A Systematic Review of Biologic and Technical Complications with Fixed Implant Rehabilitations for Edentulous Patients

Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA.
The International journal of oral & maxillofacial implants (Impact Factor: 1.45). 01/2012; 27(1):102-10.
Source: PubMed


The purpose of this systematic review was to assess the incidence and types of biologic and technical complications associated with implant-supported fixed complete dental prostheses (IFCDPs) for edentulous patients.
An electronic MEDLINE/PubMED search was conducted to identify randomized controlled clinical trials and prospective cohort studies with IFCDPs for edentulous patients. Reports with at least 5 years of follow-up after prosthesis insertion were selected. Pooled data were analyzed statistically, and the cumulative complication rates were calculated by meta-analysis and regression.
Of a total of 281 one-piece IFCDPs (mean exposure time of 9.5 years) and 653 complication events, the complication rate was estimated at 24.6% per 100 restoration-years. The cumulative rates of "prosthesis free of complications" after 5 and 10 years were 29.3% and 8.6%, respectively. The most common implantrelated biologic complication was peri-implant bone loss (> 2 mm), at rates of 20.1% after 5 years and 40.3% after 10 years. The most frequent implant-related technical complication was screw fracture, yielding a 5-year complication rate of 10.4% and a 10-year rate of 20.8%. The most frequent prosthesis-related biologic complication was hypertrophy or hyperplasia of tissue around the IFCDPs (13.0% and 26.0% after 5 and 10 years, respectively). The most common prosthesis-related technical complication reported with IFCDPs was chipping or fracture of the veneering material (33.3% at 5 years and 66.6% at 10 years).
Biologic and technical complications after the placement of IFCDPs occur continuously over time as a result of fatigue and stress. These events may not lead to implant/prosthetic failures, but they are significant in relation to the amount of repair and maintenance needed, time, and cost to both the clinician and patient.

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Available from: Panos Papaspyridakos, Aug 28, 2014
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    • "Although high survival rate of a fixed detachable prosthesis over a 15 year period has been reported[9], but complications do exist. Panos Papaspyridakos[10]et al did a systematic review on biological and technical complications with fixed implant rehabilitations for edentulous patients. He stated that there were both kinds of complications associated with these kinds of prosthesis. "
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    ABSTRACT: Oral rehabilitation for a patient with severe loss of alveolar bone and soft tissue resulting from severe periodontitis presents a challenge to clinicians. The use of dental implants for replacement of teeth has become a routine procedure also in the periodontally compromised patient .The presence of periodontal inflammation and periapical infection often delay the placement of bone grafts as well as dental implants. When transitioning from a failing dentition to complete-arch implant rehabilitation, significant treatment planning is required. In this report a patient with severe chronic periodontitis underwent a full mouth reconstruction with staged approach. The oral function and esthetics was restored with fixed screw retained implant supported prosthesis. However supportive periodontal therapy becomes the most important aspect for survival of complex prosthesis.
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    • "Implant loss, in the context of mechanical complications, includes of course implant fracture, which is considered a severe complication requiring extraction of the implant and its supporting bone (Snauwaert et al., 2000; Simonis et al., 2010; Gealh et al., 2011; Papaspyridakos et al., 2012). A series of recent systematic reviews, based on several clinical studies with at least 5 and 10 year follow up periods, reported a high incidence of such mechanical complications' (Pjetursson et al., 2010, 2014; Papaspyridakos et al., 2012) with a 5-year complication rate for a total number of mechanical complications ranging from 16.3% to 53.4%. Pjetursson et al. (2014) Fracture of the fixation screw is one of the most common mechanical complication, with a 5 and 10 year estimated complication rate of 9.3% and 18.5%, respectively. "
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