Clinical Study on the Efficiency of Three Different Attachment Systems for Implant-supported Mandibular Overdenture
NCT ID: NCT01034930
Last Updated: 2015-02-04
Study Results
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Basic Information
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COMPLETED
NA
69 participants
INTERVENTIONAL
2004-08-31
2012-12-31
Brief Summary
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Detailed Description
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Selected patients will be informed about the two different treatment options, about the benefit of treatment with an overdenture retained by two endosseous implants and a written informed consent will be obtained from all participants.
Initial examination
At the beginning of the treatment for each patient will be recorded:
* The medical status.
* The dental history, oral and radiographic examination.
* The hygiene status.
* An evaluation of the existing dentures.
* The estimation of dysfunctional problems.
Treatment procedure Each patient will receive 2 screw-type Straumann (Institut Straumann AG, Basel, Switzerland) standard implants Ø4.1 mm, with SLA surface in the canine region of the mandible with an interconnecting line approaching parallelism with the terminal mandibular hinge axis. The implant lengths will be 10mm and 12mm. The choice of implant length will be dictated by the preoperative radiographic assessment of bone height in the canine region and drilling distance with the principal concern achieving primary stability.
The implants will be inserted under local anaesthesia using a surgical template derived from a tooth wax-up. The implants will be placed in a 1-stage non-submerged procedure according to a strict protocol (Weingart D and ten Bruggenkate 2000). Postoperatively, antibiotics for 5 days treatment (Amoxicillin and Clavulanate Potassium or Erytromycin - for patients alergic to Penicillin), analgesics and Clorhexidine 0,12% mouth rinse will be prescribe for 14 days. Patients will not be allowed to wear the mandibular denture during the first two weeks post-operatively.
One, two and four weeks after the surgical procedure, the patients will be recalled for follow-up visits. At the first recall visit, sutures will be removed. At the second visit the lower denture will be adjusted by selective grinding at the implant location, and Protefix® (Queisser Pharma Germany) Adhesive Cushions will be provided for patients. At all recall visits, patients will receive oral hygiene instructions.
At the third follow-up visit the manufacturing of a new maxillary denture (for the full maxillary edentulous patients) and a mandibular over-denture will be initiated.
After 6 weeks healing period implants will be loaded and the patients will be randomly assigne to one of two main groups:
* Group B of 23 patients will receive retentive anchors (Institut Straumann AG, Basel, Switzerland).
* Group M of 23 patients will receive magnets (Titanmagnetics® Institut Straumann AG, Basel, Switzerland ).
Group B will be randomly divided in two subgroups: full lower denture with two gold matrices with variable retention (four lamellae functioning like a spring - 12 patients and full lower denture with two titanium matrices with defined retention (spring with a defined extraction force of 700-1100g - B.2) - 11 patients. A new mandibular overdenture with metal reinforcement will be made.
The two groups of patients will be compared in the second part of the study with 23 patients receiving Locator system abutments (Group L) following same research protocol.
A new mandibular overdenture with metal reinforcement will be made.
The prosthetic procedure will be performed according the recommendations of the producer (Straumann Dental Implant System) for retentive anchors, magnets and Locator System by experienced prosthodontists. The occlusion will be assessed on the articulator and intra-orally to secure a balanced occlusion in centric relation without anterior tooth contact.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
NONE
Study Groups
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Retentive Anchors
23 patients will receive as retention system for overdentures Retentive Anchors (Straumann).
Insertion of dental implants
Each patient will receive 2 screw-type Straumann (Institut Straumann AG, Basel, Switzerland) standard implants Ø4.1 mm, with SLA surface in the canine region of the mandible with an interconnecting line approaching parallelism with the terminal mandibular hinge axis, according to a standard surgical protocol.
Magnets
23 patients will receive Magnets (Straumann) as retention system for overdenture.
Insertion of dental implants
Each patient will receive 2 screw-type Straumann (Institut Straumann AG, Basel, Switzerland) standard implants Ø4.1 mm, with SLA surface in the canine region of the mandible with an interconnecting line approaching parallelism with the terminal mandibular hinge axis, according to a standard surgical protocol.
Locator System
23 patients will receive Locator System (Straumann) as retention for the mandibular overdenture.
Insertion of dental implants
Each patient will receive 2 screw-type Straumann (Institut Straumann AG, Basel, Switzerland) standard implants Ø4.1 mm, with SLA surface in the canine region of the mandible with an interconnecting line approaching parallelism with the terminal mandibular hinge axis, according to a standard surgical protocol.
Interventions
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Insertion of dental implants
Each patient will receive 2 screw-type Straumann (Institut Straumann AG, Basel, Switzerland) standard implants Ø4.1 mm, with SLA surface in the canine region of the mandible with an interconnecting line approaching parallelism with the terminal mandibular hinge axis, according to a standard surgical protocol.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Acceptance of a mandibular over-denture retained by two endosseous implants.
* Patients agree to a 5-year follow-up period.
Exclusion Criteria
* Angle class II relationship.
* Physical severe consideration that will affect the minimal invasive surgical procedure or constitute a hindrance for a 5-year follow-up.
* History of radiotherapy in the head and neck region.
* History of pre-prosthetic surgery (including bone graft procedures) or previous oral implants.
18 Years
ALL
No
Sponsors
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ITI International Team for Implantology, Switzerland
OTHER
Concordia Dent Srl
OTHER
Responsible Party
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Corina Marilena Cristache
Dr Corina Marilena Cristache, DMD, PhD, senior lecturer
Principal Investigators
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CORINA MARILENA I CRISTACHE, DMD, PhD
Role: PRINCIPAL_INVESTIGATOR
Concordia Dent Srl
Locations
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Concordia Dent Clinic
Bucharest, , Romania
Countries
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References
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Thomason JM, Feine J, Exley C, Moynihan P, Muller F, Naert I, Ellis JS, Barclay C, Butterworth C, Scott B, Lynch C, Stewardson D, Smith P, Welfare R, Hyde P, McAndrew R, Fenlon M, Barclay S, Barker D. Mandibular two implant-supported overdentures as the first choice standard of care for edentulous patients--the York Consensus Statement. Br Dent J. 2009 Aug 22;207(4):185-6. doi: 10.1038/sj.bdj.2009.728.
Meijer HJ, Raghoebar GM, Batenburg RH, Vissink A. Mandibular overdentures supported by two Branemark, IMZ or ITI implants: a ten-year prospective randomized study. J Clin Periodontol. 2009 Sep;36(9):799-806. doi: 10.1111/j.1600-051X.2009.01442.x. Epub 2009 Jun 26.
Meijer HJ, Raghoebar GM, Batenburg RH, Visser A, Vissink A. Mandibular overdentures supported by two or four endosseous implants: a 10-year clinical trial. Clin Oral Implants Res. 2009 Jul;20(7):722-8. doi: 10.1111/j.1600-0501.2009.01710.x. Epub 2009 Mar 27.
Naert I, Alsaadi G, van Steenberghe D, Quirynen M. A 10-year randomized clinical trial on the influence of splinted and unsplinted oral implants retaining mandibular overdentures: peri-implant outcome. Int J Oral Maxillofac Implants. 2004 Sep-Oct;19(5):695-702.
Naert I, Alsaadi G, Quirynen M. Prosthetic aspects and patient satisfaction with two-implant-retained mandibular overdentures: a 10-year randomized clinical study. Int J Prosthodont. 2004 Jul-Aug;17(4):401-10.
Feine JS, Carlsson GE, Awad MA, Chehade A, Duncan WJ, Gizani S, Head T, Lund JP, MacEntee M, Mericske-Stern R, Mojon P, Morais J, Naert I, Payne AG, Penrod J, Stoker GT, Tawse-Smith A, Taylor TD, Thomason JM, Thomson WM, Wismeijer D. The McGill consensus statement on overdentures. Mandibular two-implant overdentures as first choice standard of care for edentulous patients. Montreal, Quebec, May 24-25, 2002. Int J Oral Maxillofac Implants. 2002 Jul-Aug;17(4):601-2. No abstract available.
Boerrigter EM, van Oort RP, Raghoebar GM, Stegenga B, Schoen PJ, Boering G. A controlled clinical trial of implant-retained mandibular overdentures: clinical aspects. J Oral Rehabil. 1997 Mar;24(3):182-90.
van Steenberghe D, Quirynen M, Naert I, Maffei G, Jacobs R. Marginal bone loss around implants retaining hinging mandibular overdentures, at 4-, 8- and 12-years follow-up. J Clin Periodontol. 2001 Jul;28(7):628-33. doi: 10.1034/j.1600-051x.2001.028007628.x.
Cristache CM, Muntianu LA, Burlibasa M, Didilescu AC. Five-year clinical trial using three attachment systems for implant overdentures. Clin Oral Implants Res. 2014 Feb;25(2):e171-8. doi: 10.1111/clr.12086. Epub 2012 Dec 21.
Cristache CM, Ionescu C, Cristache G, Ionescu I, Iliescu AA, Burlibasa M. A 5-year prospective randomised clinical trial on the efficiency of two different attachment systems as retention for implant-supported mandibular overdenture. Radiographic assessment, cost analysis and final evaluation of treatment's success. Metalurgia International vol. XIV (2009)Special Issue nr. 16:27-34.
Cristache CM, Ionescu C, Burlibasa M, Cristache G, Iliescu AA, Dumitriu HT. Retentive anchors versus magnets as attachment systems for mandibular overdenture. A 5-year prospective randomised clinical study.Metalurgia International vol. XIV (2009) special issue no.16: 59-64
Other Identifiers
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316/03-207-507
Identifier Type: -
Identifier Source: org_study_id
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