10 Years Experiences with Laser-Welded Titanium Frameworks on Implants

Objectives: Follow-up studies longer than 5 years are not available on laser-welded titanium frameworks. The purpose was to report and compare 10-year data on implant-supported prostheses in the edentulous mandible provided with laser-welded titanium and conventional gold-alloy frameworks. Methods: Altogether, 155 patients were consecutively treated with prostheses with two generations of fixed laser-welded titanium frameworks (test groups). A control group of 53 randomly selected patients with gold-alloy castings was used for comparison. Clinical and radiographic 10-year data was collected for the three groups. Cumulative Survival Rate (CSR); implants and Cumulative Success Rates (CSR); prostheses were calculated according to life table techniques, Log-rank test formally tested differences in CSR for prosthesis, and changes in bone resorption were analyzed with the Mann-Whitney U-test. Statistical significance: P<0.05. Results: All patients followed-up for 10 years (n-112) had still a fixed prosthesis in the mandible (CSR 100%). The overall 10-years CSR was 92.8% and 100% for titanium- and gold-alloy frameworks, respectively. Ten-year implant CSR was 99.4% and 99.6% for the test and control group, respectively. Average 10-year bone loss was 0.6 (SD 0.45) mm for the titanium group and 0.8 (SD 0.36) mm for the control group (p<0.05). The most common complications for titanium frameworks were resin or veneer fractures, soft tissue inflammation, and fractures (12.9%) of the metal frame. Loose and fractured implant screw components were below 3%. Conclusions: Excellent long-term results with 100% CSR could be achieved with the present treatment modality. Fractures of the metal frames and remade prostheses were more common for the laser-welded titanium frameworks, and the first generation of titanium frameworks worked poorly when compared to gold-alloy frameworks during 10 years (p<0.05). More average bone loss was observed for implants supporting gold-alloy frameworks during 10 years. The reasons for this difference are unclear.