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Clinical performance of a fixed-removable CAD CAM implant bar overdenture on 4 implants- 1-year data

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EAO-2018

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Abstract

Background: The fit and stability of traditional dentures can deteriorate over time. Implant-supported fixed-removable overdentures offer functional and esthetic benefits over traditional tissue-supported dentures. However, few clinical studies have been performed on CAD/CAM implant bar overdentures to date. Aim/Hypothesis: This open prospective multicenter study evaluated the clinical and radiological performance of an individualized CAD/CAM bar overdenture supported by locator attachments on 4 anodized implants with conical connection placed in the maxilla and mandible. 1-year interim outcomes are reported. Material and Methods: Patients needing full-arch restoration in the maxilla or mandible were included. Implants (NobelReplace CC, Nobel Biocare AB, Gothenburg, Sweden) were placed in healed or extraction sites. On the day of implant placement, a soft tissue-based overdenture was incorporated without pressure on the implants. The final CAD/CAM bar (NobelProcera,) and overdenture were provided ≥ 3 months after implant placement. Clinical and radiographic evaluations were performed at implant insertion and the 1-year follow-up visit. The primary outcome was marginal bone level change (ΔMBL). The secondary outcomes were implant and prosthetic cumulative survival rate (CSR), cumulative success rate, soft tissue outcomes, patient satisfaction, and quality of life according to OHIP-EDENT 21. Calculations were performed using SPSS v24.0 (SPSS Inc., Chicago, IL, USA) and SAS v9 (SAS Institute, Cary, NC, USA). Results: 308 implants were placed in 77 patients (40 maxilla; 37 mandible). 72 patients (290 implants: 146 maxilla, 144 mandible) completed the 1-year visit. The ΔMBL for the maxilla and mandible were -1.82 ± 1.72 mm (n=84) and -1.24 ± 1.59 mm (n=103), respectively. ΔMBL was not significantly different between jaws (p=0.093). The implant and prosthetic CSR was 99.0% and 100%, respectively (96.1% patient level survival). Three maxillary implants failed in 3 patients and no prostheses failed. The cumulative success rate for implants and prostheses were 91.4% and 94.7%, respectively. Soft tissue parameters were less favorable at 1-year compared to implant insertion. OHIP-EDENT 21 scores fell from 48.5 ± 16.4 to 28.3 ±8.4 from pretreatment to 1-year. According to patient satisfaction surveys, 34% of patients stated that they would prefer a fixed solution at 1 year. Conclusion and clinical implications: These outcomes suggest that a fixed-removable CAD/CAM bar overdenture supported on four anodized tapered implants with conical connection exhibit very good survival rates after 1-year of function. However, approximately one third of patients indicated a preference for a fixed solution, suggesting that patients desire restorative treatments with minimal maintenance requirements and function that more closely resembles natural dentition.

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© Copyright 2020 Morressier GmbH.
All rights reserved.