Maxillary implant overdenture retained by four unsplinted attachments and opposed by a natural or fixed dentition: One‐year clinical outcomes

Objectives The aim of this prospective study was to evaluate the implant, prosthesis, and patient‐reported outcomes of maxillary removable prostheses retained by 4 implant‐supported study abutments after a follow‐up period of 1 year in patients with natural teeth or a fixed rehabilitation in the mandible. Materials and Methods A total of 30 patients were included, and all received 4 implants in the upper maxilla. After 12 weeks, the prostheses were connected to the implant with unsplinted attachments. The implant and prosthodontics outcomes were assessed over a follow‐up period of 1 year. Patient‐reported outcome measures (PROMs) were evaluated with the Oral Health Impact Profile (OHIP‐20) questionnaire and an adaptation of the McGill Denture Satisfaction Instrument using a visual analogue scale (VAS). Results A single patient dropped out. At the post‐operative 12‐week follow‐up, 79.3% (95% CI: 64.6%–94.1%) of the patients displayed peri‐implant mucosa hyperplasia and 69.0% (95% CI: 52.1%–85.8%) showed pain. After 1 year, 16 implants failed in 10 patients, leading to an implant survival rate of 86.2% (95% CI: 79.0%–92.5%), and the mean peri‐implant bone loss was 1.01 ± 0.77 mm (95% CI: 0.85–1.16 mm). The prosthesis survival rate was 96.6% (95% CI: 82.2%–99.9%). The OHIP‐20 and VAS scores both improved significantly from baseline to 1 year ( p  < .001). Conclusion The implant survival rate was lower compared to the literature for the upper maxilla. Despite the encountered problems, PROMs showed significant improvement with the implant overdenture retained by 4 unsplinted implants compared to conventional dentures.