BioHPP Fixed Hybrid Prosthesis versus BioHPP Bar Overdenture as Treatment Options for Mandibular Edentulous Ridge (Prosthetic Maintenance and Patients’ Satisfaction)

Abstract

Aims: To evaluate prosthetic maintenance and patients' satisfaction with the BioHPP (biocompatible high-performance polymer) was used as a skeletal substructure for the hybrid (implant fixed detachable) prosthesis versus the BioHPP bar supporting and retaining implant overdenture based on the visual analogue scale (VAS). Materials and Methods: twenty completely edentulous male patients were selected randomly from the outpatient clinic of the Department of Prosthodontics, Faculty of Dentistry, Ain Shams University; the patients complained of ill-fitting mandibular dentures due to ridge atrophy. All patients received new complete dentures; four inter foramina implants were placed using a surgical guide. Three months after osseointegration, the patients divided into two groups received CAD-CAM BioHPP framework hybrid prosthesis (group I) and BioHPP bar supported and retained overdenture (group II). The prosthetic complication was recorded, and the patient's subjective evaluation using a questionnaire based on the VAS includes five points for speech, chewing, comfort, aesthetics, oral hygiene, and general satisfaction was recorded. Results: Patient satisfaction revealed no difference between groups I and II at followup, with both groups highly satisfied after 12 months of follow-up. The general satisfaction for Group I was 4.43 ± 0.34, while that group II was 4.43 ± 0.50. Conclusion: The CAD/CAM BioHPP framework materials offer treatment modalities that are a good alternative for mandibular rehabilitation. Excellent levels of subjective patient satisfaction and prosthetic maintenance during the oral function were seen.

A systematic review and meta-analysis of the clinical performance of implant-supported overdentures retained by CAD-CAM bars

“…Moreover, there were no significant differences in satisfaction between BioHPP bar-retained overdentures and BioHPP-fixed hybrid prostheses. 33 Overall, CAD-CAM bars had positive outcomes in terms of patient satisfaction with IODs. Different types of bars, including titanium, zirconia, and BioHPPs, offered varying levels of patient satisfaction, ease of oral hygiene, and practitioner preferences.…”

“…Among them, two studies specifically evaluated BioHPP and PEEK bars and reported the occurrence of peri-implantitis as a complication. 33 , 34 Moreover, studies evaluating titanium and zirconia CAD-CAM bars showed fewer biological complications after four and one year of follow-up, respectively. 14 , 17 , 28 , 31 These findings suggest that polymer-based bars, such as BioHPP and PEEK, may be associated with unfavorable biological conditions, including peri-implantitis, after 18 months of follow-up.…”

“…However, they observed complications related to bar adaptation, probably due to intraoral scanning issues. Al-Asad, et al 33 (2023) found prosthesis fractures in two implant overdentures, but no significant differences compared with hybrid prostheses. These results are detailed in Table 1 .…”

“… 14 , 17 , 28 , 31 These findings suggest that polymer-based bars, such as BioHPP and PEEK, may be associated with unfavorable biological conditions, including peri-implantitis, after 18 months of follow-up. 33 , 34 A summary of these results is presented in Table 2 .…”

“…Assessment of bias in the selected studies showed that most had good methodological quality, especially those with control groups. 14 , 30 , 32 , 33 , 35 Table 4 presents detailed data. However, one study scored 7 due to a lack of reporting on how the comparability of selected cases was controlled.…”