A 10-year Retrospective Study on Full-Arch Implant Prostheses: Comparison of Ceramic and Toronto Bridges.

Abstract

Purpose: To compare the survival, success rate, and technical complications of two immediately loaded fixed prosthetic designs- full-arch ceramic prostheses and full-arch Toronto bridges- at a 10-year follow-up.

Materials and methods: Patient records from 2009 to 2012 at the Tuscan Stomatological Institute were retrospectively analyzed. Individuals treated with immediately loaded; full-arch prosthetic restorations were divided into two groups: Group A (full-arch ceramic prostheses) and Group B (Toronto bridges with acrylic resin occlusal surfaces and metal frameworks). Data on implant/prosthesis survival, success, and complications were collected over a 10-year follow-up. Survival was assessed with Kaplan-Meier analysis and log-rank tests (p < 0.05).

Results: Fifty-six patients received 60 full-arch ceramic prostheses supported by 450 implants, and 62 patients received 70 Toronto bridges supported by 410 implants. Five early dental implant failures occurred, all replaced without compromising final prostheses. Over 10 years, 20 patients experienced implant loss: 6 implants in Group A and 14 in Group B. Prostheses with failing implants generally required replacement. There was a significant difference (p=0.0004) in cumulative survival rates between maxillary full-arch ceramic (90.6%) and Toronto bridges (73.7%). Moreover, mandibular Toronto bridges showed significantly higher cumulative survival rate (87.5%) compared with maxillary Toronto bridges (73.7%, p = 0.0002). Fractures and chipping were more common in full-arch ceramic prostheses, leading to a 10-year cumulative success rate of 69.4%, whereas detachments occurred more frequently in Toronto bridges, with a final success rate of 65.2%. Despite these differences, no significant intergroup differences in overall prosthesis success were observed, with 10-year cumulative success rates ranging between 60% and 71% in both groups.

Conclusions: Both full-arch ceramic prostheses and Toronto bridges proved to be reliable rehabilitation strategies over 10 years. Fractures were more common in ceramic restorations, while detachments prevailed in Toronto bridges. Ceramic prostheses showed higher survival rates, especially in the maxilla. Overall, long-term success rates were comparable between the two treatments.