Long-term prosthetic aftercare of direct vs. indirect attachment incorporation techniques to mandibular implant-supported overdenture

Objective The aim of this long-term study was to compare the need for prosthetic aftercare of direct vs. indirect attachment incorporation techniques to mandibular implant-supported overdenture. Materials and methods Forty-five consecutive patients were included (130 implants were placed). Treatment was randomly allocated, resulting in 22 patients (group A) to be treated with direct ball attachment incorporation and 23 patients (group B) to be treated with indirect ball attachment incorporation. All patients were treated by experienced oral-maxillofacial surgeons/periodontists and experienced prosthodontists/residents. From the first day that the patients visited the clinic up to 20 years after the first treatment session, all surgical or prosthetic therapeutic interventions were recorded. The recorded data for the present study included the number of aftercare visits and dental treatment received (pressure sores relieve, liner changes due to loss of retention and attachment replacement due to wear). Results The mean follow-up was 93 +/- 57 months. No implants were lost. Statistical analysis revealed a statistically significantly (P < 0.001) greater need for prosthetic interventions in group B vs. group A. The mean number of visits dedicated to - pressure sores relieve (7.04 +/- 1.4 vs. 3.63 +/- 0.84); liner exchange due to loss of retention (3.6 +/- 1.3 vs. 1.09 +/- 1.06) was significantly higher in group B. Attachment replacement due to wear occurred only in group B (11/23 - 47.8%). Conclusion The direct technique for attachment incorporation in mandibular implant-supported overdentures using ball attachments is superior to the indirect technique from the aftercare perspective during a long-term evaluation period. To cite this article:Nissan J, Oz-Ari B, Gross O, Ghelfan O, Chaushu G. Long-term prosthetic aftercare of direct vs. indirect attachment incorporation techniques to mandibular implant-supported overdenture.Clin. Oral Impl. Res. 22, 2011; 627-630doi: 10.1111/j.1600-0501.2010.02026.x.