Prosthetic aspects of osseointegrated fixtures supporting overdentures. A 4-year report

Eighty-six consecutive patients, provided with 84 resilient and two nonresilient overdentures (six in the upper and 80 in the lower jaw), were examined. The overdentures were supported by a total of 173 osseointegrated titanium fixtures (the standard Branemark abutment), with a mean loading time of 19.1 months (range 4 to 48 months). In each jaw only two fixtures anchored the overdentures. No failures occurred during the observation period but two fixtures were lost before loading. The radiographic annual bone loss around fixtures in the lower jaw was -0.8 mm for the first year and less than -0.1 mm for the following years. The change in marginal bone height did not correlate with parameters such as the occlusion and articulation pattern, the presence or absence of a soft liner around the abutments, and the magnitude of the interabutment distance. The patients' reactions to overdenture treatment were, on the whole, positive concerning chewing function, phonetics, and comfort. The need for maintenance care of the clip-bar attachment was minimal.