Citation Information :
Abdelaziz AA, Nabil MS, Habib AA. Comparison between Two Design Concepts of Four Implants Placement Used to Support Telescopic Mandibular Overdenture: A Prospective Study of Implant Marginal Bone Height Changes. J Contemp Dent Pract 2023; 24 (4):238-243.
Aim: The aim of this present study was to compare two placement designs of four implants used to support a telescopic mandibular overdenture regarding the marginal bone height changes.
Materials and methods: Each patient received four implants. Two anterior implants were installed vertically in the canine area. Patients were randomized into two groups according to the direction of posterior implants installed in the premolar area. Group I: where the implants were installed vertically parallel to the anterior implants and group II: where the implants were installed 30° distally. The implants were delayed loaded with a telescopic mandibular overdenture. The implant's marginal bone changes were evaluated after 6 and 12 months of overdenture insertion.
Results: Mean marginal bone loss of anterior implants showed a statistically significant difference between both groups. The vertically parallel posterior implants in group I showed statistically significant higher marginal bone loss than posterior implants in group II after follow-up periods. The 30° distally tilted posterior implants maintained the implant marginal bone after 12 months of overdenture insertion.
Conclusion: Rehabilitation of the edentulous mandible with telescopic overdenture supported by four parallel implants is a promising successful treatment option.
Clinical significance: Tilting the posterior implants will improve the anteroposterior spread that in turn increases the support and the survival rate of the implants. Also, using this technique gives us an opportunity to use fewer implants.
Naert I, Alsaadi G, Quirynen M. Prosthetic aspects and patient satisfaction with two-implant-retained mandibular overdentures: A 10-year randomized clinical study. Int J Prosthodont 2004;17(4):401–410. PMID: 15382775.
ELsyad MA, Elsaadawy MG, Abdou AM, et al. Effect of different implant positions on strain developed around four implants supporting a mandibular overdenture with rigid telescopic copings. Quintessence Int 2013;44(9):679–686. DOI: 10.3290/j.qi.a29187.
Malo P, Rangert B, Nobre M. All-on-four immediate-function concept with Branemark system implants for completely edentulous mandibles: A retrospective clinical study. Clin Implant Dent Relat Res 2003;5 Suppl 1:2–9. DOI: 10.1111/j.1708-8208.2003.tb00010.x.
Bevilacqua M, Tealdo T, Menini M, et al. The influence of cantilever length and implant inclination on stress distribution in maxillary implant-supported fixed dentures. J Prosthet Dent 2011;105(1):5–13. DOI: 10.1016/S0022-3913(10)60182-5.
Del Fabbro M, Bellini CM, Romeo D, et al. Tilted implants for the rehabilitation of edentulous jaws: A systematic review. Clin Implant Dent Relat Res 2012;14(4):612–621. DOI: 10.1111/j.1708-8208.2010.00288.x.
Hinze M, Thalmair T, Bolz W, et al. Immediate loading of fixed provisional prostheses using four implants for the rehabilitation of the edentulous arch: A prospective clinical study. Int J Oral Maxillofac Implants 2010;25(5):1011–1018. PMID: 20862417.
Patzelt SB, Bahat O, Reynolds MA, et al. The all-on-four treatment concept: A systematic review. Clin Implant Dent Relat Res 2014;16(6):836–855. DOI: 10.1111/cid.12068.
Kokubo Y, Fukushima S. Magnetic attachment for esthetic management of an overdenture. J Prosthet Dent 2002;88(3):354–355. DOI: 10.1067/mpr.2002.123352.
Eitner S, Schlegel A, Emeka N, et al. Comparing bar and double-crown attachments in implant-retained prosthetic reconstruction: A follow-up investigation. Clin Oral Implants Res 2008;19(5):530–537. DOI: 10.1111/j.1600-0501.2007.01500.x.
Awaad NM, Eladl NM, Abbass NA. Assessments of bone height loss in telescopic mandibular implant-retained overdentures retained by two and four end - osseous implants: A randomized clinical trial. Open Access Maced J Med Sci 2019;7(4):623–637. DOI: 10.3889/oamjms.2019.108.
Misch CE. Treatment options for mandibular implant overdentures. In: Misch CE, Bidez MW, Judy KWM, et al., (eds.) Dental implant prosthetics. 3rd edition. St. Louis: Mosby; 2005. pp. 218–235.
Naitoh M, Hayashi H, Tsukamoto N, et al. Labial bone assessment surrounding dental implant using cone-beam computed tomography: An in vitro study. Clin Oral Implants Res 2012;23(8):970–974. DOI: 10.1111/j.1600-0501.2011.02249.x.
Campelo LD, Camara JR. Flapless implant surgery: A 10-year clinical retrospective analysis. Int J Oral Maxillofac Implants 2002;17(2):271–276. PMID: 11958411.
Branemark PI, Hansson BO, Adell R, et al. Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period. Scand J Plast Reconstr Surg Suppl 1977;16:1–132. PMID: 356184.
Raes F, Renckens L, Aps J, et al. Reliability of circumferential bone level assessment around single implants in healed ridges and extraction sockets using cone beam CT. Clin Implant Dent Relat Res 2013;15(5):661–672. DOI: 10.1111/j.1708-8208.2011.00393.x.
Varinauskas V, Diliūnas S. Influence of cantilever length on stress distribution in peri-implant bone with full dental arch on four implants concept. Sveikatos Mokslai 2014;24(2):24–29.
Khatami AH, Smith CR. “All-on-four” immediate function concept and clinical report of treatment of an edentulous mandible with a fixed complete denture and milled titanium framework. J Prosthodont 2008;17(1):47–51. DOI: 10.1111/j.1532-849X.2007.00246.x.
Conrad HJ, Pesun IJ, DeLong R, et al. Accuracy of two impression techniques with angulated implants. J Prosthet Dent 2007;97(6):349–356. DOI: 10.1016/S0022-3913(07)60023-7.
Rashidan N, Alikhasi M, Samadizadeh S, et al. Accuracy of implant impressions with different impression coping types and shapes. Clin Implant Dent Relat Res 2012;14(2):218–225. DOI: 10.1111/j.1708-8208.2009.00241.x.
Ehsani S, Siadat H, Alikhasi M. Comparative evaluation of impression accuracy of tilted and straight implants in All-on-Four technique. Implant Dent 2014;23(2):225–230. DOI: 10.1097/ID.0000000000000064.
Daoudi MF, Setchell DJ, Searson LJ. A laboratory investigation of the accuracy of two impression techniques for single-tooth implants. Int J Prosthodont 2001;14(2):152–158. PMID: 11843452.
Hsu CC, Millstein PL, Stein RS. A comparative analysis of the accuracy of implant transfer techniques. J Prosthet Dent 1993;69(6):588–593. DOI: 10.1016/0022-3913(93)90287-x.
Hohlweg-Majert B, Metzger MC, Kummer T, et al. Morphometric analysis - Cone beam computed tomography to predict bone quality and quantity. J Craniomaxillofac Surg 2011;39(5):330–334. DOI: 10.1016/j.jcms.2010.10.002.
Elsyad MA, Elsaih EA, Khairallah AS. Marginal bone resorption around immediate and delayed loaded implants supporting a locator-retained mandibular overdenture. A 1-year randomised controlled trial. J Oral Rehabil 2014;41(8):608–618. DOI: 10.1111/joor.12182.
Piao CM, Lee JE, Koak JY, et al. Marginal bone loss around three different implant systems: Radiographic evaluation after 1 year. J Oral Rehabil 2009;36(10):748–754. DOI: 10.1111/j.1365-2842.2009.01988.x.
Albrektsson T, Zarb G, Worthington P, et al. The long-term efficacy of currently used dental implants: A review and proposed criteria of success. Int J Oral Maxillofac Implants 1986;1(1):11–25. PMID: 3527955
Weng D, Richter EJ. Maxillary removable prostheses retained by telescopic crowns on two implants or two canines. Int J Periodontics Restorative Dent 2007;27(1):35–41. PMID: 17370660.
Caruso G, Cattaneo A. Removable prosthesis supported by implants according to the Cagliari modified conometry technique: Case report. Int J Periodontics Restorative Dent 2007;27(3):259–265. PMID: 17694949.
Mitrani R, Brudvik JS, Phillips KM. Posterior implants for distal extension removable prostheses: A retrospective study. Int J Periodontics Restorative Dent 2003;23(4):353–359. PMID: 12956479.
Bevilacqua M, Tealdo T, Pera F, et al. Three-dimensional finite element analysis of load transmission using different implant inclinations and cantilever lengths. Int J Prosthodont 2008;21(6):539–542. PMID: 19149073.
Krekmanov L, Kahn M, Rangert B, et al. Tilting of posterior mandibular and maxillary implants for improved prosthesis support. Int J Oral Maxillofac Implants 2000;15(3):405–414. PMID: 10874806.
Zampelis A, Rangert B, Heijl L. Tilting of splinted implants for improved prosthodontic support: A two-dimensional finite element analysis. J Prosthet Dent 2007;97(6 Suppl):S35–S43. DOI: 10.1016/S0022-3913(07)60006-7.