Immediate Rehabilitation of the Edentulous Mandible with a Definitive Prosthesis Supported by an Intraorally Welded Titanium Bar

Purpose: The aim of this prospective study was to evaluate the suitability of intraoral welding of implant frameworks to allow placement of the definitive restoration on the same day of surgery. Materials and Methods: Forty patients with an edentulous mandible were planned to be treated with a fixed restoration supported by an intraoral welded titanium bar. Definitive abutments were to be connected to the implants and then welded to a titanium bar using an intraoral welding unit. This framework was to be used as support for the definitive restoration, which was to be placed on the same day as the implants. Mean marginal bone loss and radiographically detectable alterations of the welded framework were to be assessed using periapical radiographs immediately after surgery, and at 6-, 12-, and 24-month follow-up examinations. Results: Twenty men and 20 women, with a mean age of 47.8 years (± 13.9), were consecutively treated with 160 immediately loaded implants. All implants osseointegrated. No fractures or radiographically detectable alterations of the welded frameworks were present. All implants were clinically stable at the 24-month follow-up. Mean marginal bone loss (n = 160 at all time points), assessed using 640 periapical radiographs, was 0.59 ± 0.12 mm at 6 months, 0.21 ± 0.051 mm at 12 months, and 0.11 ± 0.036 mm at 24 months. The accumulated mean marginal bone loss was 0.91 ± 0.21 mm. Conclusions: It is possible to successfully rehabilitate the edentulous mandible on the same day as implant placement surgery with a fixed definitive prosthesis supported by an intraorally welded titanium framework. Keywords: dental implants, immediate restoration, implant-supported prosthesis, titanium framework