Abstract
There have been no studies of implant-crown-retained removable partial dentures (IC-RPD) for the treatment of maxillary edentulism. The purpose of this study was to perform clinical and radiographic evaluations of implants in IC-RPD compared to implant overdentures (IOD) in maxillary edentulous patients. Twenty IC-RPDs with 74 splinted implant crowns and 18 IODs with 71 implants retained with magnet attachments were observed in 38 patients. We statistically analyzed survival rates and marginal bone loss (MBL) of implants based on multiple variables including first year pathologic condition, location of placed implant, age, and sex in both treatments. Patient reported oral measurements (PROMs) regarding functional/esthetic improvement after IC-RPD or IOD treatments and prosthetic complications were also statistically analyzed. After a median observation period of 47.1 months (up to 147 months), we observed 97.3% implant survival rates for IC-RPD and 70.4% for IOD (p < 0.001). Among variables, first year pathologic condition (p < 0.001) and sex (p = 0.027) influenced implant survival rates. The MBL of implants for IC-RPD and IOD groups at the final check-up were 1.12 ± 1.19 mm and 3.31 ± 1.71 mm, respectively (p < 0.001). In both groups, patients with peri-implantitis (p < 0.001) and patients older than 65 years (p = 0.029) showed significantly higher implant MBL regardless of treatment modality. Functional and esthetic satisfaction were significantly improved (p < 0.001) after both treatments. The IOD group showed more frequent prosthetic complications compared to the IC-RPD group. Within the limitations of a retrospective study, we concluded that RPD with few splinted implant crowns is a feasible alternative treatment modality for maxillary edentulous patients with anatomical limitations.
Highlights
The conventional treatment modality for edentulous maxilla is conventional dentures (CD), but for several decades, implant dentistry has been able to restore edentulous maxillae with full fixed prostheses
The implant overdentures (IOD) group showed more frequent prosthetic complications compared to the implant-crown-retained removable partial denture (IC-removable partial dentures (RPDs)) group
We examined patient reported oral measurements (PROMs) after IC-RPD and IOD treatment according to visual analog scales (VAS) of 1–5, in which 1 was the least favorable
Summary
The conventional treatment modality for edentulous maxilla is conventional dentures (CD), but for several decades, implant dentistry has been able to restore edentulous maxillae with full fixed prostheses. Socioeconomic limitations of patients and difficulties of zygomatic implant surgeries or lateral sinus floor elevation often prevent extensive surgery in the resorptive maxilla. In such cases, clinicians may consider restoring the edentulous maxilla with implant overdentures (IOD) using a few implants without bone augmentation or additional surgeries. For any type of prosthesis is associated with maxillary IOD [1] This low success rate is attributed primarily to bone quality in the edentulous maxilla, since a looser arrangement of trabecular bone with a thin, or even absent cortical plate, is generally less capable of stabilizing and supporting implants [2]. The divergent implant axis due to adverse ridge morphology in the maxilla might cause excessive prosthesis loading
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