The aim of this preliminary study is to compare patient-reported outcomes between immediately and conventionally loaded mandibular two-implant overdentures retained by magnetic attachments. Nineteen participants with edentulous mandibles were randomly assigned into either an immediate loading group (immediate group) or a conventional loading group (conventional group). Each participant received 2 implants in the inter-foraminal region by means of flapless surgery. Prostheses in the immediate and conventional groups were loaded using magnetic attachments on the same day as implant placement or 3 months after surgery, respectively. All participants completed questionnaires (the Japanese version of the Oral Health Impact Profile for edentulous [OHIP-EDENT-J], the patient's denture assessment [PDA], and general satisfaction) before implant placement (baseline) and 1, 2, 3, 4, 5, 6, and 12 months after surgery. The median differences between baseline and each monthly score were compared using the Mann-Whitney U test. The differences in median and 95% confidence interval between two groups were analyzed. The immediate group showed slightly lower OHIP-EDENT-J summary score at 1 and 3 months than the conventional group (P=0.09). In the lower denture domain of PDA, the immediate group showed a statistically higher score at 3 months (P=0.04). There was no statistically significant difference in general satisfaction between the two groups. Based on this preliminary study, immediate loading of mandibular two-implant overdentures with magnetic attachments tends to improve oral health-related quality of life and patient assessment earlier than observed with a conventional loading protocol.

The study aimed to compare the mixing ability (MA), comminuting ability (CA), and maximum bite force (MBF) of single-implant overdentures (IODs) and clinically acceptable complete dentures (CDs) through a randomized crossover control trial. New CDs were fabricated for 22 patients. One implant was inserted in the middle of the symphyseal region for each patient. The patients were randomly allocated into two groups: group IC received an IOD, whereas group CI received a CD, for 2 months; the treatments were interchanged for the next 2 months. The MA, CA, and MBF were evaluated with the old CDs, new CDs (at the end of CD treatment period), and IODs (at the end of IOD treatment period). The MA, CA, and MBF of the IODs were significantly higher than those of the old and new CDs (p < 0.01). New CDs only showed a significant improvement in MA (p < 0.05), while there were no significant differences in CA and MBF between the old and new CDs. Compared with the CD, IOD is more effective in restoring the MA, CA, and MBF of edentulous mandibles.

The present article describes a novel clinical procedure for mandibular overdentures supported by two freestanding implants loaded immediately after placement via computer-guided flapless surgery. A conventional acrylic complete denture was fabricated, and CT scans obtained using the denture as a radiographic guide. Preoperative computer-assisted planning was performed using commercially available software, permitting simulation of implant placement at optimal positions. Using simulation data, a surgical guide was manufactured and used during surgery. The surgical guide was placed and local anesthesia injected for drilling of anchor pins to stabilize the surgical guide. The drilling protocol for each osteotomy site achieved an insertion torque greater than 35 Ncm. Immediately after implant placement, a keeper of the magnetic attachment was connected to each implant, and the magnetic assembly incorporated into the denture. The mucosal surface of the denture around the magnet was relieved to avoid excessive tissue pressure. The patients were instructed to wear the denture in place continually for the following 7 days. After six months of healing and follow-up, a final denture with a metal framework may be fabricated if necessary. A novel treatment protocol for immediately loaded implant-supported mandibular overdentures is described in detail. The protocol ensures secure precise and safe implant placement, successful osseointegration, and immediate improvement of oral health-related quality of life for patients with unstable complete dentures.

Objective: Neurotrophins, such as nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF), promote neuronal development and neuronal survival, but their mechanisms remain controversial. This study aimed to investigate the hypothesis that NGF and BDNF interfere with angiotensin-II- and glutamate-induced facilitation of voltage-dependent Ca²⁺ channels (VDCCs) in nucleus tractus solitarius (NTS) neurons. Design: The profile of NGF and BDNF actions in acutely dissociated rat NTS was studied using the whole-cell configuration of the patch-clamp technique. Results: Pretreatment with NGF and BDNF attenuated angiotensin-II-induced facilitation of VDCCs, but did not attenuate glutamate-induced facilitation of the L-type VDCC current in NTS neurons. NGF-induced attenuation was antagonised by pretreatment with a tyrosine kinase A (TrkA) receptor antagonist K-252a. Conclusions: NGF attenuated angiotensin-II-induced facilitation of L-type VDCCs mediated by TrkA receptors in NTS neurons.

Few studies have comprehensively assessed long-term patient-reported outcomes for overdentures supported by two immediate implants. The purpose of the study was to evaluate patient-reported outcomes of immediately loaded two-implant-supported overdentures retained by ball attachments over a 5-year evaluation period. Nineteen participants with edentulous mandibles were provided with immediately loaded two-unsplinted-implant-supported overdentures retained by ball attachments. The participants completed the Japanese version of the Oral Health Impact Profile (OHIP)-EDENT-19 and the Patient's Denture Assessment (PDA). Additionally, patient satisfaction was measured by a 100-mm visual analog scale (VAS). Measurements were performed at baseline, and at 1 and 5 years following implant surgery. Seventeen participants and 14 participants were evaluated at the 1-year and 5-year assessment, respectively. Considering the OHIP-EDENT-19, there was a significant decrease in the total (p = 0.046), “functional limitation” (p = 0.021), and “physical disability” (p = 0.034) scores at 1 year and the total (p = 0.045) and “physical disability” (p = 0.024) scores at 5 years following surgery, compared to the baseline scores. Considering the PDA, there was a significant increase in the “function” (p = 0.038) and “lower denture” (p = 0.003) scores at 1 year and the “function” (p = 0.032), “lower denture” (p = 0.008), and “esthetic and speech” (p = 0.043) scores at 5 years following surgery, compared to the baseline scores. Patient satisfaction at 1 year following surgery was significantly greater than that at baseline (p = 0.005). Immediately loaded two-unsplinted-implant-supported overdentures retained by ball attachments improved the oral health-related quality of life and self-assessment of dentures by the patients up to 5 years following implant surgery.

Prosthesis for missing maxillary molars with dental implants often requires maxillary sinus augmentation owing to insufficient alveolar bone height. However, the anatomical structure of the maxillary sinus is a significant risk factor. This study used preoperative cone-beam computed tomography (CBCT) to investigate changes in the anatomical structure of the maxillary sinus due to tooth loss and conducted an epidemiological survey of Japanese people to determine the effects of gender and age on these changes. Preoperative CBCT scans were analyzed in patients aged ≥ 50 years with free-end maxillary molar edentulism involving ≥ 2 missing teeth seeking implant treatment. Statistical analyses were performed. One hundred and twenty participants (46 males, 74 females; mean age, 62.1 ± 7.4 years) with 3.0 ± 0.9 missing teeth and an existing bone volume of 6.2 ± 3.1 mm were included. Lateral wall thickness, sinus angle, sinus membrane thickness, maxillary sinus length and width, and the presence of the sinus septa significantly differed between missing and non-missing sides. Maxillary sinus height and sinus membrane thickness on missing side and maxillary sinus height and width on non-missing side varied significantly. Aging was associated with maxillary sinus length and width changes on the non-missing side in males, whereas no age-associated effects were identified in females. To ensure the safe execution of maxillary sinus augmentation, a thorough understanding of maxillary sinus anatomy is crucial prior to surgery.