Rate of Technical Complications in Direct and Indirect Fixed Temporary Restorations on Immediately Loaded Implants in the Edentulous Jaw

Immediate loading in the edentulous jaw with provisional bridges (pB) can lead to technical complications during the healing phase causing implant loss. In particular, fractures of the provisional in the healing phase can contribute to movement of the implants and thus endanger the osseointegration. The temporaries are often made from an existing denture in the patient's mouth (directly) or after an impression in the laboratory (indirectly). The present study compares the fracture rate of these two different provisional restorations. Material and methods: In a retrospective analysis, the fracture rate of pB was examined on immediately loaded implants in the edentulous jaw during the healing phase. The pB were either created directly from the existing total dentures or prepared indirectly in the laboratory after a postoperative impression and determining the inter-maxillary relation. Results: In 17 women and 7 men (mean age: 63 years ± 10), 11 direct and 15 indirect temporaries were analysed in 21 toothless upper and 5 lower jaws on 4 (n = 12) or 6 (n = 14) implants (n = 132). In 31% of pB (n = 8), a total of 20 fracture complications occurred after an average time of 88 ± 39 days. Both the number of implants (p = 0.597), the localisation in the respective jaw (p = 0.562) and the type of pB (p = 0.597) had no influence on the fracture probability. The distance between the individual implants (p = 0.454) or the entire length of the implant arch (p = 0.967) also had no influence on the fracture rate. Overall, 8% of the implants (n = 10) were not osseointegrated in the healing phase. In cases where fracture of pB was obtained, the implant loss rate was almost twice as high (38% vs 22%, p = 0.418). In all cases with implant loss, post-implantation was performed. Conclusion: The fracture rate of both investigated variants of the temporaries for immediate loading in the edentulous jaw appears to be very high. There are at least indications that a fracture between two implants increases the risk of implant loss during the phase of osseointegration. Keywords: Immediate loading in the edentulous jaw, implantation, provisional bridges, complications