Abstract
ObjectivesCompletion of adolescent growth represents the earliest time point for implant placement, yet craniofacial growth persists into adulthood and may affect implant position. We aimed to assess whether implants placed in the anterior maxillae of adults show angular changes over time.Material and methodsWe conducted a cephalometric pilot study in postpubertal patients with no growth disorders, skeletal malformations, or parafunctions. The patients received a single implant in the anterior maxilla and no orthodontic or orthognathic treatment afterwards. We measured angular changes of implants and central incisors on cephalograms taken immediately and after at least 5 years postoperatively with the Sella-Nasion line (SNL) and the nasal line (NL) as references. Changes in implant-SNL angles were the primary outcome.ResultsIn 21 patients (30.2 ± 11.5 years at surgery) after a mean follow-up of 8.6 ± 1.3 years, implant-SNL angles and implant-NL angles changed in 81% and 57% of implants, respectively. Implant-SNL changes ranged from 3° counterclockwise to 4° clockwise and were more prevalent in males (100% vs. 58%) and patients under 30 at surgery (85% vs. 63%); mean absolute differences were larger in males (1.8 ± 1.0° vs. 1.3 ± 1.4°) and patients under 30 at surgery (1.5 ± 1.4° vs. 1.1 ± 1.4°). Incisor-SNL angles and incisor-NL angles changed in 89% and 32% of incisors, respectively.ConclusionsImplants placed in the anterior maxillae of adults show modest angular changes over time.Clinical relevanceChanges in implant angles have potential functional and esthetic consequences.
Highlights
Osseointegration is a “functional ankylosis” similar to that observed in teeth following injuries [1, 2]
With regard to implant-Sella-Nasion line (SNL) angles, changes were found in 81% of implants
Based on a cephalometric analysis, we found that after a mean follow-up time of 8.6 years, 81% of implants placed in the anterior maxillae showed modest rotational changes ranging from 3° counterclockwise to 4° clockwise with reference to the SNL and 57% of implants showed rotational changes with reference to the nasal line (NL)
Summary
Osseointegration is a “functional ankylosis” similar to that observed in teeth following injuries [1, 2]. Like ankylosed teeth, do not follow the growth of the alveolar processes during eruption [3]. The placement of implants in growing jawbones results in the submersion of the implants over time, relative to adjacent erupting teeth [4]. In order to avoid this phenomenon, the earliest time point recommended for implant placement is following the end of adolescence, when growth is thought to be completed [5, 6]. With regard to dental implants, the clinical implications of this residual growth have largely been underestimated [11, 12]. Previous work has suggested vertical changes in implants as a result of continuous growth in adults [13, 14].
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