Page 134 - Peri-implant health: the effect of implant design and surgical procedure on bone and soft tissue stability

CHAPTER 5
Another explanation for the relatively high plaque scores could be the dexterity problems inducing imperfect cleaning abilities in elderly patients. On the other hand, plaque is screened at a given moment in time during the clinical inspection and this may be several hours after cleaning and not necessarily reflects the overall hygiene of the patient over time.
This is the reason why the bleeding index is considered more useful. It reflects the degree of inflammation as a result of the long-term plaque control and is less momentarily. The current study revealed that high plaque score did not result in high bleeding scores.
The support of a mandibular overdenture by two implants has a significant positive effect on the quality of life. The OHIP-14 score was calculated irrespective of the implant group because it is a patient-related outcome variable. On all the seven domains measured with the OHIP-14 questionnaire a statistically significant difference was measured, all in favor of the support of a mandible overdenture by two implants. These findings are in accordance with a clinical trial reporting a significant improvement in satisfaction and health-related quality of life when subjects who received two implants are compared with subjects requesting a new conventional denture. Besides the improvement in the quality of life, they reported that patients requesting implants reported that tooth loss and denture wearing problems had a much greater impact in their quality of life than patients seeking conventional dentures.5
CONCLUSIONS
Within the limitations of this study, it can be concluded that an implant supported mandibular overdenture significantly improves the quality of life, with limited biologic complications and a high survival rate of the implants. All seven domains of the OHIP-14 questionnaire significantly reduced when the mandible overdenture is supported by two implants. No differences were observed in crestal bone remodeling between minimally rough and moderately rough implant surfaces. However, initial bone remodeling was affected by initial soft tissue thickness. Anticipating biologic width re-establishment by adapting the vertical position of the implant in relation to the available soft tissue thickness may avoid peri-implant bone loss. The biologic variance of the patient might be more important compared to the configuration of the implant surface. Long-term follow-up of the study
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