Maxillary Bone Resorption with Conventional Dentures and Four-Implant–Supported Fixed Prosthesis Opposed by Distal-Extension Partial Dentures: A Preliminary 5-year Retrospective Study

Purpose: The aim of this preliminary study was to evaluate maxillary bone resorption with conventional dentures and implant-supported prostheses opposed by distal-extension removable partial dentures (RPDs). Materials and Methods: Fifteen patients (seven women and eight men) with totally edentulous maxillary ridges and partially edentulous mandibular ridges (Class I Kennedy classification) received maxillary fixed prostheses on four implants and mandibular distal-extension RPDs (study group). The control group consisted of 15 patients who received conventional maxillary dentures and distal-extension mandibular RPDs without any implant treatment but were matched to the study group and acted as a historical group. Evaluation of vertical maxillary bone resorption for both groups was made at the time of prosthesis insertion (T0) and 5 years later (T2) using the proportional area measurements made on digital panoramic radiographs for anterior and posterior areas. Results: The control group showed significantly higher vertical bone loss than the test group (P .001). The control group had 0.270 higher maxillary bone loss than the test group. For both groups, anterior maxillary areas showed significantly higher bone loss than posterior areas (P .003). Anterior maxillary areas had 0.122 higher bone loss compared with posterior areas. Women had 0.035 higher maxillary bone loss compared with men. Conclusion: Within the limitations of this study, implant-supported fixed prostheses for the edentulous maxilla opposed by remaining mandibular anterior teeth reduce maxillary anterior and posterior alveolar bone loss compared with conventional dentures. However, they do not prevent maxillary bone loss. Keywords: All-on-4, bone resorption, combination syndrome, partial dentures