Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2017-12-06, 11:14:19 | version 1.38.0
| research Immediate restoration in the digital workflow Part II: Results and discussion Authors: José Eduardo Maté Sánchez de Val & José Luis Calvo Guirado, Spain Part I Tab. 1: Friedman test of ISQ analysis and measurements at initial day. Results as mean and medians. No significant differences with p < 0.05 were found. Tab. 2: Friedman test of BIC values. Comparison between titanium and hybrid PEEK-Ti abutments. Follow-up eight weeks after implant placement. Data shows mean, Sd and medians. No significant differences with p < 0.05 were found. The success of immediately placed implants has been investigated in various studies with encourag- ing results already. But what is rather simple in the anterior mandible needs more attention when it comes to the anterior maxilla. Here, clinicians are oftentimes concerned not only about achieving adequate implant stability, but also about fulfilling patients’ desires for aesthetic results that resemble the natural dentition. To shorten procedures and eliminate intermediate prosthetic steps, digital tech- nologies were developed that allow the intraoral scanning of models and attachments with a high de- gree of precision and reproducibility. The article demonstrates the reliability of the single-session protocol using digital methods for scanning and producing crowns complemented with platform switching and evaluates the peri-implant soft-tissue seal. In part I of the article (published in implants 2/17), the authors described materials and methods used in an experiment with animals and in the treatment of humans. In part II of the article, the results are presented and discussed. ISQ value Insertion p value Mean ± Sd Median BioHPP abutment 74.46 ± 4.55 74.46 Titanium abutment 74.19 ± 4.29 74.19 0.16 0.23 Table 1 BIC (%) Titanium PEEK p value Mean ± Sd 61.29 ± 1.45 62.52 ± 4.63 0.32 Median 61.29 62.52 Table 2 06 implants 3 2017 Rationale for immediate restoration Research has shown that, for two-stage implants, marginal bone loss occurs primarily during the first year following placement and that this has mainly been attributed to the establishment of biologic width adjacent to the implant.19 Some studies have shown that bone remodelling can be biologically ascribed to bacterial colonisation of the micro- leakage present in a two-stage implant system and subsequent inflammation.20 The crestal bone loss around implants has both horizontal and vertical components. Following abutment connection, crestal bone has been shown to recede from the implant/ abutment junction microgap by 1.3 to 1.4 mm, mea- sured horizontally.21 Animal study Immediate implant placement and restoration minimise the harmful contamination of the peri- implant biological space and the resultant bone re- sorption. Immediate loading requires that certain prerequisites are met. The best way to objectively quantify the feasibility of immediate loading clinically is to analyse implant stability either by measuring the insertion torque, recommended at above 30 Ncm, or using the Osstell Mentor ultrasonic stability measur- ing device that returns ISQ values, which if above 65–70 allow us to load immediately with some confi- dence (Tab. 1). Changes in the peri-implant tissue can be quanti- fied by histomorphometry and histological evalua- tion in experimental studies (Tabs. 2 & 3). The radio- logical results of the animal experiments are documented in Figures 1a & b and Table 4. The histo- logical connection between the soft tissue and the SKY elegance abutment is tight. In combination with platform switching, this produces a high level of bone stability at the implant collar (Figs. 2a & b).