Abstract
ObjectiveThe aim of this study was to evaluate whether increased crown-to-implant (C/I) ratio influences implant stability or not under proper healthy control of peri-implant mucosa. The hypothesis of this study is that implant stability can be maintained despite High C/I, under appropriate plaque control.Materials and MethodsFive male Beagle-Labrador hybrid dogs (2 years old) were used. Their bilateral mandibular premolar extraction was performed. After allowing 12 weeks for bone healing, 3 types of vertical marginal bone loss were simultaneously prepared randomly. Then, 30 titanium implants were placed in the edentulous areas and defined as High C/I, Mid C/I and Low C/I groups. This time point was designated as the baseline (0 Week). Twelve weeks after implant placement, metal superstructures were cemented to the implants and an occlusal plate was set at the opposite side. At the same time, Calcein green was injected for remodeling evaluation. Implants were loaded by feeding the dogs a hard pellet diet. Tooth brushing was performed 5 days per week during the study to maintain healthy peri-implant mucosa. Twenty-four weeks following implant placement, the interface structure was evaluated clinically, radiologically, and histologically.ResultImplant stability quotient (ISQ) increased with time in all 3 groups, without any significant correlation with the C/I value (p >0.05). Moreover, mean marginal bone loss adjacent around implants in all 3 groups ranged between 0.11 and 0.19 mm, with no significant difference (p >0.05). Many fluorescence-labeled bones are shown in the High C/I group. It is considered that high remodeling activity prevent marginal bone loss in the High C/I group and this may provide favorable implant stability under proper plaque control.ConclusionThese findings suggest that increased C/I may not be a risk factor for implant failure if the peri-implant mucosa is kept healthy, as was the case in this animal model.
Highlights
Osseointegration [1] is defined as direct contact between bone and implant with no soft tissue intervention, and is regarded as a prerequisite for long-term implant success [2,3]
It is considered that high remodeling activity prevent marginal bone loss in the High C/I group and this may provide favorable implant stability under proper plaque control. These findings suggest that increased C/I may not be a risk factor for implant failure if the peri-implant mucosa is kept healthy, as was the case in this animal model
The hypothesis of this study is that implant stability can be maintained despite High C/I, under appropriate plaque control
Summary
Osseointegration [1] is defined as direct contact between bone and implant with no soft tissue intervention, and is regarded as a prerequisite for long-term implant success [2,3]. The criteria for implant success were defined at a conference in Toronto in 1998 [4] : individually unattached implants should be immobile when tested clinically and mean vertical bone loss should be ,0.2 mm 12 months following implantation. In recent years, periimplantitis has come to be regarded as a major factor for loss of osseointegration, resulting in implant failure. Excessive periimplant bone loss leads to a higher crown-to-implant (C/I) ratio, altering the biomechanics of the implant [5]. C/I ratio is defined as the physical relationship between individual restorative items located both within and outside the bone [6].
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