ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Mini Implants Have Lower Survival Rate but Superior Patient Satisfaction Compared to Standard Implants in Mandibular Overdentures
Clinical Question In a healthy edentulous patient, how do mini implants compare to standard implants in terms of survival rate and patient satisfaction with mandibular overdenture?
Clinical Bottom Line Mini-implants show a lower survival rate but superior patient satisfaction with mandibular overdentures compared to standard implants, and are a cost-effective solution for patient's with narrow mandibular ridges.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 26294416De Souza/2015120 edentulous patientsRandomized Controlled Trial
Key results120 patients were randomly assigned to 3 groups: group 1 (n=38) had 4 mini-implants placed, group 2 had (n=42) 2 mini-implants placed, and group 3 had (n=40) 2 standard implants placed. Mini implants were 2x10mm in dimension and standard implants were 4x10mm, and all were placed in the anterior mandible. Groups were evaluated using Oral Health Related Quality of Life (OHRQoL), patient satisfaction with dentures, and implant survival rate. Survival was defined as an implant with no indication for removal due to mobility, pain to percussion, or radiographic evidence of failed osseointegration. In terms of OHRQoL, mini implants, regardless of their number, resulted in significantly better scores than standard implants (95% confidence interval). Overall patient satisfaction and masticatory ability was significantly higher for treatment with 4 mini-implants than for 2 standard implants (95% confidence interval), with intermediate ratings for 2 mini-implants. At the 12-month follow up, implant survival rates were significantly different for the 3 groups (P = 0.004), with similarity between groups 1 and 2, and significantly higher for group 3. The survival rate of initially placed implants was 89%, 82%, 99%, in groups 1, 2 and 3, respectively.
Evidence Search Mini implants AND standard implants AND overdenture
Comments on
The Evidence
Validity: All three groups were similar in baseline sex, age and case complexity (mandibular ridge morphology). Randomization was computer-generated and a researcher not involved prepared envelopes with implants opened by the surgeon immediately prior to implant insertion. Groups received similar prosthetic procedures of hollowing out the mandibular denture and insertion of attachment matrices 3 months following the surgery. Participants in the third group underwent second-stage surgery to receive a 2.0mm ball attachment immediately before insertion. The different attachment systems used may be the critical factor in the OHRQoL evaluation, rather than the size of implant placed. This study had a completion rate of 88% (n=106). Perspective: Long-term studies are still needed to assess factors such as implant survival, as this study only focuses on a 12-month time span. This study also only addresses implants placed in healed ridges, rather than immediate implant placement.
Applicability Implant-retained overdentures have become the new standard of care for patients with mandibular edentulous ridges; however, there are some limitations when it comes to standard implant placement. Costs may be prohibitive, systemic health issues in the elderly can limit surgery procedures and time, and some patients may have narrow ridges that prohibit standard implant placement if not for more extensive, costly surgery. Mini implants are an alternative that can be inserted into narrow ridges with a simpler, faster approach, and subsequently with a reduced cost.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics)
Keywords Mini implants, dental implants, overdentures
ID# 2962
Date of submission: 11/16/2015spacer
E-mail wylies@livemail.uthscsa.edu
Author S. Jade Wylie, DDS
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Barbara MacNeill, DMD
Faculty mentor/Co-author e-mail macneill@uthscsa.edu
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