Mechanical complications of implant-supported complete-arch restorations and impact on patient quality of life: A retrospective cohort study

Sánchez‐Torres, Alba; Cercadillo-Ibarguren, Iñaki; Figueiredo, Rui; Gay‐Escoda, Cosme; Valmaseda‐Castellón, Eduard

doi:10.1016/j.prosdent.2020.01.006

Cited by 15 publications

(20 citation statements)

References 18 publications

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“…However, as Modi et al (2015) concluded that although nonrigid connectors lead to a decrease in stress at the level of the prosthesis, they lead to an increase in stress at the level of the alveolar ridge. Moreover, the most common complications in the use of multi-unit abutments are abutment screw loosening ( Freitas et al, 2012 ; Rocha Ferreira et al, 2018 ; Benalcázar Jalkh et al, 2021 ; Sánchez-Torres et al, 2021 ). Just as the conclusion obtained in our study, stress was mostly significantly concentrated at the joint between the abutments and segmental superstructure, which would increase the significant incidence of mechanical problems.…”

Section: Discussionmentioning

confidence: 99%

The effect of mandibular flexure on the design of implant-supported fixed restorations of different facial types under two loading conditions by three-dimensional finite element analysis

Jiang

et al. 2022

Front. Bioeng. Biotechnol.

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Objective: Investigating the biomechanical effects of mandibular flexure (MF) on the design of implant-supported fixed restorations in edentulous jaws of different facial types.Methods: Three-dimensional finite element models were established to analyze mandibular displacement and stress distribution of implant-supported fixed restorations (four or six implants, different implant numbers and sites, and the design of the superstructure across the dental arch in one or two or three pieces, under the loading conditions of maximum opening or right unilateral molar occlusion) in mandibular edentulous patients of three different facial types (brachyfacial, mesofacial, and dolichofacial types).Results: The brachyfacial type presented higher mandibular flexure and stress in the overall restorative system, followed by the mesofacial and dolichofacial types. During jaw opening and occlusal movements, the one-piece framework showed the lowest bone stress values surrounding the anterior implants and gradually increased to the distal position, and the three-piece framework showed the highest stress values for peri-implant bones. Also, the split framework could greatly increase the stress on abutments and frameworks. Moreover, fixed implant prostheses with cantilevers can generate high amounts of biomechanical stress and strain on implants and surrounding bones. The bone surrounding the anterior implant increased in stress values as the most distal implants were more distally located regardless of frameworks. The zirconia framework demonstrated higher stresses than the titanium framework.Conclusion: The design of edentulous fixed implant-supported restorations can be optimized for facial types. For patients of the brachyfacial type or with high masticatory muscle strength, the non-segmented framework without a cantilever provides an optimal biomechanical environment.

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Section: Discussionmentioning

confidence: 99%

The effect of mandibular flexure on the design of implant-supported fixed restorations of different facial types under two loading conditions by three-dimensional finite element analysis

Jiang

et al. 2022

Front. Bioeng. Biotechnol.

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“… 6 7 Many studies have evaluated the effect of cantilever extension on the stability of implant abutment connections and it was found that screw loosening is one of the most common complications of ICFDPs with an estimated rate of 5.01% in 5 - 10 years. 1 5 8 9 10 Loss of preload is a major cause of screw loosening as it is stated that only 10% of the initial torque is transformed to preload while the other 90% is used to overcome the friction between the irregular surfaces of the implant abutment connection. 11 12 Achieving adequate preload results in a clamping force that secures the implant abutment connection.…”

Section: Introductionmentioning

confidence: 99%

The effect of the digital manufacturing technique of cantilevered implant-supported frameworks on abutment screw preload

2022

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PURPOSE The purpose of this study was to investigate the misfit and screw preload at the implant abutment connection of implant supported fixed dental prosthesis with cantilever (ICFDP) manufactured using different digital manufacturing techniques and to compare the screw preload before and after cyclic loading. MATERIALS AND METHODS Mandibular jaw model with four intra-foraminal implants was scanned using digital scanner. Stereolithography file was used to design a framework with nonengaging (NE) abutments and 10 mm cantilever distal to one terminal implant. Five frameworks were constructed using combined digital-conventional techniques (CAD-cast), and five frameworks were constructed using three-dimensional printing (3DP). Additional CAD-cast framework was constructed in a way that ensures passive fit (PF) to use as control. Scanning electron microscope (SEM) measured the implant abutment connection misfit. Sixty screws were used on the corresponding frameworks. Screws were torqued and pre-cyclic loading reverse torque value (RTV) was recorded. Frameworks were subjected to 200,000 loading cycles with a loading point 9 mm from the center of terminal implants adjacent to the cantilever and post-cyclic loading RTVs were recorded. RESULTS Microscopic readings showed significant differences between frameworks. PF demonstrated the lowest measurements of 16.04 (2.6) µm while CAD-cast demonstrated the highest measurements of 29.2 (3.1) µm. In all groups, RTVs were significantly lower than the applied torque. Post-cyclic loading RTV was significantly lower than pre-cyclic loading RTV in PF and 3DP frameworks. Differences in RTVs between the three manufacturing techniques were insignificant. CONCLUSION Although CAD-cast and three-dimensionally printed (3DP) both produce frameworks with clinically acceptable misfit, 3DP might not be the technique of choice for maintaining screw’s preload stability under an aggressive loading situation.

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“…In this sense, the large majority of available information is based on retrospective and cross-sectional studies. 18,[25][26][27][28]30,39,40…”

mentioning

confidence: 99%

“…Papaspyridakos et al, 31 in a 5‐year study, reported that, for metal‐ceramic IFCDPs, the most frequent minor and major complications were wear (9.8%/year) and fracture (1.6%/year) of the prosthetic material. While the occurrence of prosthetic complications appears to be fairly common during the treatment of edentulous patients with fixed implant prostheses, it is important to underscore that the relationship between the occurrence of complications and patient satisfaction is less clear 18,25–28,30,39,40 . In addition, an adequate understanding of the relationship between prosthetic complications and associated patient‐ and treatment‐based risk factors could potentially help minimize their occurrence.…”

mentioning

confidence: 99%

“…In addition, an adequate understanding of the relationship between prosthetic complications and associated patient‐ and treatment‐based risk factors could potentially help minimize their occurrence. In this sense, the large majority of available information is based on retrospective and cross‐sectional studies 18,25–28,30,39,40 . Prospective data on the relationship between risk factors and the occurrence of prosthetic complications could therefore enhance the strength of information available to the profession.…”

mentioning

confidence: 99%

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Survival rates, patient satisfaction, and prosthetic complications of implant fixed complete dental prostheses: a 12‐month prospective study

Nikellis

Lampraki²,

Romeo

et al. 2022

Journal of Prosthodontics

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Purpose To determine the survival rate, incidence of prosthetic complications, and patient satisfaction of implant fixed complete dental prostheses (IFCDPs) after a mean observation period of 1.4 years. Materials and methods Twenty‐eight (28) eligible participants were recruited according to specific inclusion and exclusion criteria. The definitive metal‐acrylic resin IFCDPs consisted of titanium bars veneered with acrylic resin and acrylic denture teeth. Prosthodontic complications, divided into major and minor, were monitored. Parameters such as gender, jaw location, bruxism, and occlusal scheme were evaluated. Moreover, a questionnaire was administered throughout the study to assess patient satisfaction. Poisson regression as well as repeated measures ANOVA were used for statistical analysis. Results Fourteen (14) males and 14 females were enrolled and followed‐up at 3, 6, and 12 months. All IFCDPs survived (100% survival rate). The most frequent minor complication was the loss of material used to close the screw access hole (20% out of total complications). The most frequent major complication was chipping of the acrylic denture teeth (77.14% out of total complications). Gender (p = 0.008) and bruxism (p = 0.030) were significant predictors for the total major complications (major wear and major chipping) while occlusal scheme was a significant predictor for major chipping events (p = 0.030). Conclusions While IFCDPs demonstrated high prosthetic survival rates, they also exhibited a high number of chipping events of the acrylic veneering material, especially in males, bruxers, and individuals with canine guidance occlusion. However, the occurrence of these prosthetic complications did not negatively affect patient satisfaction.

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Mechanical complications of implant-supported complete-arch restorations and impact on patient quality of life: A retrospective cohort study

Cited by 15 publications

References 18 publications

The effect of mandibular flexure on the design of implant-supported fixed restorations of different facial types under two loading conditions by three-dimensional finite element analysis

The effect of mandibular flexure on the design of implant-supported fixed restorations of different facial types under two loading conditions by three-dimensional finite element analysis

The effect of the digital manufacturing technique of cantilevered implant-supported frameworks on abutment screw preload

Survival rates, patient satisfaction, and prosthetic complications of implant fixed complete dental prostheses: a 12‐month prospective study

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