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Complications with Computer‐Aided Designed/Computer‐Assisted Manufactured Titanium and Soldered Gold Bars for Mandibular Implant‐Overdentures: Short‐Term Observations
Author(s) -
Katsoulis Joannis,
Wälchli Julia,
Kobel Simone,
Gholami Hadi,
MericskeStern Regina
Publication year - 2015
Publication title -
clinical implant dentistry and related research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.338
H-Index - 85
eISSN - 1708-8208
pISSN - 1523-0899
DOI - 10.1111/cid.12130
Subject(s) - implant , bar (unit) , dentistry , prosthesis , materials science , mandible (arthropod mouthpart) , dental prosthesis , orthodontics , titanium , medicine , surgery , metallurgy , physics , botany , meteorology , biology , genus
Background Implant‐overdentures supported by rigid bars provide stability in the edentulous atrophic mandible. However, fractures of solder joints and matrices, and loosening of screws and matrices were observed with soldered gold bars ( G ‐bars). Computer‐aided designed/computer‐assisted manufactured ( CAD / CAM ) titanium bars ( T i‐bars) may reduce technical complications due to enhanced material quality. Purpose To compare prosthetic‐technical maintenance service of mandibular implant‐overdentures supported by CAD / CAM T i‐bar and soldered G ‐bar. Materials and Methods Edentulous patients were consecutively admitted for implant‐prosthodontic treatment with a maxillary complete denture and a mandibular implant‐overdenture connected to a rigid G ‐bar or T i‐bar. Maintenance service and problems with the implant‐retention device complex and the prosthesis were recorded during minimally 3–4 years. Annual peri‐implant crestal bone level changes (Δ BIC ) were radiographically assessed. Results Data of 213 edentulous patients (mean age 68 ± 10 years), who had received a total of 477 tapered implants, were available. Ti‐bar and G ‐bar comprised 101 and 112 patients with 231 and 246 implants, respectively. Ti‐bar mostly exhibited distal bar extensions (96%) compared to 34% of G ‐bar ( p < .001). Fracture rate of bars extensions (4.7% vs 14.8%, p < .001) and matrices (1% vs 13%, p < .001) was lower for T i‐bar. Matrices activation was required 2.4× less often in T i‐bar. Δ BIC remained stable for both groups. Conclusions Implant overdentures supported by soldered gold bars or milled CAD / CAM T i‐bars are a successful treatment modality but require regular maintenance service. These short‐term observations support the hypothesis that CAD / CAM T i‐bars reduce technical complications. Fracture location indicated that the titanium thickness around the screw‐access hole should be increased.