engleski

Rehabilitation of extremely resorbed completely edentulous mandible with short mini dental implants

Objectives: In patients with extreme alveolar ridge atrophy it is almost impossible to achive stable and well functioning complete dentures. In cases when mandibular hight is less than 10 mm and the buccolingual diameter is less than 4 mm, it's impossible to insert standard size implants without bone augmentation. 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 patients over time. Materials and methods: Twenty 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. 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. They also completed a questionnaire related to pain and swelling perception after implant insertion. Patients also provided data about analgetics intake after the procedure. Retroalveolar and panoramic radiographs were also obtained. Results: Twenty patients were successfully provided with short and slim MDIs for denture retention. They did not perceive a high level of pain and reported no swelling. They took analgetics only after the procedure, and 1 to 2 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 up to 24 months. No MDIs were lost. Conclusion: A success of both, slim and short implants has not been 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.

extreme alveolar ridge atrophy ; mini dental implants ; mandibular overdenture

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