RESUMEN
Placement of short implants is a common approach to rehabilitate edentulous areas. The objective of this study was to evaluate the long-term survival of 7.0- and 8.5-mm implants placed in either a delayed or immediate loading protocol. Life table analysis revealed the implants treated with the delayed loading protocol had a 90.9% survival rate and the implants treated with the immediate loading protocol had a survival rate of 92.0%. The results of this 8-year prospective study demonstrate similar survival rates of short, cylindrical threaded implants placed by either a delayed or immediate loading protocol.
Asunto(s)
Implantes Dentales , Carga Inmediata del Implante Dental , Arcada Edéntula/cirugía , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Dentadura Parcial Fija , Estudios ProspectivosRESUMEN
Tooth extraction is usually followed by bone reduction. In the maxillary posterior region, this remodelling combined with sinus pneumatisation and periodontal defects may lead to a reduced basal bone height available for implant placement. Sinus floor elevation can be performed with different surgical techniques. Crestal approach has demonstrated to be effective, less invasive, and associated with a reduced morbidity. This article reports a modified sinus floor elevation by means of rotary, noncutting instruments, addition of xenograft, and 2 short-threaded implant placements. The aim of the study was to evaluate the implant's success and intrasinus radiographical bone gain after 4 years of functional loading. The premolar implant site presented a starting basal bone height of 6 mm, while the molar site was of 2 mm. In the first surgical step, sinus floor elevation was performed mesially and the implant was inserted, and distally only sinus floor elevation was performed. After 6 months, the mesial implant was uncovered and the second implant was inserted; 4 months later, the second fixture was uncovered, and both fixtures were loaded with single provisional screw-retained crowns and later with single screw-retained porcelain fused to metal crowns. Implants integrated successfully, and crestal bone remodelling did not exceed the smooth collar. Bone gain was 3 mm for the mesial implant and more than 5 mm for the distal one.
RESUMEN
Bone and soft tissue remodeling after tooth extraction may have dramatic effects. The socket preservation technique has demonstrated to be effective in maintaining volume before implant placement. The Pink Esthetic Score (PES) is an easy and complete evaluation of esthetic parameters. The aim of this study was to compare the PES index of anterior teeth needing to be replaced and the correspondent implant-supported prostheses after the socket preservation technique with 1 year of follow-up. Twenty-four patients were enrolled in this study. Eighteen maxillary central incisors and 6 maxillary lateral incisors were extracted, and then, every alveolar site was treated with the socket preservation technique and filled with Bio-Oss, mixed with fibrin glue, and covered with a collagen sponge. After 6 months of undisturbed healing, implants were placed and left healing for 4 months. After they were regularly loaded and at 1 year of follow-up, peri-implant PESs were recorded. All implants integrated successfully. No dropouts were recorded. Comparing PES results before extraction (mean, 12.25) and after implant loading (mean, 12.35), those around implants are similar if not better, and there are no statistically significant differences as analyzed with the t-test. The socket preservation technique combined with delayed implant placement and a standard healing time before implant loading has demonstrated to be effective in maintaining volumes and also esthetic values around implants compared with PES values before tooth extraction.
Asunto(s)
Pérdida de Hueso Alveolar/cirugía , Implantes Dentales de Diente Único , Estética Dental , Incisivo/cirugía , Extracción Dental , Alveolo Dental/cirugía , Adolescente , Adulto , Anciano , Sustitutos de Huesos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Minerales , Adulto JovenRESUMEN
PURPOSE: The aim of this ongoing prospective study was to determine the 5-year survival rate of short porous dental implants in the posterior atrophic maxilla combined, when necessary, with crestal sinus floor elevation and often adding anorganic bovine bone. MATERIALS AND METHODS: In 87 partially edentulous patients, 110 short porous implants were placed and followed up for 5 years. The implants used were of two lengths (5 and 7 mm) and two diameters (4.1 and 5 mm) and were chosen according to the available crestal height and width. In 47 sites, osteotome sinus floor elevation was performed (in 8 cases compacting basal bone, in 39 adding a xenograft). The unloaded healing period was 6 months. A total of 63 implants were restored with single crowns and 47 were splinted to the adjacent implants. Outcome measures were prosthesis and implant failures, any complications, and peri-implant marginal bone resorption. RESULTS: Five years after loading, no patients dropped out. Eleven implants failed: 2 implants at uncovering and 9 after prosthetic loading. Eleven patients (12.6%) lost 1 implant. In 6 patients (6.9%) a prosthesis failure occurred (implants loaded with single crowns). One surgical complication (membrane perforation) occurred but the implant was normally inserted. No complications occurred during the healing period. In 3 patients, severe peri-implantitis occurred post loading and the implants had to be removed. Two abutments became loose and one crown chipped. At the end of the follow-up period the implant survival rate was 90%, and 93.1% with regard to prosthetic reconstruction. The mean peri-implant marginal bone loss was 1.4 mm. CONCLUSIONS: The use of short porous implants showed an acceptable clinical outcome in the treatment of the posterior maxilla in this interim 5-year report. Longer follow-ups are needed to confirm these results.
Asunto(s)
Implantes Dentales , Diseño de Prótesis Dental , Maxilar/cirugía , Atrofia , Matriz Ósea/trasplante , Sustitutos de Huesos/uso terapéutico , Estudios de Cohortes , Coronas , Diseño de Implante Dental-Pilar , Implantación Dental Endoósea/instrumentación , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Femenino , Estudios de Seguimiento , Humanos , Masculino , Minerales/uso terapéutico , Oseointegración/fisiología , Osteotomía/instrumentación , Periimplantitis/etiología , Periimplantitis/cirugía , Porosidad , Complicaciones Posoperatorias , Estudios Prospectivos , Elevación del Piso del Seno Maxilar/métodos , Propiedades de Superficie , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
PURPOSE: The aim of this ongoing prospective study was to determine the 5-year survival rate of short porous implants in the posterior atrophic mandible. MATERIALS AND METHODS: In 40 partially edentulous patients, 55 short porous implants were placed. The implants used were of two lengths (5 and 7 mm) and two different diameters (4.1 and 5 mm) and were chosen according to the available crestal height and width. The unloaded healing period was 4 months. Twenty-one implants were restored with single crowns, 32 were splinted to the adjacent implant, 2 were used with an overdenture and were followed for 5 years. Outcome measures were prosthesis failures, implant failures and complications. RESULTS: No patients dropped out. Nine implants were removed: 1 implant at uncovering and 8 after prosthetic loading. Eight patients lost 1 implant and 1 patient lost 2 implants. Four crowns failed. No complications occurred during the healing period. In 2 patients severe peri-implantitis occurred after loading and the implants had to be removed. At the end of the follow-up period the survival rate was 84% at implant level and 80% at patient level. CONCLUSIONS: The use of short porous implants showed an acceptable clinical outcome in the treatment of the posterior mandible in this interim 5-year report. These preliminary results must be confirmed by longer follow-ups.