Extra short dental implants supporting an overdenture in the edentulous maxilla: a proof of concept.
ABSTRACT This study investigates the outcome of short implants additionally placed with longer implants to support a maxillary overdenture.
Twelve patients received six implants to support a maxillary overdenture. Only one patient still had two molars in the maxilla, while the others had no remaining teeth. The status of the opposing arch was diverse. The distal implant in each quadrant was 6 mm in height (S) and the middle implants ranged between 10 and 14 mm (L). All implants were placed following a one-stage procedure and early loaded (6 weeks). Clinical and radiological parameters were assessed 6, 12 and 24 months after loading.
One short implant failed 2 weeks after surgery, probably due to early mobilization by the provisional prosthesis. The mean bone loss on the rough part of the implant was 0.7 mm (S) vs. 1.3 mm (L) during the first year and 0.3 mm (S) vs. 0.2 mm (L) during the second year after loading. The mean implant stability quotient values were 67 (S) vs. 70 (L) at placement and 75 (S) vs. 78 (L) after 1 year. At the 2-year follow- up, all prostheses were still stable and comfortable.
An overdenture on six implants, of which two have a reduced length, might represent a successful treatment option. No significant difference could be found between both implant lengths at 2 years' follow-up. However, bone loss with short implants may increase the likelihood of failure.
- SourceAvailable from: Daniel Buser[show abstract] [hide abstract]
ABSTRACT: Increased surface roughness of dental implants has demonstrated greater bone apposition; however, the effect of modifying surface chemistry remains unknown. In the present study, we evaluated bone apposition to a modified sandblasted/acid-etched (modSLA) titanium surface, as compared with a standard SLA surface, during early stages of bone regeneration. Experimental implants were placed in miniature pigs, creating 2 circular bone defects. Test and control implants had the same topography, but differed in surface chemistry. We created the test surface by submerging the implant in an isotonic NaCl solution following acid-etching to avoid contamination with molecules from the atmosphere. Test implants demonstrated a significantly greater mean percentage of bone-implant contact as compared with controls at 2 (49.30 vs. 29.42%; p = 0.017) and 4 wks (81.91 vs. 66.57%; p = 0.011) of healing. At 8 wks, similar results were observed. It is concluded that the modSLA surface promoted enhanced bone apposition during early stages of bone regeneration.Journal of Dental Research 08/2004; 83(7):529-33. · 3.83 Impact Factor
- [show abstract] [hide abstract]
ABSTRACT: The purpose of this article is to identify the types of complications that have been reported in conjunction with endosseous root form implants and associated implant prostheses. A Medline and an extensive hand search were performed on English-language publications beginning in 1981. The searches focused on publications that contained clinical data regarding success/failure/complications. The complications were divided into the following 6 categories: surgical, implant loss, bone loss, peri-implant soft tissue, mechanical, and esthetic/phonetic. The raw data were combined from multiple studies and means calculated to identify trends noted in the incidences of complications. The most common implant complications (those with a greater than a 15% incidence) were loosening of the overdenture retentive mechanism (33%), implant loss in irradiated maxillae (25%), hemorrhage-related complications (24%), resin veneer fracture with fixed partial dentures (22%), implant loss with maxillary overdentures (21%), overdentures needing to be relined (19%), implant loss in type IV bone (16%), and overdenture clip/attachment fracture (16%). It was not possible to calculate an overall complications incidence for implant prostheses because there were not multiple clinical studies that simultaneously evaluated all or most of the categories of complications. Although the implant data had to be obtained from different studies, they do indicate a trend toward a greater incidence of complications with implant prostheses than single crowns, fixed partial dentures, all-ceramic crowns, resin-bonded prostheses, and posts and cores.Journal of Prosthetic Dentistry 09/2003; 90(2):121-32. · 1.72 Impact Factor
- [show abstract] [hide abstract]
ABSTRACT: Immediate and early loading of implants can simplify treatment and increase patient satisfaction. This 3-year randomized-controlled trial will therefore evaluate survival rates and bone-level changes with immediately and early loaded Straumann implants with the SLActive surface. Partially edentulous patients >or=18 years of age were enrolled. Patients received a temporary restoration (single crown or two to four unit fixed partial denture) out of occlusal contact either immediately (immediate loading) or 28-34 days later (early loading group), with permanent restorations placed 20-23 weeks after surgery. The primary endpoint was change in crestal bone level from baseline (implant placement) to 12 months; the secondary variables were implant survival and success rates. A total of 383 implants (197 immediate and 186 early) were placed in 266 patients; 41.8% were placed in type III and IV bone. The mean patient age was 46.3+/-12.8 years. Four implants failed in the immediate loading group and six in the early loading group, giving implant survival rates of 98% and 97%, respectively (P=NS). There were no implant failures in type IV bone. The overall mean bone level change from baseline to 12 months was 0.77+/-0.93 mm (0.90+/-0.90 and 0.63+/-0.95 mm in the immediate and early groups, respectively; P<0.001). However, a significant difference in implantation depth between the two groups (P<0.0001) was found. After adjusting for this slight difference in initial surgical placement depth, time to loading no longer had a significant influence on bone-level change. Significant influence was found for: center (P<0.0001), implant length (P<0.05) and implant position (P<0.0001). Bone gain was observed in approximately 16% of implants. The results demonstrated that Straumann implants with the SLActive surface are safe and predictable when used in immediate and early loading procedures. Even in poor-quality bone, survival rates were comparable with those from conventional or delayed loading. The mean bone-level change was not deemed to be clinically significant and compared well with the typical bone resorption observed in conventional implant loading.Clinical Oral Implants Research 12/2008; 19(11):1119-28. · 3.43 Impact Factor