Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2017-03-17, 11:08:54 | version 1.38.0
Fig. 10 Periapical radiograph taken one year after delivery of the definitive restoration. 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 Fig. 10 perienced pain and swelling up to 3 weeks after implant placement, resulting in a MBL greater than 2 mm. Nevertheless, no further pathologi- cal MBL was experienced. Most of the implants were placed at crest level or a little below. In the case of post- extractive implants, they were placed 1.0–1.5 mm below the buccal bone plate. At the definitive prosthesis delivery, the mean MBL was 0.26 ± 0.25 mm (95% CI: 0.27–0.30). The cumu lative mean MBL between implant placement and the one year after loading follow-up was 0.37 ± 0.25 mm (95% CI: 0.26–0.30). The MBL in the interval between the definitive prosthesis delivery and the one year after loading follow-up was 0.11 ± 0.14 mm (95% CI: 0.08–0.10). Overall, 86.8% of the implants (n = 211) showed an MBL of ≤ 0.5 mm one year after loading, while only three implants showed an MBL of > 1.0 mm. Two patients were asymp- tomatic, while a third patient presented with pain without suppuration. This patient was treated with an antibiotic and analgesic until the resolu- tion of the pathology. Eighty-two out of 243 pa- tients (33.7%) reached the two-year follow-up. In this cohort of patients, MBL between the one- and the two-year follow- up was 0.05 ± 0.14 mm (range of 0.0–0.2 mm; 95% CI: -0.01–0.10). Comparison of MBL and the investigated risk factors found statistically higher MBL for smok- ers, a thin gingival biotype and GBR. Immediate loading and placement of the definitive abutment on the day of surgery were found to be protective factors, with statistically signifi cantly lower MBL. Most of the implants (n = 203; 83.5%) reached an insertion torque of 45 N cm. The other 40 implants were placed at an insertion torque ranging from ≥ 35 to < 45 N cm (n = 33; 13.6%), > 25 to < 35 N cm (n = 4; 1.6%) and < 25 N cm (n = 3; 1.3%). No statistically signifi- cant correlation was found between insertion torque and MBL (p = 0.3726). At implant placement, the mean ISQ value was 71.6 ± 5.5 (range of 45–88); At the six- month follow-up, mean ISQ was 76.7 ± 4.4 (range of 66–89). The diference was statisti- cally significant (p = 0.0001). One hundred and sixty-six implants were placed in bone of Type 1 and 2 quality (n = 18). The remaining 77 implants were placed in Type 3 and 4 bone. No statistically significant cor- relation was found between insertion torque and MBL (p = 0.4216). A thin gingival biotype was associated with higher MBL compared with a thick biotype. The difference was statistically significant rations) and cemented on to the remaining 61 implants (33 single crowns, nine FPDs and one full-arch restoration). Three patients (six implants) received overdentures on OT Equator attachments (Rhein 83, Bologna, Italy) and two patients (eight implants) received overdentures fully supported by a titanium CAD/CAM bar (New Ancorvis) and OT Equator attachment screwed on the top. Five implants failed in five patients, resulting in a cumulative implant survival rate of 97.9% at the follow- up one year after loading. All of those implants failed before definitive loading. Two implants were placed in combination with bone augmentation procedures (p = 0.6310), one im- plant was immediately loaded (p = 1.000) and two were placed immediately after tooth ex- traction (p = 0.2108). Of these, two implants were placed using guided surgery (p = 0.6572). No statis tically significant diferences were found (p > 0.05). Two out of seven implants placed at an insertion torque of < 35 N cm failed (p = 0.0068). No definitive prosthesis failed, resulting in a cumulative prosthetic survival rate of 100%. Four patients experienced one technical compli- cation each, resulting in a cumulative prosthetic success rate of 97.2% at the follow-up one year after loading. One zirconia-based, full-arch framework, delivered on six implants, presented a misfit between the framework and the most distal implant at the try-in appointment. The framework was remade with no further compli- cations. One zirconia-based, full-arch, screw- retained restoration, delivered on six implants, fractured at the bisque bake try-in appointment. The restoration was remade with no further complications. Two patients with a single screw-retained restoration experienced screw loosening. The screws were replaced chairside with no further complications. One patient ex- Journal of Oral Science & Rehabilitation Volume 3 | Issue 1/2017 75