Please activate JavaScript!
Please install Adobe Flash Player, click here for download

implants - internationalmagazine of oral implantology

I clinical study _ flapless implant surgery Fig. 5_Bleeding on probing. Fig. 6_Probing depth PD distribution. ventional insertion. The clinical performance of dental implants with different design (two types of titanium two-piece implants with different ma- chined collar height and zirconium-oxide one- piece implants) and from different manufacturers was compared. Soft tissue health was evaluated in particular. The relationship of keratinised mucosa and the health status of peri-implant soft tissue was analysed. _Materials and methods In this study, 347 implants inserted between January 2001 and February 2009 were evaluated. All were placed by one surgeon using the flapless surgical protocol. The patients were recruited from the six months resp. one-year recall programme. For the purposes of the clinical longitudinal study, 115 (67 female and 48 male) patients with a mean age of 63 (18 to 85) were followed up. They received a total of 347 implants: 236 Straumann, 102 Thommen and nine Z-Systems. The patient sample included seven smokers, two patients with diabetes (receiving oral antidiabetics), seven pa- tients with hemorrhagic diathesis (receiving oral anti-coagulants) and one patient with intravenous bisphosphonate therapy. Patients were excluded fromthestudyiftheyshowedseveregeneralmed- ical contra-indications. Patients elected received one shot of standard prophylactic antibiotics (penicillin1MioIUorclindamycin600mgp.o.)one hour before surgery. The implant bed was prepared according to the recommendations and instru- mentation of each manufacturer. Straumann (Standard and Standard+) and Thommen Medical (ELEMENT and CONTACT) tita- nium two-piece implants, and Z-Systems zirco- nium-dioxide one-piece implants (Z-Look3) were used.Theimplantsusedhadaplatformdiameterof 3.5 to 6.5 mm (Straumann: 3.5mm, 4.8mm and 6.5mm; Thommen: 3.5mm, 4mm, 4.5mm and 5mm;Z-Systems:5mmand6mm).Thesoft-tissue punches used in this study showed a diameter of 4 or 5mm. Post-operative clinical examination of stability and peri-implant soft tissue was performed one, two, three, four and 16 weeks after implant inser- tion. Radiological examination was done before and immediately after implant surgery, after os- seointegration and one year after prosthetic load- ing.Allimplantswereloadedforatleast12months with either fixed or removable prosthetic restora- tions. Mouth hygiene was assessed visually and clas- sifiedintofourcategories:verygood(noplaque,no tartar), good (little plaque, little tartar), medium (some plaque, some tartar) and poor (excessive plaque, excessive tartar). The presence or absence of keratinised gingiva was also recorded. The gingival depth resp. thickness around the implant neck was measured with a calibrated probe.Themeasurementwasdonewithslightpres- sure exerted from the gingival margin until resist- ance was encountered. For implants, as opposed to natural teeth, an increased pocket depth of up to 4 mm is acceptable without further measurements (Behneke etal. 1997). This is due to the parallel ori- entation of the connective tissue fibres. Bleeding on probing and pathological secretion were recorded. Selected results were tested by means of the Wilcoxon U test (NPAR1WAY procedure, SAS Ver. 9.1.3.) for non-normally distributed data. Sig- nificance was assumed if p<0.05 ( = 5%). The number of tests was limited to minimise the prob- ability of false-positive results. _Results The 3.75 (0.25–9.7) year follow-up period of all implants showed only one failed (explanted) im- plant(Straumann).Thiswasduetoperi-implantin- 10 I implants4_2011 Fig. 5 Fig. 6