Patient Reported Outcome of immediate loaded mandibular 2-implant
overdentures retained by magnetic attachments: 3 years follow-up
Y. Uehara1, M. Kanazawa1, A. Miyayasu1, R. Shimada1, M. Negoro1, D. Sato2, S. Minakuchi1
1

Gerodontology and Oral Rehabilitation, Graduate school of Medical and Dental Science, Tokyo
Medical and Dental University
2
Oral Implantology and Regenerative Dental Medicine, Graduate school of Medical and Dental
Science, Tokyo Medical and Dental University
Abstract
Objectives
There is much evidence about immediate loading of mandibular implant overdenture. But the longterm prognosis of immediate loading is lacking. This study aimed to evaluate the patient-reported
outcomes of immediate and conventional loaded mandibular 2-implant overdentures retained bymagnetic attachments.
Methods
Nineteen patients with edentulous mandibles were enrolled in this study. Patients were randomly
divided into the immediate loading group (IL group) and the conventional loading group (CL group).
The keepers of the magnet attachments were connected to the implants on the day of implant surgery
for IL group, while for CL group, keepers are connected in 3 months. OHRQoL was evaluated by theJapanese version of the Oral Health Impact Profile for edentulous subjects (OHIP-EDENT-J), and100 mm VAS was used to measure satisfaction ratings.
Results
Patient satisfaction tended to be high in both groups from the early stage of implant placement.
The improvement of OHIP only showed in IL group up to the first 3 months after implant surgery, andin both groups after 6 months.
Three years after implant placement, patient-reported outcomes were suggested to be maintained athigh levels in both groups.

Introduction
In recent years, several studies have reported that immediate loading of 2-IOD with non-splinted
attachments is a feasible way of treating mandibular edentulous patients (1,2). However, the evidenceof the long-term prognosis of immediate loading compared with conventional loading is lacking.

Objective
This study aimed to evaluate the patient-reported outcomes of immediate and conventional loaded
mandibular 2-implant overdentures retained by magnetic attachments.

Materials and Methods(1) Nineteen patients were randomly divided into the immediate loading group (IL group) and theconventional loading group (CL group) (Figure 1). Before implant surgery, a new mandibularcomplete denture will be delivered to each patient. Assessments were done after they adapted tothe new denture. The result was used as baseline data.
(2) The keepers of the magnet attachments were connected to the implants on the day of implant
surgery for IL group, while for CL group, keepers are connected in 3 months. (Figure 2)(3) OHRQoL was evaluated by the Japanese version of the Oral Health Impact Profile for edentulous
subjects (OHIP-EDENT-J), and 100 mm VAS was used to measure satisfaction ratings.
(4) The differences were analyzed by using the Wilcoxon signed-rank test in the group, and using
Mann-Whitney U test between groups.

Figure1

Figure2

Results

1. OHRQoL- There were no significant differences compared to the baseline in 1Y and 3Y assessment within
nor between IL group and CL group. (Figure3,4)-Up to the first 3 months, improvement of OHRQoL was observe only in IL group. Both groups
showed lower OHIP scores in 6 months follow up, which means, both groups got higher OHRQoL,and immediate loading leaded to the improvement at a comparatively earlier period after implant
placement. (Figure5)
2.

Patient Satisfaction-There were no significant differences between IL group and CL group compared to the baseline
up to 1Y and 3Y. (Figure 6)-Within IL group, patient satisfaction was significantly increased in 1Y and 3Y after implant
placement. Both groups had higher satisfaction compared to baseline and had kept at a high levelfrom the early stage to 3 years. (Figure7,8)

Figure3

Figure4

Figure5

Figure6

Figure7Figure8Discussions
1.

Why there was no significant differences about OHRQoL within nor between IL group and CL
group.
-OHIP scores were already at a low level at baseline.
-OHIP only captures negative impacts, which is not good at showing positive changes in patients
who had few complains about their dentures.
-Small sample size is a limitation due to its low statistical power.

2. Why there was no significant differences about patient satisfaction between IL group and CL
group?
-Patient satisfaction is a complex phenomenon which influenced by many factors, not only theoral system.
-Complains about the upper dentures were heard in this study, which may indirectly affect thesatisfaction of the 2-IODs.
-Small sample size is a limitation due to its low statistical power.

Conclusions
Immediate loading of mandibular two-implant overdentures with magnetic attachments is a feasible
treatment for mandibular edentulous patients. The results indicate that immediate loading may achieve
sooner satisfaction improvement compared to conventional loading protocol.

References[1] Marzola R, Scotti R, Fazi G, Schincaglia GP. Immediate loading of two implants supporting aball attachment-retained mandibular overdenture: A prospective clinical study. Clin Implant Dent
Relat Res 2007;9(3):136-143.
[2] Büttel AE, Gratwohl DA, Sendi P, Marinello CP. Immediate loading of two unsplinted
mandibular implants in edentulous patients with an implant-retained overdenture: an observational
study over two years. Schweiz Monatsschr Zahnmed 2012;122(5):392-397.