Immediate Loading of Tooth-Implant-Supported Telescopic Mandibular Prostheses

Purpose: Extractions in partially edentulous patients often lead to insufficient stability of an existing partial prosthesis and a need for additional anchorage. Implants may therefore be placed as supplementary abutments to increase patient comfort and satisfaction. The aim of this study was to evaluate the longterm clinical outcome of implants combined with teeth to support telescopic abutment-retained removable full-arch prostheses under an immediate functional loading protocol. Materials and Methods: The present retrospective study included implants placed and connected via removable prostheses with periodontally healthy teeth immediately postplacement using prefabricated abutments. Secondary copings, precisely fit to the abutments, were placed and the partial dentures were relined chairside. The prosthetic restorations were not removed for 10 days. Clinical and radiographic evaluations of implants loaded for at least 2 years were performed. Results: One hundred ten implants with a progressive thread design (Ankylos, Dentsply) were placed in 55 patients (mean age, 63.51 ± 9.95 years). Twenty-five implants were placed in fresh extraction sockets (22.73%) and 85 implants were placed in healed ridges. All implants were placed 2 to 3 mm subcrestally (measured from the midfacial bone level). After a mean follow-up of 61.58 ± 28.47 months (range, 24 to 125 months), there were only three failures (2.73%); another six implants (5.45%) displayed crestal bone loss greater than 2 mm but remained stable. Therefore, the failure rate was 8.18% for the entire observation period of 5.13 years. The success rate was 91.82% and the cumulative survival rate was 97.27%. All patients were satisfied with the stability of their prostheses, and no prosthetic, peri-implant, or abutment tooth problems were observed. Conclusions: Telescopic tooth-implant-supported mandibular restorations with immediate loading present an alternative prosthetic solution for partially edentulous patients, providing a long-term predictable clinical outcome. Parole chiave: dental implants, partial edentulism, prosthesis, telescopic attachments