Rehabilitation of the Edentulous Mandible with an Immediately Loaded Full-Arch Fixed Prosthesis Supported by Three Implants: A 5-Year Retrospective Analysis

Abstract

To evaluate the clinical and radiographic outcomes of full-arch mandibular rehabilitation with fixed prostheses supported by three immediately loaded implants after at least 5 years of follow-up. The sample comprised 58 patients who underwent treatment with immediate loading. Radiographic evaluation of bone loss was carried out in Adobe Photoshop CS5 by a single calibrated examiner using digitized panoramic radiographs. Clinical examination of the technical conditions of the prosthetic device assessed the condition of the acrylic resin base, dental occlusion, metal framework, presence of cover screws, screw fixation of the prosthesis and abutments, and length of cantilever and resistance arms. Five implants in four patients failed, for an overall success rate of 97.13%. Mean bone loss was 2.65 ± 1.06 mm around central implants and 2.11 ± 0.84 mm around distal implants. The most common complication was loss of abutment torque. Half of all patients in the sample experienced some prosthetic complication. There was no evidence of a statistically significant relationship of cantilever length with bone loss or prosthetic complications. The immediately loaded three-implant-supported fixed prosthesis protocol tested in this study proved to be a viable therapeutic strategy for mandibular rehabilitation in edentulous patients, with favorable outcomes after 5 years of clinical and radiographic follow-up.