Abstract
We aimed to assess the biological and mechanical-technical complications and survival rate of implants of full-arch metal-ceramic prostheses, during five years of follow-up. 558 implants (of three different brands) retaining 80 full-arch metal-ceramic prostheses were placed in 65 patients, all of whom were examined annually for biological and mechanical-technical complications during the five years of follow-up. Descriptive statistics and univariate logistic regression were calculated. The cumulative survival rate of the implants was 99.8%, and 98.8% prosthesis-based. Mucositis was the most frequent of the biological complications and peri-implantitis was recorded as 13.8% at restoration-level, 16.9% at patient level and 2.0% at implant level. An implant length greater than 10 mm was shown to be a protective factor against biological complications. The mechanical-technical complications were associated with implant diameter, abutment/implant connection and retention system. Loss of screw access filling was the most frequent prosthetic complication, followed by the fracture of the porcelain. Full-arch metal-ceramic prostheses show a high prevalence of implant and prosthesis survival, with few biological and mechanical-technical complications.
Highlights
It is well known that the loss of all the teeth of one or both dental arches causes important anatomical, functional, aesthetic and psychological changes, which significantly reduce the quality of life and comfort of patients
Exclusion criteria were: (1) poor general health due to systemic diseases that may compromise or contraindicate implant surgery, (2) previous treatments or taking medications that can seriously influence implant osseointegration, (3) poor oral hygiene conditions and lack of motivation for dental hygiene. This last condition was verified by the examiner in the remaining teeth of the antagonistic arch after periodontal treatment that must be done of necessity to patients who are going to carry a full-arch implant-supported prosthesis
Compared to previous studies of full-arch metal-porcelain prostheses, the implant survival of this study (99.8%) is similar to the 99.1% found at two years of average functioning [21] and a little higher than the survival rate from other studies at five-year [22] and ten-year follow-up [6,20]
Summary
It is well known that the loss of all the teeth of one or both dental arches causes important anatomical, functional, aesthetic and psychological changes, which significantly reduce the quality of life and comfort of patients. The predictability, good prognosis and high survival rates of dental implants seem to be the ideal solution to ensure the stability/retention of the complete prosthesis and the satisfaction of patients in cases of total edentulism. Both overdentures and fixed full-arch metal-porcelain or metal-acrylic resin (hybrid) prostheses, with or without cantilever, are possible solutions. Restorations of this kind have shown high levels of satisfaction and comfort, quality of life and functionality in clinical studies compared to a conventional complete prosthesis [1,2,3]
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