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      Rehabilitation of resorbed mandibular ridges using mini implant retained overdentures: A case series with 3 year follow-up

      case-report

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          Abstract

          With the increasing average life expectancy of human beings, the need to cater geriatric patients is ever increasing. Complete dentures are an indispensable tool in this regard. The loose and unstable lower complete denture owing to residual ridge resorption is one of the most common problems faced by edentulous patients. Dental implant retained overdentures have emerged as an efficient treatment modality for such patients. Though useful, not every patient is a suitable candidate to go for conventional implant-borne prosthesis, limitation being the available bone width. In such cases, mini implants may be used for augmenting the retention of the dentures and improving the quality of life of patients. In this case series, rehabilitation of three compromised cases with mini implant retained overdentures have been described wherein patients are experiencing instability of lower denture due to thin resorbed mandibular ridges. In one of the cases, three mini implants placed in A, C, and E position were splinted using a cemented bar to retain the mandibular denture. The other two cases were rehabilitated using unsplinted ball type one piece mini implants placed in A, C, and E position in one case and B and D position in another case. Though splinted bar design should be preferred but the lack of available vertical space precluded the utilization of bar in other two cases. The results were found to be satisfactory with no complications reported during a follow-up period of over 3 years in all the cases.

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          Most cited references12

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          Mandibular two implant-supported overdentures as the first choice standard of care for edentulous patients--the York Consensus Statement.

          The Annual Conference of the BSSPD (British Society for the Study of Prosthetic Dentistry) was held in York on 6 and 7 April 2009. At the symposium on mandibular overdentures, presenters offered a synopsis of the research available on the efficacy of implant-supported mandibular overdentures in the edentulous mandible. Emphasis was given to both qualitative and quantitative research based on patient-centred outcomes of treatment. A draft consensus was circulated to all presenters and to the Council members of the BSSPD and to BSSPD members on the Society's website. The statement was modified in the light of their comments, audience feedback following the presentations and members' feedback. We hope that this consensus statement will be a useful guide for patients and clinicians and that it will act to stimulate wider debate. We also hope that it will prove useful to other patient and professional organisations and will inform discussions with providers of national healthcare and with independent funders.
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            Density of bone: effect on treatment plans, surgical approach, healing, and progressive boen loading.

            C E Misch (1989)
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              Vertical distance from the crest of bone to the height of the interproximal papilla between adjacent implants.

              As patient demand increases for more natural restorations in the esthetic zone, clinicians must have the highest level of skill and knowledge to maintain or reform the interdental papilla between teeth, between implants and teeth, and between adjacent implants. To date, there are no reports that have measured the distance from the contact point to the bony crest between implants. One reason for this may be the fact that, with two adjacent implants, the contact point of the crown can be established at any distance from the gingival margin according to the restorative dentist's specifications. Therefore, in this study, the height of the soft tissue to the crest of bone was measured between two adjacent implants independent of the location of the contact point. The purpose of this study was to determine the range and average height of tissue between two adjacent implants. A total of 136 interimplant papillary heights were examined in 33 patients by eight different examiners in five private dental offices. After administration of appropriate local anesthesia, a standardized periodontal probe was placed vertically from the height of the papilla to the crest of bone. The measurements were rounded off to the nearest millimeter. The mean height of papillary tissue between two adjacent implants was 3.4 mm, with a range of 1 mm to 7 mm. Clinicians should proceed with great caution when placing two implants adjacent to each other in the esthetic zone. In most cases, only 2, 3, or 4 mm of soft tissue height (average 3.4 mm) can be expected to form over the interimplant crest of bone. These results showed that modification of treatment plans may be necessary when esthetics are critical for success.
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                Author and article information

                Journal
                J Indian Prosthodont Soc
                J Indian Prosthodont Soc
                JIPS
                The Journal of the Indian Prosthodontic Society
                Medknow Publications & Media Pvt Ltd (India )
                0972-4052
                1998-4057
                Apr-Jun 2016
                : 16
                : 2
                : 221-226
                Affiliations
                [1]Department of Prosthodontics, Crown and Bridge, Maulana Azad Institute of Dental Sciences, New Delhi, India
                [1 ]Department of Periodontics, NDMC Hospital, Chanakya Puri, New Delhi, India
                Author notes
                Address for correspondence: Dr. Pooja Kumari, Department of Prosthodontics, Crown and Bridge, Maulana Azad Institute of Dental Sciences, New Delhi - 110 002, India. E-mail: pooja_pathak4@ 123456yahoo.in
                Article
                JIPS-16-221
                10.4103/0972-4052.167948
                4837782
                27141177
                229125b5-e170-460f-bf2b-06ba3f985052
                Copyright: © The Journal of Indian Prosthodontic Society

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                : 22 July 2015
                : 08 September 2015
                Categories
                Case Report

                complete denture,dental implant,mini-implants,overdentures,retention

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