Evaluation of Mucosal Displacement and Denture Settlement for Direct Vs. Indirect Attachment Incorporation in Implant Assisted Mandibular Overdentures

Abstract

Background: One of the attachments used nowadays are the stud Positioner attachments, these attachments can be incorporated in the denture base of the implant assisted overdenture directly inside the patients mouth or indirectly in the laboratory. No studies evaluated the difference in denture-tissue relation in overdentures with attachments incorporation directly or indirectly. Therefore the aim of the present study was to evaluate whether a difference in denture-tissue relation exists between direct or indirect attachment incorporation. Two implants were placed for 7 patients and then an implant assisted overdenture was fabricated, first with indirect attachment incorporation, then with direct attachment incorporation. CBCT scans were performed on the patients with the overdentures in place after 1 week of denture insertion. The area of the mucosa between the fitting surface of the denture and the bone was measured as a guide for denture-tissue relation. Results: The mean anterior mucosal surface area in dentures constructed using indirect attachment incorporation was 21.07mm2±4.89 while the surface area at point M in dentures constructed by direct attachment incorporation was 20.53mm2±5.14. While the mean posterior mucosal surface area in dentures constructed using indirect attachment incorporation was 35.88mm2±3.98 while the mean posterior mucosal surface area in dentures constructed by direct attachment incorporation was 34.22mm2±3.72. Conclusion: Direct attachment incorporation causes greater posterior denture settling than indirect attachment incorporation.