Laser-welded titanium frameworks supported by implants in the partially edentulous mandible: a 10-year comparative follow-up study.

BACKGROUND

Comparative long-term knowledge of different framework materials in the partially edentulous implant patient is not available.

PURPOSE

To report and compare 10-year data on free-standing implant-supported partial prostheses with laser-welded titanium (test) and conventional gold alloy (control) frameworks.

MATERIALS AND METHODS

Altogether, 52 partially edentulous patients were consecutively provided with laser-welded prostheses (n = 60) in the partially edentulous lower jaw (test group). A control group of 52 randomly selected patients with gold alloy castings (n = 60) was used for comparison. Clinical and radiographic 10-year data were retrospectively collected and evaluated for both groups.

RESULTS

The overall 10-year implant cumulative survival rate (CSR) was 93.0% (loaded implants, 96.4%), with a 10-year implant CSR of 91.5 and 94.7% for test and control implants, respectively (p > .05). Out of a total of 22 lost implants, 17 implants (77.3%) were shorter than 10 mm. The overall 10-year prosthesis CSR was 93.7%, with a corresponding 10-year CSR of 88.4 and 100% for test and control groups, respectively (p < .05). Average 10-year bone loss was 0.46 mm (SD 0.47) and 0.69 mm (SD 0.53) for the test and control groups (p < .001), respectively. Only 1% of the implants had >3 mm accumulated bone loss after 10 years. Altogether, 10 of the prostheses in both groups had implant component mechanical problems (8.3%). None of the frameworks or implants fractured, but more fractures of porcelain veneers were observed in the test group (p < .05).

CONCLUSION

The protocol of implant treatment in the partially edentulous jaw functioned well during 10 years, although prosthodontic maintenance was required. However, laser-welded titanium frameworks presented more problems as compared with gold alloy frameworks. More loaded implants were lost (p < .05), and higher incidence of porcelain chipping was noted in the test group (p < .05). However, bone loss was on an average lower for the test group during the 10 years of follow-up (p < .001).