Laser-welded titanium frameworks supported by implants in the partially edentulous mandible: a 10-year comparative follow-up study

Background: Comparative long‐term knowledge of different framework materials in the partially edentulous implant patient is not available. Purpose: To report and compare 10‐year data on free‐standing implant‐supported partial prostheses with laser‐welded titanium (test) and conventional gold alloy (control) frameworks. Materials and Methods: Altogether, 52 partially edentulous patients were consecutively provided with laser‐welded prostheses (n = 60) in the partially edentulous lower jaw (test group). A control group of 52 randomly selected patients with gold alloy castings (n = 60) was used for comparison. Clinical and radiographic 10‐year data were retrospectively collected and evaluated for both groups. Results: The overall 10‐year implant cumulative survival rate (CSR) was 93.0% (loaded implants, 96.4%), with a 10‐year implant CSR of 91.5 and 94.7% for test and control implants, respectively (p > .05). Out of a total of 22 lost implants, 17 implants (77.3%) were shorter than 10 mm. The overall 10‐year prosthesis CSR was 93.7%, with a corresponding 10‐year CSR of 88.4 and 100% for test and control groups, respectively (p < .05). Average 10‐year bone loss was 0.46 mm (SD 0.47) and 0.69 mm (SD 0.53) for the test and control groups (p < .001), respectively. Only 1% of the implants had >3 mm accumulated bone loss after 10 years. Altogether, 10 of the prostheses in both groups had implant component mechanical problems (8.3%). None of the frameworks or implants fractured, but more fractures of porcelain veneers were observed in the test group (p < .05). Conclusion: The protocol of implant treatment in the partially edentulous jaw functioned well during 10 years, although prosthodontic maintenance was required. However, laser‐welded titanium frameworks presented more problems as compared with gold alloy frameworks. More loaded implants were lost (p < .05), and higher incidence of porcelain chipping was noted in the test group (p < .05). However, bone loss was on an average lower for the test group during the 10 years of follow‐up (p < .001).