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Circumferential bone level and bone remodeling in the posterior mandible of edentulous mandibular overdenture wearers: influence of mandibular bone atrophy in a 3-year cohort study

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Evaluate circumferential bone level and morphological alterations in the posterior mandibular ridge of atrophic (AP) and non-atrophic (NAP) patients using implant-retained mandibular overdentures (MO) over 3 years.

Materials and methods

Twenty-six edentulous patients categorized according to mandibular atrophy (AP = 13/NAP = 13) received two narrow diameter implants (Facility, 2.9 × 10 mm) in the anterior region of mandible. The vertical and horizontal bone level was measured along with bone remodeling at 4 distances from the mental foramen in the posterior region of the mandible (L1–L4) via CBCT.


NAP showed significantly higher total height and medullary height in all posterior regions at 1 and 3 years (p ≤ 0.01). Cortical height and width were significantly higher (p ≤ 0.05) in this group at distances L1 and L4, respectively, in year 1. NAP shows a significantly higher % of medullary height at distances L1 (p ≤ 0.05), L2 (p ≤ 0.01), and L3 (p ≤ 0.05) after 1 year, and at all distances (p ≤ 0.05) after 3 years. Bone remodeling in the groups differed significantly (p ≤ 0.05) in terms of cortical width and % medullary width at L3.


AP and NAP showed similar vertical and horizontal bone level. Bone resorption in the posterior ridge was stabilized by MO over 3 years; however, AP are more susceptible to the long-term substitution of medullary bone by cortical bone.

Clinical relevance

This study is the first to longitudinally evaluate bone dimensions in atrophic and non-atrophic two-implant MO users by CBCT and revealed that MO is a predictable treatment based on the stabilization of the posterior bone resorption.

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The authors thank to Neodent for supplying the dental implants used in the study.


The work was supported by the Junior Postdoctoral Scholarship – funded by the National Council for Scientific and Technological Development – CNPq (157253/2018–0 process, Postdoctoral researcher A.J. Schuster).

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Correspondence to Fernanda Faot.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The investigation was approved by Research Ethics Committee of the School of Dentistry- UFPel (nº 69/2013, report 3.725.829).

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Schuster, A.J., da Rosa Possebon, A.P., Schinestsck, A.R. et al. Circumferential bone level and bone remodeling in the posterior mandible of edentulous mandibular overdenture wearers: influence of mandibular bone atrophy in a 3-year cohort study. Clin Oral Invest 26, 3119–3130 (2022).

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