Clinical Outcome of Immediate Loading UV-Photofunctionalized Implants in Patients with Completely Edentulous Mandible, Placed with Guided Surgery.

Abstract

The purpose of this study was to evaluate clinical results of immediate loading UV-photofunctionalized dental implants placed using guided surgery in patients with completely edentulous mandible. In this study, 58 fully edentulous patients were treated with immediate loading implant-supported mandibular prostheses. All patients underwent a thorough clinical examination according to the generally accepted scheme; qualitative and quantitative parameters of the jaw bones patients were diagnosed with cone beam computerized tomography (CBCT). Surgical templates modeled in the 3 Shape software were made from biocompatible polymeric materials and provided with depth-calibrated drill sleeves for preparing osteotomies using a 3D printer (Stratasys). Before short implant placement, ultraviolet functionalization of implant surfaces was performed by UV Activator YWJ-QSY001 (Foshan, Wenjian Medikal Enstriman) in the device for 20s. After flapless surgery, implant sockets were prepared with guided surgery and implants were placed through the sleeves of the surgical template tightening torque of 35-45 Ncm. An implant-supported temporary prosthesis made of acrylic resin was installed 6h after implantation. Final dental prosthetics was performed 2months after implant placement.The patients had 128 short (length 5-6mm, diameters 4,5-5mm) and 256 implants with length greater than 10mm in bone segments with sufficient bone parameters. The following parameters were assessed: implant success, prosthetics survival and changes in peri-implant marginal bone loss(MBL). During a clinical examination, no serious biological or prosthetic complications have been reported. The esthetic result evaluated from patients was excellent. The mean ISQ of short implants was 69.2 ± 8 for primary stability at implant placement and 73.6 ± 4 ISQ after 3months. The mean of implants with length greater than 10mm was 71,2ISQ at implant placement, respectively, and 75,6 ISQ after 3months. After 3months of prosthetic loading for short implants marginal bone loss (MBL) 0.74mm, after 1year of MBL 11.21mm, after 5years of MBL 1,37mm, for implants with length greater than 10mm after 3months of MBL 0.72mm, after 1year of MBL 1.19mm and after 5years of MBL 1.35. There was no statistically significant difference in clinical indices between short and standard implants. After 5years of follow-up, stable levels of bone tissue around the implants and healthy tissues around the implants were recorded, and postoperative occlusal function was favorable. The success rates of the short implants in maxilla were 95.5%, and the success rates of the short implants in mandible were 98.7%. The success rates of the implants with length greater than 10mm in maxilla were 97.8%, and the success rates of the implants with length greater than 10mm in mandible were 98.8%. Computer-guided implant surgery and immediate loading of UV-photofunctionalized implants in patients with completely edentulous mandible are a predictable and effective method with a minimum rehabilitation period.