The onset of bulbar symptoms indicated the time to loss of speech better than when assessed from ALS diagnosis or the first speech therapy evaluation. In clinical work, it is important to take the initial type of ALS into consideration when determining the urgency of AAC measures as people with bulbar-onset ALS are more susceptible to delayed evaluation and AAC intervention.

In a 5-year prospective clinical study, 155 endosseous implants were installed in the mandible anterior to the mental foramina in 33 edentulous patients (13 males and 20 females). Usually 6 implants were installed for fixed prostheses (FP), 13 patients with 77 implants, and 4 implants for overdentures (OD) with a Dolder bar, 20 patients with 78 implants. At the time of abutment connection 1 implant in 2 patients was found to be loose and removed. However, in both these patients overdentures were successfully placed on the remaining 3 implants. Narrow-beam radiography was used for radiological evaluation. The mean (SD) total marginal bone loss in 5 years was 0.48 (0.38) mm (0.36 (0.22) mm in the FP group and 0.56 (0.45) mm in the OD group). Very few complications were reported during the 5 years, most of them being related to the superstructures. The overall cumulative implant survival rate was 98.7% (100% in the FP group and 97.4% in the OD group). The survival rate of the superstructures was 100%. The present study has demonstrated that Astra Tech implants offer reliable and predictable medium-term support for fixed prostheses and overdentures in the edentulous mandible.

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