Maxillary implant overdenture retained by four unsplinted attachments and opposed by a natural or fixed dentition: Five‐year clinical outcomes. A prospective case series

Abstract

AbstractObjectivesThe objective of this study was to assess, over a period of 5 years, implant prosthesis and patient‐reported outcomes of complete dentures retained by four implant‐supported attachments in the edentulous maxilla facing either natural teeth or fixed rehabilitation in the lower jaw.Materials and MethodsImplant, prosthodontic and patient‐related outcomes were assessed in 30 patients at 1, 3 and 5 years. Prosthodontic survival, complications or maintenance events as well as implant survival were recorded. Patient‐reported outcome measures (PROMs) were evaluated with the Oral Health Impact Profile (OHIP‐20) questionnaire and a visual analogue scale (VAS) before implant placement (baseline) and during the follow‐up period.ResultsAfter 5 years, three patients dropped out, 21 implants failed, and four overdentures were replaced leading to a prosthesis survival rate of 85.2% (95% CI: 71.8%–98.6%) and an implant survival rate of 80.6% (95% CI: 73.1%–88.0%). Prosthodontic success rate decreased from 86.2% to 74% between the 1st and the 3rd year and reached 63% after 5 years. OHIP results improved significantly from baseline to 1 year (p < .0001) and to 3 years (p = .036), but, at 5 years, the improvement was no longer significant when compared to baseline (p = .12). The overall VAS score remained significantly higher up to 5 years (p < .001).ConclusionA substantial number of prosthetic complications and replacements occurred over the 5‐year follow‐up. After 5 years, the OHIP‐20 deteriorated and reached again the baseline level. Nonetheless, the VAS results suggest significantly increased patient satisfaction after implant‐supported retention was provided for the removable prostheses.