The Effect of Two Implant-Abutment Connections on Maximum Bite Force, Prosthetic Maintenance and Peri-Implant Sulcular Fluid in Mandibular Implant Supported Telescopic Overdenture: A Split-mouth study

Purpose: The aim of this study was to evaluate and compare two different implant-abutment connections (conical and trilobe connection) in mandibular implant supported telescopic overdenture. The parameters of evaluation were the maximum bite force, prosthetic maintenance and peri-implant sulcular fluid.
Materials and method: Twelve completely edentulous patients received new complete dentures. After 3 months of adaption to the new denture, 24 implants (12 implants with conical implant-abutment connection (group A) and 12 implants with trilobe implant-abutment connection (group B). The Insertion of each type of implant was randomly assigned between the two contralateral sides intraorally for each patient using a statistical software. Each patient was treated according to split mouth design. The implants were inserted in the canine region of the mandible using two-stage surgical technique and conventional loading protocol. After 3 months, implants were exposed and a telescopic overdenture was constructed. The maximum bite force, prosthetic maintenance and peri-implant sulcular fluid for each group of implants were evaluated at loading time, after 6 and 12 months.
Results: There was no statistically significant difference in maximum bite force between group A and B the at loading time, but there was a statistically significant difference at 6 and 12 months follow up visits. The prosthetic maintenance events in group A were 1 event compared to 5 events in group B. There was no statistically significant difference between group A and B in the peri-implant sulcular fluid at loading time, 6 and 12 months follow up visits.
Conclusion: Within the limitations of this study, it can be concluded that the conical implant- abutment connection is associated with increased maximum bite force compared to the trilobe Implant-abutment connection. Conical implant-abutment connection can provide a stable implant system with fewer prosthetic complications and maintenance services compared to trilobe implant -abutment connection.