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      EVALUATION OF THE INCLINATION EFFECT OF NON-SPLINTED IMPLANTS ON THE PROSTHETIC BEHAVIOR OF OVERDENTURES IN MANDIBLE EDENTULOUS PATIENTS Translated title: EVALUACIÓN DEL EFECTO DE LA INCLINACIÓN DE IMPLANTES NO FERULIZADOS SOBRE EL COMPORTAMIENTO PROTÉSICO DE SOBREDENTADURAS EN PACIENTES DESDENTADOS MANDIBULARES

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          Abstract

          ABSTRACT. Introduction: the aim of this study was to evaluate the sagittal inclination of implants with respect to the occlusal plane of mandibular overdentures and their effect on the prosthetic behavior of the overdentures. Methods: 52 implants were evaluated in 26 fully mandible edentulous adults (two interforaminal implants per patient), rehabilitated with ball attachments and overdenture. Cephalometric tracing was conducted, evaluating the sagittal inclination of the implant to mandibular plane (MI), occlusal plane (OI), compensation angle (CA), and anterior facial height. The following clinical variables of prosthetic behavior were assessed: the need for prosthesis rebasing, changes in prosthetic accessories, and loosening of the prosthetic attachment. The variables were described with measurements of central tendency and dispersion. Intragroup comparisons were made with the Student’s t test (p < 0.05) and correlations with the Pearson coefficient. Results: 26 patients were evaluated: 70.4% females and 29.6% males. The average age was 67.93 ± 8.6 years. The follow-up period ranged from 24 to 30 months. The average MI was 78.89 ± 10.9 degrees. There was a statistically significant correlation (r = 0.6) between MI and OI in patients who underwent a change in accessories and between MI and bone loss (r = 0.557) (p = 0.007). The average MI was higher in patients subjected to rebasing (89.70 ± 11.7 degrees), compared with those who were not subjected to rebasing (76.91 ± 9.8 degrees). A relationship with prosthetic pillar loosening could not be determined. Conclusions: the sagittal inclination of implants with respect to the occlusal plane in overdentures affects bone loss, leading to a change of accessories as well as prosthesis rebasing after two years of service.

          Translated abstract

          RESUMEN. Introducción: el objetivo del presente estudio consistió en evaluar la inclinación sagital de los implantes con respecto al plano oclusal de sobredentaduras mandibulares y su efecto sobre el comportamiento protésico de las mismas. Métodos: se evaluaron 52 implantes en 26 adultos desdentados totales inferiores (dos implantes interforaminales por paciente), rehabilitados con pilares tipo bola y sobredentadura. Se realizaron trazos cefalométricos y se evaluó la inclinación sagital del implante con respecto al plano mandibular (MI), el plano oclusal (OI), el ángulo de compensación (CA) y la altura facial anterior. Se evaluaron variables clínicas de comportamiento protésico: necesidad de rebase de la prótesis, cambio de aditamentos retentivos y aflojamiento del pilar protésico. Las variables se describieron con medidas de tendencia central y dispersión. Las comparaciones intragrupales se hicieron con prueba t de Student (p < 0,05), y las correlaciones con el coeficiente de Pearson. Resultados: se evaluaron 26 pacientes: 70,4% mujeres y 29,6% hombres. La edad promedio fue de 67,93 ± 8,6 años. El rango de seguimiento fue de 24 a 30 meses. El MI promedio fue de 78,89 ± 10,9 grados. Hubo una correlación (r = 0,6) estadísticamente significativa entre MI y OI en los pacientes a quienes se les realizó cambio de aditamentos y entre MI y la pérdida ósea (r = 0,557) (p = 0,007). La MI promedio fue mayor en aquellos pacientes a quienes se les hizo rebase (89,70 ± 11,7 grados), en comparación con los que no tuvieron rebase (76,91 ±9,8 grados). No se pudo determinar la relación con el aflojamiento del pilar protésico. Conclusiones: la inclinación sagital de los implantes con respecto al plano oclusal de las sobredentaduras tiene un efecto sobre la pérdida ósea, lo que conlleva al cambio de aditamentos y rebase de la prótesis después de dos años de observación.

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          A 5-year prospective randomized clinical trial on the influence of splinted and unsplinted oral implants retaining a mandibular overdenture: prosthetic aspects and patient satisfaction.

          Prosthetic outcome and patient satisfaction were evaluated in order to investigate whether there is a need or advantage to splint two implants in the mandible retaining a hinging overdenture. This study included 36 fully edentulous patients randomly divided into three groups according to the attachment system they received: magnets, ball attachments or straight bars (reference group). None of the implants failed during the whole observation period in any of the groups. After 5 years of observation, the Bar group presented the highest retention capacity and the least prosthetic complications but revealed more mucositis and gingival hyperplasia. Patient satisfaction rated similar for all groups although the Magnet group showed lower retention forces. All patients would repeat the same treatment even though the majority of the Magnet group would prefer a more retentive solution because of limited denture stability.
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            Prospective clinical evaluation of mandibular implant overdentures: Part I--Retention, stability, and tissue response.

            Seventeen subjects with preexisting conventional complete dentures were evaluated in this prospective clinical study. Two implants were placed bilaterally in the anterior mandible. In a crossover experimental design, the conventional dentures were modified, and the retention, stability, and tissue response for conventional dentures were compared with implant overdentures that had O-ring and magnet overdenture attachments for all subjects. The study indicated statistical superiority of the implant overdenture to the conventional denture. The O-ring attachment proved significantly better than the magnet attachment for retention and stability. The soft tissue response showed a slight but significant improvement with implant overdenture therapy.
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              The in vitro effect of different implant angulations and cyclic dislodgement on the retentive properties of an overdenture attachment system.

              The retentive capacity of ball attachments may be altered by a change in implant angulations. The purpose of this in vitro study was to investigate the effect of cyclic dislodgement on the retention of an overdenture attachment system when 2 implants were placed at angulations of 0, 5, 10, 15, and 20 degrees. Twelve acrylic resin blocks were fabricated and divided into 6 groups of 2 pairs each. In each of the 6 groups, 1 acrylic resin block was used to house the implants (block A), while the other (block B) was used to house the overdenture attachments. Two implants positioned at 0/0 degrees, with a standard plastic component(white) designed for 0-degree angulations, served as a control (CTRL), while the other 5 pairs of implants were placed in 5 different angulations: 0D: 0/0 degrees, 5D: 5/5 degrees, 10D: 10/10 degrees, 15D: 15/15 degrees, 20D: 20/20degrees (n=5). The extended range (green color) attachment was used for all groups except the control group. Implants(4.3 mm x 13 mm, internally hexed) were placed in blocks B. All angled implants were mesially tilted. Thirty pairs of attachments (Locator) were used. Dislodging cycles were applied to the overdenture attachment system. The initial retentive forces among the groups were not identical. The cycles required for the retentive forces of the attachments to decrease from the initial values to 60 N, and then to 40 N and 20 N, were recorded for standardization purposes.One-way ANOVA and Tukey HSD tests were used to analyze the difference in retention loss among the 6 groups(alpha=.05). A regression analysis (alpha=.05) was also performed to investigate the relationship between the implant angulation,the retentive force, and the logarithm of the number of cycles required for ball attachment retention decrease. The 1-way ANOVA and the Tukey HSD tests revealed significant differences for the number of cycles required by different implant angulation groups for the initial retentive values to decrease to 60 N, 40 N, and 20 N (P<.001).The 0D and 5D groups required the longest time for retention loss, while 20D and CTRL groups demonstrated the shortest time for retention loss. The results of the regression analysis of the logarithmic number of cycles on retentive force and implant angulation demonstrated a significant effect (P<.001). Implant angulations negatively affect attachment retention longevity. (J Prosthet Dent 2009;102:140-147)
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                Author and article information

                Journal
                rfoua
                Revista Facultad de Odontología Universidad de Antioquia
                Rev Fac Odontol Univ Antioq
                Universidad de Antioquia (Medellín, Antioquia, Colombia )
                0121-246X
                December 2017
                : 29
                : 1
                : 13-35
                Affiliations
                [4] Manizales Caldas orgnameUniversidad Autónoma de Manizales Colombia
                [1] Manizales Caldas orgnameUniversidad Autónoma de Manizales Colombia
                [3] Manizales Caldas orgnameUniversidad Autónoma de Manizales Colombia
                [2] Manizales Caldas orgnameUniversidad Autónoma de Manizales Colombia
                Article
                S0121-246X2017000200013 S0121-246X(17)02900100013
                10.17533/udea.rfo.v29n1a1
                2d93d2b8-f1c6-404e-82b9-d404c7d4aee0

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 02 August 2016
                : 09 May 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 34, Pages: 23
                Product

                SciELO Colombia

                Self URI: Full text available only in PDF format (EN)
                Categories
                Original article

                prótesis mandibular,dental implants,prosthetic veneer,mandibular prosthesis,implantes dentales,prótesis de recubrimiento

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