AIM: This systematic review enumerated the criteria used to determine the survival and success of the rehabilitation of the immediately loaded completely edentulous maxilla with surgically guided implant placement and restoration via fixed prostheses. By identifying these variables, the authors of this review hope to propose a new set of criteria that addresses current expectations of success and facilitates a better comparison of rehabilitation protocols.
MATERIALS AND METHODS: The electronic databases PubMed and ScienceDirect were searched for clinical studies of restoration of complete maxillary implant supported fixed dental prostheses. The analysis was confined to prospective studies with a minimum follow-up of 3 years and a minimum number of 10 patients published prior to June 24th, 2021.
RESULTS: An initial total of 781 publications was screened from the database searches. After further screening by title and abstract using PRISMA protocol and defined inclusion/exclusion criteria, nine (9) articles were reviewed. Analysis for survival and success criteria resulted in the following:
1. It was difficult to define a conclusion from the selected articles since there was little uniformity as to study design and the criteria used to evaluate the data.
2. High implant and implant supported fixed prosthesis survival could be achieved in the short-term (less than 5 years) when at least 4 implants were placed.
3. The type of surgical guide used for implant placement did not affect the survival and success of implants and implant supported fixed prostheses.
4. Immediate loading of the prostheses did not affect the success and survival of implant and implant supported fixed prostheses.
5. Widely accepted and reproducible criteria should be established to facilitate a better comparison of future materials, rehabilitation protocols.
6. The author proposes the following:
Proposed Success Criteria (Ramesh 2023)
Successful (Optimal Health):
1. No pain or tenderness associated with function
2. 0 mobility
3. Radiographic bone loss of 20% or less of implant length from initial surgery
4. No bleeding on probing or exudate
5. <4 mild/moderate complications
Satisfactory:
1. No pain associated with function
2. 0 mobility
3. Radiographic bone loss 20-40% of implant length
4. Peri-implant mucositis
Compromised:
1. May have sensitivity associated with function
2. 0 mobility
3. Radiographic bone loss >40% of implant length
4. Peri-implantitis
Failed (clinical or absolute failure):
Any of the following:
1. Pain associated with function
2. Mobility
3. Uncontrolled exudate
4. No longer in mouth
5. Non-restorable
*This criteria borrows concepts from the Pisa Consensus 200
7. The following list of considerations is necessary to include in all future implant study designs.
Proposed necessary factors:
1. Standardized protocols
a. Guide design
b. Guide fabrication
c. Defining conventional versus other methods
2. Maintenance intervals
a. Recall with yearly data collection
b. Maintenance visits (at least twice yearly)
3. Individual implant review findings
4. Consistent follow up (as previously defined on page 41)
a. Must include all the necessary variables to determine implant success
5. Implant location
a. Anterior: cuspids and forward
b. Posterior: bicuspids and back
6. Implant details - brand, length, diameter
7. Prosthesis design and fabrication, dictated by existing or regenerated bone base
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/46281 |
| Date | 30 May 2023 |
| Creators | Ramesh, Nivedhitha |
| Contributors | Price, Albert M |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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