title: Freestanding and tooth-implant connected prostheses in the treatment of partially edentulous patients. Part I: An up to 15-years clinical evaluation.
abstract: In 123 patients, 339 implants were connected to 313 teeth by means of fixed partial prostheses (test) and followed up for 1.5-15 years (mean: 6.5). In another ad random selected 123 patients, 329 implants were connected to each other by means of 123 freestanding fixed partial prostheses (control) and were followed up for 1.3-14.5 years (mean: 6.2). The aim of this study was to compare both treatment modalities with each other based on implant, tooth and prosthesis complications. The cumulative implant success, based on implant immobility and/or lack of implant fractures after loading, in the test and control groups amounted to 95% and 98.5%, respectively. Although in the test group 10 implants versus only 1 in the control group failed, a regression analysis of the survival data, based on the cox proportional hazards model, revealed no significant difference. In the test group periapical lesions (3.5%), tooth fracture (0.6%) and tooth extraction due to fatal decay or periodontitis (1%) were observed, besides tooth intrusion (3.4%) and crown cement failure (8%). Framework fracture occurred in 3 patients. In the control group, only 2 abutment screws fractured. The treatment of partial edentulism by means of oral implants was beneficial for our patients. Because of a clear tendency of more implant failures (mobility or fractures) and tooth complications in the tooth-implant connected prostheses, the freestanding solution is the primary option to be considered. To avoid intrusion of abutment teeth, the connection, if made, should be completely rigid.
authors.affiliation: Department of Prosthetic Dentistry/BIOMAT Research Group, Catholic University of Leuven Belgium.
authors.forename: I E
authors.initials: IE
authors.lastname: Naert
authors.forename: J A
authors.initials: JA
authors.lastname: Duyck
authors.forename: M M
authors.initials: MM
authors.lastname: Hosny
authors.forename: D
authors.initials: D
authors.lastname: Van Steenberghe
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003442:Crowns; D000044:Dental Abutments; D003731:Dental Caries / Q000145:classification; D003738:Dental Cements / Q000737:chemistry; D015921:Dental Implants; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003830:Denture, Partial, Fixed; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000534:rehabilitation / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016348:Osseointegration; D010483:Periapical Diseases / Q000145:classification; D010518:Periodontitis / Q000145:classification; D016016:Proportional Hazards Models; D012044:Regression Analysis; D013314:Stress, Mechanical; D016019:Survival Analysis; D014081:Tooth Extraction; D014082:Tooth Fractures / Q000145:classification; D016896:Treatment Outcome
chemical_list: D003738:Dental Cements; D015921:Dental Implants