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Τετάρτη 7 Σεπτεμβρίου 2022

Polyetheretherketone CAD‐CAM framework for all‐on‐4 mandibular full arch prosthesis: Three years' retrospective study of periimplant soft tissue changes and ridge base relationship

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ABSTRACT

Purpose

: This study was conducted to evaluate the clinical peri-implant soft tissue changes during first year after occlusal loading and the ridge base relation after three years for mandibular CAD-CAM manufactured screw-retained implant-supported hybrid prosthesis of polyetheretherketone (PEEK) framework utilized with All-on-Four treatment concept.

Material and methods

: Sixteen completely edentulous patients were rehabilitated by 4 implants following the All-On-Four protocol. After 3 months, the definitive prosthesis was constructed to be a screw retained CAD-CAM milled framework from the modified PEEK (BioHPP), bonded to polymethylmethacrylate (PMMA) teeth and a pink shaded indirect light-polymerized nanofilled composite resin imitating the soft tissues. Peri-implant soft tissue changes regarding plaque, bleeding, gingival scores, and probing depth were evaluated at prosthesis insertion (T0), six months (T1) and 12 months (T2) after insertion. Also, monitoring of the ridge base relation was performed using cone beam computed tomography after one year (T0), two years (T1), and three years (T2) after mandibular fixed detachable All-on-Four framework insertion. Using Shapiro Wilk tests using SPSS® software version 22 (SPSS Inc.), all clinical data were non- parametric while the ridge base relation data was parametric.

Results

: There were statistically significant differences regarding plaque, gingival, and bleeding scores for all implants with advancement of time. However, there was a statistically insignificant difference regarding probing depth in the posterior implants (p = .581). Regarding ridge base relation, there was a significant difference between observation times only in the anterior ridge area in between the two anterior implants (p = .011).

Conclusion

: Within limitations of the study, the full arch PEEK framework of fixed-detachable, hybrid prosthesis used with All-on-Four concept for rehabilitation of mandibular edentulous arches is an acceptable treatment approach. Based on the stable ridge base relation posteriorly found in this study, less stress is distributed to the underlining bone due to the shock absorbing ability of PEEK. Special considerations for frequent soft tissue follow up and regular maintenance of oral hygiene measures are recommended.

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