CONSERVATIVE APPROACH FOR MANAGEMENT OF POSTERIOR ATROPHIC MAXILLA USING IMPLANT ASSISTED OVERDENTURE (CLINCAL TRIAL) | ||||
| Alexandria Dental Journal | ||||
| Article 14, Volume 45, Issue 3, December 2020, Page 81-87 PDF (1 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/adjalexu.2020.82695 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Nayrouz A. Metwally  1; Ahmed M. Abdel-Hamid2; Ahmed M. Hommos3; Nermeen A. Rady4
| ||||
| 1Assistant lecturer, Removable Prosthodontics Department, Faculty of Dentistry, Alexandria University. | ||||
| 2Professor of Prosthodontics, Faculty of Dentistry, Alexandria University. | ||||
| 3Professor of Oral Medicine, Periodontology, Oral Diagnosis and radiology, Faculty of Dentistry, Alexandria University. | ||||
| 4Lecturer of Prosthodontics, Faculty of Dentistry, Alexandria University. | ||||
| Abstract | ||||
| CONSERVATIVE APPROACH FOR MANAGEMENT OF POSTERIOR ATROPHIC MAXILLA USING IMPLANT ASSISTED OVERDENTURE (CLINCAL TRIAL) Nayrouz A. Metwally1* BDS,MSc, Ahmed M. Abdel-Hamid2 BDS,MSc,PhD, Ahmed M. Hommos3BDS,MSc,PhD, Nermeen A. Rady4 BDS,MSc,PhD ABSTRACT Introduction: Implant assisted prostheses provide a higher degree of patient satisfaction than traditional prostheses. However, severe atrophy of the edentulous maxilla and maxillary sinus pneumatization may reduce the available bone in the posterior region for a safe and reliable implant‑supported dental rehabilitation. Tilted implants in the anterior region of the maxilla were suggested to be useful in the treatment of posterior atrophic edentulous maxilla that allows the use of longer implants to gain more stability. This may preclude the use of conventional Implant overdenture abutments, requiring the use of divergence correcting attachments. Objectives: The aim of the present study was to clinically evaluate the effect of the use of Smart Box accompanied with OT Equator attachment in retaining the inclined implant assisted overdenture for atrophic maxilla. Materials and methods: Ten patients with posterior atrophic maxilla and partially dentate mandible with posterior occlusal stops were allocated for this study. For each patient, an implant assisted maxillary overdenture was fabricated using minimally invasive flapless surgical technique. Four implants were placed while the most anterior implants were axial and the most posterior implants divergent to 25 degrees using CAD/CAM surgical guide. The implants were loaded immediately by OT EQUATOR and smart box attachment retained maxillary overdenture. Each patient was evaluated clinically at the final prosthesis insertion (baseline), three, six and nine months post insertion. Modified gingival index (MGI), Clinical attachment Level (CAL) and Peri-implant probing depth (PIPD) are the clinical parameters that were evaluated. Results:MGI, CAL and PIPD revealed significant increase in both tilted and axial groups throughout the evaluation period intervals. Tilted implants group showed significantly greater increase in all parameters when compared with the axial group. Conclusions: Within the limitations of this study, it can be concluded that combination of axial and tilted implant assisted overdenture is a predictable treatment option in case of severely atrophic posterior maxillae. | ||||
| Keywords | ||||
| Implant overdenture; Tilted implants; Atrophic maxilla; OT Equator; Smart Box | ||||
| References | ||||
|
1-Felton DA. Edentulism and comorbid factors. J Prosthodont. 2009;18(2):88-96.
2-Bhandari S. Outcome of single maxillary complete dentures opposing mandibular teeth: A need to introspect on the prosthodontic treatment protocol. J Indian Prosthodont Soc. 2016;16(1):15-9.
3-Adell R, Eriksson B, Lekholm U, Branemark P, Jemt T. Long-term follow-up study of osseointegrated implants in the treatment of totally edentulous jaws. Int J Oral Maxillofac Implants. 1990;5: 347–59.
4-Chiapasco M, Brusati R, Ronchi P. LeFort I osteotomy with interpositional bone grafts and delayed oral implants for the rehabilitation of extremely atrophied maxillae: A 1 ‑9‑ year clinical follow‑up study on humans. Clin Oral Implants Res.2007:18:74‑85.
5-Wallace S, Froum SJ. Effect of maxillary sinus augmentation on the survival of endosseous dental implants as compared to the survival of implants placed in the nongrafted posterior maxilla: an evidence-based literature review. Ann Periodontol. 2003;8:328-43.
6-Del Fabbro M, Testori T, Francetti L, Weinstein R. Systematic review of survival rates for implants placed in grafted maxillary sinus. Int J Periodontics Restorative Dent. 2004;24:565–77.
7-Bahat O. Osseointegrated implants in the maxillary tuberosity: report on 45 consecutive patients. Int J Oral Maxillofac Implants. 1992;7: 459–67.
8-Branemark PI, Grondahl K, Ohrnell LO, Nilsson P, Petruson B, Svensson B et al. Zygoma fixture in the management of advanced atrophy of the maxilla: technique and long-term results. Scand J Plast Reconstr Surg Hand Surg. 2004; 38: 70-85.
9-Krekmanov L, Kahn M, Rangert B, Lindstrom H. Tilting of posterior mandibular and maxillary implants for improved prosthesis support. Int J Oral Maxillofac Implants. 2000;15(3):405-14.
10-Soto-Penaloza D, Zaragozí-Alonso R, Penarrocha-Diago M, Penarrocha-Diago M. The all-on-four treatment concept: Systematic review. Journal of Clinical and Experimental Dentistry. 2017;9(3):474-88.
11-Hof M, Tepper G, Semo B, et al. Patients’ perspectives on dental implant and bone graft surgery: Questionnairebased interview survey. Clin Oral Implants Res 2014;25:42–45.
12-Kronström M, Widbom C, Soderfeldt B. Patient evaluation with maxillary implant-supported overdentures. Clin Oral Implants Res 2006;8:39–43.
13-Zitzmann NU, Marinello CP. Treatment plan for restoring the edentulous maxilla with implant-supported restorations: Removable overdenture versus fixed partial denture design. J Prosthet Dent 1999;82:188–196.
14-Evtimovska E, Masri R, Driscoll CF, Romberge V.The Change in Retentive Values of Locator Attachments and Hader Clips over Time. I J Prosthodont 2009;18:479-83.
15-Rizk F. Comparative study of OT-Equator profile attachment versus GPS attachment in implant retained mandibular overdenture case. Egypt Dent J. 2012,58(1):65-9.
16-Rhein83 USA Product Catalog 2015-2016.
17-Silness J, Löe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand 1964; 22:121-35.
18-Mombelli A, Van Oosten MA, Schurch E, Land NP. The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiol Immunol. 1987; 2:145-51.
19-Brägger U, Bürgin WB, Hämmerle CH, Lang NP. Associations between clinical parameters assessed around implants and teeth. Clin Oral Implants Res 1997; 8:412-21.
20-Kirkpatrick LA, Feeney BC. A simple guide to IBM SPSS statistics for version 20.0. Student ed. Belmont, Calif.: Wadsworth, Cengage Learning; 2013.
21-Takanashi y, Penrod JR, Lund JP, et al. A cost comparison of mandibular two-implant overdenture and conventional denture treatment. Int J Prosthodont. 2004; 17:181-186.
22-Heydecke G, Thomason JM, Awad MA, et al. Do mandibular implant overdentures and conventional complete dentures meet the expectations of edentulous patients? Quintessence Int. 2008;39:803-809.
23-Sadowsky SJ. Treatment considerations for maxillary implant overdentures: a systematic review. J Prosthet Dent. 2007 Jun;97(6):340-8. 24-Morand M, Irinakis T. The challenge of implant therapy in the posterior maxilla: providing a rationale for the use of short implants. J Oral Implantol. 2007;33:257–66.
25-Albrektsson T, Brånemark P-I, Eriksson A, Lindstrom J. The preformed autologous bone graft. Scand J Plast Reconstr Surg 1978;12:215–223.
26-Baig MR, Rajan M. Effects of smoking on the outcome of implant treatment: a literature review. Indian J Dent Res 2007; 18: 190-5.
27-Scully C, Hobkirk J, Dios PD. Dental endosseous implants in the medically compromised patient. J Oral Rehabil 2007; 34: 590-9
28-Chung DM, Oh TJ, Shotwell JL, et al. Significance of keratinized mucosa in maintenance of dental implants with different surfaces. J Periodontol. 2006; 77(8):1410-1420.
29-DarioLJ. A maxillary implant overdenture that utilizes angle- correcting abutments. J Prosthodont 2002;11:41–45.
30-Malo P, Rangert B, Nobre M. All‐on‐4 immediate‐function concept with Branemark system implants for completely edentulous maxillae: a 1‐year retrospective clinical study. Clin Implant Dent Relat Res 2005; 7 (1):88–94.
31-Weinstein R, Agliardi E, Fabbro MD, Romeo D, Francetti L. Immediate rehabilitation of the extremely atrophic mandible with fixed full‐prosthesis supported by four implants. Clin Implant Dent Relat Res 2012; 14:434–441.
32-Lee JY, Park HJ, Kim JE, Choi YG, Kim YS, Huh JB et al. A 5-year retrospective clinical study of the Dentium implants. J Adv Prosthodont. 2011 Dec; 3: 229–35.
33-Arisan V, Karabuda CZ, Ozdemir T (2010) Implant surgery using bone- and mucosa-supported stereolithographic guides in totally edentulous jaws: surgical and post-operative outcomes of computer-aided vs. standard techniques. Clin Oral Implants Res 21: 980– 988.
34-Sunitha RV, Sapthagiri E (2013) Flapless implant surgery: a 2-year follow-up study of 40 implants. Oral Surg Oral Med Oral Pathol Oral Radiol 116: e237–e243
35-Holst S, Blatz MB, Eitner S. Precision for computerguided implant placement: using 3D planning software and fixed intraoral reference points. J Oral Maxillofac Surg. 2007;65:393–399.
36-Slot W, Raghoebar GM, Vissink A, Huddleston Sla ter JJ, Meijer HJA. A systematic review of implant-supported maxillary overdentures after a mean observation period of at least 1 year. J Clin Periodontol 2010; 37:98–110
37-Cavallaro JS Jr, Tarnow DP. Unsplinted implants retaining maxillary overdentures with partial palatal coverage: report of 5 consecutive cases. Int J oral Maxillofac Implants. 2007;22:808-814.
38-Eccellente T, Piombino M, Piattelli A, et al. Immediate loading of dental implants in the edentulous maxilla. Quintessence Int. 2011;42:281-289.
39-Jour E, Fadl E, AbdelFattah. Comparative Study of Two Designs of Maxillary Implant-Supported Overdentures. Egy dent J 2009;55(2):1845-56.
40-Ghoul WE, Chidiac JJ . Prosthetic Requirements for Immediate Implant Loading: A Review. J Prosthodont 2012; 21(2):141–54.
41-AlFadda S. Early and immediate loading protocols for overdentures in completely edentulous maxillae: A comprehensive review in the clinical trials. The journal of contemporary dental practice.2014;15(6):797-805.
42-Naema A, Nabila M , Ahmed A. Clinical Evaluation of the Implant Retained Overdenture with OT-Equator Attachments. IJSR 2016;5(9): 643-7.
43-Marrone A, Lasserre J, Bercy P, Brecx MC. Prevalence and risk factors for peri‐implant disease in Belgian adults. Clin Oral Implants Res . 2013;24(8):934-40.
44-Joseph D, Gallina S, Paoli N, Miller N, Penaud J, Ambrosini P. A retrospective clinical study of implantretained prosthetic partial dentures: A follow up investigation. J of Dent Implants. 2014;4(1):38-43.
45-Schätzle M, LÖE H, Lang NP, H Heinz-Mayfield LJ, BüRGIN W, Anerud A et al. Clinical course of chronic periodontitis. III. Patterns, variations and risks of attachment loss. J of clin implant ; 2003;30(10): 9-18.
46-Myshin HL, Wiens JP. Factors affecting soft tissue around dental implants: a review of the literature. J Prosthet Dent. 2005;94(5):440-4.
47-Neiva RF, Neiva KG, Oh TJ, Wang HL. Clinical and morphological aspects of the implant/soft tissue interface. Int Chin J Dent, 2, pp. 151-61, 2002.
48-Buser D, Weber HP, Lang NP. Tissue integration of non‐ submerged implants. l‐year results of a prospective study with 100 ITI hollow‐ cylinder and hollow‐screw implants. Clin Oral Implants Res . 1990;1(1):33-40.
49-Salvi GE, Lang NP. Diagnostic parameters for monitoring peri-implant conditions. Int J oral Maxillofac Implants. 2004;19(7) 56-66
50-Wei-Shao Lin, Steven E. Eckert .Clinical performance of intentionally tilted implants versus axially positioned implants: A systematic review. Clin Oral Impl Res. 2018;29(16):78–105.
51-Degidi M, Nardi d, Piattelli A. Immediate Loading of the Edentulous Maxilla with a Definitive Restoration Supported by an Intraorally Welded Titanium Bar and Tilted Implants. Int J Oral Maxillofac Implants. 2010;6(25):1175-82
52-Agnini A, Agnini A M, Romeo D, Chiesi M, Chiesi L, Stappert FJ. Clinical Investigation on Axial versus Tilted Implants for Immediate Fixed Rehabilitation of Edentulous Arches: Preliminary Results of a Single Cohort Study. Clin Implant Dent Relat Res 2014 ;16(4): 52-39 | ||||
|
Statistics Article View: 483 PDF Download: 630 |
||||
