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Background
Compound bridges (combined implant and natural tooth supported, CB) are still controversially discussed in dentistry. The combination of implant and natural tooth as support for fixed restorations requires specific inclusion criteria regarding the natural tooth’ vitality or periodontal health. Compound bridges are cost efficient because less implants are necessary. This study will examine whether compound bridges are a good choice compared to two implants with single crown restorations (SC).
Aims
Technical and biological complications and failures over 5 years are evaluated comparing implant-supported CBs with two SC in (1) tooth-bounded spaces with two missing teeth or (2) free-end spaces with the mesial adjacent tooth needing a restoration in a randomized controlled trial.
Methods
Forty patients were stratified first by jaw (upper and lower) and second by the anterior or posterior position of the natural abutment tooth. Pre-implant planning was performed using software and cone beam computer tomography (CBCT and Facilitate™). The implants were inserted according to a standardized procedure (SOP) using drill guides. Implants were exposed three months after insertion. Standard titanium abutments were used for both treatment arms. The frameworks were CAD/CAM-made. Either zirconia or non-precious alloy were used as framework materials. In general, the frameworks were fully veneered. All restorations were luted with glass ionomer cement. The restorations are followed at baseline and 6/ 12 / 24/ 36 and 60 months. At each follow-up visit patients are asked to state their satisfaction with the esthetical outcome using a visual analog scale (VAS, values 1 to 10).
Results
To date, all implants were inserted and all restorations seated. The mean observation time of the implants at the time being is 26.9 months. Three cases with minor chipping (repairable) of the restoration’s veneering were noted. Two single crowns had to be remade due to major chipping. One implant loss and one drop-out (suicide) occurred. Due to functional non-adaptation one restoration was redone before follow-up. Sixteen patients received zirconia frameworks and 23 non-precious alloy restorations. The VAS-values (baseline, 6m, 1y, 2y, and 3y) were statistically analyzed (IBM SPSS, version 23.0). Neither framework material nor the kind of treatment (compound bridge or single crowns) showed significant differences regarding the esthetical satisfaction (material: baseline p=0.482, 6m p=0.395, 1y p=0.894, 2y p=0.506, 3y p=0.492, treatment: baseline p=0.626, 6m p=0.710, 1y p=0.477, 2y p=0.831, 3y=0.175).
Conclusions
Up to now, implant-tooth-supported compound bridges showed no higher risk regarding biological or technical failures looking at the implants as well as the restorations. For both, CB and SC, very good esthetical results were achieved with both framework materials. After one year, a slight improvement of patient satisfaction with the esthetical outcome can be detected. A very high level of satisfaction was reached after two years lasting on after three years with no mentionable changes.
Background
Compound bridges (combined implant and natural tooth supported, CB) are still controversially discussed in dentistry. The combination of implant and natural tooth as support for fixed restorations requires specific inclusion criteria regarding the natural tooth’ vitality or periodontal health. Compound bridges are cost efficient because less implants are necessary. This study will examine whether compound bridges are a good choice compared to two implants with single crown restorations (SC).
Aims
Technical and biological complications and failures over 5 years are evaluated comparing implant-supported CBs with two SC in (1) tooth-bounded spaces with two missing teeth or (2) free-end spaces with the mesial adjacent tooth needing a restoration in a randomized controlled trial.
Methods
Forty patients were stratified first by jaw (upper and lower) and second by the anterior or posterior position of the natural abutment tooth. Pre-implant planning was performed using software and cone beam computer tomography (CBCT and Facilitate™). The implants were inserted according to a standardized procedure (SOP) using drill guides. Implants were exposed three months after insertion. Standard titanium abutments were used for both treatment arms. The frameworks were CAD/CAM-made. Either zirconia or non-precious alloy were used as framework materials. In general, the frameworks were fully veneered. All restorations were luted with glass ionomer cement. The restorations are followed at baseline and 6/ 12 / 24/ 36 and 60 months. At each follow-up visit patients are asked to state their satisfaction with the esthetical outcome using a visual analog scale (VAS, values 1 to 10).
Results
To date, all implants were inserted and all restorations seated. The mean observation time of the implants at the time being is 26.9 months. Three cases with minor chipping (repairable) of the restoration’s veneering were noted. Two single crowns had to be remade due to major chipping. One implant loss and one drop-out (suicide) occurred. Due to functional non-adaptation one restoration was redone before follow-up. Sixteen patients received zirconia frameworks and 23 non-precious alloy restorations. The VAS-values (baseline, 6m, 1y, 2y, and 3y) were statistically analyzed (IBM SPSS, version 23.0). Neither framework material nor the kind of treatment (compound bridge or single crowns) showed significant differences regarding the esthetical satisfaction (material: baseline p=0.482, 6m p=0.395, 1y p=0.894, 2y p=0.506, 3y p=0.492, treatment: baseline p=0.626, 6m p=0.710, 1y p=0.477, 2y p=0.831, 3y=0.175).
Conclusions
Up to now, implant-tooth-supported compound bridges showed no higher risk regarding biological or technical failures looking at the implants as well as the restorations. For both, CB and SC, very good esthetical results were achieved with both framework materials. After one year, a slight improvement of patient satisfaction with the esthetical outcome can be detected. A very high level of satisfaction was reached after two years lasting on after three years with no mentionable changes.
Background
Compound bridges (combined implant and natural tooth supported, CB) are still controversially discussed in dentistry. The combination of implant and natural tooth as support for fixed restorations requires specific inclusion criteria regarding the natural tooth’ vitality or periodontal health. Compound bridges are cost efficient because less implants are necessary. This study will examine whether compound bridges are a good choice compared to two implants with single crown restorations (SC).
Aims
Technical and biological complications and failures over 5 years are evaluated comparing implant-supported CBs with two SC in (1) tooth-bounded spaces with two missing teeth or (2) free-end spaces with the mesial adjacent tooth needing a restoration in a randomized controlled trial.
Methods
Forty patients were stratified first by jaw (upper and lower) and second by the anterior or posterior position of the natural abutment tooth. Pre-implant planning was performed using software and cone beam computer tomography (CBCT and Facilitate™). The implants were inserted according to a standardized procedure (SOP) using drill guides. Implants were exposed three months after insertion. Standard titanium abutments were used for both treatment arms. The frameworks were CAD/CAM-made. Either zirconia or non-precious alloy were used as framework materials. In general, the frameworks were fully veneered. All restorations were luted with glass ionomer cement. The restorations are followed at baseline and 6/ 12 / 24/ 36 and 60 months. At each follow-up visit patients are asked to state their satisfaction with the esthetical outcome using a visual analog scale (VAS, values 1 to 10).
Results
To date, all implants were inserted and all restorations seated. The mean observation time of the implants at the time being is 26.9 months. Three cases with minor chipping (repairable) of the restoration’s veneering were noted. Two single crowns had to be remade due to major chipping. One implant loss and one drop-out (suicide) occurred. Due to functional non-adaptation one restoration was redone before follow-up. Sixteen patients received zirconia frameworks and 23 non-precious alloy restorations. The VAS-values (baseline, 6m, 1y, 2y, and 3y) were statistically analyzed (IBM SPSS, version 23.0). Neither framework material nor the kind of treatment (compound bridge or single crowns) showed significant differences regarding the esthetical satisfaction (material: baseline p=0.482, 6m p=0.395, 1y p=0.894, 2y p=0.506, 3y p=0.492, treatment: baseline p=0.626, 6m p=0.710, 1y p=0.477, 2y p=0.831, 3y=0.175).
Conclusions
Up to now, implant-tooth-supported compound bridges showed no higher risk regarding biological or technical failures looking at the implants as well as the restorations. For both, CB and SC, very good esthetical results were achieved with both framework materials. After one year, a slight improvement of patient satisfaction with the esthetical outcome can be detected. A very high level of satisfaction was reached after two years lasting on after three years with no mentionable changes.
Background
Compound bridges (combined implant and natural tooth supported, CB) are still controversially discussed in dentistry. The combination of implant and natural tooth as support for fixed restorations requires specific inclusion criteria regarding the natural tooth’ vitality or periodontal health. Compound bridges are cost efficient because less implants are necessary. This study will examine whether compound bridges are a good choice compared to two implants with single crown restorations (SC).
Aims
Technical and biological complications and failures over 5 years are evaluated comparing implant-supported CBs with two SC in (1) tooth-bounded spaces with two missing teeth or (2) free-end spaces with the mesial adjacent tooth needing a restoration in a randomized controlled trial.
Methods
Forty patients were stratified first by jaw (upper and lower) and second by the anterior or posterior position of the natural abutment tooth. Pre-implant planning was performed using software and cone beam computer tomography (CBCT and Facilitate™). The implants were inserted according to a standardized procedure (SOP) using drill guides. Implants were exposed three months after insertion. Standard titanium abutments were used for both treatment arms. The frameworks were CAD/CAM-made. Either zirconia or non-precious alloy were used as framework materials. In general, the frameworks were fully veneered. All restorations were luted with glass ionomer cement. The restorations are followed at baseline and 6/ 12 / 24/ 36 and 60 months. At each follow-up visit patients are asked to state their satisfaction with the esthetical outcome using a visual analog scale (VAS, values 1 to 10).
Results
To date, all implants were inserted and all restorations seated. The mean observation time of the implants at the time being is 26.9 months. Three cases with minor chipping (repairable) of the restoration’s veneering were noted. Two single crowns had to be remade due to major chipping. One implant loss and one drop-out (suicide) occurred. Due to functional non-adaptation one restoration was redone before follow-up. Sixteen patients received zirconia frameworks and 23 non-precious alloy restorations. The VAS-values (baseline, 6m, 1y, 2y, and 3y) were statistically analyzed (IBM SPSS, version 23.0). Neither framework material nor the kind of treatment (compound bridge or single crowns) showed significant differences regarding the esthetical satisfaction (material: baseline p=0.482, 6m p=0.395, 1y p=0.894, 2y p=0.506, 3y p=0.492, treatment: baseline p=0.626, 6m p=0.710, 1y p=0.477, 2y p=0.831, 3y=0.175).
Conclusions
Up to now, implant-tooth-supported compound bridges showed no higher risk regarding biological or technical failures looking at the implants as well as the restorations. For both, CB and SC, very good esthetical results were achieved with both framework materials. After one year, a slight improvement of patient satisfaction with the esthetical outcome can be detected. A very high level of satisfaction was reached after two years lasting on after three years with no mentionable changes.