Four-unit fixed dental prostheses replacing the maxillary incisors supported by two narrow-diameter implants - a five-year case series.
OBJECTIVE
(1) To determine the survival rate of 10 four-unit fixed dental prostheses (FDPs) replacing the four maxillary incisors, supported by 20 narrow-diameter implants (NDIs), (2) to assess the incidence of mechanical and biological complications, and (3) to evaluate bone level changes longitudinally after final FDP insertion.


METHODS
Ten patients (six women, four men), mean age 49.4 ± 12.6 years, were treated with a four-unit anterior maxillary FDP (six screw-retained; four cemented). Biological parameters, eventual technical complications, radiographic measurements, and study casts were assessed at 1 (baseline), 3, and 5 years after implant placement. A multilevel logistic regression test was performed on clinical parameters and bone level changes (significance level P < 0.05).


RESULTS
The 5-year implant and FDP survival rate was 100%. Mean modified plaque index (mPI) values were 0.03 and 0.02 at 3 and 5 years, significantly lower when compared to mPI (0.11 ± 0.31) at 1 year. Mean modified sulcus bleeding index (mSBI) was 0.08, 0.08, and 0.15 over time. Probing depth (PD) values were 1.57, 1.64, and 2.03 mm. Statistically significant differences were found between 1 vs. 5 year (P = 0.0003) and 3 vs. 5 year (P = 0.001). Keratinized mucosa (3.65 mm) remained stable during observation period. DIB mean values were 2.01 ± 0.34, 2.13 ± 0.13, and 2.17 ± 0.38 mm. Patient satisfaction based on visual analog scale revealed favorable fulfillment of overall treatment and esthetic expectations.


CONCLUSIONS
Two NDIs supporting a four-unit FDP to replace the four missing maxillary incisors may be considered a predictable treatment modality.
Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.
Osvaldo
O
Moráguez
Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.
Francesca
F
Vailati
Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.
Linda
L
Grütter
Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.
Irena
I
Sailer
Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.
Urs C
UC
Belser
D000328:Adult; D000368:Aged; D003758:Dental Implantation, Endosseous / Q000379:methods*; D003774:Dental Plaque Index; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003830:Denture, Partial, Fixed; D005260:Female; D006801:Humans; D007180:Incisor; D008137:Longitudinal Studies; D008297:Male; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D017060:Patient Satisfaction; D010512:Periodontal Index; D011446:Prospective Studies
case series; clinical study; esthetics; implant-supported fixed dental prostheses; maxillary incisors; narrow-diameter implants