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Journal of Oral Science & Rehabilitation No. 1, 2017

P h y s i o l o g i c a l b o n e r e m o d e l i n g o n O s s t e m i m p l a n t s Introduction During the first year of function, a certain amount of physiological marginal bone loss is expected around a dental implant, both horizontally and vertically; thereafter, mini- mal further bone loss has been observed.1, 2 Marginal bone loss (MBL) of 1.5–2.0 mm during the first year of function has been assumed as normal.2 Afterward tissue stability is expect- ed.2–4 However, the criteria for defining success in implant dentistry are under constant debate in consensus statements and observational studies. Papaspyridakos et al. proposed param- eters related to soft- and hard-tissue stability that can influence the progression of MBL around implants, but is not clear whether the physiological bone remodeling is prosthesis-re- lated, host-related, implant-related or load- dependent.4 As a result, although numerous studies have reported improvements in implant design and protocols to minimize this MBL, the utilized criteria for success have remained unchanged. Several factors may increase MBL around dental implants, including surgical trauma, implant– abutment connection type, biological width establishment, mucosal tissue thickness, keratinized tissue width and bone density.5–7 The stress and strain concentrated at the periimplant crestal bone result in structural and morpho- logical changes, especially during the first year after loading.7 Hence, the bone remodeling pro- cess is one of the critical factors in evaluating implant success.8 In addition, iatrogenic factors may contribute to periimplant MBL, such as im- plant positioning, implant–abutment microgap, lack of passive fit of the superstructure and oc- clusal overloading.9–13 Many pathological factors, including history of periodontitis, smoking, poor plaque control, genetic predisposition and diabetes, may pro- duce an inflammatory reaction around an implant; nevertheless, no consensus exists with regard to a suitable definition of “periimplantitis” based on clinical and radiographic signs and symptoms or the best way to manage this emerging challenge.13, 14 The American Academy of Periodontology in 2013 defined “periimplan- titis” as an inflammatory reaction associated with the loss of supporting bone beyond the initial biological bone remodeling around an im- plant in function.15 placed in private practice and representing the daily realities of implant treatment, and then to determine the entity of the physiological mar- ginal bone remodeling expected using Osstem implants. The data were analyzed to determine any statistical relationships between explana- tory variables and early implant failure and physio logical marginal bone remodeling (within one year after loading). This study is reported according to the Strengthening the Reporting of Observational Studies in Epidemiology state- ment for improving the quality of observational studies.16 Materials and methods This investigation was designed as an open- cohort prospective study. All of the surgical and prosthetic procedures were performed in a pri- vate center in Rome, Italy, by an implant-based certified clinician (MT) between September 2014 and December 2016. All of the participants were enrolled and treated in consecutive order after being informed about the clinical proce- dures, materials to be used, benefits, and poten- tial risks and complications, and once their writ- ten consent had been obtained. This study was conducted according to the principles embodied in the Helsinki Declaration of 1975, as revised in 2008. Any completely or partially edentulous patients who received at least one bone level implant with a sandblasted and acid-etched sur- face and a Morse taper connection (Osstem TSIII, Osstem, Seoul, South Korea) were consid- ered eligible for this study, independent of the implant and prosthetic protocols used. Exclusion criteria were general medical contraindications to oral surgery (American Society of Anesthesio- logists Physical Status Class III or IV), patients treated or under treatment with intravenous aminobisphosphonates, and previous radio- therapy of the oral and maxillofacial region within the last five years. Patients who were diagnosed with active periodontal disease (≥ 6 mm probing depth) underwent periodontal surgery or initial therapy alone, prior to implant surgery. S u r g i c a l a n d p r o s t h e t i c p r o t o c o l s The aims of the present study were to report the survival and success rates of dental implants Preoperative photographs, periapical radio- graphs, panoramic radiographs or cone beam Journal of Oral Science & Rehabilitation Volume 3 | Issue 1/2017 69

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