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Long-term outcomes of three types of implant-supported mandibular overdentures in smokers
Geert Stoker1, Rien van Waas, Daniël Wismeijer
1Department of Oral Implantology and Prosthodontics, Academic Centre for Dentistry Amsterdam, Research Institute MOVE, University of Amsterdam and Free University, Amsterdam, The Netherlands. geertstoker@wxs.nl
Purpose:
The aim of the study was to compare the differences in the long-term clinical and radiologic effects for three different treatment strategies with implant-supported overdentures in the edentulous mandible, with a special emphasis on smoking.
Materials And Methods:
In a randomized- controlled clinical trial, 110 edentulous patients participated. Thirty-six patients were treated with an overdenture supported by two implants with ball attachments (2IBA), 37 patients with an overdenture supported by two implants with a bar (2ISB) and 37 patients with an overdenture supported by four implants with a triple bar (4ITB). After a mean evaluation period of 8.3 years, the clinical and radiographic parameters were evaluated.
Results:
Ninety-four out of the original 110 patients (=85%) were evaluated. In the 2IBA group, the plaque index was significantly lower (vs. 2ISB, P=0.013; vs. 4ITB, P=0.001) than in the other groups, but there was no correlation with the other peri-implant parameters. In the 4ITB group, the marginal bone loss was significantly higher than that in the two implant groups. The maximal probing depth was correlated with peri-implant bone loss (P=0.011). Smoking almost doubled marginal bone loss irrespective of the treatment strategy chosen.
Conclusions:
Patients with two implants show less marginal bone loss than those with four implants. Smoking is a risk factor for the survival of dental implants in the long run.
