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Implant-supporting telescopic maxillary prostheses and immediate loading.

UNLABELLED
Immediate loading (IL) in the maxilla is a successful concept when implants are splinted together using a fixed restoration. This concept is associated with high number of implants or difficulties in the plaque control underneath the restoration, which may reduce the patient comfort and satisfaction and compromise the implant prognosis.


OBJECTIVE
The aim of this study was to evaluate the long-term clinical outcome of implants placed in the maxilla using telescopic-retained removable prostheses under immediate functional loading protocol.


MATERIAL AND METHODS
The present retrospective study included 117 implants with a progressive thread design placed in 26 patients (age 57.04 ± 8.87 years old) with clinical and radiographic evaluation for a period of at least 2 years. A total of 29 implants (24.79%) were placed in fresh extraction sockets. All implants were placed 1-3 mm subcrestally from the mid-facial crest of bone level. The implants were connected immediately after placement with conical prefabricated abutments (4- to 6-degree angle) using a final torque of 15 Ncm immediately after surgery. Secondary prefabricated copings with precise fit for the abutments were placed and the partial dentures were relined chair-side. The restorations were palate-free and were to remain in place without removal for 10 days to splint the implants together.


RESULTS
After a loading period of 54.42 ± 15.68 months (min. 26 months/max. 87 months), the study showed 7 failures (5.98% failure rate), and 10 implants presented a crestal bone loss of more than 2 mm (8.55%). This represented a cumulative survival rate of 94.02% and a success rate for the evaluated implants of 85.47%. All patients were satisfied with the stability of their prostheses and no complications were reported.


CONCLUSIONS
Telescopic implant-supported maxillary prostheses in conjunction with IL present an alternative prosthetic solution for the edentulous maxilla, providing long-term predictability and improving the patient comfort and clinical outcome.