title: Complications and patient-centered outcomes with an implant-supported monolithic zirconia fixed dental prosthesis: 1 year results.
abstract: OBJECTIVE
  To characterize the number and type of complications that occur with a monolithic zirconia fixed dental prosthesis (MZ-FDP) supported by four endosseous implants in the edentulous mandible over time and to quantify the impact of treatment on oral health quality of life (OHQoL).
  
  
  METHODS
  Seventeen edentulous participants were enrolled. New conventional dentures were fabricated for each participant. Four Astra Tech Osseospeed TX implants (Dentsply) were then placed in the parasymphyseal mandible, and after a period of healing, a full-arch monolithic zirconia prosthesis (Zirkonzahn) was inserted. Complication data were recorded and OHQoL was evaluated using the Oral Health Impact Profile (OHIP-49), administered on four occasions: enrollment; implant surgery; and 6- and 12-month recalls.
  
  
  RESULTS
  Sixty-eight implants were placed in 17 edentulous individuals aged 30 to 78 (mean 57.9 years). Implant survival was 94% from the subject perspective and 99% from the implant perspective. Prosthesis survival was 88%. Twelve complications occurred in ten participants, whereas seven participants remained complication free. Both OHIP-49 severity and extent scores decreased significantly between enrollment and 12-month recall (p < 0.001). The mean OHIP-49 severity score at baseline was 94.8 (95% confidence interval [CI]: 73.9, 115.8) and declined an average of 76.8 (95% CI: -91.3, -62.3) units per participant. The mean OHIP-49 extent score at baseline was 17.2 (95% CI: 10.8, 23.6) and declined 16.3 (95% CI: -20.2, -12.4) units per participant on average.
  
  
  CONCLUSIONS
  Implant survival was high, and few complications related to the MZ-FDP were observed. The most common prosthetic complication was tooth chipping in the opposing maxillary denture, which accounted for 50% of all complication events. Substantial and clinically important improvements in OHQoL were achieved with both conventional dentures and the implant-supported MZ-FDP. The data of this short-term study indicate that the implant-supported MZ-FDP is a therapeutic option with particular advantages in the edentulous mandible that warrants further long-term study.
authors.affiliation: Department of Prosthodontics, University of North Carolina School of Dentistry, Chapel Hill, NC.
authors.forename: Bryan
authors.initials: B
authors.lastname: Limmer
authors.forename: Anne E
authors.initials: AE
authors.lastname: Sanders
authors.forename: Glenn
authors.initials: G
authors.lastname: Reside
authors.forename: Lyndon F
authors.initials: LF
authors.lastname: Cooper
mesh_terms: D000328:Adult; D000368:Aged; D015921:Dental Implants / Q000009:adverse effects / Q000523:psychology; D003764:Dental Materials / Q000737:chemistry*; D019094:Dental Prosthesis, Implant-Supported / Q000009:adverse effects* / Q000523:psychology; D019232:Dental Restoration Failure; D003779:Denture Design; D003781:Denture Retention; D003824:Denture, Complete / Q000009:adverse effects* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007575:Jaw, Edentulous / Q000534:rehabilitation; D008297:Male; D008334:Mandible / Q000601:surgery; D008875:Middle Aged; D010347:Patient Care Planning; D018802:Patient-Centered Care; D011446:Prospective Studies; D011788:Quality of Life; D016019:Survival Analysis; D016896:Treatment Outcome; D015040:Zirconium / Q000737:chemistry*
chemical_list: D015921:Dental Implants; D003764:Dental Materials; D015040:Zirconium; C028541:zirconium oxide
keywords: Dental implant; OHIP-49; dental prosthesis; edentulism; mandible; zirconia