Patient Reported Outcomes on Different Occlusal Schemes in Complete Denture Wearers.

PURPOSE: To compare patient-reported outcomes among balanced, lingualized, and monoplane occlusal schemes in relation to edentulous jaw classifications. MATERIALS AND METHODS: This randomized controlled trial was conducted in edentulous patients receiving new complete dentures using balanced, lingualized, or monoplane occlusal schemes. Demographic variables, bone ridge quantity, number of adjustments required after denture insertion, and satisfaction and quality of life (QoL) indices (ie, the Denture Satisfaction Questionnaire [DSQ] and General Oral Health Assessment Index [GOHAI], respectively) were assessed at 1, 2, 4, 8, 12, and 52 weeks. Within-group comparisons at different time points were carried out with Brunner-Langer nonparametric analysis. Furthermore, Kruskal-Wallis test was used to compare distributions of ordinal or continuous variables among the three occlusal scheme groups. RESULTS: A total of 60 subjects (mean age: 68.1 ± 11.1 years; 56.7% men and 43.3% women) were analyzed. All three groups presented significant improvements in DSQ and GOHAI scores between denture insertion and the 1-year follow-up appointment (P < .001). There were no statistical differences in the distribution of demographic variables (eg, age, gender, years edentulous, and age of existing dentures) or of bone ridge classifications among the three groups. Similarly, there were no statistical differences in ridge classifications or in the DSQ and GOHAI values among the three groups for both the maxilla and mandible (P > .05) over the 52-week follow-up. On the other hand, the number of cases requiring denture adjustments was significantly lower in the lingualized scheme group, as compared to the two other groups (P = .034). CONCLUSION: Within the limitations of this study, the present findings suggest that the occlusal scheme for posterior teeth did not influence patient-reported subjective outcomes. However, the lingualized occlusal scheme required significantly fewer adjustments.

Patient-based outcomes with conventional or mini-implants immediately loaded with locator-retained mandibular overdentures: A cohort study.

BACKGROUND: Little is known on the effect of varying implant diameters, especially with mini implants (ie, less than 3 mm in diameter), on oral health-related quality of life (OHrQoL). PURPOSE: To compare OHrQoL and satisfaction in patients with mandibular overdentures immediately retained by either two conventional or two mini-implants. MATERIALS AND METHODS: Edentulous patients receiving immediately loaded overdentures retained by Locators on either two conventional diameter (4.1 mm) or two mini (2.9 mm or less) implants were selected based on available buccal-lingual ridge width in the intraforaminal area. Two questionnaires were used (Oral Health Impact Profile-14 [OHIP-14]; and Denture Satisfaction Questionnaire [DSQ]) to determine OHrQoL and overall denture satisfaction. Questionnaires were filled out at six different time points up to a 1-year follow-up. Mann-Whitney U test was used for group comparisons. Friedman and Wilcoxon tests were used to identify changes within group along the time points. Correlation between OHIP-14 and DSQ was assessed with Spearman test. RESULTS: A total of 48 patients were analyzed and equally distributed to each group. The conventional group presented a significantly smaller change of OHIP functional score from the baseline to the first week of follow-up after surgery (P = .017). In addition, total DSQ scores were significantly higher for the conventional group at 12 weeks (P = .022) and there was a significant difference between groups in satisfaction with mandibular prosthesis at 24 weeks (P = .034). Correlation between OHIP-14 and DSQ was not significant (P > .05). Individual results of each group (ie, within group analysis) over all assessed time points revealed a significant OHrQoL (P = .001 for conventional, P = .006 for mini-implants) and satisfaction (P < .001 for both groups) improvement in both groups. CONCLUSION: Mandibular overdentures retained by two conventional or mini-implants lead to a significant and comparable improvements in OHrQoL and satisfaction over a 1-year follow-up.

Maintenance and risk factors for fractures of overdentures using immediately loaded conventional diameter or mini implants with Locator abutments: A cohort study.

BACKGROUND: Fractures in mandibular implant-retained overdentures are a common complication. However, little is known on the related risk factors and outcome differences when using two conventional diameter or two mini implants. PURPOSE: The purpose of this study was first, to evaluate the required maintenance and complications with the overdentures and second, to analyze risk factors for overdenture fractures. MATERIALS AND METHODS: This cohort study was conducted in edentulous patients with complete dentures. Patients received either two conventional (4.1 mm in diameter) and two mini (2.9 mm or less in diameter) implants, based on available buccal-lingual ridge width. All implants were immediately loaded with mandibular overdentures retained by Locator abutments. The number of prosthodontic after care visits (scheduled and unscheduled) were recorded and compared between the two implant diameter groups. Fracture occurrence was the primary outcome variable. Risk estimates were presented as odds ratios (ORs) with 95% confidence intervals (CIs). The ORs were adjusted for potential clinical confounders (ie, necessity of relining, matrix recapture, abutment loosening, implant diameter, height of the Locator, and retention force). RESULTS: A total of 50 edentulous patients were analyzed. One conventional diameter and three mini implants failed within a 1-year follow-up period. Prosthetic maintenance requirements for overdentures on both implant diameter groups were comparable. A total of 12 overdenture fractures (four in the mini implant group and eight in the conventional diameter group) occurred. Adjusted OR (AOR) analysis showed a significant association between abutment loosening and overdenture fracture (AOR = 12.00, 95% CI = 1.11-129.45; P = .041). CONCLUSION: Within the limitations of this study, the present findings suggest that implant diameter does not affect number of prosthetic maintenance and complications, and that abutment loosening is a risk factor for overdenture fractures, regardless of the implant diameter used.

Immediately loaded mini-implants supporting mandibular overdentures: A one-year comparative prospective cohort study.

BACKGROUND: Little is known about differences between mini-implants and conventional immediately loaded implants for overdentures. OBJECTIVES: To compare clinical outcomes using two immediately loaded conventional or mini-implants for mandibular overdentures. MATERIALS AND METHODS: Edentulous patients receiving either conventional (4.1 mm) or mini-implants (2.9 mm or less), based on available bone width were analyzed. All implants were immediately loaded with mandibular overdentures installed using locator attachments. Digital periapical radiographs for measuring marginal bone loss and clinical outcomes (ie, periodontal probing, plaque, and bleeding indices) were assessed at 1, 3, 6, and 12-month follow-up periods. RESULTS: Fifty patients (25 receiving conventional implants-12 females, mean age of 65.3 ± 7.3 years; and 25 receiving mini-implants-11 females, mean age of 66.8 ± 8.1 years) was analyzed. Peak insertion torque (P = .001) and bone loss (P = .02), as well as change in plaque (P = .02) and bleeding (P = .04) indices at 12 months differed significantly between groups. Furthermore, linear regression revealed the height of the locator as a risk factor for bone loss (P = .038). CONCLUSIONS: The present findings suggest that two mini-implants are significantly more susceptible to bone loss after immediate loading, for which the height of locator might be considered a risk factor.