The extremely resorbed mandible: a comparative prospective study of 2-year results with 3 treatment strategies.
OBJECTIVE
The aim of this prospective clinical study was to compare the clinical and radiographic results of 3 modes of implant treatment in combination with an overdenture in patients with extremely resorbed mandibles. The 3 treatment strategies used were a transmandibular implant, augmentation of the mandible with an autologous bone graft followed by placement of 4 endosseous implants, and the placement of 4 endosseous implants only.


METHODS
Sixty edentulous patients met the inclusion criteria and were assigned according to a balanced allocation method to 1 of the 3 groups. Postoperative complications, implant survival, periodontal indices, change in mandibular bone height, and prosthetic complications were assessed during a 2-year evaluation period.


RESULTS
During the evaluation period significantly more implants were lost in the transmandibular implant and the augmentation groups compared to the group with endosseous implants only. Except for the Bleeding Index and the Periotest values, the periodontal parameters did not differ significantly among the groups. In all 3 groups, there was no significant bone loss at most locations. Minimal prosthetic retreatment was necessary.


CONCLUSIONS
Although implant loss is a frequently used outcome measure for success, the necessity of retreatment seems to be of more relevance for both the patient and the clinician.


CONCLUSIONS
The results of this study suggested that patients with extremely resorbed mandibles can be treated with implants alone in this patient population.
Stellingsma
Kees
K
Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthetics, University Hospital, Groningen, The Netherlands. c.stellingsma@kchir.azg.nl
Raghoebar
Gerry M
GM
Meijer
Henny J A
HJ
Stegenga
Boudewijn
B
D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000601:surgery*; D000540:Alveolar Ridge Augmentation / Q000009:adverse effects / Q000379:methods; D000704:Analysis of Variance; D016025:Bone Transplantation; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D017267:Dental Prosthesis Design; D017268:Dental Prosthesis Retention; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003828:Denture, Overlay; D004487:Edema / Q000209:etiology; D005260:Female; D006801:Humans; D007575:Jaw, Edentulous / Q000534:rehabilitation* / Q000601:surgery; D015993:Life Tables; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000601:surgery*; D008336:Mandibular Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D018709:Statistics, Nonparametric
D015921:Dental Implants