{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T19:11:59Z","timestamp":1778094719978,"version":"3.51.4"},"reference-count":45,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T00:00:00Z","timestamp":1703116800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004488","name":"Croatian Science Foundation","doi-asserted-by":"publisher","award":["1218"],"award-info":[{"award-number":["1218"]}],"id":[{"id":"10.13039\/501100004488","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Due to a lack of long-term clinical studies that would clarify whether the insertion of three mini-implants (MDIs) can be as successful treatment as the insertion of four MDIs for the retention of mandibular overdentures (ODs), this 5-year prospective cohort study was set up. Materials and Methods: Participants (n = 83) randomly received either four or three MDIs and a mandibular OD. Clinical examinations were performed at the baseline, as well as after one, three, and five years, respectively. A total of 73 participants (38 in the four-MDI and 35 in the three-MDI groups) partook in the study. The marginal bone level change, success and survival rates, and prosthodontic maintenance were assessed. Results: Repeated measures showed that the mean peri-implant bone loss increased progressively at a small amount over five years in both groups (four-MDI group = \u22120.36 \u00b1 0.74; three-MDI group = \u22120.33 \u00b1 0.27 mm; p &lt; 0.05). However, an ANCOVA revealed no significant effects of the group (no significant difference between the three- and the four-MDI groups; F = 0.085; p = 0.771), gender (F = 0.023; p = 0.88), or covariate age (F = 1.95; p = 0.167) on the dependent variable: the 5-year MBL change. The success rate (together with successful survival) was 93.8% in the four-MDI group and 91.7% in the three-MDI group. The log-rank (Mantel\u2013Cox) test revealed no significant differences between them (X2 = 0.373; p = 0.541). Conclusions: In patients with narrow ridges, the insertion of three MDIs in the mandible for overdenture retention can be equally as successful as the insertion of four MDIs.<\/jats:p>","DOI":"10.3390\/medicina60010017","type":"journal-article","created":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T08:16:02Z","timestamp":1703146562000},"page":"17","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Clinical Outcomes of Three versus Four Mini-Implants Retaining Mandibular Overdenture: A 5-Year Randomized Clinical Trial"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5985-8966","authenticated-orcid":false,"given":"Asja","family":"Celebic","sequence":"first","affiliation":[{"name":"Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8505-5251","authenticated-orcid":false,"given":"Ines","family":"Kovacic","sequence":"additional","affiliation":[{"name":"Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikola","family":"Petricevic","sequence":"additional","affiliation":[{"name":"Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4477-3024","authenticated-orcid":false,"given":"Mohammed Nasser","family":"Alhajj","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Faculty of Dentistry, Thamar University, Thamar 87246, Yemen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jolanda","family":"Topic","sequence":"additional","affiliation":[{"name":"Private Dental Office, 21300 Makarska, Croatia"},{"name":"School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luka","family":"Junakovic","sequence":"additional","affiliation":[{"name":"Mag. Math., Libertas International University, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0338-9643","authenticated-orcid":false,"given":"Sanja","family":"Persic-Kirsic","sequence":"additional","affiliation":[{"name":"Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,21]]},"reference":[{"key":"ref_1","first-page":"892","article-title":"Multi-clinic evaluation using mini-dental implants for long-term denture stabilization: A preliminary biometric evaluation","volume":"26","author":"Bulard","year":"2005","journal-title":"Compend. Contin. Educ. Dent."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e81","DOI":"10.1016\/j.tripleo.2005.06.018","article-title":"Mini dental implants: An adjunct for retention, stability, and comfort for the edentulous patient","volume":"100","author":"Griffitts","year":"2005","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1563\/aaid-joi-D-19-00317","article-title":"Rationale for Mini Dental Implant Treatment","volume":"47","author":"Flanagan","year":"2021","journal-title":"J. Oral Implantol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"132","DOI":"10.15644\/asc56\/2\/4","article-title":"Adaptation to New Dentures and 5 Years of Clinical Use: A Comparison between Complete Denture and Mini-implant Mandibular Overdenture Patients based on Oral Health-Related Quality of Life (OHRQoL) and Orofacial Esthetics","volume":"56","author":"Kovacic","year":"2022","journal-title":"Acta Stomatol. Croat."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.1177\/0022034515601959","article-title":"Mini vs. Standard Implants for Mandibular Overdentures: A Randomized Trial","volume":"94","author":"Ribeiro","year":"2015","journal-title":"J. Dent. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1111\/ger.12683","article-title":"Mini-implant mandibular overdentures under a two-step immediate loading protocol: A 4\u20136-year retrospective study","volume":"40","author":"Park","year":"2023","journal-title":"Gerodontology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1111\/clr.13342","article-title":"Group 1 ITI Consensus Report: The influence of implant length and design and medications on clinical and patient-reported outcomes","volume":"29","author":"Jung","year":"2018","journal-title":"Clin. Oral Implants Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"117","DOI":"10.11607\/ijp.5559","article-title":"Short-Term Postoperative Pain and Swelling Associated with Mini and Standard-Size Implants in the Same Patients","volume":"31","author":"Disha","year":"2018","journal-title":"Int. J. Prosthodont."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Kahn, A., Masri, D., Shalev, T., Meir, H., Sebaoun, A., and Chaushu, L. (2021). Patients\u2019 Perception of Recovery after Dental Implant Placement. Medicina, 57.","DOI":"10.3390\/medicina57101111"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"343","DOI":"10.11607\/jomi.6991","article-title":"Survival of Mini Dental Implants Used to Retain Mandibular Complete Overdentures: Systematic Review","volume":"34","author":"Jawad","year":"2019","journal-title":"Int. J. Oral Maxillofac. Implants"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1111\/clr.13444","article-title":"A prospective cohort study on survival and success of one-piece mini-implants with associated changes in oral function: Five-year outcomes","volume":"30","author":"Enkling","year":"2019","journal-title":"Clin. Oral Implants Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"4","DOI":"10.15644\/asc53\/1\/1","article-title":"Comparison of Three Prosthodontic Treatment Modalities for Patients with Periodontally Compromised Anterior Mandibular Teeth: A 2-year follow-up study","volume":"53","year":"2019","journal-title":"Acta Stomatol. Croat."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"28","DOI":"10.11607\/ijp.4457","article-title":"Oral Health-Related Quality of Life in Different Types of Mandibular Implant Overdentures in Function Longer Than 3 Years","volume":"29","year":"2016","journal-title":"Int. J. Prosthodont."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1016\/j.prosdent.2021.11.010","article-title":"Factors and clinical outcomes for standard and mini-implants retaining mandibular overdentures: A systematic review and meta-analysis","volume":"130","author":"Borges","year":"2023","journal-title":"J. Prosthet. Dent."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1111\/clr.13542","article-title":"A cohort study on short mini-implants for mandibular overdentures compared to those of standard length","volume":"31","author":"Celebic","year":"2020","journal-title":"Clin. Oral Implants Res."},{"key":"ref_16","first-page":"7597851","article-title":"Rehabilitation of an Extremely Resorbed Edentulous Mandible by Short and Narrow Dental Implants","volume":"2018","author":"Kovacic","year":"2018","journal-title":"Case Rep. Dent."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1016\/j.joms.2022.07.145","article-title":"Are Mini Dental Implants Suitable for Support of Crowns or Small Bridges in the Mandibular Incisor Region? A 5-year Longitudinal Study","volume":"80","year":"2022","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1767","DOI":"10.1007\/s00784-022-04805-2","article-title":"Survival and stability of strategic mini-implants with immediate or delayed loading under removable partial dentures: A 3-year randomized controlled clinical trial","volume":"27","author":"Mundt","year":"2023","journal-title":"Clin. Oral. Investig."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Celebic, A., Kovacic, I., Petricevic, N., Puljic, D., Popovac, A., and Kirsic, S.P. (2023). Mini-Implants Retaining Removable Partial Dentures in Subjects without Posterior Teeth: A 5-Year Prospective Study Comparing the Maxilla and the Mandible. Medicina, 59.","DOI":"10.3390\/medicina59020237"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"178","DOI":"10.11607\/jomi.7707","article-title":"Stabilizing Removable Partial Dentures by Immediate or Delayed Loading of Mini-implants: Chewing Efficiency in a Randomized Controlled Clinical Trial","volume":"35","author":"Mundt","year":"2020","journal-title":"Int. J. Oral Maxillofac. Implants"},{"key":"ref_21","first-page":"128","article-title":"Local and systemic factors associated with marginal bone loss around dental implants: A retrospective clinical study","volume":"52","author":"Cabbar","year":"2020","journal-title":"Quintessence Int."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1111\/prd.12176","article-title":"Initial and long-term crestal bone responses to modern dental implants","volume":"73","author":"Albrektsson","year":"2017","journal-title":"Periodontology 2000"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1590\/0103-6440201600874","article-title":"Parameters Associated with Marginal Bone Loss around Implant after Prosthetic Loading","volume":"27","author":"Koller","year":"2016","journal-title":"Braz. Dent J."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Galindo-Moreno, P., Catena, A., Lopez-Chaichio, L., Borges, T., O\u2019Valle, F., Torrecillas-Mart\u00ednez, L., and Padial-Molina, M. (2023). The Influence of History of Severe Periodontitis on Estimated Long-Term Marginal Bone Loss around Implants Restored with Fixed Segmented Full-Arch Rehabilitation. J. Clin. Med., 12.","DOI":"10.3390\/jcm12206665"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.cden.2019.02.004","article-title":"Are There Contraindications for Placing Dental Implants?","volume":"63","author":"Kullar","year":"2019","journal-title":"Dent. Clin. N. Am."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1097\/ID.0b013e3181676059","article-title":"Implant Success, Survival, and Failure: The International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference","volume":"17","author":"Misch","year":"2008","journal-title":"Implant Dent."},{"key":"ref_27","first-page":"47","article-title":"Mini-Implants for Mandibular Overdentures: Cost-Effectiveness Analysis alongside a Randomized Trial","volume":"3","author":"Leles","year":"2018","journal-title":"JDR Clin. Trans. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1111\/jopr.12373","article-title":"Mandibular Overdentures Retained by Two Mini-Implants: A Seven-Year Retention and Satisfaction Study","volume":"25","author":"Marchesani","year":"2016","journal-title":"J. Prosthodont."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"558","DOI":"10.11607\/ijp.5589","article-title":"Immediate Loading of Mandibular Overdentures Retained by Two Mini-Implants: A Case Series Preliminary Report","volume":"31","author":"Bellia","year":"2018","journal-title":"Int. J. Prosthodont."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1111\/j.1600-0501.2009.01834.x","article-title":"The effect of maximum bite force on marginal bone loss of mini-implants supporting a mandibular overdenture: A randomized controlled trial","volume":"21","author":"Hamada","year":"2010","journal-title":"Clin. Oral Implants Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"162","DOI":"10.4103\/jips.jips_393_19","article-title":"A comparison of cost and cost-effectiveness analysis of two- implant-retained overdentures versus other removable prosthodontic treatment options for edentulous mandible: A systematic review","volume":"20","author":"Roy","year":"2020","journal-title":"J. Indian Prosthodont. Soc."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1111\/cid.12952","article-title":"Maintenance and risk factors for fractures of overdentures using immediately loaded conventional diameter or mini implants with Locator abutments: A cohort study","volume":"22","author":"Mifsud","year":"2020","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1902\/jop.2014.140343","article-title":"Immediate loading of mandibular overdentures supported by one-piece, direct metal laser sintering mini-implants: A short-term prospective clinical study","volume":"86","author":"Mangano","year":"2015","journal-title":"J. Periodontol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.jdent.2016.11.009","article-title":"Complete overdentures retained by mini implants: A systematic review","volume":"57","author":"Lemos","year":"2017","journal-title":"J. Dent."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1111\/clr.13272","article-title":"Narrow-diameter implants: A systematic review and meta-analysis","volume":"29","author":"Schiegnitz","year":"2018","journal-title":"Clin. Oral Implants Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1055\/s-0040-1714763","article-title":"Marginal Bone Level Changes and Oral Health Impact Profile (14) Score of Smokers Treated by Mandibular Mini Implant Overdentures: A 5-Year Follow-up Study","volume":"14","author":"Hussein","year":"2020","journal-title":"Eur. J. Dent."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.11607\/jomi.4012","article-title":"Changes in Bone Levels Around Mini-Implants in Edentulous Arches","volume":"30","author":"Mundt","year":"2015","journal-title":"Int. J. Oral Maxillofac. Implants"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.11607\/jomi.5981","article-title":"Implant Mandibular Overdentures Retained by Immediately Loaded Implants: A 1-Year Randomized Trial Comparing the Clinical and Radiographic Outcomes Between Mini Dental Implants and Standard-Sized Implants","volume":"32","author":"Zygogiannis","year":"2017","journal-title":"Int. J. Oral Maxillofac. Implants"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1111\/clr.13591","article-title":"Clinical Outcomes and Bone-Level Alterations around One-Piece Mini Dental Implants Retaining Mandibular Overdentures: 5-Year Follow-up of a Prospective Cohort Study","volume":"31","author":"Enkling","year":"2020","journal-title":"Clin. Oral Implants Res."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Gonz\u00e1lez-Gil, D., Dib-Zaitum, I., Flores-Fraile, J., and L\u00f3pez-Marcos, J. (2022). Importance of Osseoperception and Tactile Sensibility during Masticatory Function in Different Prosthetic Rehabilitations: A Review. Medicina, 58.","DOI":"10.3390\/medicina58010092"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1111\/clr.12660","article-title":"Patient Satisfaction and Prosthetic Aspects with Mini-Implants Retained Mandibular Overdentures. A 5-Year Prospective Study","volume":"27","author":"Elsyad","year":"2016","journal-title":"Clin. Oral Implants Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"320","DOI":"10.11607\/jomi.9406","article-title":"Effect of Ti-Base Abutment Gingival Height on Maintenance of Crestal Bone in Thick Biotype Patients: A Randomized Clinical Trial with 1-Year Follow-up","volume":"37","author":"Linkevicius","year":"2022","journal-title":"Int. J. Oral Maxillofac. Implants"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1002\/JPER.19-0716","article-title":"Peri-implant soft tissue phenotype modification and its impact on peri-implant health: A systematic review and network meta-analysis","volume":"92","author":"Tavelli","year":"2021","journal-title":"J. Periodontol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2151","DOI":"10.1902\/jop.2008.070647","article-title":"The effect of thick mucosa on peri-implant tissues: An experimental study in dogs","volume":"79","author":"Jeong","year":"2008","journal-title":"J. Periodontol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1007\/s11136-014-0817-2","article-title":"Influence of Different Prosthodontic Rehabilitation Options on Oral Health-Related Quality of Life, Orofacial Esthetics and Chewing Function Based on Patient-Reported Outcomes","volume":"24","year":"2015","journal-title":"Qual. Life Res."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/1\/17\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:39:38Z","timestamp":1760132378000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/1\/17"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,21]]},"references-count":45,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1]]}},"alternative-id":["medicina60010017"],"URL":"https:\/\/doi.org\/10.3390\/medicina60010017","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,21]]}}}