Journal of Oral Implantology Retrospective Analysis of Implant Overdenture Treatment in the Advanced Prosthodontic Clinic at the University of Illinois at Chicago --Manuscript Draft-Manuscript Number:
aaid-joi-D-14-00089R1
Full Title:
Retrospective Analysis of Implant Overdenture Treatment in the Advanced Prosthodontic Clinic at the University of Illinois at Chicago
Short Title:
Retrospective Analysis of Implant Overdenture Treatment
Article Type:
Clinical Research
Keywords:
Implant, Overdenture, Maxillary, Mandibular, OHIP, Clinical Outcomes, Locators, Quality of Life, Advanced Prosthodontics Clinic
Corresponding Author:
Aristotelis marinis, DDS, MS, FACP University of Illinois at Chicago Chicago, Illinois UNITED STATES
Corresponding Author Secondary Information: Corresponding Author's Institution:
University of Illinois at Chicago
Corresponding Author's Secondary Institution: First Author:
Aristotelis marinis, DDS, MS, FACP
First Author Secondary Information: Order of Authors:
Aristotelis marinis, DDS, MS, FACP Fatemeh Afshari Judy Yuan Cortino Sukotjo Damian Lee George Syros Kent Knoernschild Stephen Campbell
Order of Authors Secondary Information: Abstract:
Introduction: The aim of the present retrospective study was to evaluate the clinical outcomes of implant supported overdenture treatment provided by prosthodontic specialty residents. Material and methods: Twenty-three patients with 25 implant supported overdentures (IODs) participated in the study. Seventy four implants were placed by periodontic, prosthodontics, or oral and maxillofacial surgery students. All prostheses were fabricated in the advanced prosthodontics clinic at University of Illinois at Chicago. The implants, prostheses, and the condition of the peri-implant soft tissue were evaluated. Complications and any maintenance were documented. Patients completed an oral health impact profile-14 and semantic differential scale questionnaires. Statistical analyses were performed using SPSS software. Results: Twenty mandibular and 5 maxillary IODs were evaluated. Ninety-seven percent of the attachments were locators (Zest Anchors) and 3% ball attachments. None of the implants had lost osseo-integration but 14 implants (19%) had developed marginal Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation
bone loss one-third of the implant length or more. Fourteen (19%) implants had developed dehiscence, which ranged from 1-4mm. A variation in the width of the keratinized tissue, the gingival, plaque, and calculus index was observed. There was a statistically significant relationship between the presence of plaque and the bleeding on probing on the buccal aspect of implants (p=0.012). Incidence of dehiscence is significantly higher on the mid-facial when the keratinized tissue was less than 2mm (p5
Facial 16 (22 ) 8 (11 ) 8 (11 ) 19 (25 ) 10 (14 ) 9 (12 ) 4 (5 )
Lingual 0 1 2 3 4 5 >5
n (%)
Lingual
0 1
29 (39 ) 14 (19 ) 10 (13 ) 11 (15 ) 0 (0 ) 2 ( 3) 8 ( 11)
2
65 (88) 6 (8) 1 (1)
3
1 (1)
4
1 (1)
29
Table 6. Gingival Index versus Plaque Index. The presence (“yes) or absence (“no”) of bleeding and plaque observed mid-facial (white cells) and mid-lingual (gray cells) of all assessed implants. Percentages of total implants are also displayed.
Bleeding Plaque
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65
No
Yes
No
32 (43.2%)* 34 (45.9%)
3 (4.1%)*
6 (8.1%)
Yes
25 (33.8%)* 22 (29.7%)
14 (18.9%)*
12 (16.2%)
* annotates statistical significance (p < 0.05)
30
Table 7. Gingival Index versus Keratinized Tissue. The presence (“yes”) or absence (“no”) of gingival bleeding relative to the amount of keratinized tissue observed mid-facial (white cells) and mid-lingual (gray cells) of all assessed implants. Percentages of total implants are also displayed. Keratinized Tissue
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65
Bleeding No
Yes
0-2 mm
28 (37.8%)
41 (58.6%)
4 (5.4%)
12 (17.1%)
> 2 mm
29 (39.2%)
15 (21.4%)
13 (17.6%)
2 (2.9%)
31
Table 8. Dehiscence versus Keratinized Tissue. The presence (“yes”) or absence (“no”) of dehiscence relative to the amount of keratinized tissue observed mid-facial (white cells) and mid-lingual (gray cells) of all assessed implants. Percentages of total implants are also displayed. Keratinized Tissue
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65
Presence of Dehiscence No
Yes
0-2 mm
19 (25.7%)* 44 (62.9%)
13 (17.6%)*
9 (12.9%)
> 2 mm
41 (55.4%)* 17 (24.3%)
1 (1.4%)*
0 (0.0%)
* annotates statistical significance (p < 0.05)
32
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65
Table 9. Complications Complication Type Surgical / Implant Soft tissue inflammation/dehiscence/overgrowth Postoperative pain Bone loss Perforation of inferior border of mandible Prosthetic Replacement plastic insert (worn/lost insert, loose IOD) Broken/loose teeth in over denture or opposing denture Speech problem (patient) Difficulty to completely sit the prosthesis Difficulty to take out the prosthesis
n (%) 14 (19) 2 ( 9) 14 (19) 1 (4 ) 8 (35 ) 17 (74 ) 1 (4 ) 2 (9 ) 3 (13 )
33
Table 10. Incidence of denture tooth fracture relative to the functional duration of the prosthesis. N represents the number of denture teeth fracture occurrences for all the prostheses (N) in function during the specified time period.
Functional Duration
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65
0-12 mo 13-24 mo 25-36 mo 37-48 mo 49-60 mo
Incidence(n/N, %) 3 / 25 (12%) 4 / 21 (19%) 4 / 17 (23%) 4 / 11 (36%) 2 / 6 (33%)
34
Copyright Form Click here to download Copyright Form: Dear JOI.docx
aaid-joi-D-14-00089R1
Full Title:
Retrospective Analysis of Implant Overdenture Treatment in the Advanced Prosthodontic Clinic at the University of Illinois at Chicago
Short Title:
Retrospective Analysis of Implant Overdenture Treatment
Article Type:
Clinical Research
Keywords:
Implant, Overdenture, Maxillary, Mandibular, OHIP, Clinical Outcomes, Locators, Quality of Life, Advanced Prosthodontics Clinic
Corresponding Author:
Aristotelis marinis, DDS, MS, FACP University of Illinois at Chicago Chicago, Illinois UNITED STATES
Corresponding Author Secondary Information: Corresponding Author's Institution:
University of Illinois at Chicago
Corresponding Author's Secondary Institution: First Author:
Aristotelis marinis, DDS, MS, FACP
First Author Secondary Information: Order of Authors:
Aristotelis marinis, DDS, MS, FACP Fatemeh Afshari Judy Yuan Cortino Sukotjo Damian Lee George Syros Kent Knoernschild Stephen Campbell
Order of Authors Secondary Information: Abstract:
Introduction: The aim of the present retrospective study was to evaluate the clinical outcomes of implant supported overdenture treatment provided by prosthodontic specialty residents. Material and methods: Twenty-three patients with 25 implant supported overdentures (IODs) participated in the study. Seventy four implants were placed by periodontic, prosthodontics, or oral and maxillofacial surgery students. All prostheses were fabricated in the advanced prosthodontics clinic at University of Illinois at Chicago. The implants, prostheses, and the condition of the peri-implant soft tissue were evaluated. Complications and any maintenance were documented. Patients completed an oral health impact profile-14 and semantic differential scale questionnaires. Statistical analyses were performed using SPSS software. Results: Twenty mandibular and 5 maxillary IODs were evaluated. Ninety-seven percent of the attachments were locators (Zest Anchors) and 3% ball attachments. None of the implants had lost osseo-integration but 14 implants (19%) had developed marginal Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation
bone loss one-third of the implant length or more. Fourteen (19%) implants had developed dehiscence, which ranged from 1-4mm. A variation in the width of the keratinized tissue, the gingival, plaque, and calculus index was observed. There was a statistically significant relationship between the presence of plaque and the bleeding on probing on the buccal aspect of implants (p=0.012). Incidence of dehiscence is significantly higher on the mid-facial when the keratinized tissue was less than 2mm (p5
Facial 16 (22 ) 8 (11 ) 8 (11 ) 19 (25 ) 10 (14 ) 9 (12 ) 4 (5 )
Lingual 0 1 2 3 4 5 >5
n (%)
Lingual
0 1
29 (39 ) 14 (19 ) 10 (13 ) 11 (15 ) 0 (0 ) 2 ( 3) 8 ( 11)
2
65 (88) 6 (8) 1 (1)
3
1 (1)
4
1 (1)
29
Table 6. Gingival Index versus Plaque Index. The presence (“yes) or absence (“no”) of bleeding and plaque observed mid-facial (white cells) and mid-lingual (gray cells) of all assessed implants. Percentages of total implants are also displayed.
Bleeding Plaque
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65
No
Yes
No
32 (43.2%)* 34 (45.9%)
3 (4.1%)*
6 (8.1%)
Yes
25 (33.8%)* 22 (29.7%)
14 (18.9%)*
12 (16.2%)
* annotates statistical significance (p < 0.05)
30
Table 7. Gingival Index versus Keratinized Tissue. The presence (“yes”) or absence (“no”) of gingival bleeding relative to the amount of keratinized tissue observed mid-facial (white cells) and mid-lingual (gray cells) of all assessed implants. Percentages of total implants are also displayed. Keratinized Tissue
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65
Bleeding No
Yes
0-2 mm
28 (37.8%)
41 (58.6%)
4 (5.4%)
12 (17.1%)
> 2 mm
29 (39.2%)
15 (21.4%)
13 (17.6%)
2 (2.9%)
31
Table 8. Dehiscence versus Keratinized Tissue. The presence (“yes”) or absence (“no”) of dehiscence relative to the amount of keratinized tissue observed mid-facial (white cells) and mid-lingual (gray cells) of all assessed implants. Percentages of total implants are also displayed. Keratinized Tissue
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65
Presence of Dehiscence No
Yes
0-2 mm
19 (25.7%)* 44 (62.9%)
13 (17.6%)*
9 (12.9%)
> 2 mm
41 (55.4%)* 17 (24.3%)
1 (1.4%)*
0 (0.0%)
* annotates statistical significance (p < 0.05)
32
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65
Table 9. Complications Complication Type Surgical / Implant Soft tissue inflammation/dehiscence/overgrowth Postoperative pain Bone loss Perforation of inferior border of mandible Prosthetic Replacement plastic insert (worn/lost insert, loose IOD) Broken/loose teeth in over denture or opposing denture Speech problem (patient) Difficulty to completely sit the prosthesis Difficulty to take out the prosthesis
n (%) 14 (19) 2 ( 9) 14 (19) 1 (4 ) 8 (35 ) 17 (74 ) 1 (4 ) 2 (9 ) 3 (13 )
33
Table 10. Incidence of denture tooth fracture relative to the functional duration of the prosthesis. N represents the number of denture teeth fracture occurrences for all the prostheses (N) in function during the specified time period.
Functional Duration
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65
0-12 mo 13-24 mo 25-36 mo 37-48 mo 49-60 mo
Incidence(n/N, %) 3 / 25 (12%) 4 / 21 (19%) 4 / 17 (23%) 4 / 11 (36%) 2 / 6 (33%)
34
Copyright Form Click here to download Copyright Form: Dear JOI.docx
