抄録
The two implant-retained overdenture (IOD) is a costeffective treatment option for the edentulous mandible.In the early days, an unloaded healing period of 3 months was generally advocated. However, due to the inconvenience of this long healing period, the immediately-loaded IOD has recently been trialed. As one of the most important issues with immediate loading is osseointegration failure due to excessive stress on peri-implant bone during the healing period, the use of magnetic attachments has been considered due to their potential to limit hazardous lateral forces. However, literature regarding immediately-loaded magnetic attachment IODs remains limited, at least in Japan. Furthermore, the advantage of immediately-loaded IODs needs to be demonstrated not only by survival rate, but also by patient-reported outcomes such as oral health-related quality of life (OHRQoL) profiles.
The oral health impact profile (OHIP) is a tool for measuring OHRQoL. Recently described OHIP items represent four dimensions of OHRQoL:Pain;Oral Function;Aesthetic;and Social Psychological Impact. It is believed that these dimensions offer a framework to better understand and measure the impact of oral conditions and the effectiveness of dental interventions. This paper introduces a treatment protocol for immediately-loaded mandibular IODs with magnetic attachments, and an evaluation of treatment outcomes using the new OHIP dimensions.
Two patients treated with immediately-loaded IODs with magnetic attachments were selected from patients who visited the Department of Prosthodontics at Showa University. The chief complaint was inability to chew foods due to denture instability. For both patients, surgery to place two interforaminal implants was planned and performed, then magnetic attachments were delivered immediately postoperatively. No complications have been observed in either patient during follow-up.
OHIP questionnaires measuring frequency of impacts experienced during the previous month were administered to each subject after obtaining informed consent, at baseline, 1 month and 1 year postoperatively. The results showed substantial decreases in OHIP summary scores for both patients (66% and 98% decreases, respectively) at 1 year postoperatively. Four-dimensional analysis revealed that the dimension of Oral Function in both patients was both significantly impaired at baseline and significantly improved with immediately-loaded IODs treatment.
Within the limitations of this small case series, immediately-loaded IODs employing magnetic attachments appear to offer effective treatment resulting in an improved functional component of OHRQoL within a one-month period.
