Implant-supported maxillary overdentures retained with milled bars: maxillary anterior versus maxillary posterior concept--a retrospective study.
OBJECTIVE
The aim of the present retrospective investigation was to evaluate implant-supported maxillary overdentures using either anterior (group 1) or posterior (group 2) maxillary implant placement.


METHODS
Maxillary overdentures were planned with support by either 4 implants placed in the maxillary anterior region (group 1) or 6 to 8 implants placed in augmented maxillary posterior regions (group 2, bilateral sinus augmentation) and anchored either on an anterior or on 2 bilaterally placed milled bars. Cumulative implant survival rate, peri-implant conditions (marginal bone loss, pocket depth, Plaque Index, Gingival Index, Bleeding Index, and Calculus Index) and the incidence and type of prosthodontic maintenance were assessed and compared for the 2 groups. In addition, the cumulative survival rate for implants placed in grafted regions was compared with that of implants placed in nongrafted regions.


RESULTS
Thirty-four patients (16 for group 1 and 18 for group 2) with 179 implants were available for follow-up examination after a mean period of 42.1 +/- 20.1 months. Four initially placed implants failed to osseointegrate and were replaced, but no further losses were seen during the loading period, for a 5-year cumulative implant survival rate of 978%. No differences in implant survival rates were seen between either the group-1 (98.4%) and group-2 (97.4%) concepts or nongrafted (98.0%) and grafted (97.5%) implants. The peri-implant parameters showed a healthy soft tissue, good oral hygiene, and an acceptable degree of peri-implant marginal bone loss. The rigid fixation of all overdentures was associated with a low incidence of prosthodontic maintenance, without any significant differences between the 2 groups.


CONCLUSIONS
In well-planned overdenture treatment programs, a high survival rate and excellent peri-implant conditions can be achieved for implants placed in the anterior or posterior maxilla. Rigid anchorage of maxillary overdentures either on an extended anterior milled bar or on 2 bilateral posterior milled bars provides for a low incidence of prosthodontic maintenance.
Krennmair
Gerald
G
Department of Prosthodontics, Dental School, University of Vienna, Austria. krennmair@aon.at
Krainhöfner
Martin
M
Piehslinger
Eva
E
D016301:Alveolar Bone Loss / Q000209:etiology; D016025:Bone Transplantation; D003758:Dental Implantation, Endosseous; D019094:Dental Prosthesis, Implant-Supported / Q000009:adverse effects; D019232:Dental Restoration Failure; D003781:Denture Retention / Q000295:instrumentation*; D003827:Denture, Complete, Upper; D003828:Denture, Overlay; D005260:Female; D006801:Humans; D007180:Incisor; D015993:Life Tables; D008297:Male; D008443:Maxillary Sinus / Q000601:surgery; D008875:Middle Aged; D008963:Molar; D013516:Oral Surgical Procedures, Preprosthetic; D017060:Patient Satisfaction; D010512:Periodontal Index; D012189:Retrospective Studies; D016896:Treatment Outcome