Relationship between Radiographic Misfit and Clinical Outcomes

Full Title: Relationship between Radiographic Misfit and Clinical Outcomes in Immediately Loaded Complete-Arch Fixed Implant-Supported Prostheses in Edentulous Patients.

Journal of Prosthodontics. 2019 Aug 21. doi: 10.1111/jopr.13105.

Authors: Slauch RW, Bidra AS, Wolfinger GJ, Kuo CL.

Pi Dental Center at the Institute for Facial Esthetics, Fort Washington, PA.

Department of Reconstructive Sciences, University of Connecticut Health Center, Farmington, CT.

Department of Community Medicine and Health Care, University of Connecticut Health Center, Farmington, CT.

Abstract

PURPOSE:

To examine if an uncorrected radiographically detected immediate postoperative misfit (implant level or abutment level) in immediately loaded conversion prosthesis plays a significant role in early implant or prosthesis failure. In addition, clinical characteristics related to type of arch, implant position, type of implant, implant orientation, type of connection, and type of surgery were analyzed relative to their relationship to early implant or prosthesis failure.

MATERIALS AND METHODS:

Immediate postoperative and subsequent follow-up panoramic radiographs of 425 arches with immediately loaded complete-arch fixed implant-supported prostheses were screened in a retrospective analysis. Implants with misfit and nonmisfit within a given arch were summarized separately with respect to each clinical characteristic and the difference between misfit and nonmisfit groups was tested using a mixed-effects logistic regression model with a patient-specific random intercept. A p-value <0.05 was determined to be statistically significant.

RESULTS:

A total of 2025 implants from 311 patients were identified in the 425 arches that were screened for radiographic misfit. A total of 48 implants with misfit were found within 33 arches (23 patients) for a 2.4% prevalence rate. Among the misfit implants, two failures were documented during the healing phase for an early implant survival rate of 95.8%. Five conversion prostheses with misfit fractured during the healing phase for early prosthesis survival rate of 84.8%. None of the clinical variables analyzed were significantly associated with the misfit status (p < 0.05).

CONCLUSIONS:

The results from this retrospective study showed that misfit in immediately loaded complete-arch fixed implant-supported prostheses may not play a detrimental role in the implant survival but may affect survival of the conversion prostheses.

© 2019 by the American College of Prosthodontists.

KEYWORDS:

Dental implant; conversion prosthesis; implant survival; misfit; prosthesis survival

Read article in PDF format

Pi Dental Center, Fort Washington, PA