Dentisterie

Abstrait

Retrospective Analysis of Biological and Technical Complications Using Individual CAD/CAM Abutments

Ali-Reza Ketabi, Sandra Ketabi, Martin Brenner, Hans-Christoph Lauer and Silvia Brandt

Purpose: The aim of the present study was to assess the biological and technical complication and survival rates of implants and prosthetic superstructures using custom-milled CAD/CAM abutments made of titanium or zirconia. Material and Methods: A total of 109 patients were treated with 225 AstraTech OsseoSpeed implants (Dentsply IH) between July 2008 and November 2012 in the same private dental practice. Following submerged healing, the implants were uncovered and restored with Atlantis custom CAD/CAM abutments made of zirconia or titanium. Single crowns, fixed bridges, or telescope crowns as attachments for removable prostheses were connected to the abutments with zinc oxide phosphate cement. Patients were clinically and radiologically followed at the abutment level for a mean 20.85 months. The clinical assessment included biological and technical complications a well as the survival of the implants, abutments, and prosthetic superstructures. Mean crestal bone loss was assessed on standardized radiographs. Patient satisfaction was surveyed with a self-developed questionnaire. Results: The records of 69 patients (49 female, 20 male: mean age: 53.51 years) treated with 124 implants/custom abutments were included in the final analysis. Most abutments were made of titanium (n=90), followed by zirconia (n=34). The survival rates of implants and abutments were 100.00%. Eight restorations (6.50%) had to be replaced during follow-up, for an implant/abutment-related cumulative prosthetic success rate of 93.50%. The patient-related cumulative prosthetic survival rate was 92.75%. A mean bone gain of 0.06 mm (SD: 0.28 mm) on the mesial side and 0.11 mm (SD: 0.37 mm) at the distal side of the implants (n=122) was recorded. Only a few cases of soft-tissue complications such as mucositis, loss of papilla height, or bleeding on probing were observed. Therapy was rated as very good by 92.65% of patients. The esthetic result was assessed as very good as well by the majority of patients (88.41%). Due to the small sample size, no tests for statistical significance could be performed for any of the examination parameters, except for radiological crestal bone loss. No statistical significance was found for crestal bone loss as a function of the abutment material (p ≥ 0.05). Conclusions: Individual CAD/CAM -abutments are a good and predictable treatment option and deliver high patient satisfaction concerning the therapeutic and esthetic results.