engleski

Case reports of mandibular overdenture rehabilitation in patients with extreme alveolar ridge atrophy by means of both slim and short mini dental implants

Objectives: It is almost impossible to achive stable and well functioning complete dentures in patients with extreme alveolar ridge atrophy. Moreover, in cases when mandibular hight is less than 10 mm and the buccolingual diameter is reduced, standard size implants are not recommended. According to standard procedures, mini dental implants (MDI) for retention of mandibular overdentures should be at least 10 mm long. We aimed to rehabilitate patients with less than 10 mm of mandibular hight by means of both, slim and short implants for complete denture retention and to monitor them over time. Methods: Several patients with extreme mandibular ridge atrophy (D or E classification according to Leckholm and Zarb, 1985.) were examined by means of panoramic radiographs and CBCTs. Each patient recieved four mini dental implants (2, 0 or 2, 5 mm wide and 6 to 8 mm long) by flapless techique. Insertion torque varied between 20 and 30 N/cm2 (less than 35 N/cm2). Therefore, implants were splinted temporarily with composite resin and left 2-3 months to ossteointegrate. Meanwhile, mandibular new complete dentures were made. Dentures were reinforsed with CoCr metal framework to prevent denture fractures. Patients completed the OHIP-EDENT questionnaire, as well as the chewing function questionnaire at the baseline, and one month after the dentures were delivered and adjusted. They also completed a questionnaire related to pain and swelling perception after implant insertion. Patients also provided data about analgetics intake after the procedure. Results: Five patients were successfully provided with short and slim MDIs for denture retention. They did not perceive a high level of pain and reported almost no swelling. They took analgetics only after the procedure, and 1 to 3 times afterwards. Panoramic radiograph after implant insertion showed that implants had been in proper positions. Dentures were delivered 2-3 months after insertion. Implants were firm, without any clinical signs of periimplantitis. After all denture adjustments had been finished, the OHIP EDENT scores significantly decreased from the baseline scores (p< 0.05), as well as the scores of the chewing function questionnaire, presenting satisfied individuals. Patients have been successfully wearing respective dentures between 5 months and one year and no implant has been lost. Conclusions: A success of both, slim and short implants have not been thoroughly investigated or reported yet. Preliminary experimental clinical results in our patients show a clinical success in extremly resorbed mandibles, however more patients and controled clinical cases throughout a longer time period of observation are necessary to confirm this treatment option as valid. Acknowlegment: Croatian Science Foundation for funding project: 1218, Acronim: Mini dental implants

extreme alveolar ridge atrophy ; mini dental implants ; mandibular overdenture

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