Quality of fixed restorative treatment on Brånemark implants. A 3-year follow-up study in private dental practices

The aim of the present prospective study were to describe the quality of implant supported reconstructions made by dentists previously inexperienced with implant prosthodontics and to evaluate alterations and complications from the moment of insertion to 3 years later. Before starting with the prosthodontic work, the dentists had participated in a 2-day postgraduate course focusing on planning and practical training. Forty-nine patients were clinically examined within 4 months after insertion of the fixed implant supported prosthesis. Three years later 39 of the 49 participants underwent a second examination by the same independent examiner. Thirty-one patients had a complete rehabilitation (25 with resin teeth bonded to a metal framework and 6 ceramo-metal bridges); 8 patients had partial ceramo-metal reconstructions. The parameters assessing the quality of the restoration were design, fit, occlusion/articulation and esthetics. Oral hygiene and health of the peri-implant tissues were also examined. Each parameter was scored as perfect, acceptable, to be corrected or to be redone. These scores were a modification of "The guidelines for the assessment of clinical quality and professional performance of the Californian Dental Association". The initial prosthodontic quality was rated perfect to acceptable except for one restoration which had an unacceptable fit and had to be modified. After 3 years of function the quality did not change except for esthetics which worsened for resin bonded teeth (P < 0.05). The esthetic appearance of ceramo-metal reconstructions were unaltered. The peri-implant condition was predominantly healthy and stable during 3 years. The conclusion of the present study is that dentists previously inexperienced with implant prosthodontics implemented the information from a training course satisfactorily. They were able to make a clinically acceptable restoration with a quality that was stable after 3 years except for discoloration in resin bonded teeth. This, however, had no effect on patient's opinion and satisfaction.