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Maintenance and risk factors for fractures of overdentures using immediately loaded conventional diameter or mini implants with Locator abutments: A cohort study.

BACKGROUND
Fractures in mandibular implant-retained overdentures are a common complication. However, little is known on the related risk factors and outcome differences when using two conventional diameter or two mini implants.


PURPOSE
The purpose of this study was first, to evaluate the required maintenance and complications with the overdentures and second, to analyze risk factors for overdenture fractures.


MATERIALS AND METHODS
This cohort study was conducted in edentulous patients with complete dentures. Patients received either two conventional (4.1 mm in diameter) and two mini (2.9 mm or less in diameter) implants, based on available buccal-lingual ridge width. All implants were immediately loaded with mandibular overdentures retained by Locator abutments. The number of prosthodontic after care visits (scheduled and unscheduled) were recorded and compared between the two implant diameter groups. Fracture occurrence was the primary outcome variable. Risk estimates were presented as odds ratios (ORs) with 95% confidence intervals (CIs). The ORs were adjusted for potential clinical confounders (ie, necessity of relining, matrix recapture, abutment loosening, implant diameter, height of the Locator, and retention force).


RESULTS
A total of 50 edentulous patients were analyzed. One conventional diameter and three mini implants failed within a 1-year follow-up period. Prosthetic maintenance requirements for overdentures on both implant diameter groups were comparable. A total of 12 overdenture fractures (four in the mini implant group and eight in the conventional diameter group) occurred. Adjusted OR (AOR) analysis showed a significant association between abutment loosening and overdenture fracture (AOR = 12.00, 95% CI = 1.11-129.45; P = .041).


CONCLUSION
Within the limitations of this study, the present findings suggest that implant diameter does not affect number of prosthetic maintenance and complications, and that abutment loosening is a risk factor for overdenture fractures, regardless of the implant diameter used.