الفهرس 
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Abstract
The present study was designed to evaluate the survival outcome of complete mandibular overdentures when retained with endosseous implants of varied length in situations when the implant diameter is not a variable.
Six male edentulous patients were selected for this study, from prosthodontic department, faculty of Dentistry, Alexandria University. All patients were free from any systemic diseases that would affect the osseointegration of dental implants with their age ranges from 40 60 years. All patients accepted implant overdenture treatment modality.
All patients received new upper and lower complete dentures constructed using the conventional method. Selected patients were planned to have two endosseous root form implants with different lengths (IMTEC Co, U.S.A). Implants were decided to be placed in the right and left mandibular canine areas.
Accordingly, patients were classified into two groups, with each patient being a member of both groups according to split mouth design. The groups were as follows:
1. Group I (Study group):
A lingual modified full thickness mucoperiosteal flap was reflected in the left mandibular canine area. Then an 11x3.5 mm implant was placed. The flap was sutured to cover the implant.
Patients were instructed to have soft diet. Antibiotic, anti inflammatory and mouthwash were prescribed. Sutures were removed after 1 week.
2. Group II (Control group):
A lingual modified full thickness mucoperiosteal flap was reflected in the right mandibular canine area. Then a 14x3.5 mm implant was placed. The flap was sutured to cover the implant.
Patients were instructed to have soft diet. Antibiotic, anti inflammatory and mouthwash were prescribed. Sutures were removed after 1 week.
After a stress free healing period of three months, the implants were uncovered using punch technique and healing abutments were connected. Patients were instructed to have soft diet for the first week. Antibiotic, anti inflammatory and mouthwash were prescribed.
One week later, when the soft tissues attain sufficient seal around the implants, the healing abutments were removed and ball abutments were fixed to the implants and the metal housings with the rubber O rings were attached to the fitting surface of the lower dentures using direct pick up technique with a cold cured acrylic resin.
Methods of evaluation:
1. Clinical evaluation:
a. Modified gingival index: Modified gingival index around the implants was recorded immediately after implants loading with the prosthesis and every 3 months up to 1 year.
b. Modified plaque index: Modified plaque index around the implants was recorded immediately after implants loading with the prosthesis and every 3 months up to 1 year.
c. Peri-implant probing depth: Peri-implant probing depth was recorded immediately after implants loading with the prosthesis and every 3 months up to 1 year.
d. Relative clinical attachment level: Relative clinical attachment level around the implants was recorded immediately after implants loading with the prosthesis and every 3 months up to 1 year.
e. Mobility: Implants mobility test was performed immediately after implants loading with the prosthesis and every 3 months up to 1 year.
2. Radiographic evaluation:
Radiographic assessment of the vertical bone loss and bone density were carried out around the implants through a standardized per apical radiographic survey with a superimposed grid and image j soft ware. The measurements were recorded immediately after loading of the implants with the prosthesis and every 3 months up to 1 year.
Conclusion
From the results of this study, it could be concluded that:
1. Difference in implants’ length did not affect the survival rate of mandibular implant overdenture.
2. Soft tissue healing around the implants showed marked progression by the use of punch technique.
3. None of the implants showed any degree of mobility of all patients.
4. Results of modified gingival index, modified plaque index, peri-implant probing depth and relative clinical attachment level showed no statistical significant difference around the implants of both groups.
5. Results of bone density and bone level changes around the implants showed no statistical significant difference between the two groups.
Recommendations:
- Further studies are recommended to evaluate the effect of implants length on the survival rate of mandibular implant overdenture in cases of using splinted or non splinted, longer or shorter implants or carried out over a prolonged period of evaluation on more number of patients or implants.
- Study of the effect of using different implants’ diameters on the survival of implant overdenture is also recommended to be evaluated.
- The punch technique is advisable in second stage surgery in cases of implant supported crowns and fixed partial dentures to allow proper healing and preservation of attached gingiva around the implants’ abutments and so obtain better aesthetic results.
- Split mouth design of research is highly recommended to be used whenever possible in any dental research in order to obtain accurate results, decrease the bias and reduce the cost.