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Facility-Equator system predictability as mandibular overdenture retainer- a 1-year follow-up study
EAO Online Library. Faot F. Oct 9, 2018; 232459; P- CI - 8
Fernanda Faot
Fernanda Faot
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A new narrow dental implants (NDI) system, Facility-Equator, is available as a mandibular overdenture (MO) retainer. This system has a five-degree angled morse connection with frictional retention including a screwless stud type attachment system installed with the aid of a hammer. The biological behavior of this new implant locking taper system to retain the MO during the healing and functional loading, its predictability and inherent system maintenance problems have not yet been investigated.This study investigated the clinical ad biological behavior of the peri-implant tissues, the NDI’s survival and success rates, the changes in the masticatory function (MF) and satisfaction levels and the presence of complications during the treatment with MOs retained by the Facility-Equator system.Sixteen clinically atrophic edentulous patients were rehabilitated with MO retained by 2 NDI (2.9x10mm – Facility NeoPoros) and Equator type attachments. The implants were evaluated through the following variables- i) cytokine release (TNF-alfa, IL-1beta, IL-6, IL-10) in the peri-implant crevicular fluid (PICF)+ ii) peri-implant health through plaque index (PI), calculus index (CI), gingival index (GI), probing depth (PD) and bleeding on probing (BoP)+ (iii) primary and secondary stability (ISQ) through the resonance frequency analysis+ iv) marginal bone level (MBL) and bone level change (BLC)+ v) success rates. The assessments were performed at 4, 8, 12, 24, and 48 weeks after surgery. The influence of the insertion torque, bone type, mandibular atrophy, edentulism time, and smoking was analyzed. The MF was evaluated via masticatory performance and swallowing threshold tests. The satisfaction and OHRQoL were evaluated by the Dental Impact on Daily Living (DIDL) questionnaire. ****PICF analyses showed that TNF-alfa presented stable levels throughout the follow-up time. IL-1beta remained stable until week (w) 12, rising progressively from w24 and peaked at w48 . At w48, IL-6 concentration was significantly higher than at w8 and w12. High concentrations of IL-10 were present up to w24 and decreased significantly at w48. The PI peaked at w4 (69.8%), and the PD decreased significantly between w1 and w24. The ISQ decreased significantly from the baseline to w4 remaining stable afterwards. MBL-baseline was similar to MBL-w48, and the BLC was negligible (0.12 ± 0.71). Success rate was 81.3%. TNF-alfa, IL-1beta, IL-10, PI, GI, and PD outcomes influenced the success rates, and the GI contributed most to implant failure [-1.066 (-1.895 – 0.237)]. The MF, satisfaction and OHRQoL significantly improved at the first post-loading evaluation. The most frequent maintenance problems were loosening of the Equator attachment, prosthesis adjustments, and O-ring replacement.The cytokine release and the PD were strongly influenced by mandibular bone atrophy, edentulism time, and smoking habits. The peri-implant parameters that are highly dependent on patient care (PI, GI, and PD) are the most important factors affecting the success of implants. The MO improve the MF, satisfaction and OHRQoL, and improvements are already observed at one and three months post-loading, respectively.
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