Clinical Peri-Implant Parameters and Marginal Bone Loss for Early Mandibular Implant Overdentures: A Follow-Up of 60 Months.

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.

Evaluation of Peri-Implant Parameters and Functional Outcome of Immediately Placed and Loaded Mandibular Overdentures: A 5-year Follow-up Study.

PURPOSE: To evaluate the peri-implant parameters of immediately placed and loaded mandibular overdentures over a 5-year follow-up period. MATERIALS AND METHODS: All subjects who had been advised and planned for two-implant mandibular overdenture treatment were included in this study. The peri-implant parameters -including plaque index (PI), bleeding index (BI) and peri-implant pocket depth (PIPD) as well as marginal bone loss (MBL) - were assessed. In addition, prosthodontic parameters including abutment-, implant- and denture-related complications were assessed. Patients were evaluated at follow-up visits, scheduled at 1, 12, 24, 36, 48, and 60 months. The data distribution was analysed with the Shapiro-Wilk test. Data within follow-up categories were compared using ANOVA and the Tukey-Kramer test. A p-value < 0.05 was considered statistically significant. RESULTS: Among the 32 participants, 19 were males and 13 were females, with a mean age of 60.5 ± 7.33. The mean plaque index (PI), bleeding index (BI) and peri-implant pocket depth (PIPD) varied over time. However, no statistically significant difference was observed in the plaque index, bleeding index and peri-implant pocket depth over time (p > 0.05). The mean value at baseline was found to be -0.9 ± 0.3. The values increased over time, with the highest value observed at 60 months 2.6 ± 0.7, which was statistically significant (p < 0.001). CONCLUSION: Immediately placed and loaded mandibular implant overdentures using two un-splinted implants with locator attachments showed acceptable PI, BI and PIPD at the 5-year follow-up. Statistically significantly greater marginal bone loss was observed from baseline to follow-up, but it was within acceptable limits. A moderate number of restorative and abutment complications were observed during the follow-up of IODs.