The effect of maximum bite force on marginal bone loss in mandibular overdenture treatment: an in vivo study

: The impact of bite force on the marginal bone response around implants is a subject of debate. This study focused on the effect of maximum bite force on marginal bone levels in mandibular implant overdenture treatment. In addition, the effect of the sequence of 3 different loading conditions on marginal bone loss was evaluated in vivo. The patient population consisted of a group of 18 patients. They received 2 implants in the mandible and a new denture without attachments during the period of submerged implant healing. After second stage surgery, the denture was provided with a ball, magnet or bar‐clip attachment. There was a transition of attachment type after 3 and 6 months of function. The sequence in which the attachments were used was randomised. Radiographic marginal bone loss was measured after the period of submerged implant healing and after 3, 6 and 9 months of functional implant loading. Maximum bite force measurements were obtained just prior to second stage surgery with the new denture without attachment. Bite force measurements were also obtained after 3, 6 and 9 months of loading with the implant‐retained overdenture. The latter 3 values were averaged. The mean bone loss during the period of submerged healing and during functional loading was 1.7 mm (0.7 mm) and 1.3 mm (0.6 mm), respectively. A relationship between maximum bite force during the period of submerged healing or during the period of functional loading on the one hand and the amount of marginal bone loss on the other could not be demonstrated. The sequence in which the different attachment types were used did not influence the observed amount of marginal bone loss. Résumé L'impact des forces d'occlusion sur la réponse de l'os marginal autour d'implants est sujet à débat. Cette étude s'est centrée sur l'effet de la force d'occlusion maximale sur les niveaux d'os marginaux dans le traitement de prothèses mandibulaires sur implants. De plus l'effet de la séquence de trois conditions de mise en charge différentes sur la perte osseuse marginale a étéévaluée in vivo. Les patients étaient au nombre de douze. Ils avaient reçu deux implants dans la mandibule et une nouvelle prothèse sans attache durant la période de guérison lorsque les implants étaient enfouis. Après la deuxième chirurgie, la prothèse amovible a été utilisée avec une boule, un aimant ou une barre comme attache. Il y avait une transition du type d'attache après trois et six mois de mise en fonction. La séquence suivant