Implant-supported welded titanium frameworks in the edentulous maxilla: a 5-year prospective multicenter study

Area of Science:

• Dental Implantology
• Prosthodontics
• Biomaterials Science

Background:

• Fixed implant-supported prostheses are crucial for restoring function in edentulous maxillas.
• Framework material selection impacts long-term prosthesis performance and patient outcomes.
• Evaluating novel materials like welded titanium against traditional alloys is essential for clinical decision-making.

Purpose of the Study:

• To compare the 5-year clinical and radiographic performance of fixed implant-supported maxillary prostheses with welded titanium versus conventional cast-gold alloy frameworks.
• To assess implant survival and success rates for both framework types.
• To evaluate prosthesis survival and success rates over a 5-year period.

Main Methods:

• A randomized controlled trial involving 58 patients with 349 osseointegrated implants in the edentulous maxilla.
• Patients received prostheses with either laser-welded titanium (n=28) or cast-gold alloy (n=30) frameworks.
• Clinical and radiographic data were collected for 5 years post-prosthesis placement.

Main Results:

• Both titanium and cast-gold framework groups showed similar cumulative survival and success rates (CSR) for implants and prostheses.
• 5-year implant CSR ranged from 91.4% to 94.0% (from placement) and 94.9% to 95.6% (from delivery).
• 5-year prosthesis CSRs were 96.4% (titanium) and 93.3% (cast-gold); average bone loss was 0.59 mm with no significant difference between groups.

Conclusions:

• Welded titanium frameworks exhibit comparable clinical performance to cast-gold alloy frameworks in fixed implant-supported maxillary prostheses.
• The study confirms favorable 5-year outcomes for both material types in the edentulous maxilla.
• Implant failures were infrequent and concentrated in a small number of patients within each group.