Effect of Implant Position on Clinical Outcomes
Condition: Bone Loss; Patient Satisfaction
Study type: Interventional

Summary: 
      the study aims to investigate the clinical influence of different implant locations; lateral
      incisor, canine, and first premolar areas; supporting 2-implant retained mandibular
      over-dentures with locator attachment on prosthesis retention and peri-implant health.
    

Detailed description: 
      the study aims to investigate the clinical influence of different implant locations; lateral
      incisor, canine, and first premolar areas; supporting 2-implant retained mandibular
      over-dentures with locator attachment on prosthesis retention and peri-implant health.

        -  Thirty-six edentulous patients will be recalled from the database set of the clinic of
           the removable prosthodontic department, Faculty of Dentistry, Mansoura University.
           Patients will be recruited from previous studies, having two-implant mandibular
           overdentures.

        -  All selected patients with the following criteria: mandibular two implants retained
           overdenture opposing complete edentulous maxillary arch, attended the previous follow-up
           recalls with previous CBCT examination. Patients who didn't attend previous follow-up
           recalls, didn't perform radiographic follow-up, or had para-functional habits will be
           excluded from the study.

        -  The patients will be grouped based on the implant position:

      Group I (12 patients): patients having mandibular two implants in lateral incisor positions.

      Group II (12 patients): patients having mandibular two implants in the canine positions.

      Group III (12 patients): patients having mandibular two implants in the premolar positions.

        -  Implant-retained overdenture construction procedures:

             1. Primary maxillary and mandibular impressions were made, and custom trays were
                fabricated using auto-polymerizing acrylic resin. The mandibular tray was
                fabricated with holes above the implant sites and molded with green impression
                compound modeling plastic.

             2. Definitive impressions were made with non-eugenol zinc oxide paste, and the
                impression copings were threaded to the implants, and polyether material was
                injected around the copings through the opening of the tray. Auto-polymerizing
                acrylic resin was used to pick up the copings with the tray. Implant analogs were
                screwed to the copings and the impressions was poured with stone.

             3. Locator abutment (Dentium, Co. Ltd., Korea) screwed in the analogs. Jaw relations
                were recorded, and semi-anatomical acrylic teeth eeee arranged in balanced
                occlusion.

             4. The locator housing and retentive clips were incorporated into the fitting surface
                of the overdentures during denture processing.

                Method of evaluation

        -  Assessment of the peri-implant soft tissue health including Plaque index, Probing depth,
           and bleeding index. Also, evaluation of the peri-implant bone loss was done at one, two,
           and three years after insertion using a CBCT, following the methodology described by
           Elsyad et al.

        -  Measurements of retention values: using the device of measuring the clinical retentive
           forces.

        -  Assessment of patient satisfaction and Oral Health-Related Quality of Life: using a
           visual analog scale (VAS) questionnaire.
    

Intervention name(s): overdenture retained by locator attachments.
Intervention type(s): Device
Intervention description(s): • Implant-retained overdenture construction procedures:
Primary maxillary and mandibular impressions were made, and custom trays were fabricated using auto-polymerizing acrylic resin.
Definitive impressions were made with non-eugenol zinc oxide paste, and the impression copings were threaded to the implants, and polyether material was injected around the copings through the opening of the tray. Auto-polymerizing acrylic resin was used to pick up the copings with the tray. Implant analogs were screwed to the copings and the impressions was poured with stone.
Locator abutment (Dentium, Co. Ltd., Korea) screwed in the analogs. Jaw relations were recorded, and semi-anatomical acrylic teeth eeee arranged in balanced occlusion.
The locator housing and retentive clips were incorporated into the fitting surface of the overdentures during denture processing.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: peri-implant; retention; overdenture; patient satisfaction