Abstract
The present study aims to investigate clinical and patient-centered outcomes after the implant-supported rehabilitation of narrow ridges using a novel wedge-shaped implant. Forty-four patients were treated with the insertion of 59 tissue-level wedge implants (1.8 mm bucco-lingual width) in horizontally atrophic ridges (mean bone width 3.8 ± 0.4 mm). The main outcome measures were: implant stability quotient (ISQ), marginal bone loss (MBL) and patient morbidity. Fifty-eight implants were functioning satisfactorily after one year of loading (98.3% survival rate). ISQ values measured in the mesio-distal direction resulted significantly higher than those in the bucco-lingual direction at all time points (p < 0.001). Both mesio-distal and bucco-lingual ISQ values at 6-month follow-up resulted significantly higher than at 4-month follow-up (p < 0.001 for both). Mean MBL was 0.38 ± 0.48 mm at prosthesis delivery (6 months after implant insertion) and 0.60 ± 0.52 mm after one year of functional loading. The majority of patients reported slight discomfort related to the surgical procedure. Postoperative pain score was classified as mild pain on the day of surgery and the first postoperative day and no pain over the following five days. Within the limitations of the present study, the device investigated showed low morbidity and positive short-term clinical results in narrow ridges treatment.
Highlights
The progressive resorption of the alveolar ridge after tooth extraction may lead to different degrees of jaw atrophy, resulting in reduced horizontal or vertical dimensions of the bone crest or in a combination of the above [1]
Various surgical techniques [5,6,7,8] have been proposed to increase crestal bone width and implants inserted into augmented sites have shown functional and aesthetic satisfactory long-term results [9]
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Summary
The progressive resorption of the alveolar ridge after tooth extraction may lead to different degrees of jaw atrophy, resulting in reduced horizontal or vertical dimensions of the bone crest or in a combination of the above [1]. Blade implants presented various designs generally characterized by a rectangular shape with two flat surfaces facing buccal and lingual corticals and one or more abutments originating from the thin coronal section of the plate These implants showed a high failure rate [12,13] due to unpredictability in achieving primary stability, the type of loading protocol and postoperative complications. In 2014, based on new information, the Food and Drug Administration reclassified blade-form endosseous dental implants from class III (devices presenting potential high risk of illness or injury and needing pre-market submission for approval) to class II (low risk devices without the need of pre-market submission) [16] This measure paved the way for the introduction of the clinical use of novel implant shapes deriving from the blade implant concept, but exploiting current knowledge significantly improved the implant site preparation technique, surface treatment and prosthetic protocols. The aim of the present multicenter prospective cohort study is to evaluate clinical effectiveness and patient-centered outcomes after implant-supported rehabilitation of edentulous ridges with reduced horizontal width using a recently designed wedge-shaped implant
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