From practitioner to practitioner - ZZI 02/2015

Clinical experience with various prosthetic materials for circular fixed bridges on tilted implants

Introduction: The treatment of edentulous jaws with circular bridges and a reduced number of implants has become an established treatment option. For the prosthetic restoration various treatment concepts are available that have been investigated in this retrospective study of possible risk factors.

Material and method: In a period from May 2008 to September 2013 a total number of 54 patients received 62 fixed bridges in the mandible or maxilla. 26 fixed bridges were delivered in group A with a metal or zirconium oxide framework and ceramic veneering. In group B, after the temporary restoration a metal framework with the veneering by prefabricated composite veneers was used in 29 jaws. In group C, the superstructures were made by high performance poly-mer framework and the fixation of prefabricated composite veneers in 7 jaws.

Results: In group A, 3 bridges showed a smaller chipping with the loss of one or more superficial layers of the ceramic veneering. For one bridge a deep fracture of the veneering occured. Two patients did not accept the superstructure, since at maximum intercuspidation a very rigid bit down was felt without damping behavior. Two patients were disappointed because the temporary restoration with the composite veneers was classified as aesthetically pleasing to the ceramic supply. In group B, there was a flaking of the composite veneer, after a previously well-controlled oromandibular dysfunction due to current stress load started again. In 2 patients with a renewed high nicotine consumption of 30 and 40 cigarettes per day after 29 and 42 months, an extra-oral polishing and revision of the bridges was necessary. In group C no complications were evident in the short follow-up period.

Conclusion: The use of composite veneers for a circular fixed bridge shows a high aesthetic acceptance at a low rate of complications requiring treatment. Subjects with impaired compliance or a history of functional disorders are particularly suitable for a composite veneered superstructure, as these can be easily, quickly and inexpensively repaired. The application of ceramic-filled PEEK resin enables a cost-effective framework fabrication and shows after the first application phase no noticeable complication.

Keywords: implant number; angled implant position; chipping; resin framework; complication; patient acceptance

Zitierweise: Neugebauer J et al.: Klinische Erfahrungen mit unterschiedlichen prothetischen Werkstoffen bei zirkulären festsitzenden Brückenversorgungen auf angulierten Implantaten. Z Zahnärztl Implantol 2015;31:140–149

DOI 10.3238/ZZI.2015.0140–0149