Biologic complications in short implant-assisted versus conventional partial dentures.

A commentary on: Benzaquen S I, Ardakani M T, Tsigarida A et al. Biologic complications with removable partial dentures assisted by short implants: A 34-month pilot randomized controlled clinical trial. J Prosthet Dent 2025; https://doi.org/10.1016/j.prosdent.2025.01.026 .

Design: This single-centre, parallel-arm, pilot randomised controlled clinical trial (RCT) was conducted in accordance with CONSORT guidelines. The primary objective was to compare the incidence of biologic complications between conventional removable partial dentures (CRPDs) and short implant-assisted removable partial dentures (IARPDs) in patients with Kennedy Class I bilateral distal-extension edentulism. A secondary objective was to evaluate implant survival and peri-implant outcomes over a mean follow-up period of 34 months.

Case selection: Thirty-three partially edentulous adult participants (aged 36-87 years) were recruited. Included participants had sufficient bone height to accommodate 6 mm implants without the need for bone augmentation. A strict exclusion criteria included current smoking, uncontrolled diabetes, pregnancy or lactation, and use of immunosuppressive or antiresorptive medications. Random allocation to receive either CRPDs (n = 19) or IARPDs supported by two short implants (n = 14) was conducted after initial CRPD fabrication.

Data analysis: Both implant- and non-implant-related biologic complications were recorded at baseline and annual follow-up visits up to four years. Parameters included caries, gingival inflammation, abutment tooth loss, peri-implant mucositis, peri-implantitis, and marginal bone level (MBL) changes. Statistical analyses were performed using chi-square tests, Fisher's exact test and paired and unpaired t-tests, with significance set at p = 0.05.

Results: Non-implant biologic complications affected 44.7% of abutment teeth in the CRPD group and 21.4% in the IARPD group; however, this difference was not statistically significant (p > 0.05). The most common complications were gingival inflammation and caries. One abutment tooth was lost in the CRPD group versus none in the IARPD group. Peri-implant mucositis and peri-implantitis were observed in 42.9% and 10.7% of implants, respectively. Implant survival was 81.2%. Most MBL occurred prior to prosthetic loading, with minimal loss thereafter.

Conclusions: Both CRPDs and IARPDs are viable treatment options for patients with Kennedy Class I edentulism, with no significant difference in the incidence of biologic complications between groups.