Comparison of overdentures

Article Outline
Background
Methods
Results
Discussion
Further Reading

Background
Implant-retained overdentures can be mainly mucosa-supported, combined mucosa-implant– supported, or
implant-supported. Mainly mucosa-supported overdentures are attached to 2 implants by resilient stud
attachments or magnets and permit rotation and translation of the overdenture. The combined mucosa-
implant–supported overdenture is retained by 2 to 4 implants in the anterior part of the mandible and
connected via a bar. Rotation around the bar is permitted by retentive clips or a retentive sleeve. These 2
types of overdentures were compared.

Methods
Twenty press-fit dental implants (2 in each patient) were placed at the canine regions of the mandible in 10
completely edentulous patients. The implants were left submerged and unloaded for 4 months. Mandibular
overdentures retained with a magnet attachment, representing mainly mucosa-supported overdentures,
were used in group 1. The magnets were attached to the denture with a chairside resilient magnet bond
(Dyna I.M.P. system), which reduces the load transmitted to the implant. Mandibular overdentures retained
by a bar attachment, representing combined mucosa-implant–supported dentures, were used for group 2.
Clinical and radiographic assessments were conducted immediately after the overdentures were placed
and after 6, 12, and 18 months.

Results
None of the implants became mobile, and patient satisfaction was high in both groups. No significant
differences were found between the 2 groups at the follow-up periods, but a significant difference between
the groups was determined from the first day to the 18-month evaluations. Gingival index differed to a highly
significant degree between the 2 groups over the 18-month period. Group 1 had a significant increase in the
plaque index after 18 months compared with the initial value. No statistically significant difference was noted
in marginal bone height in the mesial aspect. A highly significant difference was noted at 12 months and a
very highly significant difference after 18 months for the distal marginal bone height. The radiographic
evaluations showed highly significant differences in the mesial marginal bone height between 1 day and 18
months for group 1 patients. Mesial marginal bone height in group 2 differed highly significantly between 1
day and 6 months, with even greater differences between 1 day and 12 months and 1 day and 18 months.
Similar findings were noted for distal marginal bone height on radiographic analysis. Bone density did not
differ between the groups for the mesial and apical aspects. However, distal aspect bone density was
significantly different after 12 months and highly significantly different after 18 months.
Discussion
Less bone resorption distal to the implants accompanied the use of mainly mucosa-supported overdentures
compared with combined mucosa-implant–supported overdentures. Patients receiving magnet-retained
overdentures had significantly high plaque index scores. A significant increase in gingival inflammation
occurred after 18 months in the combined group compared with the magnet group. Increasing functional
load may influence bone density and resorption. Clinical Significance.—Comparison of the 2 systems cited
reveals less bone resorption and gingival inflammation in the magnet retained, tissue borne system
compared to combined bar retained system. Are these results applicable to natural tooth abutments?
Uncited reference
Assad AS, El-Dayem MAA, Badawy MM: Comparison between mainly mucosa-supported and combined
mucosa–implant-supported mandibular overdentures. Implant Dent 13:386-394, 2004.
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Reprints available from AS Assad, 21 Mohamed Shafik St, Heliopolis, Cairo, Egypt; fax: +2 02 6320222; e-
mail: ahmed.assad@link.net.com

Dental Abstracts
Volume 50, Issue 5, September-October 2005, Page 312