Failures and complications in 391 consecutively inserted fixed prostheses supported by Brånemark implants in edentulous jaws

Difficulties associated with implant-supported restorations during the first year following insertion were evaluated in this retrospective clinical study. Three hundred eighty-four consecutive patients were treated at the Brånemark Clinic (Göteborg, Sweden) with 2199 fixtures in 391 arches. Fixed restorations were made using a one-piece casting of a Type III gold alloy and a passive fit for each framework was verified. The posterior cantilever measured 15 to 20 mm (maxillary) and 7 to 12 mm (mandibular). Acrylic resin or composite resin teeth were used for the restorations. Failure occurred in 1.1 percent of the fixtures before loading and in 0.6 percent within the first year after loading. The most common prosthetic problems 1 year after prosthesis insertion were difficulties in diction in 31.2 percent of patients with maxillary prostheses and cheek/lip biting in 6.6 percent of patients with mandibular restorations. Other problems reported included fracture of the resin teeth, hyperplasia, fistulas, esthetic problems, and pontic irritation. More difficulties were encountered with maxillary restorations. No gold screw, abutment, or implant screw fractures were reported. Prosthesis retrievability was cited as a major factor in the management of various problems.