Factors Related to Early Marginal Bone Loss in Dental Implants—A Multicentre Observational Clinical Study

Marielle Bazzo Di Domênico,Mateus Bertolini Fernandes Dos Santos,Kauê Farias Collares,Mutlu Özcan,Pedro Henrique Corazza,César Dalmolin Bergoli

doi:10.3390/app112311197

Marielle Bazzo Di Domênico, Mateus Bertolini Fernandes Dos Santos + Show 4 more

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https://doi.org/10.3390/app112311197

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Abstract

This study evaluated the effect of clinical and patient-related factors on marginal bone loss. The sample was composed of individuals who were treated at two dental schools in southern Brazil. The variables evaluated were divided into individual (age, sex, diabetes, hypertension and antihypertensive use), and implant levels (arch, position, brand, protection, torque, time). After implant installation and following the second stage, periapical radiographs were obtained to measure the distance between the peri-implant bone crest and implant platform. Measurements were performed using ImageJ software. Data were analyzed using linear and Poisson multilevel regression. Fifty-eight patients with 113 implants were evaluated. The mean marginal bone loss was 0.45 ± 0.48 mm. Considering the linear multivariate model, age, diabetes, torque and time between surgery and reopening were found to be significant (p < 0.05). In the dichotomous model (bone loss <0.2 mm and ≥0.2 mm), only high torques resulted in higher marginal bone loss (p = 0.033). Marginal bone loss occurred before the second surgical stage and was greater in implants with high torque. Torque below 20 N, reopening performed after six months, diabetic status and young age all resulted in higher marginal bone loss, but these values are probably not clinically significant. These variables must be better explored in future studies.

Highlights

The marginal bone loss (MBL) of implants is one criterion used to determine the success rate of rehabilitation [1]
Insertion torque is the force required for the implant to lock in the bone structure, expressed in newton centimeters (Ncm) [8]
Considering the average difference in MBL between regular and high torque and the study sample size, the analysis showed a power of 89.8%

Summary

Introduction

The marginal bone loss (MBL) of implants is one criterion used to determine the success rate of rehabilitation [1]. Osseointegration has been defined as a direct and functional connection between the bone and an artificial implant Both bone quality and quantity can influence the success of these procedures [6]. The optimal torque value depends on the manufacturer’s recommendations, but it is usually between 30 and 40 Ncm [9], and the higher the insertion torque, the greater the tension in the region. This may be associated with peri-implant bone injury and difficulties in vascularization, contributing to osteocyte necrosis, and resulting in microfractures in the cortical bone, extensive bone remodeling and minimal bone formation [10]

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