Fixed and removable implant-supported restorations for edentulous maxilla have similar clinical performance

A study was conducted to analyze and compare the costs of different prosthetic rehabilitations for the edentulous maxilla.

Edentulism, the loss of all-natural teeth, is a debilitating and irreversible condition. While there is a downward trend in edentulism in several countries, it is region-specific, and the need for rehabilitation of edentulous patients is likely to remain relevant for the foreseeable future.

Edentulism is thus still an important public health issue globally, associated with considerable disability. For the edentulous patient, there are basically three rehabilitation strategies: removable complete denture (RCD), implant-supported overdenture (ISOD), or implant-supported full-arch fixed dental prosthesis (ISFAFDP). RCD provides the least expensive treatment among these three rehabilitation options, but there is sometimes a considerable dissatisfaction among patients with RCDs, essentially related to suboptimal retention, adaptation difficulties and the ensuing sense of insecurity. Patients with edentulous maxillae were rehabilitated with either of three implant-supported prosthetic protocols; removable overdenture supported by 2 implants (ISOD 2), fixed dental prostheses supported by 4 (ISFAFDP 4) or 6 (ISFAFDP 6) implants. Cost of treatment and costs during follow-up were registered and compared.

The results of the study are:

• Twenty-four patients were included: six patients received ISOD 2 treatment, eight patients received ISFADP 4 treatment and ten patients received ISFADP 6 treatment.
• Initial costs for ISFAFDP 6 were higher than costs for ISFAFDP 4 and ISOD 2, but there were no differences in cost for maintenance i.e., the ISOD treatment remained the least costly treatment alternative after a 1-year follow-up.
• The lack of difference in cost for maintenance and repair over the first year suggests that implant-supported overdentures will remain the least costly treatment option for the edentulous maxilla, at least from a short-term perspective.

Thus, Removable maxillary overdentures supported by 2 implants may be a valid low-cost treatment option.

Reference:

Comparative cost analysis of different prosthetic rehabilitations for the edentulous maxilla: early results from a randomized clinical pilot study by Peyman Ghiasi et al. published in the BDJ Open.

DOI

https://doi.org/10.1038/s41405-022-00100-0