Patient satisfaction and oral health-related quality of life for four implant-assisted mandibular overdentures fabricated with CAD/CAM milled poly methyl methacrylate, CAD/CAM-milled poly ether ether ketone, or conventional poly methyl methacrylate: A crossover clinical trial.

BACKGROUND: New materials for overdenture base construction were evolved. Thus, more clinical trials are needed to validate these materials. OBJECTIVE: This study aimed to compare the difference between CAD/CAM-milled poly methyl methacrylate (PMMA), poly ether ether ketone (PEEK) and conventional mandibular implant-assisted overdentures regarding patient satisfaction and oral health-related quality of life (OHRQL). METHODS: This randomised, crossover, clinical study included 18 completely edentulous subjects rehabilitated with three mandibular implant-assisted overdentures with three different denture base materials opposing a maxillary single denture. These materials were as follows: CAD/CAM-milled PMMA, CAD/CAM-milled PEEK and conventional PMMA. Every participant first received each mandibular overdenture in a random manner. After 6 months of each overdenture use, patient satisfaction and oral health-related quality of life were assessed using visual analogue scale (VAS) and Oral Health Impact Profile (OHIP-EDENT-19), respectively, and then crossover to other groups was done. The same was repeated to the last group. Comparison of VAS and OHIP-EDENT-19 between groups was done using Kruskal-Wallis test followed by Bonferroni test. RESULTS: Regarding all the VAS items, there were statistically significant higher scores for CAD/CAM-milled PMMA and PEEK than conventional PMMA base except for speech, aesthetic and smell. Regarding OHIP-EDENT-19, many items revealed statistically lower problem scores for CAD/CAM-milled PMMA, and CAD/CAM-milled PEEK than conventional PMMA base except psychological discomfort, psychological disability and social disability. CONCLUSION: Within the limit of this study, CAD/CAM-milled PMMA and CAD/CAM-milled PEEK were recommended as implant-assisted overdenture bases as it revealed higher patient satisfaction and better oral health-related quality of life in comparison with conventional PMMA implant-assisted overdenture.

Efficacy of stabilisation splint and low-level laser therapy for patients with chronic closed lock from non-reducible displaced temporo-mandibular joint discs: A parallel randomised clinical trial.

BACKGROUND: Stabilisation splint therapy (SST) and low-level laser therapy (LLLT) are effective-invasive treatment for temporo-mandibular disorder (TMD) patients. However, the specific efficacy of each therapy in patients with chronic closed lock (CCL) from temporo-mandibular joints (TMJ) disc displacement without reduction (DDwoR) remains unknown. OBJECTIVES: The aim of this study was to assess and compare the efficacy of SST and LLLT alone or in combination in patients with CCL from TMJ DDwoR. METHODS: This parallel randomised clinical trial included 42 patients who were diagnosed with CCL from TMJ DDwoR. Patients were allocated equally and randomly into three treatment groups: group I received combined SST and LLLT, group II received LLLT and group III received SST. Maximum mouth opening (MMO), visual analogue scale (VAS), muscle and joint palpation scores and time required to achieve normal state were evaluated at baseline, 1, 2, 4 weeks, 3 and 6 months after the intervention. Data were collected and analysed using SPSS software. RESULTS: Regarding MMO and VAS, a statistically significant improvement was found between group I versus group II and versus group III at all evaluation times. Regarding muscle and joint palpation scores, a statistically significant difference was found between group I versus group III, while non-significant difference was found between group I and group II. A statistically significant faster improvement was found in group I versus group III and versus group II. CONCLUSION: All treatment modalities can be effective in management of CCL from a TMJ DDwoR cases, but the combined SST and LLLT group seems to provide the best and quickest improvement. CLINICAL TRIAL REGISTRATION NUMBER: NCT05548894.

Effect of Ridge Splitting of Mandibular Knife Edge Ridges with Two-implant Retained Overdenture with Locator Attachments on Peri-implant Bone Level and Posterior Ridge Resorption: A One-year Preliminary Study.

AIM: This study was conducted to evaluate peri-implant bone height changes and posterior ridge resorption by using two-implant retained polyetheretherketone (PEEK) overdentures with locator attachments following expansion of mandibular knife edge ridges by ridge splitting. MATERIALS AND METHODS: Eighteen patients were selected for ridge splitting followed by expansion, implant placement, and bone graft application. Six months later, the fabrication of PEEK overdentures retained by locator attachments was accomplished. Friedman test, Wilcoxon signed-rank test, and Spearman correlation were used to evaluate the changes over time. RESULTS: Peri-implant bone height loss increased significantly with the advance of time between 6 and 12 months following denture insertion. Posterior area index changes were significant over time when measured at the time of denture insertion and twelve months following denture insertion. CONCLUSION: The effect of using PEEK as overdenture base material retained with two locator attachments allowed sharing the load between the peri-implant bone anteriorly and residual ridge posteriorly in cases with ridge splitting technique. CLINICAL SIGNIFICANCE: Using PEEK as an overdenture base material is a successful means of bone preservation. How to cite this article: Helmy MA, El-Shaheed NH, El Waseef FA, et al. Effect of Ridge Splitting of Mandibular Knife Edge Ridges with Two-implant Retained Overdenture with Locator Attachments on Peri-implant Bone Level and Posterior Ridge Resorption: A One-year Preliminary Study. J Contemp Dent Pract 2023;24(11):834-839.

Tissue Surface Adaptation and Clinical Performance of CAD-CAM Milled versus Conventional Implant-Assisted Mandibular Overdenture.

Purpose: To evaluate the surface adaptation and maximal biting force of CAD-CAM milled mandibular overdenture (CAD-CAM MOD) compared to conventional compression mold mandibular overdenture (CC MOD). Materials and Methods: Ten completely edentulous subjects with persistent complaints of their complete mandibular dentures were received four dental implants in the anterior mandible. Three months after osseointegration, subjects were randomly received either conventional compression mold or CAD-CAM MOD in a crossover design. To assess tissue surface adaptation, the fitting surfaces of each denture base were scanned and placed on the reference master cast. Three and six months after each overdenture was inserted, clinical performance in the form of maximum biting force was evaluated. Results: The results of this study indicated that the tissue surface adaptation of the CAD-CAM MOD bases was significantly better than the conventional (compression mold technique) processed bases where (P=0.0001). Regarding clinical performance (maximum biting force), the CAD-CAM MOD exhibited better clinical performance (P=0.0001). Conclusions: In denture processing methods, the CAD-CAM overdenture delivered more precise adaption and clinical performance than the compression mold technique.