Clinical and radiographical evaluation of implant-supported fixed partial prostheses

Seo, Ji Young; Shim, June Sung; Lee, Jae Hoon; Lee, Keun Woo

Abstract

Statement of problem: A conventional 3-unit fixed partial denture design with a pontic between two retainers is the most commonly used. However, in cases where the mental nerve is in close proximity to the second premolar, a cantilever design can be considered. As such, logical and scientific evidence is lacking for the number and position of implants to be placed for partially edentulous patients, and no clear-cut set of treatment principles currently exist. Purpose: The purpose of this study was to evaluate prognosis of implant-supported fixed partial dentures, and to compare changes in bone level which may rise due to the different factors. Material and method: The present study examined radiographical marginal bone loss in patients treated with implant-supported fixed partial dentures(87 prostheses supported by 227 implants) and evaluated the influence of the span of the pontic, type of the opposing dentition. Clinical complications were studied using a retrospective method. Within the limitation of this study, the following result were drawn. Result: 1. Seven of a total of 227 implants restored with fixed prostheses failed, resulting in a 96.9% success rate. 2. Complications encountered during recall appointments included dissolution of temporary luting agent (17 cases), porcelain fracture (8 cases), loosened screws (5 cases), gingival recession (4 cases), and gingival enlargement (1 case). 3. Marginal bone loss, 1 year after prosthesis placement, was significant(P<0.05) in the group that underwent bone grafting, however no difference in annual resorption rate was observed afterwards. 4. Marginal bone loss, 1 year post-placement, was greater in cantilever-type prostheses than in centric pontic protheses(P<0.05). 5. Marginal bone loss was more pronounced in posterior regions compared to anterior regions(P<0.05). 6. The degree of marginal bone loss was proportional to the length of the pontic(P<0.05).
Conclusion
The success rate of implant-supported fixed partial dentures, including marginal bone loss, was satisfactory in the present study. Factors influencing marginal bone loss included whether bone graft was performed, location of the pontic(s), location of the surgical area in the arch, pontic span. Long-term evaluation is necessary for implant-supported fixed partial dentures, as are further studies on the relationship between functional load and the number of implants to be placed.