Immediately loaded CAD-CAM manufactured fixed complete dentures using flapless implant placement procedures: A cohort study of consecutive patients

Statement of problem. Data available regarding the treatment outcome for completely edentulous jaws by means of a prefabricated fixed complete denture placed immediately after flapless implant insertion using a surgical guide are only short term. Purpose. The purpose of this study was to follow the survival of implants inserted in completely edentulous jaws using a flapless procedure and immediately loaded with prefabricated fixed complete dentures for several years. A second purpose was to investigate whether there is a difference in marginal bone remodeling in smoking (S) and nonsmoking (NS) patients. Material and methods. During a 5-year period (mean time of follow-up 2.2 years), 30 consecutive patients, 12 women, 38-74 years of age (average 56 years) were treated for complete edentulism in I arch in the Department of Periodontology at the University Hospitals in Leuven. The S group included 13 and the NS group 17 patients. Descriptive statistics were used to analyze the data. Two outcome parameters were analyzed: the cumulative survival rate (CSR) of individual implants and the marginal bone remodeling for up to 5 years in the 2 groups. Results. Nine (4.9%) implants failed. Eight of the failures occurred in 3 smoking patients. The absolute survival rate for all patients was 95%, while the cumulative survival rate (CSR) after 5 years was 91.5%. For the NS group, the CSR was 98.9%, while for the S it was 81.2%. The mean marginal bone resorption was - 2.6 and - 1.2 mm in the S and NS groups, respectively. Conclusions. The present findings indicate that the treatment protocol described results in good implant survival rate even after several years. Smoking may eventually compromise the efficacy of this treatment concept.