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.

Thesis (M.S.)--University of Michigan, 1987.

Thesis (M.S.)--University of Michigan, 1987.

Abstract The retention of a complete denture and the patient’s adaptation varies considerably among different individuals. Resorption of the edentulous alveolar ridge differs greatly and some patients need implant-retained overdentures to enable adequate retention of their prostheses. In some extreme cases it is necessary to increase the volume of the alveolar ridge with bone grafts. The aim of this study was to examine the outcome of implant-supported overdenture treatment conducted in Oulu University Hospital. The aim was also to assess the impact of treatment on oral health-related quality of life and patient satisfaction. The study group was comprised of patients treated with a mandibular or maxillary implant overdenture and a group of patients with extreme mandibular bone resorption treated with extraoral bone grafts and implants. The treatments were performed in 1985–2013 thus also providing long-term results. The results of this study showed predictable and successful treatment outcomes also among elderly patients and in severe situations with bone deficiency. The most frequent complication in the clinical follow-up was loosening of the retention mechanism, commonly noted in other previous studies. Despite some minor mechanical defects in prosthetic structures or mild mucosal inflammation around the implants, they did not hinder everyday use of the prostheses. Neither the number of supporting implants nor the connection type seemed to have a great impact on patient satisfaction. Older patients with a mandibular overdenture seemed to be most satisfied. In conclusion, treatment with implant overdentures seems to be successful also in the long-term. / Tiivistelmä Kokoproteesin pysyvyys ja potilaan sopeutuminen proteesiin vaihtelee huomattavasti eri yksilöiden välillä. Hampaattoman luuharjanteen resorptiossa on eroja, ja osalle potilaista implanttikiinnitteinen peittoproteesi on välttämätön riittävän proteesin pysymisen mahdollistamiseksi. Hyvin pitkälle edenneissä luuharjanteen resorptioissa voi leukaluun lisääminen luusiirteillä olla tarpeellista. Tutkimuksen tarkoituksena oli selvittää Oulun yliopistollisessa sairaalassa tehtyjen implanttikiinnitteisten peittoproteesihoitojen tuloksia. Tavoitteena oli myös arvioida hoidon vaikutusta suunterveyteen liittyvään elämänlaatuun ja potilastyytyväisyyteen. Tutkittava ryhmä koostui potilaista, joille oli valmistettu alaleukaan tai yläleukaan implanttikiinnitteinen peittoproteesi, ja potilasjoukosta, jolle hyvin pitkälle edenneen luuresorption vuoksi implanttihoito oli tehty luusiirteiden avulla. Hoidot tehtiin vuosina 1985–2013, ja tutkimuksissa voitiin arvioida myös peittoproteesihoidon pitkäaikaistuloksia. Tutkimus osoitti, että hoitotulokset olivat ennustettavia ja onnistuneita myös iäkkäillä potilailla sekä potilailla, joilla luupuutos oli kaikkein vaikein. Yleisin todettu komplikaatio kliinisessä tutkimuksessa oli proteesin kiinnitysmekanismin löystyminen. Pienet proteesirakenteiden rikkoutumiset tai lievät limakalvon tulehdusreaktiot implanttien ympärillä eivät kuitenkaan haitanneet proteesin toimintaa ja päivittäistä käyttöä. Peittoproteesia tukevien implanttien määrällä tai kiinnitystyypillä ei todettu olevan suurta vaikutusta potilastyytyväisyyteen. Kaikkein tyytyväisimpiä vaikuttivat olevan iäkkäät potilaat, joille oli tehty alaleuan peittoproteesi. Tutkimus osoittaa, että implanttikiinnitteinen peittoproteesihoito on menestyksellistä myös pitkällä aikavälillä.