Implant treatment in the edentulous maxillae: a 15-year follow-up study on 76 consecutive patients provided with fixed prostheses.
BACKGROUND
Few long-term follow-up studies are available on implant treatment based on patient level data related to time.


OBJECTIVE
The aim of this study was to report 15-year patient-based data in relation to time of follow up after treatment with fixed prostheses supported by implants in the edentulous upper jaw.


METHODS
Seventy-six edentulous consecutive patients, provided with 450 turned Brånemark implants, were followed up with regard to maintenance, complications, and radiographs taken during the follow-up period.


RESULTS
Forty-four patients provided with 247 implants were lost to follow up. Patients followed up for 15 years showed as a group a trend of better implant survival than patients lost to follow up (p > .05). Altogether, 37 implants and 5 fixed prostheses failed during the follow-up period. Most implants were lost at abutment surgery (n- 15) and another nine during the first year of function. The 15-year implant and fixed prosthesis cumulative survival rate was 90.9 and 90.6%, respectively. Resin veneer fractures caused most problems, more frequent in the earlier stage while severe wear increased in the later stage of follow up. No implant fractures or loosening of abutment/bridge locking screws were noted. The mean marginal bone loss was 0.5 mm (SD 0.47) after 5 years, followed by only minimal average changes during the following years. No radiographic parameter showed any time-dependent relationship. The percentage of patients presenting at least one implant with more than 2.0-mm bone loss was 4.9% in the interval from 0 to 5 years and 4.0% between 10 and 15 years. Only 1.3% of implants showed >3.0 mm accumulated bone loss after 15 years.


CONCLUSIONS
Implant treatment in the edentulous upper jaw functions well in a 15-year time perspective, but an insignificant trend of higher implant failures was observed for patients lost to follow up. Besides wear and fractures of veneers, no other parameter showed any time-related relationship, indicating an increased risk for more complications during later stages of follow up. However, accumulation of smaller amount of bone loss during the years resulted in an increasing number of implants and patients with bone levels below the third thread, which could be speculated to increase future maintenance after 15 years.
Jemt
Torsten
T
Chairman, The Brånemark Clinic, Public Dental Health Service, Göteborg, Sweden. torsten.jemt@vregion.se
Johansson
Jesper
J
D000180:Acrylic Resins / Q000737:chemistry; D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000145:classification; D000044:Dental Abutments; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D019554:Dental Restoration Wear; D003801:Dental Veneers; D003779:Denture Design; D003781:Denture Retention; D005260:Female; D005500:Follow-Up Studies; D006047:Gold Alloys / Q000737:chemistry; D006801:Humans; D007575:Jaw, Edentulous / Q000534:rehabilitation / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D016019:Survival Analysis; D013997:Time Factors
D000180:Acrylic Resins; D015921:Dental Implants; D006047:Gold Alloys