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Journal of Oral Science & Rehabilitation Volume 2 | Issue 2/2016 21 T h r e e - y e a r r e s u l t s o f A l l - o n - 4 i n d a i l y p r a c t i c e fiedwiththefunctionofyourimplant-support- ed prosthesis? Are you satisfied with the es- thetic outcome of your implant-supported prosthesis? Would you undergo the same therapy again? An independent assessor evaluated the implant and prosthesis survival and success rates. Com- plicationswereassessedandtreatedbythesame clinicians.The marginalbone losswas evaluated by an independent radiologist. S t a t i s t i c a l a n a l y s i s Patient data were collected in an Excel spread- sheet (Microsoft). Finally, all of the data were exported into IBM SPSS StatisticsforMacintosh (Version 22.0; IBM, Armonk, N.Y., U.S.) for sta- tistical analysis.Abio-statistician with expertise in dentistry analyzed the data using PASW Sta- tisticsforWindows(Version18.0;SPSS,Chicago, Ill., U.S.). Descriptive analysiswas performed for numeric parameters using mean ± standard de- viation (median; 95% CI). Dichotomous and con- tinuous outcomeswere compared usingthe chi- squared test and one-way analysis of variance, respectively. Differences in the proportions of patientswith implantfailures, prosthesisfailures andcomplications(dichotomousoutcomes)were comparedbetweenthesubgroupsusingtheFish- er exact test. Patient was the statistical unit of the analyses. All statistical comparisons were conducted at a 0.05 level of significance. Results Thirty-two patientswere screened for eligibility. Two patients were not enrolled in the trial, be- cause of refusal to sign the informed consent. A total of 120 NobelSpeedy Groovy implants were placed using either computer-assisted tem- plate-guided (n=15) or conventional freehand surgery (n = 15) in 30 consecutive patients (18 females and 12 males) with a mean age of 67.4 ± 6.9 (range of 51–87). Thirty CAD/CAM screw-retained implant-supported com- plete-arch FDPs (18 inthe mandible and 12 inthe maxilla)were delivered. No patients dropped out of the study within three years after implant placement and no deviation from the original protocol occurred. All of the patients were fol- lowed up for a minimum period of three years (mean of53.8 months; range of36–84 months). Data collected were included in the statistical analysis. The main patients’ and interventions’ characteristics are summarized in Table 1. Atthethree-yearfollow-up examination, one out of 120 implants (0.8%) had failed, resulting in a cumulative implant survival rate of 99.2%. The only implant failure occurred in one patient two months after placement, before delivery of the final prosthesis. The affected implant had an in- fectiousetiology(pain,swellingandsuppuration) and it was 11.5mm long in position 16, placed usingguidedsurgeryinahealedsite.Theimplant was replaced three months after bone healing. Thetemporaryprosthesiswasshortened,butnot replaced by a conventional complete removable denture, and the patient was adequately in- formedandinstructedtopayattentionandfollow a soft diet.Atthethree-yearfollow-up examina- tion,nodefinitiveprostheseshadfailed,resulting in a cumulative prosthesis survivalrate of100%. Eleven patients experienced one technical or biological complication each, resulting in eight technical and three biological complications re- ported during the entire follow-up period. Six technical and one biological complication were reported during the healing period with tempo- rary prostheses, while two technical and two biological complications were reported after de- finitive prosthesis delivery. All of the complica- tions were successfully resolved. Three prosthetic screws loosened inthetem- porary prostheses (in three patients) during the healing period, and this was resolved by retight- ening the screws, stabilizing the occlusion and advisingthepatientsnottooverloadtheprosthe- ses (not to ingest food that may require signifi- cant masticatory effort). Three fractures of the provisional acrylic prostheses occurred (in three patients) during the healing period. The tempo- rary prosthesis was adjusted chairside, the oc- clusion was stabilized and a night guard was delivered for each patient. Fracture of the com- posite veneering material of the definitive im- plant-supported cross-arch FDPoccurred in one patient two years after loading, most likely due to occasional parafunctional habits. These situ- ations were resolved by adjusting the definitive prosthesischairside,stabilizingtheocclusionand a delivering a night guard. Thefirstbiologicalcomplicationwasreported sixweeks afterimplant placement in an 11.5mm long implant placed in position 45, using guided surgeryinahealedsite.Thepatientreportedpain andswellingwithoutsuppuration.Thetemporary abutmentwasreplacedwithahealingabutment. The temporary prosthesis was shortened to the Volume 2 | Issue 2/201621