Professional hygiene care, adjustments and complications of mandibular implant-retained overdentures: A three-year retrospective study
Identifieur interne : 000203 ( Istex/Corpus ); précédent : 000202; suivant : 000204Professional hygiene care, adjustments and complications of mandibular implant-retained overdentures: A three-year retrospective study
Auteurs : Abram C. L. Den Dunnen ; Ad P. Slagter ; Cees De Baat ; Warner KalkSource :
- The Journal of Prosthetic Dentistry [ 0022-3913 ] ; 1997.
English descriptors
- KwdEn :
- Abutment, Abutment replacement, Acrylic resin fractures, Artificial teeth, Complication, Dent, Denture, Edentulous, Edentulous mandible, Esthetic problems, First year, Fracture, Hygiene, Hygiene care, Implant, Loose screws, Mandibular, Mandibular bone loss, Mandibular overdentures, Maxillary, Maxillary dentures, Maxillofac, Occlusal, Oral implants, Oral maxillofac implants, Overdentures, Postinsertion care, Professional hygiene care, Prosthesis, Prosthet dent, Prosthetic dentistry, Psychologic problems, Resilient components, Retentive clips, Subsequent years, Superstructure, Third year.
- Teeft :
- Abutment, Abutment replacement, Acrylic resin fractures, Artificial teeth, Complication, Dent, Denture, Edentulous, Edentulous mandible, Esthetic problems, First year, Fracture, Hygiene, Hygiene care, Implant, Loose screws, Mandibular, Mandibular bone loss, Mandibular overdentures, Maxillary, Maxillary dentures, Maxillofac, Occlusal, Oral implants, Oral maxillofac implants, Overdentures, Postinsertion care, Professional hygiene care, Prosthesis, Prosthet dent, Prosthetic dentistry, Psychologic problems, Resilient components, Retentive clips, Subsequent years, Superstructure, Third year.
Abstract
Abstract: Purpose. This report presents a retrospective evaluation of postinsertion care required by 104 edentulous patients with advanced mandibular bone loss. Material and methods. The patients were treated with new maxillary dentures and mandibular overdentures retained by two implants with a single bar-clip attachment. Distinction was made between professional hygiene care, adjustments, and treatment of complications. The follow-up period after insertion of dentures was 3 years for all patients. Results. Approximately a third of the patients needed professional hygiene care. The need for adjustments declined during the years of function. Complications were encountered in approximately a third of the patients. The majority of these were not related to the implants, but to the superstructure and both the maxillary and mandibular dentures. Conclusions. Many edentulous patients with advanced mandibular bone loss who were treated with mandibular implant-retained overdentures need professional hygiene care, adjustments, and treatment of complications. (J Prosthet Dent 1997;78:387-90.)
Url:
DOI: 10.1016/S0022-3913(97)70046-5
Links to Exploration step
ISTEX:04365701F0783B66470E0BB6E1C205453D3AD860Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Professional hygiene care, adjustments and complications of mandibular implant-retained overdentures: A three-year retrospective study</title><author><name sortKey="Den Dunnen, Abram C L" sort="Den Dunnen, Abram C L" uniqKey="Den Dunnen A" first="Abram C. L." last="Den Dunnen">Abram C. L. Den Dunnen</name><affiliation><mods:affiliation>Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, Nijmegen, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Slagter, Ad P" sort="Slagter, Ad P" uniqKey="Slagter A" first="Ad P." last="Slagter">Ad P. Slagter</name><affiliation><mods:affiliation>Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, Nijmegen, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="De Baat, Cees" sort="De Baat, Cees" uniqKey="De Baat C" first="Cees" last="De Baat">Cees De Baat</name><affiliation><mods:affiliation>Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, Nijmegen, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Kalk, Warner" sort="Kalk, Warner" uniqKey="Kalk W" first="Warner" last="Kalk">Warner Kalk</name><affiliation><mods:affiliation>Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, Nijmegen, The Netherlands</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:04365701F0783B66470E0BB6E1C205453D3AD860</idno><date when="1997" year="1997">1997</date><idno type="doi">10.1016/S0022-3913(97)70046-5</idno><idno type="url">https://api.istex.fr/document/04365701F0783B66470E0BB6E1C205453D3AD860/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">000203</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000203</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Professional hygiene care, adjustments and complications of mandibular implant-retained overdentures: A three-year retrospective study</title><author><name sortKey="Den Dunnen, Abram C L" sort="Den Dunnen, Abram C L" uniqKey="Den Dunnen A" first="Abram C. L." last="Den Dunnen">Abram C. L. Den Dunnen</name><affiliation><mods:affiliation>Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, Nijmegen, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Slagter, Ad P" sort="Slagter, Ad P" uniqKey="Slagter A" first="Ad P." last="Slagter">Ad P. Slagter</name><affiliation><mods:affiliation>Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, Nijmegen, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="De Baat, Cees" sort="De Baat, Cees" uniqKey="De Baat C" first="Cees" last="De Baat">Cees De Baat</name><affiliation><mods:affiliation>Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, Nijmegen, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Kalk, Warner" sort="Kalk, Warner" uniqKey="Kalk W" first="Warner" last="Kalk">Warner Kalk</name><affiliation><mods:affiliation>Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, Nijmegen, The Netherlands</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">The Journal of Prosthetic Dentistry</title><title level="j" type="abbrev">YMPR</title><idno type="ISSN">0022-3913</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1997">1997</date><biblScope unit="volume">78</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="387">387</biblScope><biblScope unit="page" to="390">390</biblScope></imprint><idno type="ISSN">0022-3913</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-3913</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Abutment</term><term>Abutment replacement</term><term>Acrylic resin fractures</term><term>Artificial teeth</term><term>Complication</term><term>Dent</term><term>Denture</term><term>Edentulous</term><term>Edentulous mandible</term><term>Esthetic problems</term><term>First year</term><term>Fracture</term><term>Hygiene</term><term>Hygiene care</term><term>Implant</term><term>Loose screws</term><term>Mandibular</term><term>Mandibular bone loss</term><term>Mandibular overdentures</term><term>Maxillary</term><term>Maxillary dentures</term><term>Maxillofac</term><term>Occlusal</term><term>Oral implants</term><term>Oral maxillofac implants</term><term>Overdentures</term><term>Postinsertion care</term><term>Professional hygiene care</term><term>Prosthesis</term><term>Prosthet dent</term><term>Prosthetic dentistry</term><term>Psychologic problems</term><term>Resilient components</term><term>Retentive clips</term><term>Subsequent years</term><term>Superstructure</term><term>Third year</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Abutment</term><term>Abutment replacement</term><term>Acrylic resin fractures</term><term>Artificial teeth</term><term>Complication</term><term>Dent</term><term>Denture</term><term>Edentulous</term><term>Edentulous mandible</term><term>Esthetic problems</term><term>First year</term><term>Fracture</term><term>Hygiene</term><term>Hygiene care</term><term>Implant</term><term>Loose screws</term><term>Mandibular</term><term>Mandibular bone loss</term><term>Mandibular overdentures</term><term>Maxillary</term><term>Maxillary dentures</term><term>Maxillofac</term><term>Occlusal</term><term>Oral implants</term><term>Oral maxillofac implants</term><term>Overdentures</term><term>Postinsertion care</term><term>Professional hygiene care</term><term>Prosthesis</term><term>Prosthet dent</term><term>Prosthetic dentistry</term><term>Psychologic problems</term><term>Resilient components</term><term>Retentive clips</term><term>Subsequent years</term><term>Superstructure</term><term>Third year</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Abstract: Purpose. This report presents a retrospective evaluation of postinsertion care required by 104 edentulous patients with advanced mandibular bone loss. Material and methods. The patients were treated with new maxillary dentures and mandibular overdentures retained by two implants with a single bar-clip attachment. Distinction was made between professional hygiene care, adjustments, and treatment of complications. The follow-up period after insertion of dentures was 3 years for all patients. Results. Approximately a third of the patients needed professional hygiene care. The need for adjustments declined during the years of function. Complications were encountered in approximately a third of the patients. The majority of these were not related to the implants, but to the superstructure and both the maxillary and mandibular dentures. Conclusions. Many edentulous patients with advanced mandibular bone loss who were treated with mandibular implant-retained overdentures need professional hygiene care, adjustments, and treatment of complications. (J Prosthet Dent 1997;78:387-90.)</div></front></TEI><istex><corpusName>elsevier</corpusName><keywords><teeft><json:string>mandibular</json:string><json:string>overdentures</json:string><json:string>denture</json:string><json:string>abutment</json:string><json:string>implant</json:string><json:string>prosthesis</json:string><json:string>maxillary</json:string><json:string>professional hygiene care</json:string><json:string>mandibular bone loss</json:string><json:string>third year</json:string><json:string>first year</json:string><json:string>mandibular overdentures</json:string><json:string>maxillofac</json:string><json:string>occlusal</json:string><json:string>fracture</json:string><json:string>oral maxillofac implants</json:string><json:string>edentulous</json:string><json:string>hygiene care</json:string><json:string>prosthetic dentistry</json:string><json:string>retentive clips</json:string><json:string>prosthet dent</json:string><json:string>superstructure</json:string><json:string>maxillary dentures</json:string><json:string>complication</json:string><json:string>resilient components</json:string><json:string>acrylic resin fractures</json:string><json:string>esthetic problems</json:string><json:string>psychologic problems</json:string><json:string>loose screws</json:string><json:string>abutment replacement</json:string><json:string>subsequent years</json:string><json:string>oral implants</json:string><json:string>edentulous mandible</json:string><json:string>postinsertion care</json:string><json:string>artificial teeth</json:string><json:string>hygiene</json:string><json:string>dent</json:string></teeft></keywords><author><json:item><name>Abram C.L. den Dunnen DDSa</name><affiliations><json:string>Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, Nijmegen, The Netherlands</json:string></affiliations></json:item><json:item><name>Ad P. Slagter DDS, PhDb</name><affiliations><json:string>Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, Nijmegen, The Netherlands</json:string></affiliations></json:item><json:item><name>Cees de Baat DDS, PhDb</name><affiliations><json:string>Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, Nijmegen, The Netherlands</json:string></affiliations></json:item><json:item><name>Warner Kalk DDS, PhDc</name><affiliations><json:string>Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, Nijmegen, The Netherlands</json:string></affiliations></json:item></author><arkIstex>ark:/67375/6H6-WHMZRV39-3</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>Full-length article</json:string></originalGenre><abstract>Abstract: Purpose. This report presents a retrospective evaluation of postinsertion care required by 104 edentulous patients with advanced mandibular bone loss. Material and methods. The patients were treated with new maxillary dentures and mandibular overdentures retained by two implants with a single bar-clip attachment. Distinction was made between professional hygiene care, adjustments, and treatment of complications. The follow-up period after insertion of dentures was 3 years for all patients. Results. Approximately a third of the patients needed professional hygiene care. The need for adjustments declined during the years of function. Complications were encountered in approximately a third of the patients. The majority of these were not related to the implants, but to the superstructure and both the maxillary and mandibular dentures. Conclusions. Many edentulous patients with advanced mandibular bone loss who were treated with mandibular implant-retained overdentures need professional hygiene care, adjustments, and treatment of complications. (J Prosthet Dent 1997;78:387-90.)</abstract><qualityIndicators><refBibsNative>true</refBibsNative><abstractWordCount>150</abstractWordCount><abstractCharCount>1099</abstractCharCount><keywordCount>0</keywordCount><score>6.409</score><pdfWordCount>2609</pdfWordCount><pdfCharCount>17194</pdfCharCount><pdfVersion>1.3</pdfVersion><pdfPageCount>4</pdfPageCount><pdfPageSize>598 x 792 pts</pdfPageSize></qualityIndicators><title>Professional hygiene care, adjustments and complications of mandibular implant-retained overdentures: A three-year retrospective study</title><pmid><json:string>9338870</json:string></pmid><pii><json:string>S0022-3913(97)70046-5</json:string></pii><genre><json:string>research-article</json:string></genre><serie><title>Overdentures on oral implants.</title><language><json:string>unknown</json:string></language><pages><first>43</first><last>55</last></pages></serie><host><title>The Journal of Prosthetic Dentistry</title><language><json:string>unknown</json:string></language><publicationDate>1997</publicationDate><issn><json:string>0022-3913</json:string></issn><pii><json:string>S0022-3913(05)X7045-7</json:string></pii><volume>78</volume><issue>4</issue><pages><first>387</first><last>390</last></pages><genre><json:string>journal</json:string></genre></host><namedEntities><unitex><date><json:string>1997</json:string><json:string>1989</json:string></date><geogName><json:string>Ill</json:string></geogName><orgName><json:string>University of Nijmegen</json:string><json:string>Dutch National Dental Insurance</json:string><json:string>Research Associate</json:string></orgName><orgName_funder></orgName_funder><orgName_provider></orgName_provider><persName><json:string>I. Distribution</json:string></persName><placeName><json:string>Germany</json:string><json:string>Mannheim</json:string><json:string>Nijmegen</json:string><json:string>Sweden</json:string></placeName><ref_url></ref_url><ref_bibl><json:string>Hemmings et al.</json:string><json:string>Gcertman et al.</json:string></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/6H6-WHMZRV39-3</json:string></ark><categories><wos><json:string>1 - science</json:string><json:string>2 - dentistry, oral surgery & medicine</json:string></wos><scienceMetrix><json:string>1 - health sciences</json:string><json:string>2 - clinical medicine</json:string><json:string>3 - dentistry</json:string></scienceMetrix><scopus><json:string>1 - Health Sciences</json:string><json:string>2 - Dentistry</json:string><json:string>3 - Oral Surgery</json:string></scopus><inist><json:string>1 - sciences appliquees, technologies et medecines</json:string><json:string>2 - sciences biologiques et medicales</json:string><json:string>3 - sciences medicales</json:string><json:string>4 - otorhinolaryngologie. stomatologie</json:string></inist></categories><publicationDate>1997</publicationDate><copyrightDate>1997</copyrightDate><doi><json:string>10.1016/S0022-3913(97)70046-5</json:string></doi><id>04365701F0783B66470E0BB6E1C205453D3AD860</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/04365701F0783B66470E0BB6E1C205453D3AD860/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/04365701F0783B66470E0BB6E1C205453D3AD860/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/04365701F0783B66470E0BB6E1C205453D3AD860/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Professional hygiene care, adjustments and complications of mandibular implant-retained overdentures: A three-year retrospective study</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>ELSEVIER</publisher><availability><p>©1997 Editorial Council of The Journal of Prosthetic Dentistry</p></availability><date>1997</date></publicationStmt><notesStmt><note>a Assistant Research Associate.</note><note>b Associate Professor.</note><note>c Professor and Chairman.</note><note>Reprint requests to: A.C.L. den Dunnen Department of Oral Function and Prosthetic Dentistry PO Box 9101 6500 HB Nijmegen THE NETHERLANDS</note><note>0022-3913/97/$5.00 + 0 10/1/84587</note><note type="content">Table I: Distribution of patients with regard to adjustments during the 3 subsequent years of follow-up</note><note type="content">Table II: Distribution of patients with regard to complications during the 3 subsequent years of follow-up</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Professional hygiene care, adjustments and complications of mandibular implant-retained overdentures: A three-year retrospective study</title><author xml:id="author-0000"><persName><forename type="first">Abram C.L.</forename><surname>den Dunnen</surname></persName><roleName type="degree">DDSa</roleName><affiliation>Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, Nijmegen, The Netherlands</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Ad P.</forename><surname>Slagter</surname></persName><roleName type="degree">DDS, PhDb</roleName><affiliation>Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, Nijmegen, The Netherlands</affiliation></author><author xml:id="author-0002"><persName><forename type="first">Cees</forename><surname>de Baat</surname></persName><roleName type="degree">DDS, PhDb</roleName><affiliation>Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, Nijmegen, The Netherlands</affiliation></author><author xml:id="author-0003"><persName><forename type="first">Warner</forename><surname>Kalk</surname></persName><roleName type="degree">DDS, PhDc</roleName><affiliation>Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, Nijmegen, The Netherlands</affiliation></author><idno type="istex">04365701F0783B66470E0BB6E1C205453D3AD860</idno><idno type="DOI">10.1016/S0022-3913(97)70046-5</idno><idno type="PII">S0022-3913(97)70046-5</idno></analytic><monogr><title level="j">The Journal of Prosthetic Dentistry</title><title level="j" type="abbrev">YMPR</title><idno type="pISSN">0022-3913</idno><idno type="PII">S0022-3913(05)X7045-7</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1997"></date><biblScope unit="volume">78</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="387">387</biblScope><biblScope unit="page" to="390">390</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1997</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Purpose. This report presents a retrospective evaluation of postinsertion care required by 104 edentulous patients with advanced mandibular bone loss. Material and methods. The patients were treated with new maxillary dentures and mandibular overdentures retained by two implants with a single bar-clip attachment. Distinction was made between professional hygiene care, adjustments, and treatment of complications. The follow-up period after insertion of dentures was 3 years for all patients. Results. Approximately a third of the patients needed professional hygiene care. The need for adjustments declined during the years of function. Complications were encountered in approximately a third of the patients. The majority of these were not related to the implants, but to the superstructure and both the maxillary and mandibular dentures. Conclusions. Many edentulous patients with advanced mandibular bone loss who were treated with mandibular implant-retained overdentures need professional hygiene care, adjustments, and treatment of complications. (J Prosthet Dent 1997;78:387-90.)</p></abstract></profileDesc><revisionDesc><change when="1997">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/04365701F0783B66470E0BB6E1C205453D3AD860/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier doc found" wicri:toSee="Elsevier, no converted or simple article"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 5.0.1//EN//XML" URI="art501.dtd" name="istex:docType"></istex:docType><istex:document><article docsubtype="fla" xml:lang="en"><item-info><jid>YMPR</jid><aid>84587</aid><ce:pii>S0022-3913(97)70046-5</ce:pii><ce:doi>10.1016/S0022-3913(97)70046-5</ce:doi><ce:copyright type="other" year="1997">Editorial Council of The Journal of Prosthetic Dentistry</ce:copyright></item-info><ce:floats><ce:table id="tab1" colsep="0" rowsep="0" frame="topbot"><ce:label>Table I</ce:label><ce:caption><ce:simple-para>Distribution of patients with regard to adjustments during the 3 subsequent years of follow-up</ce:simple-para></ce:caption><tgroup cols="4"><colspec colname="col1" colsep="0"></colspec><colspec colname="col2" colsep="0"></colspec><colspec colname="col3" colsep="0"></colspec><colspec colname="col4" colsep="0"></colspec><thead><row><entry><ce:bold>Adjustments</ce:bold></entry><entry namest="col2" nameend="col4" align="right"><ce:bold>Number of patients (patients with recurring adjustments in parentheses)</ce:bold></entry></row><row><entry></entry><entry align="right"><ce:bold>1st year</ce:bold></entry><entry align="right"><ce:bold>2nd year</ce:bold></entry><entry align="right"><ce:bold>3rd year</ce:bold></entry></row><row rowsep="1"><entry></entry><entry align="right"><ce:bold><ce:italic>n</ce:italic> = 104</ce:bold></entry><entry align="right"><ce:bold><ce:italic>n</ce:italic> = 103</ce:bold></entry><entry align="right"><ce:bold><ce:italic>n</ce:italic> = 103</ce:bold></entry></row></thead><tbody><row><entry>Loose screws/abutments</entry><entry align="right">33</entry><entry align="right">12 (10)</entry><entry align="right">7</entry></row><row><entry>Decubital ulceration treatments</entry><entry align="right">22</entry><entry align="right">11 (3)</entry><entry align="right">8 (2)</entry></row><row><entry>Minor occlusal adjustments</entry><entry align="right">6</entry><entry align="right">5</entry><entry align="right">6</entry></row><row><entry>Activation of retentive clips</entry><entry align="right">8</entry><entry align="right">9</entry><entry align="right">4 (3)</entry></row><row><entry>Replacement resilient components</entry><entry align="right">6</entry><entry align="right">9 (1)</entry><entry align="right">1</entry></row><row><entry>Abutment replacements</entry><entry align="right">6</entry><entry align="right">10</entry><entry align="right">18</entry></row><row><entry>Corrections denture borders</entry><entry align="right">10</entry><entry align="right">10 (1)</entry><entry align="right">2 (1)</entry></row><row><entry>Replacement of fractured artificial teeth</entry><entry align="right">3</entry><entry align="right">6</entry><entry align="right">3</entry></row></tbody></tgroup></ce:table><ce:table id="tab2" colsep="0" rowsep="0" frame="topbot"><ce:label>Table II</ce:label><ce:caption><ce:simple-para>Distribution of patients with regard to complications during the 3 subsequent years of follow-up</ce:simple-para></ce:caption><tgroup cols="4"><colspec colname="col1" colsep="0"></colspec><colspec colname="col2" colsep="0"></colspec><colspec colname="col3" colsep="0"></colspec><colspec colname="col4" colsep="0"></colspec><thead><row><entry><ce:bold>Complications</ce:bold></entry><entry namest="col2" nameend="col4" align="right"><ce:bold>Number of patients (patients with recurring complications in parenthese)</ce:bold></entry></row><row><entry></entry><entry align="right"><ce:bold>1st year</ce:bold></entry><entry align="right"><ce:bold>2nd year</ce:bold></entry><entry align="right"><ce:bold>3rd year</ce:bold></entry></row><row rowsep="1"><entry></entry><entry align="right"><ce:bold><ce:italic>n</ce:italic> = 104</ce:bold></entry><entry align="right"><ce:bold><ce:italic>n</ce:italic> = 103</ce:bold></entry><entry align="right"><ce:bold><ce:italic>n</ce:italic> = 103</ce:bold></entry></row></thead><tbody><row><entry>Implant loss</entry><entry align="right">1</entry><entry align="right">0</entry><entry align="right">0</entry></row><row><entry>Abutment fractures</entry><entry align="right">1</entry><entry align="right">2</entry><entry align="right">3</entry></row><row><entry>Ill-fitting superstructures</entry><entry align="right">2</entry><entry align="right">3</entry><entry align="right">1</entry></row><row><entry>Ill-fitting retentive clips</entry><entry align="right">2</entry><entry align="right">6</entry><entry align="right">2 (1)</entry></row><row><entry>Relining maxillary dentures</entry><entry align="right">15</entry><entry align="right">5</entry><entry align="right">4 (2)</entry></row><row><entry>Relining mandibular dentures</entry><entry align="right">5</entry><entry align="right">2</entry><entry align="right">3</entry></row><row><entry>Peri-implant problems needing surgery</entry><entry align="right">2</entry><entry align="right">3</entry><entry align="right">1</entry></row><row><entry>Major adjustments</entry><entry align="right">5</entry><entry align="right">4</entry><entry align="right">5</entry></row><row><entry>New maxillary dentures</entry><entry align="right">1</entry><entry align="right">0</entry><entry align="right">0</entry></row><row><entry>New mandibular dentures</entry><entry align="right">1</entry><entry align="right">0</entry><entry align="right">0</entry></row><row><entry>Esthetic problems</entry><entry align="right">2</entry><entry align="right">0</entry><entry align="right">0</entry></row><row><entry>TMJ disorders</entry><entry align="right">2</entry><entry align="right">0 (1)</entry><entry align="right">0</entry></row><row><entry>Psychologic problems</entry><entry align="right">4</entry><entry align="right">0 (4)</entry><entry align="right">0 (4)</entry></row></tbody></tgroup></ce:table></ce:floats><head><ce:article-footnote><ce:label>☆</ce:label><ce:note-para><ce:sup>a</ce:sup> Assistant Research Associate.</ce:note-para></ce:article-footnote><ce:article-footnote><ce:label>☆☆</ce:label><ce:note-para><ce:sup>b</ce:sup> Associate Professor.</ce:note-para></ce:article-footnote><ce:article-footnote><ce:label>★</ce:label><ce:note-para><ce:sup>c</ce:sup> Professor and Chairman.</ce:note-para></ce:article-footnote><ce:article-footnote><ce:label>★★</ce:label><ce:note-para><ce:italic>Reprint requests to:</ce:italic> A.C.L. <ce:small-caps>den Dunnen Department of Oral Function and Prosthetic Dentistry</ce:small-caps> PO <ce:small-caps>Box</ce:small-caps> 9101 6500 HB <ce:small-caps>Nijmegen</ce:small-caps> THE NETHERLANDS</ce:note-para></ce:article-footnote><ce:article-footnote><ce:label>♢</ce:label><ce:note-para>0022-3913/97/$5.00 + 0 <ce:bold>10/1/84587</ce:bold></ce:note-para></ce:article-footnote><ce:title>Professional hygiene care, adjustments and complications of mandibular implant-retained overdentures: A three-year retrospective study</ce:title><ce:author-group><ce:author><ce:given-name>Abram C.L.</ce:given-name><ce:surname>den Dunnen</ce:surname><ce:degrees>DDS<ce:sup>a</ce:sup></ce:degrees></ce:author><ce:author><ce:given-name>Ad P.</ce:given-name><ce:surname>Slagter</ce:surname><ce:degrees>DDS, PhD<ce:sup>b</ce:sup></ce:degrees></ce:author><ce:author><ce:given-name>Cees</ce:given-name><ce:surname>de Baat</ce:surname><ce:degrees>DDS, PhD<ce:sup>b</ce:sup></ce:degrees></ce:author><ce:author><ce:given-name>Warner</ce:given-name><ce:surname>Kalk</ce:surname><ce:degrees>DDS, PhD<ce:sup>c</ce:sup></ce:degrees></ce:author><ce:affiliation><ce:textfn>Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, Nijmegen, The Netherlands</ce:textfn></ce:affiliation></ce:author-group><ce:abstract><ce:section-title>Abstract</ce:section-title><ce:abstract-sec><ce:simple-para><ce:bold>Purpose.</ce:bold> This report presents a retrospective evaluation of postinsertion care required by 104 edentulous patients with advanced mandibular bone loss.</ce:simple-para><ce:simple-para><ce:bold>Material and methods.</ce:bold> The patients were treated with new maxillary dentures and mandibular overdentures retained by two implants with a single bar-clip attachment. Distinction was made between professional hygiene care, adjustments, and treatment of complications. The follow-up period after insertion of dentures was 3 years for all patients.</ce:simple-para><ce:simple-para><ce:bold>Results.</ce:bold> Approximately a third of the patients needed professional hygiene care. The need for adjustments declined during the years of function. Complications were encountered in approximately a third of the patients. The majority of these were not related to the implants, but to the superstructure and both the maxillary and mandibular dentures.</ce:simple-para><ce:simple-para><ce:bold>Conclusions.</ce:bold> Many edentulous patients with advanced mandibular bone loss who were treated with mandibular implant-retained overdentures need professional hygiene care, adjustments, and treatment of complications. (J Prosthet Dent 1997;78:387-90.)</ce:simple-para></ce:abstract-sec></ce:abstract></head><body><ce:sections><ce:para><ce:display><ce:textbox><ce:textbox-body><ce:sections><ce:para><ce:bold><ce:italic>This retrospective study confirms the need for routine follow-up services of hygiene care, adjustments, and treatment of complications for patients restored with implant-retained overdentures.</ce:italic></ce:bold></ce:para></ce:sections></ce:textbox-body></ce:textbox></ce:display></ce:para><ce:para>Treatment with mandibular implant-retained overdentures can solve long-term problems in edentulous patients. <ce:cross-refs refid="bib1 bib2 bib3 bib4 bib5 bib6 bib7"><ce:sup>1-7</ce:sup></ce:cross-refs> Some authors have investigated the maintenance requirements and complications of implant-retained overdentures. Tolman and Laney <ce:cross-ref refid="bib8"><ce:sup>8</ce:sup></ce:cross-ref> reported problems relating to magnets, O-rings, or bar-attachments. Johns et al. <ce:cross-ref refid="bib9"><ce:sup>9</ce:sup></ce:cross-ref> described fractures of dentures, bars, and clips and a frequent need to reactivate clips. In a clinical trial, Geertman et al. <ce:cross-ref refid="bib3"><ce:sup>3</ce:sup></ce:cross-ref> noted several complications within 1 year after insertion, including gingival hyperplasia, occlusal discrepancies, clip loosening, coping screw loosening, broken abutments, nonfitting superstructures, fracture of superstructures, and deep peri-implant sulci. Walton and MacEntee <ce:cross-ref refid="bib10"><ce:sup>10</ce:sup></ce:cross-ref> observed a high incidence of adjustments and repairs. Hemmings et al. <ce:cross-ref refid="bib11"><ce:sup>11</ce:sup></ce:cross-ref> found that adjustments in the first year were common for overdentures.</ce:para><ce:para>The purpose of this study was to evaluate retrospectively the postinsertion care required by edentulous patients with advanced mandibular bone loss who were treated with implant-retained mandibular overdentures. For this purpose, a distinction was made between professional hygiene care, adjustments, and treatment of complications.</ce:para><ce:section><ce:section-title>Material and methods</ce:section-title><ce:para>During the period 1988 to 1992, a group of edentulous patients with advanced mandibular bone loss who were unsuccessfully wearing conventional dentures had been referred by general practitioners to the Clinic of Maxillofacial Prosthodontics and Special Dental Care at the Dental School of the University of Nijmegen. None of the patients had implants inserted before or medical risks interfering with the treatment or with (expected) implant success. All patients received new conventional maxillary dentures and mandibular overdentures retained by two implants and a single bar-clip attachment. This treatment followed a standardized method for denture fabrication, including functional impressions with an individual tray, intraoral gothic arch registration, and lingualized occlusion. <ce:cross-refs refid="bib12 bib13"><ce:sup>12,13</ce:sup></ce:cross-refs> A prosthodontist and an oral surgeon proposed this treatment because no beneficial result could be expected by retreatment with conventional dentures because of advanced mandibular bone loss (class V and class VI, according to Cawood and Howell). <ce:cross-ref refid="bib14"><ce:sup>14</ce:sup></ce:cross-ref></ce:para><ce:para>Of the 104 patients treated, 74 were women (mean age 52.7 years, standard deviation 9.3) and 30 were men (mean age 54.6 years, standard deviation 8.6). A total of 102 patients were treated with two IMZ implants (Friedrichsfeld, Mannheim, Germany), and two patients with two Brånemark implants (Nobelpharma, AB, Göteborg, Sweden).</ce:para><ce:para>Data were obtained from patients' records. All treatments were noted. A distinction was made between professional hygiene care, adjustments, and treatment of complications. Professional hygiene care is defined as need for oral hygiene instruction and treatment by a dental hygienist. All patients had received specific instructions about oral hygiene and maintenance before and during the treatment. During the 3 months after insertion of the (over)dentures, a prosthodontist examined whether additional professional hygiene care was needed or not. Adjustments included tightening of loose screws and abutments, treatment of decubital ulcerations, minor occlusal adjustments, activation of retentive clips, replacement of worn out stress-absorbing resilient components, replacement of abutments, correction of denture borders, and replacement of fractured artificial teeth. Complications included implant loss, abutment fractures, ill-fitting superstructures or retentive clips (resulting in replacement of the total superstructure, replacement of retentive clips, or sectioning and resoldering bars), acrylic resin fractures, relinings, gingival hyperplasia, peri-implant bone resorption, major occlusal discrepancies, esthetic problems, psychologic problems, and temporomandibular joint (TMJ) disorders. Instability and inadequate retention of the dentures were criteria used to indicate a relining. The follow-up period after insertion of the overdentures was 3 years for all patients.</ce:para></ce:section><ce:section><ce:section-title>Results</ce:section-title><ce:para>In the first year after insertion of the overdentures, 43 patients required additional professional hygiene care. The number of patients needing additional professional hygiene care declined to 32 and 31 patients in the second and the third year, respectively.</ce:para><ce:para><ce:cross-ref refid="tab1">Table I</ce:cross-ref> presents the frequencies of adjustments during the 3 subsequent years of function.
<ce:float-anchor refid="tab1"></ce:float-anchor>The incidence of tightening screws and abutments declined from 33 times in the first year to 7 times in the third year, whereas the incidence of abutment replacement increased from 6 patients in the first year to 18 patients in the third year. Treatment of decubital ulcerations was frequently needed (46 times). Finally, minor occlusal adjustments were needed in 17 patients, activation of retentive clips had to be carried out in 21 patients, replacement of resilient components was needed in 16 patients, correction of denture borders had to be carried out 24 times, and fractures of artificial teeth occurred in 12 patients. The need for adjustments declined during the years of function.</ce:para><ce:para>Complications occurred in 36 patients during the first year, in 29 patients during the second year, and in 26 patients during the third year of follow-up. Of these patients, 8 had complications in more than 1 follow-up year. The frequencies of these complications and treatments are shown in <ce:cross-ref refid="tab2">Table II</ce:cross-ref> .
<ce:float-anchor refid="tab2"></ce:float-anchor>In one patient (1.0%), an implant was lost. This failure occurred 6 months after overdenture insertion. The failing implant was replaced. During the healing period of this new implant, the patient was not able to function with an implant-retained overdenture. Therefore the patient was left out of the results from the second and third year of follow-up. In six patients, abutment fracture occurred. In all these cases, abutments with resilient components were involved.</ce:para><ce:para>Mechanical problems related to the superstructure were present in 6 patients. Acrylic resin fractures were not present. Relinings of maxillary dentures were performed in 24 patients, and mandibular denture relining was needed in 10 patients. Soft tissue surgery because of peri-implant problems had to be carried out in 6 patients. Membranes for guided tissue regeneration were used around three implants. Mucosal grafts from the palate were used around three other implants. In 15 patients, major adjustments of dentures or new dentures were needed. Finally, 2 patients had esthetic problems, 4 patients had psychologic problems, and 2 patients had TMJ disorders, which required additional attendance.</ce:para><ce:para>Most of the complications occurred in different patients, but in some cases multiple complications or adjustments were present in one patient. In three such patients, abutment fractures occurred. After abutment replacement, sectioning and resoldering of the bars had to be carried out because of misfit, and retentive clips had to be replaced. In three other patients, a relining was needed for both the maxillary denture and the mandibular implant-retained overdenture. For one of these patients, a new maxillary denture and a new mandibular implant-retained overdenture were fabricated because of persistent problems.</ce:para><ce:para>Almost no differences were noticed between men and women regarding frequencies of adjustments and complications. The percentages of patients with complications were equal for men and women during the first and the second year, but not during the third year. In the third year, 29.7% of the women had complications, which is more than twice as much as for men (13.3%). Esthetic problems (two women), TMJ disorders (two women), and psychological problems (three women) were more often present in women.</ce:para></ce:section><ce:section><ce:section-title>Discussion</ce:section-title><ce:para>In contrast to previous studies, <ce:cross-refs refid="bib8 bib9 bib10 bib11"><ce:sup>8-11</ce:sup></ce:cross-refs> this clinical report made a distinction between professional hygiene care, adjustments, and treatment of complications, giving a more detailed reflection of the postinsertion care needed. The failure rate for implants can be considered in agreement with other studies, <ce:cross-refs refid="bib15 bib16"><ce:sup>15,16</ce:sup></ce:cross-refs> as implant loss mostly occurs in early stages of loading. <ce:cross-refs refid="bib16 bib17 bib18"><ce:sup>16-18</ce:sup></ce:cross-refs> Hemmings et al. <ce:cross-ref refid="bib11"><ce:sup>11</ce:sup></ce:cross-ref> noted a relatively high incidence of maintenance treatment for implant-supported overdentures in the first year, decreasing in the following years, which is similar to our findings.</ce:para><ce:para>In the patient population, implant-retained overdentures were preferred to implant-retained fixed prostheses because of advanced mandibular bone loss. Moreover, since 1989, oral rehabilitation with dental implants is included in the Dutch National Dental Insurance scheme for patients with advanced bone loss, but it is restricted to implant-retained overdentures. <ce:cross-ref refid="bib19"><ce:sup>19</ce:sup></ce:cross-ref> Therefore treatment results of implant-retained overdentures and implant-retained fixed prostheses cannot be compared.</ce:para><ce:para>Loose screws and abutments were the most common mechanical problems in this study. However, the frequency of loose screws and abutments decreased during the 3 follow-up years, whereas an increasing frequency of abutment replacement was noted. An explanation for this phenomenon is that, in our clinic, abutments with a resilient stress-absorbing component were frequently used some years ago. It is known that the clinical durability of this resilient component, known as the intramobile element (IME), is approximately 1 year, <ce:cross-ref refid="bib20"><ce:sup>20</ce:sup></ce:cross-ref> and fatigue and fracture is no exception. <ce:cross-ref refid="bib21"><ce:sup>21</ce:sup></ce:cross-ref> During the follow-up years, frequent loosening and sometimes fractures of intramobile elements occurred. Because of these problems, IMEs were replaced by rigid titanium abutments. The frequency of loosened or fractured abutments decreased when a titanium abutment was used. The replacement of IMEs by rigid abutments may also account for replacement or resoldering of superstructures. Because of its resilience, the IME can obscure misfits and conceal the stress being created. Replacement or resoldering of bars was needed in three patients after replacement of intramobile elements by titanium abutments. If rigid titanium abutments had been used at baseline, less complications would probably have been present.</ce:para><ce:para>Unlike other studies, which reported several acrylic resin fractures for overdentures supported by oral implants <ce:cross-ref refid="bib22"><ce:sup>22</ce:sup></ce:cross-ref> as well as natural tooth abutments, <ce:cross-ref refid="bib23"><ce:sup>23</ce:sup></ce:cross-ref> no acrylic resin fractures occurred in this study's patient sample. An explanation for this phenomenon could be that during the overdenture treatment, attention was given to sole support by the bar-clip attachment, or in other words, absence of direct contact between denture base and implants. In this way, the implants cannot act as fulcrum points, resulting in fatigue resin fractures.</ce:para><ce:para>Treatment of decubital ulcerations and relinings of maxillary dentures were frequently needed, especially in the first year of function, which corresponds closely to the report of Walton and MacEntee. <ce:cross-ref refid="bib22"><ce:sup>22</ce:sup></ce:cross-ref> It is likely that complete maxillary dentures opposed by implant-supported overdentures are subjected to higher occlusal forces and are more easily dislodged, so that adequate retention is more difficult to achieve. Moreover, the patient sample in this study included patients with unfavorable maxillary ridges.</ce:para><ce:para>Finally, a small number of patients with psychologic problems and patients with insufficient oral hygiene that resulted in peri-implant problems required additional attendance, even in the third year of function. However, these patients benefit from implant-retained overdentures, although time spent and costs are higher.</ce:para><ce:para>A randomized clinical trial on patients receiving either implant-retained mandibular overdentures or implant-retained fixed prostheses would be desirable in the future to make a detailed comparison between both groups regarding surgical results, prosthodontic treat ments, laboratory procedures and postinsertion care, and treatment of complications.</ce:para></ce:section><ce:section><ce:section-title>Conclusions</ce:section-title><ce:para>In 1.0% of the patient population with advanced mandibular bone loss who were treated with implant-retained mandibular overdentures, implant failure occurred. Approximately a third of the patients needed professional hygiene care. The need for adjustments declined during the follow-up period. Tightening of loose screws and abutments, treatment of decubital ulcerations, and correction of denture borders were the most common adjustments. Complications occurred in approximately a third of the patients. The majority of these were not related to the implants, but to the superstructure and to both the maxillary and the mandibular denture. 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study</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Professional hygiene care, adjustments and complications of mandibular implant-retained overdentures: A three-year retrospective study</title></titleInfo><name type="personal"><namePart type="given">Abram C.L.</namePart><namePart type="family">den Dunnen</namePart><namePart type="termsOfAddress">DDSa</namePart><affiliation>Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, Nijmegen, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ad P.</namePart><namePart type="family">Slagter</namePart><namePart type="termsOfAddress">DDS, PhDb</namePart><affiliation>Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, Nijmegen, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Cees</namePart><namePart type="family">de Baat</namePart><namePart type="termsOfAddress">DDS, PhDb</namePart><affiliation>Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, Nijmegen, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Warner</namePart><namePart type="family">Kalk</namePart><namePart type="termsOfAddress">DDS, PhDc</namePart><affiliation>Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, Nijmegen, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1997</dateIssued><copyrightDate encoding="w3cdtf">1997</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><abstract lang="en">Abstract: Purpose. This report presents a retrospective evaluation of postinsertion care required by 104 edentulous patients with advanced mandibular bone loss. Material and methods. The patients were treated with new maxillary dentures and mandibular overdentures retained by two implants with a single bar-clip attachment. Distinction was made between professional hygiene care, adjustments, and treatment of complications. The follow-up period after insertion of dentures was 3 years for all patients. Results. Approximately a third of the patients needed professional hygiene care. The need for adjustments declined during the years of function. Complications were encountered in approximately a third of the patients. The majority of these were not related to the implants, but to the superstructure and both the maxillary and mandibular dentures. Conclusions. Many edentulous patients with advanced mandibular bone loss who were treated with mandibular implant-retained overdentures need professional hygiene care, adjustments, and treatment of complications. (J Prosthet Dent 1997;78:387-90.)</abstract><note>a Assistant Research Associate.</note><note>b Associate Professor.</note><note>c Professor and Chairman.</note><note>Reprint requests to: A.C.L. den Dunnen Department of Oral Function and Prosthetic Dentistry PO Box 9101 6500 HB Nijmegen THE NETHERLANDS</note><note>0022-3913/97/$5.00 + 0 10/1/84587</note><note type="content">Table I: Distribution of patients with regard to adjustments during the 3 subsequent years of follow-up</note><note type="content">Table II: Distribution of patients with regard to complications during the 3 subsequent years of follow-up</note><relatedItem type="host"><titleInfo><title>The Journal of Prosthetic Dentistry</title></titleInfo><titleInfo type="abbreviated"><title>YMPR</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">199710</dateIssued></originInfo><identifier type="ISSN">0022-3913</identifier><identifier type="PII">S0022-3913(05)X7045-7</identifier><part><date>199710</date><detail type="volume"><number>78</number><caption>vol.</caption></detail><detail type="issue"><number>4</number><caption>no.</caption></detail><extent unit="issue-pages"><start>337</start><end>433</end></extent><extent unit="pages"><start>387</start><end>390</end></extent></part></relatedItem><identifier type="istex">04365701F0783B66470E0BB6E1C205453D3AD860</identifier><identifier type="ark">ark:/67375/6H6-WHMZRV39-3</identifier><identifier type="DOI">10.1016/S0022-3913(97)70046-5</identifier><identifier type="PII">S0022-3913(97)70046-5</identifier><accessCondition type="use and reproduction" contentType="copyright">©1997 Editorial Council of The Journal of Prosthetic Dentistry</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-HKKZVM7B-M">elsevier</recordContentSource><recordOrigin>Editorial Council of The Journal of Prosthetic Dentistry, ©1997</recordOrigin></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/document/04365701F0783B66470E0BB6E1C205453D3AD860/metadata/json</uri></json:item></metadata></istex></record>Pour manipuler ce document sous Unix (Dilib)
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