New approach for immediate prosthetic rehabilitation of the edentulous mandible with three implants: a retrospective study

Abstract

Immediate/early prosthetic rehabilitation of the edentulous mandible with four or more implants for support of a fixed bridge is a well-documented procedure. Only a few studies have reported on the outcome of using three implants for this purpose. To retrospectively analyze the clinical outcome when using three implants for support of an immediately loaded fixed bridge in the totally edentulous mandible. In total, 132 patients (67 females and 65 males, mean age 62.6 years, range 35-85 years) treated with 396 implants (Brånemark System) over an 11-year period in one clinic were retrospectively analyzed with regard to implant survival. Implants with both machined and oxidized surface had been used. Eighty percent of the implants were 13 mm in length or longer. The permanent bridge with acrylic teeth was delivered to the patient the same day. The patients were re-called annually for clinical examinations. All patients had been followed for at least 1 year, with the longest follow-up of 10 years and a mean follow-up of 5 years. Thirteen implant failures in 10 patients were experienced, all occurring during the first 12 months of loading. The overall survival rate was 96.7% for implants and 92.4% for original bridges. More machined than oxidized implants failed, 7% vs. 1.2%. Fourteen additional implants were placed at the time of removal of the failed implants when also the fixed bridge was adjusted on the same day. Thus, all patients received and maintained a fixed bridge, except for a few hours in the 10 failure cases when the bridges were adjusted. This retrospective survival analysis shows that three implants can be used to support a fixed bridge for immediate loading in the edentulous mandible. The study indicated that oxidized implants were more successful than machined ones.