Immediate Loading of Fixed Complete Denture Prosthesis Supported by 4-8 Implants Placed Using Guided Surgery: A 5-Year Prospective Study on 66 Patients with 356 Implants

Clin Implant Dent Relat Res. 2017 Feb;19(1):195-206. doi: 10.1111/cid.12449. Epub 2016 Sep 15.

Abstract

Background: High primary implant stability is considered one of the main factors necessary for achieving predictable treatment outcomes with immediately loaded implant-supported screw-retained fixed complete denture prosthesis (FCDP).

Purpose: To evaluate the 5-year clinical and radiographic outcomes of immediately loaded implants placed in edentulous patients using computer-assisted template-guided surgery to support a FCDP.

Materials & methods: Patients in need to be restored with a FCDP in the mandible or maxilla were included in this prospective study/ and treated using computer-assisted template-guided surgery. Implant sites were prepared in order to achieve an insertion torque ranging between 35-45 Ncm in the mandible and 45-55 Ncm in the maxilla. A prefabricated screw-retained provisional prosthesis was delivered the day of the surgery. Outcomes were: implant and prosthesis cumulative survival rate (CSR), any complications, and peri-implant marginal bone loss (MBL).

Results: Sixty-six patients received 356 implants to support 68 FCDPs. Each patient received 4-8 implants. Seven implants failed in six patients, resulting in a CSR of 98.1%. Two definitive prostheses failed resulting in CSR of 97.1%. Mean MBL of 1.62 ± 0.41 mm was reported at the 5-year follow-up. Five implants (1.4%) showed a mean mesio-distal peri-implant bone loss greater than 3.0 mm and received nonsurgical therapy.

Conclusions: immediately loaded implants placed in edentulous patients using computer-assisted template-guided surgery to support a FCDP is a valid treatment concept in the medium term follow-up, for edentulous patients.

Keywords: computer assisted surgery; guided surgery; immediate loading.

MeSH terms

  • Aged
  • Dental Implantation, Endosseous / methods*
  • Dental Prosthesis Design
  • Dental Prosthesis, Implant-Supported / methods*
  • Denture, Complete*
  • Female
  • Follow-Up Studies
  • Humans
  • Imaging, Three-Dimensional
  • Immediate Dental Implant Loading / methods*
  • Male
  • Mandible / surgery
  • Maxilla / surgery
  • Middle Aged
  • Prospective Studies
  • Surgery, Computer-Assisted / methods*
  • Treatment Outcome