Typescript. Bibliography: leaves 131-167.

published_or_final_version / Dental Surgery / Master / Master of Dental Surgery

The purpose of this study was to ascertain whether simplifying mandibular overdenture treatment utilising single stage surgery and immediate prosthetic loading of a single implant, will achieve similar implant success rates and functional improvement to that expected using conventional techniques. As part of this study, the Mk III Brånemark implant with an oxidised surface (TiUnite™ Nobel Biocare AB, Göteborg, Sweden) was compared to the classical machined Mk III Brånemark fixture.Materials and Methods: 35 patients with a mean age of 68 years and problematic mandibular dentures were treated. The primary complaints among the patients referred to the clinic for treatment related to poor retention of the mandibular denture, instability, denture sores and phonetic problems. Patients were initially placed randomly into the “machined surface” or “oxidised surface” group. A single implant was placed into the mandibular midline with high initial stability. A ball attachment was placed and the retentive cap incorporated into the existing denture. Reviews took place at 3,12 6 6 and 36 months. Clinical assessments, radiographs made with custom film holders, and stability measurements by both manual and resonance frequency analysis methods were recorded. All complications, failures, maintenance and reasons for dropout were noted. Visual analogue scale questionnaires were utilised to record patient satisfaction. (ANOVA p<.05) Results: Three out of 8 machined surface implants failed, representing an unacceptably high failure rate (37.5%). The machined surface was therefore discontinued for this study. Three oxidised surface implants did not achieve sufficient primary stability to be immediately loaded, so were treated with a two stage delayed loading protocol. The 25 immediately loaded oxidised surface implants were all classified as surviving at the 36-month recall. Patient satisfaction was very high with a significant increase in all comfort and functional parameters. Conclusions: Within the limitations of this study and research design, it appears that the immediately loaded single implant retained mandibular overdenture, using an oxidised implant surface in a small group of maladaptive patients, can provide a beneficial treatment outcome over a three year observation period. If insufficient stability at insertion is not achieved for immediate loading, then a delayed loading protocol should be utilised.