΔMBL, with stable MBLs after 5 years. The prosthetic survival rate after 10 years was 93%. ΔMBLs were not influenced by implant position or gender but were significantly smaller in subjects older than 65 years. Conclusively, one-piece MDIs with O-ring attachments offer a reliable treatment option for horizontally atrophied mandibles after 10 years, with high implant and prosthetic survival rates, potentially benefiting from advanced age regarding peri-implant bone stability. [ABSTRACT FROM AUTHOR]

Background and Objectives: Despite the identified benefits of early implant loading, studies have questioned its advantages compared to delayed loading in edentulous patients. This study aimed to evaluate clinical peri-implant parameters and marginal bone loss around early placed and loaded mandibular implant overdentures with a 60-month follow-up. Materials and Methods: In this prospective cohort study, 43 patients were enrolled to receive 86 early loading sub-crestal dental implants through prosthetic guides. Implant overdentures were supported by two isolated implant locator attachments between two mental foramens. Clinical peri-implant parameters, including plaque index (PI), bleeding index (BI), peri-implant pocket depth (PIPD), and marginal bone loss (MBL) were evaluated using standardized techniques at 1, 12, 24, 36, 48, and 60 months follow-up. At 60 months, complications associated with implant overdentures (IOD's) were noted. The mean comparison of peri-implant clinical parameters was performed through ANOVA test. A p-value of ≤0.05 was taken as significant. Results: Out of the total 43 enrolled patients, 8 patients were lost during follow-up; as a result, 35 patients completed the 5 years follow-up. The mean values of PI, BI, and PIPD increased with no statistical difference (p > 0.05). For marginal bone loss, an increase in the mean values was noted at different time intervals with statistical differences (p < 0.001). The most common complications noted were loosening of the abutment, occlusal adjustment, retentive locator loosening and replacement, and relining of the denture. Conclusions: Early placement of IODs failed to prevent bone loss over time and was associated with complications, predominantly consisting of abutment loosening, occlusal adjustments, broken retentive locator components, relining, and rebasing. [ABSTRACT FROM AUTHOR]

Background This study aimed to compare the perceived masticatory ability (PrMA) in completely edentulous patients (EDPs) with thermoplastic conventional complete dentures (CDs) versus single implant-retained mandibular overdentures. Methods The current study was conducted in the outpatient Prosthodontic Clinic, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt. PrMA was evaluated in 45 completely edentulous patients (46% males, mean age 50.4 ± 4.7 years). Each patient received a thermoplastic PMMA complete denture (Polyan IC TM Bredent GmbH & Co.KG, Germany). The PrMA was evaluated at one-month and six-month intervals of denture use. An immediate loading single implant was placed into the mid-symphyseal for each patient, and the denture was adjusted. Subsequently, the PrMA was reevaluated after one month and six months. The data were collected and statistically analyzed using the SPSS@V25 to assess the changes in PrMA. Results The PrMA demonstrated improvement after six months of thermoplastic conventional denture use. However, this improvement was not statistically significant (p = 0.405). In addition, the PrMA showed a substantial increase following a single implant placement at one and six months (p

Purpose: To evaluate patient satisfaction and prosthetic complications of maxillary conventional dentures and implant overdentures opposing mandibular implant overdentures with different attachments. Materials and Methods: A total of 60 patients with maxillary conventional dentures (maxillary CD) and mandibular two-implant overdentures received four implants in the maxilla. The implants were connected to the maxillary overdentures with a stud attachment (maxillary OD). The participants were classified into three groups according to the type of mandibular overdenture attachment: bar overdentures (BOD, n = 20), resilient telescopic overdentures (TOD, n = 20), and resilient stud/Locator overdentures (LOD, n = 20). Patient satisfaction (using a visual analog scale [VAS] and oral health--related quality of life (OHRQoL)] and prosthetic/soft tissue complications were evaluated for maxillary CD and maxillary OD after 1 year of insertion. Results: LOD showed higher VAS and oral health impact profile (OHIP-14) scores with maxillary CD and maxillary OD than BOD and TOD except for ease of chewing (VAS) and satisfactory diet (OHIP-7). For maxillary CD, TOD showed a significantly higher frequency of prosthetic and soft tissue complications than BOD and LOD. For all groups, maxillary OD showed significantly higher patient satisfaction regarding VAS and OHIP-14 scores, and lower prosthetic and soft tissue complications than the maxillary CD. Conclusion: Locator-retained maxillary overdentures opposing mandibular implant overdentures improved patient satisfaction and reduced prosthetic complications compared to conventional maxillary dentures. Such overdentures are best opposed by Locator-retained mandibular overdentures, as they increase patient satisfaction and reduce prosthetic and soft tissue complications compared to the bar and telescopic attachments. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate strain around resilient stud and bar attachments for inclined implants supporting mandibular overdentures during loading and dislodging. Materials and Methods: A mandibular edentulous model was printed using the laser sintering technique. Two vertical implants and two 30-degree distally inclined implants were placed in canine and premolar areas, respectively. Overdentures were attached to the implants with either a resilient stud (Locator, group 1) or a bar/clip (group 2) attachment. Three strain gauges were mounted at the buccal, lingual, and proximal surfaces of each implant. Microstrains were registered during vertical loading and dislodging force applications and compared between attachments (resilient stud and bar) and implant positions (vertical and inclined). Results: For canine implants, bar overdentures recorded significantly higher microstrains than Locator overdentures during vertical loading. For premolar (inclined) implants, Locator overdentures recorded significantly higher microstrains than bar overdentures during vertical dislodging. For both groups (during loading) and the bar overdenture group (during dislodging), canine (vertical) implants showed significantly higher microstrains than premolar (inclined) implants. Conclusion: Within the limitations of this in vitro study, canine (vertical) implants may be at risk of increased stresses during loading if bar attachments are used for vertical and inclined implants supporting mandibular overdentures, and premolar (inclined) implants may be at risk of increased stresses during dislodging if Locator attachments are used. For both attachments, canine implants showed significantly higher microstrains than premolar implants during loading and dislodging. [ABSTRACT FROM AUTHOR]

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.

Abstract Different characteristics of bars (cross-sectional shape, diameter, distal extension etc.) lead to different biomechanical behavior (retention and stress) with implants and peri-implant tissues. Aim: To evaluate the impact of implant-supported removable prostheses bar designs in fully edentulous arch (in the maxilla and/or mandibula), with 4 implants or more, on the peri-implant soft and hard tissues. Two reviewers searched for observational studies, RCT and in vitro studies, published on five main databases and three from the grey literature, without restrictions on November 2023. Of the 3049 selected articles, four met the inclusion criteria. Four RCT evaluated peri-implant health tissues in full edentulous arches with 4 or 6 implants rehabilitated with implant bar overdentures. One prospective study with 5 years follow-up evaluated the success/survival rate of implants and implant bar overdentures. Overall, 261 subjects were enrolled in our systematic review with 1176 implants. Overdentures’ survival rate was 100%. There was a trend that plaque indices and gingival indices were low in all of the studies, however no statistical analysis was done due to the lack of information. Due to the lack of information in the included studies, we cannot confirm if bar characteristics affect the peri-implant tissues health.

Purpose: The aim of this study was to measure and compare the retention degrees of different attachment systems before and after 1 year of mastication and removal/insertion simulations. Materials and Methods: A 4 x 10--mm implant embedded in self-curing acrylic resin was placed inside a rectangular metal frame installed in a plastic container with artificial saliva at 37ºC. Three different attachment systems were connected to the implants: Dalbo Classic, Locator (with blue, pink, and clear inserts), and Klockner Rotula. A loading test at 100 N and 1.25 Hz frequency was repeated 10 times for each attachment (changing the matrix component or plastic insert) until a total of 300,000 cycles and 1,095 removal/insertion sequences. The retention force was assessed at baseline until the end of the test (1 year) after 3-month intervals of simulation. One-way analysis of variance (ANOVA) and post hoc Tukey test (P < .05) were performed for statistical analyses. Results: Klockner Rotula showed the highest retention values at the beginning (69.6 ± 9.2 N; 7.1 ± 0.9 kg) and the end of the test (51.4 ± 5.4 N; 5.2 ± 0.6 kg), while Dalbo Classic showed the lowest values both at the beginning (13.1 ± 1.7 N; 1.3 ± 0.2 kg) and the end of the test (6.7 ± 1.6 N; 0.7 ± 0.2 kg). Locator with clear insert exhibited the lowest retention loss ratio (20.4%), while Locator with blue insert showed the highest (50.8%). At the end of the test, all attachment systems showed a significant decrease in retention force in comparison with the initial retention (P < .001). Conclusion: Locator attachments with clear and pink inserts and the Klockner Rotula attachment system showed retention forces > 20 N (2 kg) after 1 year of mastication and prosthesis insertion/removal simulation. All attachment systems showed a progressive loss of retention, which was higher for Locator attachments with blue and pink inserts and Dalbo Classic. The Klockner Rotula attachment system showed the highest retention values both at the beginning and the end of the test. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate the clinical outcomes and patient satisfaction of 4‐implant‐assisted maxillary overdentures using two different designs. Materials and Methods: Thirty edentulous participants received four implants in the maxillary ridge. The patients were randomly divided into two equal groups: (1) the control (CG, Vertical) group (n = 15); participants received four vertical implants with straight locator attachments to retain maxillary overdentures, and (2) the study (SG, Angled) group (n = 15); participants received four angled implants with angled locator attachments to retain maxillary overdentures. Peri‐implant tissue health [Plaque (PL) and gingival (GI) indices, pocket depth (PD), implant stability (ISQ) and crestal bone loss (CBL)] were evaluated after denture insertion (T0), 6 (T6), and 12 (T12) months after insertion. Patient satisfaction was evaluated using a visual analog scale (VAS) after 12 months. Results: The survival rates were 96.7% and 95% for the control and study groups respectively. PL, GI, and PD increased significantly in both groups with the passage of time. No significant difference in PL, GI, PD, and ISQ was noted between groups at all observation times. CG showed higher CBL than SG at T12. For the VAS results, there was no significant difference between groups. SG recorded significantly higher satisfaction regarding comfort with maxillary and mandibular dentures, retention of mandibular dentures, oral hygiene, the ability to chew hard food, and occlusion than CG. Conclusion: Within the limitations of this study, angled implants with angled locator attachments may be recommended to retain maxillary overdentures opposing intact dentition or fixed restoration as it was associated with improvements of several parameters of peri‐implant tissue health and patient satisfaction compared to vertical implants with straight locator attachments. [ABSTRACT FROM AUTHOR]

Background: The present study analyzes the clinical aspects of the use of small-diameter implants for the fixation of total overdenture-type prostheses on both totally edentulous dental arches. Materials and methods: This is a review of all randomized controlled trials of at least ten patients with a control group in which at least two narrow implants were placed, published between January 2010 and July 2023. Most databases were analyzed, and clinical studies involving the insertion of at least two narrow implants (<3.5 mm in diameter) were analyzed. Results: Studies showed that the survival rate of narrow implants varied from 78% to 100%. Conclusions: The results indicated that narrow-type implants have satisfactory and predictable clinical performance for the long-term stability of overdenture-type prostheses. [ABSTRACT FROM AUTHOR]

Objectives: 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. Material and Methods: 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. Results: 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). Conclusions: 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. [ABSTRACT FROM AUTHOR]

Different characteristics of bars (cross-sectional shape, diameter, distal extension etc.) lead to different biomechanical behavior (retention and stress) with implants and peri-implant tissues. Aim: To evaluate the impact of implant-supported removable prostheses bar designs in fully edentulous arch (in the maxilla and/or mandibula), with 4 implants or more, on the peri-implant soft and hard tissues. Two reviewers searched for observational studies, RCT and in vitro studies, published on five main databases and three from the grey literature, without restrictions on November 2023. Of the 3049 selected articles, four met the inclusion criteria. Four RCT evaluated peri-implant health tissues in full edentulous arches with 4 or 6 implants rehabilitated with implant bar overdentures. One prospective study with 5 years follow-up evaluated the success/survival rate of implants and implant bar overdentures. Overall, 261 subjects were enrolled in our systematic review with 1176 implants. Overdentures' survival rate was 100%. There was a trend that plaque indices and gingival indices were low in all of the studies, however no statistical analysis was done due to the lack of information. Due to the lack of information in the included studies, we cannot confirm if bar characteristics affect the peri-implant tissues health. [ABSTRACT FROM AUTHOR]

Purpose This study aimed to evaluate the retentive force between stud and resilient telescopic crown attachments for implant‑retained mandibular overdenture. Patients and methods A total of 20 male patients were selected from the Clinic of Removable Prosthodontics Department. Faculty of Dentistry, Sinai University (Kantara). Patients were divided into two equal groups. Group I (control group): patients were treated with two implants of 3.7 mm diameter and 13 mm length (in the canine regions), retaining mandibular overdentures with ball abutments, and by conventional maxillary complete dentures. Group II: patients were treated with two implants of 3.7 mm diameter and 13 mm length (in the canine regions), retaining mandibular overdentures with conical abutments with a 6° taper, and by conventional maxillary complete dentures. Retention force was recorded at the time of insertion (T0), 6 months (T6), and 12 months (T12) later. Results One‑way anova revealed significant differences between the two groups in initial retention forces (T0). However, no significant difference was observed between the two groups at T6 and T12. Group II (telescopic attachment) was associated with significantly higher retention losses than Group I (ball attachment). In comparing the mean retention loss values for the two groups at different follow‑up periods, significant differences were observed for both groups. Conclusion Within the limitations of this study, it can be concluded that: telescopic attachment with taper 6° can provide acceptable retention compared to ball and socket attachment during 12 months of overdenture use. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to systematically review the frequency and type of intraoral prosthetic rehabilitation in patients with rhino-orbital-cerebral-mucormycosis (ROCM). Settings and Design: Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Materials and Methods: An electronic search was conducted in databases including PubMed, Web of Science, Scopus, and Google Scholar. Case reports that documented prosthetic rehabilitation following surgery in patients with ROCM were included. This review was registered under the International Prospective Register of Systematic Reviews CRD42021262284. Assessment of the quality of the included studies was done using the Joanna Briggs Institute Critical Appraisal Checklist for Case reports, which comprised of an eight-item checklist. The recorded observations were organized and subjected to analysis. Statistical Analysis Used: Qualitative analysis was used. Results: Among the 25 case reports, type IId defect was the most common. Three types of prosthetic treatments were rendered, with the obturator being the most common choice of rehabilitation, followed by implant-retained obturator overdenture and fixed implant-supported prosthesis. Patients undergoing implant-based rehabilitation exhibited a 100% survival rate for implants, with follow-up periods spanning from 6 months to 3 years. No prosthetic complications were reported in any of the included case reports. Conclusions: The prevailing defect type identified was IId (48%), while the treatment of choice most frequently employed was an obturator (84%). However, with limited evidence available at present, further research is required to draw more definitive conclusions. [ABSTRACT FROM AUTHOR]

Introduction: Down syndrome (DS), an easily recognized congenital disease, is associated with a high prevalence of dental anomalies. Therefore, special dental care is required. Case presentation: This case report described the minimally invasive prosthetic rehabilitation of a 31‐year‐old female patient with DS. Prompt diagnosis, consultation with physicians and family, and accurate medical history were needed, and relevant dental, medical, mental, and behavioral factors were considered. A minimally invasive treatment plan was decided after clinical examination, orthopantomography (OPG), and study model analysis. For the upper jaw, an over denture was constructed. For the lower jaw, a simple metal‐frame partial denture was made. This treatment plan was decided after considering the difficulty in dentist‐patient collaboration and a small maxilla with poor positioning of teeth and negative overbite and over jet. Conclusion: Considering different patient factors including patient cooperation, as well as the medical and dental conditions associated with DS, a minimally invasive prosthodontic treatment option was recommended. [ABSTRACT FROM AUTHOR]

Purpose: The bar-clip retention system is the most retentive; however, the best material choice is questionable. So, this review aimed to answer “How does the material used for overdenture bars influence the results?”. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed, and the protocol was registered in the Open Science Framework. A personalized search strategy was applied in four databases and grey literature. The selection process was carried out in two stages independently by two reviewers according to the eligibility criteria, in vitro or in vivo experimental articles that evaluated the influence of bar material on the results. The risk of bias was analyzed using a checklist of important parameters. Results: Three hundred and sixty-one articles were found, and after the removal of duplicates, 308 were evaluated, of which six met the eligibility criteria, and all had a low risk of bias. The qualitative analysis was subdivided into stress distribution, bar deformation, clip retention, esthetic, and hygiene. Conclusion: 1) PEEK and BioHPP when compared to metallic alloys, are promising materials for the bar because they have a lower modulus of elasticity, low affinity for bacterial adhesion, and greater esthetic; 2) Clinical studies with longer follow-up times are required to evaluate the biomechanical performance of zirconia bars (ZrO2) because their stiffness and hardness can lead to increased stress concentration and replacement of the plastic clip, although they are associated with high esthetic and low affinity for bacterial adhesion.

Key Clinical Message A 64‐year‐old edentulous woman with a mandibular fracture received a subperiosteal implant for fracture fixation and dental rehabilitation. However, the ball abutments were submerged by the soft tissue because they were too short. Therefore, we designed a connector to lengthen the attachment and achieve adequate stability and retention for the overdenture.

Objetivo: Comparar dos procedimientos de soldadura convencionales empleando una aleación de Cr-Co, para conectar barras coladas seccionadas a ser fijadas sobre implantes. Materiales y métodos: A partir de un modelo maestro que representa un maxilar desdentado con cuatro implantes, se confeccionaron veinte (n=20) probetas seccionadas en tres partes. Se conformaron dos grupos, cada uno con diez (n=10) ejemplares. Una vez acondicionadas, fueron atornilladas al modelo maestro. Su desajuste inicial se analizó utilizando una lupa estereoscópica, con una cámara incorporada y un software. Las partes fueron soldadas empleando un procedimiento diferente para cada grupo. Las correspondientes al Grupo I se invistieron en un block refractario a base de sílico-fosfato. Las del Grupo II se montaron en una estructura metálica Clever Spider. El desajuste fue mensurado y los resultados procesados estadísticamente. El nivel de significación fue establecido en p0,05. Al comparar entre sí los grupos I y II, por medio de la prueba t y de comprobación no paramétrica de Mann-Whitney, se observaron diferencias no significativas, p=0,41 y p=0,38 respectivamente. Conclusiones: Bajo las condiciones de este estudio, se observó que los dos métodos de soldadura analizados fueron confiables para unir supraestructurasos metálicas sin que se afecte su ajuste final. //Aim: Compare two conventional welding procedures using a Cr-Co alloy, to connect sectioned cast bars to be fixed on implants. Materials and methods: From a master model representing a toothless jaw with four implants, twenty (n=20) specimens sectioned into three parts were made. Two groups were formed, each with ten (n=10) specimens. Once conditioned, they were screwed to the master model. Its initial mismatch was analyzed using a stereoscopic magnifier, with a built-in camera and a software. The parts were welded using a different procedure for each group. Those corresponding to Group I were invested in a refractory block based on silyl-phosphate. Those of Group II were mounted on a Clever Spider metal structure. The mismatch was measured, and the results processed statistically. The level of significance was established at p0.05. When comparing groups I and II, using the t-test and the Mann-Whitney nonparametric verification, non-significant differences were observed, p=0.41 and p=0.38 respectively. Conclusions: Under the conditions of this study, it was observed that the two welding methods analyzed were reliable for joining metallic superstructures without affecting their final fit.

Protetik planlama ve tedavilerde estetik, fonasyon ve fonksiyonun yeniden düzenlenmesi hedeflenmektedir. Tedavi öncesi hasta talepleri ve tedavi sonrası şikayetler bunların öncelik sıralamasını etkileyebilmektedir. Birinci olgu sunumunda; 55 yaşında kadın tam dişsizlik olgusunun, alt üst (üst 4, alt 3 adet) implant destekli overdenture protezler ile olan tedavisi anlatıldı. Konvansiyonel adımlardan farklı bir protokolle tedavisi tamamlanan hastanın tedavisi pantografik kayıt cihazı ile eklemine ait dinamik verilerin açısal değerleri ile programlı tam ayarlanabilir artikülatör kullanılarak tamamlandı. İkinci olgu sunumunda; Mevcut protezlerinin yenilenmesini isteyen 65 yaşında kadın hastanın, tam dişsiz üst çenenin total protez ile, alt çenenin implant destekli overdenture protez ile olan tedavisi anlatıldı. Tedavi ilk olgu sunumuna benzer bir protokolle tamamlandı. Her iki vakanın final protezlerinde elde edilen pembe ve beyaz estetik memnuniyet vericidir. Ancak protezlerin final estetiğine rağmen artikülasyondaki erken temaslar memnuniyetsizliğe yol açmıştır. Her iki olguda da protezlerin teslimi sonrası hastaların protezlerinin belirli diş temaslarında yerinden oynadığı yönünde şikayetleri oldu. Gerekli dinamik stabilitenin sağlanabilmesi için her iki olgu sunumunda da direkt ağız içi tespitle dinamik faset onarımları yapıldı. 1. olguda dinamik stabilite 6 haftanın sonunda, 2. olguda ise teslim anında sağlanabildi.

Background. The objective of the current research was to evaluate how stress is distributed in the peri-implant bone of a mandibular overdenture with implants placed asymmetrically to the midline. Methods. A 26-year-old male’s mandible, with missing teeth, was examined using computed tomography (CT) scanning. Two implants were inserted at right angles to the occlusal plane, in the positions of the right canine and left lateral incisor of the mandible, with an internal connection. Two types of attachments (bar and ball) were designed. To simulate the clinical condition, anterior (on central incisors) and bilateral posterior (on premolars and molars) loadings were applied. The stress distribution was assessed using finite element analysis (FEA). Results. The lateral incisor level implant was found to have the highest maximum principal stress (about 33 MPa) in both models in the anterior loading condition. However, in both models, the canine-level implant revealed more stress values (about 22 MPa) in the posterior loading condition. Conclusion. In mandibular implant-supported overdentures, when implants were placed asymmetrically to the midline, one acted as a fulcrum and sustained more occlusal load. The bar attachment system did not reveal superior results in terms of stress distribution compared to the ball attachment.

Background: The present study analyzes the clinical aspects of the use of small-diameter implants for the fixation of total overdenture-type prostheses on both totally edentulous dental arches. Materials and methods: This is a review of all randomized controlled trials of at least ten patients with a control group in which at least two narrow implants were placed, published between January 2010 and July 2023. Most databases were analyzed, and clinical studies involving the insertion of at least two narrow implants (

Purpose: Treatment alternatives based on implant-supported prostheses (ISPs) may be almost impossible in cases with extremely atrophic mandibles. Vertical bone augmentation is then the only possibility to achieve an ISP. Materials and Methods: The consequences of vertical augmentation in extremely atrophic mandibles (≤ 10-mm bone height) of edentulous patients using allogeneic block grafts via a submental approach were assessed. The recorded parameters were sex, age, physical status, hospitalization duration, postoperative complications, implant characteristics (length, diameter), early and late implant failure (yes/no; primary outcome variable). Bone height was measured at three points using the pregrafting and pre–implant placement CBCT imaging. The difference between the measurements was defined as bone gain (primary outcome variable). Results: Sixteen patients (2 men, 14 women) were included. The preoperative bone height ranged from 4 to 10 mm. A mean of 5.3 ± 1 months was allowed for graft consolidation. The average bone height gain was 11.2 ± 3.1 mm. Two to six dental implants were placed in the grafted bone. Early implant failure occurred in 4 out of 73 (5.5%). Follow-up ranged from 12 to 92 (mean: 48 ± 30) months. All patients were followed for more than a year, and two additional late implant failures were recorded, rendering a 92% cumulative survival rate. Conclusion: Bone grafting using allogeneic bone blocks via a submental approach seems to be a promising solution for reconstruction of the extremely atrophic mandible. [ABSTRACT FROM AUTHOR]