Implant‐Retained Mandibular Overdentures with Immediate Loading: a 3‐ to 8‐Year Prospective Study on 328 Implants
Bibliographic record
Abstract
PURPOSE: The purpose of this study is to evaluate prospectively survival and success rates of implants placed in the interforaminal area of edentulous mandibles and immediately loaded with an implant-supported overdenture. MATERIALS AND METHODS: Eighty-two patients, 33 males and 49 females, aged between 42 and 87 years (mean age 58.6 yr), presenting edentulous mandibles were rehabilitated with an implant-supported overdenture in the mandible. Three hundred twenty-eight screw-type osseointegrated implants (164 Ha-Ti, Mathys Dental, Bettlach, Switzerland; 84 ITI Dental Implant System, Straumann Institute, Waldenburg, Switzerland; 40 Brånemark Conical, Nobel Biocare AB, Gothenburg, Sweden; 40 Frialoc, Friatec, AG Mannheiti, Germany), were placed in the intraforaminal area of the mental symphysis (4 implants per patient). Immediately after implant placement, a U-shaped gold or titanium bar was fabricated and implants were rigidly connected with the bar and immediately loaded with an implant-retained overdenture. Success rate of implants was evaluated clinically and radiographically every year after the loading of the prostheses according to the following parameters: (1) absence of clinical mobility of implants tested individually after bar removal, (2) absence of periimplant radiolucency evaluated on panoramic radiographs, (3) absence of pain and radiologic or clinical signs of neural lesion, and (4) periimplant bone resorption mesial and distal to each implant less than 0.2 mm after the first year of prosthetic load. RESULTS: Of 328 implants placed, 296 were followed up from a minimum of 36 months to a maximum of 96 months, with a mean follow-up of 62 months. Seven implants in 6 different patients were removed owing to loss of osseointegration, whereas 18 implants, although still osseointegrated, did not fulfill success criteria due to bone resorption > 0.2 mm/year after the first year of loading. Despite implant losses, all patients maintained their bars supporting overdentures, although in 6 patients they were supported by 3 instead of 4 implants. The only patient who lost 2 implants received 2 new implants, which survived normally. Therefore, the absolute success and survival rates were 91.6% and 97.6%, respectively, whereas the cumulative survival and success rates of implants obtained with a life table analysis were 96.1% and 88.2%, respectively. CONCLUSIONS: Results of this study seem to demonstrate that survival and success rates of immediately loaded implants placed in the intraforaminal area of the mandible and rigidly connected with a bar through an implant-supported overdenture are consistent with those reported in the international literature as far as delayed loading is concerned after 3 years of loading. After longer observation times, this study demonstrated that, while survival rates of implants and bar-supported overdentures are still consistent with results published in the international literature pertaining to delayed loading, a moderate decrease in success rates of implants was found. Nevertheless, it must be stressed that this decrease (88.8 and 90.4% after a 7- to 8-year observation period for Ha-Ti and ITI implants) is related only to two implant systems; no data are available for the other two implant systems because of the shorter follow-up period.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".