| Objective: Poor oral conditions mandibular edentulous patients who were treated with overdenture supported by implant and retained by the locator attachment.Observation and statistics implant survival rate,implant stability,marginal bone resorption,biological and hardware complications and subjective satisfaction of patients,to evaluate the short-term clinical application effect of this treatment,and to provide guidance and suggestions for clinical work.Materials and methods: The patients who had completed the mandibular overdenture retained with locator attachment,Dalian Stomatological Hospital from January 2015 to January 2018 were followed up visits.A total of 17 patients were included,including seven male patients and ten female patients,the average age was67.9 years old,the maximum age was 81 years old,and the youngest age was 59 years old.Straumann soft tissue implants were used in all 17 patients,including four 4.1/8(mm)implants,eighteen 4.1/10(mm)implants,ten 4.1/12(mm)implants and two4.8/10(mm)implants,in 17 patients,two implants were placed in the bilateral mandibular lateral-canines regions,a total of 34 implants were placed,and all the implants were placed in parallel.Treated with overdenture after four months of implant placing,the denture is made of resin tooth,resin base and cast metal mesh.17 patients were followed up for an average of 36 months,with the longest follow-up of 62 months and the shortest of 28 months(After implant was placed until January 2020),statistics implant survival rate,measurement implant stability quotient(ISQ)by osstell,measurement marginal bone response,observation and statistics of biological and hardware complications,OHIP-14 was used to investigate the subjective satisfaction ofpatients,evaluate and analyze all results.Results:(1)There was no exfoliation of 34 implants,implant survival rate is 100%.The primary stability of the implant was good on the day of the implant operation,mean ISQ values is 77.74±2.83,after 28 months of implant placing mean ISQ values is80.44±3.54,after long-term loading,the stability of the implant is still good.(2)28months after 34 implants were placed,the average mesial vertical bone resorption was0.37 ± 0.23 mm,and distal vertical bone resorption was 0.35 ± 0.21 mm,these differences were not statistically significant(P>0.05),marginal bone resorption is stable.(3)There were six patients need relining(35.3%),the prosthesis needs to be relined every 42 months on average,two patients had to remake the prosthesis due to severe wear of resin teeth,no fracture occurred in other prostheses,the survival rate of prosthesis is 88.2%,During the follow-up period,there are 131 locator nylon retention worn out and loss of retention,nylon retainers need to be changed every 8.6 months on average,there are 18 metal base cap worn out(52.9%),there are 6 Locator abutments worn out(17.6%),replacing the nylon retention is the main cost for the later maintenance of the restoration.(4)The average peri-implant plaque index was 1.03±0.64,the average probing depth(PD)of labial,lingual,mesial and distal implants was0.99 ± 0.58 mm,1.05 ± 0.48 mm,1.61 ± 0.59 mm and 1.34 ± 0.56 mm,sufficient keratinized mucosa around the implant,two patients had redness,swelling,hyperplasia and probe bleeding of the mucosa around the implant,while the other patients had good peri-implant mucosa.(5)The patients felt that the diet and quality of life after treat were significantly improved compared with those before treat,and they were satisfied with the treat method.Conclusion: The short-term clinical application of mandibular overdentures retained with the locator attachment is good,patient satisfaction is high,but after the completion of the repair,the integrity of each part of the restoration should be checked regularly to ensure continuous and effective maintenance..The sample size of this study is small,and the follow-up observation time is short,so the long-term effect evaluation of this treatment needs to increase the number of observed cases and follow-up time. |
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