title: Four-implant overdenture fully supported by a CAD-CAM titanium bar: A single-cohort prospective 1-year preliminary study.
abstract: BACKGROUND
  In patients with an altered skeletal maxillomandibular relationship and bone resorption, the rehabilitation of edentulous jaws by combining 4 implants, 2 straight medially and 2 tilted distally, may be preferred to avoid a bone augmentation procedure.
  
  
  OBJECTIVE
  The purpose of this single cohort 1-year prospective study was to evaluate the clinical performance of a 4-implant overdenture fully supported by a computer-aided designed and computer-aided manufactured (CAD-CAM) titanium bar.
  
  
  METHODS
  This single cohort prospective study included edentulous participants rehabilitated with a 4-implant overdenture in 1 of the 2 jaws. The outcomes were implant and prosthetic survival and success rates, any biologic and technical complications, periimplant marginal bone loss, changes in the oral health impact profile (OHIP), bleeding on probing, and the plaque index.
  
  
  RESULTS
  Eighteen participants received 72 implants. One year after implant placement, no implants or prosthesis had failed, and no biologic or technical complications had been observed. At the 1-year follow-up, the mean marginal bone loss was 0.29 ±0.16 mm. The OHIP summary scores demonstrated a significant improvement in oral health-related quality of life. At the 1-year follow-up, positive bleeding was found in 2 participants (11.1%) around 3 implants (4.1%). Three participants (16.6%), accounting for 5 implants (6.9%), showed a slight amount of plaque.
  
  
  CONCLUSIONS
  A 4-implant overdenture supported by a CAD-CAM titanium bar may be a reliable option for the treatment of the edentulous mandible and maxilla over a 1-year period. Oral health-related quality of life significantly improved in all treated participants.
authors.affiliation: Interim Chair, Oral Surgery and Implant Dentistry, Marche Polytechnic University, Ancona, Italy. Electronic address: studiopozzi@me.com.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pozzi
authors.affiliation: Lecturer, University of Sassari, Surgical, Micro-Surgical and Medical Science Department, Sassari, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Tallarico
authors.affiliation: Chair and Director, Implant Dentistry and the Dental Implant Center at UCLA, University of California, Los Angeles, Calif.
authors.forename: Peter K
authors.initials: PK
authors.lastname: Moy
mesh_terms: D000368:Aged; D017076:Computer-Aided Design; D019094:Dental Prosthesis, Implant-Supported / Q000379:methods*; D019232:Dental Restoration Failure / Q000706:statistics & numerical data; D003779:Denture Design; D003828:Denture, Overlay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014025:Titanium
chemical_list: D014025:Titanium