Survival and complication rates of combined tooth-implant-supported fixed partial dentures.
OBJECTIVE
The objective of this study has been to review the incidence of biological and technical complications in case of tooth-implant-supported fixed partial denture (FPD) treatments on the basis of survival data regarding clinical cases.


METHODS
Based on the treatment documentations of a Bundeswehr dental clinic (Cologne-Wahn German Air Force Garrison), the medical charts of 83 patients with tooth-implant-supported FPDs were completely recorded. The median follow-up time was 4.73 (time range: 2.2-8.3) years. In the process, survival curves according to Kaplan and Meier were applied in addition to frequency counts.


RESULTS
A total of 84 tooth-implant (83 patients) connected prostheses were followed (132 abutment teeth, 142 implant abutments (Branemark, Straumann). FPDs: the time-dependent illustration reveals that after 5 years, as many as 10% of the tooth-implant-supported FPDs already had to be subjected to a technical modification (renewal (n=2), reintegration (n=4), veneer fracture (n=5), fracture of frame (n=2)). In contrast to non-rigid connection of teeth and implants, technical modification measures were rarely required in case of tooth-implant-supported FPDs with a rigid connection. There was no statistical difference between technical complications and the used implant system. Abutment teeth and implants: during the observation period, none of the functionally loaded implants (n=142) had to be removed. Three of the overall 132 abutment teeth were lost because of periodontal inflammation. The time-dependent illustration reveals, that after 5 years as many as 8% of the abutment teeth already required corresponding therapeutic measures (periodontal treatment (5%), filling therapy (2.5%), endodontic treatment (0.5%)). After as few as 3 years, the connection related complications of implant abutments (abutment or occlusal screw loosening, loss of cementation) already had to be corrected in approximately 8% of the cases. In the utilization period there was no screw or abutment fracture.


CONCLUSIONS
Technical complications of implant-supported FPDs are dependent on the different bridge configurations. When using rigid functional connections, similarly favourable values will be achieved as in case of solely implant-supported FPDs. In this study other characteristics like different fixation systems (screwed vs. cemented) or various implant systems had no significant effect to the rate of technical complications.
Nickenig
Hans-Joachim
HJ
Department of Prosthodontics, School of Dental Medicine, University of Aachen, Pauwelsstrasse 30, G-52074 Aachen, Germany. dr.a.nickenig@t-online.de
Schäfer
Corinna
C
Spiekermann
Hubertus
H
D000328:Adult; D002484:Cementation; D000044:Dental Abutments / Q000009:adverse effects; D015921:Dental Implants / Q000009:adverse effects; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003793:Dental Restoration, Permanent; D003779:Denture Design / Q000009:adverse effects; D003780:Denture Repair; D003830:Denture, Partial, Fixed; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010518:Periodontitis / Q000209:etiology / Q000628:therapy; D012390:Root Canal Therapy; D016019:Survival Analysis; D014070:Tooth
D015921:Dental Implants