Narrow Dental Implants Research Articles

The Fatigue Behavior of Narrow Single-body Titanium Implants in Saline and Acidic Media.

The objective of this study was to examine how the saline and acidic environment affects the mechanical integrity of narrow single-body titanium implants for oral rehabilitation. Thirty titanium-base alloy implants with 2.5 mm diameter were placed into a polyacetal holder and coupled to a stainless-steel prosthetic cap for fatigue testing in three different environments, as follows: dry air; saline solution (pH at 7.6); and lactic acid solution (pH at 3.4). The fracture surfaces were analyzed using a Scanning Electron Microscope (SEM). Also, finite element analysis was carried out to estimate the maximum von Mises stresses. The fatigue resistance was higher in the group tested in dry air (60%), followed by saline solution (30%) and lactic acid (10%). Regardless of the environment, fracture occurred at the same region of the failed specimens in line with the highest stress concentration spots, according to the finite element analysis. SEM analyses revealed two distinct failure regions, both with the presence of fatigue streaks: fatigue and overload. A high incidence of secondary cracks was also noticed on the specimens exposed to the solutions. The present study revealed that both saline and acidic solutions significantly affect the fatigue resistance of narrow dental implants. Critical regions of the narrow implants were also susceptible to cracks and plastic deformation that should be taken into consideration in planning for oral rehabilitation.

Is fatigue mechanism implicated in intraoral fracture of narrow dental implants? A thorough retrieval analysis of two failed implant fixtures retrieved from a single patient

PurposeThis study aimed to perform a thorough failure analysis of two fractured narrow dental implants after medium-term in vivo use. Materials and methodsThe top parts of two fractured Narrow Dental Implant (NDI) fixtures were retrieved from two different locations at two different times from the same patient. The NDI-specimen-1 was 12-months in service while the NDI-specimen-2 was 17-months in service. In both cases, the top parts of the fractured NDI fixtures that were attached to prosthetic components were retrieved and subjected to thorough, non-destructive and destructive testing. ResultsLight Microscopy (LM) and Scanning Electron Microscopy (SEM) revealed that both the retrieved fractured NDIs failed because of fatigue, characterized by beach and ratchet marks. Macroscopic examination revealed that fatigue cracks initiated at the internal thread surfaces of the implants and propagated around them until final fracture. Both samples fractured near the end of the retaining screw and followed the root of the internal thread. Optical and SEM analyses revealed a uniform distribution of irregularly shaped grains (diameter = 2 to 5 μm). X -ray Energy Dispersive Spectroscopy (EDS) analysis showed that the NDI-specimen-1 was made using Ti-14%Zr with a Vickers Hardens (HV) of 288 ± 5. ConclusionSince the fracture occurred by a fatigue; thus, an increase in fatigue resistance will be beneficial for the longevity of NDI.

Biomechanical Behavior of Narrow Dental Implants Made with Aluminum- and Vanadium-Free Alloys: A Finite Element Analysis.

Titanium (Ti) alloys used for narrow dental implants usually contain aluminum (Al) and vanadium (V) for improved resistance. However, those elements are linked to possible cytotoxic effects. Thus, this study evaluated the biomechanical behavior of narrow dental implants made with Al- and V-free Ti alloys by the finite element method. A virtual model of a partially edentulous maxilla received single implants (diameter: 2.7 and 2.9 mm; length: 10 mm) at the upper lateral incisor area, with respective abutments and porcelain-fused-to-metal crowns. Simulations were performed for each implant diameter and the following eight alloys (and elastic moduli): (1) Ti-6Al-4V (control; 110 GPa), (2) Ti-35Nb-5Sn-6Mo-3Zr (85 GPa), (3) Ti-13Nb-13Zr (77 GPa), (4) Ti-15Zr (113 GPa), (5) Ti-8Fe-5Ta (120 GPa), (6) Ti-26.88Fe-4Ta (175 GPa), (7) TNTZ-2Fe-0.4O (107 GPa), and (8) TNTZ-2Fe-0.7O (109 GPa). The implants received a labially directed total static load of 100 N at a 45° angle relative to their long axis. Parameters for analysis included the maximum and minimum principal stresses for bone, and von Mises equivalent stress for implants and abutments. Ti-26.88Fe-4Ta reaches the lowest maximum (57 MPa) and minimum (125 MPa) principal stress values, whereas Ti-35Nb-5Sn-6Mo-3Zr (183 MPa) and Ti-13Nb-13Zr (191 MPa) models result in the highest principal stresses (the 2.7 mm model surpasses the threshold for bone overload). Implant diameters affect von Mises stresses more than the constituent alloys. It can be concluded that the narrow implants made of the Ti-26.88Fe-4Ta alloy have the most favorable biomechanical behavior, mostly by mitigating stress on peri-implant bone.

How Streptococcus mutans Affects the Surface Topography and Electrochemical Behavior of Nanostructured Bulk Ti.

The metabolization of carbohydrates by Streptococcus mutans leads to the formation of lactic acid in the oral cavity, which can consequently accelerate the degradation of dental implants fabricated from commercially available microcrystalline Ti. Microstructure influences surface topography and hence interaction between bacteria cells and Ti surfaces. This work offers the first description of the effect of S. mutans on the surface topography and properties of nanostructured bulk Ti, which is a promising candidate for modern narrow dental implants owing to its superior mechanical strength. It was found that S. mutans incubation resulted in the slight, unexpected decrease of surface nanoroughness, which was previously developed owing to privileged oxidation in areas of closely spaced boundaries. However, despite the changes in nanoscale surface topography, bacteria incubation did not reduce the high level of protection afforded by the oxide layer formed on the nanostructured Ti surface. The results highlight the need–hitherto ignored–to consider Ti microstructure when analyzing its behavior in the presence of carbohydrate-metabolizing bacteria.

Are Mini Dental Implants Suitable for Support of Crowns or Small Bridges in the Mandibular Incisor Region? A 5-year Longitudinal Study

It has not been previously studied whether 1-piece category 1 narrow dental implants (≤2.5mm wide) can successfully support crowns or small bridges. The purpose of this study was to evaluate the long-term benefits of the fixed-type mini dental implants (MDIs) for replacement of mandibular incisors. In a prospective cohort study, fixed-type 1-piece MDIs, replacing single or multiple mandibular incisors, supporting metal-ceramic single crowns (unsplinted group), or splinted crowns/small bridges (splinted group) were observed over the period of 5years. The primary predictor was the splinting status. The primary outcome variables were peri-implant marginal bone level (MBL) change, success, and survival rates (assessed as per Pisa Consensus Conference). The secondary outcomes were dental patient-reported outcome measures (dPROMs) and oral hygiene assessment. Descriptive statistics, Chi-squared test, t-test, Mann-Whitney and Wilcoxon tests, Kaplan-Meier survival analysis, log-rank (Mantel-Cox) comparison, Cox proportional hazard analyses adjusting for number of implants, Spearman correlation, and repeated measures were used for data analysis. From 44 participants (mean age 56.02±5.72years), 40 completed the 5-year study: 23 in the splinted and 17 in unsplinted group. Three subjects did not respond, while 1 MDI failed (third year) in the unsplinted group. Mean marginal bone level (MBL) change in both groups was small; however, it increased over time (-0.22±0.38mm after 1 year; -0.54±0.56mm after 5years; P<.05). After 5years mean MBL change was -0.59±0.71mm in the unsplinted and -0.50±0.41mm in the splinted group (P>.05). Survival analysis revealed no significant difference between the unsplinted (85.7% success, 4.8% failures, and 9.5% satisfactory survivals) and splinted group (93.4% success and 6.6% satisfactory survivals) (P>.05). The group affiliation (unsplinted vs splinted) and number of implants were not significant predictors of MDI failure or survival rates (P>.05). Significant improvement in dPROMs after rehabilitation remained unchanged over 5years (P>.05). Modified plaque index significantly increased over time, correlating with the MBL loss. MDIs supporting crowns and/or small bridges in the mandibular incisor region showed small rates of marginal bone loss, acceptable success, and survival rates and improved dPROMs over a 5-year observation period.

Short Narrow Dental Implants versus Long Narrow Dental Implants in Fixed Prostheses: A Prospective Clinical Study.

There is a paucity of studies that assess short and narrow dental implants. This prospective study aimed to evaluate the performance of both short (≤8 mm) and narrow (≤3.5 mm width) dental implants supporting fixed prostheses in the atrophic maxilla or mandible. Towards that aim, patients with short implants were included in the study. The control group was those with long and narrow dental implants (length > 8 mm and diameter ≤ 3.5 mm). Clinical and demographic variables were extracted from clinical records. During the follow-up, implant survival and marginal bone loss were evaluated and statistically analysed. Forty-one implants were included (18 and 23 implants in the test and control groups, respectively). The median follow-up time was 26 months since insertion in both groups. The results revealed that there was no implant failure and no statistically significant differences in terms of marginal bone loss. Only one screw-loosening effect occurred in the short implants group. Short, narrow dental implants could be an alternative for the restoration of severely resorbed jaws.

Clinical performance of narrow-diameter implants with hydrophobic and hydrophilic surfaces with mandibular implant overdentures: 1-year results of a randomized clinical trial.

To compare peri-implant clinical and radiographic parameters between hydrophilic and hydrophobic narrow dental implants in patients with mandibular implant overdentures for 1year. In a randomized, double-blind, split-mouth study with a 1-year follow-up, sixteen edentulous participants received two narrow-diameter implants in the anterior mandibular region with 2 types of surfaces: hydrophobic (Neoporos surface, NS) and hydrophilic (Acqua surface, AS). During the osseointegration period and after loading with mandibular implant overdentures, the outcomes monitored were (i) peri-implant health: early healing index (EHI), visible plaque index (VPI), calculus presence (CP), peri-implant inflammation (PI), probing depth (PD), and bleeding on probing (BOP); (ii) implant stability quotient (ISQ), (iii) crestal bone loss (CBL) and bone level change (BLC); and (iv) implant success and survival rates. The PD in NS implants decreased by 31.78% between 15 and 30days, while a similar reduction (-31.28%) occurred in the 3rd month in the AS group. The ISQ also decreased significantly during the 1st month in both groups: -10.95% after 7days in the NS group and -7.46% after 15days in the AS group. At 12months, statistically significant differences were not observed; however, the AS surface presented 50.6% smaller CBL and 41.3% smaller BLC values. The success and survival rates were 62.5% for AS implants and 87.5% for NS implants. Narrow-diameter implants with hydrophilic and hydrophobic surfaces loaded with mandibular implant overdentures showed no differences in peri-implant healing, stability, and peri-implant bone remodeling in the 1st year of follow-up.

The comparison of narrow and regular platform dental implants placed in posterior regions: A retrospective, longitudinal study

The comparison of narrow and regular platform dental implants placed in posterior regions: A retrospective, longitudinal study

Narrow Diameter Dental Implants as an Alternative Treatment for Atrophic Alveolar Ridges. Systematic Review and Meta-Analysis.

To determine the marginal bone loss and the survival, success and failure rates of narrow dental implants, a systematic literature search was carried out in the MEDLINE (Pubmed), Cochrane, Scopus, and Scielo databases for articles published between 2010 and 2021. The exclusion criteria were: systematic reviews, case reports, expert opinions; animal studies; samples of less than 10 subjects; follow-up periods of less than 36 months; smokers of minimum 10 cigarettes/day; and articles about mini-implants for orthodontic anchorage. Meta-analyses were performed to assess marginal bone loss and implant survival, success, and failure rates. Fifteen studies were included: 7 clinical trials, 3 randomized clinical trials, 3 cohort studies, and 2 case series. The total number of subjects was 773, in whom 1245 implants were placed. The survival rate for the narrow diameter implants was 97%, the success rate 96.8%, and the failure rate 3%. Marginal bone loss was 0.821 mm. All these data were evaluated at 36 months. Based on the literature, it can be considered that there is sufficient evidence to consider small diameter implants a predictable treatment option. These show favorable survival and success rates and marginal bone loss. All of them are comparable to those of standard diameter dental implants.

Effect of bone loss on the fracture resistance of narrow dental implants after implantoplasty. An in vitro study.

Background Implantoplasty (IP) involves polishing of the exposed surface of implants affected by peri-implantitis (PI). A study was made to determine whether the degree of bone loss influences the fracture resistance of implants with or without IP.Material and Methods An in vitro study was carried out on 32 narrow (3.5 mm) dental implants with a rough surface and external hexagonal connection. Implantoplasty was performed in half of the implants of the sample. Both the IP and control implants were divided into two subgroups according to the amount of bone loss (3 mm or 7.5 mm). Standardized radiographic assessment of implant width was performed using specific software. The main outcome variable was the maximum compression force (Fmax) of implants when subjected to static resistance to fracture tests. Implant fractures were subsequently analyzed by scanning electron microscopy. A descriptive and bivariate analysis of the data was performed.Results Significant changes in implant width were observed after IP (p<0.05). No significant differences between IP and control implants were recorded in terms of the Fmax values in the two bone loss subgroups (3 mm: control 854.37N 195.08 vs. IP 752.12N 186.13; p=0.302, and 7.5 mm: control 548.82N 80.02 vs. IP 593.69N 111.07; p=0.370). Greater bone loss was associated to a decrease in Fmax, which proved significant for the control implants (p=0.001). Fractures were more frequently located in the platform (n=13).Conclusions Implants with more apical bone levels appear to be more susceptible to fracture. On the other hand, IP does not seem to significantly decrease the fracture resistance of narrow (3.5 mm) platform dental implants with external hexagonal connections. The fact that most fractures occur in the platform area indicates that the latter is exposed to more mechanical stress. Key words:Peri-implantitis, dental implants, compressive strength, titanium, implantoplasty.

Effect of crown to implant ratio and implantoplasty on the fracture resistance of narrow dental implants with marginal bone loss: an in vitro study

BackgroundPeri-implantitis is a biological complication that affects soft and hard tissues around dental implants. Implantoplasty (IP) polishes the exposed implant surface, to decontaminate it and make it less prone to bacterial colonization. This study investigates whether a higher clinical crown-to-implant-ratio (CIR) reduces implant fracture resistance and whether implants are more fracture-prone after IP in the presence of 50% of bone loss.MethodsForty-eight narrow platform (3.5 mm) 15 mm long titanium dental implants with a rough surface and hexagonal external connection were placed in standardized bone-like resin casts leaving 7.5 mm exposed. Half were selected for IP. The IP and control groups were each divided into 3 subgroups with different clinical CIRs (2:1, 2.5:1 and 3:1). The implant wall width measurements were calculated using the software ImageJ v.1.51 through the analysis of plain x-ray examination of all the samples using standardized mounts. A fracture test was performed and scanning electron microscopy was used to evaluate maximum compression force (Fmax) and implant fractures.ResultsIP significantly reduced the implant wall width (P < 0.001) in all reference points of each subgroup. Fmax was significantly higher in the 2:1 subgroup (control = 1276.16 N ± 169.75; IP = 1211.70 N ± 281.64) compared with the 2.5:1 (control = 815.22 N ± 185.58, P < 0.001; IP = 621.68 N ± 186.28, P < 0.001) and the 3:1 subgroup (control = 606.55 N ± 111.48, P < 0.001; IP = 465.95 N ± 68.57, P < 0.001). Only the 2.5:1 subgroup showed a significant reduction (P = 0.037) of the Fmax between the controls and the IP implants. Most fractures were located in the platform area. Only 5 implants with IP of the 2:1 CIR subgroup had a different fracture location (4 fractures in the implant body and 1 in the prosthetic screw).ConclusionsIP significantly reduces the fracture resistance of implants with a 2.5:1 CIR. The results also suggest that the CIR seems to be a more relevant variable when considering the resistance to fracture of implants, since significant reductions were observed when unfavorable CIR subgroups (2.5:1 and 3:1 CIR) were compared with the 2:1 CIR samples.

Long-Term Retrospective Study of 3.0-mm-Diameter Implants Supporting Fixed Multiple Prostheses: Immediate Versus Delayed Implant Loading.

Narrow dental implants are commonly used to restore narrow alveolar ridges. Although the good performance of narrow dental implants supporting multiple prostheses has been repeatedly demonstrated, there are few studies analyzing their performance in a long-term follow-up together with the influence of the loading protocol. Thus, the objective was to assess the influence of implant loading protocol (immediate vs delayed) on the long-term outcomes of 3.0-mm-diameter dental implants supporting fixed multiple prostheses. This retrospective cohort study included 202 3.0-mm-diameter dental implants supporting multiple prostheses placed between January 2006 and April 2009. Immediate loading was performed when the implants were inserted in bone types I, II, and III and achieved an insertion torque ≥ 25 Ncm; otherwise, delayed loading was performed. The survival of the dental implants was recorded together with clinical and demographic information of the participants. The prosthetic complications (ceramic chipping, screw loosening, screw fracture, decementation, prosthesis failure) were also recorded. The marginal bone loss since insertion and the marginal bone loss since loading were calculated. Delayed implant loading was performed in 131 implants and immediate loading in 71 implants. The follow-up time was 106 ± 40 months and 117 ± 38 months in the delayed and immediately loaded implants, respectively. The implant loading protocol (delayed vs immediate) showed no influence on the implant survival rate (96.2% vs 97.2%) and the marginal bone loss since insertion (1.2 ± 1.0 mm vs 1.2 ± 1.0 mm). The implant loading protocol (immediate vs delayed) did not influence the long-term outcomes (survival and marginal bone loss) of 3.0-mm-diameter dental implants supporting fixed multiple prostheses. These results are in favor of considering immediately loaded narrow dental implants as a viable treatment alternative for horizontally resorbed ridges. Nevertheless, future randomized clinical trials are needed to confirm these observations.

Evaluation of the survival rate of extra narrow dental implants (unitite slim 2.9 mm) full- arch implant supported

The purpose was evaluating the short term survival rate of extra narrow diameter dental implants (2.9 mm, Unitite Slim, S.I.N. Implant System) used to support full-arch mandibular reconstructions. This was a randomized clinical trial analyzing the survival rate of 25 implants measuring 2.9 mm in diameter and 11.5 mm in length (Slim, Unitite, S.I.N. Implant System), and up to 40 N loading torque with immediate loading for protocol-type rehabilitation in the mandible region. Of the 25 implants, 100% remained in function after three months or 180 days of installation. Rehabilitation of total edentulous patients in the mandible with extra-narrow implants (2.9 mm) proved to be effective and promising as an alternative therapy to grafts.

Fatigue of Narrow Dental Implants: Influence of the Hardening Method.

The use of narrow titanium dental implants (NDI) for small ridges, reduced interdental space, or missing lateral incisors can be a viable option when compared to the conventional wider dental implants. Furthermore, in many cases, standard diameter implant placement may not be possible without grafting procedures, which increases the healing time, cost, and morbidity. The aim of this study was to analyze the mechanical viability of the current narrow implants and how narrow implants can be improved. Different commercially available implants (n = 150) were tested to determine maximum strength, strain to fracture, microhardness, residual stress, and fatigue obtaining the stress–number of cycles to fracture (SN) curve. Fractography was studied by scanning electron microscopy. The results showed that when the titanium was hardened by the addition of 15% of Zr or 12% cold worked, the fatigue limit was higher than the commercially pure grade 4 Ti without hardening treatment. Grade 4 titanium without hardening treatment in narrow dental implants can present fractures by fatigue. These narrow implants are subjected to high mechanical stresses and the mechanical properties of titanium do not meet the minimal requirements, which lead to frequent fractures. New hardening treatments allow for the mechanical limitations of conventional narrow implants to be overcome in dynamic conditions. These hardening treatments allow for the design of narrow dental implants with enhanced fatigue life and long-term behavior.

Mini-dental implants for definitive prosthesis retention- A synopsis of the current evidence.

Background: This narrative review provides an evidence-based overview of the comparison between mini-dental implants (MDI) and conventional dental implants for definitive prosthesis retention. In addition, recommendations are made on whether the use of reduced diameter dental implants is more appropriate. Method: A literature review was conducted via electronic search addressing the following topics: (1) osseointegration, (2) peri-implant soft tissue characteristics, (3) biomechanics, (4) implant survival and (5) implant success. Conclusion: The procedure for dental implant prosthetic rehabilitation should preferentially include conventional dental implants (i.e. [Formula: see text][Formula: see text]mm fixture diameter). Small (3-3.25[Formula: see text]mm) and narrow (3.3-3.5[Formula: see text]mm) dental implants should primarily be used in non-load-bearing regions. MDI ([Formula: see text][Formula: see text]mm) should be considered to retain definitive prosthesis, only for reasons of anatomy or patient-centred preferences and as a last resort. If MDI are to be used, patients should be made aware of the lack of long-term, high-quality evidence as a part of the informed consent process and that most of the prospective data available pertain to MDI retaining complete dentures.

Fracture and Fatigue of Titanium Narrow Dental Implants: New Trends in Order to Improve the Mechanical Response.

Sixty-four fractured commercially pure titanium (cp-Ti) narrow dental implants (NDIs) with similar macrogeometry and connection designs were studied after different implantation times in humans in order to determine their reliability and to evaluate the causes of the fracture. These NDIs were compared with other similar implants, made with alloyed titanium with 15% Zr and with 12% strained titanium. Original implants were tested under static and fatigue conditions, simulating the tri-axial loads in the mouth by means of a Bionix hydraulic test machine. Fractography was studied using field-emission scanning electron microscopy (FSEM). The results showed that cp-Ti NDI exhibits low strength for mechanical cycling, and the alloyed Ti and strained titanium increase the mechanical strength, guaranteeing long term mechanical behavior. NDIs fractured due to fatigue, and, in some cases, the presence of cracks in the original NDIs quickly led to fracture. These cracks were attributed to plastic deformation during machining were found to be exacerbated due to acid etching in the passivation process. All cases of fracture were cp-Ti dental implants due to the low fatigue limit. The results show that, when titanium is alloyed or cold-worked, the fatigue limit is higher than cp-Ti. This in vitro research will help clinicians to select a better NDI system for safer treatment.

Narrow Dental Implants in Multiple Fixed Prosthesis: A Controlled Clinica Trial

Narrow Dental Implants in Multiple Fixed Prosthesis: A Controlled Clinica Trial

Deformation of the Internal Connection of Narrow Implants after Insertion in Dense Bone: An in Vitro Study.

Implant connections must resist surgical and prosthetic procedures without deformation. This study evaluated the deformation of different internal connections (IC) of narrow dental implants (NDI) after their insertion in artificial dense bone. Thirty NDI, with different IC geometries, Group A (internal hexagon), Group B (tri-channeled), and Group C (four-channeled), with the same length and similar narrow diameters, were inserted in type II density bone blocks. Drilling protocols for dense bone from each implant manufacturer were followed. The Insertion torque (IT), connection length, vertex angles, and wall deformations were analyzed before and after the insertion of the implants. ANOVA (Analysis of Variance) and Tukey post-test were used for statistical comparisons. IT values were higher for Group A, surface damage, and titanium particles were observed in the IC in all the groups. Angle deformations between 5 and 70 degrees were present in all the groups, and the walls of Group B connection were the most affected by deformations (p < 0.05). Within the limitations of this experiment, it can be concluded that narrow diameter implants will suffer deformation of the implant connection and will also experience surface damage and titanium particle release when inserted in type II bone density.

Influence of Insertion Torque on Clinical and Biological Outcomes before and after Loading of Mandibular Implant-Retained Overdentures in Atrophic Edentulous Mandibles.

Aim To evaluate the influence of primary insertion torque (IT) values of narrow dental implants on the peri-implant health, implant stability, immunoinflammatory responses, bone loss, and success and survival rates. Methods Thirty-one edentulous patients received two narrow implants (2.9x10mm, Facility NeoPoros) to retain mandibular overdentures. The implants were categorized in four groups according to their IT: (G1) IT > 10 Ncm; (G2) IT ≥ 10Ncm and ≤ 30 Ncm; (G3) IT >30Ncm and < 45Ncm; (G4) IT ≥ 45Ncm, and all implants were loaded after 3 months of healing. The following clinical outcomes were evaluated 1, 3, 6, and 12 months after implant insertion: (i) peri-implant tissue health (PH), gingival index (GI), plaque index (PI), calculus presence (CP), probing depth (PD), and bleeding on probing (BOP); (ii) implant stability quotient (ISQ) by resonance frequency analysis; and (iii) IL-1β and TNF-α concentration in the peri-implant crevicular fluid. The marginal bone level (MBL) and changes (MBC) were evaluated. The Chi2 test, Kruskal-Wallis test, mixed-effects regression analysis, and the Kendall rank correlation coefficient were used for statistical analysis (α = 5%). Results G1 presented the highest PD at all evaluated periods. G2 presented higher PI at month 6 and 12. G4 showed increased GI at month 3 and 12 and more CP at month 1 (p=.003). G2 and G4 had higher ISQ values over the study period, while those from G1 and G3 presented lower ISQ values. The IL-1β concentration increased until month 12 and was independent of IT and bone type; G4 had a higher IL-1β concentration in month 3 than the other groups (p=.015). The TNF-α release was negatively correlated with IT, and TNF-α release was highest in G1 at month 12. The MBL immediately after surgery and the MBC at month 12 were similar between the groups, and G4 presented a positive MBC at month 12. The survival and success rates were 75% for G1, 81.3% for G2, 64.3% for G3, and 95% for G4. Conclusion The IT did not influence the clinical outcomes and the peri-implant immunoinflammatory responses and was weakly correlated with the narrow dental implants primary stability. The observed success rates suggest that the ideal IT for atrophic fully edentulous patients may deviate from the standardized IT of 32 Ncm.

Assessment of Implant Stability Changes and Success Rate of Narrow Dental Implants

Assessment of Implant Stability Changes and Success Rate of Narrow Dental Implants