Clinical Evaluation of Mandibular Posterior Three-Unit Combined Tooth-/Implant-Supported Fixed Partial Dentures: Controlled Prospective Clinical Study

Abstract

The aims of the study were to evaluate the clinical performance and the complications of combined tooth-/ implant-supported three-unit fixed partial dentures (FPDs) in the posterior mandible. A total of 78 partially edentulous patients in the posterior mandible were recruited for the study (n = 26/group). Group 1 served as the control group and received two dental implants to support a three-unit FPD. Groups 2 and 3 were the experimental groups in which one implant was placed in conjunction with support from an adjacent tooth to support a three-unit FPD. Standard implants (≥ 8 mm) were included in Group 2, while short implants (< 8 mm) were included in Group 3. Periapical radiographs were taken for evaluation of crestal bone loss (CBL). Modified plaque index (MPI), bleeding index (BI), and sulcus depth values of the abutment teeth were recorded at the time of FPD delivery, 6 months after FPD delivery, and annually thereafter. Recorded complications included abutment tooth intrusions, cementation failures of the restorations, porcelain chipping/delamination, framework fracture, abutment screw loosening, abutment and abutment screw fracture, and implant fracture. Statistically significant differences were observed between Group 1 (0.06 ± 0.17) and Group 2 (0.18 ± 0.32) and between Group 1 and Group 3 (0.17 ± 0.30) in terms of MPI (P ≤ .05). No difference was observed between Group 2 (0.11 ± 0.34) and Group 3 (0.14 ± 0.36) or between Group 1 (0.04 ± 0.22) and Group 2 in terms of BI. There were statistically significant differences in terms of CBL between Group 1 (0.259 ± 0.05 mm) and Group 3 (0.11 ± 0.03 mm) and between Group 2 (0.03 ± 0.03 mm) and Group 3 (P ≤ .05). The mean abutment tooth sulcus depth was 1.11 ± 0.31 mm for Group 2 and 1.20 ± 0.46 mm for Group 3. Within the limitations of the current study, it was concluded that combined tooth/implant-supported prostheses (CTISPs) are a predictable treatment choice in the posterior mandible. When a CTISP is planned, it is more predictable to use a short implant than a standard-length implant.