Abstract
This study evaluated retrospectively the association among occlusal, periodontal and implant-prosthetic parameters and marginal bone loss (MBL) around implants and survival rate at 5.7 ±3.2 years of follow-up after prosthetic loading. Eighty-two patients received 164 external hexagon implants. After the standard healing period (3 to 6 months), the implants were restored with single-tooth or up to three splinted crowns. All patients were followed according to a strict maintenance program with regular recalls and clinically evaluated by a calibrated examiner. The MBL measurements taken from standardized radiographs made at permanent crown placement (baseline) and after the last evaluation were calculated considering occlusal, periodontal and implant-prosthetic parameters. Veneer fractures and abutment loosening were not considered failure. Two implants failed during the follow-up period, resulting in a survival rate of 98.8%. Cox regression analyses showed MBL associated with non-working side contacts (p=0.047), inadequate anterior guidance (p=0.001), lateral group guidance involving teeth and implants (p=0.015), periimplant plaque index (p=0.035), prosthetic design (p=0.030) and retention (p=0.006). Inadequate occlusal pattern guide, presence of visible plaque, and cemented and splinted implant-supported restoration were associated with greater MBL around the implant.
Highlights
Despite the excellent survival rates of dental implants, long-term studies have shown 1.5 to 2 mm of bone loss around the implant neck during the first year after functional loading [1,2] and an annual rate of marginal bone loss (MBL) around 0.2 mm, after the first year [3]
Progressive chronic peri-implant infection and overload together with the host characteristics are considered as major etiological factors causing late failures [5]. It seems that infection alone cannot cause progressive bone resorption, but overloading associated with marginal peri-implant infection could certainly result in MBL and implant failure [6,7]
This study evaluated retrospectively the association among occlusal, periodontal and implant-prosthetic parameters and MBL around implants and survival rates at 5.7±3.2 years of follow-up after prosthetic loading
Summary
Despite the excellent survival rates of dental implants, long-term studies have shown 1.5 to 2 mm of bone loss around the implant neck during the first year after functional loading [1,2] and an annual rate of marginal bone loss (MBL) around 0.2 mm, after the first year [3] Among other factors, this acceptable bone loss is most likely due to occlusal forces directed on the bone, which responds mechanically to this situation, remodeling it naturally [4]. Progressive chronic peri-implant infection and overload together with the host characteristics are considered as major etiological factors causing late failures [5]. Several aspects concerning implant survival rate and peri-implant bone loss have been reported, [1,2,3,4,5,6,7,8,9,10,11] there is still lack of clinical investigations in humans considering the role of unsuitable occlusal factors on the establishment and maintenance of oral implant osseointegration [12,13,14], together with implant-prosthetic and periodontal parameters
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