Effect Of Using Two Splinted Mini-Implants Versus Two Conventional Implants Retaining Mandibular Overdenture On Crestal Bone Loss

Abstract

Objective: was to compare the marginal bone loss around two splinted Mini-implants and two conventional implants retaining mandibular overdenture.Material and methods: Fourteen completely edentulous male patients were selected from those attended the out-patient clinic of Removable Prosthodontic Department, Faculty of Dentistry-Ain Shams University to participate in this study. Based on the cone beam computed tomographic (CBCT) assessment, the selected patients were divided into two equal groups: Group (I):Patients received conventional complete maxillary dentures opposed by mandibular overdentures supported and retained by two splinted Mini-implants of 2.5mm diameter and 12 mm length in the interforaminal region. Group (II): Patients received conventional complete maxillary dentures opposed by mandibular overdentures supported and retained by two conventional implants of 4mm diameter and 12mm length placed in the lateral-canine regions. CBCT records were obtained upon Overdenture Insertion (Baseline), Six Months, Twelve Months after insertion. The Mesial, Distal, Buccal and Lingual marginal bone heights around the implants were evaluated, using the linear measurement system of the software with flat panel detector supplied by the cone beam CT. Results: Peri-Implant Bone Loss in Group (I):Six months following denture insertion calculated means of the measured bone loss for the Mesial surfaces were 0.55 ± 0.1 mm, for the Distal surfaces were 0.68 ± 0.03 mm, for the Buccal surfaces were 0.53 ± 0.12 mm and for the Lingual surfaces were 0.51±0.03mm.The calculated means of the measured bone loss was statistically significant at P < 0.05. At twelve months following denture insertion, the calculated means of the measured bone loss for the Mesial surfaces were 0.68 ± 0.1 mm, for the Distal surfaces were 0.87 ± 0.7 mm, for the Buccal surfaces were 0.69 ± 0.1mm and for the lingual surface 0.67± 0.03mm. The calculated means of the measured bone loss were statistically significant ( P ≤ 0.05). Peri-Implant Bone Loss in Group (II):Six months following denture insertion calculated means of the measured bone loss for the Mesial surfaces were 0.51 ± 0.10 mm, for the Distal surfaces were 0.62 ± 0.08 mm, for the Buccal surfaces were 0.51 ± 0.09 mm and for the Lingual surfaces were 0.50 ± 0.09mm. The calculated means of the measured bone loss were statistically significant (P ≤ 0.05).

Comparison of marginal bone loss in mandibular overdentures supported by two solitary versus splinted mini-implants

“…When the influence of implant diameter was considered, Mini implants produced the highest stresses and strains in both axial and off-axial loading when compared to conventional implants since the mini implants have a smaller surface area and volume, putting more stress per square millimetre against the bone than larger diameter implants [23] . However, the difference in the marginal bone loss was clinically insignificant [24] . A systematic review by Ma et al [25] showed that for early loaded implants, the average marginal bone loss was between 0 to 2 mm during the first year.…”