The influence of resilient liner and clip attachments for bar‐implant‐retained mandibular overdentures on opposing maxillary ridge. A 5‐year randomised clinical trial

This study aimed to compare the influence of resilient liner and clip attachments for bar‐implant‐retained mandibular overdentures on opposing maxillary ridge after 5 years of denture wearing. Thirty edentulous male patients (mean age 62·5 years) received two implants in the anterior mandible after being allocated into two equal groups using balanced randomisation. After 3 months, implants were connected with resilient bars. New maxillary complete dentures were then constructed, and mandibular overdentures were retained to the bars with either clips (group I, GI) or silicone resilient liners (group II, GII). The prosthetic and soft tissue complications of the maxillary dentures were recorded 6 months (T_6 m), 1 year (T1), 3 years (T3) and 5 years (T5) after overdenture insertion. Traced rotational tomograms were used for measurements of maxillary alveolar bone loss. The proportional value between bone areas and areas of reference not subject to resorption was expressed as a ratio (R). Change in R immediately before (T0) and after 5 years (T5) of overdenture insertion was calculated. Maxillary denture relining times and frequency of flabby anterior maxillary ridge occurred significantly more often in GI compared with GII. The change of R in anterior part of maxilla was significantly higher than change of R in posterior part in both groups. GI showed significant resorption of anterior residual ridge compared with GII. Relining times and frequencies of flabby ridge were significantly correlated with change in R. Within the limitations of this study, resilient liner attachments for bar‐implant‐retained mandibular overdentures are associated with decreased resorption and flabbiness of maxillary anterior residual ridge and fewer maxillary denture relining times when compared with clip attachments.     

Locator附着体和球帽附着体在种植覆盖义齿中的临床修复效果比较

目的探讨球帽基台和locator基台在种植体覆盖义齿(IODs)修复中临床效果的比较。方法选择单颌牙根嵴严重萎缩全口无牙颌患者27例,共计54枚种植体,其中球基台附着体26枚,locator基台附着体28枚。上部修复完成后6个月复诊并每年随访,从种植体、牙周黏膜、附着体等方面进行复查,统计其总的并发症发生率并对患者的满意度进行评价。结果两种基台支持式覆盖义齿患者的满意度明显高于普通全口义齿(P<0.05)。2年后两种附着体种植覆盖义齿边缘骨吸收率(BML)没有差别(P>0.05)。locator基台支持的覆盖义齿并发症的发生率仅为14.28%,球帽种植覆盖义齿总的并发症发生率为38.46%。结论 locator基台和球帽基台支持式全口义齿均优于常规全口义齿,locator基台产生的并发症更少。     

locator种植覆盖义齿在下颌无牙颌修复中的应用

目的：探讨locator附着体种植覆盖义齿在下颌无牙颌修复中的临床应用效果。方法：对12例下颌无牙颌患者,每名患者下颌植入2枚种植体,共24枚,3~4个月后完成locator附着体覆盖义齿修复。术后2年期间进行随访。结果：24枚种植体均无松动,骨无明显吸收,患者对义齿咀嚼及固位满意。结论：locator附着体固位的种植覆盖义齿是下颌无牙颌患者理想的修复方式。     

Prosthetic aspects and patient satisfaction with two-implant-retained mandibular overdentures: a 10-year randomized clinical study

PURPOSE: This study aimed to compare the prosthetic aspects and patient satisfaction with prosthetic care in two-implant-retained mandibular overdentures, whether implants were splinted with a bar or left with magnets or ball attachments. MATERIALS AND METHODS: Thirty-six completely edentulous patients had two Br?nemark implants placed in the mandibular canine area. A randomized procedure allocated patients into three groups of equal size, each with a different attachment system: bars, magnets, or balls. Prosthesis retention and mechanical as well as soft tissue complications were recorded in addition to patient satisfaction. A linear mixed model was fitted with attachment type and time as classification variables and adjusted by Turkey's multiple range test. RESULTS: Ball-retained overdentures showed at year 10 the greatest vertical retention force (1,327 g), followed by bars (1,067 g) and magnets (219 g). In the ball group, need for tightening of abutment screws was the most common mechanical complication; in the magnet and bar groups, respectively, the most common complications were wear and corrosion, and the need for clip activation. Prosthesis stability and chewing comfort for the overdenture were rated significantly lower for the magnet group compared to the ball and bar groups. Prosthesis stability of the maxillary denture was rated significantly lower in the bar group compared to ball and magnet groups. CONCLUSION: The ball group scored best in relation to retention of the overdenture, soft tissue complications, and patient satisfaction at year 10. The bar group scored lower for comfort and stability of the maxillary denture. Magnets offered patients the least comfort.     

Removable four implant-supported mandibular overdentures rigidly retained with telescopic crowns or milled bars: a 3-year prospective study

Purpose: The present study evaluated implant survival/success rate, peri‐implant parameters and prosthodontic maintenance efforts for four implant‐supported mandibular overdentures (IOD) rigidly retained on either milled bar or double crowns (telescopic) attachments. Material and methods: In a randomized prospective trial, 51 patients with edentulism received four mandibular interforaminal implants and complete maxillary dentures. For IOD, rigid denture stabilization was chosen randomly selecting 26 patients for milled bars (group I) and 25 patients for double (telescopic) crowns (group II). During a 3‐year follow‐up period, implant survival/success, peri‐implant parameters (marginal bone resorption, pocket depth, plaque‐, bleeding‐, gingival index [BI and GI], calculus) and prosthodontic maintenance efforts were evaluated and compared between both retention modalities used. Results: Forty‐five patients (23 group I, 22 group II) were available for a 3‐year follow‐up (dropout rate: 11.8%) presenting a high implant survival/success rate (100%). Peri‐implant marginal bone resorption, pocket depth as well as BI and GI did not differ for both rigid retention modalities. However, annually higher values for plaque‐ (NS) and calculus index (P<0.035) were noticed for the bar (group I) than for the telescopic crown (group II) attachments. Prevalence of prosthodontic maintenance did not differ between both retention modalities (group I: 0.41/maintenance efforts/year/patients vs. group II; 0.45 maintenance/efforts/year/patients). However, prosthodontic adaption for handling mechanism showed benefits for the bar retention. Conclusion: Rigid anchoring of IOD retained either by bar or telescopic attachments showed high implant success rates and minor prosthodontic maintenance efforts regardless of retention modalities used. Stable denture retention presented healthy peri‐implant structure for implants in bar and telescopic anchoring systems. Drawbacks such as higher plaque/calculus for bar retention and less favorable handling properties (output) for telescopic crown attachment leave the decision on the selection at the discretion of the clinician. To cite this article:
Krennmair G, Sütö D, Seemann R, Piehslinger E. Removable four implant‐supported mandibular overdentures rigidly retained with telescopic crowns or milled bars: a 3‐year prospective study.
Clin. Oral Impl. Res. 23 , 2012 481–488.
doi: 10.1111/j.1600‐0501.2011.02169.x     

Patient satisfaction with different types of implant-retained overdentures in the edentate mandible

The purpose of this study was to determine patient satisfaction with implant supported mandibular overdentures using magnet, bar-clip and ball-socket attachments, and to assess the relation between maximum bite force and patient satisfaction. In a crossover clinical trial, 18 edentulous patients with lower denture complaints received 2 mandibular implants and new lower and upper dentures. The lower denture initially came without any kind of attachment system, but was fitted with one of the attachment types after 3 months. The attachments were changed 3 months thereafter, in random order. A questionnaire concerning denture complaints was given at baseline (with the old denture), after 3 months of functioning with the new denture without attachments and after 3 months of functioning with each of the attachments (within-subject comparison). In addition, at the end of the experiment patients were asked to express their overall satisfaction with their dentures on a visual analogue scale (VAS). Data regarding maximum bite force were obtained from a previous study with the same population. Mandibular implant supported overdenture treatment reduced various denture complaints. The VAS score reflected patients' preference more accurately than scale-scores. Patients strongly preferred bar-clip (10 subjects) and ball-socket attachments (7 subjects) over magnet attachments (1 subject). Patients' preference could not be predicted on the basis of baseline observations. Maximum bite force was not correlated to scale- or VAS scores.     

Implant-supported maxillary overdentures retained with milled bars: maxillary anterior versus maxillary posterior concept--a retrospective study

PURPOSE: The aim of the present retrospective investigation was to evaluate implant-supported maxillary overdentures using either anterior (group 1) or posterior (group 2) maxillary implant placement. MATERIAL AND METHODS: Maxillary overdentures were planned with support by either 4 implants placed in the maxillary anterior region (group 1) or 6 to 8 implants placed in augmented maxillary posterior regions (group 2, bilateral sinus augmentation) and anchored either on an anterior or on 2 bilaterally placed milled bars. Cumulative implant survival rate, peri-implant conditions (marginal bone loss, pocket depth, Plaque Index, Gingival Index, Bleeding Index, and Calculus Index) and the incidence and type of prosthodontic maintenance were assessed and compared for the 2 groups. In addition, the cumulative survival rate for implants placed in grafted regions was compared with that of implants placed in nongrafted regions. RESULTS: Thirty-four patients (16 for group 1 and 18 for group 2) with 179 implants were available for follow-up examination after a mean period of 42.1 +/- 20.1 months. Four initially placed implants failed to osseointegrate and were replaced, but no further losses were seen during the loading period, for a 5-year cumulative implant survival rate of 978%. No differences in implant survival rates were seen between either the group-1 (98.4%) and group-2 (97.4%) concepts or nongrafted (98.0%) and grafted (97.5%) implants. The peri-implant parameters showed a healthy soft tissue, good oral hygiene, and an acceptable degree of peri-implant marginal bone loss. The rigid fixation of all overdentures was associated with a low incidence of prosthodontic maintenance, without any significant differences between the 2 groups. CONCLUSIONS: In well-planned overdenture treatment programs, a high survival rate and excellent peri-implant conditions can be achieved for implants placed in the anterior or posterior maxilla. Rigid anchorage of maxillary overdentures either on an extended anterior milled bar or on 2 bilateral posterior milled bars provides for a low incidence of prosthodontic maintenance.     

Locator式和球帽式下颌种植覆盖义齿在牙槽嵴应力分布的光弹性研究

目的 分析比较含2个种植体的下颌种植覆盖义齿分别使用球帽附着体和Locator附着体在正中,侧向及前伸(牙合)应力加载时对其种植体和余留牙槽嵴的应力分布差异.方法 应用三维光弹实验的方法,在Atwood 3级无牙颌模型双侧至尖牙区域内各植入1枚种植体后制作环氧树脂光弹模型,进行3种咬合状态下的1kg垂直加载.应力冻结后,比较两者的应力分布差异.结果 正中及前伸(牙合)位加载时,2种附着体均可达到颊舌侧应力分布相近,球帽式牙槽嵴顶应力分布略大;侧向(牙合)加载时,球帽式覆盖义齿较Locator式覆盖义齿工作侧与平衡侧应力差更小;3种(牙合)位加载时,球帽式覆盖义齿种植体周围的应力均小于Locator式覆盖义齿,其中侧向(牙合)尤为明显.结论 (1)在下颌牙槽嵴重度吸收时,使用球帽附着式覆盖义齿较Loctor式覆盖义齿可能对种植体周围的骨质及剩余牙槽嵴有更好的保护作用,建议作为首选(2)在使用Locator附着体时建议选用可减少侧向力的(牙合)型,如舌向集中(牙合)等.     

杆卡、球帽和locator附着体种植覆盖义齿的临床对比研究

目的：比较杆卡、球帽、locator附着体种植覆盖义齿修复1．3年后的临床效果。方法：对38名无牙颌患者进行覆盖义齿修复,其中杆卡、球帽、locator附着体种植覆盖义齿分别为11、18和9例。在义齿完成后0．5、1年及每年复查1次。对各组种植体周围粘膜状况和边缘骨吸收（MBL）进行评估,同时检验患者满意度。结果：杆卡、球帽、locator附着体最近一次随访的种植体边缘骨吸收为（1．3±1．0）ram、（1.2±0．8）mm、（1．4±1．0）mm,3种方式修复后MBL比较无统计学意义（P〉0．05）。与原有全口义齿比较,患者满意度均有明显提升（P〈0．05）。三种义齿间种植体周围粘膜状况、患者满意度亦无统计学差异。结论：杆卡、球帽、locator附着体种植覆盖义齿均能明显改善无牙颌患者的咀嚼功能。出于经济学考虑,我们建议选用2枚种植体支持的球帽或locator附着体覆盖义齿,临床上角度偏差较大的种植体可以优先考虑locator附着体覆盖义齿修复。     

An analysis of the implant‐supported overdenture in the edentulous mandible

This investigation examined the cumu‐lative survival rate of the implant‐supported overdenture using two types of attachments in patients treated at Show Chwan Memorial Hospital Implant Center from 1992 to 2006. Fifty‐one patients (30 men and 21 women) were treated with mandibular implant‐supported overdentures. Attachment systems used were the Hader bar with bilateral, cast ERA attachments (Group A, 31 patients with 15 men and 16 women, 134 implants) and the Hader bar with bilateral, distal extension cantilevers (Group B, 20 patients with 15 men and 5 women, 85 implants). Two hundred and four implants remained at the end of the follow‐up period. Among failed implants, 10 implants were in Group A (failure rate: 10/134 = 7·5%), whereas five implants were in Group B (failure rate: 5/85 = 5·9%). Sixty‐six point seven per cent (10/15) of failed implants were placed in the distal anterior mandible, and 33·3% (5/15) were placed in the middle anterior mandible. Survival was also examined with respect to condition of the opposing arch. Patients wearing a maxillary removable partial denture had the highest implant failure rate (5/51 = 9·8%), whereas the failure rate of the maxillary complete denture group was only 5·7%. The most frequent need for maintenance was wear over patrix component of ERA or Hader clip (n = 56). Eight patients experienced connector fracture between ERA and Hader bar, and one experienced distal extension cantilever fracture. The implant‐supported overdenture can be an effective and reliable alternative to the conventional complete mandibular denture. Fewer prosthetic complications were seen in overdentures retained with distal extension cantilever attachments.     

Cleansability of and patients' satisfaction with implant-retained overdentures: a retrospective comparison of two attachment methods

BACKGROUND: Two important factors in the use of implant-retained overdentures are cleansability and patients' satisfaction. Limited research has been published concerning the cleansability of these overdentures On the other hand, studies have compared patients' satisfaction with conventional dentures and various designs of implant overdentures. However, no studies have compared overdentures retained by Hader bars (Sterngold, Attleboro, Mass.) and direct ERA attachments (Sterngold) in terms of both cleansability and patients' satisfaction. PURPOSE: The authors' aim was to determine the cleansability of and patients' acceptance of overdentures retained by direct ERA attachments and overdentures supported by a Hader bar with distal ERA attachments and a Hader clip. MATERIALS AND METHODS: Two groups of 10 subjects each were evaluated: Group A, consisting of patients with overdentures retained by direct ERA attachments, and Group B, consisting of patients with overdentures retained by Hader bars. The authors evaluated the subjects between 18 and 24 months after the delivery of the overdentures by means of a questionnaire and a clinical examination to score each patient on gingival, plaque and calculus indexes. RESULTS: Group A exhibited better results than Group B on calculus, plaque and gingival indexes, but the difference was not statistically significant. The authors found no significant difference between the two experimental groups in satisfaction. CONCLUSIONS: When evaluated in terms of subjects' satisfaction and calculus, plaque and gingival index scores, implant-retained overdentures supported by direct ERA attachments were similar to those supported by a Hader bar. CLINICAL IMPLICATIONS: The two types of overdentures studied are equally satisfactory and easy to clean. Other factors such as biomechanics, patients' preference and previous experience may be more critical when selecting the retention design for an overdenture supported by four implants.     

Long‐term clinical and prosthetic outcomes of soft liner and clip attachments for bar/implant overdentures: a randomised controlled clinical trial

Long‐term clinical and prosthetic outcomes of soft liner attachments for bar/implant overdentures were not sufficiently investigated. The aim of this trial was to evaluate clinical and prosthetic outcomes of resilient liner and clip attachments for bar/implant‐retained mandibular overdenture after 7 years. Thirty edentulous male participants received two implants in the canine areas of the mandible. Three months later, implants were splinted with a resilient bar. Mandibular overdentures were connected to the bars with either clip (CR group, n = 15) or resilient liner (RR group, n = 15) attachments. Plaque index (PI), gingival index (GI), probing depth (PD), vertical bone loss (VBL), horizontal bone loss (HBLO) and prosthetic complications (PCs) were evaluated at denture delivery (T0), 6 (T_6m), 12 (T1), 24 (T2), 36 (T3), 48 (T4), 60 (T5), 72 (T6) and 84 (T7) months after insertion. PI and GI increased significantly with time for CR and decreased significantly for RR (P < 0·001). PD increased at T1 (CR) and T6 m (RR) and then decreased thereafter (P < 0·05). VBL increased significantly with time in both groups (P < 0·005). HBLO increased at T2 (CR) and T1 (RR) and then decreased thereafter. CR recorded significant higher PI, GI, PD, VBLO and HBLO compared to RR at all observation times (P < 0·042). The survival rates were 96·6% and 100% for CR and RR after 7 years. The most common PCs for CR and RR were clip wears and separation of the resilient liner from the denture base, respectively. Within the limitations of this study, resilient liner attachments are recommended for bar/implant‐retained mandibular overdentures than clip attachments in terms of peri‐implant tissue health and prosthetic complications after 7 years.     

Patient satisfaction and preference with magnet, bar-clip, and ball-socket retained mandibular implant overdentures: a cross-over clinical trial

PURPOSE: The purposes of this study were to: (1) determine patient satisfaction with implant-supported mandibular overdentures using magnet, bar-clip, and ball-socket attachments; and (2) assess the relation between maximum bite force and patient satisfaction. MATERIALS AND METHODS: In a cross-over clinical trial, 18 edentulous patients with mandibular denture complaints received two mandibular implants and new mandibular and maxillary dentures. The mandibular denture was initially without any kind of attachment system, but it was fitted with one of the attachment types after 3 months. The attachments were changed 3 months thereafter, in random order. A questionnaire on denture complaints was administered at baseline (with the old denture), after 3 months of function with the new denture without attachments, and after 3 months of function with each of the attachments (within-subject comparison). In addition, patients were asked to express their overall appreciation of their dentures on a VAS. Patients' preferences were determined at the end of the experiment. Maximum bite forces were obtained from a previous study with the same population. Five scales of denture complaints were constructed. Mean scale and VAS scores at the five evaluation points were compared among the groups. Pearson correlation was calculated between maximum bite force and scale and VAS scores. RESULTS AND CONCLUSION: Mandibular implant-supported overdenture treatment reduced various denture complaints. The VAS score better reflected patients' preferences than did scale score. Patients strongly preferred bar-clip (10/18 subjects) and ball-socket attachments (7/18 subjects) over magnet attachments (1/18 subjects). Patients' preferences could not be predicted on the basis of baseline observations. Maximum bite force was not correlated to scale or VAS score. Hence, patients with higher maximum bite forces were not necessarily more satisfied.     

Effects of attachment type on the mobility of implant-stabilized overdentures--an in vitro study

PURPOSE: To stabilize overdentures, a wide range of attachments to implants is suggested. Although there is evidence that denture stability is an important factor for patient satisfaction, there are no data on how these attachments may reduce denture mobility. It was the purpose of this study to compare the effects of different types of attachments on the mobility of implant-stabilized overdentures in vitro, designing a measurement device that could also be used in vivo. MATERIALS AND METHODS: On an acrylic model with 2 implants in the canine areas, magnets were fixed to one of the implant abutments. Four Hall-effect devices were attached to the denture opposite the magnet, which allowed contact-free measurements of denture movements. RESULTS: In vitro experiments loading an overdenture showed very small, largely insignificant differences in denture mobility when different bar or ball attachments were used. Geometric aspects of load application were more important than the choice of attachment. CONCLUSION: The measurements gave no guide to the choice of an attachment. The similarity of the attachments must be confirmed by in vivo measurements.     

无牙颌患者种植义齿修复

目的:无牙颌患者采用种植义齿修复可有效的增强义齿的固位,提高义齿的修复效果。方法:从1999年至2007年,对22例无牙颌患者,年龄45-82岁,行种植义齿修复,其中,有2例采用种植固定义齿修复,7例采用杆-卡式种植覆盖义齿修复,11例采用球-帽式种植覆盖义齿修复,1例采用双套筒冠种植覆盖义齿修复,1例采用磁性固位种植覆盖义齿修复。患者种植体植入2-9颗,共植入种植体97枚,种植体采用Frialit-2,Fri-alit-xive系统,观察时间108个月,采用临床检查、X线观察和患者主观评价等来评价种植体与骨组织结合状态,评价其义齿的修复效果。结果:观察期内发现1枚种植体脱(球-帽式固位种植体),1枚种植体未作修复,仍埋入在粘膜下的颌骨内。种植义齿修复后固位稳定作用良好,患者咀嚼有力,对义齿修复效果满意。结论:无牙颌患者种植义齿修复效果良好,患者满意度高。     

Maintenance requirements associated with mandibular implant overdentures: clinical results after first year of service

The aim of this clinical study was to evaluate the prosthodontic maintenance requirements during the first year of service of mandibular overdentures supported by interforaminal implants and to assess the influence of attachment type, implant number, and bite force on these requirements. Fifty-nine patients treated with mandibular implant overdentures between the years 2004 and 2009 and appearing in the 12th-month recall were included in this study. The overdentures constituted 4 groups: 2 single interforaminal implants (1 group with locator and 1 group with ball attachments), 3 single interforaminal implants, 3 splinted interforaminal implants (bar), and 4 splinted interforaminal implants (bar). During the examination, prosthetic parameters such as occlusion, tissue adaptation, condition of the retentive mechanism (matrice and patrice), and the condition of the denture-bearing tissues were evaluated and recorded. No statistically significant relation was found between attachment type, bite force values, implant number, and the occurring complications except the need for relining, which was found significantly more in the ball attachments than in other attachment groups (P = .03). After 12 months following the overdenture insertion, there seems to be no relation between occurring complications and patient-related factors, such as maximum bite force, age, and gender, as well as factors related to the overdentures such as number and type of attachments.     

Morse taper connection implants supporting "planned" maxillary and mandibular bar-retained overdentures: a 5-year prospective multicenter study

Objectives: In contrast to the excellent long‐term outcomes described for implant‐supported mandibular overdentures, less favorable long‐term survival and success rates have been reported for maxillary implants supporting overdentures. The aim of this study was to evaluate the treatment outcome of “planned” bar‐retained maxillary and mandibular overdentures supported by Morse taper connection implants, investigating implant survival, peri‐implant tissue health, marginal bone resorption and prosthetic complications. Material and methods: Over a 2‐year period, 60 patients were enrolled in this study, in four different clinical centers. The overdentures (maxilla 38, mandible 34) were planned with support from four implants anchored on a bar. A total of 288 Morse taper connection implants (Leone Implant System^®) were inserted (152 maxilla, 136 mandible). Implants were evaluated 5 years after insertion. Success criteria included the absence of pain, suppuration or clinical mobility, the distance between implant shoulder and first crestal bone–implant contact (DIB) <2 mm and no exudate history. Results: The overall 5‐year implant survival rate was 98% (maxilla 97.4%, mandible 98.6%), with 282 implants still in function. Among these surviving implants, 278 (98.6%) were classified in the success group. At the 5‐year examination, the mean DIB was 0.7 mm (±0.53). Few prosthetic complications were reported. Conclusions: With “planned” bar‐retained maxillary and mandibular overdentures supported by Morse taper connection implants, satisfactory survival and success rate can be achieved. To cite this article:
Mangano C, Mangano F, Shibli JA, Ricci M, Sammons R, Figliuzzi M. Morse taper connection implants supporting “planned” maxillary and mandibular bar‐retained overdentures: a 5‐year prospective multicenter study.
Clin. Oral Impl. Res. 22 , 2011; 1117–1124
doi: 10.1111/j.1600‐0501.2010.02079.x     

Oral and general health-related quality of life with conventional and implant dentures

Implant overdentures and conventional prostheses have been compared in several trials using a variety of functional and oral health-related quality of life (OHQOL) outcomes. In this paper, we describe the impact of implant overdentures on general and OHQOL in seniors. OBJECTIVES: To compare the oral health-related and general quality of life of seniors (aged 65-75 years) who received either mandibular implant overdentures or conventional dentures. METHODS: Sixty edentulous patients were recruited. Thirty received mandibular overdentures retained by two implants (IOD) and a conventional maxillary denture, the other 30 subjects received new maxillary and mandibular conventional complete dentures (CD). All completed the 20-item version of the Oral Health Impact Profile (OHIP-20) before treatment, then at two and 6 months after delivery of the dentures. The SF-36 general health questionnaire was completed at baseline and 6 months only. RESULTS: Pretreatment and 6-month data from 55 subjects were analyzed. Those who received the IODs had significantly better OHIP-20 total scores at 6 months. Results for IOD subjects were also superior in the functional limitation, physical pain, physical disability and psychological disability subscales. While no significant between group difference was found on the SF-36 health survey, significant pre-post-treatment differences within the IOD group were detected for the role emotional, vitality and the social function scales. CONCLUSIONS: Mandibular overdentures retained by two implants provide elderly patients with better OHQOL. General health-related quality of life improved in the implant group.     

Maxillary implant‐supported overdentures opposed by (partial) natural dentitions: a 5‐year prospective case series study

The aim of this study was to assess the 5‐year treatment outcome of maxillary implant‐retained overdentures opposed by natural antagonistic teeth. Fifty consecutive patients received maxillary overdentures supported by six dental implants. Implants were placed in the anterior region, if enough bone was present (n = 25 patients) Implant were placed in the posterior region if implant placement in the anterior region was not possible (n = 25 patients). Variables assessed included survival of implants, condition of hard and soft peri‐implant tissues and patients' satisfaction. The five‐year implant survival rate was 97·0% and 99·3%, and mean radiographic bone loss was 0·23 and 0·69 mm in the anterior and posterior group, respectively. Median scores for plaque, calculus, gingiva, bleeding and mean scores for pocket probing depth were low and stayed low. Patients' satisfaction after treatment was high in both groups. Within the limits of this 5‐year study, it is concluded that six dental implants (placed in the anterior or posterior region) connected with a bar and opposed to natural antagonistic teeth result in acceptable results for clinical parameters and good outcomes for marginal bone level changes and patient satisfaction.