This article aimed to examine the clinical and radiographic outcome of mini dental implants (MDIs) supporting a mandibular overdenture. Twenty-eight patients (16 men and 12 women) complaining from insufficient retention of their mandibular denture received a total of 112 MDIs (four per patient) in the interforaminal area of the mandible using the non-submerged flapless surgical approach. Implants were immediately loaded with mandibular overdentures after implant insertion. Each implant was evaluated at the time of initial prosthetic loading, 6, 12, 24 and 36 months thereafter. Clinical evaluation was performed using plaque index (PI), gingival index (GI), probing depth (PD) and periotest values (PTVs). Radiographic evaluation was performed in terms of vertical (VBLO) and horizontal (HBLO) alveolar bone loss. Cumulative success and survival rates were calculated using life table analysis. Plaque index, GI, PD, VBLO and HBLO increased significantly in the first year after overdenture insertion, and no significant difference between subsequent observations was noted. Periotest values demonstrated no significant difference between observation times. The cumulative survival and success rates of MDIs were 96·4% and 92·9%, respectively. Within the limitations of this study, clinical and radiographic peri-implant tissue responses of immediately loaded MDIs supporting a mandibular overdenture were favourable after 3 years. However, randomised, controlled clinical trials are needed to compare these responses to that of conventional-diameter implants.

Immediately loaded two implants supporting a ball-retained mandibular overdenture are associated with more marginal bone resorption and increased probing depths when compared with conventionally loaded implants after 3 years. The bone resorption and probing depths at distal and labial sites are significantly higher than those at mesial and lingual sites. Clinical outcomes do not differ significantly between loading protocols.

The aim of this 1-year study was to evaluate and compare crestal bone loss and clinical outcomes of immediate and delayed loaded implants supporting mandibular overdentures with Locator attachments. In a randomised controlled clinical trial, 36 completely edentulous patients (mean age 59.6 years) who desired to improve the stability of their mandibular dentures were randomly assigned into two groups. Each patient received two implants in the canine area of the mandible after a minimal flap reflection. Implants were loaded by mandibular overdentures either 3 months (delayed loading group, G1) or the same day (immediate loading group, G2) after implant placement. Locator attachments were used to retain all overdentures to the implants. Peri-implant vertical (VBL) and horizontal (HBLO) bone losses and clinical parameters [plaque scores (PI), gingival scores (GI), probing depths (PD) and implant stability (ISQ)] were assessed at time of overdenture insertion (T0), 6 months (T6) and 12 months (T12) after overdenture insertion. After 12 months of overdenture insertion, two implants (5.5%) failed in G2. Vertical bone loss was significantly higher in G2 compared with G1, while HBLO demonstrated insignificant differences between groups. All clinical parameters (PI, GI, PD and ISQ) did not differ significantly between groups. Vertical bone loss was significantly correlated with PD and HBLO. Immediately loaded two implants supporting a Locator-retained mandibular overdenture are associated with more vertical bone resorption when compared to delayed loaded implants after 1 year. Clinical outcomes do not differ significantly between loading protocols.

Within the limitations of this clinical study, patient satisfaction with mini-implant retained mandibular overdentures increased significantly with time. However, this treatment required a considerable amount of prosthetic maintenance and repair after 5 years of service.

Four-implant-supported overdentures seem to present a functional advantage vs. two-implant-supported overdentures, independent of the chosen attachment system.

This study aimed to evaluate peri-implant tissue health of immediate loaded two implants retaining a mandibular overdenture with either magnetic or locator attachment. Thirty two completely edentulous patients (20 males/12 females) were randomly assigned into two groups. Each patient received two implants in the canine area of the mandible using flapless surgical technique. Mandibular overdentures were immediately connected to the implants with either magnetic (group I, GI) or locator (group II, GII) attachments. Peri-implant tissue health was evaluated clinically in terms of plaque scores (PI), bleeding scores (BI), probing depth (PD), implant stability (ISQ) and interleukin-1-β (IL-1b) concentrations in peri-implant sulcular fluid. PI, BI and PD were measured at mesial, distal, buccal and lingual surfaces of each implant. Radiographic evaluation was performed in terms of vertical (VBL) and horizontal (HBLO) alveolar bone loss. Evaluations were performed 2 weeks (T0), 6 months (T1) and 12 months (T2) after overdenture insertion. Plague scores, PD, IL-1b, VBL and HBLO increased significantly with time. ISQ decreased significantly with time. BI showed no significant differences between observation times. GI recorded significant higher PI, ISQ and IL-1b at T2 compared to GII. GII recorded significant higher VBL than GI at T2 only. For HBLO, no significant differences between groups were noted. VBL and HBLO showed a significant positive correlation with PD. Locator attachments for immediate loaded implants retaining mandibular overdentures are associated with decreased plaque accumulation, decreased implant stability, decreased interleukin-1β concentration in peri-implant crevicular fluid and increased per-implant vertical bone loss compared to magnetic attachments after 1 year.

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Resilient telescopic attachments are associated with increased chewing efficiency and MBF compared bar attachments when used to retain overdentures to the implants in patients with atrophied mandibles.