Prosthodontic outcomes of mandibular overdenture treatment with one or two implants: 4‐year results of a randomized clinical trial

Abstract

Objective: To assess the incidence of prosthodontic maintenance events and complications during 4 years of follow-up after mandibular overdenture treatment with one or two implants.Methods: Participants received one or two implants inserted in the midline (1-IOD group) or the lateral incisor-canine area bilaterally (2-IOD group). Implants were loaded with an early loading protocol after 3 weeks. Programmed recall visits were scheduled at the 6-, 12-, 36-, and 48-month follow-ups and nonprogrammed visits in case of prosthodontic complaints. The type of maintenance was registered, and the final treatment outcome was classified as successful, surviving, unknown, dead, repair, or retreatment.Results: Forty-seven participants, mean age 65.4 ± 8.6, 74.5% female, were included (1-IOD = 23; 2-IOD = 24) and 44 completed the 4-year follow-up. A total of 159 prosthodontic maintenance events occurred and 89 in unscheduled visits. The most common event was the need for minor modifications of the denture base due to sore spots in the oral mucosa (n = 56 in 31 patients), matrix activation (n = 54 in 34 patients), and overdenture fracture (n = 25 in 18 patients). A "successful" or "surviving" outcome could be attributed to 57.5% of cases, whereas 38.3% needed repair. No significant differences in the incidence of prosthodontic events or treatment outcomes were found between the two groups.Conclusions: Findings show that 1-IODs perform similar to 2-IODs when considering the incidence of fractures and the need for prosthodontic maintenance, including adjustments of the overdenture and the attachment system.

Mandibular overdenture with a single implant in the canine region (c-SIMO): a feasibility study

“…These events were considered normal maintenance events in the short-term follow-up after overdenture treatment. This is in accordance with a previous RCT comparing the prosthodontic maintenance and complications of 1and 2-IODs over 4 years [24]. It was demonstrated that the majority of the aforementioned maintenance events occurred in the first year, irrespective of the treatment group, and that a longer follow-up did not increase the incidence of the events.…”

“…As mentioned previously, denture fracture has also been reported as a frequent complication associated with SIMOs [16,23,36,59]. Similar rates of this complication can be seen throughout various SIMO studies with no cast framework, with fractures occurring in 20 to over 30% of cases, and even increasing up to 55% in a long-term study [23,24,36,59]. Different distribution patterns of the incidence of denture fractures can be seen, some studies having an increase in the yearly incidence during follow-up, while in another, almost half of the denture fractures occurred during the first year [16,36].…”

“…It was demonstrated that the majority of the aforementioned maintenance events occurred in the first year, irrespective of the treatment group, and that a longer follow-up did not increase the incidence of the events. Indeed, almost 80% of all denture base adjustments and approximately 50% of matrix activations occurred during the first year [24]. The expected additional maintenance during a longer follow-up may therefore be minimal for c-SIMOs as well.…”

“…Most studies comparing SIMOs directly to 2-IODs have demonstrated no differences in implant survival rates between both modalities [2,5,6,16,59,66,71]. Studies have reported that the frequent prosthodontic complications and maintenance events encountered with SIMOs included denture fracture around the midline implant and matrix activation or replacement, respectively [5,16,20,22,24,25,41,52,59,71]. Furthermore, SIMOs have been evidenced with increased patient satisfaction and improved Oral Health-Related Quality of Life (OHRQoL) [5,7,8,16,17,20,52,57,71].…”

The Effects of a Mandibular Overdenture on Edentulous Patients’ Quality of Life: A Clinical Study

“…The costs of overdentures retained by two implants are somewhat similar to those of conventional complete dentures. Using unsplinted anchors can lower the cost of implantretained overdentures compared to those with splinted anchors [14][15][16]. Even single implant overdentures can be efficient in improving patients' quality of life, as demonstrated by Abdelal et al [17].…”