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Can implant-retained overdenture components cause damage to the opposing natural dentition? Nahal Razaghi Mike Hughes Mital Patel Dental Update 2024 48:7, 707-709.
Authors
NahalRazaghi
BDS (Hons), MJDF RCS (Eng), PG Dip (Dis)
StR in Restorative Dentistry, Royal London Dental Hospital, Barts Health Trust, London
This clinical case series highlights an under-reported and often unidentified complication of implant-retained overdentures that may leave patients with a risk of long-term discomfort and preventable damage to the opposing dentition. A variety of cases is discussed to demonstrate potential problems and symptoms that can flag up signs of parafunctional habits in implant patients, and how these can be managed successfully.
CPD/Clinical Relevance: Implant-retained overdentures provide a significant improvement in quality of life; however, careful patient assessment and management is essential to ensure the components do not cause damage to the opposing dentition.
Article
When a patient presents for rehabilitation of an edentulous arch, the prosthodontic options are a complete tissue-supported removable denture, an implant-retained overdenture or an implant-retained fixed prosthesis.
The McGill Consensus 2002 concluded that first-choice treatment for the edentulous mandible was an overdenture retained by two implants.1 In 2009, the York statement, based on randomized controlled trials, stated that ‘patients’ satisfaction and quality of life with implant supported mandibular over-dentures are significantly greater than for conventional dentures’.2,3
There is less guidance and evidence available for implant-retained overdentures in the maxilla. According to the International Team for Implantology (ITI),4 conventionally loaded maxillary overdentures are well documented with four to six implants. In a systematic review on maxillary overdenture systems,5 the most successful was six implants splinted together with a bar with a survival rate of 98.2%, followed by 96.3% with four implants and a bar, and 95.2% in cases of four implants with a ball anchorage system for a period of at least 1 year. Six dental implants in the edentulous maxilla connected with a bar have also been shown to provide a proper base for the support of an overdenture opposed by mandibular teeth.6 Sanna et al reported a cumulative survival rate of 99.3% over 10 years of maxillary four to six interconnected implant-supported overdentures.7 There was no detail, however, on the positions of the implants in the studies.
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