What are the long-term survival and complication rates of complete-arch fixed implant rehabilitation in edentulous patients?

Abstract

Cohort selection The study cohort was selected through screening of electronic records of all patients rehabilitated with interforaminal implants and implant-supported fixed complete dental prostheses (IFCDPs) over an 11-year period at the Tufts University School of Dental Medicine. Evaluation was based on medical and dental history; clinical oral examination of hard and soft tissues; and radiographic examination during a single visit.Data analysis Survival and failure rates of implants and prostheses were recorded based on predefined criteria. Along with descriptive statistics, the observed annual incidence, and the estimated five- and ten-year biologic and technical complications were computed with 95% confidence intervals.Results The study cohort included 41 patients with an average age of 65.8 years (range = 39 to 88 years) and comprised 19 females and 22 males. A total of 359 moderately rough surface dental implants (Nobel Biocare, Straumann, Biomet 3i) were used to rehabilitate 36 cement-retained and 19 screw-retained metal-ceramic IFCDPs in maxilla (N = 32) mandible (N = 23). The mean observation times for implants and prostheses were 5 and 7.5 years, respectively. Two implant failures in a single patient were recorded 11 years post-insertion, yielding an implant survival rate of 99.4%. The cumulative prostheses survival rate was 98.2% (100% at five years and 92.9% at ten years). Biologic and/or technical complications were associated with all 55 prostheses. Among major complications, the most frequent biologic complication was peri-implantitis while porcelain fractures were the most common technical complication. The cumulative rates of 'prostheses free of biologic complications' were 50.4% (95% CI: 36.4% to 63.0%) at five years and 10.1% (95% CI: 3.5% to 20.8%) at ten years. The cumulative rates for 'prosthesis free of technical complications' were 56.4% (95% CI: 41.7% to 68.8%) at five years and 9.8% (95% CI: 3.2% to 21.0%) at ten years.Conclusions Metal-ceramic implant-supported fixed full arch dental prostheses show high survival rates at five-year follow-up, including an implant survival rate of 99.4% and prosthesis survival rate of 98.2%. However biological and technical complications were observed in 47.1% and 42%, respectively.