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Provisional Full-arch Restoration Immediately after All-on-4 5 6 Implant Therapy- Technical and Biological Complications
EAO Online Library. Fürhauser R. Oct 9, 2018; 232682
Rudolf Fürhauser
Rudolf Fürhauser
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Immediate provisional loading at the day of implant placement according to the All-on-4 5 6-concept offers major benefits for the patient, such as total avoidance of removable prostheses and no need to adapt to changes regarding function, esthetics as well as phonetics.The aim of the present study was to investigate technical as well as biological complications (implant failure) associated with provisional implant bridges in edentulous jaws.A total of 765 provisional resin-bonded bridges (glass-fibre reinforced, no cantilevers) supported by 3609 implants were manufactured for 652 patients at the day of immediate All-on-4 5 6 implant therapy. The provisional restoration was followed-up until final prosthetic delivery after at least 3 months.The rate of technical complications was 60%, however, three quarters were considered minor and could be solved in office. Major complications (requiring lab technicians) were seen in only 15% and the implant failure rate was 2.2%. Biomechanical complications (bridge fracture, veneer fracture, abutment or screw loosening, screw access channel fillings) were most frequent (66%). 75% of implant failures occured within the first 9 months while technical complications were low after 6 months and started accelerating not before the first year of loading.Technical complications with resin-bonded glass-fibre reinforced full-arch implant bridges are frequent within the first 6 months after immediate provisionalization, however, 45% of patients show minor problems that can be solved chairside and only 15% need extensive repair. Extending the provisional phase to up to 1 year does not significantly increase rates of biomechanical complications.
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