title: Removable dentures with implant support in strategic positions followed for up to 8 years.
abstract: OBJECTIVE
  The aim of this study was to analyze prosthetic maintenance in partially edentulous patients with removable prostheses supported by teeth and strategic implants.
  
  
  METHODS
  Sixty patients with removable partial prostheses and combined tooth-implant support were identified within the time period from 1998 to 2006. One group consisted of 42 patients (planned group) with a reduced residual dentition and in need of removable partial dentures (RPDs) or overdentures in the maxilla and/or mandible. They were admitted consecutively for treatment. Due to missing teeth in strategic important positions, one or two implants were placed to improve symmetrical denture support and retention. The majority of residual teeth exhibited an impaired structural integrity and therefore were provided with root copings for denture retention. A few vital teeth were used for telescopic crowns. The anchorage system for the strategic implants was selected accordingly. A second group of 18 patients (repair group) wearing RPDs with the loss of one abutment tooth due to biologic or mechanical failure was identified. These abutment teeth were replaced by 21 implants, and patients continued to wear their original prostheses. The observation time for planned and repair groups was 12 months to 8 years. All patients followed a regular maintenance schedule. Technical or biologic complications with supporting teeth or implants and prosthetic service were registered regularly.
  
  
  RESULTS
  Three maxillary implants were lost after loading and three roots with copings had to be removed. Biologic problems included caries and periodontal/peri-implant infection with a significantly higher incidence in the repair group (P < .05). Technical complications with the dentures were rather frequent in both groups, mostly related to the anchorage system (matrices) of root copings and implants. Maintenance and complications were observed more frequently in the first year after delivery of the denture than in the following 3 years (P < .05). No denture had to be remade.
  
  
  CONCLUSIONS
  The placement of a few implants allows for maintaining a compromised residual dentition for support of RPDs. The combination of root and implant support facilitates treatment planning and enhances designing the removable denture. It also proves to be a practical rescue method. Technical problems with the anchorage system were frequent, particularly in the first year after delivery of the dentures.
authors: Department of Prosthodontics, University of Bern, Bern, Switzerland.
authors: Regula
authors: R
authors: Kaufmann
authors: Monika
authors: M
authors: Friedli
authors: Stephan
authors: S
authors: Hug
authors: Regina
authors: R
authors: Mericske-Stern
mesh_terms: D016301:Alveolar Bone Loss / Q000209:etiology; D015331:Cohort Studies; D000044:Dental Abutments; D003731:Dental Caries / Q000209:etiology; D015921:Dental Implants; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D019554:Dental Restoration Wear; D003823:Denture Rebasing; D003780:Denture Repair; D003781:Denture Retention; D003828:Denture, Overlay; D003832:Denture, Partial, Removable; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000534:rehabilitation / Q000601:surgery; D008297:Male; D008334:Mandible / Q000601:surgery; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D019558:Occlusal Adjustment; D010518:Periodontitis / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants