Restoration of Immediately Loaded Implants in a Minimal Number of Appointments: A Retrospective Study of Clinical Effectiveness

Purpose: The purpose of this study was to assess the clinical effectiveness of an experimental technique versus the conventional method for the fabrication of implant-supported fixed complete dentures. Materials and Methods: Between January 2005 and June 2010, edentulous patients who had received rehabilitation by means of nonsegmented fixed implant-supported complete dentures were identified from the pool of individuals treated at Eastman Institute for Oral Health, University of Rochester. Data collection consisted of a chart review and recording of treatment variables in a customized database. Variables of interest included number of implants per patient, time of implant placement, number of appointments required to complete prosthesis fabrication, type of appointments, manufacturing process used for creation of the framework, and fit of the framework. The number of appointments for conventional and experimental protocols was evaluated for statistical significance using two-way analysis of variance. Presence or absence of clinically acceptable prosthesis fit with the two techniques was evaluated using the Fisher exact test and exact logistic regression analysis. Results: Forty-two patients (48 arches) were included. When the experimental technique was used, prosthesis fabrication and delivery required an average of 4 appointments, whereas the conventional technique required an average of 7.8 appointments to deliver the definitive prosthesis. The prostheses fabricated with the experimental technique showed clinically passive fit on the implants in 17 of 18 arches. The frameworks fabricated with the conventional technique achieved clinically passive fit in 18 of 30 arches. Conclusions: The experimental technique significantly reduced the number of appointments required to fabricate a nonsegmented fixed implant-supported prosthesis. Moreover, this experimental technique provided clinically acceptable fit of the prosthesis in a significantly greater number of cases compared to a conventional implant elastomeric impression technique. Keywords: dental implants, edentulous mandible, edentulous maxilla, immediate loading, implant-supported prosthesis