Overkappingsprothese op mini-implantaten bij edentate ouderen

De implantaatgedragen overkappingsprothese heeft de afgelopen 25 jaar zijn succes bewezen. Voor oudere edentate patiënten kan de plaatsing ervan echter nogal eens problemen opleveren. Het is de vraag of de toepassing van mini-implantaten die bezwaren kan ondervangen. De bevindingen in een onderzoek laten vooralsnog vergelijkbare resultaten zien voor de conventionele implantaatgedragen overkappingsprothese en de op mini-implantaten geplaatste voorziening.

The objective of the study was to analyse implant survival, prosthetic aftercare and quality of life (QoL) after stabilisation of complete dentures with mini-implants. Many edentulous patients refuse implant therapy due to the expenses and fear of surgery. Studies on minimally invasive and low-cost mini-implants remain rare. A total of 133 participating patients from 9 private practices were evaluated via patient records, questionnaires and clinical examinations. Complications, maintenance, QoL questions and the German short version of the oral health impact profile (OHIP-G14) were analysed. After 7 to 61 months, 15 of 336 maxillary implants and 11 of 402 mandibular implants had to be removed. In addition, 4 mandibular implants experienced fracture. The difference between the 4-year survival rates of 94.3% for the maxilla and 95.7% for the mandible was not statistically significant (p = 0.581). All original 144 overdentures remained functional. The prosthetic interventions were typically limited to repairs of acrylic base fractures (about one in five patients), changes of plastic O-rings and relining procedures. The participants showed OHIP-G14 scores (median = 2) that were comparable with those of patients with overdentures retained by conventional implants. Mini-implant survival was similar to that of regular-diameter implants. Although some prosthetic aftercare was necessary, none of the overdentures had to be replaced. Prospective studies comparing conventional and mini-implants are warranted

Bron

Mundt T, Schwahn C, Stark T, Biffar R. Clinical response of edentulous people treated with mini dental implants in nine dental practices. Gerodontology 2013 Jul 17. doi: 10.1111/ger.12066. [Epub ahead of print].