Abstract
Objectives To investigate treatment outcome of splinted and unsplinted implants retaining mandibular hinging overdenture.
Design 5-year prospective randomised-controlled-trial (RCT)
Setting Prosthetic Department of Dental School in Belgium.
Patients 36 edentulous patients (17 male, 19 female) with a Mean age of 63 yrs (range 36-85 years). Exclusion criteria were, insufficient bone volume to harbour at least 2 10mm implants, Angle class II jaw relationship, physiological problems for accepting dentures, gagging reflexes, less than 1 year of edentulism in mandible, absence of a maxillary complete denture and administrative or physical considerations that would seriously affect the surgical procedure or follow-up.
Intervention Each patient was provided with 2 screw shaped c.p. titanium implants (Branemark system). 3–5 months later transmucosal abutments were placed. The patients were randomised to 3 groups with different retention systems, (a bar group, a magnet group and a ball group) for attachment of the overdenture. Patients received regular follow-up for 60mths.
Results 5 patients failed to complete all the follow-up visits (3 in Bar group, 1 Magnet, 1 Ball). None of the loaded implants failed. 1 implant was replaced at abutment surgery and survived. Of the peri-implant outcomes considered (plaque levels, mucosal bleeding, pocket depth, attachment level and marginal bone level) the only significant finding was a higher level of plaque in the magnet group compared to the ball group. No differences in plaque levels were noted between the bar and ball or between the bar and magnet groups.
Conclusions The peri-implant outcome is hardly any difference between splinted and unsplinted implants, Plaques levels a slightly higher on abutments fitted with magnets. There was no correlation between bleeding on probing and marginal bone loss. Marginal bone loss and attachment loss were not statistically different at year 5. The bone-implant interface rigidity was equal between the groups and increased over time.
Naert I, Gizani S, Vuylsteke, Van Steenberghe D. A 5-year randomised clinical trial on the influence of splinted and unsplinted oral implants in the mandibular overdenture therapy. Part 1. Peri-implant outcome. Clin Oral Impl Res 1998; 9: 170–177
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Address: I Naert, Department of Prosthetic Dentistry, BIOMAT Research Group, School of Dentistry, Oral and Maxillofacial Surgery, Catholic University Leuven, Belgium
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Isidor, F. Splinting does not affect the oral tissues surrounding the implants. Evid Based Dent 1, 21 (1998). https://doi.org/10.1038/sj.ebd.6490015
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DOI: https://doi.org/10.1038/sj.ebd.6490015