Mandibular Overdentures vs All-on-4 With PEEK
Long-Term Peri-Implant Outcomes of Mandibular Overdentures and All-on-4 Prostheses With PEEK Frameworks
Menoufia University
40 participants
Aug 1, 2025
OBSERVATIONAL
Conditions
Summary
This study compares long-term peri-implant outcomes between two mandibular full-arch rehabilitation approaches-four-implant-retained overdentures and All-on-4 fixed prostheses-when both are fabricated with polyetheretherketone (PEEK) frameworks. While overdentures and All-on-4 prostheses are widely used, evidence on the clinical performance of PEEK frameworks in these modalities is scarce. By evaluating marginal bone loss and other peri-implant parameters, the research aims to clarify whether prosthetic design influences biological outcomes when using this high-performance polymer.
Eligibility
Inclusion Criteria11
- Adults aged ≥40 years.
- Completely edentulous mandible for at least 6 months prior to implant placement.
- Treated with either:
- Four-implant-retained mandibular overdenture with a PEEK framework, or
- Mandibular All-on-4 fixed prosthesis with a PEEK framework.
- All implants placed in the lateral incisor and first premolar regions (per respective protocol).
- Restorations fabricated via CAD/CAM-milled PEEK framework with acrylic denture teeth.
- Prosthesis delivered with a delayed loading protocol.
- Minimum clinical and radiographic follow-up of 4 years.
- Availability of standardized baseline and follow-up periapical radiographs for marginal bone level assessment.
- Treated by the same surgical and prosthodontic team.
Exclusion Criteria10
- History of uncontrolled systemic diseases that could affect bone healing (e.g., uncontrolled diabetes, osteoporosis under bisphosphonate therapy).
- History of head and neck radiotherapy.
- Active periodontal or peri-implant infection at the time of implant placement.
- Insufficient bone volume in the interforaminal region requiring grafting beyond minor augmentation.
- Heavy smoking habit (>10 cigarettes/day) at the time of treatment.
- Parafunctional habits (e.g., severe bruxism or clenching) documented in patient records.
- Use of medications known to affect bone metabolism (e.g., high-dose corticosteroids, antiresorptive drugs).
- Pregnancy at the time of implant placement.
- Incomplete clinical or radiographic records.
- Follow-up period of less than 4 years.
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Interventions
Group I: Four-implant-retained mandibular overdenture with a CAD/CAM-milled PEEK framework and acrylic denture teeth, retained via attachment mechanisms; implants placed in lateral incisor and first premolar sites; delayed loading protocol. Group II: Mandibular All-on-4 fixed prosthesis with a CAD/CAM-milled PEEK framework and acrylic denture teeth; two anterior straight and two posterior tilted implants placed in lateral incisor and first premolar sites; delayed loading protocol.
Locations(1)
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NCT07137533