Comparing Masticatory Performance of Maxillary Mini Dental Implant Overdentures, Complete Removable Dentures and Dentate Subjects

Background: Mini dental implant (MDI) overdenture rehabilitation for the edentulous maxilla is a valuable, less invasive and affordable treatment alternative for complete removable dentures (CRD). However, comparative quantification of masticatory performance in different oral conditions are scarce. Purpose: This study compares objective masticatory performance of dentate groups, maxillary CRD and MDI overdentures and subjective masticatory performance in maxillary CRD and MDI overdentures. Materials and Methods: Four groups were defined, age 20+ dentate dental students (DS), age 50+ complete dentate subjects (DP), age 50+ maxillary CRD or MDI overdentures/dentate mandible. Objective masticatory performance was evaluated by measuring circular Variance of Hue (VOH) or the mixture degree of two-color chewing gum (Hue-check View Gum® Test). Additionally, subjective masticatory comparison was investigated in the CRD and MDI groups, with a visual analogue scale (VAS) for different food consistencies and the Oral Health Related Quality of Life (OHRQL) OHIP-14 questionnaire. Results: The mean VOH was 0.11 (SD 0.50, range 0.05–0.27) for the dentate dental 20+ students, 0.13 (SD 0.08, range 0.03–0.31) for the 50+ dentate group (p = 0.774), 0.41 (SD 0.41, range 0.14–0.76) for the CRD group and 0.39 (SD 0.18, range 0.07–0.76) for the MDI group (p = 0.725). Based on the VAS scores, no improvement was found between the CRD and the MDI overdenture group (p > 0.050). The mean OHIP-14 total score was 12.10 (SD 15.87, range 0–56) for CRD, while the MDI group (p = 0.039) saw a significant improvement to 2.85 (SD 2.85, range 0–15). Conclusion: Comparable results in objective masticatory performance were registered in dentate 20+ and 50+ subjects with a remarkable inferior outcome for the CRD and MDI group. Compared to CRD, MDI overdentures revealed no substantial improvement in subjective and objective masticatory performance. However, for MDI a significant increase in OHRQL was apparent.

Rationale for Definitive Mini Dental Implant Treatment

Mini dental implants can be used to support crowns and partial and complete dentures in compromised edentulous sites. Lack of bone width or site length may be treated with mini implants. Mini implants have less percutaneous exposure and displacement that may reduce complications. Nonetheless, mini implants transmit about twice the load to the supporting bone and thus control of occlusal loading is important. In fixed prosthetics, rounded flat cusps, splinting, implant protective occlusal schemes and only placement in dense bone sites are features of successful mini implant treatment. With removable prosthetics, multiple mini implants may be needed for appropriate retention and load resistance. Maxillary lateral incisor and mandibular incisor sites may be best suited for mini implant treatment.Caveat: Past research of dental implants has been directed at standard sized implants. While mini implants are dental implants, indeed, they behave somewhat differently under functional load and the clinician should be circumspect and very judicious in their use.

Mini-Implants and Zirconium Crowns in Treating Congenitally Missing Maxillary Lateral Incisors: Case Report

SummaryBackground/Aim: A problem of congenitally missing lateral incisors is frequently encountered in dentistry, with several available treatment modalities, the choice depending on each case. Case Report: A young female patient with bilateral missing lateral incisors was in need for dental treatment for esthetics. She had spacing among the upper anterior teeth with class I molar relationship. Orthodontic space creation was carried out followed by two-piece mini dental implant placement. Two-stage protocol was followed. After osseointegration, implants were exposed. Healing collars were installed to allow mucosal healing. Closed tray implant level impression was taken. Zirconium crowns were chosen for optimum esthetic results. Conclusions: Mini-implants can be used successfully for restoring congenitally missing lateral incisors after space opening. Esthetic results can be enhanced using Zirconium crowns