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The goal of this clinical study is to evaluate clinical performance of combined tooth-implant supported 3 unit fixed partial dentures in the posterior mandible and was to compare and evaluate them with the complications of 3 unit fixed partial dentures supported with free standing dental implants.The main question[s] it aims to answer are:
1.Is there any difference in terms of mechanical and biological complications as well as marginal bone level between free standing and combined tooth-implant supported 3 unit Fixed Partial Dentures in posterior mandible.
Participants will receive either 2 dental implants(Control group) or 1 standart length dental implants to be combine with abutment tooth or 1 short dental implant to be combine with abutment tooth for supporting 3 unit fixed partial dentures.
Purpose: The aim of the study was to evaluate clinical performance of combined tooth-implant supported 3 unit fixed partial dentures in the posterior mandible and was to compare and evaluate them with the complications of 3 unit fixed partial dentures supported with free standing dental implants.
Material and methods: 78 partially edentulous patients in the posterior mandible (Kennedy 1 and Kennedy 2), age between 18-65 with no systemic disorders were recruited for the study (n=26). Group 1served as control group and received 2 dental implants for supporting 3 unit fixed partial dentures (FPD). In group 2 dental implants longer than 8 mm and in group 3 shorter than 8 mm were inserted to replace first or second molar combined with first or second premolar respectively to support cement retained 3 units FPD. Periapical radiographs were taken with parallel technique for evaluation of marginal bone resorption (CBL) and modified plaque index (MPI), bleeding index (BI) and sulcus depth of abutment teeth was recorded at the time of FPD insertion, 6 months after FPD insertion and annually. Abutment tooth intrusions, de-cementation of the restoration, porcelain chipping/delamination, framework fracture, abutment screw loosening, abutment and abutment screw fracture, implant fracture were also recorded as complications.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group2 | Experimental | Mandibular first or second premolar is combined with standard length(8-12mm) dental implants to support 3 unit Fixed Partial Dentures |
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| Group3 | Experimental | Mandibular first or second premolar is combined with short dental implants(5-6mm) to support 3 unit Fixed Partial Dentures |
|
| Group1 | Active Comparator | Standard length (8-12mm) dental implants are inserted in posterior mandible replacing either first premolar and first molar or second premolar and second molar to support 3 unit fixed partial dentures. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Insertion of 1 Nucleoss T4 dental implants in posterior mandible | Procedure | Nucleoss T4 dental implants is combined with first or second premolar to support 3 unit fixed partial dentures |
| Measure | Description | Time Frame |
|---|---|---|
| Marginal bone loss | Mesial and distal marginal bone loss around dental implants is measured by periodical radiographs | At baseline |
| Marginal bone loss | Mesial and distal marginal bone loss around dental implants is measured by periodical radiographs | 6 months |
| Marginal bone loss | Mesial and distal marginal bone loss around dental implants is measured by periodical radiographs | 1 year |
| Marginal bone loss | Mesial and distal marginal bone loss around dental implants is measured by periodical radiographs | 2 years |
| Marginal bone loss | Mesial and distal marginal bone loss around dental implants is measured by periodical radiographs | 3 years |
| Marginal bone loss | Mesial and distal marginal bone loss around dental implants is measured by periodical radiographs | 4 years |
| Marginal bone loss | Mesial and distal marginal bone loss around dental implants is measured by periodical radiographs | 5 years |
| Marginal bone loss | Mesial and distal marginal bone loss around dental implants is measured by periodical radiographs |
| Measure | Description | Time Frame |
|---|---|---|
| Modified gingival index | The clinician evaluated bleeding around selected teeth using a periodontal probe and by giving scores between 0 and 3 | At baseline |
| Modified gingival index | The clinician evaluated bleeding around selected teeth using a periodontal probe and by giving scores between 0 and 3 |
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Inclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| ORHUN EKREN, PhD | Cukurova University | Study Director |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 1453301 | Background | Meffert RM, Langer B, Fritz ME. Dental implants: a review. J Periodontol. 1992 Nov;63(11):859-70. doi: 10.1902/jop.1992.63.11.859. | |
| 32323043 | Background | Rameh S, Menhall A, Younes R. Key factors influencing short implant success. Oral Maxillofac Surg. 2020 Sep;24(3):263-275. doi: 10.1007/s10006-020-00841-y. Epub 2020 Apr 23. |
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| Insertion of 1 Nucleoss T5 dental implants in posterior mandible | Procedure | Nucleoss T5 dental implants is combined with first or second premolar to support 3 unit fixed partial dentures |
|
| Insertion of 2 Nucleoss T4 dental implants posterior mandible | Procedure | 2 freestanding Nucleoss T4 dental implants is used to support 3 unit fixed partial dentures |
|
| 6 years |
| 6 months |
| Modified gingival index | The clinician evaluated bleeding around selected teeth using a periodontal probe and by giving scores between 0 and 3 | 1 year |
| Modified gingival index | The clinician evaluated bleeding around selected teeth using a periodontal probe and by giving scores between 0 and 3 | 2 years |
| Modified gingival index | The clinician evaluated bleeding around selected teeth using a periodontal probe and by giving scores between 0 and 3 | 3 years |
| Modified gingival index | The clinician evaluated bleeding around selected teeth using a periodontal probe and by giving scores between 0 and 3 | 4 years |
| Modified gingival index | The clinician evaluated bleeding around selected teeth using a periodontal probe and by giving scores between 0 and 3 | 5 years |
| Modified gingival index | The clinician evaluated bleeding around selected teeth using a periodontal probe and by giving scores between 0 and 3 | 6 years |
| Plaque index | the clinician evaluated plaque accumulation around selected teeth using a periodontal probe and by giving scores to buccal, lingual, mesial and distal surfaces between 0 and 3 | At baseline |
| Plaque index | the clinician evaluated plaque accumulation around selected teeth using a periodontal probe and by giving scores to buccal, lingual, mesial and distal surfaces between 0 and 3 | 6 months |
| Plaque index | the clinician evaluated plaque accumulation around selected teeth using a periodontal probe and by giving scores to buccal, lingual, mesial and distal surfaces between 0 and 3 | 1 year |
| Plaque index | the clinician evaluated plaque accumulation around selected teeth using a periodontal probe and by giving scores to buccal, lingual, mesial and distal surfaces between 0 and 3 | 2 years |
| Plaque index | the clinician evaluated plaque accumulation around selected teeth using a periodontal probe and by giving scores to buccal, lingual, mesial and distal surfaces between 0 and 3 | 3 years |
| Plaque index | the clinician evaluated plaque accumulation around selected teeth using a periodontal probe and by giving scores to buccal, lingual, mesial and distal surfaces between 0 and 3 | 4 years |
| Plaque index | the clinician evaluated plaque accumulation around selected teeth using a periodontal probe and by giving scores to buccal, lingual, mesial and distal surfaces between 0 and 3 | 5 years |
| Plaque index | the clinician evaluated plaque accumulation around selected teeth using a periodontal probe and by giving scores to buccal, lingual, mesial and distal surfaces between 0 and 3 | 6 years |
| 1487588 | Background | Zarb GA, Lewis DW. Dental implants and decision making. J Dent Educ. 1992 Dec;56(12):863-72. |
| 28424733 | Background | Al-Omiri MK, Al-Masri M, Alhijawi MM, Lynch E. Combined Implant and Tooth Support: An Up-to-Date Comprehensive Overview. Int J Dent. 2017;2017:6024565. doi: 10.1155/2017/6024565. Epub 2017 Mar 23. |
| 29521677 | Background | de Paula GA, Silva GC, Vilaca EL, Cornacchia TM, de Magalhaes CS, Moreira AN. Biomechanical Behavior of Tooth-Implant Supported Prostheses With Different Implant Connections: A Nonlinear Finite Element Analysis. Implant Dent. 2018 Jun;27(3):294-302. doi: 10.1097/ID.0000000000000737. |
| 27861651 | Background | Tsouknidas A, Giannopoulos D, Savvakis S, Michailidis N, Lympoudi E, Fytanidis D, Pissiotis A, Michalakis K. The Influence of Bone Quality on the Biomechanical Behavior of a Tooth-Implant Fixed Partial Denture: A Three-Dimensional Finite Element Analysis. Int J Oral Maxillofac Implants. 2016 Nov/Dec;31(6):e143-e154. doi: 10.11607/jomi.5254. |
| 11203652 | Background | Hosny M, Duyck J, van Steenberghe D, Naert I. Within-subject comparison between connected and nonconnected tooth-to-implant fixed partial prostheses: up to 14-year follow-up study. Int J Prosthodont. 2000 Jul-Aug;13(4):340-6. |
| 11359481 | Background | Naert IE, Duyck JA, Hosny MM, Van Steenberghe D. Freestanding and tooth-implant connected prostheses in the treatment of partially edentulous patients. Part I: An up to 15-years clinical evaluation. Clin Oral Implants Res. 2001 Jun;12(3):237-44. doi: 10.1034/j.1600-0501.2001.012003237.x. |
| 10635188 | Background | Gunne J, Astrand P, Lindh T, Borg K, Olsson M. Tooth-implant and implant supported fixed partial dentures: a 10-year report. Int J Prosthodont. 1999 May-Jun;12(3):216-21. |
| 16958689 | Background | Nickenig HJ, Schafer C, Spiekermann H. Survival and complication rates of combined tooth-implant-supported fixed partial dentures. Clin Oral Implants Res. 2006 Oct;17(5):506-11. doi: 10.1111/j.1600-0501.2006.01259.x. |
| 32111268 | Background | Schwartz SR. Short Implants: An Answer to a Challenging Dilemma? Dent Clin North Am. 2020 Apr;64(2):279-290. doi: 10.1016/j.cden.2019.11.001. Epub 2020 Jan 2. |
| 29303816 | Background | Benlidayi ME, Ucar Y, Tatli U, Ekren O, Evlice B, Kisa HI, Baksi U. Short Implants Versus Standard Implants: Midterm Outcomes of a Clinical Study. Implant Dent. 2018 Feb;27(1):95-100. doi: 10.1097/ID.0000000000000710. |
| 30328189 | Background | Jung RE, Al-Nawas B, Araujo M, Avila-Ortiz G, Barter S, Brodala N, Chappuis V, Chen B, De Souza A, Almeida RF, Fickl S, Finelle G, Ganeles J, Gholami H, Hammerle C, Jensen S, Jokstad A, Katsuyama H, Kleinheinz J, Kunavisarut C, Mardas N, Monje A, Papaspyridakos P, Payer M, Schiegnitz E, Smeets R, Stefanini M, Ten Bruggenkate C, Vazouras K, Weber HP, Weingart D, Windisch P. Group 1 ITI Consensus Report: The influence of implant length and design and medications on clinical and patient-reported outcomes. Clin Oral Implants Res. 2018 Oct;29 Suppl 16:69-77. doi: 10.1111/clr.13342. |