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Assessment of masticatory function of mandibular implant-supported overdenture wearers: A 3-year prospective study

Khalid T, Yunus N, Ibrahim N, Saleh NBM, Goode D, Masood M

J Prosthet Dent, 2020 Dec;124(6):674-681.
PMID: 31952858 DOI: 10.1016/j.prosdent.2019.08.005

STATEMENT OF PROBLEM: Wearers of mandibular complete dentures (CDs) often complain of retention and stability problems resulting in poor masticatory function. Evidence suggests that a mandibular overdenture (MOD) stabilized by 2 implants represents the treatment of choice to improve stability and masticatory function. Measurements are needed of the improvement in masticatory function after providing mandibular implant-stabilized overdentures.
PURPOSE: The purpose of this prospective clinical study was to evaluate the changes in masticatory function from baseline (T0) to 3 months (T1) and 3 years (T2) in participants with MODs and to assess the effect of baseline mandibular bone height and volume on masticatory function after 3 years.
MATERIAL AND METHODS: Participants were assessed for masticatory function by using masticatory performance involving paraffin wax cubes as an objective measure and by using masticatory ability involving a questionnaire as a subjective measure. Edentulous individuals presenting for replacement dentures were provided with conventional mucosa-supported prostheses and evaluated for masticatory function after a 3-month settling-in period (baseline measure). Before implant placement, baseline measures of bone height and volume were recorded from cone beam computed tomography (CBCT) images. The prostheses were then converted to implant-stabilized mandibular overdentures while any maxillary prostheses remained supported by the mucosa. Masticatory function was reassessed at 3 months and 3 years after insertion of the mandibular overdentures, and the mean changes from baseline were analyzed with the Wilcoxon signed-rank test. The effect of variables on masticatory function was determined by using multivariate linear regression analyses.
RESULTS: A total of 23 participants were included in the study, with only 1 participant not completing the 3-year assessment. Significant improvement was observed in the masticatory performance (mixing ability index) (P

Matched MeSH terms: Denture, Complete, Lower
Blood Flow Alterations in the Anterior Maxillary Mucosa as Induced by Implant-Retained Overdenture

Alsrouji MS, Ahmad R, Ibrahim N, Kuntjoro W, Al-Harbi FA, Baba NZ

J Prosthodont, 2019 Apr;28(4):373-378.
PMID: 30875139 DOI: 10.1111/jopr.13047

PURPOSE: Blood flow disturbance from functional pressure may lead to ischemia and accumulation of metabolites leading to residual ridge resorption (RRR) underneath complete dentures. The purposes of this study were to determine the effect of mandibular complete denture (CD) and implant-retained overdenture (IRO) on blood flow disturbance in the opposing denture bearing-mucosa of maxillary CD and to compare the blood flow disturbance to RRR of the anterior maxilla.
MATERIALS AND METHODS: The test group included 9 participants rehabilitated by maxillary CD opposing mandibular IRO, while the control group consisted of 4 participants with CDs. Blood flow was measured by laser Doppler flowmetry (LDF) after denture removal for 0, 30, 60, and 90 minutes. RRR was quantified as reduction in bone volume a year post-treatment. The measurement of blood flow was then compared to the quantification of RRR.
RESULTS: The mean blood flow measure for the IRO group was significantly lower than CD after immediate denture removal and 30 minutes later. After 60 minutes, the mean difference was not significant between groups, and at 90 minutes, the mean blood flow of both groups equalized to reach a steady state of 377 BPU. The mandibular IRO had reduced the initial blood flow measure in the opposing anterior maxilla mucosa to almost a quarter (103 BPU) of the steady state value (377 BPU) compared to the CD, which reduced it to only about one half (183 BPU), suggesting greater blood flow disturbance in the IRO group. This result is in tandem with the greater reduction of bone volume observed in the IRO group, which was 7.3 ± 1.3% after a year, almost three times higher than CD group at 2.6 ± 1.7%.
CONCLUSION: IRO may cause significantly higher blood flow disturbance than CD and may have contributed to greater RRR in the anterior maxilla.

Matched MeSH terms: Denture, Complete, Lower
Association between occlusal force distribution in implant overdenture prostheses and residual ridge resorption

Khuder T, Yunus N, Sulaiman E, Ibrahim N, Khalid T, Masood M

J Oral Rehabil, 2017 May;44(5):398-404.
PMID: 28295492 DOI: 10.1111/joor.12504

This study aimed to investigate residual ridge resorption (RRR) of anterior and posterior maxillary and mandibular edentulous ridges, in patients treated with mandibular implant overdentures (IOD) and compare with conventional complete denture (CD) wearers, and to determine at each location, the association of RRR with the occlusal forces distribution and other patients' variables. The anterior and posterior RRR of IOD (six males, 17 females) and CD (12 males, 11 females) groups were determined using baseline and follow-up dental panaromic radiographs (DPT) (mean intervals 4 ± 1·8 years). The bone ratios were calculated using proportional area: anatomic to fixed reference areas and mean difference of ratios between the intervals determined RRR. The ridge locations included anterior and posterior maxillary and posterior mandibular arches. The T-Scan III digital occlusal system was used to record anterior and posterior percentage occlusal force (%OF) distributions. There were significant differences in anterior and posterior %OF between treatment groups. Two-way anova showed RRR was significant for arch locations (P = 0·005), treatment group (IOD versus CD) (P = 0·001), however, no significant interaction (P = 0·799). Multivariate regression analyses showed significant association between RRR and %OF at anterior maxilla (P = 0·000) and posterior mandible (P = 0·023) and for treatment groups at posterior maxilla (P = 0·033) and mandibular areas (P = 0·021). Resorption was observed in IOD compared to CD groups, with 8·5% chance of less resorption in former and 7·8% in the latter location. Depending on arch location, ridge resorption at various locations was associated with occlusal force distribution and/or treatment groups (implant prostheses or conventional complete dentures).

Matched MeSH terms: Denture, Complete, Lower*
A three-visit, complete-denture technique utilizing visible light-cured resin for tray and base plate construction

Ling BC

Quintessence Int, 2004 Apr;35(4):294-8.
PMID: 15119715

This article describes a technique of constructing a set of maxillary and mandibular complete dentures in three visits instead of the usual five clinical appointments. This system of complete-denture construction is made possible because of the combined use of visible light-cured material as an impression tray and record base material, as well as the use of new biometric wax occlusion rims. Unlike some earlier techniques that use light-cured resin composites as the denture base materials, this method retains the use of heat-cured polymethylmethacrylate as the denture base material.

Matched MeSH terms: Denture, Complete, Lower
Zygomatic implant-retained fixed complete denture for an elderly patient

Baig MR, Rajan G, Yunus N

Gerodontology, 2012 Jun;29(2):e1140-5.
PMID: 21615782 DOI: 10.1111/j.1741-2358.2010.00433.x

Dental rehabilitation of a completely edentulous geriatric patient has always been a challenge to the clinician, especially in treating those with higher expectations and demands. Treatment duration and the amount of residual alveolar bone available are often important considerations when planning for dental implant-based fixed treatment for these patients. With the introduction of zygomatic implants, a graftless alternative solution has emerged for deficient maxillary bone with provision for immediate loading. This article describes the treatment of a completely edentulous elderly patient using zygomatic implants in conjunction with conventional implants. The implants were immediately loaded using a definitive acrylic resin fixed denture reinforced with a cast metal framework, to provide function and aesthetics.

Matched MeSH terms: Denture, Complete, Lower
Full-arch metal-resin cement- and screw-retained provisional restoration for immediately loaded implants

Baig MR, Rajan G

J Oral Implantol, 2010;36(3):219-23.
PMID: 20553176 DOI: 10.1563/AAID-JOI-D-09-00048

Abstract This article describes the clinical and laboratory procedures involved in the fabrication of laboratory-processed, provisional, screw-retained, implant-supported maxillary and mandibular fixed complete dentures incorporating a cast metal reinforcement for immediate loading of implants. Precise fit is achieved by intraoral luting of the cast frame to milled abutments. Effective splinting of all implants is attained by the metal substructure and retrievability is provided by the screw-retention of the prosthesis.

Matched MeSH terms: Denture, Complete, Lower