Abstract
Background: The aim of this three-year prospective study was to examine the outcome of a solution for full-arch rehabilitation through a fixed implant-supported hybrid prosthesis (polyetheretherketone (PEEK)-acrylic resin) used in conjunction with the All-on-4 concept. Methods: Thirty-seven patients (29 females, 8 males), with an age range of 38 to 78 years (average: 59.8 years) were rehabilitated with 49 full-arch implant-supported prostheses (12 maxillary rehabilitations, 13 mandibular rehabilitations and 12 bimaxillary rehabilitations). The primary outcome measure was prosthetic survival. Secondary outcome measures were marginal bone loss, plaque and bleeding scores, veneer adhesion issues, biological complications, mechanical complications, and the patients’ subjective evaluation. Results: There were two patients (maxillary rehabilitations) lost to follow-up, while one patient withdrew (maxillary rehabilitation). One patient with bimaxillary rehabilitation fractured the mandibular PEEK framework, rendering a 98% prosthetic survival rate. Implant survival was 100%. Average (standard deviation) marginal bone loss at 3-years was 0.40 mm (0.73 mm). Veneer adhesion was the only technical complication (n = 8 patients), resolved for all patients. Nine patients (n = 11 prostheses) experienced mechanical complications (all resolved): fracture of acrylic resin crowns (n = 3 patients), prosthetic and abutment screw loosening (n = 4 patients and 3 patients, respectively), abutment wearing (n = 1 patient). One patient experienced a biological complication (peri-implant pathology), resolved through non-surgical therapy. A 90% satisfaction rate was registered for the patients’ subjective evaluation. Conclusions: Based on the results, the three-year outcome suggests the proposed rehabilitation solution as a legitimate treatment option, providing a potential shock-absorbing alternative that could benefit the implant biological outcome.
Highlights
Polyetheretherketone (PEEK) is a high-performance thermoplastic polymer with high strength-toweight ratio and corrosion resistance that makes it suitable as a selectable material to replace metal [1].Considering its original development (Victrex plc, Lancashire, UK) [2], the fabrication process [3] results in a number of properties including chemical stability, biostability, biocompatibility, creep and wear resistance, and superior mechanical behavior
Despite the scarce in vivo publications, PEEK was demonstrated to be a valid treatment option compared to titanium in the rehabilitation of severely atrophic maxillary alveolar ridges both through patient-specific sub-periosteal implants [24] and as a customized mesh for bone augmentation [25]
We evaluated prosthetic survival as primary outcome measure
Summary
Polyetheretherketone (PEEK) is a high-performance thermoplastic polymer with high strength-toweight ratio and corrosion resistance that makes it suitable as a selectable material to replace metal [1].Considering its original development (Victrex plc, Lancashire, UK) [2], the fabrication process [3] results in a number of properties including chemical stability, biostability, biocompatibility, creep and wear resistance, and superior mechanical behavior. Despite the scarce in vivo publications, PEEK was demonstrated to be a valid treatment option compared to titanium in the rehabilitation of severely atrophic maxillary alveolar ridges both through patient-specific sub-periosteal implants [24] and as a customized mesh for bone augmentation [25] The aim of this three-year prospective study was to examine the outcome of a solution for full-arch rehabilitation through a fixed implant-supported hybrid prosthesis (polyetheretherketone (PEEK)-acrylic resin) used in conjunction with the All-on-4 concept. Conclusions: Based on the results, the three-year outcome suggests the proposed rehabilitation solution as a legitimate treatment option, providing a potential shock-absorbing alternative that could benefit the implant biological outcome
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