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Retrospective study comparing the clinical outcomes of bar-clip and ball attachment implant-supported overdentures
Malmö University, Faculty of Odontology (OD). Malmö University, Biofilms Research Center for Biointerfaces.ORCID iD: 0000-0002-3460-3374
Malmö University, Faculty of Odontology (OD).ORCID iD: 0000-0001-6625-4482
Malmö University, Faculty of Odontology (OD).
Malmö University, Faculty of Odontology (OD).
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2020 (English)In: Journal of Oral Science, ISSN 1343-4934, E-ISSN 1880-4926, Vol. 62, no 4, p. 397-401, article id 19-0412Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to compare the clinical outcomes of implant-supported overdentures (ODs) with either bar-clip or ball attachments. The implant, prosthesis failure, and technical complications were the outcomes analyzed in this retrospective clinical study conducted in a specialty clinic. Seventy-five patients with 242 implants supported by 76 ODs (36 maxillary, 40 mandibular) were included in the study and followed up for 88.8 ± 82.9 months (mean ± standard deviation). Bar-clip and ball attachments were used in 78.9% and 21.1% of the cases, respectively. Forty-three implant failures (17.8%) in 17 prostheses (17/76; 22.4%) were observed in this study. The average period of implant failure was 43.3 ± 41.0 months, and most of them were maxillary turned implants. The bar-clip system demonstrated more complications in the attachment parts compared to the ball attachment system. Poor retention of the prosthesis was similar between the two systems. Loss of implants resulted in the failure of 10 ODs in this study. ODs opposed by natural dentition or fixed prostheses presented with more complications. The Cox proportional hazards model did not show a significant effect on prosthesis failure for any of the factors. These findings indicated that patients with ODs need constant maintenance follow-ups to address the technical complications and perform prosthodontic maintenance regardless of the attachment system used.

Place, publisher, year, edition, pages
Tokyo Nihon University School of Dentistry , 2020. Vol. 62, no 4, p. 397-401, article id 19-0412
Keywords [en]
Overdenture, dental implant, attachment, prosthodontic maintenance, failure
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-18133DOI: 10.2334/josnusd.19-0412ISI: 000573430900010PubMedID: 32848099Scopus ID: 2-s2.0-85091647505OAI: oai:DiVA.org:mau-18133DiVA, id: diva2:1461633
Available from: 2020-08-27 Created: 2020-08-27 Last updated: 2024-02-05Bibliographically approved
In thesis
1. Studies on maxillary overdentures: implant- and prosthesis survival, cost analysis and patient-reported outcomes
Open this publication in new window or tab >>Studies on maxillary overdentures: implant- and prosthesis survival, cost analysis and patient-reported outcomes
2022 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Edentulism is a debilitating condition which may negatively affect quality of life, particularly in relation to nutritional and social health, speech, and poor facial appearance. Prosthetic options available range from conventional complete dentures to implant-supported overdentures (ISODs) and implant-supported full arch fixed partial dentures (ISFAFDPs). The choice of treatment is connected to the patient's general health, oral status, preferences and financial means. From the point of view of the treatment provider, there is a lack of evidence to support choice of treatment, as information from randomised clinical trials is sparse. This is particularly true when it comes to cost analysis and patient-reported outcome measures (PROMs). There is consensus today that an implant-supported overdenture is a valid treatment option for the edentulous mandible, but the same recommendation cannot be made for maxillary overdentures due to a lack of evidence.

The present study investigates implant-supported maxillary overdentures regarding implant and prosthesis survival, costs and PROMs in comparison to fixed implant-supported prostheses.

The thesis comprises four studies.Study I analysed implant and prosthesis failure rates with implant-supported maxillary overdentures in a systematic review. The cumulative survival rate (CSR) for the implants and the prostheses was 70.4% and 79.8%, respectively. The main finding was that patients with few implants presented higher prosthesis failure rates than patients with more implants per prosthesis.Of the most commonly used attachment systems, the ball/O-ring and the Ceka were the ones with the highest rates of patients with at least one implant failure. Most of the failures happened within the first year after installation for both implants (52.1%) and prostheses (41.8%).Study II, a retrospective analysis, compared the clinical outcomes of implantsupported overdentures (ISODs) with either bar-clip or ball attachments. The results showed that all ISOD failures resulted from loss of implants. The bar-clip system resulted in more complications than the ball attachment system, suggesting that ISODs with the bar-clip system may necessitate a greater number of appointments and chair time for adjustments, thus increasing the maintenance costs for the patient.Studies III and IV were based on a prospective clinical trial comparing different implant-supported prosthetic rehabilitations for the edentulous maxilla: implantsupported full-arch fixed partial dentures on 4 or 6 implants (ISFAFDP 4 orISFAFDP 6) versus maxillary overdentures on 2 implants.Study III is a comparative cost analysis, the results of which showed that all implants and restorations were in function at follow-up after the first year, i.e., the survival rate was 100%. Initial costs, i.e., cost of prostheses at delivery, were higher for ISFAFDP 6 and ISFAFDP 4 due to the higher number of implants and higher cost of materials and fees. There were no statistically significant differences in post-treatment costs between the groups.In study IV, patient-reported outcomes regarding aesthetics and function were compared. The results showed that all patients, irrespective of group, showed improved patient-reported outcomes from before treatment to the one-year follow-up. There were no significant differences between groups regarding functional status of the masticatory system (Jaw Functional Limitation Scale -JFLS parameters) or how patients perceive their dental and Orofacial Aesthetic Scale (OAS), and only minor differences between the two groups with fixed restorations regarding patients’ perception of the social impact of oral disorders on their well-being (Oral Health Impact Profile - OHIP).

Place, publisher, year, edition, pages
Malmö: Malmö University Press, 2022. p. 64
Series
Doctoral Dissertation in Odontology
Keywords
Prosthodontic, Dental Implants, Dental Prosthesis, Implant-Supported overdenture, cost analysis, Maxilla, Prosthesis Failure
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-56192 (URN)10.24834/isbn.9789178773213 (DOI)9789178773220 (ISBN)9789178773213 (ISBN)
Public defence
2022-12-16, Aulafoajén på Odontologiska fakulteten, Carl Gustafs väg 34, 09:15
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Available from: 2022-11-23 Created: 2022-11-23 Last updated: 2024-03-01Bibliographically approved

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Chrcanovic, Bruno RamosGhiasi, PeymanKisch, JenöLindh, LiselottLarsson, Christel

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