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Rehabilitation of resorbed mandibular ridges using mini implant retained overdentures: A case series with 3 year follow-up

View Article: PubMed Central - PubMed

ABSTRACT

With the increasing average life expectancy of human beings, the need to cater geriatric patients is ever increasing. Complete dentures are an indispensable tool in this regard. The loose and unstable lower complete denture owing to residual ridge resorption is one of the most common problems faced by edentulous patients. Dental implant retained overdentures have emerged as an efficient treatment modality for such patients. Though useful, not every patient is a suitable candidate to go for conventional implant-borne prosthesis, limitation being the available bone width. In such cases, mini implants may be used for augmenting the retention of the dentures and improving the quality of life of patients. In this case series, rehabilitation of three compromised cases with mini implant retained overdentures have been described wherein patients are experiencing instability of lower denture due to thin resorbed mandibular ridges. In one of the cases, three mini implants placed in A, C, and E position were splinted using a cemented bar to retain the mandibular denture. The other two cases were rehabilitated using unsplinted ball type one piece mini implants placed in A, C, and E position in one case and B and D position in another case. Though splinted bar design should be preferred but the lack of available vertical space precluded the utilization of bar in other two cases. The results were found to be satisfactory with no complications reported during a follow-up period of over 3 years in all the cases.

No MeSH data available.


Three mini implants placed in B, C, and D position splinted together with bar attachment
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Figure 4: Three mini implants placed in B, C, and D position splinted together with bar attachment

Mentions: A 47-year-old completely edentulous woman presented with highly resorbed mandibular ridge leading to compromised retention of the lower denture. The width of the bone was inadequate in the interforaminal region. With the patient's consent, mini implant retained over denture with bar and clip attachment was planned. Bar and clip attachment was preferred as it allows rigid splinting of the implants and the available vertical space to accommodate it was found to be satisfactory. Three mini implants (MS implant narrow ridge, Osstem, South Korea, Lot: FMN11C009) of crown and bridge type having dimensions of 2.5 × 13 were placed in B, C, and D positions in the interforaminal region after raising full thickness flap. Nonresorbable silk suture was used for flap approximation, and simple interrupted sutures were given. On the day of the surgery itself, the implants were prepared to reduce the height of the abutments to around 3 mm in height and an impression was made in a stock tray using irreversible hydrocolloid material for fabrication of primary cast. The mandibular denture was relieved on the intaglio surface and was relined with tissue conditioner (Viscogel, Dentsply, Germany). Patient was recalled after one week for suture removal. Also in this visit, a final impression of the prepared abutments was made using custom tray that was fabricated over the primary cast. The impression was made using polyether impression material (Impregum™ Polyether MB, 3M ESPE, US) for fabrication of cementable bar. The bar was fabricated over the implant abutments using castable Hader bar plastic pattern (Rhein 83, Item code-022OBB). Two weeks postsurgery, implants were splinted with cementable Hader bar [Figures 4 and 5]. The bar was luted in place using self-adhesive resin cement (RelyX™ U200, 3M ESPE). The denture was cleaned of previously loaded tissue conditioner material, and additional space was created for the bar and it was again relined with tissue conditioner. The patient was kept on a regular follow-up and after 15 weeks of healing phase, the clip was incorporated in the denture over the cemented Hader bar using self-cure acrylic resin through a chairside reline procedure. The positions of implants lead to fabrication of nonlinear bar. Only one clip was used as the use of multiple clips would reduce the prosthetic mobility considerably on such nonlinear bar. Patient has been using the prosthesis satisfactorily since last 3 years.


Rehabilitation of resorbed mandibular ridges using mini implant retained overdentures: A case series with 3 year follow-up
Three mini implants placed in B, C, and D position splinted together with bar attachment
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4837782&req=5

Figure 4: Three mini implants placed in B, C, and D position splinted together with bar attachment
Mentions: A 47-year-old completely edentulous woman presented with highly resorbed mandibular ridge leading to compromised retention of the lower denture. The width of the bone was inadequate in the interforaminal region. With the patient's consent, mini implant retained over denture with bar and clip attachment was planned. Bar and clip attachment was preferred as it allows rigid splinting of the implants and the available vertical space to accommodate it was found to be satisfactory. Three mini implants (MS implant narrow ridge, Osstem, South Korea, Lot: FMN11C009) of crown and bridge type having dimensions of 2.5 × 13 were placed in B, C, and D positions in the interforaminal region after raising full thickness flap. Nonresorbable silk suture was used for flap approximation, and simple interrupted sutures were given. On the day of the surgery itself, the implants were prepared to reduce the height of the abutments to around 3 mm in height and an impression was made in a stock tray using irreversible hydrocolloid material for fabrication of primary cast. The mandibular denture was relieved on the intaglio surface and was relined with tissue conditioner (Viscogel, Dentsply, Germany). Patient was recalled after one week for suture removal. Also in this visit, a final impression of the prepared abutments was made using custom tray that was fabricated over the primary cast. The impression was made using polyether impression material (Impregum™ Polyether MB, 3M ESPE, US) for fabrication of cementable bar. The bar was fabricated over the implant abutments using castable Hader bar plastic pattern (Rhein 83, Item code-022OBB). Two weeks postsurgery, implants were splinted with cementable Hader bar [Figures 4 and 5]. The bar was luted in place using self-adhesive resin cement (RelyX™ U200, 3M ESPE). The denture was cleaned of previously loaded tissue conditioner material, and additional space was created for the bar and it was again relined with tissue conditioner. The patient was kept on a regular follow-up and after 15 weeks of healing phase, the clip was incorporated in the denture over the cemented Hader bar using self-cure acrylic resin through a chairside reline procedure. The positions of implants lead to fabrication of nonlinear bar. Only one clip was used as the use of multiple clips would reduce the prosthetic mobility considerably on such nonlinear bar. Patient has been using the prosthesis satisfactorily since last 3 years.

View Article: PubMed Central - PubMed

ABSTRACT

With the increasing average life expectancy of human beings, the need to cater geriatric patients is ever increasing. Complete dentures are an indispensable tool in this regard. The loose and unstable lower complete denture owing to residual ridge resorption is one of the most common problems faced by edentulous patients. Dental implant retained overdentures have emerged as an efficient treatment modality for such patients. Though useful, not every patient is a suitable candidate to go for conventional implant-borne prosthesis, limitation being the available bone width. In such cases, mini implants may be used for augmenting the retention of the dentures and improving the quality of life of patients. In this case series, rehabilitation of three compromised cases with mini implant retained overdentures have been described wherein patients are experiencing instability of lower denture due to thin resorbed mandibular ridges. In one of the cases, three mini implants placed in A, C, and E position were splinted using a cemented bar to retain the mandibular denture. The other two cases were rehabilitated using unsplinted ball type one piece mini implants placed in A, C, and E position in one case and B and D position in another case. Though splinted bar design should be preferred but the lack of available vertical space precluded the utilization of bar in other two cases. The results were found to be satisfactory with no complications reported during a follow-up period of over 3 years in all the cases.

No MeSH data available.