Abstract
This study aims to assess the treatment outcomes (functional and subjective) of full-arch fixed hybrid rehabilitations made of PEEK (poly-ether-ether-ketone) with milled crowns of nano-filled composite (NFC) supported on four to six implants. In this randomized clinical trial, 34 edentate patients in the upper and/or the lower jaws were treated with the fixed hybrid dentures. In 16 patients (47.1% of the sample), the implants were loaded immediately (IL) by means of a provisional fixed rehabilitation made of PMMA (polymethylmethacrylate) screwed on Multi-Unit (MU) abutments connected after emplacement of the implant; however, in the counterparts (n = 18) these MU abutments were covered by healing caps and were left unloaded during two months (conventional loading protocol—CL), when all patients received a fixed hybrid PEEK-NFC rehabilitation on the upper and/or the lower jaw. Treatment outcomes were assessed 12 months after prostheses delivery. Functional outcomes were calculated according to masticatory performance, estimated by mixing ability tests of two colored chewing gums after ten chewing strokes, by the occlusal force/area recorded by pressure-sensitive sheets, and by electromyography of masseters and temporal muscles at maximum biteforce. The subjective outcomes of the treatment were assessed using both the oral satisfaction scale (visual analog scale) and the Spanish version of the Oral Health Impact Profile (OHIP-20). The findings of the present study showed that treatment with fixed PEEK-NFC hybrid prostheses significantly improved the masticatory performance, bite force, occlusal pattern, quality of life, and satisfaction, with the IL group being those with significantly higher occlusal bite forces and greater satisfaction in comparison with CL group. It should be concluded that PEEK-NFC hybrid prostheses can improve several patient-centered outcomes and that loading protocol significantly affects the patient’s self-rated satisfaction.
Highlights
The natural evolution of the most prevalent dental diseases contributes to dental loss, usually after ablative therapeutic intervention
The purpose of the present study was to evaluate the functional and subjective outcomes of implant-supported full-arch hybrid rehabilitations made of PEEK-nano-filled composite (NFC) for treating edentate patients depending on the loading protocol
This study found that despite both groups being comparable in terms of sociodemographic, behavioral, and anatomical variables, one year after treatment, the full occlusal area, the average pressure, and the total occlusal load was significantly higher among the IL group (Table 4)
Summary
The natural evolution of the most prevalent dental diseases (caries and periodontal disease) contributes to dental loss, usually after ablative therapeutic intervention. Of the Spanish elderly (65–74 years), 7.3% (CI 95% 4.4–10.2%) are fully edentulous and wear complete conventional dentures [1] and usually suffer from oral pain, functional problems [2], and poor quality of life [3]. Until more than 30 years ago conventional complete dentures were the only therapeutic resource for replacing missing teeth in fully edentulous patients. The indication of either implant-retained or implant-supported prostheses was born and is still especially indicated in the edentulous mandible, since the area of support of this jaw is much lower than that of the maxilla (which takes advantage of using the hard palate as retention area), being, the most uncomfortable place to wear conventional dentures. That is why overdentures retained on two implants are considered the standard of care for mandibular edentulism [6]
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