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

The aim of the present prospective study were to describe the quality of im plant supported reconstructions made by dentists previously inexperienced w ith implant prosthodontics and to evaluate alterations and complications fr om the moment of insertion to 3 years later. Before starting with the prost hodontic work, the dentists had participated in a 2-day postgraduate course focusing on planning and practical training. Forty-nine patients were clin ically examined within 4 months after insertion of the fixed implant suppor ted prosthesis. Three years later 39 of the 49 participants underwent a sec ond examination by the same independent examiner. Thirty-one patients had a complete rehabilitation (25 with resin teeth bonded to a metal framework a nd 6 ceramo-metal bridges); 8 patients had partial ceramo-metal reconstruct ions. The parameters assessing the quality of the restoration were design, fit, occlusion/articulation and esthetics. Oral hygiene and health of the p eri-implant tissues were also examined. Each parameter was scored as perfec t, acceptable, to be corrected or to be redone. These scores were a modific ation of "The guidelines for the assessment of clinical quality and profess ional performance of the Californian Dental Association". The initial prost hodontic quality was rated perfect to acceptable except for one restoration which had an unacceptable fit and had to be modified. After 3 years of fun ction the quality did not change except for esthetics which worsened for re sin bonded teeth (P<0.05). The esthetic appearance of ceramo-metal reconstr uctions were unaltered. The peri-implant condition was predominantly health y and stable during 3 years. The conclusion of the present study is that de ntists 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.