Oral Health and Dental Management

Immediate placement and loading of maxillary single-tooth implants: A 3-year prospective study of marginal bone level

International Conference and Exhibition on Dentistry

March 18-20, 2015 Dubai, UAE

Antoine Berberi

Posters-Accepted Abstracts: Oral Health Dent Manag

Abstract:

Background: Prevention of marginal bone loss following loading is of upmost importance in maintaining stable peri-implant tissues and preservation of final esthetic outcome of the restoration.Clinical reports have suggested that immediate placement of provisional crowns cemented on final abutments offered additional clinical control over soft tissue architecture. Introduction of Computer Aided Design / Computer Aided Manufacturing (CAD/CAM) technology to the dental field widened the scope of the design and application of all ceramic restorations. Prediction of optimal implant position with respect to anatomical limitations and prosthetic principles, such as occlusion and function, is becoming a basic integrated feature in the software module of many CAD/CAM systems. Aim/Hypothesis: The purpose of this study was to evaluate marginal bone level around single-toothimplants placed in anterior maxilla and immediately restored. Material and Methods: 20 Implants were placed in 20 patients (8 men and 12 women) that were selected for this study. Following atraumatic non-surgical extraction of tooth, all patients immediately received implant and the definitive prefabricated abutment was placed. Implant position was transferred to the scanning unit of the CAD/CAM system using prefabricated surgical guide. Temporary crowns were immediately fabricated and cemented. Eight weeks later final crowns were luted. Outcome assessment as implant survival and level of marginal bone radiographic evaluations were performed at 8 weeks, 1 year and 3 years time period after loading. Results: All implants placed osseointegrated successfully after 3 years of functional loading. The mean marginal bone loss was 0.16mm (SD, 0.167mm), 0.275mm (SD, 0.171mm) and 0.265mm (SD, 0.171mm) at 8 weeks, 1 year and 3 years time period respectively. Four out of the 20 implants showed no bone loss. Conclusions and Clinical Implications: Immediate loading technique using the final abutment directly eliminated the need for a second stage surgery and prevented interruption of soft and hard tissue at implant neck, which resulted in better soft tissue response and reduced marginal bone loss. Clinical significance: Immedi ately loaded implants, in fresh extraction sockets by insertion of a provisional restoration on the titanium abutment without any later manipulation, helped to protect the initially forming blood clot and presented a template for soft tissue contouring that resulted in significant reduction of marginal bone resorption and maintenance of soft tissue architecture.