Fixed/Removable Full Arch Implant-Supported Prostheses: Analysis of Published Data

Fixed/Removable Full Arch Implant-Supported Prostheses: Analysis of Published Data
M. ALI, Y. ISMAIL, J. CLOSE, M. SHMERELZON, and B. LEUNG, University of Pittsburgh, PA, USA
March 2004
Clinical Implant Studies
Objectives: Treatment options for the completely edentulous arches include implant supported fixed prostheses and implant supported removable prostheses. The removable prostheses had been advocated because of lesser cost, less demanding oral hygiene for the elderly, and better support for the oral-facial soft tissues. On the other hand, the implants' survival and prostheses' serviceability of either option has not been properly addressed.
Methods: A literature search was conducted using the bibliographic database MEDLINE for the past 20 years regarding the effectiveness of both treatment options for full arch implant restoration. Thirty-four articles were obtained according to pre-identified inclusion criteria. Fifty-eight observations of prostheses type (31 implant supported fixed prostheses, and 27 implant supported removable prostheses) and location (27 maxillary and 31 mandibular arches), were included for a follow up time of 1-15 years. The number of implants for support of prostheses was also evaluated and the survival rate of implants was calculated. T-tests and logistic regression were utilized to analyze the findings.
Results: The results indicated no significant difference in survival rate between prostheses types (fixed or removable) and location (maxilla or mandible) during the first five years of function (p>0.06). However, the survival rate of fixed prostheses was significantly higher for over five years follow up periods (p<0.0001). A positive relationship between the number of implants and survival rate of both prosthesis types was also observed.
Conclusion: Based on these results, it was concluded that implant supported fixed prostheses are more favorable due to better survival rate, and that increasing the number of implants for support of removable prostheses is recommended to improve their survival rate.