Patient-centered and clinical outcomes of mandibular overdentures retained with the locator system: A prospective observational study

Fernández-Estevan, Lucía; Montero, Javier; Otaolaurruchi, Eduardo José Selva; Ruiz, Fernanda Sola

doi:10.1016/j.prosdent.2016.07.013

Cited by 16 publications

(20 citation statements)

References 19 publications

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“…This may in part explain the high frequency of prosthetic maintenance and prosthetic interventions during the observation period. Most studies reporting on the general frequency of complications concluded implant‐retained overdentures require a higher level of maintenance, and the incidence of complications reported in this study is consistent with results reported in other studies (Evtimovska, Masri, Driscoll, & Romberg, ; Fernandez‐Estevan, Montero, Selva Otaolaurruchi, & Sola Ruiz, ; Payne & Solomons, ). The need for relining was the most common prosthetic intervention in our study as reported in the literature (Goodacre, Bernal, Rungcharassaeng, & Kan, ).…”

Section: Discussionsupporting

confidence: 91%

Immediate versus delayed loading of mandibular implant‐retained overdentures: A 60‐month follow‐up of a randomized clinical trial

Salman

Thacker

Rubin

et al. 2019

J Clinic Periodontology

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Aim The purpose of this observational, post‐trial follow‐up study was to evaluate 60‐month outcomes of a randomized controlled clinical trial that compared immediately and delayed loaded two unsplinted implants, supporting a locator‐retained mandibular overdenture. Materials and Methods Patients from a randomized controlled clinical trial, treated with either immediate or delayed loading of two implants, supporting a locator‐retained mandibular overdenture, were recalled for 60‐month evaluation. Patients underwent a clinical and radiographic examination to evaluate the peri‐implant soft tissue parameters and bone. Prosthetic maintenance needs and complications were also recorded. Results Twenty three of the 30 patients were available for the 60‐month follow‐up. The mean radiographic bone level change measured using standardized periapical radiographs from baseline to 60 months was 0.89 mm (±0.74) and 0.18 (±0.41) for delayed loading and immediate loading groups, respectively. A statistically significant difference was observed at 60 months with a smaller radiographic bone level change in the immediate loading group. No implants were lost between 12 and 60 months. At 60 months, per‐protocol implant survival rate was 100% for both the groups. No difference was found in the peri‐implant soft tissue parameters and prosthetic needs between the groups. Conclusion Both immediately and delayed loaded implants supporting a locator‐retained mandibular overdenture showed similar clinical outcomes.

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Section: Discussionsupporting

confidence: 91%

Immediate versus delayed loading of mandibular implant‐retained overdentures: A 60‐month follow‐up of a randomized clinical trial

Salman

Thacker

Rubin

et al. 2019

J Clinic Periodontology

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“…Contrary to others, the overall wear of abutments with 5‐year use was high (83%) although it was not correlated to bone volume or implant position (Aroso et al, ; Fernandez‐Estevan et al, ). Obviously, the treating dentist did not consider that replacement of abutments was necessary when the retention problem could still be solved by changing the insert.…”

Section: Discussionmentioning

confidence: 58%

“…The cylindrical stud attachment (Locator) is widely used in general practice and has proven to be effective in IOD retention as well as OHRQoL improvement (Bilhan, Geckili, Sulun, & Bilgin, ; Enami et al, ; Fernandez‐Estevan, Selva‐Otaolaurruchi, Montero, & Sola‐Ruiz, ; Khalid, Yunus, Ibrahim, Elkezza, & Masood, ; Kleis, Kämmerer, Hartmann, Al‐Nawas, & Wagner, ). A low maintenance and complication rate are important given its impact on cost aspects in the long run (Cristache, Muntianu, Burlibasa, & Didilescu, ; Fernandez‐Estevan, Montero, Selva Otaolaurruchi, & Sola Ruiz, ; Kim, Lee, Shin, & Bryant, ; Parmar, Karir, Walmsley, & Patel, ; Trakas, Michalakis, Kang, & Hirayama, ). In this context, it is important to elucidate what is the most effective system in a specific patient‐related oral situation.…”

Section: Introductionmentioning

confidence: 99%

“…The most commonly reported prosthetic complications for the 2IOD on stud abutments are replacements of the retentive inserts, fracture of dentures and teeth, relining and food accumulation inside the top of the abutment (Bilhan, Geckili, Sulun, et al, 2011;Engelhardt, Zeman, Behr, & Hahmel, 2016;Guédat, Nagy, Schimmel, Müller, & Srinivasan, 2018;Kappel, Giannakopoulos, Eberhard, Rammelsberg, & Eiffler, 2016;Marinis et al, 2016;Matthys, Vervaeke, Jacquet, & De Bruyn, 2018;Troeltzsch et al, 2013). It is obvious that technical complications may affect the long-term cost but unfortunately information on the cost of prosthetic complications is often underreported (Fernandez-Estevan et al, 2017). There is a further need for more long-term evidence on maintenance requirements and this with respect to patient factors such as implant position, the connection technique and the opposing arch (Assaf, Daas, Boittin, Eid, & Postaire, 2017).…”

Section: Introductionmentioning

confidence: 99%

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Five‐year study of mandibular overdentures on stud abutments: Clinical outcome, patient satisfaction and prosthetic maintenance—Influence of bone resorption and implant position

Matthys

Vervaeke

Besseler³

et al. 2019

Clinical Oral Implants Res

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Objectives This prospective study analyses the 5‐year clinical outcome, patient satisfaction and the technical outcome of a 2‐implant overdenture on stud abutments. In addition, the influence of mandibular resorption and implant position on these outcomes was assessed. Material and methods Patients received two implants in a one‐stage delayed protocol. Final prosthesis on stud abutments was finalized after 3 months. Implant survival, bone loss, plaque and sulcus bleeding index, OHIP‐14, technical outcome and costs were assessed after 5 years. The Cawood–Howell classification defined the mandibular resorption. Inter‐implant distances and angles (frontal, sagittal) were digitally measured. The significance level was p < .05. Results Fifty‐six patients, 23 female and 33 males (mean age = 66.3, range 41–82), completed the follow‐up. No implants were lost. Radiographical crestal bone loss was on average 1.25 mm (standard deviation SD 1.06), bleeding index was 0.75 (SD 0.73), and plaque index was 1.15 (SD 0.75) and higher for low mandibles (p = .001). The OHIP‐14 reduction post‐connection and after 5 years was significant (p < .001). Five‐year maintenance required on average 6.7 (SD 4.8, range 0–25) interventions per patient. A larger inter‐implant distance was associated with fewer replacement of retention inserts (p = .034) and less interventions (p = .006). Larger frontal (p = .023) and sagittal (p = .046) inter‐implant angles (non‐parallelism) required more inserts. The maintenance cost negatively influences the patient satisfaction (p = .004). 83% of the stud abutments showed wear. Conclusion The implant overdenture on cylindrical stud abutments is a good and stable solution, irrespective of the resorption profile of the mandible. OHIP‐14 improved permanently up to 5 years but is negatively influenced by complication cost. A small inter‐implant distance, more frontal, sagittal inter‐implant divergence increased maintenance.

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“…The LOCATOR® Legacy (Zest Dental Solutions) attachments have been documented to be one of the most popular attachments for IODs (Kronstrom & Carlsson, ). These attachments have been evidenced with good patient—, as well as clinician— satisfaction while also improving the oral health‐related quality of life of the patients (Cakarer, Can, Yaltirik, & Keskin, ; Fernandez‐Estevan, Montero, Selva Otaolaurruchi, & Sola Ruiz, ; Kappel, Giannakopoulos, Eberhard, Rammelsberg, & Eiffler, ; Mackie, Lyons, Thomson, & Payne, ; Zou et al, ; Zou, Wu, Huang, Zhang, & Zhang, ). However, the LOCATOR® Legacy attachments have also been reported to have a few known disadvantages such as rapid loss of their retention, high maintenance needs, and attachment wear (Al‐Ghafli, Michalakis, Hirayama, & Kang, ; Alsabeeha, Atieh, Swain, & Payne, ; Evtimovska, Masri, Driscoll, & Romberg, ; Kleis, Kammerer, Hartmann, Al‐Nawas, & Wagner, ; Kobayashi et al, ; Srinivasan, Schimmel, Badoud, et al, ; Srinivasan, Schimmel, Kobayashi, et al, ).…”

Section: Introductionmentioning

confidence: 99%

Microbiological evaluation of LOCATOR® Legacy attachments: A cross‐sectional clinical study

Nagy

Guédat

Giannopoulou

et al. 2019

Clinical & Exp Dental Res

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ObjectiveThis retrospective cross‐sectional study aimed to evaluate quantitatively the oral microbiome in the tri‐lobe central cavity of Locator Legacy attachment and verify whether it harbors a different, potentially more pathogenic, bacterial spectrum than the adjacent edentulous ridge.Materials and MethodsEdentulous patients rehabilitated with implant overdentures using Locator Legacy attachments were recruited for this study. The clinical examination comprised probing depths, mobility, peri‐implant, and periodontal health along with intraoral swabs for microbiological evaluation, polymerase chain reaction (PCR) testing, and candida culture. The swabs were collected from the trilobed cavity of the attachment and the adjacent edentulous ridge. PCR was performed to detect six specific bacteria, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Treponema denticola, Prevotella intermedia, and Parvimonas micra. Statistical analyses were performed using McNemar's test and Wilcoxon's rank sum test with the significance set to p < .05.ResultsA total of 50 participants with a mean age of 71.5 ± 9.6 years participated in the study. No significant differences in the microbiome were found between samples from the ridge and the attachment. No significantly different numbers in the candida cultures were identified, and the presence of a removable prostheses did not demonstrate a significant association with the prevalence of candida.ConclusionsWithin the limits of this study and the investigated bacterial species, the trilobed cavity of the attachment does not seem to increase the bacterial load.

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Patient-centered and clinical outcomes of mandibular overdentures retained with the locator system: A prospective observational study

Cited by 16 publications

References 19 publications

Immediate versus delayed loading of mandibular implant‐retained overdentures: A 60‐month follow‐up of a randomized clinical trial

Immediate versus delayed loading of mandibular implant‐retained overdentures: A 60‐month follow‐up of a randomized clinical trial

Five‐year study of mandibular overdentures on stud abutments: Clinical outcome, patient satisfaction and prosthetic maintenance—Influence of bone resorption and implant position

Microbiological evaluation of LOCATOR® Legacy attachments: A cross‐sectional clinical study

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