Mandibular overdentures retained by 1 or 2 implants: a 5-year randomized clinical trial on implant stability and peri-implant outcomes

IF 3.1 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Oral Investigations Pub Date : 2024-09-16 DOI:10.1007/s00784-024-05914-w

Cláudio Rodrigues Leles, Gabriela Pereira de Resende, Nilva de Oliveira Martins, Lays Noleto Nascimento, Nadia Lago Costa, Murali Srinivasan, Martin Schimmel

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Abstract

Aim

This is a report of the 5-year results of a two-group parallel randomized clinical trial comparing longitudinal implant stability, and clinical and radiographic peri-implant outcomes of mandibular overdentures retained by one (1-IOD group) or two (2-IOD group) implants.

Methods

All participants received 4.1 mm diameter tissue-level implants (Straumann^® Standard Plus – SLActive^®, Institut Straumann AG), installed in the mandible midline (1-IOD; n = 23) or the lateral incisor-canine area bilaterally (2-IOD; n = 24), and loaded after 3 weeks. Implant Stability Quotient (ISQ) was measured using a resonance frequency device (Osstell^® Mentor, Integration Diagnostics) at implant placement, after three weeks (loading), and at the 6-month, 1-, 3-, and 5-year follow-ups. Marginal bone loss and clinical implant outcomes (plaque, calculus, suppuration and bleeding) were assessed periodically up to 5 years after loading.

Results

Only minor changes in marginal bone level were observed after 5 years (mean = 0.37; SD = 0.44 mm), and satisfactory and stable peri-implant parameters were observed throughout the 5-year follow-up. No significant differences between groups were found. Overall, the mean primary implant stability was considered high (> 70) for the two groups (1-IOD = 78.1 ± 4.5; 2-IOD = 78.0 ± 5.8). No noticeable changes were observed between implant insertion and loading. A marked increase was observed from insertion to the 6-month follow-up – the mean difference for the 1-IOD group was + 5.5 ± 5.5 (Effect size = 1.00), while for the 2-IOD group, the mean difference was + 6.0 ± 5.6 (Effect size = 1.08). No relevant changes were observed throughout the follow-up periods up to 5 years. Linear mixed-effect model regression showed no influence of the bone-related variables (p > 0.05) and the number of implants (p = 0.087), and a significant effect of the time variable (p < 0.001).

Conclusion

Satisfactory peri-implant outcomes and stable secondary stability suggest good clinical performance and successful long-term osseointegration of the implants for single and two-implant mandibular overdentures. Using a single implant to retain a mandibular overdenture does not seem to result in detrimental implant loading over the five years of overdenture use.

Clinical relevance

This study corroborates the use of a single implant to retain a mandibular denture.

Abstract Image

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下颌覆盖义齿由 1 个或 2 个种植体固位：关于种植体稳定性和种植体周围效果的 5 年随机临床试验

目的这是一项两组平行随机临床试验的5年结果报告，该试验比较了由一个（1-IOD组）或两个（2-IOD组）种植体固位的下颌覆盖义齿的纵向种植体稳定性以及种植体周围的临床和放射学结果。方法所有参与者都接受了直径为4.1毫米的组织水平种植体（Straumann® Standard Plus - SLActive®，Institut Straumann AG），安装在下颌骨中线（1-IOD；n = 23）或双侧切牙-犬齿区（2-IOD；n = 24），3周后进行加载。使用共振频率装置（Osstell® Mentor，Integration Diagnostics）测量种植体植入时、三周后（加载）以及 6 个月、1 年、3 年和 5 年随访时的种植体稳定性商数（ISQ）。结果5年后观察到的边缘骨水平变化很小（平均 = 0.37; SD = 0.44 mm），5年随访期间观察到令人满意的稳定的种植体周围参数。各组之间未发现明显差异。总体而言，两组的平均初次种植稳定性都很高（> 70）（1-IOD = 78.1 ± 4.5；2-IOD = 78.0 ± 5.8）。在种植体植入和加载之间没有观察到明显的变化。从植入种植体到 6 个月的随访期间，观察到了明显的增长--1-IOD 组的平均差异为 + 5.5 ± 5.5（效应大小 = 1.00），而 2-IOD 组的平均差异为 + 6.0 ± 5.6（效应大小 = 1.08）。在长达 5 年的随访期间，未观察到相关变化。线性混合效应模型回归结果显示，骨相关变量（p >0.05）和种植体数量（p = 0.087）没有影响，而时间变量（p <0.001）有显著影响。使用单种植体固位下颌覆盖义齿似乎不会在覆盖义齿使用的五年内造成有害的种植体负荷。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Oral Investigations 医学-牙科与口腔外科

CiteScore

6.30

自引率

5.90%

发文量

484

审稿时长

3 months

期刊介绍： The journal Clinical Oral Investigations is a multidisciplinary, international forum for publication of research from all fields of oral medicine. The journal publishes original scientific articles and invited reviews which provide up-to-date results of basic and clinical studies in oral and maxillofacial science and medicine. The aim is to clarify the relevance of new results to modern practice, for an international readership. Coverage includes maxillofacial and oral surgery, prosthetics and restorative dentistry, operative dentistry, endodontics, periodontology, orthodontics, dental materials science, clinical trials, epidemiology, pedodontics, oral implant, preventive dentistiry, oral pathology, oral basic sciences and more.