Long-term prosthetic aftercare of direct vs. indirect attachment incorporation techniques to mandibular implant-supported overdenture.
OBJECTIVE
The aim of this long-term study was to compare the need for prosthetic aftercare of direct vs. indirect attachment incorporation techniques to mandibular implant-supported overdenture.


METHODS
Forty-five consecutive patients were included (130 implants were placed). Treatment was randomly allocated, resulting in 22 patients (group A) to be treated with direct ball attachment incorporation and 23 patients (group B) to be treated with indirect ball attachment incorporation. All patients were treated by experienced oral-maxillofacial surgeons/periodontists and experienced prosthodontists/residents. From the first day that the patients visited the clinic up to 20 years after the first treatment session, all surgical or prosthetic therapeutic interventions were recorded. The recorded data for the present study included the number of aftercare visits and dental treatment received (pressure sores relieve, liner changes due to loss of retention and attachment replacement due to wear).


RESULTS
The mean follow-up was 93±57 months. No implants were lost. Statistical analysis revealed a statistically significantly (P<0.001) greater need for prosthetic interventions in group B vs. group A. The mean number of visits dedicated to - pressure sores relieve (7.04±1.4 vs. 3.63±0.84); liner exchange due to loss of retention (3.6±1.3 vs. 1.09±1.06) was significantly higher in group B. Attachment replacement due to wear occurred only in group B (11/23 - 47.8%).


CONCLUSIONS
The direct technique for attachment incorporation in mandibular implant-supported overdentures using ball attachments is superior to the indirect technique from the aftercare perspective during a long-term evaluation period.
Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel. nissandr@post.tau.ac.il
Joseph
J
Nissan
Beni
B
Oz-Ari
Ora
O
Gross
Oded
O
Ghelfan
Gavriel
G
Chaushu
D000328:Adult; D000359:Aftercare / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D019554:Dental Restoration Wear / Q000706:statistics & numerical data; D003779:Denture Design; D003822:Denture Liners / Q000706:statistics & numerical data; D003823:Denture Rebasing / Q000706:statistics & numerical data; D003780:Denture Repair / Q000706:statistics & numerical data; D003781:Denture Retention; D003826:Denture, Complete, Lower; D003828:Denture, Overlay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D013282:Stomatitis, Denture / Q000628:therapy; D016019:Survival Analysis; D055815:Young Adult
D015921:Dental Implants