Leles, Cláudio Rodrigues; de Paula, Marcella Silva; Curado, Thalita Fernandes Fleury; Silva, Jésio Rodrigues; Leles, José Luiz Rodrigues; McKenna, Gerald; Schimmel, Martin (2022). Flapped versus flapless surgery and delayed versus immediate loading for a four mini implant mandibular overdenture: a RCT on post-surgical symptoms and short-term clinical outcomes. Clinical oral implants research, 33(9), pp. 953-964. Wiley-Blackwell 10.1111/clr.13974
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Clinical_Oral_Implants_Res_-_2022_-_Leles_-_Flapped_versus_flapless_surgery_and_delayed_versus_immediate_loading_for_a_four.pdf - Accepted Version Available under License Publisher holds Copyright. Download (1MB) | Preview |
OBJECTIVE
This factorial randomized clinical trial tested the effects of the surgical approach (flapped - FPS versus flapless - FLS surgery) and loading protocol (delayed - DL versus immediate - IL) for treatment with a four mini implant mandibular overdenture.
MATERIAL AND METHODS
A total of 296 one-piece titanium-zirconium mini implants were inserted in 74 patients (IL/FLS=17; IL/FPS=18; DL/FLS=20; DL/FPS=19). Outcomes included patient's perceived surgical burdens, clinical time, implant survival, and post-surgical symptoms and complications, assessed immediately after surgery, in the 7-day and 6-week follow-ups.
RESULTS
Perceived surgical burdens were relatively low, higher for females, and no difference was found between flapped and flapless surgery. Surgical time was lower for flapless surgery. Overall symptoms were mild after 24 hours, and higher for females. Less symptoms were recorded for the flapless surgery compared to the flapped for the delayed loading patients, and flapless surgery was associated with lower risk of bleeding. No early implant failure was observed until the 6-week follow-up. Delayed was associated with discontinuous use of the prosthesis and poor function. Lower complaint rates were observed for immediate loading regardless of the surgery protocol.
CONCLUSIONS
Mini implants for mandibular overdenture is a feasible option regardless of surgical access and loading protocol, with high safety and predictable survival rates, and low incidence of post-insertion complications. Flapless surgery requires less clinical time and result in easier intraoral prosthetic incorporation of attachments compared to flapped surgeries. Immediate loading did not increase the risk of early implant failure when satisfactory primary stability was achieved.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > School of Dental Medicine > Department of Reconstructive Dentistry and Gerodontology |
UniBE Contributor: |
Schimmel, Martin |
ISSN: |
0905-7161 |
Publisher: |
Wiley-Blackwell |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
18 Jul 2022 10:42 |
Last Modified: |
13 Jul 2023 00:25 |
Publisher DOI: |
10.1111/clr.13974 |
PubMed ID: |
35818640 |
BORIS DOI: |
10.48350/171318 |
URI: |
https://boris.unibe.ch/id/eprint/171318 |
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