The Use of Immediate-load Mini Dental Implant to Retain Mandibular Distal-extension Removable Partial Denture: A Preliminary Prospective Clinical Study Results
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Abstract
Background: The most frequent complications of distal extension mandibular removable partial dentures are loss of retention and irritation or ulceration. Other problems are unesthetic retentive clasps and discomfort when chewing. The resiliency of soft tissue can cause the rotational movement of the dentures. Long-term use
can result in ill-fitting prostheses and pain due to edentulous ridge resorption. Many authors have published case reports on the use of dental implants to support distal extension removable partial dentures, with high patient satisfaction. However, many patients who need partial dentures have limited bone support in which to place conventional-size dental implants and cannot wait three to four months for osseointegration. There are few randomized clinical studies of immediate implant-retained removable partial dentures.
Aim: To evaluate the clinical outcomes of using immediate-loaded mini dental implants with Equator® attachments when used to retain mandibular Kennedy Class I removable partial dentures.
Materials and methods: fifteen patients with mandibular Kennedy Class I removable partial dentures were recruited as participants. All participants received a full oral examination and completed a “patient satisfaction” questionnaire before treatment. Mini dental implants diameter 3.0 mm length 10 mm were placed at the mandibular first molar area on both sides using a flapless surgical technique. The removable partial dentures were connected immediately to the implants with an Equator® attachment (Insertion torque > 35 Ncm). Patients were recalled on the postoperative day as well as at one, four and eight weeks, three and six months after surgery. Outcome measures included changes in radiological peri-implant bone level and patient satisfaction were recorded. Data were analyzed using the Paired t-test (P=0.05).
Results: Two implants from 30 implants failed to osseointegrate (6.7%). After six months mean radiographic bone loss was 0.48 ± 0.31mm. Patient satisfaction showed significant improvement after treatment in all aspect. The success rate of mini dental implant was 93.3%.
Conclusions: Mini dental implant-retained removable partial dentures can improve patient satisfaction. Immediate-loaded mini dental implants can be used successfully to retain mandibular Kennedy Class I removable partial under specific conditions and precaution.
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References
Suominen-Taipale AL, Alanen P, Helenius H, Nordblad A, Uutela A. Edentulism among Finnish adults of working age, 1978-1997. Community Dent Oral Epidemiol. 1999 Oct;27(5):353–365.
Douglass CW, Watson AJ. Future needs for fixed and removable partial dentures in the United States. J Prosthet Dent. 2002 Jan;87(1):9–14.
Zitzmann NU, Hagmann E, Weiger R. What is the prevalence of various types of prosthetic dental restorations in Europe? Clin Oral Implants Res. 2007 Jun;18 Suppl 3:20–33.
Müller F, Naharro M, Carlsson GE. What are the prevalence and incidence of tooth loss in the adult and elderly population in Europe? Clin Oral Implants Res. 2007 Jun;18 Suppl 3:2–14.
Ulmer FC. Kennedy-Applegate classification of partially edentulous dental arches. NADL J. 1983 Jun;30(3):37–40.
Mijiritsky E. Implants in conjunction with removable partial dentures: a literature review. Implant Dent. 2007 Jun;16(2):146–154.
Bilhan H, Erdogan O, Ergin S, Celik M, Ates G, Geckili O. Complication rates and patient satisfaction with removable dentures. J Adv Prosthodont. 2012 May;4(2):109–115.
Halterman SM, Rivers JA, Keith JD, Nelson DR. Implant support for removable partial overdentures: a case report. Implant Dent. 1999;8(1):74–78.
Keltjens HM, Kayser AF, Hertel R, Battistuzzi PG. Distal extension removable partial dentures supported by implants and residual teeth: considerations and case reports. Int J Oral Maxillofac Implants. 1993;8(2):208–213.
Kuzmanovic DV, Payne AGT, Purton DG. Distal implants to modify the Kennedy classification of a removable partial denture: a clinical report. J Prosthet Dent. 2004 Jul;92(1):8–11.
Mitrani R, Brudvik JS, Phillips KM. Posterior implants for distal extension removable prostheses: a retrospective study. Int J Periodontics Restorative Dent. 2003 Aug;23(4):353–359.
Payne AGT, Tawse-Smith A, Wismeijer D, De Silva RK, Ma S. Multicentre prospective evaluation of implant-assisted mandibular removable partial dentures: surgical and prosthodontic outcomes. Clin Oral Implants Res. 2016 Jan 22;
Fields H, Campfield RW. Removable partial prosthesis partially supported by an endosseous blade implant. J Prosthet Dent. 1974 Mar;31(3):273–278.
Ohkubo C, Kurihara D, Shimpo H, Suzuki Y, Kokubo Y, Hosoi T. Effect of implant support on distal extension removable partial dentures: in vitro assessment. J Oral Rehabil. 2007 Jan;34(1):52–56.
Sato M, Suzuki Y, Kurihara D, Shimpo H, Ohkubo C. Effect of implant support on mandibular distal extension removable partial dentures: relationship between denture supporting area and stress distribution. J Prosthodont Res. 2013 Apr;57(2):109–112.
Ohkubo C, Kobayashi M, Suzuki Y, Hosoi T. Effect of implant support on distal-extension removable partial dentures: in vivo assessment. Int J Oral Maxillofac Implants. 2008 Dec;23(6):1095–1101.
Grossmann Y, Nissan J, Levin L. Clinical effectiveness of implant-supported removable partial dentures: a review of the literature and retrospective case evaluation. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg. 2009 Sep;67(9):1941–1946.
Fueki K, Kimoto K, Ogawa T, Garrett NR. Effect of implant-supported or retained dentures on masticatory performance: a systematic review. J Prosthet Dent. 2007 Dec;98(6):470–477.
Cheng T, Sun G, Huo J, He X, Wang Y, Ren Y-F. Patient satisfaction and masticatory efficiency of single implant-retained mandibular overdentures using the stud and magnetic attachments. J Dent. 2012 Nov;40(11):1018–1023.
Shahmiri RA, Atieh MA. Mandibular Kennedy Class I implant-tooth-borne removable partial denture: a systematic review. J Oral Rehabil. 2010 Mar;37(3):225–234.
de Freitas RFCP, de Carvalho Dias K, da Fonte Porto Carreiro A, Barbosa G a. S, Ferreira M a. F. Mandibular implant-supported removable partial denture with distal extension: a systematic review. J Oral Rehabil. 2012 Oct;39(10):791–798.
Flanagan D, Mascolo A. The mini dental implant in fixed and removable prosthetics: a review. J Oral Implantol. 2011 Mar;37 Spec No:123–132.
Flanagan D. Flapless dental implant placement. J Oral Implantol. 2007;33(2):75–83.
Shatkin TE, Petrotto CA. Mini dental implants: a retrospective analysis of 5640 implants placed over a 12-year period. Compend Contin Educ Dent Jamesburg NJ 1995. 2012;33 Spec 3:2–9.
Shatkin TE, Shatkin S, Oppenheimer BD, Oppenheimer AJ. Mini dental implants for long-term fixed and removable prosthetics: a retrospective analysis of 2514 implants placed over a five-year period. Compend Contin Educ Dent Jamesburg NJ 1995. 2007 Feb;28(2):92,99-101.
Cunha LDAP, Pellizzer EP, Verri FR, Pereira JA. Evaluation of the influence of location of osseointegrated implants associated with mandibular removable partial dentures. Implant Dent. 2008 Sep;17(3):278–287.
Memari Y, Geramy A, Fayaz A, Rezvani Habib Abadi S, Mansouri Y. Influence of Implant Position on Stress Distribution in Implant-Assisted Distal Extension Removable Partial Dentures: A 3D Finite Element Analysis. J Dent Tehran Iran. 2014 Sep;11(5):523–530.
Aunmeungtong W. Development of mini dental implant system for implant retained denture. Doctor of Philosophy (Dentistry). Chiang Mai University, 2016.
Misch CE, Perel ML, Wang H-L, Sammartino G, Galindo-Moreno P, Trisi P, et al. Implant success, survival, and failure: the International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference. Implant Dent. 2008 Mar;17(1):5–15.
Klein MO, Schiegnitz E, Al-Nawas B. Systematic review on success of narrow-diameter dental implants. Int J Oral Maxillofac Implants. 2014;29 Suppl:43–54.
Kunavisarut C, Kumpirichaya R. Short-term evaluation of mini- implant retained removable partial denture. M Dent J. 2014;34(3):215–224.
Rocha EP, Francisco SB, Del Bel Cury AA, Cury JA. Longitudinal study of the influence of removable partial denture and chemical control on the levels of Streptococcus mutans in saliva. J Oral Rehabil. 2003 Feb;30(2):131–138.
Elsyad MA, Setta FA, Khirallah AS. Strains around distally inclined implants retaining mandibular overdentures with Locator attachments: an in vitro study. J Adv Prosthodont. 2016 Apr;8(2):116–124.
Atashrazm P, Ansari H, Khorsand M, Fatemi M, Shahab MS, Azarmeh S. The Influence of Inclined Implants and Attachments on the Retention and Longevity of Implant-Retained Overdentures: An In Vitro Study. J Dent Shiraz Univ Med Sci. 2012 Jun 1;13(3):90–96.
de Freitas Santos CM, Pellizzer EP, Verri FR, de Moraes SLD, Falcón-Antenucci RM. Influence of implant inclination associated with mandibular class I removable partial denture. J Craniofac Surg. 2011 Mar;22(2):663–668.
Gonçalves TMSV, Campos CH, Garcia RCMR. Implant retention and support for distal extension partial removable dental prostheses: satisfaction outcomes. J Prosthet Dent. 2014 Aug;112(2):334–339.
Gallucci GO, Benic GI, Eckert SE, Papaspyridakos P, Schimmel M, Schrott A, et al. Consensus statements and clinical recommendations for implant loading protocols. Int J Oral Maxillofac Implants. 2014;29 Suppl:287–290.
Javed F, Romanos GE. The role of primary stability for successful immediate loading of dental implants. A literature review. J Dent. 2010 Aug;38(8):612–620.
Manzano-Moreno FJ, Herrera-Briones FJ, Bassam T, Vallecillo-Capilla MF, Reyes-Botella C. Factors Affecting Dental Implant Stability Measured Using the Ostell Mentor Device: A Systematic Review. Implant Dent. 2015 Oct;24(5):565–577.
Chikunov I, Doan P, Vahidi F. Implant-retained partial overdenture with resilient attachments. J Prosthodont Off J Am Coll Prosthodont. 2008 Feb;17(2):141–148.
Al-Nawas B, Brägger U, Meijer HJA, Naert I, Persson R, Perucchi A, et al. A double-blind randomized controlled trial (RCT) of Titanium-13Zirconium versus Titanium Grade IV small-diameter bone level implants in edentulous mandibles--results from a 1-year observation period. Clin Implant Dent Relat Res. 2012 Dec;14(6):896–904.
Quirynen M, Al-Nawas B, Meijer HJA, Razavi A, Reichert TE, Schimmel M, et al. Small-diameter titanium Grade IV and titanium-zirconium implants in edentulous mandibles: three-year results from a double-blind, randomized controlled trial. Clin Oral Implants Res. 2015 Jul;26(7):831–840.
Müller F, Al-Nawas B, Storelli S, Quirynen M, Hicklin S, Castro-Laza J, et al. Small-diameter titanium grade IV and titanium-zirconium implants in edentulous mandibles: five-year results from a double-blind, randomized controlled trial. BMC Oral Health. 2015;15(1):123.