FLAPLESS PLACEMENT AND IMMEDIATE LOADING OF TWO MANDIBULAR IMPLANTS RETAINING CROSS-ARCH FIXED PROSTHESES: A 13-YEAR FOLLOW-UP RETROSPECTIVE SINGLE COHORT STUDY

PURPOSE. To evaluate the 13-year clinical outcomes of two implants placed flapless in fully edentulous mandibles and immediately restored with a metal-resin screw-retained cross-arch prosthesis. MATERIALS AND METHODS. Eighty patients consecutively treated from June to November 2010 at a single centre with two immediately-loaded mandibular implants were recalled from June to October 2023. To be immediately loaded, implants had to be inserted with a minimum torque of 80 Ncm. Forty-six laser-welded titanium and 34 cast silver-palladium frameworks with resin teeth were initially delivered within 8 and 48 hours, respectively. Outcome measures were prosthesis and implant failures, complications, and patient sa-tisfaction. RESULTS. Thirteen years after loading, 12 patients (15%) were lost to follow-up and 14 prostheses (17.5%) failed or were remade. Seven implants failed in five patients (6.25%). Forty-six patients (57.5%) had at least one complication. Fifty-six (82.4%) patients were fully satisfied, 10 (14.7%) were partially satisfied, and two (2.9%) were unsatisfied. CONCLUSIONS. Mandibular cross-arch prostheses can be immediately loaded and retained by only two implants up to 13 years if made with a robust cast framework. A multi-centre trial confirming these results would be required to determine whether this conclusion could be generalized.