Radiographic Assessment of Three-implant-retained Mandibular Overdentures: A Clinical Study of Alveolar Bone Height Changes (Randomized Clinical Trial)
Rahma EL Hussany Mohammed, Osama Mohammed Askar, Fatma Ahmad EL-Waseef, Mohammed Mohammed Fouad
Keywords :
Block-out spacer, Digital radiograph, Locator attachment, Pick-up
Citation Information :
Mohammed RE, Askar OM, EL-Waseef FA, Fouad MM. Radiographic Assessment of Three-implant-retained Mandibular Overdentures: A Clinical Study of Alveolar Bone Height Changes (Randomized Clinical Trial). J Contemp Dent Pract 2023; 24 (11):847-852.
Aim: To evaluate the residual alveolar ridge bone height changes regarding the impact of the block-out spacer used during the pick-up procedures of implant-assisted mandibular complete overdentures.
Materials and methods: This study was a randomized clinical trial conducted on 18 patients. All patients received three mandibular dental implants with definitive locator attachments which were directly picked up with two different techniques. Patients were classified randomly without any bias into two equal groups (Group I block-out spacer) and (Group II without block-out spacer). Over a year, the digital radiographic technique with new technique of reference points was employed to evaluate the changes in the residual alveolar ridge bone heights. The data were statistically analyzed to test the significance difference between groups.
Results: Concerning the residual alveolar ridge resorption RRR, group I exhibited a significantly higher RRR than group II.
Conclusion: In terms of residual alveolar ridge preservation, not using the block-out spacer was more beneficial than using it.
Clinical significance: Alveolar bone heights can be affected by the use of block-out spacer during pick-up procedure within accepted physiologic values. The removal of the block-out spacer could be more beneficial with respect to the preservation of the residual alveolar ridge.
Taddei C, Metz M, Waltman E, et al. Direct procedure for connecting a mandibular implant-retained overdenture with ball attachments. J Prosthet Dent 2004;92(4):403–404. DOI: 10.1016/j.jpor.2017.06.004.
Lambade D, Lambade P, Gundawar S. Implant supported mandibular overdenture: A viable treatment option for edentulous mandible. J Clin Diagnostic Res 2014;8(5):ZD04–ZD6. DOI: 10.7860/JCDR/2014/7711.4332.
Emami E, Alesawy A, Grandmont P, et al. A within-subject clinical trial on the conversion of mandibular two-implant to three-implant overdenture: Patient-centered outcomes and willingness to pay. J Clin Oral Implants Res 2019;30(3):218–228. DOI: 10.1111/clr.13408.
El Khourazaty N, Nassouhy N. Clinical and radiographic assessment of implant overdentures retained by different attachment systems. Egy Dental J 2017;63:3325–3333. DOI: 10.21608/EDJ.2017.76193.
Waddell JN, Payne AGT, Swain MV. Physical and metallurgical considerations of failures of soldered bars in bar attachment systems for implant overdentures: A review of the literature. J Prosthet Dent 2006;96:283–288. DOI: 10.1016/j.prosdent.2006.07.005.
Salah El-Din A, Osama AM. The Effect of using different locator attachments with a different retention value on the bone height changes in Implant Supported class I removable Mandibular partial overdenture, A Radiographic Evaluation. Egy Dental J 2019; 65:2945–54. DOI: 10.21608/EDJ.2019.72690.
Daas M, Dubois G, Bonnet AS, et al. A complete finite element model of a mandibular implant-retained overdenture with two implants: Comparison between rigid and resilient attachment configurations. J Med Engine & Phys 2008;30(2):218–225. DOI: 10.1016/j.medengphy.2007.02.005.
Närhi TO, Geertman ME, Hevinga M, et al. Changes in the edentulous maxilla in persons wearing implant-retained mandibular overdentures. J Prosthet Dent 2000;84:43–49. DOI: 10.1067/mpr.2000.107113.
Çehreli MC, Iplikçioğlu H, Bilir ÖG. The influence of the location of load transfer on strains around implants supporting four-unit cement-retained fixed prostheses: In vitro evaluation of axial versus off-set loading. J Oral Rehabil 2002;29:394–400. DOI: 10.1046/j.1365-2842.2002.00867.x.
Elmowafy DA, Emera RMK, Hegazy SA. Two versus three implants for retaining mandibular overdenture with low-profile attachment: A study of retention and peri−implant tissue health Correspondence. J Dent Maxillofacial Res 2019;2:70–77. DOI: 10.30881/jdsomr.00033.
Hulley SB, Cummings SR, Browner WS, et al. Designing clinical research: an epidemiologic approach. 4th ed. Philadelphia. Lippincott Williams & Wilkins 2013; pp. 6C–79.
Phogat S, Madan R. An innovative technique to fabricate duplicate denture in severe undercuts. J Res Adv Dent 2021;5:81–85. Available from: https://www.researchgate.net/publication/307545201_An_Innovative_Technique_to_Fabricate_Duplicate_Denture_in_Severe_Undercuts_A_Case_Report.
Kremer U, Schindler S, Enkling N, et al. Bone resorption in different parts of the mandible in patients restored with an implant overdenture. A retrospective radiographic analysis. Clin Oral Implants Res 2016;27:267–272. DOI: 10.1111/clr.12523.
Tiwari P, Karambelkar V, Patel JR, et al. Use of panoramic radiographs for evaluation of maxillary and mandibular residual ridge resorption: In vitro study. J Evol Med Dent Sci 2014;3(60):13380–13392. DOI: 10.14260/jemds/2014/3785.
Ural Ç, Bereket C, Şener I, et al. Bone height measurement of maxillary and mandibular bones in panoramic radiographs of edentulous patients. J Clin Exp Dent 2011;3(1):5–9. DOI: 10.4317/jced.3.e5.
Heckmann SM, Winter W, Meyer M, et al. Overdenture attachment selection and the loading of implant and denture-bearing area. Part 2: A methodical study using five types of attachment. Clin Oral Impl Res 2001;12:640–647. DOI: 10.1034/j.1600-0501.2001.120613.x.
Abd-Elrahman, Osman O, Al-Tonbry Y, et al. Effect of blocking ring used during picking up the female housings of ball attachments used for retaining 4-implants mandibular complete overdenture: In vitro stress analysis study. Mans J Dent 2019; 6:43–46. DOI: 10.21608/mjd.2019.199085.
Amal I. The Effect of bar curvature on stress distribution in implant supported mandibular overdenture. Ain Shams Dental J 2010; 13:149. Available from: http://research.asu.edu.eg/bitstream/12345678/9723/1/99676p1309.pdf.
Sadowsky SJ, Caputo AA. Effect of anchorage systems and extension base contact on load transfer with mandibular implant-retained overdentures. J Prosthet Dent 2000;84(3):327–334. DOI: 10.1067/mpr.2000.109378.
Takeshita S, Kanazawa M, Minakuchi S. Stress analysis of mandibular two-implant overdenture with different attachment systems. Dent Mater J 2011;30(6):928–934. DOI: 10.4012/dmj.2011-134.
ELsyad MA, Omran AO, Fouad MM. Strains around abutment teeth with different attachments used for implant-assisted distal extension partial overdentures: an in vitro study. J of Prosthodontics 2017;26(1):42–47. DOI: 10.1111/jopr.12370.
Chun HJ, Park DN, Han CH, et al. Stress distributions in maxillary bone surrounding overdenture implants with different overdenture attachments. J Oral Rehabil 2005;32(3):193–205. DOI: 10.1111/j.1365-2842.2004.01407.x.