title: Early laser-welded titanium frameworks supported by implants in the edentulous mandible: a 15-year comparative follow-up study.
abstract: BACKGROUND
  Comparative long-term knowledge of different framework materials in the edentulous implant patient is not available for 15 years of follow-up.
  
  
  OBJECTIVE
  To report and compare a 15-year retrospective data on implant-supported prostheses in the edentulous mandible provided with laser-welded titanium frameworks (test) and gold alloy frameworks (control).
  
  
  METHODS
  Altogether, 155 patients were consecutively treated with abutment-level prostheses with two early generations of fixed laser-welded titanium frameworks (titanium group). Fifty-three selected patients with gold alloy castings formed the control group. Clinical and radiographic 15-year data were collected and compared for the groups.
  
  
  RESULTS
  All patients who were followed up for 15 years (n = 72) still had a fixed prosthesis in the mandible at the termination of the study. The 15-year original prosthesis cumulative survival rate (CSR) was 89.2 and 100% for titanium and control frameworks (p = .057), respectively (overall CSR 91.7%). The overall 15-year implant CSR was 98.7%. The average 15-year bone loss was 0.59 mm (SD 0.56) and 0.98 mm (SD 0.64) for the test and control groups (p = .027), respectively. Few (1.3%) implants had >3.1-mm accumulated bone loss after 15 years. The most common complications for titanium frameworks were resin or veneer fractures and soft tissue inflammation. Fractures of the titanium metal frame were observed in 15.5% of the patients. More patients had framework fractures in the earliest titanium group (Ti-1 group) compared to the gold alloy group (p = .034). Loose and fractured implant screw components were few (2.4%).
  
  
  CONCLUSIONS
  Predictable overall long-term results could be maintained with the present treatment modality. Fractures of the metal frames and remade prostheses were more common in the test group, and the gold alloy frameworks had a tendency to work better when compared with welded titanium frameworks during 15 years. However, on the average, more bone loss was observed for implants supporting gold alloy frameworks.
authors.affiliation: The Brånemark Clinic, Public Dental Health Service, Göteborg, Sweden. anders.ortorp@vgregion.se
authors.forename: Anders
authors.initials: A
authors.lastname: Ortorp
authors.forename: Torsten
authors.initials: T
authors.lastname: Jemt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016301:Alveolar Bone Loss / Q000209:etiology; D003188:Composite Resins / Q000737:chemistry; D000044:Dental Abutments; D015921:Dental Implants; D003764:Dental Materials / Q000737:chemistry*; D017269:Dental Prosthesis Repair; D017268:Dental Prosthesis Retention; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D012994:Dental Soldering / Q000379:methods*; D003801:Dental Veneers; D005500:Follow-Up Studies; D006047:Gold Alloys / Q000737:chemistry; D006801:Humans; D007575:Jaw, Edentulous / Q000534:rehabilitation* / Q000601:surgery; D007834:Lasers; D008137:Longitudinal Studies; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D016348:Osseointegration / Q000502:physiology; D010518:Periodontitis / Q000209:etiology; D012189:Retrospective Studies; D016019:Survival Analysis; D014025:Titanium / Q000737:chemistry*
chemical_list: D003188:Composite Resins; D015921:Dental Implants; D003764:Dental Materials; D006047:Gold Alloys; D014025:Titanium