Complications and patient-centered outcomes with an implant-supported monolithic zirconia fixed dental prosthesis: 1 year results

摘要

Purpose: To characterize the number and type of complications that occur with a monolithic zirconia fixed dental prosthesis (MZ-FDP) supported by four endosseous implants in the edentulous mandible over time and to quantify the impact of treatment on oral health quality of life (OHQoL). Methods: Seventeen edentulous participants were enrolled. New conventional dentures were fabricated for each participant. Four Astra Tech Osseospeed TX implants (Dentsply) were then placed in the parasymphyseal mandible, and after a period of healing, a full-arch monolithic zirconia prosthesis (Zirkonzahn) was inserted. Complication data were recorded and OHQoL was evaluated using the Oral Health Impact Profile (OHIP-49), administered on four occasions: enrollment; implant surgery; and 6- and 12-month recalls. Results: Sixty-eight implants were placed in 17 edentulous individuals aged 30 to 78 (mean 57.9 years). Implant survival was 94% from the subject perspective and 99% from the implant perspective. Prosthesis survival was 88%. Twelve complications occurred in ten participants, whereas seven participants remained complication free. Both OHIP-49 severity and extent scores decreased significantly between enrollment and 12-month recall (p < 0.001). The mean OHIP-49 severity score at baseline was 94.8 (95% confidence interval [CI]: 73.9, 115.8) and declined an average of 76.8 (95% CI: -91.3, -62.3) units per participant. The mean OHIP-49 extent score at baseline was 17.2 (95% CI: 10.8, 23.6) and declined 16.3 (95% CI: -20.2, -12.4) units per participant on average. Conclusions: Implant survival was high, and few complications related to the MZ-FDP were observed. The most common prosthetic complication was tooth chipping in the opposing maxillary denture, which accounted for 50% of all complication events. Substantial and clinically important improvements in OHQoL were achieved with both conventional dentures and the implant-supported MZ-FDP. The data of this short-term study indicate that the implant-supported MZ-FDP is a therapeutic option with particular advantages in the edentulous mandible that warrants further long-term study.