Immediate versus Delayed Attachment Incorporation Impact on Prosthetic Aftercare among Mandibular Implant-Supported Overdenture Wearers

J Clin Med. 2022 Jun 19;11(12):3524. doi: 10.3390/jcm11123524.

Abstract

Background: Substantial effort is dedicated to finding the most favorable parameters that will ensure low aftercare demands among edentulous patients wearing mandibular implant supported overdentures (MISODs). The purpose of this retrospective cohort study was to compare prosthetic aftercare between MISOD patients with a simultaneous (group A) vs. a three-week settling in period (group B) prior to attachment incorporation.

Methods: Forty-five patients enrolled in this study. Two implants per patient were placed using a two-stage implant insertion protocol. Second-stage surgery was performed after three months. All patients received ball attachments using the direct (chairside) incorporation method. Twenty-two patients received their dentures with simultaneous attachment activation and the rest-twenty-three patients-after a three-week settling in period. Patients' files were scanned for aftercare visits. Outcome parameters included sore spot relief, attachment incorporation, and denture repair. Additionally, gingival index measurements were compared. Confounding factors included age, gender, and implant dimensions.

Results: The mean follow-up for the entire cohort was 84 ± 21 months, and the range 39-120 months. The mean number of visits for group A vs. B respectively: pressure sores relieve (3.63 ± 0.84 vs. 3.71 ± 0.61, p = 0.581), liner exchange due to loss of retention (2.09 ± 1.03 vs. 2.31 ± 1.04 p = 0.487), and gingival index (1.3 ± 0.3 vs. 1.03 ± 0.2, p = 0.653) exhibited no statistically significant differences between the tested groups. No statistically significant differences between the groups were also noted for the denture repair aftercare treatments (p = 0.318) and the independent variables including age, gender, and implant length.

Conclusions: Prosthetic aftercare in MISOD wearers is similar whether a simultaneous or a three-week settling in period for attachment incorporation is applied.

Keywords: aftercare; delayed activation; denture settling; immediate activation; mandibular implant overdenture.

Grants and funding

This research received no external funding.