Purpose:The study was conducted to clinically evaluate and compare splinted and unsplinted four short implants used to support mandibular overdentures in cases with atrophic mandible. Materials and Methods:A prospective randomized controlled trial (RCT) was conducted in which a total of 48 short implants (5.5mm in length and 5mm in diameter) were inserted in 12 completely edentulous male subjects using a flapless surgical approach with the aid of a partially guided CAD-CAM surgical guides. Subjects were equally allocated into a test group A where patients' implants (n = 24) kept unsplinted with ball and socket attachments and a control group B in which patients' implants (n = 24) were splinted with a customized bar with ball attachments for retaining the mandibular overdenture following the delayed loading protocol. Clinical parameters including peri-implant probing depth (PIPD) and modified gingival index (MGI) were evaluated at time of prosthetic loading (baseline), 3, 6, and 12 month intervals.Results: By the end of 12 month, there was a statistically significant difference between the two groups regarding PIPD and MGI values (P =.038,.004) respectively. Conclusion:For atrophic mandibles, the use of four unsplinted short implants is a predictable alternative to splinted ones to retain a mandibular overdenture.
INTRODUCTION: Short implants non-invasively tackles severely resorbed ridges. In mandibular overdentures, most literature considered splinting of short implants the safest option despite its complications. Therefore, unsplinted short implants is a promising alternative. The stability of implants given their short lengths is an issue that needs to be addressed. AIM OF THE STUDY: Evaluate splinted and unsplinted short implant stability retaining mandibular overdentures in a one year followup. In addition, to evaluate the correlation between marginal bone loss and implant stability. MATERIALS AND METHODS: 12 edentulous patients were included in the study and were divided into two groups (n=6), patients received mandibular overdentures. In the test group four short implants were kept unsplinted with ball and socket attachments, while in the control group four short splinted implants with a customized bar with ball attachments were used. Implants stability were evaluated at the time of implant placement and after one year of loading using a Resonance Frequency Analysis device. Marginal bone loss was measured on digital periapical x-rays at the one year mark to evaluate the correlation between bone loss and implant stability. RESULTS: After one year, Implant Stability Quotient (ISQ) values were 81.04 ± 0.89 and 81.54 ± 0.89 for the test and control groups respectively, with no statistically significant differences. Marginal bone loss was 0.97mm ± 0.07 with unsplinted implants, and 0.92mm ± 0.12 with splinted implants. There was a negative correlation between implant stability and marginal bone loss. CONCLUSION: Unsplinted short implants provide similar stability as splinted implants after retaining mandibular overdentures for one year.
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