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

Abstract

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.

Crestal Bone Changes and Patient Satisfaction with Single Implant‐Retained Mandibular Overdentures with Dalla Bona and Locator Attachments with Immediate Loading Protocols. A Randomized Controlled Clinical Study

“…21,22 Researchers have done studies comparing different attachment systems used to retain two IODs with delayed loading protocols. [23][24][25][26] Dalla Bona, ball and socket, and Locators have routinely used attachments and provide good retention and stability and are easy to use. [27][28][29][30][31][32] There is a lack of literature comparing the outcomes of immediate loaded Dalla Bona and Locator attachments in single implant-retained mandibular overdentures (SIMO).…”

Seven Years Maintenance Cost of Implant-Retained Overdentures on Ball Versus Locator ® Abutments.

“…The average initial cost for the treatment was 3850 euro [6,7]. When comparing the cumulative amount of maintenance costs in relation to the initial treatment costs, there was no significant difference (p=0.540) between both treatment groups (Figure 3).…”

“…After confirmation of successful integration, the implants were provided with either ball or locator abutments. For the details concerning patient selection, surgical and prosthetic treatment we refer to the previous published article by Matthys and coworkers [6]. The treatment groups were not randomized.…”

“…A total of 69 fully edentate patients (male: 41, female: 28) originating from 90 investigated earlier on [6,7] also passed the 7 year follow up and have been included in this study ( Figure 2). Mean age at time of surgery was 65 years (range 46 -83).…”

Do implant‐retained mandibular overdentures maintain radiographic, functional, and patient‐centered outcomes after 3 years of loading?

“…In addition, the installation of at least two implants in the anterior region of the mandible decreases posterior bone resorption (Kordatzis, Wright, & Meijer, 2003; Radu, Marandici, & Hottel, 2004; Wright, Glantz, Randow, & Watson, 2002). The IMO benefits related to the ideal number of implants for better retention is still intensely debated (Kern et al, 2016; Klemetti, 2008; Passia et al., 2017; Roccuzzo, Bonino, Gaudioso, Zwahlen, & Meijer, 2012; Thomason, Kelly, Bendkowski, & Ellis, 2012) along with the optimal retention system options (Elsyad, Denewar, & Elsaih, 2018; Matthys, Vervaeke, Besseler, & De Bruyn, 2019; Matthys, Vervaeke, Jacquet, & De Bruyn, 2018; Payne et al, 2018; Shah, Yilmaz, & McGlumphy, 2017). IMO rehabilitation proposals frequently advocate reducing the number of implants to minimize the treatment cost and surgical invasiveness.…”