Clinical and patient-centered outcomes following rehabilitation of atrophic edentulous maxilla using six implants placed simultaneously with bilateral maxillary sinus augmentation: a retrospective case series

Abstract

Abstract Objectives To evaluate treatment success, patient satisfaction, and oral health-related quality of life (OHRQoL) after rehabilitation of atrophic edentulous maxilla (AEM) with six implants placed simultaneously with bilateral maxillary sinus floor augmentation (MSFA). Materials and methods The selected patients were fully edentulous with atrophic maxillary posterior residual ridges, who rehabilitated with 6 implants placed simultaneously with bilateral MSFA and immediate all-on-4 provisional fixed prosthesis (PFP). After 7–12 months of implant surgery, all patients have received all-on-6 definitive fixed prosthesis (DFP). After at least one year of function with DFP, the clinical and radiographic examinations were performed. Patient satisfaction with DFP was assessed through a visual analog scale (VAS). The OHRQoL before treatment (T0), during provisional (T1), and after definitive prosthesis (T2) was evaluated using OHI-14. Results 20 maxillary edentulous patients were rehabilitated with 120 implants (6 for each maxilla combined with bilateral MSFA), 20 immediate all-on-4 PFP, and 20 all-on-6 DFP. Of those,12 patients have passed at least year follow-up after DFP insertion, and were eligible to be included for the assessment of treatment success. After a mean of 20 (12–36) months follow-up, the implant and prosthesis survival rate were both 100%. The success rate at the implant level was 98.6%. The peri-implant soft tissue condition was stable without biological complications. The mean marginal bone loss (MBL) was 0.09 ± 0.06 mm. No prosthetic or postoperative complications was observed. The patient satisfaction after treatment was high and the mean general satisfaction was (91.75 ± 7.06). There was a significant improvement in most OHIP-14 domains during the provisional all-on-4 (T1) and in all domains during the final all-on-6 prosthesis (T2) (P < 0.01). Conclusions Rehabilitation of the AEM utilizing six implants combined with simultaneous bilateral MSFA, immediate All-on-4 PFP, and delayed All-on-6 DFP is a successful treatment approach associated with minimal postoperative complications high patient satisfaction, significant improvement in OHRQoL. Clinical relevance: Rehabilitation of AEM with six implants inserted simultaneously with bilateral MSFA enables the prosthesis to restore/extend to the first or second molars without a cantilever, which improves clinical outcome and OHRQoL compared to cantilevered and shortened dental arch concept prosthesis.