الفهرس 
Problems of EdentulismOnly 14 pages are availabe for public view
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Abstract
This study was carried out to evaluate clinically and radiographically the three different types of attachment system ball and socket, locator and magnet on immediately loaded two implants retaining complete mandibular overdentures. Materials and Methods: Twenty-one completely edentulous male patients were selected from the out- patient clinic of Prosthodontic Department, Faculty of Dentistry, Tanta University. All patients were complaining from reduced retention and stability of their lower denture despite of their proper denture periphery, extension, and stability. All patients were completely edentulous, with age ranged between 40-6o years, with normal maxilla-mandibular class I Angle’s classification relationship with enough inter-arch space at least 12mm from soft tissue, they were systemically free. The bone height was not less than 15 mm and the labiolingual width is not less than 6 mm at the mandibular prospective implant site. For all patients, conventional maxillary and mandibular complete dentures were fabricated using the conventional standardized procedures. All patients received 2 implants in the canine region of the mandible and flapless surgical technique with surgical stent were used for implant placement. Patients were randomly classified into three groups, seven patients each. group (A): patients received a conventional maxillary denture and implant retained mandibular over denture with ball and socket attachments. group (B): patients received a conventional maxillary denture and implant retained mandibular over denture with locator attachments. group (C): patients received a conventional maxillary denture and implant retained mandibular over denture with magnet attachments. Dentium implant system was used. All implants of 12mm.length and 3.4mm.diameter.The implants were immediately loaded in the same day the implants are inserted and attached to the mandibular overdenture either with either ball and socket, locator, or magnet attachment. Patients were instructed for overdenture use and preservation of denture hygiene following strict oral hygiene measures. Patients were recalled every 3 days for denture adjustment and occlusal refinement during two weeks post denture insertion. Evaluation: In each group, each patient was evaluated clinically and radiographically at time of denture insertion (T0) then at three (T1), six (T2) and twelve (T3) months following overdenture insertion. Clinical evaluation was carried out in terms of implant survival rate, implant stability measurements using resonance frequency analysis (RFA) with the Osstell monitor device and expressed with ISQ measurement scale (implant stability quotient), peri- implant tissue changes (plaque index, bleeding index, probing pocket depth measurements) and prosthetic complications. While radiographic evaluation was carried out in terms of periimplant marginal bone height changes and residual ridge bone height changes distal to the implants. Results: The results of this study demonstrated that: All implants were successfully osseointegrated except one implant failed in one patient belonged to group (C). group (B) recorded the highest implant stability, followed by group (A) and group (C). group (C) recorded the highest plaque score, followed by group (A) and group (B). Plaque scores significantly increased with advance of time for all groups No significant difference in gingival bleeding index between groups. group (C) recorded the highest probing pocket depth, followed by group (A) and group (B). group (C) record significant higher mucositis followed by group (B) and group (A) and no significant difference between groups in sores, ulcers, hyperplasia and flappy ridges. group (B) showed the highest attachment replacement, followed by group (A) and group (C). group (C) recorded significant higher peri-implant marginal bone loss and residual ridge resorption distal to the implant followed by group (A) and group (B).