title: CNC-milled titanium frameworks supported by implants in the edentulous jaw: a 10-year comparative clinical study.
abstract: BACKGROUND
  No long-term clinical studies covering more than 5 years are available on Computer Numeric Controlled (CNC) milled titanium frameworks.
  
  
  OBJECTIVE
  To evaluate and compare the clinical and radiographic performance of implant-supported prostheses provided with CNC titanium frameworks in the edentulous jaw with prostheses with cast gold-alloy frameworks during the first 10 years of function.
  
  
  METHODS
  Altogether, 126 edentulous patients were by random provided with 67 prostheses with titanium frameworks (test) in 23 maxillas and 44 mandibles, and with 62 prostheses with gold-alloy castings (control) in 31 maxillas and 31 mandibles. Clinical and radiographic 10-year data were collected for the groups and statistically compared on patient level.
  
  
  RESULTS
  The 10-year prosthesis and implant cumulative survival rate was 95.6% compared with 98.3%, and 95.0% compared with 97.9% for test and control groups, respectively (p > .05). No implants were lost after 5 years of follow-up. Smokers lost more implants than nonsmokers after 5 years of follow-up (p < .01). Mean marginal bone loss in the test group was 0.7 mm (SD 0.61) and 0.7 mm (SD 0.85) in the maxilla and mandible, with similar pattern in the control group (p > .05), respectively. One prosthesis was lost in each group due to loss of implants, and one prosthesis failed due to framework fracture in the test group. Two metal fractures were registered in each group. More appointments of maintenance were needed for the prostheses in the maxilla compared with those in the mandible (p < .001).
  
  
  CONCLUSIONS
  The frequency of complications was low with similar clinical and radiological performance for both groups during 10 years. CNC-milled titanium frameworks are a viable alternative to gold-alloy castings for restoring patients with implant-supported prostheses in the edentulous jaw.
authors.affiliation: Department Prosthetic Dentistry/Dental Materials Science, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Sweden. anders.ortorp@vgregion.se
authors.forename: Anders
authors.initials: A
authors.lastname: Örtorp
authors.forename: Torsten
authors.initials: T
authors.lastname: Jemt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging; D016009:Chi-Square Distribution; D017076:Computer-Aided Design; D003442:Crowns; D003735:Dental Casting Technique; D015921:Dental Implants; D017267:Dental Prosthesis Design / Q000379:methods*; D017269:Dental Prosthesis Repair; D017268:Dental Prosthesis Retention; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D005260:Female; D006047:Gold Alloys; D006801:Humans; D007575:Jaw, Edentulous / Q000534:rehabilitation; D016014:Linear Models; D016015:Logistic Models; D059012:Lost to Follow-Up; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D018709:Statistics, Nonparametric; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants; D006047:Gold Alloys; D014025:Titanium