Postmortem evaluation of mandibular implant-supported fixed complete denture after 30 years of service (original) (raw)

2018, Journal of Prosthetic Dentistry

Brånemark et al 1 introduced osseointegrated implant-supported prostheses primarily for patients with severely debilitated ridges who could not wear conventional dentures. Since that time, a mandibular implant-supported fixed complete denture opposing a maxillary complete denture has become a popular treatment option, providing excellent function for patients with complete edentulism. Although many studies have reported high success rates for dental implant treatment, long-term clinical studies that exceed 20 to 30 years are scarce. 2-6 A recent retrospective study reported that 88% of implantsupported prostheses for patients with complete edentulism were free of implant failure at 20 years. 7 However, postmortem studies on implants supporting fixed complete dentures in service for between 20 and 30 years are also scarce. 8-10 Therefore, this postmortem examination was conducted to provide a comprehensive understanding of the implant-bone interface and prosthesis. Although this was a postmortem evaluation, the data reported here provide a comparable representation of the living human because all evaluations, except for the histomorphometric analysis, were performed on an unembalmed mandible containing 5 implants within 8 weeks of the donor's death. CLINICAL REPORT An 86-year-old woman donated her body to the University of Minnesota anatomy bequest program after successfully wearing a 5-implantesupported mandibular fixed complete denture for 30 years. The University of Minnesota's institutional review board determined that this study was exempt from the review. The woman's medical condition at death included osteoarthritis, vitamin B12 deficiency, degenerative disk disease, pneumonia, Sjögren's syndrome, total hip revision arthroplasty, appendectomy, gastroesophageal disorder, hypercholesterolemia, hypertension, macular degeneration, and osteoporosis. The cause of death was a non-small cell lung cancer. A review of the woman's dental history showed the provision of maxillary and mandibular conventional complete dentures in August 1982. In September 1985, 5 machined 3.75×13-mm external hexagon titanium implants (Brånemark System; Nobel Biocare Services AG)