Clinical and radiological investigations of mandibular overdentures supported by conventional or mini-dental implants: A 2-year prospective follow-up study.
BACKGROUND
Conventional dental implants are not applicable in the mandibular interforaminal region if bone volume is limited. Mini-dental implants offer an alternative means of supporting mandibular overdentures in a narrow residual ridge, without additional surgery.


OBJECTIVE
The purpose of this nonrandomized clinical trial was to compare the ability of mini-dental implants with that of conventional dental implants in supporting mandibular overdentures during a 2-year clinical follow-up. Bone quality, bone resorption, implant stability, and oral health were assessed radiographically.


METHODS
A total of 32 participants with edentulism were included. Twenty-two participants (99 implants) received 4 to 5 mini-dental implants (diameter: 1.8-2.4 mm; length: 13-15 mm, study group), and 10 participants (35 implants) received 2 to 4 conventional dental implants (diameter: 3.3-3.7 mm; length: 11-13 mm, control group). The selection of the participants in the study or control group was based on the available bone volume in the mandible. The selection was not randomized. The density of cortical bone thickness was measured in Hounsfield units (HU) from computed tomography data, and patients were followed for 2 years. The participants were examined 3, 6, 12, and 24 months after surgery. Primary stability immediately after the insertion of dental implants (Periotest), secondary stability 6 months after implantation, modified plaque, bleeding on probing indices, and probing depth were measured and analyzed statistically (α=.05).


RESULTS
The mean HU value 6 months after implantation in the participants who received mini-dental implants was significantly (P=.035) higher (1250 HU) than that in the participants who received conventional dental implants (1100 HU). The probing depths around the conventional dental implants (1.6 and 1.8 mm, respectively) were significantly higher than those around the mini-dental implants (1.3 and 1.2 mm, respectively) 12 and 24 months after surgery, respectively (P<.001). The mean primary and secondary stability values for conventional dental implants were -4.0 and -4.9, respectively. The primary and secondary stability values for the mini-dental implants were -0.3 and -1.4, respectively. The Periotest values of the primary (measured immediately after implant insertion) and secondary implant stabilities (measured 6 months after implant insertion) were significantly higher for the conventional dental implants than for the mini-dental implants (P<.001).


CONCLUSIONS
Based on this 2-year clinical trial, patients receiving mini-dental implants had clinical outcomes similar to those of patients receiving conventional dental implants to support overdenture prostheses.
Dental student, Endowed Chair of Oral Technology, Rheinische Friedrich-Wilhelms University, Bonn, Germany.
Sonay
S
Temizel
Research Associate Professor, Department of Prosthodontics, Gerodontology and Biomaterials, University of Greifswald, Greifswald, Germany.
Friedhelm
F
Heinemann
Doctoral student, Endowed Chair of Oral Technology, Rheinische Friedrich-Wilhelms University, Bonn, Germany.
Cornelius
C
Dirk
Professor, Endowed Chair of Oral Technology, Rheinische Friedrich-Wilhelms University, Bonn, Germany.
Christoph
C
Bourauel
Senior researcher, Department of Prosthetic Dentistry, Preclinical Education and Materials Science, Dental School, Rheinische Friedrich-Wilhelms University, Bonn, Germany. Electronic address: ihasan@uni-bonn.de.
Istabrak
I
Hasan
D000368:Aged; D000369:Aged, 80 and over; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging; D003758:Dental Implantation, Endosseous / Q000379:methods; D019094:Dental Prosthesis, Implant-Supported / Q000379:methods; D003826:Denture, Complete, Lower; D003828:Denture, Overlay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies