Implant survival rates and biologic complications with implant‐supported fixed complete dental prostheses: A retrospective study with up to 12‐year follow‐up

Abstract

Purpose To report the rate of technical complications and prosthesis survival in a cohort of edentulous patients treated with implant‐supported fixed complete dental prostheses (IFCDPs) after a mean observation period of at least 1 year. Materials and Methods The single‐visit examination included clinical and radiographic assessment, occlusal analysis, photographs and questionnaire assessing patient satisfaction in a cohort of 52 patients rehabilitated with 71 IFCDPs (supported by 457 implants). The IFCDPs were assessed for technical complications, number of implants and cantilever extension, retention type and prosthetic material type. Comparison was made between ceramic IFCDPs (Group 1) and metal‐resin IFCDPs (Group 2). Kaplan‐Meier survival curve analysis was carried out for assessment of prosthesis survival and was done for both Groups 1 and 2 separately. The Cox proportional hazard model was used for survival analysis, adjusting for a number of potential confounders, to evaluate the association between prosthesis survival and several risk factors such as type of opposing occlusion, nightguard use, and presence of bruxism. Responses to patient satisfaction questions were compared with Fisher's exact test. Results Out of 71 edentulous arches (52 patients) restored with IFCDPs, 6 IFCDPs had failed, yielding a cumulative prosthesis survival rate of 91.6 % after a mean observation period of 5.2 years (range: 1‐12 years) after definitive prosthesis insertion. Three IFCDPs were lost due to implant failures after 5.8 to 11 years of functional loading. Additionally, 3 metal‐resin IFCDPs failed due to technical complications. Minor complications were the most frequent complications observed, namely wear of the prosthetic material (9.8% annual rate) being the most common, followed by decementation of cement‐retained IFCDPs (2.9%), and loss of the screw access filing material of the screw‐retained IFCDPs (2.7%). The most frequently observed major complication was fracture of the prosthetic material (1.9% annual rate), followed by fracture of occlusal screw (0.3%), and fracture of framework (0.3%). The annual rate of wear of prosthetic material was 7.3% for porcelain IFCDPs (n = 19/55) and 19.4% for metal‐resin IFCDPs (n = 13/16), yielding a statistically significant difference between the 2 groups (p = 0.01). Conclusions After a mean exposure time of 5.2 years, 91.6% prosthesis survival rates were achieved (65 out of 71 IFCDPs). The most frequent minor technical complication was wear of the prosthetic material with estimated 5‐year rate of 49.0%, while the most frequent major complication was fracture of the prosthetic material with estimated 5‐year dental unit‐based rate of 9.5%. The cumulative rates for “prosthesis free of minor complications” at 5‐ and 10‐years were 60.5% (95% CI: 47.2‐71.3%) and 8.9% (95% CI: 2.9‐18.0%), respectively. The cumulative rates for “prosthesis free of major technical complications” at 5‐ and 10‐years were 85.5% (95% CI: 73.0‐92.5%) and 30.1% (95% CI: 12.0‐50.6%), respectively. Pr...

Ten years follow‐up retrospective study on implant survival rates and prevalence of peri‐implantitis in implant‐supported full‐arch rehabilitations

“…We can observe that the results were lower than those observed in the present study and the difference could be due to the surface characteristics of the implants used, and this observation was corroborated by scientific evidence (De Bruyn et al, ). Another retrospective study on 457 moderately rough dental implants supporting 71 FAISRs placed in 52 patients explored the cumulative survival rate over a period of 12 years from loading (Papaspyridakos et al, ). The authors reported a CSR% of 95.93% after 9 years and 83.14% after 10 years reporting that one third of the total failures (2 out of 6) occurred between 9 and 10 years.…”

“…One recently published consensus statement suggested to make a diagnosis of peri‐implantitis in presence of bleeding and/or suppuration on gentle probing, in presence of increased probing depth as compared to previous examinations and when evaluating the presence of bone loss beyond crestal bone changes resulting from initial bone remodeling (Berglundh et al, ). In the present study, we considered the presence of peri‐implantitis when we detected evidence of bleeding/suppuration (evidence of inflammatory reaction) and a concomitant bone resorption process of 2 mm or more, as it was done in other similar studies (Heitz‐Mayfield et al, ; Papaspyridakos et al, ). The present study reported the data about peri‐implantitis both implant‐based and patient‐based following the recommendation of the paper published by Sanz, Chapple, and Working Group 4 of the ().…”

“…Implant survival was defined as implant in situ, stable, supporting a functional prosthesis (Heitz‐Mayfield et al, ; Papaspyridakos et al, ; Papaspyridakos, Chen, Chuang, & Weber, ; Papaspyridakos, Mokti et al, ). An implant was considered failed when it was extracted by one operator due to loss of osseointegration or when it was spontaneously lost (Heitz‐Mayfield et al, ; Papaspyridakos et al, ).…”

“…Since Brånemark described for first the osseointegration process in the 1960s (Branemark et al, ), the use of titanium implants to support dental prosthesis in edentulous sites has been widely described and validated by a number of evidence‐based scientific papers. In particular, several longitudinal studies, with a follow‐up of 5 years or more, investigated the outcomes of the treatment of completely edentulous patients by the use of full‐arch implant‐supported rehabilitations (FAISRs; Attard & Zarb, ; Ekelund, Lindquist, Carlsson, & Jemt, ; Jemt, ; Jemt & Stenport, ; Jemt, Stenport, & Friberg, ; Lindquist, Carlsson, & Jemt, ; Papaspyridakos et al, ; Papaspyridakos, Mokti et al, ; Rohlin et al, ). Some of the studies with longer follow‐up referred to subjects treated with turned/machined implants that demonstrated a cumulative survival rate of more than 90% in mandibles and more than 80% in maxilla, with a follow‐up of 5 years or more (Albrektsson, Zarb, Worthington, & Eriksson, ; Jimbo & Albrektsson, ; Lindquist, Carlsson, & Jemt, ).…”

“…One recently published long‐term retrospective study on machined implants reported a cumulative survival rate % (CSR%) of 88.3% for implants with turned design after more than 20 years of follow‐up (Chrcanovic, Kisch, Albrektsson, & Wennerberg, ). Moreover, Papaspyridakos et al () reported a CSR% of 98.7% on 457 moderately rough implants supporting full‐arch rehabilitations after a mean period of 5.2 years from loading (range 1–12 years; Papaspyridakos et al, ). Implants with rough surfaces, that are manufactured through several industrial procedures, were proposed more recently than machined ones and were described to be more capable to establish a long‐standing osseointegration, with favorable clinical outcomes (De Bruyn et al, ).…”