Extraction of remaining teeth and same day loading of Neoss Proactive dental implants with a full-arch fixed provisional bridge. A survival analysis.

Abstract

Removal of remaining teeth and same day loading of an implant-supported full-arch bridge may be a sensible treatment modality for many patients presenting with a severely diseased partial dentition. The aim of the present study was to retrospectively analyse 30 consecutive patients (21 female/ 9 male, mean age 61.9 + 11.1 years) subjected to removal of all remaining teeth, placement of four to six implants and loading of a full-arch provisional bridge the same day. A total of 156 dental implants (Proactive Straight, Neoss Ltd, Harrogate, UK) 3.5 to 5 mm in diameter and 9 to 13 mm in lengths were placed in 21 maxillae and 14 mandibles. Provisional acrylic bridges were fabricated in the in-house dental laboratory and fitted after a few hours from the surgical procedures using screw retention. The fabrication of the definitive prostheses was initiated between three to six months from the implant placement. A total of four implants failed in three patients during the initial healing period with provisional bridges in place, giving a cumulative survival rate of 97.3 % during a mean follow-up period of 3.5 + 1.0 years (range 2–5 years). Two failures occurred in the maxilla as a result of fracture of the provisional bridge and two in the mandible due to infection. These three patients had new implants placed and could maintain the repaired or a new provisional bridge during the additional healing period. A total of seven provisional acrylic bridges fractured. No implant failures were observed after placement of the permanent fixed bridges. Few minor other complications occurred during the follow-up. It is concluded that the evaluated treatment concept resulted in a high implant survival rate and few complications after a follow-up of 2 to 5 years. Although not quantified, the positive effects on self-esteem and psychosocial well being was obvious.