Rehabilitation particularities of completely mandibulary edentulous patients with overdentures supported by implants

Abstract

Introduction: Prosthetic constructions with a muco-oseus support have a small performance, lead to a faster atrophy of the bone and anatomical elemnts cannot provide adequate stability of the prosthetic construction during function. The McGhill Consensus (2002) cites that conventional prosthesis isn’t anymore the optimal treatment modality for completely edentulous patients. That’s why nowadays the overdentures popularity is rapidly increasing. The huge variety of elements for prosthesis anchorage, support and stabilization allows its application in different clinical situations. Purpose and Objectives: The treatment evaluation of completely mandibulary edentulous patients with removable overdentures suported by 2 and 4 two stage dental implants and comparative analysis of the methods reported to the literature data. Materials and methods: Two completely mandibulary edentulous patients have been included in the study. Both cases have been solved initialy by removable prostheses. Because of poor stability and speaking difficulties, the removable prostheses have been transformed into implant supported overdentures at 8 weeks after surgery. The first case has been solved by an overdenture supported by 2 dental implants the second patient -phased, only two implants have been loaded after the second stage, the other two had special releasing holes in the prosthesis. They were connected only after 8 weeks, to create a time for patient adaptation to the prosthesis. The following steps were performed in both cases: impression obtaining with silicone material, determination of intermaxillary positions, bail-attachment fixation, oclusal adjustment, periodic control. The following values have been monitored for one year: Mombelli plaque indices measured on the o-ring, implant stability (Periotest Classic, Siemens AG, Bensheim, Germany), the satus of denture and anchorage system. Results: Because of a small implant number, the two implants suported overdenture is less stable during function and accelerates the bone resorption from the lateral regions of mandible and stabilization sistem wearing. 4 implants supporteded overdenture provided a better stabilization and lesser wearing of the o-ring. Both patients had second degree plaque deposits (Mombelli) during the control visit after 3 months from prosthetic delivery. After a short instructing in oral hygiene the plaque indice the following visit was I (Mombelli). The secondary stability values were -6 for implants and-7 for 1 implant. Conclusion: The choose of one or another method depends mostly from bone volume, arch form, the demands and possibility of patients. The use of overdentures suported by two and four dental implants have a better stability than conventional prosthesis, provide a good esthetic appearance, improve the function of masticatory system.