Success Rate Of Prostheses Research Articles

Success and complications of implant-retained prostheses provided by the Post-Doctoral Prosthodontics Program, University of Puerto Rico: A cross-sectional study

Statement of problemThe success rate of implant-retained prostheses in a postdoctoral prosthodontics program was unknown and could not be related to any set of potential clinical issues or patient characteristics. PurposeThe purpose of this study was to determine the success rate of implant-retained prostheses placed by prosthodontic residents between 1997 and 2012 and to evaluate the associations between patient classifications and specific restoration characteristics as related to prosthesis success or failure. Material and methodsA total of 272 prostheses in 119 patients were clinically evaluated. Success was defined as the absence of prosthetic complications or any implant-related complication that affected prosthesis survival. Logistic regression was used to evaluate associations between prosthesis success/failure and a wide array of study variables, adjusting for patient age, sex, and prosthesis longevity. ResultsThe overall success rate was 71%, with a mean prosthesis age of 4.5 years (range: 4 months to 16.8 years). Implant single crowns were the most successful prosthesis type (81% success). The most common complications observed were porcelain fractures in fixed dental prostheses (15%) and lack of stability (31%) and retention (29%) in removable dental prostheses. Having a removable prosthesis (versus natural dentition) in the opposing occlusion significantly decreased the odds of success (OR=0.26, 95% CI: 0.11-0.64). Definitively cemented fixed prostheses were more successful than those cemented with an interim cement (OR=4.56, 95% CI: 1.37-15.22). ConclusionsThe overall success rate of the implant-retained prostheses placed in the program was low compared with previously published studies. This study revealed the need for an efficient, comprehensive recall system for patients receiving implant-retained prostheses, either fixed or removable.

Review of follow-up of clinical success of implant-supported complete dental prostheses

OBJECTIVE: The aim of this study was to assess the clinical success rate of implant-supported complete dental prostheses, which are being used as a feasible alternative in planning of oral rehabilitation. Over the years, the two-stage surgical protocol has increasingly been replaced by immediate loading procedures, especially in the mandibular anterior region in cases of rehabilitation of completely edentulous patients. This procedure has become feasible due to the high success rate of the technique with very satisfactory results. METHODS: By means of a literature review focused on published articles with clinical follow-up between 8 and 15 years. RESULTS: Implants placed in the mandible had higher success rates than those inserted in the maxilla. Cases with longer follow-up periods, 15 years, showed higher success rates in comparison with follow-up periods of 8 and 10 years. CONCLUSION: Success rates of implant-supported complete dental prostheses are very high.

A 10-year retrospective analysis of clinical results of implant-retained/ supported prostheses in full edentulous patients

To evaluate the 10-year clinical results of implant prostheses in edentulous patients. Between August 1994 and November 2009, 762 implants were placed in 127 patients (162 jaws) with the mean age of (56.0 ± 10.9) years in Peking University, School and Hospital of Stomatology. Sinus lift, guide bone regeneration (GBR) and onlay graft were used according to the indications of bone defect types. Overdentures and fixed bridges were delivered.Overdentures were retained/supported by ball, magnet, telescopic crown or milled bar. Clinical evaluation included peri-implant soft tissue health status, prostheses functional status and complications.Radiographic evaluations were conducted at operation day, 3 months post-operatively, right after prostheses delivery, and annually afterwards. Clinical data were collected and analyzed. Of the 127 patients, 116 were edentulous mandible and 46 edentulous maxilla, with a mean follow-up period 109.2 months(45-228 months). Thirteen implants were lost and the 10-year implant cumulative survival rate was 97.8% and the prostheses success rate was 100.0%. The prevalence of peri-implantitis was 3.8% (29/762). Sixty-seven point nine percent of the patients underwent implant placement without bone graft.Sinus lift technique and guided bone regeneration technique were the most often used with 84.8% (39/46) in the upper jaws and 6.2% (10/162) in the total jaws respectively. Seventy-one percent of the cases(115/162) was overdentures. Telescopic, milled-bar, and magnetic retained/supported overdentures were the most commonly used with 34.8% (40/115) , 27.0% (31/115) , and 20.0% (23/115) respectively. The implant-supported fixed prostheses included adhesive retained fixed bridges and screw retained fixed bridges with the ratio of 19.1% and 80.9% respectively. The prevalence of 10-year post-prosthodontic complications was 53.5% (68 cases). The most common complications were prosthetic and uperstructure complications. The 10-year implant-retained/supported prostheses was a successful modality in edentulous cases.Sinus lift technique and guided bone regeneration technique are the most commonly used techniques with predictable clinical results. Telescopic crowns milled bar and magnet with 4-6 implants retained/supported overdenture were the most often used retention systems and telescopic crown overdenture had more advantages in terms of long-term maintenance and satisfaction.

Immediate Loading of Dental Implants Inserted in Edentulous Maxillas and Mandibles: 5-Year Results of a Clinical Study

The aim of the present study was to evaluate the long-term outcome of immediately loaded full-arch, fixed, one-piece prostheses supported by dental implants inserted in completely edentulous maxillae and mandibles. Twenty-eight completely edentulous jaws in 27 patients were treated with screw-fixed provisional prostheses on the same day as implant insertion. A total of 189 implants were inserted into the jaws of the patients. All provisional prostheses were the one-piece bridge type and were made with acrylic resin. Final restoration was performed more than 2 months after surgery. Implant survival rate, prosthesis success rate, and complications during the follow-up period were evaluated. Implant size (diameter and length) and bone quality (Hounsfield units) of the region of the implant were also analyzed. Mean follow-up time was 77.9 months. The cumulative survival rate of the implants was 100%, and the success rate of the prostheses was also 100% during the observation time. Although 3 types of minor complications occurred in 10 jaws (10/28; 35.7%), no major complications were found. Immediate loading of dental implants produces an equivalent outcome as that reported in previous studies using conventional loading. We believe this study not only adds to the immediate loading data but also confirms that the immediate loading technique may be most advantageous strategy for edentulous patients.

The influence of desensitizing dentifrices on pain induced by in-office bleaching

The purpose of this study was to evaluate whether the use of desensitizing dentifrices used 15 days prior to and after in-office tooth bleaching could eliminate or reduce tooth sensitivity. After institutional review board approval and informed consent, 45 subjects were selected and divided into 3 groups according to the dentifrice selected: Colgate Total (CT), Colgate Sensitive Pro-Relief (CS) or Sensodyne ProNamel (SP). The subjects used toothpaste and a toothbrush provided to them for 15 days prior to bleaching. They were then submitted to two in-office bleaching sessions (Whiteness HP Blue Calcium). Their tooth sensitivity was assessed using the Visual Analog Scale (VAS) for a week after each session. Their tooth shade alteration was measured with a Vitapan Classical shade guide to determine if the dentifrices could influence the effectiveness of the bleaching agent. The data were submitted to Wilcoxon, Kruskal-Wallis and Mann-Whitney tests (α = 0.05). The use of desensitizing dentifrices did not affect the bleaching efficacy. In regard to tooth sensitivity, there was a statistically significant difference between the results of the Control Group and Group T2 after the first session (p = 0.048). There was no statistically significant difference in the results for the other groups after the first session. In regard to the second session, there was no statistically significant difference in the results for all the groups. The use of a desensitizing dentifrice containing nitrate potassium reduced tooth sensitivity during the bleaching regimen. Dentifrices containing arginine and calcium carbonate did not reduce tooth sensitivity. Color change was not influenced by the dentifrices used.

Assessing bone's adaptive capacity around dental implants: A literature review

Increased stress (force) on prostheses induces strain (deformation) in the peri-implant bone. Elevated stress and strain could result in the failure of implants that support prostheses. However, the survival rate of implants supporting prostheses under increased stress is high. Either the bone is stronger than expected or it adapts to increased stress. Concepts regarding bone's adaptive capacity continue to evolve and are the focus of this literature review. The authors searched the literature to find studies that addressed the bone's capacity to adjust to increased stress and strain. They assessed experimental and clinical trials in which investigators monitored healing after placement of dental implants. The data indicate that forces greater than the bone's adaptive ability can induce loss of osseointegration, as well as osseous resorption. In contrast, it is possible that increased stress on prostheses initiates a reparative process, thereby facilitating retention of implants experiencing increased stress. Numerous lines of evidence support the concept that bone can modify itself to withstand increased mechanical forces. The authors provide an explanation for the high success rate of prostheses and implants in bone that are exposed to increased stress and strain.

Immediate Loading of Dental Implants Placed in Severely Resorbed Edentulous Maxillae Reconstructed With Le Fort I Osteotomy and Interpositional Bone Grafting

Reconstruction and rehabilitation of atrophic maxillae with bone grafts is a lengthy and demanding procedure. This study reports the immediate loading of 50 implants placed on six extremely atrophied edentulous maxillae reconstructed with Le Fort I osteotomy and iliac bone grafting. Six patients, aged 49 to 68 years, with severely atrophied maxillae were treated with Le Fort I osteotomy and iliac bone grafting to allow for implant-borne prosthetic rehabilitation. Four to 5 months thereafter, 50 implants (seven to 10 per patient) were placed in reconstructed maxillae and immediately functionally loaded with a screw-retained definitive prosthesis. The patients were followed by clinical and radiographic examinations for 24 months after prosthetic loading. The grafting procedure and healing period before implant placement were uneventful in all patients. Two implants were lost within 2 months after prosthesis insertion in two patients, with an overall survival rate of 96%. The prostheses success rate was 100%. At the end of the follow-up period, all remaining implants appeared clinically healthy; crestal bone loss was >1.7 mm for six implants, resulting in a cumulative success rate of 84%. Immediate loading of implants placed after Le Fort I osteotomy and interpositional iliac bone grafting could be considered a viable protocol to rehabilitate extremely atrophied edentulous maxillae, considerably reducing the treatment time.

Immediate Rehabilitation of the Extremely Atrophic Mandible with Fixed Full‐Prosthesis Supported by Four Implants

To prospectively assess the outcome of immediate rehabilitation of extremely atrophic mandibles by a full-arch fixed bridge anchored to four implants. Twenty patients with edentulous mandibles were included in the study. Each patient received a full-arch fixed bridge supported by two axial and two distal tilted implants. Prosthetic loading was applied within 48 hours of surgery. Patients were scheduled for follow-up every 6 months up to 2 years and annually until 5 years. Radiographic evaluation of marginal bone level change was performed at 1 year. All patients were followed for a minimum of 1 year (range 20-48 months, mean 30.1 months). No failures were recorded to date. The 1-year implant survival rate and prosthesis success rate were 100%. Marginal bone loss around axial and tilted implants was similar at 12-month evaluation, being, respectively, 0.6 ± 0.3 (standard deviation) mm and 0.7 ± 0.4 mm. High patient's level of satisfaction was recorded for function, phonetics, and aesthetics. This technique could be considered a viable treatment option for the rehabilitation of the atrophic mandible.

Osseointegration Technique in Patients with Acquired Auricular Deformities and Failed Previous Reconstruction: A Retrospective Study of Long-Term Follow-Up and Chinese Experience

Objectives: To evaluate the complication rate and patient satisfaction of reconstruction of acquired auricular deformities and failed previous reconstruction by the osseointegration technique. Methods: The study enrolled 24 patients from January 2002 to December 2005. Data collected included demographic information, success rate of auricular prostheses, site of implants, survival rate of implants, occurrence of skin reaction and condition of the prosthetic ear. Results: Twenty-five ears (24 patients) were implanted. All ears were healing well with a lifelike appearance, stable fixation and natural color; except for 2 instances of implants dislocated by trauma, the rest survived well by first intention; skin reaction was the most troublesome complication, no patient was able to maintain a consistent level of soft-tissue health for the whole follow-up period, but the ratio and degree of skin reaction decreased gradually. The time of wearing prosthetic ears was more than 8 h/day. The average time length until prosthetic ear replacement was 3.5 years. There were no intracranial or systemic complications. Conclusion: The osseointegration technique can be the method of choice for acquired auricular defects and failed reconstructions. Follow-up management is important to the health of the implants and the surrounding soft tissue and to preserve the prosthesis and its retention mechanism.

Titanium–zirconium alloy narrow‐diameter implants (Straumann Roxolid®) for the rehabilitation of horizontally deficient edentulous ridges: prospective study on 18 consecutive patients

(i) To evaluate the survival and success rates of the new Roxolid narrow diameter implant placed in horizontally deficient ridges; and (ii) to evaluate the incidence of prosthetic complications. In a 24-month period (2009-2010) 18 partially or totally edentulous patients received 51 Straumann Roxolid (13 tissue level, 38 bone level) implants. Prosthetic loading of implants was either immediate (four implants; one patient) or delayed (2-12months after placement; 47 implants; 17 patients). The patients were rehabilitated with either fixed (16 patients; 45 implants) or removable (two patients; six implants) prostheses. All implants successfully achieved osseointegration and all patients completed the planned prosthetic rehabilitation. Peri-implant bone resorption values ranged from 0 to 1mm at the end of the observation period (range: 3-19months). Implant survival and success rates were therefore 100%. No prosthetic complications occurred and all implants are still in function; therefore the prosthesis success rate was 100%. Narrow diameter implants fabricated with the new titanium-zirconium alloy were demonstrated to be reliable in supporting both fixed and removable prosthetic rehabilitations in horizontally deficient ridges. Implant survival, peri-implant bone resorption, and prosthetic complication rates were consistent with those reported in the literature for standard diameter implants placed in non-deficient edentulous ridges.

Immediate Fixed Implant Rehabilitation of the Atrophic Edentulous Maxilla after Bilateral Sinus Floor Augmentation: A 12‐Month Pilot Study

The aims of this study were to evaluate a surgical/prosthetic protocol for the immediate rehabilitation of the augmented edentulous maxilla, and to compare the outcomes of implants placed in grafted (test group) versus native (control group) sites in the same patients. Twenty patients were included in the study. Each patient was treated with a bilateral sinus augmentation procedure using a 50:50 composite graft of autogenous mandibular bone and bovine hydroxyapatite. Four to 5 months later, 155 implants (90 test and 65 control) were placed and restored with screw-retained fixed definitive prostheses supported by titanium frameworks within 1 week. All patients were followed for 1 year. Implant stability quotient (ISQ) measurements and radiographic evaluation of the marginal bone resorption (MBR) were performed. Two test implants failed in two patients, giving a cumulative 1-year success rate of 98.7%; the prostheses success rate was 100%. Insertion torque and ISQ values for test implants were significantly lower than those for control implants (unpaired t-test, p < .0001). The mean MBR around control and test implants at the 1-year evaluation were similar (0.47 ± 0.25 mm and 0.43 ± 0.21 mm, respectively). The combination of implants placed in sinus-grafted and native sites can be immediately loaded with a fixed full-arch prosthesis and yield short-term successful outcomes.

Immediate Rehabilitation of the Mandible with Fixed Full Prosthesis Supported by Axial and Tilted Implants: Interim Results of a Single Cohort Prospective Study

The aims of this prospective study were to assess the treatment outcome of immediately loaded full-arch fixed bridges anchored to both tilted and axially placed implants for the rehabilitation of the mandible and to compare the outcome of axial versus tilted implants. Sixty-two patients (34 women and 28 men) were included in the study. Each patient received a full-arch fixed bridge supported by two axial implants and two distal tilted implants (All-on-Four, Nobel Biocare AB, Göteborg, Sweden). Loading was applied within 48 hours of surgery. Patients were scheduled for follow-up at 6, 12, 18, and 24 months, and annually up to 5 years. At each follow-up, plaque level and bleeding scores were assessed; moreover, patient's satisfaction for aesthetics and function was evaluated by a questionnaire. Radiographic evaluation of marginal bone level change was performed at 1 year. The overall follow-up range was 6 to 43 months (mean 22.4 months). Forty-four patients were followed for a minimum of 1 year. No implant failures were recorded to date, leading to a cumulative implant survival and prosthesis success rate of 100%. Plaque level and bleeding scores showed progressive decrease over time, parallel to increase of satisfaction for both aesthetics and function. No significant difference in marginal bone loss was found between tilted and axial implants at 1-year evaluation. The present preliminary data suggest that immediate loading associated with tilted implants could be considered a viable treatment modality for the mandible.

Early loading of ITI implants supporting maxillary fixed full‐arch prostheses

To evaluate the predictability of the early-loaded sand-blasted, large-grit and acid-etched (SLA) implants supporting maxillary-fixed full-arch prostheses. Ninety-one ITI SLA implants were placed in 12 edentulous maxillae. The impressions were taken at 4 weeks post-surgery. The abutments were tightened and the final fixed prostheses were cemented at 6 weeks after implant placement. Resonance frequency analysis (RFA) was conducted on the day of the surgery, at 4 and 6 weeks post-surgery. Panoramic radiographs were taken immediately after surgery, at 4 weeks post-surgery, immediately after prostheses attachment (baseline) and at the yearly follow-ups. The survival rate of implants was 98.90%. The success rate of prostheses was 100% during the follow-ups. The radiographic result showed no radiolucency around the implants and the marginal bone level revealed no significant resorption compared with the baseline. The marginal bone level remained coronally beyond the first thread. The RFA results revealed Implant Stability Quotient (ISQ) values of 63.44+/-4.32, 57.14+/-4.25 and 66.43+/-3.78 for the three time points. The findings of this study indicated that early loading of ITI implants supporting maxillary fixed full-arch prostheses should be predictable.

Pre-clinical validation of joint prostheses: A systematic approach

The pre-clinical validation of new joint prostheses is an important step in the development process of a new implant design. The high success rate of modern prostheses makes it very difficult to ensure that new designs will exhibit significant improvements combined with a risk of failure as low as that of the designs currently in use. This situation requires a systematic re-thinking of the pre-clinical validation protocols. We advocate that a careful combination of risk analysis, experimental and numerical modelling, and the use of statistical finite element analysis to generalize the results to a simulated population, can provide the level of confidence required by class 3 devices as the joint prostheses recently became. The proposed approach is illustrated using the validation of a cemented epiphyseal stem as an example.

Immediate occlusal loading and tilted implants for the rehabilitation of the atrophic edentulous maxilla: 1‐year interim results of a multicenter prospective study

The aims of this prospective study were to assess the treatment outcome of immediately loaded full-arch fixed bridges anchored to both tilted and axially placed implants for the rehabilitation of fully edentulous maxillae and to compare the outcome of axial vs. tilted implants. Forty-one patients with edentulous maxillae were included in the study. Each patient received a full-arch fixed bridge supported by four axial implants and two distal tilted implants. Loading was applied within 48 h from surgery. Patients were scheduled for follow-up at 6 months, 1 year and annually up to 5 years. Radiographic evaluation of marginal bone-level change was performed at 1 year. One patient died 4 months after surgery. Thirty patients were followed for a minimum of 1 year (range 3-42 months, mean 22.1 months). Three failures were recorded at 1-year follow-up (two axial implants and one tilted). Two more implants (one tilted and one axially placed) were lost within 18 months of loading. The 1-year implant survival rate was 98.8% for both axial and tilted implants. Prosthesis success rate was 100% at 1 year. Marginal bone loss around axial and tilted implants at 12-month evaluation was similar, being, respectively, 0.9+/-0.4 (standard deviation) mm and 0.8+/-0.5 mm. The present preliminary data suggest that immediate loading associated with tilted implants could be considered to be a viable treatment modality for the atrophic maxilla and that there does not seem to be a different clinical outcome between tilted and axial implants.

Retrospective Evaluation of 48 Consecutive Immediate Load Hybrid Cases Performed at the OSU OMFS Resident Clinic

Today patients are living longer and demanding more stable prostheses to replace teeth as they are lost. Replacing mandibular dentition with immediate load hybrid prostheses via the OSU protocol allows patients to have a definitive restorative solution immediately following surgery. In this retrospective evaluation we review the success rates of hybrid restorations regardless of success or failure of individual variables. The records of 60 patients that had implant surgery for hybrid restorations with immediate load between October 2001 and May 2006 were initially examined. These records were sorted based on the following five inclusion criteria: case performed in the resident clinic, restored with a mandibular hybrid, implant/hybrid complex immediately loaded, patients with a minimum follow-up time of 3 months and, lastly, complete records. Of the original cases reviewed 48 met all of the inclusion criteria. The variables examined for the implant fixture included the following: crestal bone loss, immobility, absence of symptoms (infection, pain and neurosensory disturbances), soft tissue free of inflammation and ability to maintain adequate hygiene. Variables examined for the hybrid prosthesis included the following: passive fit of framework, adequate occlusion, adequate function, esthetics, a design that enables adequate hygiene, and component integrity. Descriptive statistics. One patient (2.08%) had measurable crestal bone loss after one year, seven patients (14.58%) had mobility of at least one implant as established by Periotest (Bensheim an der Bergstrasse, Germany), five (10.41%) had continued symptoms after 3 months, nine (18.75%) had continued areas of soft tissue inflammation after 3 months of healing, and five (10.41%) were not able to adequately maintain hygiene secondary to the surgery. One prosthesis (2.08%) had a non-passive framework, one (2.08%) was found to have inadequate occlusion, eight (16.67%) were found to have inadequate function, and none were found to have poor esthetics. In eight patients (16.67%) the prosthesis inhibited adequate hygiene practices. Eighteen patients (37.5%) were found to have failed component integrity. We found multiple minor issues associated with the surgery as well as the prosthetic reconstruction. However, most of these individual issues were addressed and the patients went on to heal and function uneventfully. This shows that regardless of a number of failures in individual categories evaluated, the overall success rate of the implant/hybrid complex with immediate loading was 93.75% (44 cases). The clinical success rate of the immediate load mandibular hybrid prostheses following the OSU protocol in the resident clinic is very high. Healing time between implant placement and delivery of definitive prosthesis is decreased from 6-9 months to 2 days following the OSU immediate load protocol. This eliminates the need for an interim removable denture for esthetic or functional purposes. The fixed stability of the prosthesis allows the patient to function better and more naturally than any type of removable prosthesis. The anxiety of being seen without teeth is overcome with this treatment decreasing the amount of patient self-awareness.

Implant-supported fixed cantilever prostheses in partially edentulous arches. A seven-year prospective study.

The purpose of the following study was to evaluate the medium- to long-term prognosis of implant-supported cantilever fixed prostheses, and to establish to what degree this is influenced by factors such as length, type of cantilever (mesial or distal), and opposite dentition versus cantilever prostheses. This study was performed on a sample of 38 partially edentulous patients treated between January 1994 and March 2001 with 49 partial cantilever fixed prostheses supported by 100 implants. Marginal bone resorption (MBL) has been studied and used as a reference parameter to define therapeutic success. The MBL measurement was made possible by transposing X-ray images of patients selected on a PC and then using a software program. Statistical analysis was carried out for possible correlation between peri-implant bone resorption and the parameters considered in this study: length and type (mesial or distal) of cantilever and opposite dentition to cantilever prostheses. Seven years after loading cantilever prostheses, the overall cumulative implant survival rate (OCSR) was 97%, and the prostheses success rate is 98%. Mesial cantilever prostheses registered a lower success rate (97.1%) than distal cantilever prostheses (100%). Furthermore, a better prognosis was not observed when the opposite dentition of the prostheses comprised natural teeth, or fixed prostheses on natural teeth, when compared with the cases in which opposite teeth were implant-supported fixed prostheses. The authors concluded that medium-term prognosis of implant-supported cantilever fixed prostheses and traditional implant-supported fixed prostheses was comparable. However, a thorough pre-treatment analysis of risk factors regarding implant-supported prosthesis survival is important.

Improving vascular grafts: the importance of mechanical and haemodynamic properties.

In the last 40 years, as techniques and materials have improved, the success rate of vascular prostheses with a diameter greater than 6mm has risen steadily, 5-year survival rates exceeding 95% in most centres. With smaller grafts no comparable improvement has occurred, the majority failing within 5 years, usually as a result of intimal hyperplasia and, ultimately atherosclerosis, in and around the downstream anastomosis. Clinical evidence suggests that the patency rates of small grafts are improved by matching the elastic properties of the graft to that of the artery into which it is placed. Although there is little reliable evidence that 'elastic mismatch' per se is the cause of intimal hyperplasia, it is generally accepted that mechanical factors are important in its genesis. These include disturbed flow at the anastomosis leading to fluctuations in shear stress at the endothelium (a known cause of intimal hyperplasia in normal arteries), injury due to suturing and stress concentration at the anastomosis. Few suitable materials or techniques have yet been developed to improve the long-term survival rates of small grafts. Recent advances in tissue engineering in which prostheses are manufactured by culturing vascular smooth muscle cells on a tubular scaffold of biodegradable polymer may ultimately make it possible to manufacture biologically and haemodynamically compatible grafts with diameters as small as 1mm.