Prosthetic complications in immediately loaded All-on-Four mandibular prosthesis using titanium wire reinforcement versus non reinforced temporary framework. A Randomized Clinical Trial

Abstract

Objectives:The objective of this study was to evaluate the prosthetic complications resulting from the treatments performed with the All-on-Four concept either with splinted or un-splinted implants using the novel OT bridge system Materials and Methods: This study was conducted on twelve completely edentulous patient aged from 60 to 70 years. An upper and lower removable complete denture were constructed for each eligible patient. CBCT scan was done for the patients to quantify bone volumes at the planned implant sites. All patients received 4 implants to support an "all-on-four" fixed mandibular prosthesis. The patients were randomly divided into two equal groups. The first group patients received an immediately loaded all-on-four mandibular prosthesis with un-splinted abutments. While the second group patients received an immediately loaded all on four mandibular prosthesis where the abutments were splinted together with titanium wire. Immediate loading was performed by converting the patients' existing denture into a fixed prosthesis by a picking up procedure at the day of implant placement. Prosthetic complications were evaluated for the temporary immediately loaded prosthesis in a 6-month period. Results:In this study the overall prosthetic complications for those patients treated with splinted or un-splinted all on four technique was as follows: for Group I (un-splinted implants), total incidence of patients showed at least one Prosthetic complication were 12 (100%) patients, while 4 (33.3%) patients showed at least one Prosthetic complications in (Group II). Conclusion:From this study it can be concluded that the All-on-four concept with immediate loading is a procedure that is viable and could be helpful in completely edentulous patients. However, it can predispose the patient to some prosthetic complications specially when the implants are unsplinted with titanium wires.