Implant-Retained Maxillary Overdentures on Milled Bar Suprastructures: A 10-Year Follow-up of Surgical and Prosthetic Care and Aftercare

Purpose: The aim of this study was to evaluate surgical and prosthetic care and aftercare of maxillary overdentures supported by six endosseous implants and a milled bar mesostructure with Ceka attachments. Materials and Methods: Thirty-nine consecutive patients with an edentulous maxilla who reported problems wearing a conventional maxillary denture were treated with an overdenture supported by six endosseous implants and a milled bar mesostructure (solid bar with position Ceka attachments). Prosthetic and surgical care and aftercare were scored from the first visit until 10 years after the augmentation of the maxilla. Patient satisfaction was assessed at the end of follow-up. Results: On the basis of problems patients experienced with wearing their conventional dentures, three groups of patients were distinguished: patients with lack of retention of their conventional maxillary denture related to anatomic problems (n = 24), patients with gagging problems (n = 9), and patients not tolerating a conventional maxillary denture due to subjective problems not related to an anatomic substratum (n = 6). The need for care and aftercare was comparable between the three groups. The overall 10-year implant survival rate was 86.1%. Loss of implants occurred mostly during the first year after placement. Surgical aftercare predominately consisted of care related to the removal and replacement of implants (ie, reaugmentation, replacement of implants, and abutment connection). Prosthetic aftercare consisted mainly of routine inspections, oral hygiene care, and activation or replacement of Ceka attachments. Finally, all patients functioned well with their overdentures and remained satisfied throughout the study. Conclusion. Irrespective of the mentioned underlying reasons for not functioning with a conventional maxillary denture, an implant-retained maxillary overdenture, opposed by either an implant-retained mandibular overdenture or natural dentition, was shown to be an effective, predictable, and reliable treatment option that did not need much aftercare other than adjustments of the Ceka attachments. Int J Prosthodont 2009;22: 181-192