| Objectives：The purpose of this retrospective study was to assess the clinicaloutcomes of implant-supported overdentures; including cumulative survival rate ofimplants, marginal bone loss, soft tissue parameters and the complications behind ofprostheses. Meanwhile, according to the questionnaire, we analysis of patients，satisfactionabout different design schemes implant-retained overdentures. At last, evaluate bar-clipattachments and ball attachments, a clinical comparative study; including cumulativesurvival rate of implants, marginal bone loss, soft tissue parameters and the complicationsbehind of prostheses.Materials and methods:Part1: Between January2005and December2010,63subjects were enrolled in thisresearch with implant-retained overdentures，36males and27females, aged62.8years(20～90years). A total of74edentulous, including11edenntulous jaws and52single edenntulous jaws and treated with246implants, consist of25cases of maxilla (114implants) and49cases of mandible(132implants). The most appliance implants were172and4.1mm diameter and12mm long.54cases have enough bone and19cases carried outthe technique of bone augmentation. The follow-up clinical examination contain:cumulative survival rate (CSR), plaque index (PLI), bleeding on probing (BOP), probingpocket depth (PPD), marginal bone loss (MBL). The digital image analysis softwareDigimizer was used to gauge the distance between two points. SPSS17.0softwarepackage analyzed those data.Part2: The clinical data was as the same as that of Part1.9subjects were loss offollow-up. Because of4subjects were not final the questionnaire and were excluding thisstudy. Finally,50subjects were participating in this study.30males and20females, aged61.9years(20～90years). The average of follow-up time were42.6month (14～82). In all,61cases edentulous and treated with206implants, consist of25cases of maxilla (106implants) and36cases of mandible (100implants). Collecting data of50subjects,including age, sex, the time of follow-up, upper or lower jaws, amount of implants andrepair types. Through of the overall situation, esthetic, pronunciations, masticates,retention, comfort, evaluate the satisfaction of subjects. Every question had5levels,corresponding5scores,1scores was represent of very satisfactory,5scores was verydissatisfy. All subjects fill in questionnaires at their last follow-up time. SPSS17.0software package analyzed those data.Part3: The clinical data was as the same as that of Part1.46subjects wereconsecutively enrolled in this study.23males and23females, aged64years(20～90years).A total of46edentulous, including29findings bar-clip attachments and17findings ballattachments, and treated with128implants.37cases have enough bone and9cases carriedout the technique of bone augmentation. The clinical and radiographic evaluations werethe same as that of Part1. SPSS17.0software package analyzed those data.Results:Part1: Within the healing period of implant surgical,246implants had3implantsfailure, early failure of implants rate was1.22%. The average of healing time was42.6 month (14～82month).2cases (3implants) failures,9subjects (28implants) were loss offollow-up, and8prostheses were loose. The mean of MBL was（0.79±0.15）mm. Nostatistically significant differences were found among marginal bone resorption behind ofprostheses.11implants (5.1%rate) were peri-implant mucositis, and5implants (2.3%)were peri-implantitis.27implants (17.5%) of bar-clip attachments were mucosalhyperplasia. The major complications of bar-clip attachments were bar-clips fracture（34.1%）and prostheses fracture（27.3%） and poor retention（29.5%） and screwloosening（29.5%）. Ball attachments were poor retention（16.7%） and replacement ofmatrix coil（s22.2%）and ball abutment frature(11.1%). Telescopic crown attachments weredenture drop（16.7%）and denture base fractur（e25.0%）.Respectively of repair frequencyof3different prostheses were1.2,0.5, and0.4.Part2:63subjects were participate in this study,74cases edentulous carried outimplant-supported overdentures.9subjects were loss of follow-up. Because of4subjectswere not final the questionnaire and were excluding this study. The rate of follow-up was79.4%. Finally,50subjects were participating in this study.30males and20females, aged61.9years(20～90years). In all,61cases edentulous and treated with206implants, consistof25cases of maxilla (106implants) and36cases of mandible (100implants). Theoverall satisfaction was very high. In the esthetic, masticate, retention aspects, the patients’satisfaction of bar attachments and telescopic crown attachments were better than ballattachments’. But, there were no statistically significant differences in the pronunciationand comfort aspects. There were no correlation between age and patients’ satisfaction.However, patients’ satisfaction about retention, the age were above65years old, werelower than younger’s. In the aspects of retention and masticates, males’ satisfaction werehigher than females’, but, there were no statistically significant differences. Differences ofjaws were no statistically significant differences.Part3: Within the healing period of implant surgical,128implants had2implantsfailure, early failure of implants rate was1.6%. The average of follow-up time was49.6month (15～82month).7subjects (20implants) were loss of follow-up, and the rate offollow-up was84.8%. In the period of clinical follow-up, there was not1implant failure, and the cumulative survival rate was98.4%.5implants were diagnosis peri-implantmucositis, and3implants were peri-implantitis. Hyperplasia was found in the bar-clips (10implants,10.6%) and in the ball attachments (3implants,8.8%). No statisticallysignificant differences were found among marginal bone resorption behind of prosthesesbetween the bar-clip attachments and ball attachments.Conclusions:During the follow-up time of42.6month, The clinical effect of implant-retainedoverdenture was reliable，the seven years of cumulative survival rate was98.8%.Considering about mechanical complication and mean repair frequency, bar-clipattachments were slightly higher. Hyperplasia and mucositis were the most common softtissue complications of bar-clip attachments. Moreover, the overall satisfaction, includingesthetic, pronunciations, masticates, retention, comfort, was very higher. There were nocorrelation between age, sex, differences of jaws, amounts of implants and patients’satisfaction. Finally, the long term clinical effect of Straumann implants-supportedoverdentures was reliable. Between bar-clip attachments and ball attachments, there werenot found statistically significant differences. At the same time, bar attachmentsimplants-supported overdentures were prone to occur hyperplasia and fractures. |
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