Implant-supported overdentures with different bar designs: A retrospective evaluation after 5-19 years of clinical function
Identifieur interne : 000310 ( Pmc/Corpus ); précédent : 000309; suivant : 000311Implant-supported overdentures with different bar designs: A retrospective evaluation after 5-19 years of clinical function
Auteurs : Sven Rinke ; Hajo Rasing ; Nikolaus Gersdorff ; Ralf Buergers ; Matthias RoedigerSource :
- The Journal of Advanced Prosthodontics [ 2005-7806 ] ; 2015.
Abstract
This retrospective study evaluated the outcome of implant-retained overdentures (IODs) after 5-19 years of clinical function.
A retrospective analysis of patient files was performed referring to 27 patients who received 36 IODs with 3 different bar designs (group A=prefabricated round bars, n=7; group B=one-piece anterior milled bars, n=20; and group C=two bilaterally placed milled bars, n=9) in the mandible (n=24) and/or in the maxilla (n=12). The analysis focused on the survival and success rates (according to Kaplan-Meier) of the implants and prostheses. Technical complication rates for each type of restoration were analyzed and compared via one-way ANOVA and the Chi-squared test. The prevalence of peri-implantitis (radiographic bone loss ≥3.5 mm) was evaluated by digital analysis of panoramic radiographs taken post-operative (baseline) and after 5-19 years of clinical function (follow-up).
The mean observational time was 7.3 years. The survival rates of the prostheses and implants were 100% and 97.7%, respectively. Technical complications occurred more frequently in group A (mean: 3.5 during observational time) than in the other two groups (B: 0.8; C: 1.0). However, this difference was not statistically significant (
Bar-retained IODs are an adequate treatment option for edentulous jaws. These restorations may exhibit high implant/prosthesis survival rates (>97%), and a limited incidence of technical complications after a mean observational period of >7 years. Nevertheless, peri-implantitis was identified as a frequent and serious biological complication for this type of reconstruction.
Url:
DOI: 10.4047/jap.2015.7.4.338
PubMed: 26330982
PubMed Central: 4551791
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Implant-supported overdentures with different bar designs: A retrospective evaluation after 5-19 years of clinical function</title><author><name sortKey="Rinke, Sven" sort="Rinke, Sven" uniqKey="Rinke S" first="Sven" last="Rinke">Sven Rinke</name><affiliation><nlm:aff id="A1">Department of Prosthodontics, Georg-August-University, Goettingen, Germany.</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Private Practice, Hanau, Germany.</nlm:aff></affiliation></author><author><name sortKey="Rasing, Hajo" sort="Rasing, Hajo" uniqKey="Rasing H" first="Hajo" last="Rasing">Hajo Rasing</name><affiliation><nlm:aff id="A1">Department of Prosthodontics, Georg-August-University, Goettingen, Germany.</nlm:aff></affiliation></author><author><name sortKey="Gersdorff, Nikolaus" sort="Gersdorff, Nikolaus" uniqKey="Gersdorff N" first="Nikolaus" last="Gersdorff">Nikolaus Gersdorff</name><affiliation><nlm:aff id="A1">Department of Prosthodontics, Georg-August-University, Goettingen, Germany.</nlm:aff></affiliation></author><author><name sortKey="Buergers, Ralf" sort="Buergers, Ralf" uniqKey="Buergers R" first="Ralf" last="Buergers">Ralf Buergers</name><affiliation><nlm:aff id="A1">Department of Prosthodontics, Georg-August-University, Goettingen, Germany.</nlm:aff></affiliation></author><author><name sortKey="Roediger, Matthias" sort="Roediger, Matthias" uniqKey="Roediger M" first="Matthias" last="Roediger">Matthias Roediger</name><affiliation><nlm:aff id="A1">Department of Prosthodontics, Georg-August-University, Goettingen, Germany.</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26330982</idno><idno type="pmc">4551791</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4551791</idno><idno type="RBID">PMC:4551791</idno><idno type="doi">10.4047/jap.2015.7.4.338</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000310</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000310</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Implant-supported overdentures with different bar designs: A retrospective evaluation after 5-19 years of clinical function</title><author><name sortKey="Rinke, Sven" sort="Rinke, Sven" uniqKey="Rinke S" first="Sven" last="Rinke">Sven Rinke</name><affiliation><nlm:aff id="A1">Department of Prosthodontics, Georg-August-University, Goettingen, Germany.</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Private Practice, Hanau, Germany.</nlm:aff></affiliation></author><author><name sortKey="Rasing, Hajo" sort="Rasing, Hajo" uniqKey="Rasing H" first="Hajo" last="Rasing">Hajo Rasing</name><affiliation><nlm:aff id="A1">Department of Prosthodontics, Georg-August-University, Goettingen, Germany.</nlm:aff></affiliation></author><author><name sortKey="Gersdorff, Nikolaus" sort="Gersdorff, Nikolaus" uniqKey="Gersdorff N" first="Nikolaus" last="Gersdorff">Nikolaus Gersdorff</name><affiliation><nlm:aff id="A1">Department of Prosthodontics, Georg-August-University, Goettingen, Germany.</nlm:aff></affiliation></author><author><name sortKey="Buergers, Ralf" sort="Buergers, Ralf" uniqKey="Buergers R" first="Ralf" last="Buergers">Ralf Buergers</name><affiliation><nlm:aff id="A1">Department of Prosthodontics, Georg-August-University, Goettingen, Germany.</nlm:aff></affiliation></author><author><name sortKey="Roediger, Matthias" sort="Roediger, Matthias" uniqKey="Roediger M" first="Matthias" last="Roediger">Matthias Roediger</name><affiliation><nlm:aff id="A1">Department of Prosthodontics, Georg-August-University, Goettingen, Germany.</nlm:aff></affiliation></author></analytic><series><title level="j">The Journal of Advanced Prosthodontics</title><idno type="ISSN">2005-7806</idno><idno type="eISSN">2005-7814</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>PURPOSE</title><p>This retrospective study evaluated the outcome of implant-retained overdentures (IODs) after 5-19 years of clinical function.</p></sec><sec><title>MATERIALS AND METHODS</title><p>A retrospective analysis of patient files was performed referring to 27 patients who received 36 IODs with 3 different bar designs (group A=prefabricated round bars, n=7; group B=one-piece anterior milled bars, n=20; and group C=two bilaterally placed milled bars, n=9) in the mandible (n=24) and/or in the maxilla (n=12). The analysis focused on the survival and success rates (according to Kaplan-Meier) of the implants and prostheses. Technical complication rates for each type of restoration were analyzed and compared via one-way ANOVA and the Chi-squared test. The prevalence of peri-implantitis (radiographic bone loss ≥3.5 mm) was evaluated by digital analysis of panoramic radiographs taken post-operative (baseline) and after 5-19 years of clinical function (follow-up).</p></sec><sec><title>RESULTS</title><p>The mean observational time was 7.3 years. The survival rates of the prostheses and implants were 100% and 97.7%, respectively. Technical complications occurred more frequently in group A (mean: 3.5 during observational time) than in the other two groups (B: 0.8; C: 1.0). However, this difference was not statistically significant (<italic>P</italic>=0.58). Peri-implantitis was diagnosed for 12.4% of the implants in 37% of the patients.</p></sec><sec><title>CONCLUSION</title><p>Bar-retained IODs are an adequate treatment option for edentulous jaws. These restorations may exhibit high implant/prosthesis survival rates (>97%), and a limited incidence of technical complications after a mean observational period of >7 years. Nevertheless, peri-implantitis was identified as a frequent and serious biological complication for this type of reconstruction.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Krennmair, G" uniqKey="Krennmair G">G Krennmair</name></author><author><name sortKey="Krainhofner, M" uniqKey="Krainhofner M">M Krainhöfner</name></author><author><name sortKey="Piehslinger, E" uniqKey="Piehslinger E">E Piehslinger</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Krennmair, G" uniqKey="Krennmair G">G Krennmair</name></author><author><name sortKey="Piehslinger, E" uniqKey="Piehslinger E">E Piehslinger</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Andreiotelli, M" uniqKey="Andreiotelli M">M Andreiotelli</name></author><author><name sortKey="Att, W" uniqKey="Att W">W Att</name></author><author><name sortKey="Strub, Jr" uniqKey="Strub J">JR 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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Adv Prosthodont</journal-id><journal-id journal-id-type="iso-abbrev">J Adv Prosthodont</journal-id><journal-id journal-id-type="publisher-id">JAP</journal-id><journal-title-group><journal-title>The Journal of Advanced Prosthodontics</journal-title></journal-title-group><issn pub-type="ppub">2005-7806</issn><issn pub-type="epub">2005-7814</issn><publisher><publisher-name>The Korean Academy of Prosthodontics</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26330982</article-id><article-id pub-id-type="pmc">4551791</article-id><article-id pub-id-type="doi">10.4047/jap.2015.7.4.338</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>Implant-supported overdentures with different bar designs: A retrospective evaluation after 5-19 years of clinical function</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Rinke</surname><given-names>Sven</given-names></name><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Rasing</surname><given-names>Hajo</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Gersdorff</surname><given-names>Nikolaus</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Buergers</surname><given-names>Ralf</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Roediger</surname><given-names>Matthias</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Prosthodontics, Georg-August-University, Goettingen, Germany.</aff><aff id="A2"><label>2</label>Private Practice, Hanau, Germany.</aff><author-notes><corresp>Corresponding author: Matthias Roediger. Department of Prosthodontics, Georg-August-University, Goettingen, Robert-Koch-Str. 40, 37075 Goettingen, Germany. Tel. 49 551 39 14034: <email>matthias.roediger@med.uni-goettingen.de</email></corresp></author-notes><pub-date pub-type="ppub"><month>8</month><year>2015</year></pub-date><pub-date pub-type="epub"><day>18</day><month>8</month><year>2015</year></pub-date><volume>7</volume><issue>4</issue><fpage>338</fpage><lpage>343</lpage><history><date date-type="received"><day>25</day><month>3</month><year>2015</year></date><date date-type="rev-recd"><day>29</day><month>7</month><year>2015</year></date><date date-type="accepted"><day>05</day><month>8</month><year>2015</year></date></history><permissions><copyright-statement>© 2015 The Korean Academy of Prosthodontics</copyright-statement><copyright-year>2015</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><sec><title>PURPOSE</title><p>This retrospective study evaluated the outcome of implant-retained overdentures (IODs) after 5-19 years of clinical function.</p></sec><sec><title>MATERIALS AND METHODS</title><p>A retrospective analysis of patient files was performed referring to 27 patients who received 36 IODs with 3 different bar designs (group A=prefabricated round bars, n=7; group B=one-piece anterior milled bars, n=20; and group C=two bilaterally placed milled bars, n=9) in the mandible (n=24) and/or in the maxilla (n=12). The analysis focused on the survival and success rates (according to Kaplan-Meier) of the implants and prostheses. Technical complication rates for each type of restoration were analyzed and compared via one-way ANOVA and the Chi-squared test. The prevalence of peri-implantitis (radiographic bone loss ≥3.5 mm) was evaluated by digital analysis of panoramic radiographs taken post-operative (baseline) and after 5-19 years of clinical function (follow-up).</p></sec><sec><title>RESULTS</title><p>The mean observational time was 7.3 years. The survival rates of the prostheses and implants were 100% and 97.7%, respectively. Technical complications occurred more frequently in group A (mean: 3.5 during observational time) than in the other two groups (B: 0.8; C: 1.0). However, this difference was not statistically significant (<italic>P</italic>=0.58). Peri-implantitis was diagnosed for 12.4% of the implants in 37% of the patients.</p></sec><sec><title>CONCLUSION</title><p>Bar-retained IODs are an adequate treatment option for edentulous jaws. These restorations may exhibit high implant/prosthesis survival rates (>97%), and a limited incidence of technical complications after a mean observational period of >7 years. Nevertheless, peri-implantitis was identified as a frequent and serious biological complication for this type of reconstruction.</p></sec></abstract><kwd-group><kwd>Bar-retained overdentures</kwd><kwd>Implants</kwd><kwd>Marginal bone level</kwd><kwd>Radiographic</kwd><kwd>Peri-implantitis</kwd></kwd-group></article-meta></front><body><sec sec-type="intro"><title>INTRODUCTION</title><p>Bar-retained implant overdentures (IODs) are a common treatment option in implant prosthodontics, and the implants that support the prosthetic restorations exhibit high survival rates.<xref rid="B1" ref-type="bibr">1</xref><xref rid="B2" ref-type="bibr">2</xref><xref rid="B3" ref-type="bibr">3</xref> It has been discussed controversially if the number of implants or a placing of extensions on bars influence the clinical outcome of IODs.<xref rid="B4" ref-type="bibr">4</xref><xref rid="B5" ref-type="bibr">5</xref><xref rid="B6" ref-type="bibr">6</xref><xref rid="B7" ref-type="bibr">7</xref><xref rid="B8" ref-type="bibr">8</xref> However, the data on the prevalence of biological complications remains limited.<xref rid="B9" ref-type="bibr">9</xref><xref rid="B10" ref-type="bibr">10</xref> It has been proven that the bone resorption for IODs on prefabricated bars is lower in comparison with IODs on cast bars.<xref rid="B11" ref-type="bibr">11</xref> In contrast, a systematic review demonstrated similar bone loss around implants supporting IODs with different attachment designs.<xref rid="B12" ref-type="bibr">12</xref> This retrospective study examined the survival and success rates as well as the prevalence of peri-implantitis of IODs retained by 3 different bar designs.</p></sec><sec sec-type="materials|methods"><title>MATERIALS AND METHODS</title><p>This study is based on patient files from the departments of Maxillofacial Surgery and Prosthodontics of the University Medical Center Goettingen. It was approved by the local ethics committee (approval no. 1/9/09). Twenty-seven patients (16 female, 11 male) were treated between 1991 and 2006 with IODs (n=36) that were retained by 3 different bar designs (group A=prefabricated round bars without extensions, resilient anchorage, n=7; group B=one-piece anterior milled bars with distal extensions, rigid anchorage, n=20; and group C=two bilaterally placed milled bars, with distal extensions, rigid anchorage, n=9) on 4 to 6 implants (2 - 3 per side) (n=161, mean: 4.5 per jaw) in the mandible (n=24) and/or in the maxilla (n=12).</p><p>Inclusion criteria for the study were in compliance with annual recall intervals, a post-operative (baseline) panoramic radiograph, and at least one follow-up panoramic radiograph after a minimum observational period of 5 years (mean: 7.3 ± 3.6 years; range: 5-19 years). Furthermore, the complete documentation of all implant- and prosthesisrelated technical complications was mandatory for inclusion in the study. All radiographs were digitally analyzed (Adobe Photoshop CS4, San Jose, CA, USA). Calibration was performed by referencing the documented implant length. The marginal bone levels were calculated on the basis of the radiographic linear distance from the implant shoulder to the first bone-to-implant contact (<xref ref-type="fig" rid="F1">Fig. 1</xref>). Radiographic bone loss during the functional period was calculated by subtracting the linear distance from the implant shoulder to the marginal bone level at baseline from the distance from the implant shoulder to the marginal bone level at the last available radiograph.</p><p>Bone loss ≥3.5 mm was defined as "peri-implantitis".<xref rid="B9" ref-type="bibr">9</xref><xref rid="B10" ref-type="bibr">10</xref><xref rid="B13" ref-type="bibr">13</xref> Furthermore, all prosthodontic maintenance was recorded for the survival and success analysis according to Kaplan-Meier. Technical complication rates for each type of restoration were analyzed and compared via one-way ANOVA and the Chi-squared test (Software R version 2.8, www.r-project.org). A type one error of <0.05 was accepted as statistical significance.</p></sec><sec sec-type="results"><title>RESULTS</title><p>Two implants (one in the maxilla after 7 years and one in the mandible after 6 years) had to be removed (7-year survival rate: 97.7%). All IODs remained in function (7-year survival rate: 100%). In total, 70 of the technical complications (attachment-related: 49%, denture-related: 51%) required clinical intervention to maintain the function of the IODs (overall technical complication rate: 0.37 treatments per patient per year (T/P/Y)), (<xref ref-type="table" rid="T1">Table 1</xref>). Technical complications occurred more frequently in group A (mean: 3.5 during observational time) than in the other two groups (B: 0.8: C: 1.0). However, this difference was not statistically significant (<italic>P</italic>=0.58, <xref ref-type="fig" rid="F2">Fig. 2</xref>). The success rates (Kaplan-Meier) which represent the share of IODs that were functional without any clinical intervention are presented in <xref ref-type="fig" rid="F3">Fig. 3</xref>. Peri-implantitis was diagnosed in 20 implants (12.4%), in 12 IODs (3 in the maxilla, 9 in the mandible) (A: 2; B: 9; C: 1) in 10 of 27 patients (37%). Six of the 10 smokers (60%) that participated in the study, and 4 of the 17 non-smokers (23.5%) were diagnosed with peri-implantitis (<xref ref-type="fig" rid="F4">Fig. 4</xref>).</p></sec><sec sec-type="discussion"><title>DISCUSSION</title><p>The implant (97.7%) and prosthetic (100%) survival rates are similar to the findings reported by other studies.<xref rid="B1" ref-type="bibr">1</xref><xref rid="B2" ref-type="bibr">2</xref><xref rid="B3" ref-type="bibr">3</xref> In literature, the requirements for prosthetic maintenance of IODs vary between 0.25 and 4.03 (T/P/Y).<xref rid="B1" ref-type="bibr">1</xref><xref rid="B2" ref-type="bibr">2</xref><xref rid="B3" ref-type="bibr">3</xref><xref rid="B10" ref-type="bibr">10</xref> The overall technical complication rate of 0.37 (T/P/Y) that was calculated in the present study is at the lower end of this range, it is similar to other studies that reported technical complications of bar-retained IODs.<xref rid="B1" ref-type="bibr">1</xref><xref rid="B2" ref-type="bibr">2</xref> In the present study, IODs that were retained by milled bars exhibited rather lower but statistically insignificant rates of mechanical complications in comparison with IODs retained by prefabricated round bars. Nevertheless, this is similar to previous studies that reported lower technical complication rates for milled bars than that of prefabricated round bars.<xref rid="B1" ref-type="bibr">1</xref><xref rid="B2" ref-type="bibr">2</xref> Krennmair et al.<xref rid="B6" ref-type="bibr">6</xref> (2012) demonstrated high implant success rates and limited prosthodontic maintenance for rigid anchoring with milled bars or telescopic attachments. In this study, bar-related complications predominantly appeared for prefabricated round bars, whereas IODs retained by milled bars showed more denture-related complications. Bressan et al.<xref rid="B14" ref-type="bibr">14</xref> (2012) also demonstrated mainly bar-related complications for IODs retained by round bars supported by two implants. Alternatively, Heschl et al.<xref rid="B15" ref-type="bibr">15</xref> (2013) documented only limited complication rates for round bars supported by 4 implants with distal extensions. Other authors controversially discussed whether the number of implants and/or the use of extensions have an impact on the complication rates of IODs. Ueda et al.<xref rid="B8" ref-type="bibr">8</xref> (2011) and Meijer et al.<xref rid="B7" ref-type="bibr">7</xref> (2009) found no differences between IODs supported by 2 or 4 implants. However, Krennmair et al. (2007 & 2012) demonstrated prevention of non-axial overloading, posterior bone resorption or denture rotation for bar-structures rigidly retained by 4 implants.<xref rid="B5" ref-type="bibr">5</xref><xref rid="B6" ref-type="bibr">6</xref><xref rid="B7" ref-type="bibr">7</xref> Moreover, up to now, the relevance of extensions regarding the complication rates of IODs seems indistinct. Placing cantilevers on bars was rated useful to offer adequate occlusal posterior support.<xref rid="B4" ref-type="bibr">4</xref> However, Krennmaier et al.<xref rid="B5" ref-type="bibr">5</xref> (2007) showed that distal extensions included in their bars affected neither the degree of distal bone loss nor the implant survival rate. Nevertheless, in the present study round bars on 2 implants without extensions offered higher complication rates than milled bars on 4 implants including distal extensions.</p><p>In the present study, 12.4% of the implants in 37% of the patients exhibited radiographic symptoms of peri-implantitis. Studies using the same diagnostic criteria have reported implant-based peri-implantitis rates between 10.1-11.7%, and patient-based peri-implantitis rates of 9.2-10.0% for mean observational periods of 5.6-7 years.<xref rid="B9" ref-type="bibr">9</xref><xref rid="B10" ref-type="bibr">10</xref> The bar design might explain the comparatively high peri-implantitis rates in the present study. It may lead to a reduced accessibility for oral hygiene procedures at home.<xref rid="B10" ref-type="bibr">10</xref> IODs retained by milled bars exhibited significantly higher plaque index values than IODs retained by telescopic crowns.<xref rid="B6" ref-type="bibr">6</xref> In the present study, especially massive one-piece milled bars in the mandible showed radiological symptoms of peri-implantitis (9 out of 20, however, the rates were not statistically significant). Abd El-Dayem et al.<xref rid="B11" ref-type="bibr">11</xref> (2009) demonstrated less bone resorption for IODs supported by round bars compared to custom-made bars. In the present study, smoking patients exhibited a higher prevalence of peri-implantitis than non-smoking patients (60% vs. 23.5%), thus supporting data from previous studies suggesting that a smoking habit is a significant risk factor for the development of peri-implant diseases.<xref rid="B9" ref-type="bibr">9</xref></p></sec><sec sec-type="conclusions"><title>CONCLUSION</title><p>Within the limitations of this study, we concluded that barretained IODs are an adequate treatment option for edentulous jaws. These restorations may exhibit high implant and prosthesis survival rates (>97%) and a limited incidence of technical complications after a mean observational period of >7 years. 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person-group-type="author"><name><surname>Heschl</surname><given-names>A</given-names></name><name><surname>Payer</surname><given-names>M</given-names></name><name><surname>Clar</surname><given-names>V</given-names></name><name><surname>Stopper</surname><given-names>M</given-names></name><name><surname>Wegscheider</surname><given-names>W</given-names></name><name><surname>Lorenzoni</surname><given-names>M</given-names></name></person-group><article-title>Overdentures in the edentulous mandible supported by implants and retained by a Dolder bar: a 5-year prospective study</article-title><source>Clin Implant Dent Relat Res</source><year>2013</year><volume>15</volume><fpage>589</fpage><lpage>599</lpage><pub-id pub-id-type="pmid">21834860</pub-id></element-citation></ref></ref-list></back><floats-group><fig id="F1" orientation="portrait" position="float"><label>Fig. 1</label><caption><title>Measurement of radiographic bone loss. (A) Baseline after implant insertion, (B) After 5 years of clinical function. The implant length is marked for calibration (green line), and the highest bone loss at implant 032 (mesial site, red line) is also marked.</title></caption><graphic xlink:href="jap-7-338-g001"></graphic></fig><fig id="F2" orientation="portrait" position="float"><label>Fig. 2</label><caption><title>Number of technical complications according to the bar design (means with 95% confidence intervals) after a 7.3-year mean observation time.</title></caption><graphic xlink:href="jap-7-338-g002"></graphic></fig><fig id="F3" orientation="portrait" position="float"><label>Fig. 3</label><caption><title>Success rates (Kaplan Meier analysis) of implant-retained overdentures with 3 different bar designs after a 7.3-year mean observation time.</title></caption><graphic xlink:href="jap-7-338-g003"></graphic></fig><fig id="F4" orientation="portrait" position="float"><label>Fig. 4</label><caption><title>Distribution of peri-implantitis (red fraction) in non-smokers (4/17=23.5%) and smokers (6/10=60%).</title></caption><graphic xlink:href="jap-7-338-g004"></graphic></fig><table-wrap id="T1" orientation="portrait" position="float"><label>Table 1</label><caption><title>Technical complications of implant-retained overdentures with 3 different bar designs</title></caption><alternatives><graphic xlink:href="jap-7-338-i001"></graphic><table frame="hsides" rules="rows"><thead><tr><th valign="middle" align="center" rowspan="2" colspan="1">Complication</th><th valign="middle" align="center" rowspan="1" colspan="3">Bar design</th></tr><tr><th valign="middle" align="center" rowspan="1" colspan="1">Prefabricated round (n=7)</th><th valign="middle" align="center" rowspan="1" colspan="1">Milled, anteriorly located (n=20)</th><th valign="middle" align="center" rowspan="1" colspan="1">Milled, bilaterally placed (n=9)</th></tr></thead><tbody><tr><td valign="top" align="left" rowspan="1" colspan="1">Screw (loosening, fracture)</td><td valign="top" align="right" rowspan="1" colspan="1">3</td><td valign="top" align="right" rowspan="1" colspan="1">1</td><td valign="top" align="right" rowspan="1" colspan="1">0</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Bar (fracture, retention/friction loss, TK Snap renewal)</td><td valign="top" align="right" rowspan="1" colspan="1">22</td><td valign="top" align="right" rowspan="1" colspan="1">5</td><td valign="top" align="right" rowspan="1" colspan="1">3</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Denture (crack/fracture repair, relining, tooth renewal)</td><td valign="top" align="right" rowspan="1" colspan="1">18</td><td valign="top" align="right" rowspan="1" colspan="1">11</td><td valign="top" align="right" rowspan="1" colspan="1">7</td></tr></tbody></table></alternatives></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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