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Influence of maxillary prosthesis type on premaxillary bone loss opposing mandibular two-implant overdentures: A
Moataz Mohamed Elezaby1, Marwa Ahmed Aboelez2, Fatma Ahmad El-Waseef2
1Faculty of Dentistry, Delta University for Science and Technology, Gamasa, 35511, Egypt.
Objectives:
This clinical study aimed to evaluate the impact of maxillary prosthesis design-conventional denture versus two-implant overdenture-on premaxillary residual alveolar bone resorption in edentulous patients, addressing the concern that combining a conventional maxillary denture with a mandibular two-implant overdenture may contribute to anterior maxillary bone loss and combination syndrome.
Methods:
Fourty-four participants dissatisfied with their conventional dentures were enrolled. The control group received a maxillary conventional denture opposing a mandibular two-implant overdenture, while the test group received both maxillary and mandibular two-implant overdentures. Three months following implant insertion; all overdentures were retained with LOCATOR attachments and delivered. Vertical and horizontal bone loss in the anterior maxilla was assessed using low-dose CBCT at, insertion and at 6, 12 and 24 months post-insertion. ANOVA was used to compare bone changes between groups and over time, with Bonferroni adjustment for multiple comparisons (P<.05).
Results:
Significant vertical and horizontal bone loss was observed over time in both groups (P<.001), with the greatest changes occurring between baseline and 24 months. Changes in the test group were significant only from baseline to 24 months (p>.05), whereas significant differences were observed at all periods in the control group. At T0-T6, T6-T12, and T0-T24, respectively (p<.05), the test group showed considerably less vertical bone loss than the control group (P<.05), whereas there was no significant difference at T12-T24 (P=.203). Additionally, the test group experienced considerably less horizontal bone loss over all time intervals (P<.05).
Conclusions:
Despite limitations such as the single-center design and limited population diversity, the two-implant-retained maxillary overdenture appeared more effective in minimizing vertical and horizontal premaxillary bone loss compared to conventional maxillary dentures when opposing mandibular implant overdentures. The results endorse the use of maxillary two-implant overdentures as a viable alternative to conventional dentures, helping to prevent combination syndrome and preserve the anterior maxillary bone in edentulous patients.
Clinical Significance:
Combining a maxillary two-implant-retained overdenture with a mandibular two-implant overdenture may provide a more favorable biomechanical environment, reducing the risk of anterior maxillary bone resorption and combination syndrome. This treatment approach may enhance long-term prosthesis stability, function, and patient satisfaction in edentulous individuals.
