The effect of marginal bone level changes on the stability of dental implants in a short-term evaluation

COMPARATIVE EVALUATION OF CLINICAL APPLICATION OF MONOLITHIC AND FOLDING IMPLANTS IN REHABILITATION OF ELDERLY PATIENTS WITH VARIOUS DEGREES OF ATROPHY OF ALVEOLAR PROCESSES

OBJECTIVE

The aim: Comparative evaluation of long-term results of clinical application of one- and two-stage surgical protocols of dental implantation with the use of monolithic and collapsible implants in the rehabilitation of elderly patients.

PATIENTS AND METHODS

Materials and methods: Under clinical observation were 46 patients with various clinical diagnoses of dentition defects aged 60 to 70 years. The following methods were used in the study: one - stage surgical protocol of dental implantation operation with non - detachable implants of ART IMPLANT system with subsequent temporary splint fixed prosthesis and immediate occlusive functional load, mechanical oscillatory - resonance method, questionnaire and statistical analysis.

RESULTS

Results: The duration of surgical stages of treatment and complete rehabilitation showed statistically significant differences (p <0.05) and was significantly less when using a single-stage protocol of dental implant surgery and non-detachable implants and averaged 3.9 ± 0.8, p <0.05 months against 7.3 ± 1.2, p <0.05 months in implants according to the two-stage protocol. Assessment of patient satisfaction with the treatment was directly correlated with his timing.

CONCLUSION

Conclusions: Thus, it should be noted that the clinical use of one-stage surgical protocol of implantation and non-detachable (monolithic) dental implants of the system «ART IMPLANT» in the rehabilitation of elderly patients with varying degrees of atrophy of the alveolar processes of the jaws is clinically justified.

Evaluation of the implant stability and the marginal bone level changes during the first three months of dental implant healing process: A prospective clinical study

Achievement of adequate implant stability is one of the determinants for long-term successful osseointegration. Resonance frequency analysis was developed to monitor implant stability and is now a well-recognized, non-invasive tool for determining the appropriate time for functional loading. However, there have been few studies with continuous evaluation and comparison of implant stability and marginal bone level changes between two different macro designs and clinical situations during the implant healing process. Thus, the purpose of this clinical trial is to evaluate the implant stability and marginal bone level changes of straight and conical implants during the implant healing process. In this prospective clinical trial, 25 participants were randomized to either straight or conical implants. A total of 32 titanium dental implants with a length of 9 mm or 11 mm were installed in the maxilla and the mandible according to the manufacturer's instructions. A resonance frequency analyzer was used to measure the implant stability quotient (ISQ) at the time of implant placement and after 2 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks, and 12 weeks of healing. The changes in the peri-implant marginal bone level were evaluated from digital radiographic films taken at the time of implant placement and after 4 weeks, 8 weeks, and 12 weeks of healing. The preliminary results of this study revealed higher ISQ values and better healing tendency for conical implants in comparison with straight implants in the maxilla. Similar ISQ values and healing tendency were observed for straight and conical implants in the mandible. No significant differences in marginal bone loss were found between the straight and conical implants. However, in the mandible, slightly more marginal bone loss was found with the conical implants than straight implants after 12 weeks of healing. In conclusion, ISQ healing tendency and marginal bone loss are influenced by implant macro-design and jaw regions. Straight implants revealed similar ISQ healing tendency and marginal bone loss in both the mandible and maxilla. Conical implants were confirmed more beneficial for maintenance of implant stability and marginal bone level in the maxilla.

The Influence of Tactile Perception on Classification of Bone Tissue at Dental Implant Insertion

BACKGROUND

Various ways of using the Lekholm and Zarb (L&Z) classification have added to the lack of scientific evidence of the effectiveness of this clinical method in the evaluation of implant treatment.

PURPOSE

The study aims to assess subjective jawbone classifications in patients referred for implant treatment, using L&Z classification with and without surgeon's hand perception at implant insertion. The association between bone type classifications and quantitative parameters of primary implant stability was also assessed.

MATERIALS AND METHODS

One hundred thirty-five implants were inserted using conventional loading protocol. Three surgeons classified bone quality at implant sites using two methods: one based on periapical and panoramic images (modified L&Z) and one based on the same images associated with the surgeon's tactile perception during drilling (original L&Z). Peak insertion torque and implant stability quotient (ISQ) were recorded.

RESULTS

The modified and original L&Z were strongly correlated (rho = 0.79; p < .001); Wilcoxon signed-rank test showed no significant difference in the distribution of bone type classification between pairs using the two methods (p = .538). Spearman correlation tested the association between primary stability parameters and bone type classifications (-0.34 to -0.57 [p < .001]).

CONCLUSIONS

Tactile surgical perception has a minor influence on rating of subjective bone type for dental implant treatment using the L&Z classification.