Immediate flapless full‐arch rehabilitation of edentulous jaws on 4 or 6 implants according to the prosthetic‐driven planning and guided implant surgery: A retrospective study on clinical and radiographic outcomes up to 10 years of follow‐up. (5th October 2022)

• Record Type: Journal Article
• Authors: La Monaca, Gerardo; Pranno, Nicola; Annibali, Susanna; Di Carlo, Stefano; Pompa, Giorgio; Cristalli, Maria Paola
• Is Part Of: Clinical implant dentistry and related research. Volume 24:Number 6(2022)
• Page Start: 831
• Page End: 844
• Publication Date: 2022-10-05
• Subjects: all on four -- all on six -- computer‐aided implant dentistry -- dental implants -- dental implant loading -- immediate -- dental prosthesis -- implant‐supported -- flapless implant surgery -- full‐arch implant prosthesis -- immediate loading -- jaw, edentulous/rehabilitation -- jaw, edentulous/surgery -- surgery -- computer‐assisted -- survival analysis -- template‐guided surgery -- tilted implants -- treatment outcome; Dental implants -- Periodicals; Dental Implantation -- Periodicals; Dental Implants -- Periodicals; 617.693
• DOI: 10.1111/cid.13134
• Languages: English
• ISSNs: 1523-0899

Abstract

Abstract: Objectives: to retrospectively evaluate clinical and radiographic outcomes of immediate, flapless full‐arch prostheses, supported by 4/6 implants according to prosthetic‐driven planning and guided surgery. Materials and Methods: The study involved 28 edentulous patients (20 female/8 males; average age 67.75 ± 8.627 years), 32 prostheses (17 all‐on‐4/15 all‐on‐6) and 164 implants. The Implants survival, prostheses success/survival, peri‐implant marginal bone loss, incidence of biological and prosthetic complications were evaluated. Multiple linear regression analysis was performed to analyze the influence of implant and patient characteristics on marginal bone loss. Results: Cumulative implant survival rate was 89.7% for all‐on‐four (seven failures) and 99.0% for all‐on‐six (one failure) after a mean follow‐up of 6.46 ± 2.236 years (range 1–10 years). Cumulative prosthesis success rate was 51.5% (58.8% for all‐on‐four/ 43.8% for all‐on‐six). Prosthesis survival rate was 88.2% for all‐on‐four. No failure was registered in all‐on‐six. Mean value of marginal bone loss was 1.38 ± 0.1.28 mm at 5‐year and 2.09 ± 0.56 mm at 10‐year follow‐up. No difference was found in the mean value of marginal bone resorption between all‐on‐four (1.56 ± 1.61 mm) and all‐on‐six (1.20 ± 0.85 mm) ( p = 0.104) and between tilted (1.22 ± 1.29 mm) and axial implants (1.44 ± 1.27 mm) ( p = 0.385) after 5‐year follow‐up. The incidence of biological complications was 1.0% in all‐on‐six (one mucositis) and 10.3% in all‐on‐four (two peri‐implantitis). Prosthetic complications affected teeth of final rehabilitations with 3 detachments, 10 chippings or fractures, and 3 severe occlusal wears. Conclusions: Based on the results and within the limitations of the present study, the implant‐supported hybrid prosthesis according to prosthetic‐driven planning and guided surgery showed to be an efficient, safe, and effective approach to rehabilitate edentulous jaws.