Prosthetic Complications of Screw-Retained Restoration Using Multiunit Abutments Versus Intraoral Luting on Titanium Base in Implant-Supported Complete Overdentures Randomized Clinical Trial

Abstract

BACKGROUND: This trial aims to study the difference between prostheses screwmented on full-arch implants using the intraoral luting cement technique on titanium bases versus transmucosal abutments in terms of prosthetic complications. MATERIALS AND METHODS: Twenty patients were recruited in this trial, there were mainly two groups. A screw-retained full-arch implant-supported prosthesis was constructed over four dental implants on upper or lower jaws. For the control group, multiunit abutments were used to construct a screw-retained prosthesis. As for the experimental group, Ti-base abutments were used over the dental implants to construct a screw-retained prosthesis. In both groups, the prosthetic framework was made using polyether ether ketone (PEEK) material and luted intraorally over the titanium sleeve using resin cement. A binary outcome of prosthetic complication was taken in 6 and 12 months. Abutment screw loosening, prosthetic screw loosening, prosthetic screw fracture, abutment screw fracture, veneer fracture, framework fracture, Ti-base decementation, and overall prosthetic loosening were the prosthetic complications included in the trial. RESULTS: At the end of the study, a total of 19 patients adhered to the trial. Throughout the exposure process of implants, two implants failed in one patient from the Ti-base group. This patient was excluded from the study on his request. There was no statistically significant difference present between Ti-base and multiunit abutment groups in terms of abutment and prosthetic screw loosening, abutment and prosthetic screw fracture, veneer and framework fracture, Ti-base decementation, and overall prosthesis loosening for 6 and 12 months. Data were explored for normality using Kolmogorov–Smirnov and Shapiro–Wilk tests, data showed non-parametric (not-normal) distribution. Qualitative data were presented as frequencies and percentages. Wilcoxon and Mann–Whitney tests were used to compare the qualitative outcomes in this study. CONCLUSION: Both multiunit and Ti-base are considered a viable line of treatment to construct a screw-retained full arch implant-supported prosthesis.