Evaluation Of Marginal Bone Levels Research Articles

Radiographic evaluation of marginal bone levels around implants supporting splinted fixed bridges: A retrospective study on 412 implants.

The effect of the implant position within the prosthesis on bone remodeling is scarcely documented so far. Thus, the aim of the present study was to investigate whether central implants may suffer higher peri-implant marginal bone levels (MBL) compared to laterals in case of fixed splinted bridges supported by ≥ three implants. Partially edentulous subjects rehabilitated with at least one fixed bridge supported by ≥ three dental implants were enrolled. MBL was assessed radiographically by means of intraoral radiographs acquired with phosphor plates and imported in a dedicated software. MBL was calculated as the distance between the implant platform level and the most coronal visible bone-to-implant contact. A three-level linear mixed effects model was used for investigating the fixed effect of patient-, prosthesis-, and implant-level variables on the MBL. Overall, 90 patients rehabilitated with 130 splinted fixed bridges supported by 412 implants were included. The median follow-up was 136 months. The mean peri-implant MBL resulted statistically significantly higher at central implants if compared to lateral implants (p < .01). The estimated MBL averages for central and external implants were 1.68 and 1.18 mm, respectively. The prosthesis-level variables suggested that a cement-retained bridge was prone to a significant 0.82 mm higher MBL than a screw-retained one. Implant surface showed an association with MBL changes, although less pronounced than implant retention. In case of ≥3 adjacent implants supporting splinted bridges, central implants were more predisposed to MBL compared to laterals. At the prosthesis level, implants supporting cement-retained bridges were statistically more susceptible to MBL compared to screw-retained ones. Surface characteristics can also influence MBL stability at the implant level.

Clinical and Radiographic Evaluation of Marginal Bone Level (BL) in Two Implant-Retained Mandibular Overdenture With Lingualized Occlusion (LO): A Six-Year Clinical Trial.

The objective of this research was to assess the marginal bone loss and stability in a lingualized occlusal scheme with implant-supportedmandibular overdenturesas a viable solution for individuals experiencing difficulties with the retention of conventional mandibular dentures. The study assessed the marginal bone level (BL) using radiographic evaluation and clinically by evaluating periodontal health using probing depth indexvalues over a period of 6 years. Ten completely edentulous male patients with a bone height (BH) of 15-25 mm at the mandibular symphyseal region and dissatisfaction with their mandibular conventional complete denture were included in the study. Patients were willing to accept the conditions of the study and provide informed consent. Bleeding index, plaque index (PI), probing depth, and crestal BL were accessed during the follow-up period. Marginal BLs using Wical and Swoop Analysis method were evaluated at baseline (BL) (during loading), 3 yearsand 6 years post-loading. During the observation period, there was no incidence of implant loss, and all patients expressed contentment with the retention, stability, chewing functionality, and esthetic appeal of their dentures.Marginal BLs through clinical and radiographic evaluation, periodontal health using bleeding on probing (BOP), and probing depth were assessed during the follow-up period. Throughout the entire period of observation, no instances of implant displacement were detected. The study found that the use of a lingualized occlusal scheme with two implant-retained mandibular complete overdenture effectively transmitted horizontal loads, reduced stress on individual implants leading to decreased bone loss, and increased stability.

Evaluation of marginal bone level after implant placement and before loading, by digital radiography

Background: Marginal bone loss around dental implant is one of the criteria for evaluating implant success. Objectives: To evaluate the marginal bone loss around dental implants using digital radiographs and to determine correlation of mesial and distal bone loss around dental implants with gender and location in either arch in a period of 3-6 months after placement and before prosthetic loading. Methods: An analytical study was undertaken from July 2021 till December 2021, after ethical clearance, in 18 patients on whom 23 implants had been placed at Dhulikhel hospital. After implant placement first radiograph was taken by CE 0297 size 2 PSP plate and Carestream (CS2100) intraoral periapical radiograph machine using paralleling technique (XcpRinn Device) and second at 3-6 months later. The radiographs were viewed using image viewer software (Vistasoft2.0.1) to calculate the bone level. Calculating the difference in bone level at zero month and at 3-6 months gave us the amount of bone loss which was entered in Excel sheet and transferred to SPSS v.22 for analysis and student unpaired-t test was used.Results: The mean bone loss was 0.27 ± 0.2 mm on mesial aspect and 0.13 ± 0.3 mm on distal aspect at the end of the study period. No statistically significant bone loss in relation to gender and location of implant placement was found. Conclusion: Within the limitation of the study, no significant difference was found in the mesial and distal aspect of bone loss around dental implant when compared with different parameters.

All‐on‐4 immediate function concept

Background Nowadays the immediate loading procedure for the rehabilitation of edentulous jaws using osseointegrated implants has gained popularity among clinicians. However, the rehabilitation of edentulous jaws is often complicated by poor bone quality, especially in the posterior region and reduced bone volume due to longterm edentulism. Several clinical studies have reported that tilting of the implants may represent feasible treatment option. Such technique has several surgical and prosthetic advantages Aim/Hypothesis The purpose of this study was to prospectively evaluate the clinical and radiographic outcomes of immediate function of four implants supporting a fixed prosthesis in the completely edentulous jaws. Material and Methods This clinical case series included 10 patients with 72 immediately loaded implants (10 maxillary and 8 mandibular arch). Each patient received a full-arch fixed prosthesis supported by two distal tilted implants and two anterior axially placed implants. The provisional functional acrylic prosthesis and loading was applied within 48 hours from surgery. The patients were evaluated clinically and radiographically at implant placement, at 18 month follow-up examinations. Implant survival and prosthesis success were assessed. At follow-up plaque and bleeding score was assessed and radiographic evaluation of marginal bone level was performed. Results One immediately loaded tilted implant were lost in one patient before the 6-month follow-up. A total of 17 immediately loaded prostheses (10 in the maxilla and 7 in the mandible) were in function for at 18 months and were considered for the clinical examination. No further implant failure occurred to date. Total implant survival at 18 months was 98.6% (100% and 96.8% for the maxilla and the mandible, respectively). Marginal bone loss at 1 year averaged 0.59 mm in axial implants and 0.61 mm in tilted implants. 2 patients had a fracture of the provisional restoration, but all of the definitive prostheses remained stable throughout the study period without any complications. Conclusion and Clinical Implications The results of this clinical study show that the ìAll on Fourî immediate function concept is a viable treatment modality for the atrophic maxillae and mandibulae and there does not seem to be a different clinical outcome between tilted and axial implants.

Efficacy of Regenerative Materials and Ultrasonic Ridge Splitting Technique with Simultaneous Implants Placement into Narrow Alveolar Ridge

Aim: This study compares clinically and radiographically between efficacies of two different bone graft materials with amniotic membrane in narrow alveolar ridges subjected to ridge expansion by ultrasonic bone surgery to receive simultaneous implant placement. Subjects and Methods: Twenty-two systemically healthy patients with partial edentulous narrow anterior maxillary ridge classified randomly into the following equal groups: Group Ι patients with partial edentulous narrow ridge; treated by ridge splitting technique and simultaneous implant placement into their ridge; associated with deproteinized bovine bone (Bio-Oss ®) and amniotic membrane. Group II patients with partial edentulous narrow ridge; treated by ridge splitting technique and simultaneous implant placement into their ridge; associated with hydroxyapatite and 40% beta-tricalcium phosphate (easy-graft™ crystal) and amniotic membrane. Evaluation of implant success rate was done, and the clinical parameters were recorded for all implants. Implant stability quotient (ISQ) values was recorded. Efficacy of regenerative materials was observed by evaluation of marginal bone level and bone density. Results: Alveolar ridge width was increased in all groups. The mean value of alveolar ridge width in group I 3.64 mm ±0.3 at baseline that increased to 6.90mm ±0.6. The mean value of Alveolar ridge width in group II was 4.17 mm ±0.7at baseline that increased to 6.65 mm ±0.4. Group II showed the highest ISQ, bone density and the lowest marginal bone loss values after twelve months of implant placement. Conclusion: The use of piezo-electric surgery with bone grafting as sole tool for ridge splitting is promising technique.

Evaluation of periimplant bone level around implants with platform-switched abutments inserted using computed tomography-based software planning and computer-aided design/computer-aided manufacturing guided surgical template

Background: The maintenance of periimplant bone is a major factor in the prognosis of prosthetic rehabilitation supported by implants. In an attempt to improve long-term bone maintenance around dental implants, a new implant-to abutment connection referred to as “platform switching” has been proposed.1Lazzara R.J. Porter S.S. Platform switching: a new concept in implant dentistry for controlling postrestorative crestal bone levels.Int J Periodontics Restorative Dent. 2006; 26: 9-17PubMed Google Scholar Objectives: To compare the crestal bone height changes around dental implants with platform- and nonplatform-switched abutment inserted using computed tomography-based software planning and computer-aided design/computer-aided manufacturing (CAD/CAM) guided surgical template. Methods: A total of 14 implants were placed and patients were divided into two groups. Seven implants with a diameter of 4.6 mm and restored with platform-switched abutments (3.5 mm) served as the test group. Seven implants with a diameter of 4.6 mm and restored with a horizontally matching abutment diameter served as the control group. Standardised digital panoramic images were obtained for evaluation of marginal bone levels at the time of placements of prosthesis (baseline), 6 and 12 months follow-up. All implants were placed with CAD/CAM-generated surgical guides after virtual planning of implant placement. Findings: The platform-switched implants exhibited statistically significant less bone loss at time of insertion of the definitive prosthesis (0.93 ± 0.10 mm versus 1.40 ± 0.26, P < 0.05) and at one year (1.47 ± 0.15 versus 2.19 ± 0.15 mm, P < 0.05) when compared to the nonplatform-switched implants. Conclusion: It can be concluded that platform switching is capable of reducing or eliminating crestal bone loss.

A 7-year prospective radiographic evaluation of marginal bone level around two different implant systems: a randomized clinical trial.

The aim of this study was to evaluate the change in marginal bone level radiographically around two different implant systems after 7 years of use. Twenty fully edentulous patients were included in the study and randomly assigned to two treatment groups of machined surface implants (Brånemark, n = 40) and rough-surface implants (Xive, n = 40). The implants were early loaded with individual bar-retained overdentures. All patients were treated by the same surgeon and the same prosthodontist. Clinical and radiographic examinations were conducted at the time of implant loading (baseline) and annually for up to 7 years of use. Measurements to the nearest 0.1 mm were taken at the mesial and distal site, and the average values were calculated for each implant. A three-level mixed-effect analysis of covariance (ANOVA) was used to test the significance of the mean marginal bone change in the two implant groups. The study population consisted of 15 women (75%) and five men (25%) with an average age of 61.6 years. A total of 79 of 80 implants integrated successfully. n = 1 Brånemark implant failed after 3 weeks. There was a significant difference (P < 0.001) between the two implant systems at the baseline measurements (0.14 mm Brånemark vs. 0.39 mm Xive) and a highly significant difference for the annual bone loss (0.07 mm [Brånemark] vs. 0.18 mm [Xive], P < 0.001). Both the implant systems are clinically satisfying. Nevertheless, the Brånemark group showed a better radiological performance than the Xive group.

Evaluation of Marginal Bone Level around Platform-Switched Implants

ABSTRACT Purpose The long-term success of an implant depends on the stability of bone support for the implant. Most crestal bone loss occurs in the first year of implant placement. Platform-switching is an approach which can be clinically applied to preserve the crestal bone. The concept of ‘platform switching’ refers to the use of a smaller-diameter abutment on a larger-diameter implant collar. The purpose of the present study was to evaluate crestal bone level around platform-switched implants. Materials and methods Twenty implants with 5 mm diameter were placed in mandibular molar region. All implants had been placed at the crestal level at the time of surgery. Radiographs with grid were obtained 3, 6 and 12 months after loading and were evaluated by screen caliper software measuring the location of the crestal bone level relative to the implant platform. Results The implants showed a mean bone loss of 0.76 ± 0.1265 mm on mesial side and 0.72 ± 0.1481 mm on distal side after 1 year. Conclusion The findings of the current trial indicated that the use platform-switched implants lead to better preservation of crestal bone. How to cite this article Kapoor K, Singh RG, Puri A, Sharma A, Mittal R. Evaluation of Marginal Bone Level around Platform- Switched Implants. Int J Prosthodont Restor Dent 2014;4(1): 6-10.

Radiographic evaluation of marginal bone levels around dental implants with different designs after 1 year

Objective.The aim of this study was to use intra-oral radiographs to evaluate changes in marginal bone levels around three different implant designs after 1 year. Materials and methods.Three implant designs; two with a straight and one with a conical design, were placed adjacent to each other in the partially edentulous areas of 25 patients. The patients received 46 implants with a straight design (All fit SSO and SPI-element) and 29 implants with a conical design (SPI-contact). Two-way repeated analysis of variance (ANOVA) was used to evaluate the marginal bone changes in each group at 12 months follow-up (p < 0.05). Results.None of the implants had failed by the end of this study. After 12 months, significant differences were noted in the amount of alveolar bone loss recorded between the All fit SSO and SPI implants (p < 0.05). Mean crestal bone loss was 0.88 ± 0.43 mm for the All fit, 0.61 ± 0.34 mm for the SPI contact and 0.54 ± 0.27 mm for the SPI element implants. Conclusions.The results of this study demonstrate that straight (cylindrical) implants with shorter high polish surface displayed less bone resorption.

Radiographic evaluation of marginal bone levels during healing period, adjacent to parallel‐screw cylinder implants inserted in the posterior zone of the jaws, placed with flapless surgery

The purpose of this study was to compare changes at the marginal bone level adjacent to implants placed with flapless surgery and flap surgery during a stress-free healing period. Seven hundred and eighty-five implants were placed in 417 patients with a flapless approach and 459 implants were placed in 227 patients using flap techniques. The marginal bone level was determined radiographically, using digitized panoramic radiographs, at two time points: at implant placement (baseline) and after the healing period. The median follow-up time was 0.5 years (SD, 1.2; range: 0.3-0.7). Implants placed with flapless surgery had a mean crestal bone loss of 0.5 mm (SD, 0.5; range: -0.7-2.4) and implants placed with flap surgery had a mean bone loss of 0.5 mm (SD, 0.7; range: -2.0-3.0) after healing. Differences in bone level changes between smokers and non-smokers were statistically significant for the flapless group (P<0.01). A radiographic evaluation of marginal bone levels adjacent to implants showed comparable results for implants placed with flapless surgery and flap surgery. Appropriate case selection after virtual planning of the implant position and a sound surgical protocol is necessary for flapless surgery. Smoking habits may compromise the efficacy of flapless implant procedures.

Immediate rehabilitation of the edentulous jaws with full fixed prostheses supported by four implants: interim results of a single cohort prospective study

The purpose of this study was to prospectively evaluate the clinical and radiographic outcomes of immediately loaded full-arch fixed prostheses supported by a combination of axially and non-axially positioned implants in a large cohort of patients with completely edentulous jaws, up to 5 years of function. One hundred and seventy-three edentulous patients (80 males and 93 females) were enrolled according to specific selection criteria. Each patient received a full-arch fixed prosthesis supported by two distal tilted implants and two anterior axially placed implants. The provisional functional acrylic prosthesis was delivered the same day as surgery in all cases. All cases were finalized 4-6 months later. The patients were scheduled for follow-up at 6 and 12 months of function, and annually up to 5 years. At each follow-up plaque and bleeding score was assessed and radiographic evaluation of marginal bone level was performed. The overall follow-up range was 4-59 months. A total of 154 immediately loaded prostheses (61 in the maxilla and 93 in the mandible) were in function for at least 1 year and were considered for the analysis. Four axially placed implants failed in the maxilla and one tilted implant in the mandible, all within 6 months of loading. No further implant failure occurred to date. Implant survival at 1 year was 98.36% and 99.73% for the maxilla and the mandible, respectively. Marginal bone loss at 1 year averaged 0.9+/-0.7 mm in the maxilla (204 implants) and 1.2+/-0.9 mm in the mandible (292 implants). No difference was found in marginal bone loss between axial and tilted implants. Plaque and bleeding scores progressively improved from 6 to 12 months. Fracture of the acrylic prosthesis occurred in 14% of total cases. The present preliminary results from a relatively large sample size suggest that the present technique can be considered a viable treatment option for the immediate rehabilitation of both mandible and maxilla.

A 3-year prospective radiographic evaluation of marginal bone level around different implant systems

The aim of this study was to evaluate the change of marginal bone level radiographically around three different implant systems after 3 years in function. Fifty-four patients were included and randomly assigned to three treatment groups of rough-surface implants (TiUnite, n = 37), hybrid of smooth and rough-surface implants (Restore, n = 38) and rough surface with microthread implants (Hexplant, n = 45). Clinical and radiographic examinations were conducted at the time of implant loading (baseline), 1 and 3 years after loading. A three-level mixed-effect analysis of covariance (ancova) was used to test the significance of the mean marginal bone change of the three implant groups. A total 120 of 135 implants completed the study. None of the implants failed to integrate. Significant differences were noted in the marginal bone loss recorded for the three groups (P < 0.0001). At 3 years, the rough surface with microthread implants had a mean crestal bone loss of 0.59 +/- 0.30 mm; the rough-surface implants, 0.95 +/- 0.27 mm; and the hybrid surface implants, 1.05 +/- 0.34 mm. Within the limitations of this study, rough-surface implants with microthread at the coronal part might have a long-term positive effect in maintaining the marginal bone level against functional loading in comparison with implants without these two features.

Placement of Brånemark implants in the maxillary tuber region: anatomical considerations, surgical technique and long‐term results

Fixture placement in the tuber area is one way to overcome the problem of insufficient bone volume for routine implant surgery in the posterior maxilla due to severe resorption of jawbone and an extensive enlargement of the maxillary sinus. However, little is known about the long-term results. The aim of this study was to retrospectively evaluate the survival rate and marginal bone conditions at fixtures placed in the tuber region of the maxilla. Twenty-one patients previously treated with at least one implant in the tuber region of the maxilla were included in this retrospective analysis. A total of 23 standard Brånemark System fixtures with a turned surface had been surgically placed in the tuber regions and 71 additional implants in adjacent areas to support fixed dental bridges. All implants were allowed to heal for 6-8 months before abutment connection and following prosthetic treatment. The patients were radiographed after 1-12 years for evaluation of marginal bone levels. In addition, the relation between the apex of the fixture in the tuberosity area and the posterior border of the maxilla was measured. Twenty of the 21 patients representing 22 tuber and 64 additional implants were radiographically evaluated. No implants in the tuber areas were lost during the follow-up whereas two fixtures in the anterior region had to be removed, one before loading and the other after 4 years of loading not interfering with the prosthesis stability. The mean marginal bone level at tuber implants was situated on average 1.6 mm (SD 1.1, n=22) from the abutment-fixture junction, whilst the other implants showed an average bone level of 1.9 mm (SD 0.8, n=64). The results were similar when comparing partially and totally edentulous patients. The present retrospective study shows good clinical outcome with standard Brånemark fixtures placed in the tuber region of the posterior maxilla using a two-stage procedure. In appropriate cases where bone of adequate volume and density is available, our data indicate that the technique can be used as an alternative to more extensive surgery and especially to the sinus lift procedure. However, prospective comparative studies are needed in order to evaluate the efficacy of the described technique for this purpose.

Immediate/Early Function of Brånemark System® TiUnite™ Implants in Fresh Extraction Sockets in Maxillae and Posterior Mandibles: An 18‐Month Prospective Clinical Study

The advantages of placing implants in fresh extraction sockets and putting them in immediate/early function are many. A predicable protocol opens the possibility of performing a single surgical procedure, giving the patient a temporary prosthesis immediately, and minimizing the shrinkage of hard tissue and soft tissue recession. The aim of the present study was to develop a strict protocol for and to evaluate the feasibility of immediate/ early function on implants placed in fresh extraction sockets located in maxillae and posterior mandibles, including defects around the implants treated according to a regenerative procedure. Nineteen patients were treated after tooth extraction according to an immediate function protocol and were observed for 18 months. Fifty Mk IV TiUnite (Nobel Biocare AB, Göteborg, Sweden) implants were installed in partially edentulous areas in maxillae (n = 17) and posterior mandibles (n = 5). Implants were installed directly into the alveoli, and the temporary prostheses were connected immediately after surgery (n = 11) or within 7 days, that is, an "early function" procedure (n = 11). Thirteen implants did not require any type of regenerative procedure, whereas the remaining 37 implants had filling with autogenous bone, 4 of which also had a resorbable membrane. Standardized intraoral radiographs were taken for evaluation of marginal bone level, and 38 of the implants were systematically checked by resonance frequency analysis. All patients were followed for 18 months, and none of the 50 implants failed. However, one implant showed signs of failure after 6 weeks, but once the occlusal load was removed, the implant regained its stability completely, no longer demonstrated symptoms, and could be used successfully for prosthetic rehabilitation. The mean value of the implant stability quotient was 60 at baseline (range 45-75) and 63 after 6 months (range 46-75). The marginal bone resorption was 0.9 mm (SD 1.1 mm; n = 48) 18 months after implant insertion (1 year after final prosthesis). The immediate placement of implants into fresh extraction sockets combined with immediate/early function procedures seems to be a safe and reliable procedure when using a strict protocol.