Risk factor model of mechanical complications in implant‐supported fixed complete dentures: A prospective cohort study

Coltro, Maria Paula L.; Özkömür, Ahmet; Villarinho, Eduardo Aydos; Teixeira, Eduardo Rolim; Vigo, Álvaro; Shinkai, Rosemary Sadami Arai

doi:10.1111/clr.13344

Cited by 10 publications

(16 citation statements)

References 24 publications

(35 reference statements)

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“…A recent risk factor model of mechanical complications in implant‐supported fixed complete dentures did not register a significant association between gender and mechanical complications; whereas a recent retrospective study investigating the frequency and type of complications associated with interim, immediate loaded full‐arch prostheses per All‐on‐4 protocol did not disclose any significant association between gender and mechanical complications in interim prostheses in function for an average period of 6 months . Possible explanations for these differences may rely on the study follow‐up, with the present study comprising an evaluation with at least 10 years compared to the average of 6 months and 3 years of the previous cited investigations; or in the lack of control for other variables of interest (such as bruxism) in the present study. The type of prosthetic material used in the restoration also impacted significantly the risk of mechanical complications, with metal‐acrylic and metal‐ceramic prostheses exerting a protective effect when compared with acrylic‐resin prostheses.…”

Section: Discussioncontrasting

confidence: 58%

The All‐on‐4 treatment concept for the rehabilitation of the completely edentulous mandible: A longitudinal study with 10 to 18 years of follow‐up

Maló

Nobre

Lopes

et al. 2019

Clin Implant Dent Rel Res

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Background: There is a need for studies evaluating the long term outcomes of the All-on-4 treatment concept.Purpose: To evaluate the long term clinical and radiographic outcomes of the All-on-4 treatment concept in the mandible. Materials and Methods: This retrospective longitudinal case series study included 471 patients (women: 286, men: 185, average age = 57.7 years) rehabilitated with 1884 implants in immediate function supporting 471 fixed full-arch mandibular prostheses and followed for 10 to 18 years. Primary outcome measures were prosthetic survival and implant success and survival (estimated using life tables). Secondary outcome measures were marginal bone loss (MBL) at 10 and 15 years, biological and mechanical complications. Multivariable analysis was used to estimate potential risk indicators for implant failure (Cox regression to estimate hazard ratios and 95% confidence intervals (95%CI)), MBL > 3 mm at 10 and 15 years, biological and mechanical complications (binary logistic regression to estimate odds ratios [ORs] with 95%CI).Results: Twenty-seven patients deceased (5.7%) and 149 patients (31.6%) were lost to followup. The cumulative prosthetic survival rate was 98.8%; the implant cumulative survival and success rate was 93% and 91.7%, respectively up to 18 years of follow-up. Previous biological complications (HR = 4.43) were significantly associated with implant failure. Average (95% CI) MBL at 10-and 15-years were 1.72 mm (95%CI: 1.59, 1.85) and 2.32 mm (95% CI: 1.98, 2.66).Smoking (OR = 2.72), previous failure of a contiguous implant (OR = 3.89) and biological complication (OR = 8.11) were associated with MBL > 3 mm. The incidence of biological complications was 11.8% at implant level, with previous failure of a contiguous implant (OR = 5.56), smoking (OR = 1.75), and systemic condition (OR = 1.65) were significantly associated.The incidence of mechanical complications was 36.7% with male gender (OR = 1.67) and type of prosthetic material used in the restoration significantly associated (metal-acrylic OR = 0.30; metal-ceramic OR = 0.22)).Conclusions: Considering the implant, prosthetic and MBL outcomes it is concluded that the All-on-4 is a viable treatment option validated in the long term. Nevertheless, biological and mechanical complications can occur.

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Section: Discussioncontrasting

confidence: 58%

The All‐on‐4 treatment concept for the rehabilitation of the completely edentulous mandible: A longitudinal study with 10 to 18 years of follow‐up

Maló

Nobre

Lopes

et al. 2019

Clin Implant Dent Rel Res

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“…This clinical study was conducted in accordance with the Declaration of Helsinki (Amendment 2009), and this report followed the STROBE guidelines. This study is part of a long‐term prospective project, and the overall clinical protocol was previously described . This study was approved by the University Ethics Committee (CAAE: 69742517.8.0000.5336), and all patients signed an informed consent form.…”

Section: Methodsmentioning

confidence: 99%

“…This study is part of a long-term prospective project, and the overall clinical protocol was previously described. 15,16…”

Section: Methodsmentioning

confidence: 99%

Radiographic changes of trabecular bone density after loading of implant‐supported complete dentures: A 3‐year prospective study

Gerhardt

Villarinho

Rockenbach

et al. 2019

Clin Implant Dent Rel Res

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Background Bone tissues may undergo remodeling under functional mechanical stimuli. Purpose This prospective study on implant‐supported fixed complete dentures (IFCDs) evaluated the radiographic trabecular bone changes in density by means of gray levels and texture analysis variables after up to 3‐year loading. Materials and Methods The sample consisted of digital periapical radiographs of 63 distal implants of hybrid IFCDs installed in 30 patients (22 women, mean age of 62 ± 7.8 years). Digital periapical radiographs were taken after prosthesis installation, and 1 and 3 years after IFCD loading. Longitudinal images of each implant were superimposed, and the same regions of interest were selected for measurement of gray levels statistics (mean gray levels, SD, and coefficient of variation [CV]) and texture parameters (correlation, contrast, entropy, and angular second moment). Data were analyzed by mixed regression models. Results Mean gray levels increased for 1 year (P < .05), for 3 years (P < .01) and for maximum bite force (P < .01). The interaction between bruxism and time in 1 year was significant (P < .01) for a decrease in CV. No significant effect of texture analysis variables was found (P > .05). Conclusions The results suggest an increase of radiographic bone density as measured by an increase in mean gray levels and a decrease in CV in IFCD distal implants up to 3 years of loading.

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“…These patients present, to a greater or lesser extent, gingival inflammation that may cause peri-implant bone loss [64][65][66][67][68][69][70][71][72]. This peri-implant bone loss may be directly affected by the stress generated in the implant-bone-prosthesis area; the higher the transferred force, the higher the risk of peri-implantitis [21,[73][74][75][76][77][78][79]. The amount of cortical bone could also be a factor to be considered when choosing the material for manufacturing the prosthesis, as this cortical bone is poorly vascularized, fragile, rigid, and regenerates slowly [80][81][82][83][84].…”

Section: Introductionmentioning

confidence: 99%

A 3D Finite Element Analysis Model of Single Implant-Supported Prosthesis under Dynamic Impact Loading for Evaluation of Stress in the Crown, Abutment and Cortical Bone Using Different Rehabilitation Materials

et al. 2021

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In the literature, many researchers investigated static loading effects on an implant. However, dynamic loading under impact loading has not been investigated formally using numerical methods. This study aims to evaluate, with 3D finite element analysis (3D FEA), the stress transferred (maximum peak and variation in time) from a dynamic impact force applied to a single implant-supported prosthesis made from different materials. A 3D implant-supported prosthesis model was created on a digital model of a mandible section using CAD and reverse engineering. By setting different mechanical properties, six implant-supported prostheses made from different materials were simulated: metal (MET), metal-ceramic (MCER), metal-composite (MCOM), carbon fiber-composite (FCOM), PEEK-composite (PKCOM), and carbon fiber-ceramic (FCCER). Three-dimensional FEA was conducted to simulate the collision of 8.62 g implant-supported prosthesis models with a rigid plate at a speed of 1 m/s after a displacement of 0.01 mm. The stress peak transferred to the crown, titanium abutment, and cortical bone, and the stress variation in time, were assessed.

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Risk factor model of mechanical complications in implant‐supported fixed complete dentures: A prospective cohort study

Abstract: Within the limitations of this study, the results suggest that clinical success is associated to framework design with retention pins equal or longer than 4 mm. Quality of life improved with IFCD treatment, even in patients with mechanical complications.

Cited by 10 publications

References 24 publications

The All‐on‐4 treatment concept for the rehabilitation of the completely edentulous mandible: A longitudinal study with 10 to 18 years of follow‐up

The All‐on‐4 treatment concept for the rehabilitation of the completely edentulous mandible: A longitudinal study with 10 to 18 years of follow‐up

Radiographic changes of trabecular bone density after loading of implant‐supported complete dentures: A 3‐year prospective study

A 3D Finite Element Analysis Model of Single Implant-Supported Prosthesis under Dynamic Impact Loading for Evaluation of Stress in the Crown, Abutment and Cortical Bone Using Different Rehabilitation Materials

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