ABSTRACT
This study aims to analyze the clinical performance of two loading concepts on second-generation palatal implants (Orthosystem, Straumann, Basel, Switzerland) in a prospective multicenter randomized controlled clinical trial. At the time of this interim analysis, 41 patients have been randomized on a 1:1 basis to one of two treatment groups. Group 1 underwent conventional loading of palatal implants after a healing period of 12 weeks (gold standard) while group 2 underwent immediate implant loading within 1 week after implant insertion. We report initial results at 6 months after functional loading. The primary outcome parameter was implant success (no implant mobility, no implant loss). The implants in both groups were initially stable at the time of insertion, and all were eligible for randomization. Twenty-two patients (group 1) were subjected to conventional implant loading after 12 weeks while 19 patients (group 2) received immediate functional loading within the first week after insertion. Direct (e.g. distal jet appliances) as well as indirect forms of anchorage (conventional or modified transpalatal arch) were used. The magnitude of orthodontic forces ranged between 1 and 4 N for the immediate loading group and between 1 and 5 N for the conventional loading group. One implant in group 1 was lost during the healing phase. One dropout was registered in group 2. Thirty-nine implants were functionally loaded for over 6 months now. These preliminary data provide first evidence of the fact that immediate loading of palatal implants yields equivalent success rates as conventional loading to 4 N after 6 months.
Subject(s)
Dental Implants , Immediate Dental Implant Loading/methods , Orthodontic Anchorage Procedures/methods , Palate, Hard/surgery , Acid Etching, Dental/methods , Adolescent , Adult , Aged , Child , Dental Etching/methods , Dental Prosthesis Design , Female , Follow-Up Studies , Humans , Male , Malocclusion/classification , Malocclusion/therapy , Middle Aged , Orthodontic Anchorage Procedures/instrumentation , Orthodontic Appliance Design , Orthodontic Appliances , Osseointegration/physiology , Prospective Studies , Stress, Mechanical , Surface Properties , Tooth Movement Techniques/instrumentation , Tooth Movement Techniques/methods , Treatment Outcome , Young AdultABSTRACT
AIM: To analyze the spectrum of indications for second-generation palatal implants in relation to two different loading concepts in a prospective, multicenter, randomized controlled trial (RCT). PATIENTS AND METHODS: Forty-one patients were recruited to the study from 2006 to 2009. All implants (Orthosystem, Straumann, Basel, Switzerland; dimensions: 4.1 mm x 4.2 mm) were inserted in the median or paramedian region of the anterior palate, and each patient was randomized to one of two loading groups (immediate loading within the first week after insertion versus conventional loading after a 12-week healing phase). In this interim evaluation, we report preliminary results obtained six months after functional loading. RESULTS: All palatal implants were primarily stable at the time of insertion. One implant loss (12 weeks after surgical insertion) was documented in the cohort subjected to conventional loading, and one patient dropped out of the immediate-loading group. At the time of this investigation, 39 palatal implants are experiencing functional loads. Using both loading concepts, we had various orthodontic objectives, such as intrusion of anterior and/or posterior teeth, and the mesialization and distalization of posterior teeth. Both loading groups presented nearly identical indications, and the distribution of direct vs. indirect anchorage forms was also very similar during the active treatment. CONCLUSION: Comparison of the two treatment concepts revealed no clinical differences in implant stability. Patients undergoing immediate-loading therapy were subject to no limitations regarding indications at 6 months after functional loading compared with the patients who experienced conventional loading.
Subject(s)
Dental Implants , Jaw, Edentulous/surgery , Palate/surgery , Adolescent , Adult , Aged , Child , Dental Prosthesis Design , Equipment Failure Analysis , Female , Germany , Humans , Jaw, Edentulous/diagnostic imaging , Male , Middle Aged , Radiography , Treatment Outcome , Young AdultABSTRACT
OBJECTIVE: The purpose of this study was to evaluate the torque of upper incisors and the maxillary size in sagittal direction in patients with impacted canines. MATERIAL AND METHODS: Panoramic radiographs, cephalograms and pretreatment study models were evaluated in 199 patients (12.7 +/- 3.6 years) with impacted canines. The prevalence of malocclusions, inclination of the canine to the occlusal plane, incisors' inclination and maxillary size were determined. RESULTS: 45% of the patients showed symptoms of Class II, Division 2 malocclusion: at 18.5 degrees, the inclination of upper incisors (angle U1/NA) was lower and at 81.3 degrees the SNA angle higher than in patients with neutral conditions. CONCLUSIONS: There is no guidance for the erupting canine through the labial root torque of the upper incisors like in patients with missing lateral incisors. Patients with symptoms of Class II, Division 2 malocclusion should be regarded as a risk group for canine impaction.
