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Immediately loaded distally cantilevered fixed mandibular prostheses supported by four implants placed in both in fresh extraction and healed sites: 2-year results from a prospective study.
Eur J Oral Implantol. 2014 Summer; 7(2):173-84.EJ

Abstract

OBJECTIVES

To evaluate the outcome of immediately loaded distally cantilevered mandibular full-arch prostheses according to the 'all-on-four' concept supported by implants placed in both fresh extraction and healed sites.

MATERIAL AND METHODS

A prospective study was conducted in 24 patients with extraction of all remaining mandibular teeth and placement of 4 implants per patient (2 mesial axial and 2 distal tilted) for full-arch mandibular restorations. Implants were inserted in fresh extraction sockets 2.3 ± 1.0 per patient and 1.7 ± 1.0 implants in healed sites. Implants placed in fresh extraction sites (n = 55) were significantly (P <0.01) more deeply inserted than implants (n = 41) placed in healed sites (peri-implant alveolar crest: +1.6 ± 0.8 mm vs +0.6 ± 0.7 mm). Patients received an immediate provisional fixed dental prosthesis and, 3 months later, a definite resin veneered prosthesis with metal framework. At the 12-and 24-month follow-up, patients were evaluated for implants and prosthesis success, for prosthodontic maintenance efforts and patient satisfaction. At both follow-up examinations, peri-implant marginal bone level, implant pocket depth, plaque, bleeding, gingival and calculus indices were evaluated and compared between implants placed in fresh extraction and healed sites.

RESULTS

At the 24-month follow-up, no implant failed and all prostheses were stable. There were five fractures of the provisional prosthesis in 5 patients but no fracture of the definite prostheses. For the definite prostheses, 15 acrylic teeth had to be renewed/repaired (in 10 patients) and 18 patients presented the need for the implant-supported prosthesis to be rebased. Peri-implant marginal bone level after 12 and 24 months was -0.18 ± 0.20 mm and -0.40 ± 0.29 mm for all implants (P <0.001) representing bone level differences of 0.35 mm between implants placed in healed and post-extractive sites at both the 1st year (95%-CI:-0.49 to -0.20) and the 2nd year (95%-CI: -0.57 to -0.14) assessment. Plaque (1st year: 1.17 ± 0.48 versus 0.5 ± 0.6; P <0.001; 2nd year: 1.21 ± 0.51 versus 0.55 ± 0.6; P <0.001) and calculus indices (1st year: 0.92 ± 0.28 versus 0.45 ± 0.51; P <0.001; 2nd year: 1.00 ± 0.42 versus 0.5 ± 0.51; P <0.001) were significantly higher for implants placed in fresh extraction than in healed sites. Patients' subjective satisfaction score rating assessed by 5 items was high at the 1- (score: 4.6 ± 0.4) and 2-year evaluation (score: 4.7 ± 0.36).

CONCLUSION

Within the limits of this study, immediately loaded full-arch prostheses can be supported by four implants placed simultaneously into healed and fresh extraction sites.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

24977253

Citation

Krennmair, Stefan, et al. "Immediately Loaded Distally Cantilevered Fixed Mandibular Prostheses Supported By Four Implants Placed in Both in Fresh Extraction and Healed Sites: 2-year Results From a Prospective Study." European Journal of Oral Implantology, vol. 7, no. 2, 2014, pp. 173-84.
Krennmair S, Seemann R, Weinländer M, et al. Immediately loaded distally cantilevered fixed mandibular prostheses supported by four implants placed in both in fresh extraction and healed sites: 2-year results from a prospective study. Eur J Oral Implantol. 2014;7(2):173-84.
Krennmair, S., Seemann, R., Weinländer, M., Krennmair, G., & Piehslinger, E. (2014). Immediately loaded distally cantilevered fixed mandibular prostheses supported by four implants placed in both in fresh extraction and healed sites: 2-year results from a prospective study. European Journal of Oral Implantology, 7(2), 173-84.
Krennmair S, et al. Immediately Loaded Distally Cantilevered Fixed Mandibular Prostheses Supported By Four Implants Placed in Both in Fresh Extraction and Healed Sites: 2-year Results From a Prospective Study. Eur J Oral Implantol. 2014;7(2):173-84. PubMed PMID: 24977253.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Immediately loaded distally cantilevered fixed mandibular prostheses supported by four implants placed in both in fresh extraction and healed sites: 2-year results from a prospective study. AU - Krennmair,Stefan, AU - Seemann,Rudolf, AU - Weinländer,Michael, AU - Krennmair,Gerald, AU - Piehslinger,Eva, PY - 2014/7/1/entrez PY - 2014/7/1/pubmed PY - 2014/9/5/medline SP - 173 EP - 84 JF - European journal of oral implantology JO - Eur J Oral Implantol VL - 7 IS - 2 N2 - OBJECTIVES: To evaluate the outcome of immediately loaded distally cantilevered mandibular full-arch prostheses according to the 'all-on-four' concept supported by implants placed in both fresh extraction and healed sites. MATERIAL AND METHODS: A prospective study was conducted in 24 patients with extraction of all remaining mandibular teeth and placement of 4 implants per patient (2 mesial axial and 2 distal tilted) for full-arch mandibular restorations. Implants were inserted in fresh extraction sockets 2.3 ± 1.0 per patient and 1.7 ± 1.0 implants in healed sites. Implants placed in fresh extraction sites (n = 55) were significantly (P <0.01) more deeply inserted than implants (n = 41) placed in healed sites (peri-implant alveolar crest: +1.6 ± 0.8 mm vs +0.6 ± 0.7 mm). Patients received an immediate provisional fixed dental prosthesis and, 3 months later, a definite resin veneered prosthesis with metal framework. At the 12-and 24-month follow-up, patients were evaluated for implants and prosthesis success, for prosthodontic maintenance efforts and patient satisfaction. At both follow-up examinations, peri-implant marginal bone level, implant pocket depth, plaque, bleeding, gingival and calculus indices were evaluated and compared between implants placed in fresh extraction and healed sites. RESULTS: At the 24-month follow-up, no implant failed and all prostheses were stable. There were five fractures of the provisional prosthesis in 5 patients but no fracture of the definite prostheses. For the definite prostheses, 15 acrylic teeth had to be renewed/repaired (in 10 patients) and 18 patients presented the need for the implant-supported prosthesis to be rebased. Peri-implant marginal bone level after 12 and 24 months was -0.18 ± 0.20 mm and -0.40 ± 0.29 mm for all implants (P <0.001) representing bone level differences of 0.35 mm between implants placed in healed and post-extractive sites at both the 1st year (95%-CI:-0.49 to -0.20) and the 2nd year (95%-CI: -0.57 to -0.14) assessment. Plaque (1st year: 1.17 ± 0.48 versus 0.5 ± 0.6; P <0.001; 2nd year: 1.21 ± 0.51 versus 0.55 ± 0.6; P <0.001) and calculus indices (1st year: 0.92 ± 0.28 versus 0.45 ± 0.51; P <0.001; 2nd year: 1.00 ± 0.42 versus 0.5 ± 0.51; P <0.001) were significantly higher for implants placed in fresh extraction than in healed sites. Patients' subjective satisfaction score rating assessed by 5 items was high at the 1- (score: 4.6 ± 0.4) and 2-year evaluation (score: 4.7 ± 0.36). CONCLUSION: Within the limits of this study, immediately loaded full-arch prostheses can be supported by four implants placed simultaneously into healed and fresh extraction sites. SN - 1756-2406 UR - https://www.unboundmedicine.com/medline/citation/24977253/Immediately_loaded_distally_cantilevered_fixed_mandibular_prostheses_supported_by_four_implants_placed_in_both_in_fresh_extraction_and_healed_sites:_2_year_results_from_a_prospective_study_ L2 - https://ejoi.quintessenz.de/index.php?doc=abstract&amp;abstractID=32221/ DB - PRIME DP - Unbound Medicine ER -