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Mostafa Helmy Mostafa Ahmed¹, Henri Diederich²,  and Mohamed M Abo Heikal³

  1. Lecturer of Removable Prosthodontics/ Faculty of Dentistry, Cairo University, Egypt
  2. Henri Diederich Dental Clinic, 51 as Pasteur, L- 231, Luxembourg
  3. Assistant lecturer of Removable Prosthodontics/ Modern Science and Arts University, Egypt




The aim of this study was to compare the effect of the mandibular deformation by medial flexure on Bilaterally Splinted and Non-Splinted ImplantSupported Mandibular Full Arch Prosthesis with Immediately Loaded Implants both clinically & radiographically. In addition to Patients’ satisfaction over one year of clinical performance.

Materials & methods

For the sake of clinical investigation, twelve completely edentulous patients obtained new mandibular and maxillary complete dentures before implant placement. All patients were educated to use the denture for two months. After two months; patients were indiscriminately divided into two groups; First group (of six patients) obtained an Implant supported, fully-splinted cement-retained full arch prosthesis with immediate functional loading protocol, while Second group (of six patients) obtained an Implant-supported, non-splinted (segmented) cement-retained full arch prosthesis with immediate functional loading protocol. The clinical & the radiographic outcomes of the Implants supporting the cement retained full arch superstructure, had been calibrated at time of implants insertion, 3 months, 6 months and 12 months respectively. In addition, patients’ satisfaction was also measured utilizing a customized chart of question (A seven-point scale).


Regarding parametric data; repeated gauges ANOVA test was used to compare between the two groups as well as to study the changes by time within each group. Bonferroni’s post-hoc test was used for pair-wise comparisons when ANOVA test is significant. whereas for non-parametric data; Mann-Whitney U test was utilized to compare between the two groups. Periotest and bone density data showed normal (parametric) distribution while bone loss and satisfaction scores data showed non-normal (non-parametric) distribution.


Regarding effect of midline mandibular flexure on bilaterally splinted & nonsplinted(segmented) cement-retained, immediately-loaded mandibular prosthesis, it was found that, there was non-significant effect on both types of prosthesis and hence, splinted or nonsplinted implant-supported prostheses could be used successfully with little superiority of segmentation in midline region. In addition, Patients were completely satisfied with their implant-supported immediatelyloaded prostheses, whatever splinting protocol utilized.

Keywords: mandibular flexure, splinting, deformation, immediate loading,
patient satisfaction

Full Case Study