Clinical Versatility of the Facility-Equator Implant System as Mandibular Overdenture Retainers

The use of mandibular overdentures (MO) for the rehabilitation of totally edentulous individuals with limited bone availability is widespread and has proven clinical success. Narrow diameter implants (NDI) are available on the market as MO retainers to solve problems related to limited bone availability and bone thickness, providing a low-cost, minimally invasive treatment option. This technique evolved over the years, and changes frequently involved the number of implants used as MO retainers, as the adoption of a smaller number of implants can generate biomechanical disadvantages, contributing to the increased stress in peri-implant tissues, which may accelerate marginal bone loss (MBL), in addition to reducing masticatory capacity and satisfaction with rehabilitation. Some studies pointed out that the use of 3 or more implants as MO retainers improves the biomechanics. Thus, the objective of this study was to report 3 different clinical cases where 3 or more NDI were adopted to retain mandibular overdentures in association with diverse loading protocols: (i) 3 implants adopting conventional loading, (ii) 4 implants using progressive loading, and (iii) 4 implants with hybrid loading. The case with 4 implants and progressive loading showed a slight worsening of masticatory function at 1 year, in addition to a more pronounced MBL compared to other cases, but with improvements in satisfaction and oral health-related quality of life. Thus, NDI can be used as MO retainers with predictability and clinical success, using different numbers of implants and loading protocols.

Effects of Inspiratory Muscle Training With Progressive Loading on Respiratory Muscle Function and Sports Performance in High-Performance Wheelchair Basketball Athletes: A Randomized Clinical Trial

Purpose: To evaluate the effects of inspiratory muscle training associated with interval training on respiratory muscle strength and fatigue and aerobic physical performance (PP) in high-performance wheelchair basketball athletes. Methods: Blinded, randomized clinical trial with 17 male wheelchair basketball players, randomized into control group (CG; n = 8) and training group (TG; n = 9). Respiratory muscle strength was evaluated by measuring maximal inspiratory and expiratory pressures (MIP and MEP), aerobic PP by the Yo-Yo test for wheelchair, and recovery of inspiratory muscle fatigue was assessed at 1, 5, 10, and 15 minutes after exercise test. TG performed inspiratory muscle training protocol with incremental loading for 12 weeks with 50%, 60%, and 70% of MIP, while CG performed with load 15% of MIP. Results: After training period, CG presented a significant increase in MIP and MEP (P ≤ .05), with no change in aerobic PP (P ≥ .05). TG showed a significant increase for all variables (≤.05). MIP showed a large effect size for CG (1.00) and TG (1.35), while MEP showed a moderate effect for CG (0.61) and TG (0.73); distance covered had a moderate effect size for TG (0.70). For recovery of inspiratory muscle strength, CG did not present differences, while TG recovered in 10 minutes (≤.05), representing 87% of the pretest value. Positive and significant correlation between MIP and distance (.54; P ≤ .05) was observed. Conclusion: Inspiratory muscle training protocol with progressive loading was more effective for increasing aerobic PP and maximal inspiratory strength recovery.

Using Resonance Frequency Analysis to Compare Delayed and Immediate Progressive Loading for Implants Placed in the Posterior Maxilla: A Pilot Study

Objective: Implants placed in the posterior region of the maxilla have a high incidence of implant failure due to poor bone quality, especially when immediate implant loading is needed. Immediate Progressive Loading (IPL) can enhance bone quality and may offer an alternative solution when Immediate Implant loading is needed. Methods: Six patients (one male and five females; 34-62 years old) were included in this study. Twelve implants were inserted in the posterior region of the maxilla. Resonance Frequency Analysis (RFA) was performed at the time of implant placement and after 1, 2, 3 and 6 months. ISQ (Implant Stability Quotient) values were compared between the Delayed Loading (DL) group after 2 months and the Progressive Loading (PL) group and between different time points for each group. Results: At implant placement, the mean ISQ values for PL and DL implants were 63 and 57, respectively. One month after implant placement, the mean ISQ value for PL implants was 73. Two months after implant placement, the mean ISQ value for PL implants was 75. Three months after implant placement, the mean ISQ values for PL and DL implants were 76 and 69, respectively. Six months after implant placement, the mean ISQ values for PL and DL implants were 79 and 76, respectively. Conclusion: Despite its limitations, this pilot study indicated that compared to DL, PL can enhance bone density and implant stability, resulting in greater early functionality and fewer surgery sessions.