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Five‐year study of mandibular overdentures on stud abutments: Clinical outcome, patient satisfaction and prosthetic maintenance—Influence of bone resorption and implant position
Author(s) -
Matthys Carine,
Vervaeke Stijn,
Besseler Jos,
De Bruyn Hugo
Publication year - 2019
Publication title -
clinical oral implants research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.407
H-Index - 161
eISSN - 1600-0501
pISSN - 0905-7161
DOI - 10.1111/clr.13501
Subject(s) - dentistry , medicine , implant , patient satisfaction , bone resorption , dental abutments , orthodontics , mandible (arthropod mouthpart) , surgery , botany , biology , genus
Objectives This prospective study analyses the 5‐year clinical outcome, patient satisfaction and the technical outcome of a 2‐implant overdenture on stud abutments. In addition, the influence of mandibular resorption and implant position on these outcomes was assessed. Material and methods Patients received two implants in a one‐stage delayed protocol. Final prosthesis on stud abutments was finalized after 3 months. Implant survival, bone loss, plaque and sulcus bleeding index, OHIP‐14, technical outcome and costs were assessed after 5 years. The Cawood–Howell classification defined the mandibular resorption. Inter‐implant distances and angles (frontal, sagittal) were digitally measured. The significance level was p < .05. Results Fifty‐six patients, 23 female and 33 males (mean age = 66.3, range 41–82), completed the follow‐up. No implants were lost. Radiographical crestal bone loss was on average 1.25 mm (standard deviation SD 1.06), bleeding index was 0.75 ( SD 0.73), and plaque index was 1.15 ( SD 0.75) and higher for low mandibles ( p = .001). The OHIP‐14 reduction post‐connection and after 5 years was significant ( p < .001). Five‐year maintenance required on average 6.7 ( SD 4.8, range 0–25) interventions per patient. A larger inter‐implant distance was associated with fewer replacement of retention inserts ( p = .034) and less interventions ( p = .006). Larger frontal ( p = .023) and sagittal ( p = .046) inter‐implant angles (non‐parallelism) required more inserts. The maintenance cost negatively influences the patient satisfaction ( p = .004). 83% of the stud abutments showed wear. Conclusion The implant overdenture on cylindrical stud abutments is a good and stable solution, irrespective of the resorption profile of the mandible. OHIP‐14 improved permanently up to 5 years but is negatively influenced by complication cost. A small inter‐implant distance, more frontal, sagittal inter‐implant divergence increased maintenance.