Four or 6 implants in the maxillary posterior region to support an overdenture: 5‐year results from a randomized controlled trial

Abstract

Objective

To compare clinical and patient‐reported outcomes when providing maxillary overdentures on 4‐bar and 6‐bar connected implants placed in the posterior region during a 5‐year follow‐up period.

Materials and methods

Sixty‐six fully edentulous patients with functional maxillary denture complaints and insufficient bone volume to allow implant placement were scheduled for a maxillary sinus floor elevation procedure with bone from the anterior iliac crest and randomized to receive either 4 or 6 implants in the posterior maxilla and 4 implants in the mandible. After 3 months of osseointegration, a bar‐supported overdenture was constructed. Maxillary implant survival, overdenture survival, clinical scores, peri‐implant bone height changes and patient satisfaction were assessed.

Results

Sixty patients completed the 5‐year follow‐up. Implant survival was 100% in the 4‐implants group and 99.5% in the 6‐implants group. No new overdentures had to be made in the 4‐implants group, three new overdentures were made in the 6‐implants group due to excessive wear of the denture base and teeth (90.9% overdenture survival). Clinical parameters did not differ significantly between groups. Mean marginal bone loss compared to baseline was 0.58±0.51 mm in the 4‐implants group and 0.60±0.58 mm in the 6‐implants group, respectively. Overall, patient satisfaction improved significantly, but did not differ between groups.

Conclusion

Following a bilateral maxillary sinus floor elevation procedure, a bar‐supported overdenture on 4 implants in the posterior maxillary region is not inferior to an overdenture supported by 6 implants after a 5‐year evaluation period in patients with functional maxillary denture complaints and marked posterior resorption.

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