Mean Crestal Bone Loss Research Articles

Radiographic evaluation of hard tissue changes in open flap technique versus flapless technique for implant placement

Open flap technique allows the clinician to directly visualize the alveolar bone and assess bone morphology of the ridge.However, this technique is relatively invasive and causes patient discomfort and marginal bone loss due to decreased supraperiosteal blood supply whereas the Flapless technique is one of the latest minimally invasive surgical methods of implant placement without the need to raise a mucoperiosteal flap to overcome the bone resorption process. The present study was designed to evaluate the hard tissue changes in open flap technique versus flapless ṭechnique for implant placement at the different time interval. Minimum thirty edentulous sites from Out Patient Department, Department of Periodontology (IDST) were randomly allocated to the following two groups by the flip of coin: Group I - Implant with open flap technique (fifteen sites) and Group II - Implant with flapless technique (fifteen sites). Patients were evaluated radiographically for crestal bone loss (mesial and distal) at Baseline (Immediately after implant placement), At the time of prosthetic loading and 3 months after prosthetic loading in both the groups. The result of the present study revealed that Sites where implants were placed with flapless technique showed lesser mean crestal bone loss scores as compared to sites where implants were placed with open flap technique, although the difference was insignificant. It can be concluded that flapless procedure may be considered as a better treatment option as compared to implant placed with open flap technique in terms of minimal pain, inflammation and less crestal bone loss associated with flapless technique than open flap technique.

Does Implant Placement Below the Ridge Reduce Crestal Bone Loss? A Split-Mouth Randomized Controlled Clinical Trial.

Reducing crestal bone loss (CBL) around implants allows for soft tissue stability and long-term success. The aim of the present study was to evaluate the extent of CBL in implants placed with the implant shoulder at the equi-crestal level and 2 mm below the alveolar ridge at 2, 12, 36, and 60 months. A split-mouth randomized controlled clinical trial was conducted by selecting subjects with Kennedy Class IV partial edentulism of the lower jaw. Two implants were inserted, of equal length and diameter, one equi-crestal and the other sub-crestal, in the site corresponding to the lateral incisor. Intraoral periapical radiographs with Rinn centering devices were performed at the time of implant insertion (T0), at 2 (T1), 12 (T2), 36 (T3), and 60 months (T4). Descriptive statistics and the T-test were used, setting the significance to P⩽ 0.05. Twenty-five subjects were recruited, with a mean age of 65 years (SD 9.88, range 42-82). No subject dropped out. A total of 50 implants were inserted, 25 at crestal and 25 sub-crest level. At the 60-month follow-up, no implant or prosthetic failure was recorded. An average loss of -0.81 mm was recorded in the crestal implant group (n.25; SD: 0.40; max-min: -1.6 - -0.1) while in the implants positioned below the crest the average CBL was -0.87mm (n.25; SD: 0.41; max-min: -2 - -0.2); however, the higher CBL in the sub-crestal implant group was not statistically significant (P=0.65). Comparing the mean CBL values of the two groups at the various follow-ups, a greater crestal bone resorption was recorded in sub-crest implants between T0 and T1 (-0.25 vs -0.1) and between T1 and T2 (-0.39 vs -0.23), while in subsequent follow-ups a greater, statistically significant (P=0.01), crestal bone loss was recorded in ridge implants between T3 and T4 (-0.05 vs -0.18). Over time, therefore, the extent of CBL seems to be reduced in implants placed below the crest, with bone retention above the implant shoulder. Ultimately, although the position of the implant shoulder relative to the crestal ridge doesn't affect the CBL, sub-crestal placement is recommended in order to reduce the risk of exposure of the rough surface of the implant.

Effect of Densah Burs on Primary and Secondary Stability of Immediately Loaded Implants in Addition to Crestal Bone Loss and Gingival Probing Depth - An Evaluative Study.

Osseodensification (OD) compaction increases primary stability by leaving the residual bone particles in the osteotomy site, which in turn act as an autograft. [ 1 ] Condensing the bone trabeculae through OD has demonstrated to have a potentiating influence on secondary stability. [ 2 ]. A split-mouth study was conducted in 40 patients to determine the effect of OD on implant success rate in terms of primary and secondary stability in situations including immediate loading of implants placed in low-density bone, which was tested using resonance frequency analysis (RFA) at the interval of 0, 6 th month. In order to assess the implant success rate, gingival probing depth and crestal bone loss (CBL) around the implant were also assessed at baseline and 6 months. With respect to primary stability, at baseline, the mean RFA of Densah burs is 71.6 ± 9.5 and of conventional drills is 67.6 ± 10.4. The mean stability of Densah burs is significantly higher than conventional drills, both at baseline and after 6 months as well. CBL, at baseline, the mean CBL of Densah burs is 0.58 ± 0.11 and of conventional drills is 0.64 ± 0.12. The mean CBL of Densah burs is significantly lower than that of conventional drills for both. The implant stability values found in the present study were remarkable when compared between OD and conventional osteotomy techniques. Decreased loss of bone at the crest probing depth also aided in the increased success rate.

A Long-Term Split-Mouth Randomized Controlled Trial to Assess Implant Treatment Outcome Using Implants with a Different Surface Roughness

The influence of implant surface roughness on implant treatment outcome is still under debate. A rougher implant surface improves osseointegration but yields greater plaque accumulation and biofilm formation. Hybrid implants have a minimally rough component coronally and a moderately rough implant body. The aim of this split-mouth study is to evaluate the long-term outcome of treatment with hybrid and moderately rough implants after 6 years. As a secondary aim, Oral Health Quality of Life (OHQoL) was assessed after one and six years. Fully edentulous patients received an overdenture supported by two implants. One implant had a hybrid surface (MSC) and one implant had a moderately rough surface (DCC). Radiographic crestal bone loss (CBL), plaque score, bleeding on probing (BoP) and periodontal probing depth (PPD) were determined at one and six years. OHQoL was evaluated using the Oral Health Impact Profile-14 (OHIP-14) questionnaire and a Visual Analogue Scale (VAS). Twenty-one patients with 42 implants were evaluated after 6 years. No implants failed and a mean CBL of 0.26 mm (SD: 0.42) for the MSC group and 0.17 mm (SD: 0.29) for the DCC group was observed, which was not statistically significant. Periodontal parameters were comparable after 6 years and a significant improvement in OHQoL was observed. This randomized controlled trial concludes that hybrid implants are a predictable treatment alternative for moderately rough implants in patients with an overdenture supported by two implants.

Comparison of the effect of zirconia and titanium abutments on peri-implant hard and soft tissues.

The primary objective of this research was to assess and compare the impact of customized zirconia (Zr) and titanium (Ti) abutments, placed on early loaded dental implants, on both hard tissue (as measured crestal bone level) and soft tissue (as assessed by sulcular bleeding index [SBI], probing depth [PD], and Pink Esthetic Score [PES]), through clinical and radiographic evaluation. This research involved a sample of 15 patients who had partially dentulous mandibular arch. Within this group, a total of 30 implants were surgically placed. Specifically, each patient received two implants in the posterior region of the mandible, and the bone density in this area was classified as D2 type. In each patient, one implant was loaded with Zr abutment and the other was loaded with Ti abutment. The bone quality in the area of implant placement was Type D2. Two groups were created for this research. Each group consisted of 15 early loaded dental implants with customized Zr abutments and customized Ti abutments respectively. Hard- and soft-tissue changes were evaluated in both the groups. Evaluation of crestal bone loss (CBL) with cone beam computed tomography and SBI, PD and PESs were evaluated by various indices at 2, 4, and 6 months postloading. After obtaining the readings, data were subjected to statistical analysis and comparison of quantitative data was done, paired t-test was used. The mean CBL in the Ti abutment is higher; the difference between the two groups was not statistically significant. SBI and PD for Zr were higher, but there was no statistically significant difference between the two groups. Zr had a higher PES than Ti abutment and the difference between the two groups was statistically significant. In the literature till date, the PES of Zr abutments were proven better for provisional restorations in implant prosthesis, but very few literatures support the same for the final implant restorations. The study did not reveal a clear advantage of either Ti or Zr abutments over the other. Nevertheless, Zr abutments tended to produce a more favorable color response in the peri-implant mucosa and led to superior esthetic outcomes as measured by the PES.

Estimation of Loss of Crestal Bone Around Dental Implants in Various Tissue Biotypes Using CBCT.

To evaluate the loss of crestal bone height around dental implants placed in various tissue biotypes. 20 patients with single edentulous sites were allocated randomly, with 10 samples in each into Group I (implants were placed in thick tissue biotype) and Group II (implants were placed in thin tissue biotype). Baseline cone-beam computed tomography (CBCT) was performed after implant placement in both groups, and follow-up CBCT was taken at the time of cementation prior to occlusal loading to assess the crestal bone loss around the mesial and distal side of implants in both groups. A significant loss of crestal bone at both the distal and mesial sides of the implants at the time of cementation was observed in both groups but Group II showed more crestal bone loss as compared to Group I. Mean crestal bone loss was more in Group II (thin tissue biotype) in comparison to Group I (thick tissue biotype). The thick biotype causes less crestal bone changes than the thin biotype, which evokes more loss of crestal bone during the period of peri-implant healing.

Evaluation of Endo Perio Lesions Using Cone Beam Computed Tomography (CBCT) - A Cross Sectional Study.

An accurate assessment of the disease extent and lesion size is needed for appropriate therapy decisions of endodontic-periodontic (endo-perio) lesions. CBCT imaging with less radiation and high spatial resolution can provide a comprehensive evaluation of endo-perio lesions. A total of 71 teeth with endo-perio lesions were assessed using CBCT. Periodontal bone defects were studied for bone loss pattern (horizontal/vertical) along with bone loss levels on mesial and distal sides in association with furcation involvement. The periapical lesions were studied for their prevalence and extent based on CBCT PAI Score. Horizontal and vertical bone loss were detected in 54 teeth (76.1%) and 17 teeth (23.95%), respectively. Mean crestal bone loss levels on mesial and distal aspects were 4.80 ± 3.21 mm and 5.74 ± 3.91 mm, respectively. The mean height, width, and depth of furcation defects were 3.19 ± 2.99 mm, 1.94 ± 0.98 mm, and 4.44 ± 1.92 mm, respectively. Periapical lesions were recorded in 55 teeth (77.5%). A CBCT PAI score of 5 was scored in 35 teeth with a mean lesion diameter of 11.3 ± 2.83 mm, while 16 teeth had healthy periapical tissues (scores of 0 and 1). CBCT is a valuable diagnostic tool that can help assess endo-perio lesions by providing morphometric measurements of periodontal bone defects and the extent of associated periapical lesions.

Immediate Loading of Bicortically Engaged Long Implants in Maxillary and Mandibular Esthetic Region – A Clinicoradiographic Evaluation

Abstract Background: Bicortical engagement is the engagement of nasal cortical plate and basal cortical plate in maxillary and mandibular esthetic zone, respectively. These are longer implants which offer osseointegration along with high osseofixation. Increased length of implant provides increased bone–implant contact offering primary stability which permits immediate loading. Aim: The aim of the study was to clinicoradiographically evaluate immediate loading in bicortically engaged long implants in maxillary and mandibular esthetic region. Materials and Methods: Thirty patients with missing teeth in esthetic region were selected for the study. Implants were placed in both arches engaging nasal cortex and basal bone wherever required. One-time definitive abutment was placed and immediate loading was done. Results: No failure was observed in the study period of 9 months. The mean insertion and reverse torque was 66.67 ± 6.794 and 41.67 ± 3.101, respectively, indicating high primary stability. No pain, discomfort, infection, or implant mobility was observed. The mean crestal bone loss changes were statistically insignificant. Conclusion: Hundred percent implant survival was observed.

Comparative Evaluation of the Crestal Bone Level Around Pre- and Post-loaded Immediate Endoosseous Implants Using Cone-Beam Computed Tomography: A Clinico-Radiographic Study.

Introduction Dental implants replacemissing teeth. Dental implants are surgically placed tooth root replacements that secure prosthetic teeth and bridges. Branemark's original dental implant technique included a mesiobuccal flap and a two-stage approach, needing 6-8 months of recovery following extraction, sterile conditions, machined titanium implants, 3-6 months without stress for osseointegration, and a detachable temporary prosthesis. The restoration would usually be ready a year following the implant surgery. Implant treatment seeks the best function, aesthetics, and complication risk. Implant therapy with low patient morbidity and fast extraction-to-restoration times is asecondary target. Instantaneous implant insertion has made implant dentistry more convenient for patients and clinicians. This study measures bone height before, after, and one month after implant placement using cone-beam computed tomography (CBCT). Materialsand Methods Participants were selected from oral evaluation candidates. This investigation included 11 people missing front maxillary or mandibular teeth or root components. Diagnostic castings determined the interarch connection before surgery. Alginate maxillary and mandibular arch imprints were cast in Type III dental stone for diagnosis. CBCT scans were taken pre-operatively, post-implant, and post-prosthesis. After the tooth was removed, the empty socket was cleaned up with curettes. An intraoral periapical radiographand manual probing were done to determine the implant's size. The implant was removed for examination after three months, and healing abutments and gingival formers were placed. Finally, fins were placed. The CBCT images also captured the bone height around the implants. The soft tissue parameters were recorded and evaluated at baseline and one-month following prosthetic loading as plaque index (PI). Radiographic evaluation was done at baseline and one-month following functional loading using CBCT. After one month following functional loading, crestal bone levels were measured again with the help of CBCT using Image J software (National Institutes of Health, Bethesda,Maryland, US). Results The sample population had an average age of 42.81 years, with a standard deviation of 13.44 years. Using a paired t-test, we found that the mean PI dropped significantly from pre-loading levels to one-month post-loading levels, with a p-value of less than 0.001. The mean crestal bone level (mesial) evaluated by CBCT at baseline and one-month post-loading was 2.52 ± 1.97 mm and 1.17 ± 1.31 mm, respectively. The mean difference between mean crestal bone loss (distal) at baseline and one-month post-loading was 0.94 ± 1.89 mm, which was not statistically significant. The mean difference between mean crestal bone loss (buccal) at baseline and one-month post-loading was 1.82 ± 1.60 mm, which was statistically significant. The mean difference between mean crestal bone loss (lingual) at baseline and one-month post-loading was 1.91 ± 1.53 which was statistically significant. Conclusion CBCT provides all the diagnostic data needed for implant placement; hence, it is recommended.

Effect of local application of hyaluronic acid gel on marginal bone loss and stability of dental implants

ABSTRACT Aim: To evaluate and compare the crestal bone loss and implant stability with and without hyaluronic acid gel delivery at osteotomy site. Materials and Methods: This is a Prospective randomized controlled clinical trial. Eleven patients with 30 edentulous sites were randomly divided into two groups. Test (15 sites with hyaluronic acid gel injection) and Control (15 sites without hyaluronic acid gel injection). Peri-implant crestal bone loss around the implant and stability were measured at baseline and three months. Statistical analysis was done using Mann-Whitney U test and Wilcoxson Signed-Rank test. Results: Primary stability scores for the test and control groups were 70.45 ± 1.49 and 69.53 ± 1.69, respectively and was not statistically significant. Secondary stability scores for the test and control group were 72.37 ± 1.42and 70.63 ± 1.61 respectively and was statistically significant, mean crestal bone loss for the test and control groups was 0.83 ± 0.31 and 1.27 ± 0.32, respectively. which was statistically significant (p-value < 0.05). Conclusion: Within the study’s limitations, the results showed that the local injection of osteotomy sites with hyaluronic acid showed a significant increase in stability and reduction in crestal bone loss.

Comparison of bone loss around implants using radiographs

This article presents an original-research conducted at Pushpagiri College of Dental sciences, Thiruvalla, Kerala to compare and evaluate the vertical crestal bone changes around implants with different surface coatings and diame-ter using CBCT and RVG taken at the time of loading and one year after loading. Thirty-six samples were divided in 4 group; based on 3 parameters: implant surface coating, implant diameter, and single versus multiple implants sup-ported bridges. Length of all implants is kept standardised at 10 mm. Data were statistically analyzed by Students paired t-test and comparison between CBCT and RVG is done using interclass correlation test. The mean crestal bone loss has increased statistically significant from the time of loading and after one year of loading. The average crestal bone loss on single implants were less compared to multiple implants supported bridges at both timings. CBCT shows more accurate and reliable values than RVG both clinically and statistically. It was concluded that crestal bone loss was less among single implants with calcium phosphate surface coating and wider diameter than alumina blasted and narrow diameter implants. Single implant shows less bone loss than multiple implants. The CBCT shows a reliable method of detecting circumferential peri-implant bone defects than RVG.

Evaluation of safety and efficacy of locally developed dental implants: A noninferiority randomized controlled trial

Statement of problemVarious dental implants are available in India, but imported devices are expensive; an affordable locally produced dental implant system would be beneficial. PurposeThe purpose of this noninferiority randomized controlled trial was to compare the safety and efficacy of a locally developed dental implant system to those of an established imported dental implant system with similar microsurface characteristics. Material and methodsA total of 136 participants with 201 partially edentulous sites, aged 18 to 65 years, were enrolled in the trial, with 134 sites receiving test implants and 67 sites control implants (n ratio, 2:1). The implants received a delayed submerged healing protocol and were loaded 3 to 6 months after surgery. Maximum insertion torque (IT) was recorded during the implant surgery, and the implant stability quotient (ISQ) was evaluated on the day of surgery and at the second-stage procedure. The mean crestal bone loss (MCBL) was measured on periapical radiographs at prosthetic placement (baseline) and at 6 months and 12 months after loading. The primary measure of outcome was the implant survival rate, and the secondary measure of evaluation was the intergroup difference in MCBL at baseline, 6 months, and 12 months. ResultsA total of 127 test and 61 control implant sites were available for follow-up 1 year after prosthesis placement. At the end of 12 months, the test and control implant groups demonstrated a survival rate of 97% and 100%, respectively. The MCBL difference was significant between the 2 groups at baseline (P<.05). However, at 6 and 12 months, the difference between the test and control groups was not significantly different (P>.05). ConclusionsThe survival rate of the test group fell within the previously assumed 10% noninferiority margin. Therefore, the null hypothesis was accepted for the trial, and the locally developed implants were noninferior to the imported implants at a sample allocation ratio of 2:1.

Randomized Controlled Study on Effect of Concentrated Growth Factors on Crestal Bone Levels and Peri-implant Bone Density in Dental Implants.

Introduction:Modern dentistry aims to restore the comfort and health of the stomatognathic system. Dental implants have emerged as a promising option for this purpose. Concentrated growth factors (CGFs) have been suggested to enhance the healing of bone grafts and enhance the integration of implants into the bone. Growth factors are proteins which regulate the complex process of wound healing. They play an important role in cell migration, cell proliferation, and angiogenesis in the tissue regeneration phase. CGF was first developed by Sacco in 2006. It can be used as a barrier membrane to accelerate soft-tissue healing. CGF does not require any chemical or anticoagulants, and hence, it is free from viral transmission diseases. Crestal bone levels, peri-implant bone density, bleeding, probing depth, mobility, occlusion factors, restoration adequacy, radiographic images, oral hygiene, and patient health status are some of the important parameters for determining longevity of success rates in implant dentistry. This study will assess the peri-implant bone density and crestal bone levels with and without the use of CGF.Aim:To evaluate the effect of CGFs on peri-implant bone density and in the preservation of crestal bone levels around dental implants.Materials and Methods: Sampling procedure: Random selection of population (Sealed envelope method)Number of groups: Two-Control group (Group 1) and Experimental group (Group 2)Sample size: 20 For Group 2, implants were placed with CGF. For Group 1, implants were placed without CGF. The peri-implant bone density and bone levels were measured by Digora and signora software.Results:The mean crestal bone loss on the mesial aspect of implants placed in Group 2 is 0.294 mm and Group 1 is 0.345 mm, and the mean crestal bone loss on the distal aspect of implants placed in Group 2 is 0.320 mm and in Group 1 is 0.331 mm. There are no many significant differences on mesial and distal aspects around implants between the two groups Intragroup comparison of bone density values in Group 1 shows the mean difference from baseline to 1 month is 0.6, and after three and 6 months periods are 1.1 and 1.1, respectively, which indicates not much significant improvement in bone density values in Group 1. Intergroup comparison shows a significant difference between both the groups starting from as early as the 1st month.Conclusion:The results of this study indicate that CGF is significantly better in the regeneration of bone around the implants when comparing with nonCGF groups. Although CGF showed improvement in bone formation, there are no many differences in crestal bone level changes on mesial and distal sides of the implants between the two groups.

Long-term results of immediate implantation in mandibular posterior teeth with early loading: A retrospective case series

When immediate molar implants first were proposed, submerged initial healing and delayed loading were the norm. It is now recognized that some early loading of a nonocclusal nature can stimulate faster osseointegration, although full occlusal loading is still delayed for 3 or more months. Here, we test the hypothesis that earlier occlusal loading of mandibular premolar and molar immediate implants may be possible. In this retrospective case series study, 18 mandibular molar and nine mandibular premolar teeth were atraumatically extracted and immediate implants placed 1-2 mm apical to buccal and lingual crestal bone. Periimplant gaps received particular allograft covered with acellular dermal matrix barrier. Healing abutments were placed through puncture points in the membranes to help in stabilizing the latter and to permit nonsubmerged site healing. At 6-8 weeks, each implant was evaluated for stability using the Periotest® device and restored if the Periotest® (PTV) value seen was negative. Data were analyzed by t test and MannWhitney U at a significance level of P < 0.05. Retrospective assessment of all 27 implants after 5 years' period of follow up showed all implants to have survived. Overall mean crestal bone loss was determined to be-0.25 ± 0.54 mm. Individual mean bone levels for mesial and distal surfaces were-0.24 ± 0.77 mm and-0.26 ± 0.72 mm, respectively (P = 0.78). A statistically significant difference in bone loss between genders was detected. Overall mean probing depth was 2.09 ± 0.57 mm. Based on the widely used Albrektsson criteria, the overall survival and success rate was 100%. Immediate implants placed into mandibular premolar and molar extraction sockets and allowed nonsubmerged healing may be ready for restoration at earlier times than previously thought possible.

The Vertical Soft Tissue Thickness and Subcrestal Implant Placement as Factors for Peri-implant Crestal bone Stability

Aim&#x0D; The aim of this prospective study was to determine the influence of vertical soft tissue thickness on bone level changes in platform-switched implants placed eqicrestally or subcrestally and restored with screw-retained or cement-retained restorations.&#x0D; Methods&#x0D; Platform-switched bone-level implants were placed in a single stage manner in the posterior mandibular region. Implant sites were divided into thick (control) and thin (test) vertical soft tissue groups. The implants in the control group were placed equicrestally. The implant sites from the control group were randomly allocated to receive equicrestally or subcrestally placed implants. Bone remodeling/loss was radiographically measured at baseline, three months postoperatively and six months after delivery of final prosthetic restoration.&#x0D; Results&#x0D; The mean crestal bone loss values three months postoperatively and six months post prosthetic restoration were higher in sites with thin versus sites with thick gingiva. In implant sites with thin gingiva, subcrestally placed implants presented less bone loss than eqicrestally placed implants.&#x0D; Conclusion&#x0D; Platform switched implants are prone to more bone loss when they are placed in sites with thin soft tissue, regardless of the type of final restoration (screw-retained or cement-retained). Subcrestal placement of platform-switched implants can prevent crestal bone loss in sites with vertical soft tissue thickness &lt; 3 mm.&#x0D; &#x0D;

The influence of laser-microgrooved implant and abutment surfaces on mean crestal bone levels and peri-implant soft tissue healing: a 3-year longitudinal randomized controlled clinical trial

PurposeThe study aimed to compare clinical and radiographic parameters of peri-implant site of laser-microgrooved implants with either laser-microgrooved or regular machined prosthetic abutment post 3 years of early loading.MethodTwenty edentulous sites of systemically and periodontally healthy individuals were allocated into two groups in this prospective, two-armed, randomized double-blinded clinical trial in 1:1 ratio, wherein each site received laser-microgrooved implants with either laser-microgrooved or machined prosthetic abutments. Outcome measures included full-mouth plaque (FMPS%) and bleeding score (FMBS%), site-specific plaque (SPS%) and bleeding score (SBS%), peri-implant sulcus depth (PISD mm), and mean crestal bone loss (MCBL mm) evaluated at baseline (6 weeks), 1 and 3 years post-early loading. Mean and standard deviation of all parameters were estimated, between groups and at different time points using independent and paired t-test, respectively, Normality was checked using Kolmogorov–Smirnov test and Shapiro–Wilk test, P value ≤ 0.05 was considered as statistically significant.ResultsThree-year follow-up of test group showed statistically significant reduction in SPS, SBS, PISD (P value ≤ 0.001). The MCBL reduced from 1.93 mm to 0.61 mm (P value ≤ 0.001); in other words, a bone gain of 0.15 mm was obtained in the test group.ConclusionWithin the limitations of the present study, laser-microgrooved implants loaded with laser-microgrooved prosthetic abutments showed superior results clinically and radiographically when compared to loading with machined abutments.

Analysis of Marginal Bone Loss and Residual Ridge Resorption in Conventionally Loaded Single and Two Implant Supported Overdentures

Purpose: The aim of this study was to analyze the marginal bone loss and residual ridge resorption in patients wearing single and two implant-supported overdentures. Materials and methods: This study was conducted on 20 edentulous patients between 50-75 years of age who have been completely edentulous for a period of at least one year or more. Patients were divided into two groups: Group-A in which two implants of size 3.75x13mm were placed in B and D position and ball abutments were attached to make an overdenture; in Group-B patients, a single implant at position C was placed and overdenture was made with ball abutments. Crestal bone loss was recorded around the margins in both the groups and residual ridge resorption was calculated in the mandibular posterior region using Wical And Swoope method. The data collected were compared for analysis using the Man-Whitney U test. Results: For 2-IOD overall mean crestal bone loss for one year was 0.15± 0.03cmand for S-IOD it was 0.14 ± 0.03cm. The significance value was calculated to be 0.518 and U=41.5 which was found to be non-significant. Difference in residual ridge resorption was also found to be non-significant in both the groups with the significance value of 0.284 and U=36. Conclusion: The scope of the single implant-retained overdentures can be a promising alternative for patients with an atrophic mandible, systemically compromised patients with financial difficulties.

Radiographic comparisons of crestal bone levels around implants placed with low-speed drilling and standard drilling protocols: Preliminary results

BackgroundThe present study aimed to investigate the mean crestal bone loss (CBL) by placing implants using two different drilling-protocols, i.e., standard drilling with saline irrigation and low-speed drilling without saline irrigation. Material and MethodsThe patients were enrolled in the present study from a university teaching institute. Patients who fulfilled the inclusion criteria were randomly placed in two study groups: 1) control group: Standard drilling with saline irrigation and 2) test group: low-speed drilling without saline irrigation. The radiographic mean crestal bone loss (CBL) was evaluated at 3 months of follow-up before implant loading. Data analysis was performed using SPSS 20.0 (IBM product, Chicago, USA) and a p-value ≤ 0.05 was considered statistically significant. ResultsSixteen patients (10 males and 6 females) participated in the study. Thirty Camlog®-screw-line implants were placed (15 implants per study group). After 3 months of follow-up, the means CBL of implants placed with standard drilling and low-speed drilling protocols were 1.01 ± 0.49 mm and 0.74 ± 0.62 mm, respectively. No statistically significant difference could be recorded between two groups (p = 0.206). ConclusionsDental implants placed with low-speed drilling without saline irrigation exhibited a similar CBL to implants installed with the standard drilling protocol. However, further randomised clinical trials are recommended to obtain stronger evidence and a better understanding of the effect of the low-speed drilling protocol without saline irrigation on mean CBL and long-term implant survival.

Crestal bone loss in ultrashort implants: retrospective study on two different type of fixture.

Aim This was to assess variation of mean crestal bone loss (CBL) when two different types of ultrashort implants are placed in the upper or in the lower jaw and to evaluate differences in terms of success and survival rates. Materials and methods 99 ultrashort implants were retrospectively evaluated assessing differences at three different time-points (placement, prosthetic loading, end of follow-up) in terms of CBL in the upper and lower jaw. Correlations between CBL and diameter, platform switching, site of placement (upper or lower), type of implants, clinical crown/implant ratio and anatomical crown/implant ratio were statistically performed and success and survival rate were assessed. Results Statistically significant correlations were found between CBL and implant diameter, kind of screw and anatomical crown/implant ratio at the end of follow up. No correlation was highlighted between CBL and platform switching, and site of placement (upper or lower jaw). Survival and success rates were comparable and were found to be 96.37% in the upper jaw and 94.46% in the mandible. Conclusion CBL in ultrashort implants is an issue deserving great attention, therefore to know features and behaviours of different ultrashort implants in different quality of bone and clinical conditions represents a cut above to obtain and maintaining success in this particular kind of rehabilitation.

Five Years Follow-up of Short Implants Placed in Atrophic Maxilla with Simultaneous Sinus Floor Transcrestal Elevation.

ObjectiveMany authors have tried to face the anatomical limitations resulting from maxillary bone atrophy. Up to five millimeters bone height, the lateral sinus floor elevation is the most commonly used and validated strategy to achieve the prosthetic rehabilitation. However, the disadvantages of this technique are its invasiveness and delayed rehabilitation. The aim of this paper was to assess 5 years clinical outcome of implants placed with a technique that allows the percrestal sinus floor elevation and the immediate implant placement.Materials and Methods30 transcrestal sinus floor elevations with immediate implant placement were performed in severely atrophic maxillae. Implant survival, marginal bone level variation, harvested bone height variation and periodontal indices were assessed.ResultsAfter a five year follow up none of the thirty implants were lost. The mean value of vertical harvested bone loss was 5%. The mean crestal bone loss was -0.33 mm (Standard Deviation (SD) 0.11 mm). The mean value of periodontal indices was respectively: PD 1.22 mm (SD 0.72 mm), PI 17.47% (SD 15.01 mm), BOP 9, 87%.,(SD 19.17 mm).ConclusionThe results obtained are comparable with success criteria in implant rehabilitation. The reported technique proved to be successful in the population observed, with minimal trauma and reduced invasiveness.