Root overdentures and implant overdentures are two similar treatment options for the nearly-edent... more Root overdentures and implant overdentures are two similar treatment options for the nearly-edentulous or edentulous mandible. The purpose of this literature review was to specifically compare their prosthodontic treatment philosophies and follow-up maintenance requirements. Critical comparison of these two prosthodontic treatment philosophies revealed that the foundation for overdentures which is provided by oral implants is more predictable than that provided by the roots of natural teeth. The two treatment modalities have both similarities and differences in their associated prosthodontic maintenance. The findings of this literature review suggest the future possibility that mandibular root overdentures may become obsolete as a treatment approach.
This study aimed to evaluate the 10-year prosthodontic outcomes with splinted and unsplinted desi... more This study aimed to evaluate the 10-year prosthodontic outcomes with splinted and unsplinted designs for maxillary overdentures on three implants opposing mandibular two-implant overdentures. Using two similar implant systems, 40 edentulous participants with existing mandibular two-implant overdentures were randomly allocated to two prosthodontic treatment groups (splinted design with bar units; unsplinted design with ball attachments). Participants had three narrow-diameter implants placed in their edentulous maxillae using a one-stage surgical procedure, and they were conventionally loaded with overdentures. Prosthodontic maintenance events were documented at 1-, 2-, 5-, 7-, and 10-year recalls. Progressive attrition of the cohort resulted in 36 participants being seen for the 1-year recall, 31 participants for the 2-year recall, 30 participants for the 3-year recall, 28 participants for the 5-year recall, 26 participants for the 7-year recall, and 23 participants (nearly 60%) for...
PURPOSE: The aim of this study was to evaluate the mechanical properties of different attachment ... more PURPOSE: The aim of this study was to evaluate the mechanical properties of different attachment systems used for mandibular single-implant overdentures and to compare their wear/deformation features with clinical performance in patients after 1 year.MATERIALS AND METHODS: Three attachment systems were evaluated: large 5.9-mm titanium nitride-coated ball attachments with plastic matrices, standard 2.25-mm uncoated titanium alloy ball attachments with Dalla Bona-type gold alloy matrices, and Locator attachments of titanium nitride-coated patrices and nylon matrices. The hardness and elastic modulus of the systems were determined using the nanoindentation technique. Twelve attachments from each system were used in 36 edentulous patients to support mandibular single-implant overdentures. After 1 year, 5 samples from each system were retrieved and evaluated for wear changes under a scanning electron microscope.RESULTS: The titanium nitride-coated patrices, regardless of system, appeared unchanged and did not require any maintenance. Extensive wear was evident in the uncoated titanium alloy patrices and Dalla Bona-type gold alloy matrices, resulting in high maintenance (15 activations). Minimal wear was observed in the plastic matrices with minimal maintenance (2 replacements). The Locator nylon matrices showed extensive deformation and deterioration with a substantial need for maintenance (16 replacements). The performance of the patrices was related to hardness, while that of the matrices was related to the creep response.CONCLUSIONS: Large ball attachment systems of titanium nitride-coated patrices and plastic matrices reflect favorable wear behavior and clinical performance. These attachments are recommended for patients receiving mandibular single-implant overdentures.
The aim of this study was to review the published literature on in vitro articles investigating t... more The aim of this study was to review the published literature on in vitro articles investigating the retentive force or wear features of different attachment systems, specifically for mandibular two-implant overdentures using an unsplinted prosthodontic design. An electronic search was performed through PubMed, Embase, and Medline databases using Boolean operators to combine the following key words: "retention," "wear," "overdenture attachments," "attachment systems," "implant-retained overdentures," and "implant-supported overdentures." The search was limited to articles written in English published up to October 2008. In addition, a hand search through articles and reference lists retrieved from the electronic search and peer-reviewed journals was also conducted. From a total of 193 articles, only 15 met the specified inclusion criteria for the review. These articles provided evidence that the majority of attachment system...
Background: Before early functional loading of unsplinted implants with mandibular overdentures c... more Background: Before early functional loading of unsplinted implants with mandibular overdentures can become widespread, more clinical studies are needed to investigate the success of the approach. Purpose: To evaluate the success rates of two types of roughened titanium surface implants with early 2-week functional loading of paired mandibular interforaminal implants with overdentures. Materials and Methods: Random allocation divided 24 strictly selected edentulous participants into two groups, with each group to receive a different implant system (ITI Dental Implant System®, Straumann AG, Waldenburg, Switzerland; or Southern Implant System®, Southern Implants, Irene, South Africa). Two implants were placed in the anterior mandible of all participants using one-stage standardized surgical procedures. Previously constructed conventional mandibular dentures (opposing maxillary complete dentures) were temporarily relined and worn by the participants for the first 2 weeks; participants u...
Resonance frequency analysis (RFA) is used to measure oral implant stability. There is controvers... more Resonance frequency analysis (RFA) is used to measure oral implant stability. There is controversy with regard to its accuracy in predicting both implant stability and osseointegration. This systematic review and meta-analysis determined the prognostic accuracy of RFA in predicting implant failure following immediate loading protocols. MEDLINE, EMBASE, the Cochrane Oral Health Group's Trials Register, the United Kingdom National Research Register, the Australian New Zealand Clinical Trials Registry, the Database of Abstracts of Reviews of Effectiveness, and the Conference Proceedings Citations Index were searched to select studies that used RFA in assessing implant stability prior to immediate loading. The sensitivity, specificity, and accuracy of RFA in the selected studies were evaluated using a random effects model. The summary receiver operating characteristic was constructed to summarize the overall test performance. Fifteen studies with 2,236 immediately loaded implants we...
Clinical implant dentistry and related research, 2015
The surgical placement of four maxillary implants for overdentures may not be obligatory when opp... more The surgical placement of four maxillary implants for overdentures may not be obligatory when opposing mandibular two-implant overdentures. To determine 10-year surgical outcomes and implant success of three narrow diameter implants in edentulous maxillae with conventional loading. Forty participants with mandibular two-implant overdentures were randomly allocated for surgery for maxillary overdentures. Using osteotomes, three implants of similar systems were placed with a one-stage procedure and 12-week loading with splinted and unsplinted prosthodontic designs. Marginal bone and stability measurements were done at surgery, 12 weeks, 1-, 2-, 5-, 7-, 10 years. One hundred seventeen implants were placed in 39 participants, with 35 being seen at 1 year; 29 at 2 years; 28 at 5 years; 26 at 7 years; and 23 (59%) at 10 years. Marginal bone loss was 1.35 mm between surgery and 12 weeks; 0.36 mm between 12 weeks and 1 year; 0.48 mm between 1 and 5 years; and 0.22 mm between 5 and 10 years....
Root overdentures and implant overdentures are two similar treatment options for the nearly-edent... more Root overdentures and implant overdentures are two similar treatment options for the nearly-edentulous or edentulous mandible. The purpose of this literature review was to specifically compare their prosthodontic treatment philosophies and follow-up maintenance requirements. Critical comparison of these two prosthodontic treatment philosophies revealed that the foundation for overdentures which is provided by oral implants is more predictable than that provided by the roots of natural teeth. The two treatment modalities have both similarities and differences in their associated prosthodontic maintenance. The findings of this literature review suggest the future possibility that mandibular root overdentures may become obsolete as a treatment approach.
This study aimed to evaluate the 10-year prosthodontic outcomes with splinted and unsplinted desi... more This study aimed to evaluate the 10-year prosthodontic outcomes with splinted and unsplinted designs for maxillary overdentures on three implants opposing mandibular two-implant overdentures. Using two similar implant systems, 40 edentulous participants with existing mandibular two-implant overdentures were randomly allocated to two prosthodontic treatment groups (splinted design with bar units; unsplinted design with ball attachments). Participants had three narrow-diameter implants placed in their edentulous maxillae using a one-stage surgical procedure, and they were conventionally loaded with overdentures. Prosthodontic maintenance events were documented at 1-, 2-, 5-, 7-, and 10-year recalls. Progressive attrition of the cohort resulted in 36 participants being seen for the 1-year recall, 31 participants for the 2-year recall, 30 participants for the 3-year recall, 28 participants for the 5-year recall, 26 participants for the 7-year recall, and 23 participants (nearly 60%) for...
PURPOSE: The aim of this study was to evaluate the mechanical properties of different attachment ... more PURPOSE: The aim of this study was to evaluate the mechanical properties of different attachment systems used for mandibular single-implant overdentures and to compare their wear/deformation features with clinical performance in patients after 1 year.MATERIALS AND METHODS: Three attachment systems were evaluated: large 5.9-mm titanium nitride-coated ball attachments with plastic matrices, standard 2.25-mm uncoated titanium alloy ball attachments with Dalla Bona-type gold alloy matrices, and Locator attachments of titanium nitride-coated patrices and nylon matrices. The hardness and elastic modulus of the systems were determined using the nanoindentation technique. Twelve attachments from each system were used in 36 edentulous patients to support mandibular single-implant overdentures. After 1 year, 5 samples from each system were retrieved and evaluated for wear changes under a scanning electron microscope.RESULTS: The titanium nitride-coated patrices, regardless of system, appeared unchanged and did not require any maintenance. Extensive wear was evident in the uncoated titanium alloy patrices and Dalla Bona-type gold alloy matrices, resulting in high maintenance (15 activations). Minimal wear was observed in the plastic matrices with minimal maintenance (2 replacements). The Locator nylon matrices showed extensive deformation and deterioration with a substantial need for maintenance (16 replacements). The performance of the patrices was related to hardness, while that of the matrices was related to the creep response.CONCLUSIONS: Large ball attachment systems of titanium nitride-coated patrices and plastic matrices reflect favorable wear behavior and clinical performance. These attachments are recommended for patients receiving mandibular single-implant overdentures.
The aim of this study was to review the published literature on in vitro articles investigating t... more The aim of this study was to review the published literature on in vitro articles investigating the retentive force or wear features of different attachment systems, specifically for mandibular two-implant overdentures using an unsplinted prosthodontic design. An electronic search was performed through PubMed, Embase, and Medline databases using Boolean operators to combine the following key words: "retention," "wear," "overdenture attachments," "attachment systems," "implant-retained overdentures," and "implant-supported overdentures." The search was limited to articles written in English published up to October 2008. In addition, a hand search through articles and reference lists retrieved from the electronic search and peer-reviewed journals was also conducted. From a total of 193 articles, only 15 met the specified inclusion criteria for the review. These articles provided evidence that the majority of attachment system...
Background: Before early functional loading of unsplinted implants with mandibular overdentures c... more Background: Before early functional loading of unsplinted implants with mandibular overdentures can become widespread, more clinical studies are needed to investigate the success of the approach. Purpose: To evaluate the success rates of two types of roughened titanium surface implants with early 2-week functional loading of paired mandibular interforaminal implants with overdentures. Materials and Methods: Random allocation divided 24 strictly selected edentulous participants into two groups, with each group to receive a different implant system (ITI Dental Implant System®, Straumann AG, Waldenburg, Switzerland; or Southern Implant System®, Southern Implants, Irene, South Africa). Two implants were placed in the anterior mandible of all participants using one-stage standardized surgical procedures. Previously constructed conventional mandibular dentures (opposing maxillary complete dentures) were temporarily relined and worn by the participants for the first 2 weeks; participants u...
Resonance frequency analysis (RFA) is used to measure oral implant stability. There is controvers... more Resonance frequency analysis (RFA) is used to measure oral implant stability. There is controversy with regard to its accuracy in predicting both implant stability and osseointegration. This systematic review and meta-analysis determined the prognostic accuracy of RFA in predicting implant failure following immediate loading protocols. MEDLINE, EMBASE, the Cochrane Oral Health Group's Trials Register, the United Kingdom National Research Register, the Australian New Zealand Clinical Trials Registry, the Database of Abstracts of Reviews of Effectiveness, and the Conference Proceedings Citations Index were searched to select studies that used RFA in assessing implant stability prior to immediate loading. The sensitivity, specificity, and accuracy of RFA in the selected studies were evaluated using a random effects model. The summary receiver operating characteristic was constructed to summarize the overall test performance. Fifteen studies with 2,236 immediately loaded implants we...
Clinical implant dentistry and related research, 2015
The surgical placement of four maxillary implants for overdentures may not be obligatory when opp... more The surgical placement of four maxillary implants for overdentures may not be obligatory when opposing mandibular two-implant overdentures. To determine 10-year surgical outcomes and implant success of three narrow diameter implants in edentulous maxillae with conventional loading. Forty participants with mandibular two-implant overdentures were randomly allocated for surgery for maxillary overdentures. Using osteotomes, three implants of similar systems were placed with a one-stage procedure and 12-week loading with splinted and unsplinted prosthodontic designs. Marginal bone and stability measurements were done at surgery, 12 weeks, 1-, 2-, 5-, 7-, 10 years. One hundred seventeen implants were placed in 39 participants, with 35 being seen at 1 year; 29 at 2 years; 28 at 5 years; 26 at 7 years; and 23 (59%) at 10 years. Marginal bone loss was 1.35 mm between surgery and 12 weeks; 0.36 mm between 12 weeks and 1 year; 0.48 mm between 1 and 5 years; and 0.22 mm between 5 and 10 years....
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Papers by Alan Payne