Anteroposterior Spread and Cantilever Length in Mandibular Metal-Resin Implant-Fixed Complete Dental Prostheses: A 7- to 9-Year Analysis.

Abstract

The purpose of this retrospective study was to investigate the relationship of specific prosthetic complications in patients with a maxillary complete removable dental prosthesis (CRDP) opposing a mandibular metal-resin implant-fixed complete dental prosthesis (MRIFCDP) with respect to anteroposterior (AP) spread and cantilever length. Of the 46 patients contacted for this study, 23 patients responded. All patients had been treated with a maxillary CRDP and a mandibular MRIFCDP. They were reviewed for prosthetic complications, and the AP spread and cantilever length were evaluated. A polyvinyl siloxane impression was made of each MRIFCDP so that cantilever length and AP spread could be measured. The average recall time was 8.5 years. The mechanical complications noted were screw-related complications, including both the prosthetic and the abutment screw, consisting of loosening and/or fracture, and fracture of the metal framework. Three different individuals repeated each measurement three times. Inter- and intrarater reliability was evaluated with the intraclass correlation coefficient, and a linear regression analysis of age and average cantilever length to AP spread ratio was calculated. In addition, calculations using this ratio were divided into two groups (> 2.1 and ≤ 2.1) and examined with each variable individually. A logistic regression analysis was performed for a comparison between the two AP spread ratio groups by age, right cantilever length, left cantilever length, average cantilever length, posterior spread, and failures. None of the predictor values was significant for the linear regression analysis of age, cantilever length, and AP ratio on number of failures. There was no significance in complications between the groups that had an AP spread ratio > 2.1 and groups that had an AP spread ratio ≤ 2.1. There was no statistical significance in predicting whether a screw-related complication would occur in relation to age, cantilever length, or AP spread ratio. There was no increase or decrease in complications whether the AP spread ratio was greater than or less than or equal to 2.1. In mandibular MRIFCDPs opposing maxillary complete denture situations, screw-related complications may be less likely regardless of the patient's age, cantilever length, or AP spread ratio of the prosthesis.