Implant-retained Mandibular Overdentures: A Comparative Study of Immediate Loading vs Delayed Loading after One Year

S. Shayegh, H. Semyari, A. Shahraki, Mohammad Reza Hakimaneh, L. Mahesh
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引用次数: 2

Abstract

Purpose: The aim of this study was to compare the clinical and radiographical outcomes of two loading protocols of mandibular overdentures supported by two unsplinted implants. Materials and methods: Twenty completely edentulous patients were included in the study. Patients were categorized in two groups each containing 10 patients. In group A, patients received at least two implants in symphysis areas inserted after a minimal flap reflection, and 2 months after implant placement, a mandibular complete denture was connected to the implants using ball attachments. In second group, prosthesis was loaded immediately after placing the implants in symphysis areas without any flap reflection. Patients were examined at 1, 12, 24 and 48 weeks after loading. At postoperative visits, occlusion was checked and the need for any prosthesis maintenance was recorded. Mobility of the implants, radiolucency around the implant and amount of crestal bone loss was checked and measured for both groups during the checkup sessions. Also any prosthetic problems were recorded. Results: After 12 months of loading, in both group no implant failure was reported and the survival rate was 100% in immediate and delay loading groups. Average of bone resorption in control group at the end of study was 0.84 ± 0.05 mm and in the test group was 0.84 ± 0.03 mm. In all patients after every 6 months the plastic O-rings were changed due to frictional wearing. In test group, in three patients the mandibular denture fractured, while, in control group it happened in two patients. In the test group, two patients experienced unbearable pain, while, in the control group seven patients experienced unbearable pain and they needed analgesics. None of the patients in test group experienced edema, swelling and discomfort after surgery due to flapless surgery, while in the control group four patients experienced edema and swelling after surgery. Conclusion: The results of this study suggest that immediate loading of two implants supporting mandibular overdenture has outcomes comparable with conventional loading protocols. This clinical approach offers good stability and comfort while keeping high implant success rate.
种植保留下颌覆盖义齿:即刻装填与延迟装填一年后的比较研究
目的:本研究的目的是比较两种无夹板种植体支撑下颌覆盖义齿的临床和影像学结果。材料与方法:选取全牙缺牙患者20例。患者分为两组,每组10例。A组患者在联合区放置至少2个种植体,在最小的皮瓣反射后植入,种植体放置2个月后,使用球形附着体连接下颌全口义齿。第二组在联合区放置假体后立即加载假体,无任何皮瓣反射。患者在加载后1、12、24和48周接受检查。术后随访时,检查咬合情况,记录是否需要维护义肢。在检查期间,对两组的种植体活动度、种植体周围的透光率和牙冠骨丢失量进行了检查和测量。此外,还记录了任何假肢问题。结果:加载12个月后,两组均无种植体失效,即刻和延迟加载组的成活率均为100%。研究结束时,对照组骨吸收平均值为0.84±0.05 mm,试验组骨吸收平均值为0.84±0.03 mm。所有患者每6个月因摩擦磨损更换一次塑料o形环。试验组3例患者发生下颌义齿断裂,对照组2例患者发生下颌义齿断裂。实验组中有2例患者出现了难以忍受的疼痛,而对照组中有7例患者出现了难以忍受的疼痛,需要使用止痛药。实验组无一例患者因无瓣手术术后出现水肿、肿胀及不适,对照组有4例患者术后出现水肿、肿胀。结论:本研究结果表明,即刻加载两种种植体支持下颌覆盖义齿的效果与常规加载方案相当。这种临床方法具有良好的稳定性和舒适性,同时保持了较高的种植成功率。
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