Survival and success of tooth-implant-supported and solely implant-supported double-crown-retained overdentures: A prospective study over a period of up to 11 years

Three strategies of implant placement as an abutment for combined tooth-implant-supported double crown removable partial dentures: A clinical report of three patients up to 18 years

Double crown removable partial dentures (RPDs) are suitable treatment options for patients with a significantly reduced dentition. The prognosis for these prostheses is greatly influenced by the number, position, and distribution of the abutment teeth. If the remaining natural teeth are unfavorably positioned, placing implants in strategic positions may enhance the long-term prognosis of the prosthesis. In this clinical report, 3 patients with a reduced dentition were treated with combined tooth-implant-supported double crown RPDs using a gold electroforming system. During an up to 18-year follow-up, the implants and natural abutment teeth showed no pathologic signs. By following the 3 strategies for placing supplementary implants outlined in this clinical report, the combined tooth-implant-supported double crown RPD using a gold electroforming system can be highly recommended.

Electroplated double-crowns on implants and teeth after up to 12 years- a retrospective clinical study

PURPOSE

To retrospectively evaluate the outcome of implant-supported or combined tooth-implant-supported prostheses retained by electroplated double-crowns after 1-12 years.

METHODS

Twenty-five patients were retrospectively examined in a private dental practice in Hamburg, Germany. All had been rehabilitated with a removable prosthesis retained by electroplated double-crowns, for at least one year. Fifteen patients had implant-supported prostheses and 10 had combined tooth-implant-supported prostheses in the maxilla or the mandible. Biological and technical complications were recorded at the clinical examination and extracted from the patient records. Kaplan-Meier implant and tooth survival rates were calculated. Potential risk factors for severe complications were identified. Oral health-related quality of life (OHRQoL) was measured by a short version of the Oral Health Impact Profile (OHIP) questionnaire. Patients reported subjective chewing function using a visual analogue scale.

RESULTS

Kaplan-Meier survival rates were 100% for natural abutments and 90.9% for implants after 11.8 years (p = 0.54). Two implants in two patients were lost at 8 and 9 years due to peri-implantitis in the "solely implant" group. The most common complications were decementation of primary crowns and wear of the prosthetic teeth. The mean OHIP score for the group "tooth-implant-supported" was 5.2 ± 5.0, whereas the mean score for the "solely implant" group was 1.7 ± 2.9 (p = 0.039). Patients rated their subjective masticatory function very high with an average score of 9.4 ± 0.8 out of a possible 10.

CONCLUSIONS

Implant-supported or combined tooth-implant-supported prostheses retained by electroplated double-crowns are a viable method of treatment with a satisfactory outcome. Maintenance has been manageable and patients have reported very good subjective chewing function after several years of function.

Mid-term survival and complications of double-crown-retained removable dental prostheses placed in the dental practice - a retrospective study

OBJECTIVES

Clinical data on the performance of double-crown-retained removable dental prostheses (dcRDPs), especially beyond university studies, are rare. The objective of this retrospective clinical study was to evaluate the survival and complication-freeness probabilities of dcRDPs and to identify risk factors for failure and complications in a dental practice setting.

MATERIALS AND METHODS

Anonymized practice data of 174 patients (56.9% female) fitted with a total of 213 dcRDPs (mean of 3.3 abutment teeth per dcRDP) were evaluated up to 11 years after prothesis placement (mean observation time of 3.9 years). Probabilities of survival and complication freeness were calculated on the prosthesis- and abutment level and visualized using the Kaplan-Meier method. Factors influencing failure and complications were computed using Cox regression analyses (R Ver. 7; alpha < 0.05).

RESULTS

During our observation period, 39 (18%) of the dcRDPs failed. The mean (95% CI) overall survival was 94% (90-97%) after 2 years and 86% (80-92%) after 5 years. DcRDP survival correlated with lower patient age and more abutment teeth (P < 0.05), while other analyzed factors did not. The probability of absence of prosthesis-related complications was 92% after 2 years and 80% after 5 years. The probability of no technical complications of abutments (teeth/implants) was 85% after 2 years and 78% after 5 years, and the probability of no biological complications was 87% after 2 years and 72% after 5 years. In total, 141 dcRDPs (66.2%) faced at least one complication during the observation period.

CONCLUSIONS

Double-crown-retained prostheses fitted in a dental practice had acceptable mid-term survival rates and common technical and biological complications that were frequently easily manageable. However, prosthesis performance depended on the quality and number of abutment teeth/implants. Within the limitations of this retrospective analysis, the outcomes we observed in a dental practice are comparable to, albeit slightly worse than, those found in university studies.

CLINICAL RELEVANCE

Evaluation of the clinical performance of dcRDPs fitted in a dental practice is important to estimate durability and complication patterns in order to weigh treatment decisions.

Double crown removable partial denture for a patient with ectodermal dysplasia: A clinical report after 31 years

This clinical report describes the prosthodontic management of a 5-year-old boy with ectodermal dysplasia who had been followed for 31 years. During the first 15 years, several interim removable overdentures were fabricated and modified according to his skeletal growth. At age 20, after the completion of jaw development, 4 endosseous dental implants were inserted in the mandible with a nerve repositioning procedure. After a 6-month healing period, maxillary and mandibular double crown removable partial dentures (RPDs) using a gold electroforming system were delivered. In the 16 years since delivery, the implants and abutment teeth have shown no pathologic signs. The double crown RPDs supported by implants and natural teeth were found to be an effective, long-term stable treatment option for this patient with hypodontia. The authors are unaware of a longer follow-up period of dental rehabilitation in a patient with ectodermal dysplasia providing satisfactory functional and esthetic results.

Cumulative 10-year performance of endodontically treated teeth with prosthetic restorations of base metal alloy double crowns with friction pins-a retrospective study

OBJECTIVES

This 120-month follow-up study aimed to investigate the complication rate of abutment teeth after endodontic pretreatment with base metal alloy double crowns with friction pins.

MATERIALS AND METHODS

A total of 158 participants (n = 71, 44.9% women) aged 62.5 ± 12.7 years with 182 prostheses on 520 abutment teeth (n = 459, 88.3% vital) were retrospectively analyzed between 2006 and 2022. Of the endodontically treated abutment teeth, 6.9% (n = 36) were additionally treated with post and core reconstructions. Cumulative complication rates were calculated using the Kaplan-Meier estimator and log-rank test. In addition, Cox regression analysis was performed.

RESULTS

The cumulative complication rate at 120 months for the entire set of abutment teeth was 39.6% (confidence interval [CI]: 33.0-46.2). Endodontically treated abutment teeth (33.8%; CI: 19.6-48.0) were found to have a significantly higher cumulative fracture rate than vital teeth (19.9%; CI: 13.9-25.9, p < 0.001). Endodontically treated teeth restored with post and core reconstructions (30.4%; CI: 13.2-47.6) showed a nonsignificant lower cumulative fracture rate than that of teeth with root fillings only (41.6%; CI: 16.4-66.8, p = 0.463).

CONCLUSIONS

Higher 120-month cumulative fracture rates were observed in endodontically treated teeth. Comparable performance was observed in teeth with post and core reconstructions compared to teeth with root fillings only.

CLINICAL RELEVANCE

If endodontically treated teeth are used as abutments for double crowns, the risk of complications from these teeth should be considered when planning treatment and communicating with the patient.

Ten-year clinical performance of non-precious metal double crowns with friction pins in severely reduced dentitions—a retrospective study

Objectives

This follow-up study aimed at collecting long-term data for removable partial dentures (RPDs) retained by double crowns with spark-eroded friction pins (DCP) and comparing them in the presence of severely reduced dentition (SRD) and non-SRD (NSRD, i.e. residual dentition with more than three abutment teeth) after a 10-year wearing period.

Materials and methods

A total of 158 participants (n = 71, 44.9% women) aged 62.5 ± 12.7 years with 182 prostheses on 520 abutment teeth were followed up between 2006 and 2022. The SRD group included 144 RPDs supported by 314 abutment teeth. The data collection was performed retrospectively. 10-year survival rates of RPDs and abutment teeth were determined using the Kaplan–Meier method and compared using the log-rank test for SRD and NSRD, among others. Cox regression analyses were conducted to isolate risk factors for the survival of both RPDs and abutment teeth.

Results

The 10-year cumulative survival rate of all abutment teeth was 65.6% with significantly lower values in the SRD group (53.5%) (p < 0.001). The survival rate for all RPDs was 65.5%. The SRD group showed lower survival rates (57.9%) (p = 0.004). The number and location of the abutment teeth had a significant influence on the survival rates of the RPDs and the abutment teeth. Age, sex, jaw, relining, and vitality had a significant influence on the abutment teeth survival rates.

Conclusions

RPDs showed an acceptable clinical survival rate after 10 years. The number, location, and vitality of abutment teeth were factors that influenced the survival of both RPDs and abutment teeth.

Clinical relevance

Consideration of the influencing factors found can help improve the prognostic assessment of double crown-retained dentures in the context of prosthetic therapy planning.

Should the vent hole of posterior implant crowns be placed on the lateral surface? An in vitro study of the hydrodynamic feature of cement extrusion and retention ability

Although placing a vent hole on the occlusal surface of the implant crown can reduce cervical marginal cement extrusion, it has disadvantages. Transferring the hole to the buccal or lingual surface of the posterior implant crown could therefore be an alternative solution. This study investigated the effect of transferring the vent hole to the lateral side of the implant posterior crown on the hydrodynamics of excess cement extrusion and the crown’s retention ability. Specially fabricated posterior implant crowns were divided into five groups: crowns with an occlusal hole (OH), occlusal lateral hole (OLH), middle lateral hole (MLH), cervical lateral hole (CLH), and no hole (NH). Each set of implant analog-abutment-crown specimens was wrapped in a polymethylacrylate base. The base of the implant crown was divided into four 90-degree quadrants along the diagonal of the square base with a pen mark. Cement was used to bond the crowns and the abutments, and the weight of cement extrusions at the vent holes and the abutment cervical margins were calculated. The distribution of cement extrusion at the margin was photographed in each quadrant, and the areas of surface coverage of cement extrusion were compared with ImageJ software. Retentive strength was measured as the dislocation force using a universal testing machine. One-way analysis of variance was used for result analysis. The cervical marginal cement extrusions of crowns with lateral holes (OLH, MLH, and CLH) were significantly less than that of NH crowns (P<0.05), but more than that of OH crowns (P<0.05). Subgroup analysis among the lateral hole groups indicated that the higher the position of the lateral hole, the lower the weight of the cement extrusion, and the smaller the total distribution area of cement extrusion. The cement extrusion distribution area was larger in the quadrant with the hole than in those opposite and next to the hole. Retention strength comparison indicated no significant difference between crowns with NH, OH, or lateral holes. Transferring the vent hole of the posterior implant crown to the lateral side could reduce cement extrusion at the cervical margin while reducing retention strength deterioration and the esthetic drawbacks caused by occlusal hole opening.

Maxillary Sinus Osteoma as a Support for Dental Implant Associated to Sinus Augmentation Procedure: A Case Report and Literature Review

Background: Maxillary sinus augmentation is a method extensively used to restore sufficient bone volume in the posterior maxilla to allow for the placement of fixtures. The purpose of the present case report was to describe a rare case of sinus osteoma used for implant support and to review the relevant literature. Materials and Methods: A 58-year-old man with a radiopaque intrasinusal lesion was referred for rehabilitation of the maxilla. The lesion was probably an osteoma and involved the nasal wall of the maxillary sinus. After discussing the options with the patient, he agreed to maintain the lesion and a sinus augmentation with a bone graft. A part of the osteoma was partially removed for histological analysis while avoiding perforation or tearing of the schneiderian membrane. After six months, 6 implants (Bone System Implant, Milano, Italy) were placed in the maxilla, two of which were inserted in the osteoma. Results: The two implants placed in the osteoma were perfectly osseointegrated. The graft material appeared well-integrated with no local signs of inflammation. No postoperative events or symptoms were reported after the surgery stages and at a 6-month follow-up. Regarding the two implants placed in the osteoma: article selection identified 9 case reports, 2 case series, and 1 retrospective study for a total of 58 subjects, 35 males and 25 females. The patients’ ages were heterogeneous and ranged between 12 and 79 years old. Conclusions: In the present case, we decided to leave the osteoma because it was asymptomatic and used as dental implant support. The effectiveness of the present investigation can provide useful guidance for surgeons and dentists in the management of similar clinical situations.