Marginal Bone Loss Of Implants Research Articles

A retrospective clinical study of single short implants (less than 8 mm) in posterior edentulous areas.

PURPOSEThe goal of this study was to evaluate the clinical outcome of single short implants, less than 8 mm in length, placed in the posterior area.MATERIALS AND METHODSA total of 128 patients (75 male and 53 female, mean age: 52.6±11.2 years) with 154 implants participated. Implant marginal bone loss, and survival and success rates were measured.RESULTSThe mean follow-up period was 51.35±24.97 months. A total of 128 implants, 8 mm in length, were placed in patients who had mean marginal bone loss of 0.75 mm. These implants had a survival rate of 95.3%. Twenty-six implants, 7 mm in length, were placed in areas with a mean marginal bone loss of 0.78 mm and had a survival rate of 96.2%. Both marginal bone loss and survival rate were not statistically different among the groups. In the maxilla, 34 implants showed a mean marginal bone loss of 0.77 mm and a survival rate of 97.1%. In the mandible, 120 implants showed a mean marginal bone loss of 0.75 mm and a survival rate of 95.0%. The average marginal bone loss around all implants was 0.76±0.27 mm at the last follow-up review after functional loading. The survival rate was 95.6% and success rate was 93.5%.CONCLUSIONIn our study, single short implants less than 8 mm in length in the posterior areas had favorable clinical outcomes.

The Influence of Prosthesis Design on the Outcomes of Tooth Implants Immediately Placed and Loaded by Means of One-Piece Titanium Machined Restoration.

Our purpose was to evaluate the occurrence of complications and the degree of bone loss in a cohort of patients treated with fixed prostheses supported by immediately loaded dental implants. The primary aim was to compare partial versus full-arch fixed dental prostheses. We then tested the effect of sinus lifting. In the present retrospective cohort study, the patients had their implants restored with fixed dental prostheses supported by dental implants positioned in the posterior maxilla and mandible. When necessary, the maxillary sinuses were grafted with particulate autogenous bone. Patients were then ranked according to the following predictors: length of prosthesis, crown-to-implant ratio, number of crowns to number of implants ratio, and presence of sinus lifting. Outcomes were evaluated for up to 2 years regarding the peri-implant marginal bone loss and implant/prosthesis survival rates. Fifty-eight subjects (209 implants) were rehabilitated with 25 fixed full-arch prostheses and 33 partial fixed dental implant bridges (16 supported by implants placed in grafted sinus). The mean marginal bone loss for implants supporting partial fixed dental prostheses amounted to 0.81 mm, whereas that for implants within the group of full-arch fixed dental prostheses was 1.21 mm; the comparison of the levels in the 2 groups showed a significant difference ( P = .0055). A statistically significant difference ( P = .0006) was found between the bone loss around maxillary implants (1.53 mm) and the bone loss around mandibular implants (1.10 mm). Two implants and 4 prostheses failed; 2-year survival rates of partial and of full-arch fixed dental prostheses, respectively, were 94.1% and 96%. Bone loss in full-arch prostheses appeared to be higher than in that of partial prosthesis. Implant-supported prostheses in the maxillae exhibited a bone loss higher than that registered in mandibles.

Minimum Abutment Height to Eliminate Bone Loss: Influence of Implant Neck Design and Platform Switching.

This retrospective study quantitatively analyzed the minimum prosthetic abutment height to eliminate bone loss after 4.7-mm-diameter implant placement in maxillary bone and how grafting techniques can affect the marginal bone loss in implants placed in maxillary areas. Two different implant types with a similar neck design were singularly placed in two groups of patients: the test group, with platform-switched implants, and the control group, with conventional (non-platform-switched) implants. Patients requiring bone augmentation underwent unilateral sinus augmentation using a transcrestal technique with mineralized xenograft. Radiographs were taken immediately after implant placement, after delivery of the prosthetic restoration, and after 12 months of loading. The average mesial and distal marginal bone loss of the control group (25 patients) was significantly more than twice that of the test group (26 patients), while their average abutment height was similar. Linear regression analysis highlighted a statistically significant inverse relationship between marginal bone loss and abutment height in both groups; however, the intercept of the regression line, both mesially and distally, was 50% lower for the test group than for the control group. The marginal bone loss was annulled with an abutment height of 2.5 mm for the test group and 3.0 mm for the control group. No statistically significant differences were found regarding marginal bone loss of implants placed in native maxillary bone compared with those placed in the grafted areas. The results suggest that the shorter the abutment height, the greater the marginal bone loss in cement-retained prostheses. Abutment height showed a greater influence in platform-switched than in non-platform-switched implants on the limitation of marginal bone loss.

Effects of uncontrolled periodontitis on marginal bone alterations around implants: A case-control study.

The hypothesis of bacterial infection initiating marginal bone loss around dental implant in analogy with natural tooth is still in debate. The aim of this retrospective study was to investigate the effects of uncontrolled periodontitis on marginal bone alterations around implants compared with the periodontal health group at a mean follow-up of at least 6 years. Thirty consecutive uncontrolled periodontally compromised patients (PCP) and 30 periodontally healthy patients (PHP), with a total of 96 Straumann implants (PCP = 55, PHP = 41) were matched for age, gender, smoking, and implant characteristics. The inclusion criteria for PCPs were continuing tooth loss due to uncontrolled periodontal disease and no supportive periodontal maintenance after implant therapy. Peri-implant conditions were examined and the number of teeth lost during the follow-up periods was recorded in both groups. Radiographic marginal bone loss of implants and adjacent teeth was calculated having the restoration time point as baseline. No implant loss occurred in both groups. The mean number of teeth lost during the follow-up periods was 0.67 ± 0.80 in the PHP group, 3.93 ± 2.36 in the PCP group with statistical significance. The average overall bone loss was significantly greater at teeth than that around implants in the PCP group (0.54 ± 0.27 versus 0.22 ± 0.25 mm, P < .001), while no statistically significant differences were observed in the PHP group (0.18 ± 0.08 versus 0.22 ± 0.18 mm, P = .317). No statistically significant differences were observed between PC and PH patients when comparing the peri-implant marginal bone loss. No significant correlations were found between teeth loss and crestal bone loss at implants sites in both groups. This study indicated that the marginal bone level around implants seemed more stable in comparison to that around the natural teeth when exposed to uncontrolled periodontal disease.

Effect of Ratio of Residual Alveolar Bone to Graft Material in Contact With Fixture Surface on Marginal Bone Loss of Implants in Augmented Maxillary Sinuses: A 1-Year Retrospective Study.

The purpose of this retrospective study was to evaluate the influences of height or area ratio of residual alveolar bone to graft material on marginal bone loss around implants in the augmented maxillary sinuses with delayed implant placement. In this study, 42 patients with Astra implants in sinuses that had been augmented with alloplasts and allografts or xenografts (alveolar bone height ≤ 5 mm) were selected. Marginal bone level surrounding 1 implant per sinus was assessed by radiographic imaging at the time of final restoration delivery and 12 months after functional loading. To evaluate the marginal bone level alterations using clinical and radiographic data, Pearson's correlation analysis and Mann-Whitney test were performed. Forty-six implants were included in this study. The residual bone/implant length ratio and the residual bone/implant area ratio were not associated with marginal bone loss at 1 year after functional loading (P > 0.05). And, marginal bone loss did not differ significantly between 2 types of graft materials during the observation period (P > 0.05). The residual bone/implant length ratio and residual bone/implant area ratio were not associated with marginal bone loss around implants placed in augmented sinuses during 1 year of functional loading.

The influence of initial alveolar ridge defect morphology on the outcome of implants in augmented atrophic posterior mandible: an exploratory retrospective study.

Clinicians commonly consider atrophic site topography as an important determinant in deciding the augmentation technique to utilize, as well as forecasting the likelihood of success. The purpose of this retrospective study was to examine the influence of initial atrophic posterior mandible morphology on the outcome of implants placed following augmentation. A total of 52 patients contributed 71 edentulous sites, and 185 implants were placed with mean follow-up of 37.97months. The initial defect morphology was classified according to ABC classification (Journal of Oral Implantology, 37, 2013a and 361). Ridge augmentation was performed by "cortical autogenous tenting" (CAT) followed by either simultaneous or delayed implant placement after 4-6months of healing. The European Academy of Osseointegration success criteria were used to evaluate implant outcomes. The overall survival and success rates of dental implants were 98.91% and 80%, respectively. Cumulative success and survival rates in CAT group were 95% and 100% after 2years of follow-up. The highest marginal bone loss (MBL) was observed (1.26mm±0.99) around implants placed in augmented edentulous sites with initially narrow and flat alveolar crest (defect class CII). Conversely, least MBL (0.48mm±0.78) was detected around implants placed into edentulous sites with two sloped boney walls (defect class AII). Differences between MBL observed around implants placed into initial defect class C, initial defect type and class A (I, II), as well as class BII, were statistically significant (P<0.05). Among all implants, 148 were considered as successful, 26 exhibited satisfactory survival, nine with compromised survival, and two implants failed. The present data confirmed the effect of initial ridge morphology on the outcome of implants placed into augmented bone. Specifically, class A and class B atrophic ridge defects, with one and two vertical boney walls, respectively, may be considered as more favorable recipient sites than class C defects with flat morphology. This conclusion is based on least MBL around implants placed into initial defect class A and class B augmented sites, and higher MBL in implants placed into class C recipient sites. A randomized controlled trial is warranted to examine these exploratory observations.

Four years survival and marginal bone loss of implants in patients with Down syndrome and cerebral palsy.

To evaluate implant survival rate and marginal bone loss (MBL) after 4years in patients with Down syndrome and cerebral palsy, compared with a healthy control group. The case group comprises 102 implants in 19 patients (71 cerebral palsy, 21 Down syndrome), and the control group comprises 70 implants in 22 healthy patients. One implant per patient was selected (n=41 implants) to take clustering effects into account. MBL was measured using two panoramic radiographs (after surgery and 4years later). Lagervall-Jansson's Index was used. Statistics used are chi-squared test and Haberman's post hoc test. p Value is significant at <0.05. MBL was significantly higher in the cases in all samples (p<0.001) and when one implant was selected per patient (p<0.05). More implants were lost in the cases (p<0.01), especially those with a higher MBL (p<0.01). MBL (p<0.05) and implant loss (p<0.01) increased with age in the cases. The three-unit fixed dental prosthesis (FDP) showed higher MBL (p<0.05). Down syndrome had a higher MBL than cerebral palsy (entire sample p<0.0001, one implant per patient p<0.05). All patients with Down syndrome saw some damage to bone support (entire sample p<0.0001; one implant per patient p<0.05). Implant loss occurred only in Down syndrome (p<0.00001). MBL and implant loss 4years after placement are higher in neuropsychiatric disabilities. Down syndrome has a higher risk of MBL and implant loss; therefore, special precautions should be taken when deciding on treatment for these patients. As a consequence of this pilot study, professionals should be very cautious in placing implants in patients with Down syndrome.

The Influence of Crown-to-Implant Ratio on Short Implant Marginal Bone Loss.

There is a need for more studies evaluating the marginal bone loss (MBL) of rehabilitations in the posterior regions of extremely resorbed maxillae and mandibles supported by short-length dental implants with a high crown/implant ratio (C/I-R). The aim of this study was to evaluate the influence of the C/I-R in implants on MBL considering dental implants with 4 mm of width and 7 mm of length. This retrospective cohort study included 59 patients (mean age of 52.8 years) rehabilitated with at least one implant 4 mm in width and 7 mm in length, with an anodically oxidized surface and external connection on the premolar or molar positions, supporting a fixed prosthesis, and in function for a period of 36 months. Periapical radiographs at 36 months were used to calculate the C/I-R and MBL. The Spearman correlation coefficient was used to test the correlation between C/I-R and MBL. The level of significance was set at 5%. One hundred eighteen implants from 59 patients were evaluated. The mean ± SD MBL was 0.67 ± 0.63 mm. The C/I-R mean ± SD was 2.53 ± 0.79 mm. Thirty implants presented a C/I-R ≤ 2, while 88 implants had a C/I-R > 2. A weak nonsignificant inverse correlation (r = -0.081; P = .383, Spearman) was registered between C/I-R and MBL. Within the limitations of this study, it is possible to conclude that implant-supported fixed prostheses with C/I-R > 2 do not correlate positively with MBL.

Marginal Bone Loss in Implants Placed in the Maxillary Sinus Grafted With Anorganic Bovine Bone: A Prospective Clinical and Radiographic Study.

Sinus elevation is a reliable and often-used technique. Success of implants placed in such situations, even with bone substitutes alone, prompted the authors of this study to strive for bone loss close to zero and research variables that cause higher or lower rates of resorption. The objective of this study is to evaluate survival rates and marginal bone loss (MBL) around implants placed in sites treated with maxillary sinus augmentation using anorganic bovine bone (ABB), and identify surgical and prosthetic prognostic variables. Fifty-five implants were placed in 30 grafted maxillary sinuses in 24 patients. Periapical radiographs were evaluated immediately after implant placement (baseline), 6 months, and at the most recent follow-up. MBL was calculated from the difference between initial and final measurements, taking into account a distortion rate for each radiograph compared with original implant measurements. Survival rate was 98.2%, with only one implant lost (100% survival rate after loading) over a mean follow-up time of 2.0 ± 0.9 years. MBL ranged from 0 to 2.85 mm: 75.9% of mesial sites and 83.4% of distal sites showed <1 mm of MBL, whereas 35.2% of mesial sites and 37% of distal sites exhibited no bone loss. MBL was significantly (P <0.05) greater in open-flap compared with flapless surgery. Within the limitations of the present study, it was concluded that maxillary sinus elevation with 100% ABB gives predictable results, and that flapless surgery results in less MBL compared with traditional open-flap surgery.

Risk Factors Associated With Implant Marginal Bone Loss: A Retrospective 6-Year Follow-Up Study.

To analyze the presented evidence behind suggested reasons for long-term marginal bone loss (MBL) around 600 endosseous titanium dental implants according to the radiological findings up to 60 months. The data of 151 patients are received from the prosthodontic department of a university clinic and analyzed for the effect of implant brand, location, implant diameter and length, implant occlusal table width, cantilever, and smoking on MBL in a 6-year period. MBL is significantly higher in Zimmer SwissPlus implant system. The bone loss in posterior region was higher than anterior region for maxilla. There was no significant difference in mandible. Kruskal-Wallis test showed that MBL was significantly higher when the crown/implant (C/I) ratio was 1.5/2 (P < 0.05). Occlusal table width/implant diameter (OT/I) ratio was analyzed and it showed that MBL was significantly higher when the ratio was 2.5 to 2.99 and higher than 3. There were no significant associations between smoking and nonsmoking groups. Mann-Whitney U test revealed that cantilever does not affect MBL. The marginal bone loss is affected by location of the implants (higher in the maxillary posterior region). In addition, excessive C/I and OT/I ratios increase marginal bone loss.

Investigation of Factors That Promotes Early Implant Marginal Bone Loss in Submerged Implants

Investigation of Factors That Promotes Early Implant Marginal Bone Loss in Submerged Implants

Outcomes of implants placed with three different flapless surgical procedures: A systematic review

The aim of this systematic review was to evaluate the outcomes of flapless surgery for implants placed using either free-hand or guided (with or without 3D navigation) surgical methods. Literature searches were conducted to collect information on survival rate, marginal bone loss, and complications of implants placed with such surgeries. Twenty-three clinical studies with a minimum of 1year follow-up time were finally selected and reviewed. Free-hand flapless surgery demonstrated survival rates between 98.3% and 100% and mean marginal bone loss between 0.09 and 1.40mm at 1–4 years after implant insertion. Flapless guided surgery without 3D navigation showed survival rates between 91% and 100% and mean marginal bone loss of 0.89mm after an observation period of 2–10 years. The survival rates and mean marginal bone loss for implants placed with 3D guided flapless surgery were 89–100% and 0.55–2.6mm, respectively, at 1–5 years after implant insertion. In 17 studies, surgical and technical complications such as bone perforation, fracture of the surgical guide, and fracture of the provisional prosthesis were reported. However, none of the identified methods has demonstrated advantages over the others. Further studies are needed to confirm the predictability and effectiveness of 3D navigation techniques.

Marginal Bone Loss in Implants Placed in Grafted Maxillary Sinus

The purpose of this study is to evaluate the vertical and horizontal graft bone resorption (GR) in grafted maxillary sinuses and the marginal bone loss (MBL) around implants placed in the sinuses with different prosthetic connections and to determine the effect of other clinical factors on these tissue responses at 6 and 18 months postloading. A total of 254 implants were placed in 150 grafted maxillary sinuses of 101 patients (51.5% female) with mean age of 52.2 years (range, 32-82 years). GR and MBL measurements were made in implants placed with two different prosthetic connections (internal and external) at 6 and 18 months postloading. The complex samples general linear model was used to analyze the influence of patient age, gender, smoking habit, history of periodontal disease, implantation timing (simultaneous vs deferred), and prosthetic abutment length on radiographic GR and MBL values. At 18 months postloading, the MBL ranged from 0 mm to 5.89 mm; less than 1 mm was lost around 49.0% (mesial) and 44.3% (distal) of the implants, while no bone was lost around 32.9% (mesial) and 26.7% (distal). The GR was significantly affected by smoking, remnant alveolar bone height, graft length, graft height, gender, and age, and it significantly decreased over time. The MBL was influenced by the type of connection, implantation timing, and prosthetic abutment length. The MBL was greater with longer postloading interval and higher patient age and in smokers. Resorption of grafts that combine autogenous cortical bone with anorganic bovine bone is dependent on the anatomic features of the sinus and is not affected by the time elapsed after the first 6 months. The MBL in implants placed in these grafted areas is time dependent and mainly related to potentially modifiable clinical decisions and patient habits.

Effect of the Timing of Restoration on Implant Marginal Bone Loss: A Systematic Review

The advancement in implant dentistry has allowed shortened treatment time by restoring the implants earlier. Whether the timing of restoration has an impact on implant marginal bone level has not been systematically analyzed. The aim of this study is to compare marginal bone loss (MBL) between implants that were restored with the following protocols: 1) immediate restoration/loading (IR/L); 2) early loading (EL); and 3) conventional loading (CL). An electronic literature search from three databases (until November 2011) and a hand search in implant-related journals were conducted. Clinical human studies in English language that had reported a comparison of MBL between implants with IR/L, EL, or CL with ≥12-month follow-up were included. In addition, the minimal number of implants had to be 10 for each group. Implants with both immediate placement (IP) and delayed placement (DP) were included and analyzed separately. An assessment of the publication bias for the included randomized clinical trials (RCTs) was performed. The initial search resulted in 1,640 articles, of which 27 articles in full text were further evaluated for eligibility. Finally, 11 studies (eight RCTs, two controlled clinical trials, and one retrospective study) were qualified and classified into four groups: 1) IR/L + DP versus CL + DP (n = 6 articles); 2) IR + DP versus EL + DP (n = 2 articles); 3) EL + DP versus CL + DP (n = 1 article); and (4) IL + IP versus CL + IP (n = 2 articles). A meta-analysis performed for group 1 showed 0.09 mm (95% confidence interval = -0.27 to 0.09 mm) difference in the mean MBL, favoring the IR/L protocol but without significant difference (P = 0.33). No significant difference in MBL was found for groups 2 through 4 after adjusting for the implant placement level. The eight RCTs were determined to be at moderate-to-high risk of publication bias. This meta-analysis does not show an effect of the timing of restorations on implant MBL. The selection of restoration protocols should be based on factors other than MBL.

Clinical outcomes of implant supported fixed-hybrid prostheses in the fully edentulous arches

Purpose: The aim of this study was to evaluate clinical outcomes of implant supported fixed-hybrid prostheses (FHP) in the fully edentulous arches. Materials and methods: Patients in this retrospective study were restored with fixed-hybrid prostheses supported by 4 to 6 implants and functioned more than 1 year of loading. Outcome measures were marginal bone change of implant related with sex, anatomical location (maxilla vs. mandible), opposing teeth, loading time of patients, tilting of posterior implant by MannWhitney U test and cantilever length of superstructure by regression analysis, and complication rates. Significance level was set P .05), and cantilever length was not significantly related with a marginal bone loss of implant next to cantilever (P>.05). Complication was shown in 11 patients and veneer fracture and dislodging of artificial teeth were most prevalent. Conclusion: Within the limitations of this study, although marginal bone loss of FHP was very little, complication rates were high. Irrespective of tilting of most posterior implants, marginal bone loss of most posterior implants next to cantilever was less than those of the other implants positioned anteriorly. Cantilever length (<17 mm) did not affect a marginal bone loss of most posterior implants. (J Korean Acad Prosthodont 2013;51:183-9)

A Randomized Clinical Trial to Evaluate and Compare Implants Placed in Augmented Versus Non‐Augmented Extraction Sockets: 3‐Year Results

The alveolar ridge undergoes reabsorption and atrophy subsequent to tooth removal and thus exhibits a wide range of dimensional changes. Preservation of the alveolar crest after tooth extraction is essential to enhance the surgical site before implant fixture placement. The aim of this randomized clinical study is to investigate and compare the need for additional augmentation procedures at implant insertion, as well as the success rate and marginal bone loss for implants placed in the grafted sites versus those placed in naturally healed sites. Forty patients with ≥1 hopeless tooth were randomly allocated to: 1) a test group, receiving extraction and grafting corticocancellous porcine bone; and 2) a control group, receiving extraction without any graft. After 7 months of healing, implants were inserted in each of the sites. The implants were submerged and loaded after 4 months with metal-ceramic rehabilitation. The follow-up included evaluation of implant diameter and length, the need for additional augmentation procedures at implant placement, implant failure, and marginal bone level changes. All patients were followed over a 3-year period. One implant failed in the control group at the second stage of surgery (6 months after placement); one implant failed in the test group after 2 years of loading. The cumulative implant success rate at the 3-year follow-up visit reached 95% for both groups. No statistically significant differences were detected for marginal bone changes between the two groups. It was concluded that implants placed into grafted extraction sockets exhibited a clinical performance similar to implants placed into non-grafted sites in terms of implant survival and marginal bone loss. However, grafted sites allowed placement of larger implants and required less augmentation procedures at implant placement when compared to naturally healed sites.

Dental Implant Outcome after Primary Implantation into Double-Barreled Fibula Osteoseptocutaneous Free Flap–Reconstructed Mandible

Functional and aesthetic mandibular reconstruction can be achieved in a single operation by means of a double-barreled fibula osteoseptocutaneous free flap with dental implants loaded simultaneously into the upper barrel. The aim of this study was to evaluate the quality and result of such reconstruction. From 2005 to 2007, 10 patients underwent segmental mandibular defect reconstructions with double-barreled fibula osteoseptocutaneous flaps and simultaneous dental implantations. Implant marginal bone loss, clinical mucosal changes, marginal plaque indices, bleeding on probing, and pocket probe depth were evaluated at an average of 22.2 months after implant functional loading. Ten patients with a total of 25 osseointegrated implants were evaluated. The mean implant marginal bone loss was 0.18 ± 0.18 mm (range, 0 to 0.6 mm) at the mesial surfaces and 0.25 ± 0.2 mm (range, 0 to 0.6 mm) at the distal surfaces. Probing pocket depth was shallower for implants protected by palatal mucosal grafts (2.56 ± 0.54 mm) than by skin flaps (3.50 ± 0.90 mm) (p < 0.05). There was a significant difference in marginal bone loss between palatal mucosal grafts (0.11 ± 0.09 mm) and skin flaps (0.29 ± 0.23 mm) (p < 0.05). Bleeding on probing was more prominent when pocket depth exceeded 5 mm and occurred more frequently in skin flap-protected than in keratinized mucosa graft-protected implants. The one-stage combined surgical method is safe and reliable. Both oral function and mandible contour were good. Firmly attached gingiva-like palatal mucosal grafts prevent periimplant soft-tissue inflammation and facilitate maintenance of oral hygiene. Therapeutic, V.

Marginal bone loss in relation to the implant neck surface: An update

A review is made of the publications on the marginal bone loss of implants with a polished neck, rough neck with microthreading, and rough neck without microthreading. A PubMed search was carried out with the following key words: machined neck implant, polished neck implant, marginal bone loss, covering the period between January 1998 and March 2009. Inclusion was limited to those human clinical studies involving a minimum follow-up of 12 months, and registering the level of bone loss from the time of placement of the implant or prosthetic restoration to the end of follow-up. For most of the authors there were no significant differences in marginal bone loss between polished neck and rough neck implants. On the other hand, implants with a rough neck and microthreading showed significantly less bone loss than those with a polished neck or with a rough neck without microthreading. The survival rate of the implants with a polished neck ranged from 87% to 97.7%, versus 94.5% to 100% for those with a rough neck, and 100% for the rough neck implants with microthreading. No peri-implant disease was registered in the different studies.

Early Survival of Single-Tooth Implants in the Esthetic Zone may be Predictable Despite Timing of Implant Placement or Loading

The authors used MEDLINE, EMBASE, and CENTRAL (Cochrane Central Register of Controlled Trials) databases to locate studies for this systematic review (SR). For studies to be eligible for this SR, all had to evaluate single-implant restorations with a follow-up of at least 1 year after implant loading. A total of 19 prospective studies met inclusion and exclusion criteria. Fifteen studies provided implant survival data (499 patient/509 implants), whereas 5 studies provided radiographic marginal bone height data (52 patients/52 implants). The analysis included studies with patients with single anterior or premolar,maxillary or mandibular edentulous sites bounded by anterior and posterior neighboring teeth. Meta-analyses of prospective trials (randomized-controlled trials, clinical trials, cohort studies, case series) reported loaded implant survival with one-year or more than one-year follow-up. Meta-analysis of prospective trials reporting marginal bone loss with one-year follow-up was also reported. The key interventions were the timing of implant placement following extraction and the timing of implant loading after implant placement. Comparisons following greater than one-year follow-up were made between implants with immediate placement with immediate loading, immediate/early placement with conventional loading, conventional placement with immediate/early loading, or conventional placement with conventional loading. The main outcome was implant survival. Radiographically determined peri-implant bone level change was also reported. Meta-analyses were completed using studies that reported one-year implant survival data (15 studies) and more than one-year implant survival data (11 studies). One-year marginal bone level data were analyzed for implants treated conventionally (5 studies). For survival and marginal bone levels, weighted rates and random effects models were used to calculate overall effects of the included studies. For greater than one-year follow-up, survival data were stratified by intervention type. Results were weighted for study size and stratified based upon timing of implant placement and loading. Esthetics, and patient satisfaction, and complications were reported, but heterogeneity of study design and reported outcomes excluded the results from meta-analysis. Approximately two-thirds of patients received implants in healed edentulous sites. Survival of single-tooth implants one year in function was 95.5% [95% CI: 93.0-97.1]. Meta-analysis identified no difference in survival rate at one year when the results were weighted for study size and stratified based upon timing of implant placement and loading. Survival of single-tooth implants more than one year in function ranged from 92.4% [95% CI: 84.4-96.4] for conventional placement with immediate loading to 97.5% [95% CI: 88.3-99.5] for immediate placement with immediate loading. The third meta-analysis identified 0.20-mm [95% CI:0.034-0.36] marginal bone loss for implants one year in function. Qualitative interpretation of other esthetic, patient satisfaction, and complication outcomes revealed no difference in immediate, early, or conventional therapy approaches. The authors concluded that implant-supported single-tooth replacement in the aesthetic zone with adjacent natural teeth can lead to short-term, favorable outcomes with regard to implant survival and marginal bone level change with early/immediate or conventional surgical placement and loading strategies.

Therapy of peri‐implantitis with resective surgery. A 3‐year clinical trial on rough screw‐shaped oral implants. Part II: radiographic outcome

This clinical study on therapy of peri-implantitis aimed to compare the marginal bone loss of implants treated with different surgical approaches: implantoplasty and peri-implant resective surgery only. Over a period of 6 years, 10 patients (20 implants) were treated with implantoplasty (test group) and 9 had resective surgery (control group). A computerized analysis of radiographs was performed to calculate marginal bone loss (MBL) values mesial and distal to the implants. The measurement system was set by means of known implant sizes. Data on MBL were collected at the time of peri-implantitis diagnosis, 1, 2 and 3 years after surgery. There was no difference between the mean MBL values three years after implantoplasty in the test group: 0 and 0.01 mm of MBL mesial and distal to the implant were found (P>0.05). Conversely, the mean MBL values recorded in the control group were statistically different: 1.44 and 1.54 mm of MBL mesial and distal to the implant were found (P<0.05) 3 years after resective surgery. Moreover, the variation of peri-implant marginal bone after peri-implantitis surgical treatment was significantly lower in the test group than in the control group (P<0.05). The results of this radiographic research suggested that implantoplasty was an effective treatment of peri-implant infections and peri-implantitis progression.