IMPLANT SUPPORTED MANDIBULAR OVERDENTURES
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Contents Introduction Drawbacks of conventional complete denture Advantages of mandibular implant denture Success rates Clinical efficiency of mandibular implant overdenture Risks Conclusion Acknowledgments www.indiandetalacademy.com
•INTRODUCTIO
World health organization N (who) considers edentulism a physical impairment The treatment plan for the edentulous patient is the complete removable maxillary and mandibular denture. The treatment is relatively inexpensive in comparsion with fixed implant supported prostheses,but it has several drawbacks. www.indiandetalacademy.com
DRAWBACKS OF COMPLETE DENTURE Extensive detail required for proper fabrication Lack of stability Lack of retention Continued loss of alveolar bone leading to further instability and lack of retention www.indiandetalacademy.com
Patients using such dentures may be lead to believe that professional dental care no longer is needed Lack of chewing function when ill fitting Social concerns,slippage and unnatural appearance.
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Studies show that majority of the patients are dissatisfied due to discomfort and poor fit especially soreness and pain under the mandibular dentures
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Today's patient has high expectation for oral health. Providing a denture that eventually becomes ill-fitting does not meet these expectations. The implant supported mandibular denture is one solution to this problem. www.indiandetalacademy.com
EFFECTS OF EDENTULISM Mean alveolar ridge height reduction of 0.4mm Per year in the edentulous mandible. The process occurs more rapidly during the first year of denture wearing and perpetuates a resorptive process that gradually results in an impaired denture bearing areas. www.indiandetalacademy.com
The mandibular bone beneath an implant over-denture may resorb as little as 0.1mm Annually or remain at 0.5mm After 5 years period
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ADVANTAGES Good retention& stabilityGreet man et al reported that 91 subjects who received mandibular 2 implant over denture rated their ability to chew through tough and hard foods significantly better ,than subjects who wore conventional dentures www.indiandetalacademy.com
Improved function & esthetics Due to improved function ,patients are able to eat a wide variety of food that improves their dietary habits They include more fiber as seen in a study conducted by m.K. Jeffcoat this improves nutritional status which has a positive impact on the general health particularly for the senior adults who are more vulnerable to malnutrition. www.indiandetalacademy.com
Reduced residual ridge resorption Morris et al have conducted studies on the residual ridge resorption in five years after implant placement The rate of resorption decreases significantly from that seen in conventional mandibular dentures
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Kelmetti esa,et al has found from his study that the success rates of implants in the anterior mandible is high and a two implant overdenture retention has proved successful. awad ma,et al has concluded that a mandibular two implant overdenture opposed by a conventional maxillary denture is more satisfactory treatment than conventional dentures www.indiandetalacademy.com
Implant parallelism is of critical importance Bar attachment helps to keep the implants parallel Helps to provide horizontal stability in the atrophic jaw (Carpentieri et al) www.indiandetalacademy.com
CLINICAL EFFECTIVENESS High degree of patient satisfaction Heydecke,et al Showed that the prosthodontist is more satisfied with the general outcome of the implant supported overdenture
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RISKS Surgical complications – *post operative bleeding *numbness *infections *lack of ossseointegration It can be minimized with proper *case selection and diagnosis *training and experience www.indiandetalacademy.com
FACTORS AFFECTING THE TREATMENT -
*Healing *potential infection *Peri – implantitis *Anatomy& bone quality *inadequate practitioner training, experience or both *Patient compliance concerns
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CONCLUSION The literature and clinical evidence indicates that the implant supported prosthesis provides predictable results with improved stability, function and a high degree of satisfaction as compared to the conventional removable mandibular denture . www.indiandetalacademy.com
Clinical studies in the literature suggests that the mandibular two implant overdenture should be considered as a minimal treatment objective and first choice of care for the fully edentulous patient.
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ACKNOWLEDGMENTS I thank my prof. & Hod Dr.Geetha .K.Patil, prof. & Dr. Malathi Dayalan and Dr. Bharath Shetty for their continuous encouragement and guidance in presenting this paper. I would also like to thank the organizing committee for giving this opportunity to present the paper. Thank you one and all. www.indiandetalacademy.com
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