Author : Ana Messias
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)
Book Synopsis Immediate Vs Early Loading of Mandibular Overdentures - 3 Year Follow-up of a RCT. by : Ana Messias
Download or read book Immediate Vs Early Loading of Mandibular Overdentures - 3 Year Follow-up of a RCT. written by Ana Messias and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and Aim: Complete dentures were the traditional standard of care for edentulous patients. However, many patients have problems adapting to their complete dentures, especially to the mandibular prosthesis. The mandibular two-implant overdentures can be successful and are the first choice for prosthodontic treatment of edentulous mandibles in elderly patients. In these cases, adequate patient satisfaction can be related to improved denture retention and also to the stability achieved.Given that immediate loading implants supporting mandibular overdentures have comparable survival rates to those of conventional loading, both clinicians and patients would prefer these immediate loading protocols. However, given the uncomfortable post-surgical period from the patients' point of view, it may be advantageous to consider an early loading protocol.This study was designed as an equivalence trial. The purpose of this clinical trial was to compare the radiographic and clinical outcomes of immediate and early interforaminal loading protocols at 48 h and 2 weeks post-surgery, respectively, with two-splinted narrow-diameter implants for mandibular implant overdentures in thin, non-augmented residual ridge situations. Material and methods: Each edentulous patient included in the study received 2 implants (Tissue Level Standard Plus Implants, u00d8 3.3mm RN, SLActiveuf8e8, Roxoliduf8e8, either 10, 12, or 14 mm in length, Institute Straumann AG, Basel, Switzerland) in the interforaminal region. If primary stability after implant placement was achieved, patients were randomized either to the immediate (48h post-surgery) or the early (2 weeks after surgery) loading group. Prosthetic rehabilitation used SynOctau00ae bar prosthetic system, with a titanium Dolder bar. Implant survival and radiographic changes in crestal bone level were evaluated after three-years.Results: Twenty-four patients, with a mean age of 67u00b19 years, were included. After 3 years, 20 patients were available to follow-up (1 patient passed away before the 1st year appointment, 2 patients withdrew consent after the 1st year follow-up and 1 patient moved abroad after the 2nd year follow-up, all from the immediate loading group). Both the immediate and early loading groups presented 100% survival rate. In the immediate group, 9 patients with 18 implants, mean bone level change from surgery/loading to the third-year evaluation was 0.25u00b11.23mm (p=0.322). In the early loading group, 11 patients (22 implants), from loading to 3-years mean bone level change was 1.02u00b11.57mm (p=0.010). Though after 3 years marginal bone level changes were 0.76mm (95%CI: [-0.09, 1.61]) lower in the immediate loading group, no statistically significant differences could be found between groups (p=0.079). In fact, the estimated mean difference in marginal bone levels (DIB) of the two groups after 3 years of follow-up, obtained from a mixed effects model accounting for the variability of individual responses (implant clustering within patients) was -0.10mm (95%CI: [-0.60, 0.40]), p=0.68.Conclusions: Both protocols, immediate (48h) and early loading (2 weeks) with an implant overdenture over 2 splinted implants placed in the interforaminal region using narrow-diameter tissue level implants Straumannu00ae Standard Plus SLActiveuf8e8, Roxoliduf8ea, in an elderly population showed similar successful clinical results at three-years follow-up.
