Treatment concept of the edentulous mandible with prefabricated telescopic abutments and immediate functional loading

Purpose: The present paper demonstrates a new technique and long-term results of a treatment concept that uses four implants placed in the anterior mandible that are connected to prefabricated telescopic abutments and immediately loaded with removable restorations. Materials and Methods: The present retrospective study included 488 implants (Ankylos, Dentsply) placed in 122 patients (mean age: 65.2 ± 9.8 years) with clinical and radiographic evaluation for a period of at least 1 year. Eighty-four implants were placed in fresh extraction sockets and combined in the restorations with implants placed in healed ridges. All implants were placed 2 mm subcrestally (based on chart documentation, measured from the midfacial bone level). The implants were connected immediately after surgery to conical prefabricated abutments (angle of 4 to 6 degrees) using a final torque of 15 Ncm. Secondary prefabricated copings that fit the abutments were placed over the abutments after abutment connection, and the complete denture of each patient was relined chairside with methyl methacrylate resin. The prosthetic restorations were to remain in place for 10 days to ensure that the implants remained immobile. Results: After a mean of 79 ± 29.8 months (range, 17 to 129 months) only eight implants failed (1.6%). Twenty-one implants (4.3%) showed crestal bone loss greater than 2 mm relative to the implant position at the time of implant insertion. Therefore, the failure rate was 5.94% for the entire observation period. The success rate for the evaluated implants was 94.06%. The patients were satisfied with the stability of their prostheses, and no prosthetic or peri-implant problems were observed. Conclusions: These telescopic implant-supported restorations with immediate loading seem to be an alternative prosthetic solution for the edentulous patient, providing long-term implant stability.