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Biomedical subjects

M Quirynen

Publications and source records attributed to M Quirynen.

At least 73 records · Page 4Linked to original sources

The influence of direct composite additions for the correction of tooth form and/or position on periodontal health. A retrospective study.

The aim of this in vivo study was to evaluate the influence of 5- to 6-year-old direct composite additions on the marginal periodontal tissues. Composite additions were directly placed on 79 intact maxillary anterior teeth in 19 patients (12 to 19 years) by one operator using an ultrafine midway-filled densified resin composite. All patients were recalled 5 to 6 years later for a periodontal evaluation. Plaque index, gingivitis index, and probing depth were measured at the buccal-approximal sites of all unilaterally restored teeth (n=51). An intra-individual comparison was made between the periodontal health of the treated versus the intact sites. The plaque index (P=0.029) and gingivitis index (P=0.008) were significantly higher for the treated sites compared to the intact sites. The difference in probing depth nearly reached the level of significance (P=0.059). In conclusion, 5-to 6-year-old direct composite additions have a negative influence on marginal periodontal health, which consisted of increased plaque retention, gingival inflammation, and periodontal destruction.

Adolescent↗

The reliability of implant-retained hinging overdentures for the fully edentulous mandible. An up to 9-year longitudinal study.

The treatment of fully edentulous mandibles by means of implant-supported hinging overdentures has become a routine therapy, although long-term data on the success rate of implants and prostheses are lacking. This longitudinal study examined 207 consecutively treated patients who received, during the past 10 years, 449 Brånemark implants to retain a mandibular hinging overdenture, mainly on a Dolder bar. Clinical parameters and standardized radiographs taken at every recall visit with an interval of 6-12 months were used to judge the implant rigidity in the jawbone, the marginal bone level, and attachment level changes. The cumulative implant failure rate at 9 years was 3%. After loading, implant loss was concentrated during the first 12 months, with only one failure observed at 22 months. A radiographically determined bone loss of 0.7 mm was observed during the first year. From the second year, a mean annual bone loss of 0.05 mm occurred. The attachment loss, calculated as the sum of probing pocket depth plus the recession, was 0.07 mm/year and paralleled the changes in marginal bone level over time. The rigidity of the implant-bone interface revealed an increase over time, as shown by a decrease in Periotest values. The bar-overdenture complications were related to relining (23%), untightening of the retention clip (10%), and renewal of the prosthesis (7%). When magnets or ball attachments were used, more aftercare was needed. Fracture of the antagonistic full denture occurred in 7% of patients. The present data indicate that the mandibular overdenture therapy on two (Brånemark) implants is a very reliable and cost-effective treatment, even in a long-term perspective for the fixed full mandibular prosthesis and especially in elderly patients.

Adult↗

Comparison of surface roughness of oral hard materials to the threshold surface roughness for bacterial plaque retention: a review of the literature.

OBJECTIVES: The roughness of intraoral hard surfaces can influence bacterial plague retention. The present review evaluates the initial surface roughness of several intraoral hard materials, as well as changes in this surface roughness as a consequence of different treatment modalities. METHODS: Articles found through Medline searches were included in this review if they met the following criteria: 1) stated threshold surface roughness values and reputed change in surface roughness due to different manipulation techniques; or 2) included standardized surface conditions that could be compared to the treated surface. RESULTS: Recently, some in vivo studies suggested a threshold surface roughness for bacterial retention (Ra = 0.2 micron) below which no further reduction in bacterial accumulation could be expected. An increase in surface roughness above this threshold roughness, however, resulted in a simultaneous increase in plaque accumulation, thereby increasing the risk for both caries and periodontal inflammation. The initial surface roughness of different dental materials (e.g., teeth, abutments, gold, amalgam, acrylic resin, resin composite, glass ionomer or compomer and ceramics) and the effect of different treatment modalities (e.g., polishing, scaling, brushing, condensing, glazing or finishing) on this initial surface roughness were analyzed and compared to the threshold surface roughness of 0.2 micron. The microbiological effects of these treatment modalities, if reported, are also discussed and compared to recent in vivo data. SIGNIFICANCE: Based on this review, the range in surface roughness of different intraoral hard surfaces was found to be wide, and the impact of dental treatments on the surface roughness is material-dependent. Some clinical techniques result in a very smooth surface (compressing of composites against matrices), whereas others made the surface rather rough (application of hand instruments on gold). These findings indicated that every dental material needs its own treatment modality in order to obtain and maintain a surface as smooth as possible.

Acrylic Resins↗

Complete nose coverage to prevent airborne contamination via nostrils is unnecessary.

Besides an atraumatic procedure, aseptic techniques during surgery have been suggested to have a positive impact on the predictability of osseointegration. To avoid an infection of the surgical field, coverage of the face of the patient (drapes) and nose (surgical mask, drape and plastic film) were advocated in order to reduce airborne infections and to prevent a contact contamination of instruments and gloves. Such a coverage, however, increases the feeling of claustrophobia when local anaesthesia is used and can lead to hypoxemia. The aim of the present study was to investigate whether the expired air via the nostrils could contribute to the contamination of the oral surgical field. Test blood agar plates were installed for 30 min under the nose of volunteers lying on a surgical table; once with full coverage of their nostrils, as indicated above, and once without. Simultaneously, control plates were installed on a table besides the patient to measure the basic contamination from the environment. All plates were incubated both aerobically and anaerobically. The number of colony forming units (c.f.u.) recorded on test plates after aerobic and anaerobic incubation were surprisingly low, with a mean score of 2.7 and 5.0 c.f.u. for the uncovered situation, and 2.5 and 3.3 c.f.u. for the covered situation, respectively. The control plates were infected by a nearly comparable number of bacteria (means ranging from 2.2 to 3.2). These findings indicate that covering nostrils by a mask and sterile adhesive plastic film is not essential in avoiding airborne microbial contamination. However, the use of a meshed nose guard to prevent contact with the highly contaminated nasal skin is highly recommended.

Adult↗

The use of tetracycline-containing controlled-release fibers in the treatment of refractory periodontitis.

The purpose of this study was to evaluate the safety and clinical efficacy of controlled-release tetracycline-containing fibers in patients with refractory periodontitis versus the preceding classical treatment. One hundred twenty-one sites in 20 patients were followed from baseline to 6 months after fiber insertion. Each selected site was > or = 5 mm deep and bled on probing. All 20 patients had at least one site > or = 7 mm which bled on probing. Those pockets remained after intense and repeated conventional therapy (scaling and root planing and often surgery), often including the use of systemic antibiotics. This treatment period, the so-called control period, preceded the experimental period by at least 3 years, when the fibers were placed. Both treatments (in control and test period) were performed in the Department of Periodontology at the University Hospital in Leuven. At the start of the experimental period, all pockets > or = 5 mm were treated by the placement of fibers impregnated with 25% tetracycline. The fibers were removed after 10 days. Probing depth, clinical attachment level, gingival recession, and bleeding on probing were recorded at baseline, and at 1, 3, and 6 months following treatment. Analysis of data from all sites indicated that a significant decrease in probing depth and gain in attachment were present at all follow-up visits. The mean probing depth reduction for sites > or = 7 mm was 3.2 mm at month 6, with a gain in attachment of 2.7 mm, while this was -1.0 mm and -1.9 mm, respectively, during the preceding control period. The fraction of bleeding pockets was reduced from 77% to 27% and from 80% to 77% during the experimental and control periods, respectively. No significant adverse side-effects were observed, except for a transient redness at fiber removal in 2 sites. Fiber insertion appeared to be time-consuming even when the operator was familiarized with the procedure. The results of this study prove that tetracycline-impregnated fibers can reduce probing depth significantly for a period of 6 months in patients not responding to thorough and repeated classical periodontal treatment.

Administration, Topical↗

The influence of abutment surface roughness on plaque accumulation and peri-implant mucositis.

Bacterial adhesion to intra-oral, hard surfaces is firmly influenced by the surface roughness to these structures. Previous studies showed a remarkable higher subgingival bacterial load on rough surfaces when compared to smooth sites. More recently, the additional effect of a further smoothening of intra-oral hard surfaces on clinical and microbiological parameters was examined in a short-term experiment. The results indicated that a reduction in surface roughness below R(a) = 0.2 microns, the so-called "thresholds R(a)", had no further effect on the quantitative/qualitative microbiological adhesion or colonisation, neither supra- nor subgingivally. This study aims to examine the long-term effects of smoothening intra-oral hard transgingival surfaces. In 6 patients expecting an overdenture in the lower jaw, supported by endosseus titanium implants, 2 different abutments (transmucosal part of the implant): a standard machined titanium (R(a) = 0.2 microns) and one highly polished and made of a ceramic material (R(a) = 0.06 microns) were randomly installed. After 3 months of intra-oral exposure, supra- and subgingival plaque samples from both abutments were compared with each other by means of differential phase-contrast microscopy (DPCM). Clinical periodontal parameters (probing depth, gingival recession, bleeding upon probing and Periotest-value) were recorded around each abutment. After 12 months, the supra- and subgingival samples were additionally cultured in aerobic, CO2-enriched and anaerobic conditions. The same clinical parameters as at the 3-month interval were recorded after 12 months. At 3 months, spirochetes and motile organisms were only detected subgingivally around the titanium abutments. After 12 months, however, both abutment-types harboured equal proportions of spirochetes and motile organisms, both supra- and subgingivally. The microbial culturing (month 12) failed to detect large inter-abutment differences. The differences in number of colony- forming units (aerobic and anaerobic) were within one division of a logarithmic scale. The aerobic culture data showed a higher proportion of Gram-negative organisms in the subgingival flora of the rougher abutments. From the group of potentially "pathogenic" bacteria, only Prevotella intermedia and Fusobacterium nucleatum were detected for anaerobic culturing and again the inter-abutment differences were negligible. Clinically, the smoothest abutment showed a slightly higher increase in probing depth between months 3 and 12, and more bleeding on probing. The present results confirm the findings of our previous short-term study, indicating that a further reduction of the surface roughness, below a certain "threshold R(a)" (0.2 microns), has no major impact on the supra- and subgingival microbial composition.

Adult↗

The influence of periodontitis on the subgingival flora around implants in partially edentulous patients.

The hypothesis that teeth act as reservoirs of micro-organisms for the colonization of oral implants has recently been stated several times. The present study aimed at examining, in partially edentulous patients with severe periodontitis, whether pockets around teeth and implants harbored a comparable micro-flora. In 6 patients (3 with refractory periodontitis and 3 with advanced chronic adult periodontitis), plaque samples were taken from a deep and shallow pocket around both teeth and implants for differential phase contrast microscopy and DNA probe analysis. The results showed important differences in the sub-gingival flora between the 2 disease groups, as well as between deep and shallow pockets, around both implants and teeth. On the other hand, when pockets around teeth and implants with equal depths were compared a striking similarity was observed in the microbial composition. These observations confirm the hypothesis that pockets around teeth act as a reservoir and highlight the importance of periodontal health when oral implants are planned.

Adult↗

Full- versus partial-mouth disinfection in the treatment of periodontal infections. A pilot study: long-term microbiological observations.

A standard periodontal treatment consists of 4 to 6 scalings and rootplanings at a 1- to 2-week interval, which allows reinfection of a previously disinfected area before completion of the treatment. The present pilot study aims to examine the microbiological long-term effects of a full-mouth disinfection. 10 patients with advanced chronic periodontitis were randomly allocated to a test and control group. The patients from the control group received scaling and rootplaning and oral hygiene instructions at a 2-week interval. The full-mouth disinfection (test group) consisted of a full-mouth scaling and rootplaning in 2 visits within 24 h in combination with: tongue brushing with 1% chlorhexidine gel for 1 min, mouth rinsing with 0.2% chlorhexidine solution for 2 min and subgingival irrigation of all pockets (3x in 10 min) with 1% chlorhexidine gel. The patients of the test group were instructed to rinse 2x daily with 0.2% chlorhexidine. Plaque samples were taken at baseline and after 1, 2, 4 and 8 months. Differential phase-contrast microscopy showed a significantly larger reduction of spirochetes and motile organisms in the test group up to month 2 for the single-rooted and up to month 8 for the multi-rooted teeth. Furthermore, the culture data supported the effectiveness of the new treatment strategy. In both groups, the number of anaerobic CFU decreased 1 log around single- and 0.5 log around multi-rooted teeth. The number of anaerobic CFU remained low in the test group, in contrast to the control group. At 1 month, the test group harboured a significantly (p<0.01) lower proportion of pathogenic organisms, but this difference disappeared with time. Moreover, the test sites showed a significantly higher (p<0.02) increase in the proportion of beneficial micro-organisms up to 4 months. These findings suggest that a full-mouth disinfection leads to a significant microbiological improvement up to 2 months, which could be consolidated, although not significant, for the next 6 months.

Adult↗

Intraoral transmission and the colonization of oral hard surfaces.

The sterile abutments of 2-stage implants offer a unique model to study intraoral transmission and bacterial colonization patterns in the oral cavity. This study aimed to examine, by means of differential phase contrast microscopy, parameters that influence the intra-oral colonization of these abutments. In part one, 159 partially edentulous patients were examined to determine the influence on the microbial composition around implants of the following parameters: 1) the relative location of the teeth in relation to the implants; 2) the microbial composition of the subgingival plaque around these teeth; and 3) the frequency of deep pockets around the natural dentition. The results indicate that the subgingival flora around the implants harbored more spirochetes and motile rods when teeth were present in the same jaw (P < 0.05) and/or when the pockets around them harbored a pathogenic flora (P < 0.05). In part two, the impact of periodontitis around the remaining teeth and of probing depth around the implants on the composition of the peri-implant subgingival flora was investigated. Thirty-one partially edentulous implant patients were classified according to their periodontal condition into 3 groups: healthy (n = 17), chronic periodontitis (n = 11), and refractory periodontitis (n = 3). The samples from deep pockets (> or = 4 mm) around implants showed significant increases in the total proportion of spirochetes and motile organisms when compared to samples from healthy subjects (1.2%) or in chronic periodontitis patients (21.0%), or to patients suffering from refractory periodontitis (31.5%). For shallow pockets (< 4 mm) significant differences were only detected between subjects with a healthy periodontium (1.0%) or chronic periodontitis (2.4%), and refractory periodontitis cases (19.7%). The present findings confirm the transmission of microorganisms from teeth to implants, and thereby highlight the importance of periodontal health around the natural dentition before as well as after implant installation.

Adult↗

Microbiological response to mechanical treatment in combination with adjunctive therapy. A review of the literature.

The recognition of the microbial origin and the specificity of periodontal infections has resulted in the development of several adjunctive therapies (antibiotics and/or antiseptics) to scaling and root planing in the treatment of chronic adult periodontitis. This article aims to review the "additional" effect of a subgingival irrigation with chlorhexidine, or a local or systemic application of tetracycline or metronidazole, performed in combination with a single course of scaling and root planing in patients with chronic adult periodontitis. All treatment modalities are compared with scaling and root planing, based on their impact on: the probing depth (PD); total number of colony forming units per ml (CFU/ml); the proportions and/or the detection-frequency of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia; and/or on the percentages of cocci, spirochetes, motile, and other micro-organisms on dark field microscopy examination. All treatment modalities, including scaling and root planing without additional chemical therapy, resulted in significant reductions in the probing depth and the proportions of periodontopathogens, at least during the first 8 weeks post-therapy. However in comparison to a single course of scaling and root planing, the supplementary effect of adjunctive therapies seems to be limited. In general, only the irrigation with chlorhexidine 2%, the local application of minocycline, and the systemic use of metronidazole (in case of large proportions of spirochetes) or doxycycline (in case of large proportions of A. actinomycetemcomitans) seem to result in a prolonged supplementary effect when compared to scaling and root planing. Therefore, the use of antibiotics on a routine basis, especially in a systemic way, in the treatment of chronic adult periodontitis, can no longer be advocated, considering the increasing danger for the development of microbial resistance.

Administration, Oral↗

The adherence of periodontopathogens to periodontal probes. A possible factor in intra-oral transmission?

Periodontal probes have previously been shown to harbor several bacterial types or species after probing periodontally diseased pockets. This study aims to identify and quantify periodontopathogens that may adhere to a periodontal probe by culturing techniques. It also examines the probe's roughness on its capability to collect bacteria, comparing Merrit-B probes (with deep indentations) with TPS probes (with smooth surfaces). From the differential phase contrast microscopy findings it was seen that, while paper-points harbored nearly 50% motile rods or spirochetes, the periodontal probes were just at, or below, the 20% threshold level for pathogenicity (23.6% for the Merrit-B probe and 11.3% for the TPS probe). The cultural data showed that paper-points had significantly higher (P < 0.05) numbers of anaerobic bacteria than the 2 probe types, which still harbored up to 10(7) CFU. No significant differences could be detected between the probes. When specific periodontopathic species were considered, it was seen that for all species, even for Actinobacillus actinomycetemcomitans or Porphyromonas gingivalis, the detection frequency was comparable for the 3 sampling devices. However, the levels of Prevotella intermedia and Campylobacter rectus was significantly higher in samples from paper-points (P < 0.05), but still their numbers reached even 10(5) on the probes. Differences among the 2 probe types were again negligible. Periodontal probes harbor relatively high numbers of bacteria found in periodontal pockets and may be able to carry them over to other sites. Further studies are needed to determine if, and to what extent, transmission occurs during periodontal probing.

Adult↗

Full- versus partial-mouth disinfection in the treatment of periodontal infections. Long-term clinical observations of a pilot study.

A classical treatment for chronic adult periodontitis consists of four to six consecutive sessions of scaling and root planing at a 1- to 2-week interval. Such a so-called "quadrant or sextant therapy" might result in a reinfection of a previously disinfected area by bacteria from an untreated region. The purpose of this study was to investigate, over an 8-month period, the clinical benefits of full-mouth disinfection within a 24-hour period in the control of chronic periodontitis. Ten adult patients with advanced chronic periodontitis were randomly assigned to a test and a control group. The control group received the standard scheme of initial periodontal therapy, consisting of scaling and root planing of the four quadrants was performed within 24 hours and immediately followed by a thorough supra- and subgingival chlorhexidine application to limit any transfer of bacteria. The latter involved tongue brushing with a 1% chlorhexidine gel for 60 seconds, mouthrinsing with a 0.2% chlorhexidine solution twice for 60 seconds, repeated subgingival irrigation of all pockets with a 1% chlorhexidine gel (3 times within 10 minutes), and mouthrinsing twice daily with a 0.2% chlorhexidine solution during 2 weeks. In addition, both groups received thorough oral hygiene instructions. The plaque index, gingival index, probing depth, gingival recession, and bleeding on probing were recorded prior to professional cleaning and at 1, 2, 4, and 8 months afterwards. Although the test group scored higher plaque indices than the control group, especially at months 2 and 4, the gingival index and bleeding tendency showed similar improvements with time. However, when the gingival/plaque ratio was considered, the latter was lower in the test group at all follow-up visits. For pockets > or = 7 mm, full-mouth disinfection showed a significantly (P = 0.01) higher reduction in probing depth at each follow-up visit with, at month 8, a reduction of 4 mm (from 8 mm to 4 mm), in comparison to 3 mm (from 8 mm to 5 mm) for the classical therapy. The increase in gingival recession in the full-mouth disinfection group remained below 0.7 mm, while in the control group it reached 1.9 mm after 8 months. This resulted in a gain of clinical attachment level of 3.7 mm for the test group versus 1.9 mm for the control group. A radiographical examination also indicated a superior improvement for the test group when compared to the control group. This pilot study suggests that a full-mouth disinfection in one day results in an improved clinical outcome in chronic periodontitis as compared to scalings per quadrant at 2-week intervals over several weeks.

Adult↗

The effect of periodontal parameters on the subgingival microbiota around implants.

The study aimed to examine the relationship between the subgingival flora around implants and their periodontal parameters. Plaque samples from 561 implants (279 patients) were analyzed by means of differential phase contrast microscopy and compared with the sample site's probing depth, bleeding tendency on probing, and plaque and gingivitis indices. If possible, one implant with deep and one with shallow pockets were selected within the same patient. The impact of the intraoral exposure time on the microbial composition around the implants was examined cross-sectionally, with the same group of patients. Only tendencies can be detected by the latter, and no concrete conclusions can be drawn. From the clinical parameters, increased probing depth was found to detrimentally increase the proportion of spirochetes and motile organisms, whereas the other parameters were found to be of minor importance. For partially edentulous patients only, there was a tendency for increased proportions of spirochetes and motile organisms the longer the intraoral exposure time. These observations emphasize the importance of the periodontal health of the remaining teeth (as a reservoir of pathogenic microorganisms) in partial edentulous patients rehabilitated by means of implants and indicate the importance of shallow pockets around implants (flap trimming when aesthetics and phonetics allow).

Bacteria↗

The influence of surface roughness and surface-free energy on supra- and subgingival plaque formation in man. A review of the literature.

In the oral cavity, an open growth system, bacterial adhesion to the non-shedding surfaces is for most bacteria the only way to survive. This adhesion occurs in 4 phases: the transport of the bacterium to the surface, the initial adhesion with a reversible and irreversible stage, the attachment by specific interactions, and finally the colonization in order to form a biofilm. Different hard surfaces are available in the oral cavity (teeth, filling materials, dental implants, or prostheses), all with different surface characteristics. In a healthy situation, a dynamic equilibrium exists on these surfaces between the forces of retention and those of removal. However, an increased bacterial accumulation often results in a shift toward disease. 2 mechanisms favour the retention of dental plaque: adhesion and stagnation. The aim of this review is to examine the influence of the surface roughness and the surface free energy in the adhesion process. Both in vitro and in vivo studies underline the importance of both variables in supragingival plaque formation. Rough surfaces will promote plaque formation and maturation, and high-energy surfaces are known to collect more plaque, to bind the plaque more strongly and to select specific bacteria. Although both variables interact with each other, the influence of surface roughness overrules that of the surface free energy. For the subgingival environment, with more facilities for microorganisms to survive, the importance of surface characteristics dramatically decreases. However, the influence of surface roughness and surface-free energy on supragingival plaque justifies the demand for smooth surfaces with a low surface-free energy in order to minimise plaque formation, thereby reducing the occurrence of caries and periodontitis.

Animals↗

Full- vs. partial-mouth disinfection in the treatment of periodontal infections: short-term clinical and microbiological observations.

In a standard periodontal treatment strategy with consecutive root planings (per quadrant at a one- to two-week interval), re-infection of a disinfected area might occur before completion of the treatment. This study examines, both clinically and microbiologically, whether a full-mouth disinfection within 24 hours significantly improves the outcome of periodontal treatment. Ten patients with advanced chronic periodontitis were randomly allocated to a test and a control group. The patients from the control group received scalings and root planings as well as oral hygiene instructions per quadrant at two-week intervals. Full-mouth disinfection in the test group was sought by the removal of all plaque and calculus (in two visits within 24 hours). In addition, at each of these visits, the tongue was brushed with a 1% chlorhexidine gel for one min and the mouth rinsed with a 0.2% chlorhexidine solution for two min. Furthermore, subgingival chlorhexidine (1%) irrigation was performed in all pockets. The recolonization of the pockets was retarded by oral hygiene and 0.2% chlorhexidine rinses during two weeks. The clinical parameters were recorded, and plaque samples were taken from the right upper quadrant at baseline and after one and two months. The test group patients showed a significantly higher reduction in probing depth for deep pockets at both follow-up visits (p < 0.05). At the one-month visit, differential phase-contrast microscopy revealed significantly lower proportions of spirochetes and motile rods in the test group (p = 0.01). Culturing showed that the test group harbored significantly fewer pathogenic organisms at one month (p = 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

A method for assessing the damping characteristics of periodontal tissues: goals and limitations.

The Periotest method, an objective, noninvasive clinical diagnostic method, is a dynamic procedure that measures the resistance of the periodontium to a defined impact load. It has been reported that Periotest values depend to some extent on tooth mobility, but mainly on the damping characteristics of the periodontium. Nevertheless, the real clinical meaning of the measurements and some important limitations of the Periotest measuring principle still seem to be poorly understood. In the present study, the relationship between damping characteristics of periodontal tissues and tooth mobility was investigated. The best correlations between tooth deflection and Periotest values were found for teeth showing a certain degree of clinical mobility (R2 from .79 to .91). Nevertheless, this correlation was clearly lower when only healthy subjects were examined (R2 from .43 to .54). The better correlation found for forces greater than 1.0 N indicates that the damping characteristics assessed with the Periotest method are related to secondary tooth movement. The Periotest methodology, measuring principle, and limitations are critically reviewed.

Adult↗

A comparative prospective study of splinted and unsplinted Brånemark implants in mandibular overdenture therapy: a preliminary report.

Thirty-six edentulous patients, each provided with two Bränemark implants in the mandible to anchor an overdenture, were selected for this study and randomly divided into three groups of 12 patients each. In each group a different attachment system was used: (1) magnets, (2) ball attachments, and (3) straight bars with clips (control). The mean loading time was 12.4 months (range 3 to 24 months). This study investigated (1) the clinical behavior of loaded implants by means of overdentures related to their connection system (splinted versus unsplinted) and (2) the clinical performance of prosthetic treatment. Preliminary results indicate no differences; no failures occurred and the level of marginal bone height, as well as the probing attachment level, changed similarly in the three groups. Although splinted bar-retained overdentures scored better objectively, subjective satisfaction ratings did not differ. It was concluded that for the short follow-up period, the state of connection did not influence the clinical success of implants. However, no definite conclusions may be drawn until long-term data become available.

Adult↗