Implant survival/success and peri‐implant outcomes of titanium‐zirconium mini implants for mandibular overdentures: Results from a 1‐year randomized clinical trial

Abstract

ObjectiveTo report the 1‐year implant survival/success and peri‐implant outcomes of mandibular overdentures retained by four titanium‐zirconium mini implants (Straumann® Mini Implant System), and to assess how surgery and loading protocols influence these outcomes.Materials and MethodsA 2 × 2 factorial randomized clinical trial (RCT) tested the combined effects of two loading protocols (immediate or delayed) and two surgical approaches (flapless or flapped) on the success/survival of the mini implants, and peri‐implant parameters (plaque, bleeding, sulcus depth, gingival position, and marginal bone loss). Outcomes were assessed up to 1‐year after loading, and generalized estimating equations (GEEs) were used to analyze longitudinal and within‐patient clustered data.ResultsTwo hundred and ninety‐six implants were placed in 74 patients. The implant survival/success rates after 1 year were 100%, and no major biological complications were observed. After 1‐year, descriptive data suggest no noticeable changes in plaque scores, whilst a reduction in bleeding scores at the 6‐month and 1‐year follow‐ups compared to baseline. Good longitudinal stability was observed for the probing depth and gingival margin height measures. Overall mean marginal bone loss was 0.68 (±0.68) mm after 3 months and 0.89 (±0.75) mm after 1‐year. The flapless protocol showed better results on soft tissue stability and health but a slightly higher risk for marginal bone loss.ConclusionThe results of this RCT suggest that mandibular overdentures retained by this novel mini implant system represent a safe and predictable treatment option as confirmed by implant survival/success and peri‐implant outcomes, even when flapless surgery and immediate loading protocols are adopted.

Influence of Implant Number on Peri-Implant and Posterior Edentulous Area Strains in Mandibular Overdentures Retained by the New Ti–Zr (Roxolid®) Mini-Implants as Single-Units: In Vitro Study

“…Four Roxolid ® MDIs have been proposed for the retention of a mandibular OD, and six for the retention of a maxillary OD. Outcomes of four Roxolid ® alloy MDIs retaining a mandibular OD in a prospective clinical study are available only for one year of their clinical use but with excellent results [26]. Due to the very good mechanical properties of the new Ti-Zr mini-implant system and the excellent osseointegration of the alloy, it would be interesting to find out whether less than the recommended four Ti-Zr mini-implants inserted in the mandible as single-units can successfully support a mandibular OD.…”

One-Piece Mini Dental Implant-Retained Mandibular Overdentures: 10-Year Clinical and Radiological Outcomes of a Non-Comparative Longitudinal Observational Study

“…Although the survival rates of MDIs were described to be comparable to those of standard implants [30,32], another systematic review indicated significant differences between the three categories of narrow diameter implants (NDIs) compared with standard diameter implants [14]: While NDIs of Categories 2 and 3 had comparable survival rates, NDIs of Category 1, with a diameter of <2.5 mm or less, showed a noticeably increased risk of implant loss, with an odds ratio of 4.54 (CI: 1.51-13.65). Although novel mini implant systems show promising short-term data [33], it should be noted that none of the above-mentioned systematic reviews included long-term data. The 100% implant survival rate after 10 years in the present study could be related to the O-rings that reduce the force on the implants.…”

Mandibular Overdenture Supported by Two or Four Unsplinted or Two Splinted Ti-Zr Mini-Implants: In Vitro Study of Peri-Implant and Edentulous Area Strains

“…The novel Roxolid ® tissue-level mini-implant system has been on the dental market since 2020; therefore, only a few publications on it are available in the dental literature [ 27 , 28 ]. The manufacturer recommends the insertion of four Roxolid ® MDIs for mandibular OD retention and support.…”

“…The manufacturer recommends the insertion of four Roxolid ® MDIs for mandibular OD retention and support. The one-year study reported that the success rate of four single-unit Ti-Zr MDIs loaded by a mandibular OD was 100% in 74 patients, presenting a predictable treatment option even when flapless surgery and immediate loading were adopted [ 28 ]. However, the lack of studies dealing with the new Ti-Zr MDIs and the short period since the new system appeared on the market indicate the need for research at the in vitro level to obtain new knowledge for clinical application, especially when the insertion of less than four MDIs is being considered as an option.…”