Implant-supported Maxillary Overdentures; a 15-years Evaluation
- Background Patients experiencing problems with their conventional maxillary denture can benefit from implant- retained overdentures. Bar-retained implant overdentures can be supported by 4 or 6 implants, splinted by a bar. Evidence on maxillary implant overdentures has been mostly short to medium term, non-comparing or retrospective. Even more, 15-years data of comparative studies are lacking. It is important to evaluate treatment outcomes, such as implant survival, peri-implant bone changes and patient satisfaction at the long-term.
- Main research question The aim of this 15-years study is to evaluate a patient group treated 15 years ago in a prospective study with a maxillary overdenture on 4 or 6 implants in an edentulous maxilla. The primary objective of the study is to analyze marginal bone level changes by radiological assessments at 15-years follow-up. Secondary objectives are implant and overdenture survival, condition of peri- implant mucosa and patients' satisfaction.
- Design (including population, confounders/outcomes) The study design is an observational study of a group of patients which were treated 15 years ago with dental implants and an overdenture in the maxilla because of problems with retention and stability with their conventional denture. Outcomes: primary outcome is the change in marginal peri-implant bone level 15 years after placing the overdenture. Secondary outcome measures will be implant and overdenture survival, peri-implant mucosa health and patients' satisfaction using a questionnaire.
- Expected results Stable peri-implant bone levels, high implant and overdenture survival rate and satisfied patients.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
• Introduction and rationale In patients who present persistent complaints with respect to their maxillary denture, providing implant support improves comfort, denture satisfaction and overall quality of life considerably and high implant survival rates are reported. Implant position, the number of implants and bone volume are all factors that presumably influence success of both the maxillary overdenture and the implants.
Four- and 6-implant bar-supported maxillary overdenture studies report successful short and medium-term results, indicating that these treatment modalities are comparable and favourable. However, there is considerable heterogeneity with respect to patient and treatment variables within studies reporting on maxillary overdentures in general and four versus six implants in particular, with a lack of high quality long term data as well.
The aim of the present study is to report long term results of bar-supported maxillary implant overdentures on four and six anterior implants for which various clinical surgical and prosthetic outcome measures and subjective, patient-reported parameters are described and compared. Evidence on maxillary IOD attachment systems has been mostly short to medium term, non-comparing or retrospective and therefore inconclusive. This underlines the need for studies comparing different attachment systems with a longer follow-up.
The study design is an observational study to compare treatment outcomes of fully edentulous patients with maxillary IODs, supported by four or six implants. Patients were treated 15 years ago with dental implants and an overdenture in the maxilla because of problems with retention and stability with their conventional denture. Outcomes: primary outcome is the change in marginal peri-implant bone level 15 years after placing the overdenture. Secondary outcome measures will be implant and overdenture survival, peri-implant mucosa health and patients' satisfaction using a questionnaire.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Henny J A Meijer, Professor doctor
- Phone Number: +31503616161
- Email: h.j.a.meijer@umcg.nl
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Fully edentulous patients or patients with an overdenture in the mandible, who were referred to the Department of Oral and Maxillofacial Surgery (University Medical Center Groningen, the Netherlands) 15 years ago, because they suffered from a lack of retention and stability of the upper denture;
At the time of treatment:
- Edentulous in the maxilla for at least one year;
- Sufficient bone volume in height in the anterior or posterior region of the maxilla to place the implants;
- The patient was 18 years or older;
- Sufficient interocclusal space for placement of an overdenture with attachment system;
- The patient was capable of understanding and giving informed consent.
Exclusion criteria at the time of treatment:
- Patients with American Society of Anesthesiologists score (ASA score) ≥ III;
- Patients who were smoking;
- Patients with a history of radiotherapy in the head and neck region;
- Patients with a history of pre-prosthetic surgery or previous implant placement in the maxilla.
Exclusion Criteria:
None
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Maxillary overdenture supported by dental implants
Patients with an edentulous maxilla who were provided with dental implants, a bar retention system and an overdenture
|
Maxillary overdenture supported by dental implants
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in peri-implant marginal bone level
Time Frame: Through study completion, an average of 15 years
|
Comparison between peri-implant bone level at overdenture placement and follow-up time point in millimeters measured on intraoral radiograph
|
Through study completion, an average of 15 years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Implant and overdenture survival
Time Frame: Through study completion, an average of 15 years
|
Percentage of implants and overdentures present at follow-up time point
|
Through study completion, an average of 15 years
|
|
Patient satisfaction
Time Frame: 15 years
|
Patient satisfaction measured on a Visual Analogue Scale.
Minimum =0 (extremely dissatisfied); Maximum = 100 (extremely satisfied)
|
15 years
|
|
Plaque score
Time Frame: 15 years
|
Plaque index from 0 to 3. Minimum = 0 (zero plaque visible); Maximum = 3 (abundant amount of plaque visible)
|
15 years
|
|
Gingival score
Time Frame: 15 years
|
Health of peri-implant mucosa described by Gingival index from 0 to 3. Minimum = 0 (healthy mucosa); Maximum = 3 (very infected mucosa)
|
15 years
|
|
Pocket depth
Time Frame: 15 years
|
Probing depth in the peri-implant sulcus in millimeters measured with a periodontal probe
|
15 years
|
|
Bleeding score
Time Frame: 15 years
|
Bleeding in peri-implant sulcus after probing measured with a Bleeding index from 0 to 3. Minimum = 0 (no bleeding after probing); Maximum = 3 (abundance amount of bleeding after probing)
|
15 years
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Henny J A Meijer, Professor doctor, University Medical Center Groningen
Publications and helpful links
General Publications
- Slot W, Raghoebar GM, Cune MS, Vissink A, Meijer HJA. Maxillary overdentures supported by four or six implants in the anterior region: 10-year randomized controlled trial results. J Clin Periodontol. 2023 Jan;50(1):36-44. doi: 10.1111/jcpe.13726. Epub 2022 Oct 7.
- Slot W, Raghoebar GM, Cune MS, Vissink A, Meijer HJA. Maxillary bar overdentures on four or six posterior implants: 10-year results from a randomized clinical trial. Clin Oral Implants Res. 2022 Nov;33(11):1147-1156. doi: 10.1111/clr.13997. Epub 2022 Sep 29.
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 15 years maxillary overdenture
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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