Objectives
The aim of the present paper was to present medium‐ and long‐term data on implant survival and on the prevalence of peri‐implantitis in a cohort of patients treated with full‐arch rehabilitations.
Materials and methods
Clinical records of all patients treated with immediately loaded full‐arch rehabilitation in the Dental Clinic of the IRCCS Istituto Ortopedico Galeazzi in Milan, Italy, supported by moderately rough implants were retrospectively examined to calculate survival curves for implant loss and for the occurrence of peri‐implantitis (both at implant‐ and at patient level). Regression methods were used to evaluate the correlation between the presence of periodontitis and smoking habits with the outcomes.
Results
A total of 384 implants placed in 77 patients (96 rehabilitations) were evaluated for a mean period of 8.0 years (range 1.0–13.7 years) from loading. After 10 years, the cumulative survival rate was 96.11% (95% CI: 99.17%–93.05%; 84 implants) while the cumulative rate of implants free from peri‐implantitis was 86.92% (95% CI: 82.14%, 91.71%; 60.69% [95% CI: 44.19%, 77.19%] at patient level). The cumulative proportion of implants without peri‐implantitis after 10 years was significantly higher in mandible (89.76%, 95% CI: 84.49%, 95.03%) than in maxilla (81.71%, 95% CI: 71.91%, 91.51%; p = 0.028). No correlation was found between periodontal and smoking status and outcomes.
Conclusions
The study reported high 10‐year implant survival rate for full‐arch rehabilitations since implant loss was relatively rare. Peri‐implantitis was relatively frequent in the examined population although the number of subjects available for 10‐year evaluation was limited.
Purpose. The aims of this study were to assess the treatment outcome of immediately loaded full-arch fixed bridges anchored to both tilted and axially placed implants in the edentulous maxilla and to evaluate the incidence of biological and prosthetic complications. Materials and Methods. Thirty-four patients (18 women and 16 men) were included in the study. Each patient received a maxillary full-arch fixed bridge supported by two axial implants and two distal tilted implants. A total of 136 implants were inserted. Loading was applied within 48 hours of surgery and definitive restorations were placed 4 to 6 months later. Patients were scheduled for followup at 6, 12, 18, and 24 months and annually up to 5 years. At each followup plaque level and bleeding scores were assessed and every complication was recorded. Results. The overall follow-up range was 12 to 73 months (mean 38.8 months). No implant failures were recorded to date, leading to a cumulative implant survival rate of 100%. Biological complications were recorded such as alveolar mucositis (11.8% patients), peri-implantitis (5.9% patients), and temporomandibular joint pain (5.9% patients). The most common prosthetic complications were the fracture or detachment of one or multiple acrylic teeth in both the temporary (20.6% patients) and definitive (17.7% patients) prosthesis and the minor acrylic fractures in the temporary (14.7% patients) and definitive (2.9% patients) prosthesis. Hygienic complications occurred in 38.2% patients. No patients' dissatisfactions were recorded. Conclusions. The high cumulative implant survival rate indicates that this technique could be considered a viable treatment option. An effective recall program is important to early intercept and correct prosthetic and biologic complications in order to avoid implant and prosthetic failures.
The occurrence in well-maintained patients of technical and biological complications in full-arch rehabilitations supported by a combination of tilted and upright implants in the medium to long term is lower than previously reported by the pertinent literature. Further studies are needed to confirm this result.
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