Within the limitations of this study, the results suggest that hybrid polymer (PEEK)-acrylic resin prostheses supported by implants for full-arch rehabilitation may represent a valid treatment option, still requiring longer-term validation.
Background: The aim of this three-year prospective study was to examine the outcome of a solution for full-arch rehabilitation through a fixed implant-supported hybrid prosthesis (polyetheretherketone (PEEK)-acrylic resin) used in conjunction with the All-on-4 concept. Methods: Thirty-seven patients (29 females, 8 males), with an age range of 38 to 78 years (average: 59.8 years) were rehabilitated with 49 full-arch implant-supported prostheses (12 maxillary rehabilitations, 13 mandibular rehabilitations and 12 bimaxillary rehabilitations). The primary outcome measure was prosthetic survival. Secondary outcome measures were marginal bone loss, plaque and bleeding scores, veneer adhesion issues, biological complications, mechanical complications, and the patients’ subjective evaluation. Results: There were two patients (maxillary rehabilitations) lost to follow-up, while one patient withdrew (maxillary rehabilitation). One patient with bimaxillary rehabilitation fractured the mandibular PEEK framework, rendering a 98% prosthetic survival rate. Implant survival was 100%. Average (standard deviation) marginal bone loss at 3-years was 0.40 mm (0.73 mm). Veneer adhesion was the only technical complication (n = 8 patients), resolved for all patients. Nine patients (n = 11 prostheses) experienced mechanical complications (all resolved): fracture of acrylic resin crowns (n = 3 patients), prosthetic and abutment screw loosening (n = 4 patients and 3 patients, respectively), abutment wearing (n = 1 patient). One patient experienced a biological complication (peri-implant pathology), resolved through non-surgical therapy. A 90% satisfaction rate was registered for the patients’ subjective evaluation. Conclusions: Based on the results, the three-year outcome suggests the proposed rehabilitation solution as a legitimate treatment option, providing a potential shock-absorbing alternative that could benefit the implant biological outcome.
The use of new devices for the rehabilitation of the severely atrophic maxillae needs validation. We aimed to report the short-term outcome of severely atrophic jaws rehabilitated with zygomatic implants with no implant head angulation placed extramaxillary in conjunction with standard implants. Forty-four patients were consecutively included with 77 zygomatic implants (31 abutments of 45 degrees and 46 abutments of 60 degrees) and 115 standard implants. Outcome measures were prosthetic survival, implant/abutment success, complications, modified plaque index (mPLI), modified bleeding index (mBI), mucosal seal efficacy evaluation (MSEE) >4 mm, and Zygomatic implants classification level (ZICL). Two patients (4.5%) were lost to follow-up. No prosthesis was lost; one patient lost one zygomatic implant; two angulated abutments of 60 degrees needed to be replaced in one patient due to an aesthetic complaint; rendering a cumulative success rate at 2-years of 95.3% and 95.9% using patient and implant/abutment as unit of analysis, respectively. Mechanical and biological complications occurred in 13 and six patients, respectively; all resolved. The median mPLI and mBI was 1; MSEE > 4 mm occurred in 17% and 21% of patients at 1- and 2-years, respectively; ZICL1 was registered in 80% of patients. The current protocol enabled good short-term outcomes.
This clinical report presents the clinical outcome of a maxillary full‐arch implant‐supported fixed rehabilitation with lithium disilicate reinforced glass ceramic monolithic crowns opposing a mandibular metal‐acrylic implant‐supported fixed rehabilitation in a 62‐year‐old woman. Eight implants were successfully placed (four maxillary, four mandibular), and no complications occurred in the postoperative or maintenance periods. Six months after delivery, the maxillary and mandibular prostheses were found to be clinically, biologically, and mechanically stable, and the patient was satisfied with the esthetics and her ability to function. Although the present indications for the use of lithium disilicate are still restricted to tooth‐borne restorations, it is possible to successfully rehabilitate edentulous patients through implant‐supported fixed prostheses using lithium disilicate reinforced glass ceramic monolithic crowns.
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