Clinical performance and implant stability of cement versus implant-retained and/or supported prostheses: A randomized controlled trial

Statement of problem While implant-retained and/or supported mandibular prostheses have become an essential prosthetic alternative in complete edentulism, the biological response of implants supporting different digitally produced prostheses has not been thoroughly compared regarding the effect of 3-dimensionally (3D) printed overdentures versus milled fixed prostheses on implant stability and clinical indices.Purpose The purpose of this study was to compare the effect of digitally fabricated mandibular fixed and removable implant-retained and/or supported prostheses on implant stability and peri-implant clinical outcomes.Material and methods This study included 18 randomly distributed participants: group OD received 3D printed implant-retained and/or supported overdentures, and group FX received cement-retained milled prostheses. Guided flapless implant placement was performed, followed by digital scanning and computer-aided design and computer-aided manufacturing (CAD-CAM) fabrication of the prostheses. Repeated measures ANOVA followed by the Tukey post hoc test for parametric data and the Friedman test followed by the Dunn post hoc test for nonparametric data were used to evaluate longitudinal changes (α=.05).Results No significant intergroup differences were observed for implant stability, pocket depth, plaque index, bleeding index, or gingival index at any time point (P>.05). For OD and FX groups, implant stability increased significantly over time (except 9 versus 12 months in FX; P=.061), while pocket depth, plaque, and bleeding indices remained stable (P>.05), and gingival index showed a significant difference (PConclusions Both groups demonstrated favorable 1-year clinical outcomes, with significant improvements in implant stability and stable peri-implant parameters (pocket depth, plaque, bleeding, and gingival indices), showing no between-group differences.