engleski

Rehabilitation with Slim and Short Implants in Extremely Atrophic Mandible

Purpose: In patients with extreme alveolar ridge atrophy (intraforaminal hight < 10 mm ; buccolingual diameter < 4 mm) it is almost impossible to deliver a stable well functioning mandibular complete denture (MCD) and/or to insert standard size implants without bone augmentation. We aimed for the first time to rehabilitate such patients by means of both, slim and short (≤ 8 mm) mini dental implants (MDIs) and monitor them over time. Materials and Methods: After approving the protocol by finite element analysis, 20 patients (D or E classification according to Leckholm and Zarb assessed by panoramic radiographs and CBCTs) received four MDIs (2.0-2.5 mm wide ; 6-8 mm long) by a flapless technique. When insertion torque was ≤ 25 N/cm2 MDIs were splinted 3 month to ossteointegrate, or were early loaded (6-8 weeks, >25N/cm2). New MCDs reinforced with CoCr metal framework were made. Patients completed the OHIP- EDENT and the chewing function questionnaire (CFQ) at the baseline, one-month and one- year observation appointments. Retroalveolar and panoramic radiographs were also obtained. Results: Patients were successfully provided with slim and short MDIs and respective overdentures. From over 70% of participants not being able to wear MCDs, 100% of them wore overdentures afterwards. Two implants fractured during insertion and one failed later. All other implants were firm, without periimplantits. The OHIP EDENT and the CFQ scores significantly decreased from the baseline to the 1- year observation stage (p< 0.01). Crestal height at MDI sites remained stable, only 4 MDIs showed minimum bone loss (up to 1 mm). Ten individuals have been now successfully wearing respective dentures up to three years with no deterioration of OHRQoL and chewing ability (p>0.05). No more implants were lost. Conclusions: Preliminary clinical results are promising ; however more patients and a longer period of observation will be necessary to confirm the treatment success. Acknowlegment: Croatian Science Foundation for funding project: 1218, Acronim: Mini dental implants

slim and short implants ; alveolar ridge atrophy ; mandibular ovedentures

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