Top

Clinical Oral Investigations

Published in:

01-01-2021 | Denture | Original Article

Immediate versus delayed loading of strategic mini-implants under existing removable partial dentures: patient satisfaction in a multi-center randomized clinical trial

Authors: Ahmad Al Jaghsi, Friedhelm Heinemann, Reiner Biffar, Torsten Mundt

Published in: Clinical Oral Investigations | Issue 1/2021

Abstract

Objective

The purpose of this study was to evaluate and compare the effects of the immediate and delayed loading of strategic mini-implants (MIs) on the satisfaction of patients with removable partial dentures (RPDs).

Materials and methods

In this multi-center randomized clinical trial, strategic MIs were inserted under 79 RPDs in 76 participants. Two questionnaires, one for the upper jaw and one for the lower jaw, were given before surgical intervention and 2 weeks, 4 months, 4.5 months, 1 year, 2 years, and 3 years after implant insertion. To estimate the loading effect (immediate vs. delayed) in terms of the odds ratio, an ordinal logistic regression model was used. The Wilcoxon matched-pairs signed-rank test, which was corrected for clusters in the patient population, was used to evaluate changes in patient satisfaction.

Results

After 4 months, a statistically significant difference in favor of the immediate loading group was recognized in terms of the overall satisfaction score. The patient satisfaction scores recorded after 4.5 months and 1, 2, and 3 years showed substantial improvements compared with the scores recorded before implant insertion in both groups. At the item level, substantial improvements were noted in the following domains: general satisfaction, RPD retention, stability, support, eating, speaking, and aesthetics.

Conclusions

Strategic MIs improved the satisfaction of patients with RPDs during the medium-term follow-up period. An earlier improvement in the satisfaction of patients with RPDs was seen after immediate loading of the MIs as compared with delayed loading.

Clinical relevance

Inserting MIs under existing RPDs can improve patients’ satisfaction with their RPDs in several domains.

de Freitas RF, de Carvalho DK, da Fonte Porto Carreiro A, Barbosa GA, Ferreira MA (2012) Mandibular implant-supported removable partial denture with distal extension: a systematic review. J Oral Rehabil 39:791–798. https://doi.org/10.1111/j.1365-2842.2012.02326.xCrossRefPubMed

Wismeijer D, Tawse-Smith A, Payne AG (2013) Multicentre prospective evaluation of implant-assisted mandibular bilateral distal extension removable partial dentures: patient satisfaction. Clin Oral Implants Res 24:20–27. https://doi.org/10.1111/j.1600-0501.2011.02367.xCrossRefPubMed

Goncalves TM, Campos CH, Garcia RC (2014) Implant retention and support for distal extension partial removable dental prostheses: satisfaction outcomes. J Prosthet Dent 112:334–339. https://doi.org/10.1016/j.prosdent.2013.11.004CrossRefPubMed

Bortolini S, Natali A, Franchi M, Coggiola A, Consolo U (2011) Implant-retained removable partial dentures: an 8-year retrospective study. J Prosthodont 20:168–172. https://doi.org/10.1111/j.1532-849X.2011.00700.xCrossRefPubMed

Campos CH, Goncalves TM, Rodrigues Garcia RC (2014) Implant retainers for free-end removable partial dentures affect mastication and nutrient intake. Clin Oral Implants Res 25:957–961. https://doi.org/10.1111/clr.12165CrossRefPubMed

Krennmair G, Krainhofner M, Piehslinger E (2007) Implant-supported mandibular overdentures retained with a milled bar: a retrospective study. Int J Oral Maxillofac Implants 22:987–994PubMed

Rinke S, Ziebolz D, Ratka-Kruger P, Frisch E (2015) Clinical outcome of double crown-retained mandibular removable dentures supported by a combination of residual teeth and strategic implants. J Prosthodont 24:358–365. https://doi.org/10.1111/jopr.12214CrossRefPubMed

Joda T (2013) Combined tooth-implant-supported telescopic prostheses in a midterm follow-up of >2 years. Int J Prosthodont 26:536–540CrossRefPubMed

Mijiritsky E, Lorean A, Mazor Z, Levin L (2015) Implant tooth-supported removable partial denture with at least 15-year long-term follow-up. Clin Implant Dent Relat Res 17:917–922. https://doi.org/10.1111/cid.12190CrossRefPubMed

10.

Hug S, Mantokoudis D, Mericske-Stern R (2006) Clinical evaluation of 3 overdenture concepts with tooth roots and implants: 2-year results. Int J Prosthodont 19:236–243PubMed

11.

Bidra AS, Almas K (2013) Mini implants for definitive prosthodontic treatment: a systematic review. J Prosthet Dent 109:156–164CrossRefPubMed

12.

ELsyad MA, Ghoneem NE, El-Sharkawy H (2013) Marginal bone loss around unsplinted mini-implants supporting maxillary overdentures: a preliminary comparative study between partial and full palatal coverage. Quintessence Int 44:45–52. https://doi.org/10.3290/j.qi.a28746CrossRefPubMed

13.

Preoteasa E, Imre M, Preoteasa CT (2014) A 3-year follow-up study of overdentures retained by mini-dental implants. Int J Oral Maxillofac Implants 29:1170–1176CrossRefPubMed

14.

Mundt T, Schwahn C, Stark T, Biffar R (2015) Clinical response of edentulous people treated with mini dental implants in nine dental practices. Gerodontology 32:179–187. https://doi.org/10.1111/ger.12066CrossRefPubMed

15.

Poljak-Guberina R, Celebic A, Catovic A, Zivkovic O (2005) Epidemiological study on removable denture deliveries in different districts of Croatia, 1996-2001 and 2002. Coll Antropol 29:127–132PubMed

16.

Zitzmann NU, Hagmann E, Weiger R (2007) What is the prevalence of various types of prosthetic dental restorations in Europe? Clin Oral Implants Res 18(Suppl 3):20–33. https://doi.org/10.1111/j.1600-0501.2007.01435.xCrossRefPubMed

17.

Tomasi C, Idmyr BO, Wennstrom JL (2013) Patient satisfaction with mini-implant stabilised full dentures. A 1-year prospective study. J Oral Rehabil 40:526–534. https://doi.org/10.1111/joor.12053CrossRefPubMed

18.

Mundt T, Al Jaghsi A, Schwahn B, Hilgert J, Lucas C, Biffar R, Schwahn C and Heinemann F (2016) Immediate versus delayed loading of strategic mini dental implants for the stabilization of partial removable dental prostheses: a patient cluster randomized, parallel-group 3-year trial. BMC Oral Health 17. https://doi.org/10.1186/s12903-016-0259-z

19.

Chan AW, Tetzlaff JM, Altman DG, Laupacis A, Gotzsche PC, Krleza-Jeric K, Hrobjartsson A, Mann H, Dickersin K, Berlin JA, Dore CJ, Parulekar WR, Summerskill WS, Groves T, Schulz KF, Sox HC, Rockhold FW, Rennie D, Moher D (2013) SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med 158:200–207. https://doi.org/10.7326/0003-4819-158-3-201302050-00583CrossRefPubMedPubMedCentral

20.

Al Jaghsi A, Mundt T, Kohlmann T, Samietz S, Daboul A, Klinke T, Biffar R (2017) Development and testing of satisfaction questionnaires for patients with removable dental prostheses. Quintessence Int 48:487–496. https://doi.org/10.3290/j.qi.a38201CrossRefPubMed

21.

Harrell FE Jr (2015) Regression modeling strategies. With applications to linear models, logistic and ordinal regression, and survival analysis. Springer, HeidelbergCrossRef

22.

Datta S, Satten GA (2008) A signed-rank test for clustered data. Biometrics 64:501–507. https://doi.org/10.1111/j.1541-0420.2007.00923.xCrossRefPubMed

23.

Foundation R https://www.r-project.org/. Accessed Acces Date 01-02-2017

24.

FEJ H (2016) rms: regression modeling strategies. https://CRAN.R-project.org/package=rms. Accessed Acces Date 01-02-2017

25.

Alfadda SA, Attard NJ, David LA (2009) Five-year clinical results of immediately loaded dental implants using mandibular overdentures. Int J Prosthodont 22:368–373PubMed

26.

Zancope K, Simamoto Júnior PC, Davi LR, Prado CJ, Neves FD (2014) Immediate loading implants with mandibular overdenture: a 48-month prospective follow-up study. Brazilian Oral Research 28:1–6CrossRef

27.

Jepson NJ, Thomason JM, Steele JG (1995) The influence of denture design on patient acceptance of partial dentures. Br Dent J 178:296–300CrossRefPubMed

28.

Gorai S, Koyama S, Chiba T, Ogawa T, Hatori K, Sasaki K (2008) Multivariate analysis of factors affecting the status of wearing removable partial dentures. Nihon Hotetsu Shika Gakkai Zasshi 52:126–134CrossRefPubMed

29.

Frank RP, Brudvik JS, Leroux B, Milgrom P, Hawkins N (2000) Relationship between the standards of removable partial denture construction, clinical acceptability, and patient satisfaction. J Prosthet Dent 83:521–527CrossRefPubMed

30.

Kono K, Kurihara D, Suzuki Y, Ohkubo C (2014) Pressure distribution of implant-supported removable partial dentures with stress-breaking attachments. J Prosthodont Res 58:115–120. https://doi.org/10.1016/j.jpor.2014.01.002CrossRefPubMed

31.

Koyama S, Sasaki K, Yokoyama M, Sasaki T, Hanawa S (2010) Evaluation of factors affecting the continuing use and patient satisfaction with removable partial dentures over 5 years. J Prosthodont Res 54:97–101. https://doi.org/10.1016/j.jpor.2009.11.007CrossRefPubMed

32.

Rodrigues RC, Faria AC, Macedo AP, de Mattos MG, Ribeiro RF (2013) Retention and stress distribution in distal extension removable partial dentures with and without implant association. J Prosthodont Res 57:24–29. https://doi.org/10.1016/j.jpor.2012.07.001CrossRefPubMed

33.

Mundt T, Schwahn C, Heinemann F, Schimmel M, Lucas C, Al Jaghsi A (2020) Stabilizing removable partial dentures by immediate or delayed loading of mini-implants: chewing efficiency in a randomized controlled clinical trial. Int J Oral Maxillofac Implants 35:178–186. https://doi.org/10.11607/jomi.7707CrossRefPubMed

34.

Passia N, Abou-Ayash S, Reissmann DR, Fritzer E, Kappel S, Konstantinidis I, Konigsmarck VV, Mundt T, Stiesch M, Wolfart S, Ali S, Kern M (2017) Single mandibular implant study (SMIS) - masticatory performance - results from a randomized clinical trial using two different loading protocols. J Dent 65:64–69. https://doi.org/10.1016/j.jdent.2017.07.005CrossRefPubMed

35.

Ozbek M, Tulunoglu I, Ozkan S, Oktemer M (2003) Evaluation of articulation of Turkish phonemes after removable partial denture application. Braz Dent J 14:125–131CrossRefPubMed

36.

Rothman R (1961) Phonetics considerations in denture prosthesis. J Prosthet Dent 11:214–223CrossRef

37.

Cash TF, Fleming EC, Pruzinsky T (2002) Body image: a handbook of theory, research, and clinical practice. Guilford Publication, New York

38.

Klages U, Claus N, Wehrbein H, Zentner A (2006) Development of a questionnaire for assessment of the psychosocial impact of dental aesthetics in young adults. Eur J Orthod 28:103–111. https://doi.org/10.1093/ejo/cji083CrossRefPubMed

39.

Zlataric DK, Celebic A (2008) Factors related to patients’ general satisfaction with removable partial dentures: a stepwise multiple regression analysis. Int J Prosthodont 21:86–88PubMed

40.

Palmer R, Palmer P, Leslie H (1999) Complications and maintenance. Br Dent J 187:653–658. https://doi.org/10.1038/sj.bdj.4800358CrossRefPubMed

41.

Papaspyridakos P, Chen CJ, Singh M, Weber HP, Gallucci GO (2012) Success criteria in implant dentistry: a systematic review. J Dent Res 91:242–248. https://doi.org/10.1177/0022034511431252CrossRefPubMed

42.

Schwass DR, Lyons KM, Purton DG (2013) How long will it last? The expected longevity of prosthodontic and restorative treatment. N Z Dent J 109:98–105PubMed

Title: Immediate versus delayed loading of strategic mini-implants under existing removable partial dentures: patient satisfaction in a multi-center randomized clinical trial
Authors: Ahmad Al Jaghsi
Friedhelm Heinemann
Reiner Biffar
Torsten Mundt
Publication date: 01-01-2021
Publisher: Springer Berlin Heidelberg
Keyword: Denture
Published in: Clinical Oral Investigations / Issue 1/2021
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-020-03360-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Immediate versus delayed loading of strategic mini-implants under existing removable partial dentures: patient satisfaction in a multi-center randomized clinical trial

Abstract

Objective

Materials and methods

Results

Conclusions

Clinical relevance

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Materials and methods

Results

Conclusions

Clinical relevance

Please log in to get access to this content

Other articles of this Issue 1/2021

Material selection for tooth-supported single crowns—a survey among dentists in Germany

Effectiveness of anesthetic solutions for pain control in lower third molar extraction surgeries: a systematic review of randomized clinical trials with network meta-analysis

Analysis of the smear layer generated by different activation systems: an in vitro study

Can carotid artery calcifications on dental radiographs predict adverse vascular events? A systematic review

Root-end microsurgery using a premixed tricalcium silicate putty as root-end filling material: a prospective study

The importance of multisection sagittal and coronal magnetic resonance imaging evaluation in the assessment of temporomandibular joint disc position