Prefabricated taper crowns for the retention of implant superstructures: Three-year results of a prospective clinical trial

Statement of problem

Nonrigid retainer systems for removable implant superstructures are associated with negative effects such as rocking and increased load on the denture base. Rigid retainer systems such as telescopic crowns reduce these negative effects, but their fabrication demands highly skilled dental technicians and is therefore expensive. Whether a protocol with prefabricated retainers will reduce production time is unclear.

Purpose

The purpose of this prospective clinical trial was to evaluate a prefabricated telescopic retainer and a treatment protocol including the intraoral luting of a framework.

Material and methods

A total of 23 participants (15 women and 8 men with a mean age of 61.6 ±2.9 years) were included. After 3 dropouts, 21 removable dentures (9 mandibular and 12 maxillary) retained by 91 delayed loaded Ankylos implants were investigated. All implants were restored with prefabricated conically shaped abutments (SynCone-abutment). The prefabricated corresponding cone matrix was assembled intraorally into a metal frame with autopolymerizing resin. After a loading period of 3 years, a follow-up examination investigated the fit of the framework, the prosthetic aftercare, the technical failures, and the retention force. A questionnaire was used to evaluate participant satisfaction. In addition, laboratory fabrication time and costs were compared with those of individually fabricated restorations.

Results

One mandibular implant was lost after 25 months (survival rate, 98.9%). The removable dentures showed no apparent rocking and minimal prosthetic maintenance during the 36-month trial. No dentures required relining. The retention force was scored as good in 17 participants and high (with 6 implants in the maxilla) and low (with 2 implants in the mandible) in 2 participants each. No technical failures occurred. An assessment of laboratory fabrication time and costs revealed reduced time and costs. Patient satisfaction was significantly increased (P<.001) over the entire observation time.

Conclusions

The SynCone retainer presented a time- and cost-efficient treatment option with sufficient long-term retention for removable dentures and high patient satisfaction. Mandibular prostheses restored with 2 implants had limited success.