الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The uses of mandibular overdentures supported by three implants connected with a bar is recommended to achieve a sufficient amount of support, stability and retention. In this type of prosthesis, more support is derived from the implants than the alveolar ridge mucosa where pressure is minimized, compensating for the atrophied posterior segments or high muscular attachments. Thus, eliminates the need for a denture base extension.
The aim of this study was to investigate the stability of three implants supported by a milled bar, which carry two different attachment systems and submitted to immediate loading.
The current research was a prospective study conducted according to split-mouth design with random allocation of the tested attachments. Two types of attachments were used, OT Equator and OT Cap attachment. A total of 8 completely edentulous patients were divided into 2 Groups according to OT Equator position.
CBCT was used for the planning and construction of the surgical stent. A milled bar with the attachments was fabricated prior to implant placement. Each patient received three implants in the interforaminal region, connected with a milled bar. On one side of the bar; OT Equator attachment was used, while the other side was supplied with OT Cap attachment. Overdenture was delivered at an average time of 10 to 15 days after implantation. Follow- up period was 12-months after loading. Implant stability was evaluated using Osstel TM.
The results revealed that; there were no significant differences between all groups at implant placement time and at 12-months period for all implants and through different time intervals until the follow-up period was finished.
Patients wearing mandibular three implant supported milled bar mandibular overdentures were found to have greater patient satisfaction scores.
Primary implant stability is determined by the bone density, the implant design and the surgical technique. This study proved a positive effect of splinting on implant survival in immediate loading protocol.
Additional means of retention and milling of the bar in this case may enhance the patient satisfaction and improve the results more. The research hypothesis that no differences in bone loss or quality of life wound be found between the OT Equator and OT Cap attachments was confirmed by the study.
The use of CBCT for measuring the vertical bone height around implants has been used in this study with acceptable precision. CBCT provides cross-sectional images in the 3-dimensions that allows observation of the buccal and lingual bone levels changes around implants.
The splinting of implants with the use of a bar enables better direction of the axial load in the implants and biomechanical distribution among implants. This has a direct effect on the preservation of the marginal bone level.
In conclusion, within the limitations of this study, mandibular three-implant over- dentures appear to be a viable treatment modality that could be considered for the rehabilitation of edentulous patients.
The results of the current study indicated an increase in implant stability and due to splinting of the implants by using immediate loading protocol. Splinting of the implants using a rigid bar appears to be a successful treatment option that could be considered for treating the completely edentulous patient.
The findings presented in this study, however, are preliminary. Therefore, a platform for future clinical research with larger cohorts and long-term follow-up is recommended to evaluate circumferential peri-implant bone loss with other attachments of implant retained overdentures. Comparison between splinted and non-splinted implant are recommended for further investigations.