Outcomes Assessment of Treating Completely Edentulous Patients with a Fixed Implant-Supported Profile Prosthesis Utilizing a Graftless Approach. Part 2: Patient-Related Outcomes.

PURPOSE: To assess outcomes of treating completely edentulous patients with a fixed implant-supported profile prosthesis, utilizing a graftless approach, for the maxilla and for the mandible, with an emphasis on patient-related outcomes, specifically maximum occlusal force, patient satisfaction, and impact on quality of life. MATERIALS AND METHODS: This was a cross-sectional study with the following inclusion criteria: completely edentulous patients rehabilitated with a fixed implant-supported profile denture, utilizing a graftless approach. Patients fulfilling the inclusion criteria were asked to participate in the study during their follow-up visits; hence, a consecutive sampling strategy was used. To measure maximum occlusal force, a digital occlusal force gauge was used. Subjects were asked to answer a paper survey distributed in the clinic. The survey contained general demographic questions, visual analog scale (VAS) categories, and Oral Health Impact Profile-14 (OHIP-14). RESULTS: The mean VAS score was 8.9 out of a possible 10. The mean OHIP-14 score was 7.5 out of a possible 56. The mean maximum occlusal force recorded in the anterior region was 108 Ncm. The mean maximum occlusal force recorded in the posterior region was 205 Ncm. CONCLUSION: Results indicated that patients treated with a graftless approach reported high satisfaction and impact on quality of life. Regarding maximum occlusal force values, significant differences between men and women were reported. The impact on quality of life seemed to improve when patients presented completely edentulous at the time of treatment as opposed to terminal dentition. Finally, significant positive correlations were detected between satisfaction and impact on quality of life, impact on quality of life and posterior maximum occlusal force, anterior and posterior maximum occlusal force, and complications and anterior maximum occlusal force.

Outcomes Assessment of Treating Completely Edentulous Patients with a Fixed Implant-Supported Profile Prosthesis Utilizing a Graftless Approach. Part 1: Clinically Related Outcomes.

PURPOSE: To assess outcomes of treating completely edentulous patients with a fixed implant-supported profile prosthesis utilizing a graftless approach for the maxilla and for the mandible, with emphasis on clinically related outcomes, specifically implant and prosthesis survival. MATERIALS AND METHODS: This was a retrospective study with the following inclusion criteria: completely edentulous patients rehabilitated with a fixed implant-supported profile denture utilizing a graftless approach. Patients fulfilling the inclusion criteria were asked to participate in the study during their follow-up visits, and hence a consecutive sampling strategy was used. Data regarding implant and prosthesis cumulative survival rates (CSRs) were gathered and calculated. RESULTS: Thirty-four patients were identified with a total of 220 implants placed. An overall CSR of 98.2% was recorded with an observation of up to 10 years. For tilted, axial, and zygomatic implants, CSRs of 96.9%, 98.0%, and 100%, respectively, were observed for up to 10 years. For provisional prostheses, CSRs of 92.3% at 1 year, and 84.6% at 2 years were observed. For final prostheses, a CSR of 93.8% was observed at 10 years. CONCLUSION: The results suggest that treating completely edentulous patients with a fixed profile prosthesis utilizing a graftless approach in the maxilla and the mandible can be a reliable treatment option.

Immediate function with the zygomatic implant: a graftless solution for the patient with mild to advanced atrophy of the maxilla.

PURPOSE: In many edentulous maxillae, posterior alveolar atrophy calls for bone grafting. Patient treatment acceptance is increased by eliminating grafting using tilted implants, especially the zygomatic implant in combination with immediate function. The purpose of this study was to evaluate a protocol for immediate function (within 2 hours) of 2 zygomatic and 4 standard implants (Nobel Biocare) supporting a fixed prosthesis in the completely edentulous maxilla. MATERIALS AND METHODS: This clinical study included 14 patients with 83 immediately loaded implants (28 bilateral zygomatic and 55 premaxillary implants) supporting a complete maxillary denture converted to a fixed provisional prosthesis immediately following the surgical procedure. After 6 months of use, a new fixed metal-supported prosthesis was fabricated. RESULTS: Fourteen patients treated with immediate loading of zygomatic implants were followed for at least 12 months. All patients reported minimization of postoperative pain and security during speech, animation, and mastication. No failures occurred during the follow-up period. DISCUSSION: The patients in the study could have been candidates for sinus grafting. With the present concept these patients benefited from a less invasive procedure (1 surgical procedure and no grafting) and immediate rehabilitation (prosthesis attached directly after surgery). CONCLUSION: The high survival rate, increase in patients' immediate functional ability, and reduction of morbidity following the surgical procedure render this procedure a viable treatment option for the completely edentulous maxilla.

The zygomatic implant: preliminary data on treatment of severely resorbed maxillae. A clinical report.

The Brånemark Zygomaticus implant was used in conjunction with premaxillary standard implants for the reconstruction of resorbed edentulous maxillae. A total of 44 zygomatic implants and 80 premaxillary implants were placed in 22 patients. All implants were stabilized at phase II surgery using a rigid bar. After soft tissues had healed, implant-supported fixed prostheses were fabricated. This article presents a preliminary report on 22 patients followed for 34 months, with a 100% success rate for the zygomatic implants and a 91.25% success rate for the premaxillary implants.