Severely Atrophic Mandibles Restored With Fiber-Reinforced Composite Prostheses Supported by 5.0-mm Ultra-Short Implants Present High Survival Rates Up To Eight Years

Author(s)

Ewers, Rolf ^{[1, 2]} ; Marincola, Mauro ^[3] ; Perpetuini, Paolo ^[4] ; Morina, Adelina ^[2] ; Bergamo, Edmara T. P. ^[5] ; Cheng, Yu-Chi ^[6] ; Bonfante, Estevam A. ^[5]

Affiliation

^[1] Univ Hosp Craniomaxillofacial & Oral Surg, Waehringer Guertel 18-20, A-1090 Vienna - Austria

^[2] CMF Inst Vienna, Vienna - Austria

^[3] Univ Cartagena, Implant Dent Ctr, Cartagena - Colombia

^[4] Lab Odontotech, Cisterna Latina - Italy

^[5] Univ Sao Paulo, Bauru Sch Dent, Dept Prosthodont & Periodontol, Bauru, SP - Brazil

^[6] MIT, Dept Biol, Cambridge, MA - USA

• Document type: Journal article
• Source: JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY; v. 80, n. 1, p. 81-92, JAN 2022.
• Web of Science Citations: 0

Abstract

Purpose: Encouraging results have been reported for ultrashort single implants; however, long-term investigations are warranted for full-arch reconstructions. This study evaluated marginal bone loss, implant, and reconstruction survival of fiber-reinforced composite full-arch prostheses supported by 4 ultrashort implants. Methods: Patients with severely atrophic mandibles (Cawood and Howell class V and class VI) were included in this cohort study. Study predictors included time (initial and last follow-up) and vertical (epicrestally or subcrestally) and horizontal implant position (medial or lateral). Outcome variables included bone level changes over time, implant/prosthesis survival. Peri-implant bone level was measured on panoramic radiographs. Descriptive statistics, Kaplan-Meier, mixed model analysis of variance, and univariate and multivariate Cox Proportional Hazards Regression models, adjusted for multiple implants in the same patient, were used for data analyses. Results: Eighteen patients (mean 61.22 years old), with 72 implants placed in atrophic mandibles with an average follow-up of 55.4 months (CI, +/- 4.6/ SD, +/- 10.6 months) were analyzed. The implant survival rate was 97.2% as 2 implants were not loaded due to non-osseointegration and sensorial disturbances. Average marginal bone level at baseline (1.93 mm) and at the time of last recall (1.91 mm) was not significantly different. While implants placed subcrestally showed no significant difference between baseline (1.91 mm) and last follow up bone level (2.12 mm), implants placed epicrestally demonstrated a significant reduction on their bone level over time (initial: 1.97 mm/ final:1.33 mm). Systemic disorders were a risk factor for implant survival and bone loss. Prostheses cumulative survival rate was 100% (mean observation period of 55 months). The estimated survival rate after the 96-month follow-up was 75% (1 framework fracture after 84 months). Conclusion: Fixed fiber-reinforced composite full-arch prostheses retained by 4 ultrashort implants showed a stable bone level and high implant/prostheses survival rates up to 8 years. (C) 2021 The American Association of Oral and Maxillofacial Surgeons. (AU)

• FAPESP's process: 19/08693-1 - Experimental glass-infiltrated alumina-zirconia composites: characterization of microstructure, optical and mechanical properties.
• Grantee: Edmara Tatiely Pedroso Bergamo
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 12/19078-7 - Development and processing of Al2O3-ZrO2 translucent composite for CAD/CAM monolithic prostheses: the effect of aging on biaxial flexural strength
• Grantee: Estevam Augusto Bonfante
• Support Opportunities: Research Grants - Young Investigators Grants