Immediate definitive rehabilitation of the edentulous patient using an intraorally welded titanium framework: A 3-year prospective study

Objective: The aim of this prospective study was to evaluate the concept of intraoral welding as a suitable technique for the placement of a final restoration in the edentulous patient on the same day as surgery. Method and Materials: Any patient with a completely edentulous arch who was considered eligible received a fixed restoration supported by an intraorally welded titanium bar. Definitive abutments were connected to the implants and then welded to a titanium bar using an intraoral welding unit. This framework was used to support the definitive acrylic restoration, which was fitted on the same day as implant placement. Restoration and implant success, mean marginal bone loss, pocket probing depth, and bleeding on probing were assessed over a 36-month follow-up period. Results: Twenty-six patients with an edentulous maxilla and 34 patients with an edentulous mandible, with a mean age of 57.1 years (SD = 17.9, n = 60), were consecutively treated with 324 immediately loaded implants. No fractures or radiographically detectable alteration of the welded framework was evident. A total of 321 (99.1%) implants osseointegrated and were clinically stable at the 6-month follow-up. At the 36-month follow-up, the accumulated mean marginal bone loss was, respectively, 0.967 mm (SD = 0.361) for the maxillary cases and 1.016 mm (SD = 0.413) for the mandibular cases. Conclusions: It is possible on the same day of surgery to successfully rehabilitate the edentulous patient with a fixed definitive prosthesis supported by an intraorally welded titanium framework. Keywords: implant dentistry, osseointegration, prosthodontics