Loading [MathJax]/jax/output/HTML-CSS/fonts/TeX/fontdata.js

Journal List > J Korean Acad Prosthodont > v.54(3) > 1034877

TOOLS
Kang, Kim, Heo, Koak, Lee, and Park: Clinical evaluation of the removable partial dentures with implant fixed prostheses
ORIGINAL ARTICLE

J Korean Acad Prosthodont 2016;54(3):239-245.

Published online: 18 December 2016

DOI: https://doi.org/10.4047/jkap.2016.54.3.239

Clinical evaluation of the removable partial dentures with implant fixed prostheses

Soo-Hyun Kang1, Seong-Kyun Kim1, ∗, Seong-Joo Heo1, Jai-Young Koak1, Joo-Hee Lee2, Ji-Man Park3

1Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea

2Department of Prosthodontics, Seoul Asan Medical Center, Ulsan University, Seoul, Republic of Korea

3Department of Prosthodontics, Seoul National University Gwanak Dental Hospital, Seoul, Republic of Korea

∗Corresponding Author: Seong-Kyun Kim Department of Prosthodontics, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea +82 (0)2 2072 2661: e-mail, ksy0617@snu.ac.kr

Received 29 May 20166 July 2016       Accepted 18 July 2016

Copyright © 2016 The Korean Academy of Prosthodontics

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to identify clinical complications in removable partial denture (RPD) with implant-supported surveyed prostheses, and to analyze the factors associated with the complications such as location of the implant, splinting adjacent prostheses, the type of retentive clasps, Kennedy classification, and opposing dentition.

Materials and Methods

A retrospective clinical study was carried out for 11 patients (7 male, 4 female), mean age of 67.5, who received RPD with Implant-supported surveyed prostheses between 2000 and 2016. The mechanical complications of 11 RPDs and 37 supporting implant prostheses and the state of natural teeth and peripheral soft tissue were examined. Then the factors associated with the complications were analyzed.

Results

The average of 3.4 implant-supported prostheses were used for each RPD. Complications found during the follow-up period of an average of 42.1 months were in order of dislodgement of temporary cement-retained prostheses, opposing tooth fracture/mobility, screw fracture/loosening, clasp loosening, veneer porcelain fracture, marginal bone resorption and mobility of implant, artificial tooth fracture. Complications occurred more frequently in anterior region compared to posterior region, non-splinted prostheses compared to splinted prostheses, surveyed prostheses applied by wrought wire clasp compared to other clasps, and natural dentition compared to other removable prostheses as opposing dentition. There were no significant differences in complications according to the Kennedy classification.

Conclusion

All implant-assisted RPD functioned successfully throughout the follow-up. However, further clinical studies are necessary because the clinical evidences are still not enough to guarantee the satisfactory prognosis of implant-assisted RPD for long-term result. (J Korean Acad Prosthodont 2016;54:239-45)

Go to : Goto

Keywords: Dental implant, Removable partial denture, Implant supported denture

REFERENCES

1.Misch CE. Contemporary implant dentistry. 3rd ed.Mosby: Elsevier;2008.
2.Naert I., Gizani S., Vuylsteke M., van Steenberghe D. A 5-year prospective randomized clinical trial on the influence of splinted and unsplinted oral implants retaining a mandibular overdenture: prosthetic aspects and patient satisfaction. J Oral Rehabil. 1999. 26:195–202.
crossref
3.Thomason JM. The McGill Consensus Statement on Overdentures. Mandibular 2-implant overdentures as first choice standard of care for edentulous patients. Eur J Prosthodont Restor Dent. 2002. 10:95–6.
4.Ohkubo C., Kurihara D., Shimpo H., Suzuki Y., Kokubo Y., Hosoi T. Effect of implant support on distal extension removable partial dentures: in vitro assessment. J Oral Rehabil. 2007. 34:52–6.
crossref
5.Kaufmann R., Friedli M., Hug S., Mericske-Stern R. Removable dentures with implant support in strategic positions followed for up to 8 years. Int J Prosthodont. 2009. 22:233–41.
6.Kuzmanovic DV., Payne AG., Purton DG. Distal implants to modify the Kennedy classification of a removable partial denture: a clinical report. J Prosthet Dent. 2004. 92:8–11.
crossref
7.Mijiritsky E., Ormianer Z., Klinger A., Mardinger O. Use of dental implants to improve unfavorable removable partial denture design. Compend Contin Educ Dent. 2005. 26:744–6. 748, 750.
8.Schneid T., Mattie P. Implant-assisted removable partial dentures. Phoenix RD, Cagna DR, DeFreest CF, editors. Stewart's clinical removable partial prosthodontics. 4th ed.Hanover Park; IL: Quintessence Publishing;2008. p. 259–77.
9.Kordatzis K., Wright PS., Meijer HJ. Posterior mandibular residual ridge resorption in patients with conventional dentures and implant overdentures. Int J Oral Maxillofac Implants. 2003. 18:447–52.
10.Grossmann Y., Nissan J., Levin L. Clinical effectiveness of implant-supported removable partial dentures: a review of the literature and retrospective case evaluation. J Oral Maxillofac Surg. 2009. 67:1941–6.
11.Lacerda TESP., Laganà DC., Gonzàlez-LIMA R., Zanetti AL. Contribution to the planning of implant-supported RPD in the distal region. RPG Rev Po′s Grad. 2005. 12:293–300.
12.Mijiritsky E. Implants in conjunction with removable partial dentures: a literature review. Implant Dent. 2007. 16:146–54.
crossref
13.Ohkubo C., Kobayashi M., Suzuki Y., Hosoi T. Effect of implant support on distal-extension removable partial dentures: in vivo assessment. Int J Oral Maxillofac Implants. 2008. 23:1095–101.
14.Park JM., Koak JY., Kim SK., Joo JH., Heo SJ. Consideration for the combination treatment of removable partial denture and implant. Implantol. 2015. 19:104–11.
15.Ancowitz S. Esthetic removable partial dentures. Gen Dent. 2004. 52:453–9.
16.Mijiritsky E., Karas S. Removable partial denture design involving teeth and implants as an alternative to unsuccessful fixed implant therapy: a case report. Implant Dent. 2004. 13:218–22.
crossref
17.Vahidi F., Pinto-Sinai G. Complications associated with implant-retained removable prostheses. Dent Clin North Am. 2015. 59:215–26.
crossref
18.Mitrani R., Brudvik JS., Phillips KM. Posterior implants for distal extension removable prostheses: a retrospective study. Int J Periodontics Restorative Dent. 2003. 23:353–9.
19.Jang Y., Emtiaz S., Tarnow DP. Single implant-supported crown used as an abutment for a removable cast partial denture: a case report. Implant Dent. 1998. 7:199–204.
20.Pellecchia M., Pellecchia R., Emtiaz S. Distal extension mandibular removable partial denture connected to an anterior fixed implant-supported prosthesis: a clinical report. J Prosthet Dent. 2000. 83:607–12.
crossref
21.Starr NL. The distal extension case: an alternative restorative design for implant prosthetics. Int J Periodontics Restorative Dent. 2001. 21:61–7.
22.Chronopoulos V., Sarafianou A., Kourtis S. The use of dental implants in combination with removable partial dentures: a case report. J Esthet Restor Dent. 2008. 20:355–64.
crossref
23.Saito M., Notani K., Miura Y., Kawasaki T. Complications and failures in removable partial dentures: a clinical evaluation. J Oral Rehabil. 2002. 29:627–33.
crossref
24.Bilhan H., Erdogan O., Ergin S., Celik M., Ates G., Geckili O. Complication rates and patient satisfaction with removable dentures. J Adv Prosthodont. 2012. 4:109–15.
crossref
25.Goodacre CJ., Bernal G., Rungcharassaeng K., Kan JY. Clinical complications with implants and implant prostheses. J Prosthet Dent. 2003. 90:121–32.
crossref
26.Weinberg LA. Lateral forces in relation to the denture base and clasp design. J Prosthet Dent. 1956. 6:785–800.
27.Stoumpis C., Kohal RJ. To splint or not to splint oral implants in the implant-supported overdenture therapy? A systematic literature review. J Oral Rehabil. 2011. 38:857–69.
crossref
28.Miyaura K., Morita M., Matsuka Y., Yamashita A., Watanabe T. Rehabilitation of biting abilities in patients with different types of dental prostheses. J Oral Rehabil. 2000. 27:1073–6.
crossref
Go to : Goto

Table 1.
Datum of patients
Patient No. Gender Age Restored Arch (Mx/Mn) Kennedy Class Type of opposing dentition Number of RPD abutment (implant) Number of RPD abutement (natural teeth) Follow up period (month)
1 Female 71 Maxilla I 1 1 0 104
2 Female 60 Maxilla I 2 4 0 38
3 Male 58 Maxilla II 1 2 4 18
4 Male 74 Mandible I 4 2 3 9
5 Male 66 Maxilla I 2 1 3 9
6 Male 60 Mandible II 2 6 1 83
7 Male 68 Maxilla II 1 2 2 75
8 Female 46 Mandible II 1 5 0 48
9 Female 74 Maxilla II 2 4 0 43
10 Male 92 Maxilla IV 3 6 0 18
11 Male 73 Mandible IV 4 4 0 18

Type of opposing dentition : 1. Natural teeth, 2. Fixed partial denture (natural teeth or implants), 3. Removable partial denture, 4. Complete denture

Table 2.
Datum of implants placed and implant-supported surveyed prostheses
Anatomic location Total Implant-abutment connection type Splinting or non-splinting Type of retentive clasp
Internal type External type Splinting Non-splinting Embrasure RPA Wrought Wire Akers Rest only
Anterior 11 2 9 10 1     2 2 7
Premolar 15 7 8 15 0 9 3 3    
Molar 11 6 5 10 1 8     2 1
Total 37 15 22 35 2 17 3 5 4 8
Table 3.
Compl lications
  Dislodgement of temporary cement-retained prosthesis Screw loosening Screw fracture Clasp loosening Porcelain veneer fracture Marginal bone resorption Mobility of implant RPD artificial tooth fracture Opposing tooth fracture/ mobility
Incidence 4 times Once Twice Once Once Once Once Once Twice
(no. of patient) (2 persons) (1 person) (1 person) (1 person) (1 person) (1 person) (1 person) (1 person) (1 person)
Remark   Anterior region External Embrasure clasp Anterior region 2 threads exposed Explantation Anterior region One natural tooth crown fracture, One implant mobility
Wrought wire clasp Single implant non-splinting
Table 4.
Compli ication incidence according to the location of implan nt placed
  Total implant prostheses Dislodgement of temporary cement-retained prosthesis Screw loosening Screw fracture Clasp loosening Porcelain veneer fracture Marginal bone resorption Mobility of implant
Anterior 11 4 times (2 persons) Once (1 person) Twice (1 person)   Once (1 person)    
Premolar 15       Once (1 person)   Once (1 person)  
Molar 11             Once (1 person)
Table 5.
Complications in use / disuse of splinting
  Total implant prostheses Dislodgement of temporary cement-retained prosthesis Screw loosening Screw fracture Clasp loosening Porcelain veneer fracture Marginal bone resorption Mobility of implant
Splinting 35 Once (1 person) Once (1 person)   Once (1 person) Once (1 person) Once (1 person) Once (1 person)
Non-splinting 2 Thrice (1 person)   Twice (1 person)        
Table 6.
Complications according to the type of retentive clasps
  Total implant prostheses Dislodgement of temporary cement-retained prosthesis Screw loosening Screw fracture Clasp loosening Porcelain veneer fracture Marginal bone resorption Mobility of implant
Embrasure 17       Once (1 person)   Once (1 person) Once (1 person)
Akers 4              
RPA 3              
Wrought wire 5 4 times (2 persons) Once (1 person) Twice (1 person)   Once (1 person)    
No clasp 8              
Table 7.
Complications according to the Kennedy classification
  Total RPDs Dislodgement of temporary cement-retained prosthesis Screw loosening Screw fracture Clasp loosening Porcelain veneer fracture Marginal bone resorption Mobility of implant RPD artificial fracture tooth Opposing tooth fracture/mobility
I 4 4 times (2 person)   Twice (1person)            
II 5   Once (1 person)     Once (1 person)   Once (1 person)   Twice (1 person)
III 0                  
IV 2       Once (1 person)   Once (1 person)   Once (1 person)  
Table 8.
Complications according to the type of opposing dentition
  Total RPDs Dislodgement of temporary cement-retained prosthesis Screw loosening Screw fracture Clasp loosening Porcelain veneer fracture Marginal bone resorption Mobility of implant RPD artificial fracture tooth Opposing tooth fracture/mobility
Natural teeth dentition 4 Thrice (1 person) Once (1 person) Twice (1 person)   Once (1 person)   Once (1 person)    
FPD 4 Once (1 person)               Twice (1 person)
RPD 1               Once (1 person)  
CD 2       Once (1 person)   Once (1 person)      
TOOLS
Similar articles