Long term evaluation of locator anchored

prosthetic restaurations

Dr. M. Beldoch, Dr. R. Valentin, Köln

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Table of contents

Abstract ...................................................................................................................................... 3

Introduction ................................................................................................................................ 4

Material and Methods ................................................................................................................ 4

Results ........................................................................................................................................ 5

Discussion ................................................................................................................................... 6

Literature .................................................................................................................................... 8

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Long term evaluation of locator anchored prosthetic restaurations

Dr. M. Beldoch, Dr. R. Vollmer, Dr. R. Valentin

Abstract

Objectives: The aim of this study was to evaluate the long-term success of locator anchored

prosthetic restaurations on osseointegrated implants.

Material and methods: 46 implant sites (11 patients, 5 male, age 43-82, mean 66.9 ± 10.9) were

evaluated concerning the long term stability of locator anchored prosthetic restaurations on 2 to 7

anchors (mean 4.1). Pocket probing depths, periimplant mucositis, periimplantitis, other

complications as well as subjective satisfaction (patient and dentist) with the prosthetic rehabilitation

were recorded. IMPLA Implants (Schütz Dental GmbH, Rosbach, Germany) and IMPLA locator

abutments (Schütz Dental GmbH, Rosbach, Germany) were used. The time between implantation

and last control appointment differed between 18 and 60 months (Mean 35,0 months ± 14,0

months). Statistical analysis compared the probing depths at insertion of the prosthetics and at

control appointment as well as the subjective satisfaction of dentists and patients using Wilcoxon

matched pairs test. Correlation between number of anchors and subjective satisfaction was

measured by Spearman rank correlation.

Results: Evaluation showed no significant increase of probing depths throughout the study time

(+.01mm, p = .861, n=42). Due to periimplantitis one patient with four implant sites has been

excluded. Patient and dentist satisfaction was recorded. 9 of 11 patients assessed their prosthetic

rehabilitation as good or very good. 10 of 11 prosthesis were assessed as good or very good by the

treating dentist. Both, patient and dentist evaluated their satisfaction with the prosthesis in average

also with “good” to “very good” (mean patient 2.30 ± 0.92, mean dentist 2.44 ± .58, n=46). No

significant differences between patient and dentist assessment have been registered (.13, p=.321).

No significant correlation has been registered between subjective satisfaction and number of

anchors (for patients: Spearman r = 0.3143; for dentists: Spearman r = 0.5846). At control

appointment no other complications were registered, although throughout treatment 7 patients

were diagnosed periimplant mucositis.

Conclusion: In this study we were able to evaluate locator anchored prosthetics at control

appointment 1.5 to 5 years after insertion. We were able to show that for locator anchored

prosthesis patients as well as the treating dentist were satisfied with the outcome independently

from the number of anchors. Additionally, no increase of pocket probing depths has been shown so it

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can be stated that locator anchored prosthetic rehabilitations allow a relatively inexpensive

alternative to other anchors as telescopic crowns, ball attachments or bars for our sample.

Introduction

Implant anchored prosthetic restaurations are a common kind of prosthetic rehabilitation today

[Daou, 2015]. Inexpensive and simple ways are more and more demanded. Locators as anchors offer

such a solution. Additionally, locators are versatile up to 40° of divergence between two implants

[Mahajan & Thakkur, 2013]. In this study we examined a sample of 11 patients from a private practice

in Cologne, Germany. All patients received locator anchored prosthesis on 2 to 7 anchors between

2010 and 2013. The aim of this study was to evaluate the long-term success of locator anchored

prosthetic restaurations on osseointegrated implants, especially patient and dentist subjective

satisfaction as well as complications as periimplant inflammations (mucositis and periimplantitis). As

over 65% of patient with implants suffer from periimplant mucositis during a 5 year timeframe

[Konstantinidis et. al., 2015] this study intents to investigate if implants with locators are more

susceptible to periimplant inflammation.

Material and Methods

46 implant sites (11 patients, 5 male, age 43-82, mean 66.9 ± 10.9) were evaluated concerning the

long term stability of locator anchored prosthetic restaurations on 2 to 7 anchors (mean 4.1 ± 1.7).

Patients were recruited in a private practice in Cologne, Germany. Pocket probing depths,

periimplant mucositis, periimplantitis and other complications were recorded retrospectively. At

control appointment periimplant mucositis, periimplantitis and probing depths were recorded again.

Probing depths were measured using a PCPUNC15 probe (HU-Friedy, Tuttlingen, Germany) [Fig. 1 &

4]. Additionally, patients and dentist were to rate the prosthetic rehabilitation on a -3 to +3 scale,

with +3 being “very good” and -3 being “very poor”.

IMPLA Implants (Schütz Dental GmbH, Rosbach, Germany) and IMPLA locator abutments (Schütz

Dental GmbH, Rosbach, Germany) were used [Fig. 1 – 3, Fig. 5].

The time between implantation and last control appointment differed between 18 and 94 months

(mean 40,3 months ± 25,0 months).

Statistical analysis compared the probing depths at insertion of the prosthetics and at control

appointment as well as the subjective satisfaction of dentists and patients using Wilcoxon matched

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pairs test. Correlation between number of anchors and subjective satisfaction was measured by

Spearman rank correlation.

Results

Evaluation showed no significant increase of probing depths throughout the study time (+.01mm, p =

.861, n=42). Due to periimplantitis one patient with four implant sites has been excluded. Patient and

dentist satisfaction was recorded. 9 of 11 patients assessed their prosthetic rehabilitation as good or

very good. 10 of 11 prosthesis were assessed as good or very good by the treating dentist. Both,

patient and dentist evaluated their satisfaction with the prosthesis in average also with “good” to

“very good” (mean patient 2.30 ± 0.92, mean dentist 2.44 ± .58, n=46). No significant differences

between patient and dentist assessment have been registered (+.13, p=.321). No significant

correlation has been registered between subjective satisfaction and number of anchors (for patients:

Spearman r = 0.3143; for dentists: Spearman r = 0.5846). At control appointment no other

complications were registered, although throughout treatment 7 patients were diagnosed

periimplant mucositis.

baseline control appointment difference

mean (mm) 2.56 2.57 0.01

standard deviation 0.60 0.50

n 42 42

Table 1: probing depths, descriptive statistics, one patient (4 sites) with periimplantitis was excluded

dentist patient difference

mean 2.44 2.30 -.13

standard deviation .58 .92

Correlation with number of anchors

(Spearmans r)

.5846 .3143

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Table 2: subjective satisfaction, correlation of satisfaction with number of anchors, n=46

Discussion

In this study we were able to evaluate locator anchored prosthetics at control appointment 1.5 to 5

years after insertion. We were able to show that for locator anchored prosthesis patients as well as

the treating dentist were satisfied with the outcome independently from the number of anchors.

Additionally, no increase of pocket probing depths has been shown so – within the limits of this study

- it can be stated that locator anchored prosthetic rehabilitations allow a relatively inexpensive

alternative to other anchors as telescopic crowns, ball attachments or bars for our sample. Our study

supports already published data [Kappel et al., 2015] that locators present an easy to maintain and

sufficient alternative to other attachment systems.

Fig. 1: measurement at control appointment

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Fig. 2: locator anchored prosthesis

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Fig. 3: patient with IMPLA locators (case by Dr. R. Vollmer, private practice, Wissen)

Fig. 4: PCPUNC15 (HU-Friedy)

Fig. 5: IMPLA Locator-Abutment (Schuetz Dental GmbH, Rosbach, Germany)

Literature

Daou, Elie E. (2015): Biomaterial aspects: A key factor in the longevity of implant overdenture attachment systems.

In: Journal of International Society of Preventive & Community Dentistry 5 (4), S. 255–262. DOI: 10.4103/2231-

0762.161752.

Kappel, Stefanie; Giannakopoulos, Nikolaos Nikitas; Eberhard, Lydia; Rammelsberg, Peter; Eiffler, Constantin (2015):

Immediate Loading of Dental Implants in Edentulous Mandibles by Use of Locator® Attachments or Dolder®

Bars: Two-Year Results from a Prospective Randomized Clinical Study. In: Clinical implant dentistry and related

research. DOI: 10.1111/cid.12349.

Konstantinidis, Ioannis K.; Kotsakis, Georgios A.; Gerdes, Sebastian; Walter, Michael Horst (2015): Cross-sectional

study on the prevalence and risk indicators of peri-implant diseases. In: European journal of oral implantology 8

(1), S. 75–88.

Mahajan, Neerja; Thakkur, Rahul K. (2013): Overdenture locator attachments for atrophic mandible. In:

Contemporary clinical dentistry 4 (4), S. 509–511. DOI: 10.4103/0976-237X.123060.

Corresponding author

Dr. Matthias Beldoch Zahnarztpraxis Valentin & Partner Deutzer Freiheit 95-97 50679 Köln, Germany info@zahnarzt-beldoch.de