Implant supported mandibular overdenture/ lingual orthodontics courses

Contents
Introduction
Drawbacks of conventional complete denture
Advantages of mandibular implant denture
Success rates
Clinical efficiency of mandibular implant
overdenture
Risks
Conclusion
Acknowledgments
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World health organization (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.
•INTRODUCTIOINTRODUCTIO
NN

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

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.

Studies show that majority of the patients
are dissatisfied due to discomfort and poor
fit especially soreness and pain under the
mandibular dentures

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.

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.

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

ADVANTAGES
Good retention& stability-
Greet 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

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.

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

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

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)

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

RISKS
Surgical complications –
*post operative bleeding
*numbness
*infections
*lack of ossseointegration
It can be minimized with proper
*case selection and diagnosis
*training and experience

FACTORS AFFECTING THE
TREATMENT -
*Healing
*potential infection
*Peri – implantitis
*Anatomy& bone quality
*inadequate practitioner training,
experience or both
*Patient compliance concerns

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 .

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.

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.

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Implant supported mandibular overdenture/ lingual orthodontics courses

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