The growing success of dental implants provides an alternative to traditional dentures. Implant-supported fixed complete dental prostheses (IFCDPs) are changing modern dentistry and allowing for a new, innovative way to treat endentulism (toothlessness). As more dental providers move toward IFCDPs, data on both patient satisfaction and clinical outcomes are necessary.
Researchers from the University of Illinois at Chicago and a private practice in Dallas, Texas, recently performed a retrospective study published in the Journal of Oral Implantology that focused on patients’ oral health, quality of life and IFCDP complications. 37 patients with 49 prostheses participated in this study by completing a written questionnaire, attending an in-person interview and having an oral exam of their IFCDPs.
The synthetic materials contained in the IFCDPs included 22 metal-acrylic (MA), 14 retrievable crown (RC), seven monolithic zirconia (MZ) and six porcelain-veneered zirconia (PVZ). The most common complications found for each compound were: MA had posterior tooth wear; RC contained fractures and chipping; MZ contained wear of opposing restorations (wear on natural teeth); and PVZ had chipping of opposing restorations. The researchers deemed six prostheses as failures, mainly due to fracturing and chipping. This included two MA, two PVZ and two RC.
When reviewing patient questionnaires and interviews, the researchers found that the overall level of satisfaction patients had with their prostheses was high. 87% of patients were very to extremely satisfied, and 89% felt their IFCDPs “looked great.” However, the PVZ prostheses were shown to have the most negative effect on patients, while the MZ had the least. The chief complaint was functional limitation with regard to chewing, differences in speech patterns and hygiene. The researchers noted, “This leading-edge study helps clinicians recognize common problems with full arch dental implant supported prostheses, so that they can provide predictable results for patients…It is clear that patient satisfaction was closely related to patient expectations and patient education. By selecting the prosthesis that best suits each patient, and by sharing with patients the types of problems they might have, fewer complications and greater patient satisfaction with care is possible.”
This research is limited in its scope of observed complications as well as the size of the study group. The researchers are viewing it as a preliminary study and verification of outcomes needs to be conducted with a larger sample size and more real-time data, versus a retrospective analysis.
Full text of the article, “Patient-Reported and Clinical Outcomes of Implant-Supported Fixed Complete Dental Prostheses: A Comparison of Metal-Acrylic, Milled Zirconia, and Retrievable Crown Prostheses,” Journal of Oral Implantology, Vol. 44, No. 1, 2018, is available at: http://joionline.org/doi/full/10.1563/aaid-joi-D-17-00184.