Implant treatment in the edentulous maxillae: a 15-year follow-up study on 76 consecutive patients provided with fixed prostheses.

BACKGROUND Few long-term follow-up studies are available on implant treatment based on patient level data related to time. PURPOSE The aim of this study was to report 15-year patient-based data in relation to time of follow up after treatment with fixed prostheses supported by implants in the edentulous upper jaw. MATERIALS AND METHODS Seventy-six edentulous consecutive patients, provided with 450 turned Brånemark implants, were followed up with regard to maintenance, complications, and radiographs taken during the follow-up period. RESULTS Forty-four patients provided with 247 implants were lost to follow up. Patients followed up for 15 years showed as a group a trend of better implant survival than patients lost to follow up (p > .05). Altogether, 37 implants and 5 fixed prostheses failed during the follow-up period. Most implants were lost at abutment surgery (n- 15) and another nine during the first year of function. The 15-year implant and fixed prosthesis cumulative survival rate was 90.9 and 90.6%, respectively. Resin veneer fractures caused most problems, more frequent in the earlier stage while severe wear increased in the later stage of follow up. No implant fractures or loosening of abutment/bridge locking screws were noted. The mean marginal bone loss was 0.5 mm (SD 0.47) after 5 years, followed by only minimal average changes during the following years. No radiographic parameter showed any time-dependent relationship. The percentage of patients presenting at least one implant with more than 2.0-mm bone loss was 4.9% in the interval from 0 to 5 years and 4.0% between 10 and 15 years. Only 1.3% of implants showed >3.0 mm accumulated bone loss after 15 years. CONCLUSION Implant treatment in the edentulous upper jaw functions well in a 15-year time perspective, but an insignificant trend of higher implant failures was observed for patients lost to follow up. Besides wear and fractures of veneers, no other parameter showed any time-related relationship, indicating an increased risk for more complications during later stages of follow up. However, accumulation of smaller amount of bone loss during the years resulted in an increasing number of implants and patients with bone levels below the third thread, which could be speculated to increase future maintenance after 15 years.

[1]  G. Carlsson,et al.  Long-term marginal periimplant bone loss in edentulous patients. , 2000, The International journal of prosthodontics.

[2]  T Jemt,et al.  A prospective 15-year follow-up study of mandibular fixed prostheses supported by osseointegrated implants. Clinical results and marginal bone loss. , 1996, Clinical oral implants research.

[3]  T. Magnusson,et al.  Complications after treatment with implant-supported fixed prostheses: a retrospective study. , 2003, The International journal of prosthodontics.

[4]  A. Hugoson,et al.  A prospective longitudinal study on periodontal bone height changes in a Swedish population. , 2000, Journal of clinical periodontology.

[5]  U. Lekholm,et al.  Prevalence of subjects with progressive bone loss at implants. , 2005, Clinical oral implants research.

[6]  Carlsson Ge,et al.  Ten-year longitudinal study of masticatory function in edentulous patients treated with fixed complete dentures on osseointegrated implants. , 1994 .

[7]  T Albrektsson,et al.  Current interpretations of the osseointegrated response: clinical significance. , 1993, The International journal of prosthodontics.

[8]  J. Wennström,et al.  Periodontal conditions of adult regular dental care attendants. A 12-year longitudinal study. , 1993, Journal of clinical periodontology.

[9]  T. Jemt.  Failures and complications in 391 consecutively inserted fixed prostheses supported by Brånemark implants in edentulous jaws: a study of treatment from the time of prosthesis placement to the first annual checkup. , 1992, The International journal of oral & maxillofacial implants.

[10]  P I Brånemark,et al.  A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. , 1981, International journal of oral surgery.

[11]  T Jemt,et al.  Early failures in 4,641 consecutively placed Brånemark dental implants: a study from stage 1 surgery to the connection of completed prostheses. , 1991, The International journal of oral & maxillofacial implants.

[12]  V. Baelum,et al.  Implant survival in periodontally compromised patients. , 2004, Journal of periodontology.

[13]  P. Glantz,et al.  Quality of fixed prosthodontics after 15 years. , 1993, Acta odontologica Scandinavica.

[14]  Torsten Jemt,et al.  Implant treatment in the edentulous mandible: a prospective study on Brånemark system implants over more than 20 years. , 2003, The International journal of prosthodontics.

[15]  P. Axelsson,et al.  Some risk factors for periodontal bone loss in 50-year-old individuals. A 10-year cohort study. , 2004, Journal of clinical periodontology.

[16]  P. Branemark,et al.  Long-term follow-up of severely atrophic edentulous mandibles reconstructed with short Brånemark implants. , 2000, Clinical implant dentistry and related research.

[17]  J. Valderhaug.  A 15-year clinical evaluation of fixed prosthodontics. , 1991, Acta odontologica Scandinavica.

[18]  D. Brocard,et al.  A multicenter report on 1,022 consecutively placed ITI implants: a 7-year longitudinal study. , 2000, The International journal of oral & maxillofacial implants.

[19]  L. Rasmusson,et al.  A 10-year follow-up study of titanium dioxide-blasted implants. , 2005, Clinical implant dentistry and related research.

[20]  P. Branemark,et al.  Long-term follow-up study of osseointegrated implants in the treatment of totally edentulous jaws. , 1990, The International journal of oral & maxillofacial implants.

[21]  U. Lekholm,et al.  Implant treatment in edentulous maxillae: a 5-year follow-up report on patients with different degrees of jaw resorption. , 1995, The International journal of oral & maxillofacial implants.

[22]  L Hollender,et al.  Radiographic evaluation of osseointegrated implants of the jaws. Experimental study of the influence of radiographic techniques on the measurement of the relation between the implant and bone. , 1980, Dento maxillo facial radiology.

[23]  G Zarb,et al.  The long-term efficacy of currently used dental implants: a review and proposed criteria of success. , 1986, The International journal of oral & maxillofacial implants.

[24]  S. Karlsson,et al.  Success rate and failures for fixed partial dentures after 20 years of service: Part I. , 1998, The International journal of prosthodontics.

[25]  G. Carlsson,et al.  Association between Marginal Bone Loss around Osseointegrated Mandibular Implants and Smoking Habits: A 10-year Follow-up Study , 1997, Journal of dental research.