The influence of the implant-abutment complex on marginal bone and peri-implant conditions: A retrospective study

Purpose@#The design of the implant-abutment complex is thought to be responsible for marginal bone loss (MBL) and might affect the condition of the peri-implant tissues. This the present study aimed to evaluate the influence of the implant-abutment complex on MBL and the peri-implant tissues in partially edentulous patients treated with dental implants and determine the most advantageous design. @*Materials and Methods@# A total of ninety-one endosseous implants with different designs of implant-abutment complex [tissue level-TL (n = 30), platform switch-PS (n = 18), and platform match-PM (n = 43)] were reviewed for MBL, Probing Pocket Depth (PPD) and Bleeding on Probing (BoP). MBL was calculated for first year of the insertion and the following years. @*Results@#The median MBL for the PM implants (2.66 ± 1.67 mm; n = 43) in the first year was significantly higher than those for the other types (P=.033). The lowest rate of MBL (0.61 ± 0.44 mm; n = 18) was observed with PS implants (P=.000). The position of the crown-abutment border showed a statistically significant influence (P=.019) and a negative correlation (r=-0.395) on MBL. BoP was found significantly higher in PM implants (P=.006). The lowest BoP scores were detected in PS implants, but the difference was not significant (P=.523). The relation between PPD and connection type revealed no statistically significant influence (P >.05). @*Conclusion@# Within the limitations of the present study, it may be concluded that PS implants seem to show better peri-implant soft tissue conditions and cause less MBL.

Evaluation of two interforaminal implants and implant-assisted removable dentures on stress distribution: an in vitro study

OBJECTIVES: In mandibular edentulism, the treatment option with a two-interforaminal implant-retained bridge and a removable partial denture is rarely evaluated in literature. The aim of this in vitro study was to evaluate the stress distribution of this treatment option by comparing it with traditional treatment options with interforaminal implants in the edentulous mandible. MATERIALS AND METHODS: Two interforaminal implants were placed in a formalin-fixed cadaver mandible, and overdentures with three different types of attachments were fabricated: (1) two ball attachments and an overdenture, (2) a Dolder bar and an overdenture, and (3) screw-retained two-implant inter-canine porcelain fused to a metal bridge and an implant-assisted removable denture (IARD) with precision attachments. Three biting conditions were generated for each denture type, and the strains were documented under vertical loading of 100 N. RESULTS: The calculated strain values from measured strains in all measurement sites and loading conditions for the screw-retained two-implant inter-canine porcelain fused to a metal bridge and a cast framework partial denture with precision attachments situation were lower than in the other scenarios (P<0.05). CONCLUSION: Within the limitations of the present study, it can be concluded that an IARD may be a reasonable and valuable alternative to ball attachments or a bar in two interforaminal implants, especially when the patients prefer to be able to show their teeth even when they take out their removable dentures.

Evaluation of two interforaminal implants and implant-assisted removable dentures on stress distribution: an in vitro study

OBJECTIVES@#In mandibular edentulism, the treatment option with a two-interforaminal implant-retained bridge and a removable partial denture is rarely evaluated in literature. The aim of this in vitro study was to evaluate the stress distribution of this treatment option by comparing it with traditional treatment options with interforaminal implants in the edentulous mandible.@*MATERIALS AND METHODS@#Two interforaminal implants were placed in a formalin-fixed cadaver mandible, and overdentures with three different types of attachments were fabricated: (1) two ball attachments and an overdenture, (2) a Dolder bar and an overdenture, and (3) screw-retained two-implant inter-canine porcelain fused to a metal bridge and an implant-assisted removable denture (IARD) with precision attachments. Three biting conditions were generated for each denture type, and the strains were documented under vertical loading of 100 N.@*RESULTS@#The calculated strain values from measured strains in all measurement sites and loading conditions for the screw-retained two-implant inter-canine porcelain fused to a metal bridge and a cast framework partial denture with precision attachments situation were lower than in the other scenarios (P<0.05).@*CONCLUSION@#Within the limitations of the present study, it can be concluded that an IARD may be a reasonable and valuable alternative to ball attachments or a bar in two interforaminal implants, especially when the patients prefer to be able to show their teeth even when they take out their removable dentures.

In vitro comparison of two different materials for the repair of urethan dimethacrylate denture bases

PURPOSE: The purpose of this in vitro study was to investigate the flexural properties of a recently introduced urethane dimethacrylate denture base material (Eclipse) after being repaired with two different materials. MATERIALS AND METHODS: Two repair groups and a control group consisting of 10 specimens each were generated. The ES group was repaired with auto-polymerizing polymer. The EE group was repaired with the Eclipse. The E group was left intact as a control group. A 3-point bending test device which was set to travel at a crosshead speed of 5 mm/min was used. Specimens were loaded until fracture occurred and the mean displacement, maximum load, flexural modulus and flexural strength values and standard deviations were calculated for each group and the data were statistically analyzed. The results were assessed at a significance level of P.05) was found between the mean values of Group ES and EE. There was a statistically significant positive relation (P<.01) between the displacement and maximum load of Group ES (99.5%), Group EE (94.3%) and Group E (84.4%). CONCLUSION: The more economic and commonly used self-curing acrylic resin can be recommended as an alternative repair material for Eclipse denture bases.

The impact of frenulum height on strains in maxillary denture bases

PURPOSE: The midline fracture of maxillary complete dentures is a frequently encountered complication. The purpose of this study was to assess the effect of frenulum height on midline strains of maxillary complete dentures. MATERIALS AND METHODS: A removable maxillary complete denture was fabricated and duplicated seven times. Four different labial frenulum heights were tested for stresses occurring on the palatal cameo surface. The strains were measured with strain gauges placed on 5 different locations and the stresses were calculated. To mimic occlusal forces bilaterally 100 N of load was applied from the premolar and molar region. RESULTS: A statistically significant association between the height of the labial frenulum and the calculated stresses and strains was shown (P<.05) predominantly on the midline and especially on the incisive papilla. The results showed that stress on the anterior midline of the maxillary complete denture increases with a higher labial frenulum. CONCLUSION: Within the limitations of this in vitro study, it can be concluded that the stress on the anterior midline of the maxillary complete denture increases with a higher labial frenulum. Surgical or mechanical precautions should be taken to prevent short-term failure of maxillary complete dentures due to stress concentration and low cycle fatigue tendency at the labial frenulum region.

Assessment of demographic and clinical data related to dental implants in a group of Turkish patients treated at a university clinic

PURPOSE: This retrospective study analyzed the distribution of the dental implants with regards to age and gender of the patients and type of indication for the implant therapy, as well as the location, dimension and type of the implants. MATERIALS AND METHODS: The data of demographics (age and gender), type of indication for implant therapy, anatomical location, dimensions (length and diameter) and type (bone and tissue level) of 1616 implants were recorded from patient charts between January 2000 and January 2010. Descriptive statistics were analyzed using a chi-squared test for demographic parameters, type of indication, tooth position, anatomical location, implant dimensions and type (alpha=.05). RESULTS: The patient pool comprised of 350 women and 266 men, with a mean age of 52.12 +/- 13.79 years. The difference in n% of the implants of the age groups was statistically significant between the types of indications. The difference in the position of the implants was statistically significant between the n% of the implants of all age groups. Gender did not significantly vary, except that the diameter of the implants was significantly higher for the standard diameter implants in males. The difference between the implant positions was statistically significant when considered according to indication. The relationship between implant length and anatomical location was statistically significant. CONCLUSION: The indication for dental implant use is age dependent and the type and size of the implant seems to be strongly related to the location of the implant.

Complication rates and patient satisfaction with removable dentures

PURPOSE: The purpose of this clinical study was to evaluate the frequency and type of prosthetic complications in relation to type and properties of removable dentures and to investigate the influence of these complications and several data about the existing dentures on patient satisfaction. MATERIALS AND METHODS: Ninety nine patients (44 males and 55 females) wearing removable dentures have been included in the study. The complications of the patients were recorded; patient satisfaction was determined with a Visual Analog Scale (VAS) and the relationship of complications and patient satisfaction with several data about the dentures such as denture age, type of denture, centric relation and vertical dimension was investigated. Kruskal Wallis, Mann Whitney U and Chi square tests were used for statistical analyses. The results were evaluated statistically at a significance level of P<.05. RESULTS: Need for addition of artificial teeth for dentures with correct centric relations was found to be significantly lower than dentures with wrong centric relations (P<.01). Loss of retention, ulcerations and high vertical dimension affected the VAS chewing ability scores negatively and ulcerations affected the VAS phonation scores negatively (P<.05). CONCLUSION: Considering the results of this study, it can be concluded that loss of retention, ulcerations and high vertical dimension caused patient dissatisfaction. Additionally, dentures with wrong centric relations caused need for addition of artificial teeth.

The use of definitive implant abutments for the fabrication of provisional crowns: a case series

PURPOSE: The anterior region is a challenge for most clinicians to achieve optimal esthetics with dental implants. The provisional crown is a key factor in the success of obtaining pink esthetics around restorations with single implants, by soft tissue and inter-proximal papilla shaping. Provisional abutments bring additional costs and make the treatment more expensive. Since one of the aims of the clinician is to reduce costs and find more economic ways to raise patient satisfaction, this paper describes a practical method for chair-side fabrication of non-occlusal loaded provisional crowns used by the authors for several years successfully. METHODS: Twenty two patients (9 males, 13 females; mean age, 36,72 years) with one missing anterior tooth were treated by using the presented method. Metal definitive abutments instead of provisional abutments were used and provisional crowns were fabricated on the definitive abutments for all of the patients. The marginal fit was finished on a laboratory analogue and temporarily cemented to the abutments. The marginal adaptation of the crowns was evaluated radiographically. RESULTS: The patients were all satisfied with the final appearance and no complications occurred until the implants were loaded with permanent restorations. CONCLUSIONS: The use of the definitive abutments for provisional crowns instead of provisional abutments reduces the costs and the same results can be obtained.