A clinical study on the 6-year outcomes of immediately loaded three implants for completely edentulous mandibles: “the all-on-3 concept”
Abstract
The
objective of the current study was to demonstrate the 6-year clinical
and radiological treatment outcomes of the technique performed by
immediately loading of three implants (single straight in the mid-line
and two tilted distal implants) for the management of total edentulous
mandibles and introduce a simple decision matrix for selection of the
most appropriate protocol in cases with insufficient length of the
interforaminal area. Re-assessments were performed over a total
observation period of 6 years after surgery via measurement of bone
resorption around implants, bleeding on probing, plaque accumulation,
periodontal probing depth, bite force measurements and oral health
impact profile. A total of 29 patients (45% women and 55% men) with a
mean age of 65 ± 6 years enrolled in the study. 14 patients received an
acryl-based bridge as definitive prosthetic restoration and 15 patients
received a ceramic-based restoration. Both during the immediate loading
phase and during the 6-year follow-up, there was no implantation loss.
Regardless of the implant position, all implants showed continuous bone
loss over the observation time. The bone loss around dental implants
during observation period was only maximum 1.0 ± 1 mm and it remained
well within the limits for ‘success’ according to the 2007 Pisa
consensus (< 2 mm). The plaque index showed no significant
fluctuations between the implant positions and the individual
examination times. The approach described herein might help the surgeon
by avoiding unnecessary loss of bone strength, selecting implant sites,
and establishing the biomechanical advantage of increased A–P spread for
immediate function.
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