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Five‐Year Prospective Study of Immediate/Early Loading of Fixed Prostheses in Completely Edentulous Jaws with a Bone Quality‐Based Implant System

Identifieur interne : 007F74 ( Main/Exploration ); précédent : 007F73; suivant : 007F75

Five‐Year Prospective Study of Immediate/Early Loading of Fixed Prostheses in Completely Edentulous Jaws with a Bone Quality‐Based Implant System

Auteurs : Carl E. Misch [États-Unis] ; Marco Degidi [Italie]

Source :

RBID : ISTEX:B291313D839EB5D30BF6E9540691C5DCC921DAF7

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English descriptors

Abstract

Background: The concept of immediate loading of root‐form implants for fixed restorations has received increasing interest over the last 5 years. Several authors have commented on parameters that may influence results, including implant number, implant length, bone density, and patient habits. The trigger for bone remodeling around an implant may occur from the surgical trauma of insertion or the mechanical environment of strain at the interface. In the classic two‐stage approach, these were divided episodes, separated by 3 to 6 months. Immediate loading compresses this time frame; the two driving mechanisms for bone repair occur concurrently. A scientific approach to the interface development is to match the bone healing response of trauma (woven bone of repair) to the response of mechanical load (reactive woven bone), so the sum of these two entities does not result in fibrous tissue formation and clinical mobility of the implant. Purpose: It is the purpose of this article to review the scientific rationale of these statements and coordinate them to bone physiology and bone biomechanics. Materials and Methods: Findings from previous reports in the literature were reviewed and summarized to form the basis of a prospective study using a bone quality‐based implant system (Biohorizons, Maestro Dental Implants, Birmingham, AL, USA). A transitional prosthesis was delivered either on the day of surgery or within 2 weeks for 30 patients and 31 arches. A total of 244 implants were used to support these restorations, for an average of 7.8 implants per prosthesis. After 4 to 7 months, the final restorations were fabricated. One year after the final restoration was loaded, the implant survival was 100%; the 31 restorations also had a survival of 100% over this time frame. This report presents these implants and restorations over a 1‐ to 5‐year period, with an average follow‐up period of 2.6 years. Results: The bone loss from implant insertion to final prosthesis delivery averaged 0.7 mm. The first‐year bone loss after final prosthesis delivery averaged 0.07 mm. A slight increase in bone height was observed after the first year, but generally no increase was observed over the remaining evaluation period. Conclusions: In the current report, no implant failure occurred, and crestal bone loss values were similar to or less than values reported with the conditional two‐stage approach. This may be related to the number and position of implants, implant design, and/or the surface condition of the implant loading.

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DOI: 10.1111/j.1708-8208.2003.tb00178.x


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<term>Absolute failure</term>
<term>Abutment</term>
<term>Alveolar Bone Loss (diagnostic imaging)</term>
<term>Alveolar Bone Loss (etiology)</term>
<term>Bone Density</term>
<term>Bone implant system</term>
<term>Bone loss</term>
<term>Bone reactions</term>
<term>Clinical assessment</term>
<term>Clinical report</term>
<term>Crestal</term>
<term>Crestal bone</term>
<term>Crestal bone loss</term>
<term>Dental Implantation, Endosseous (methods)</term>
<term>Dental Implants (adverse effects)</term>
<term>Dental Prosthesis, Implant-Supported</term>
<term>Dental Restoration Failure</term>
<term>Dental Stress Analysis</term>
<term>Dental implant</term>
<term>Dentistry</term>
<term>Denture, Complete, Immediate</term>
<term>Early occlusal loading</term>
<term>Edentulous</term>
<term>Edentulous mandible</term>
<term>Edentulous patient</term>
<term>Edentulous patients</term>
<term>Fibrous tissue</term>
<term>Fibrous tissue formation</term>
<term>Final prosthesis delivery</term>
<term>Final restoration</term>
<term>First year</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Immediate loading</term>
<term>Implant</term>
<term>Implant dent</term>
<term>Implant dentistry</term>
<term>Implant design</term>
<term>Implant failure</term>
<term>Implant insertion</term>
<term>Implant interface</term>
<term>Implant placement</term>
<term>Implant survival</term>
<term>Implant system</term>
<term>Initial surgery</term>
<term>Insertion</term>
<term>Interface</term>
<term>Jaw, Edentulous (diagnostic imaging)</term>
<term>Jaw, Edentulous (rehabilitation)</term>
<term>Lamellar</term>
<term>Lamellar bone</term>
<term>Loading</term>
<term>Mandible</term>
<term>Maxillary</term>
<term>Maxillofac</term>
<term>Misch</term>
<term>Natural dentition</term>
<term>Occlusal</term>
<term>Oral implant</term>
<term>Oral maxillofac implants</term>
<term>Oral maxillofac surg</term>
<term>Osseointegration</term>
<term>Pilot study</term>
<term>Private practice</term>
<term>Prospective Studies</term>
<term>Prospective study</term>
<term>Prosthesis</term>
<term>Prosthesis delivery</term>
<term>Prosthesis insertion</term>
<term>Radiograph</term>
<term>Radiography</term>
<term>Rigid fixation</term>
<term>Several authors</term>
<term>Surface area</term>
<term>Surface condition</term>
<term>Surgical</term>
<term>Surgical approach</term>
<term>Surgical trauma</term>
<term>Suture removal appointment</term>
<term>Time frame</term>
<term>Titanium implants</term>
<term>Transitional prosthesis</term>
<term>Trauma</term>
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<keywords scheme="KwdFr" xml:lang="fr">
<term>Analyse du stress dentaire</term>
<term>Densité osseuse</term>
<term>Humains</term>
<term>Implants dentaires (effets indésirables)</term>
<term>Mâchoire édentée (imagerie diagnostique)</term>
<term>Mâchoire édentée (rééducation et réadaptation)</term>
<term>Ostéo-intégration</term>
<term>Pose d'implant dentaire endo-osseux ()</term>
<term>Prothèse dentaire complète immédiate</term>
<term>Prothèse dentaire implanto-portée</term>
<term>Radiographie</term>
<term>Résorption alvéolaire (imagerie diagnostique)</term>
<term>Résorption alvéolaire (étiologie)</term>
<term>Échec de restauration dentaire</term>
<term>Études de suivi</term>
<term>Études prospectives</term>
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<keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en">
<term>Dental Implants</term>
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<term>Alveolar Bone Loss</term>
<term>Jaw, Edentulous</term>
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<keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr">
<term>Implants dentaires</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en">
<term>Alveolar Bone Loss</term>
</keywords>
<keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr">
<term>Mâchoire édentée</term>
<term>Résorption alvéolaire</term>
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<keywords scheme="MESH" qualifier="methods" xml:lang="en">
<term>Dental Implantation, Endosseous</term>
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<keywords scheme="MESH" qualifier="rehabilitation" xml:lang="en">
<term>Jaw, Edentulous</term>
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<keywords scheme="MESH" qualifier="rééducation et réadaptation" xml:lang="fr">
<term>Mâchoire édentée</term>
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<keywords scheme="MESH" qualifier="étiologie" xml:lang="fr">
<term>Résorption alvéolaire</term>
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<term>Absolute failure</term>
<term>Abutment</term>
<term>Bone Density</term>
<term>Bone implant system</term>
<term>Bone loss</term>
<term>Bone reactions</term>
<term>Clinical assessment</term>
<term>Clinical report</term>
<term>Crestal</term>
<term>Crestal bone</term>
<term>Crestal bone loss</term>
<term>Dental Prosthesis, Implant-Supported</term>
<term>Dental Restoration Failure</term>
<term>Dental Stress Analysis</term>
<term>Dental implant</term>
<term>Dentistry</term>
<term>Denture, Complete, Immediate</term>
<term>Early occlusal loading</term>
<term>Edentulous</term>
<term>Edentulous mandible</term>
<term>Edentulous patient</term>
<term>Edentulous patients</term>
<term>Fibrous tissue</term>
<term>Fibrous tissue formation</term>
<term>Final prosthesis delivery</term>
<term>Final restoration</term>
<term>First year</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Immediate loading</term>
<term>Implant</term>
<term>Implant dent</term>
<term>Implant dentistry</term>
<term>Implant design</term>
<term>Implant failure</term>
<term>Implant insertion</term>
<term>Implant interface</term>
<term>Implant placement</term>
<term>Implant survival</term>
<term>Implant system</term>
<term>Initial surgery</term>
<term>Insertion</term>
<term>Interface</term>
<term>Lamellar</term>
<term>Lamellar bone</term>
<term>Loading</term>
<term>Mandible</term>
<term>Maxillary</term>
<term>Maxillofac</term>
<term>Misch</term>
<term>Natural dentition</term>
<term>Occlusal</term>
<term>Oral implant</term>
<term>Oral maxillofac implants</term>
<term>Oral maxillofac surg</term>
<term>Osseointegration</term>
<term>Pilot study</term>
<term>Private practice</term>
<term>Prospective Studies</term>
<term>Prospective study</term>
<term>Prosthesis</term>
<term>Prosthesis delivery</term>
<term>Prosthesis insertion</term>
<term>Radiograph</term>
<term>Radiography</term>
<term>Rigid fixation</term>
<term>Several authors</term>
<term>Surface area</term>
<term>Surface condition</term>
<term>Surgical</term>
<term>Surgical approach</term>
<term>Surgical trauma</term>
<term>Suture removal appointment</term>
<term>Time frame</term>
<term>Titanium implants</term>
<term>Transitional prosthesis</term>
<term>Trauma</term>
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<term>Analyse du stress dentaire</term>
<term>Densité osseuse</term>
<term>Humains</term>
<term>Ostéo-intégration</term>
<term>Pose d'implant dentaire endo-osseux</term>
<term>Prothèse dentaire complète immédiate</term>
<term>Prothèse dentaire implanto-portée</term>
<term>Radiographie</term>
<term>Traumatisme</term>
<term>Échec de restauration dentaire</term>
<term>Études de suivi</term>
<term>Études prospectives</term>
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<front>
<div type="abstract" xml:lang="en">Background: The concept of immediate loading of root‐form implants for fixed restorations has received increasing interest over the last 5 years. Several authors have commented on parameters that may influence results, including implant number, implant length, bone density, and patient habits. The trigger for bone remodeling around an implant may occur from the surgical trauma of insertion or the mechanical environment of strain at the interface. In the classic two‐stage approach, these were divided episodes, separated by 3 to 6 months. Immediate loading compresses this time frame; the two driving mechanisms for bone repair occur concurrently. A scientific approach to the interface development is to match the bone healing response of trauma (woven bone of repair) to the response of mechanical load (reactive woven bone), so the sum of these two entities does not result in fibrous tissue formation and clinical mobility of the implant. Purpose: It is the purpose of this article to review the scientific rationale of these statements and coordinate them to bone physiology and bone biomechanics. Materials and Methods: Findings from previous reports in the literature were reviewed and summarized to form the basis of a prospective study using a bone quality‐based implant system (Biohorizons, Maestro Dental Implants, Birmingham, AL, USA). A transitional prosthesis was delivered either on the day of surgery or within 2 weeks for 30 patients and 31 arches. A total of 244 implants were used to support these restorations, for an average of 7.8 implants per prosthesis. After 4 to 7 months, the final restorations were fabricated. One year after the final restoration was loaded, the implant survival was 100%; the 31 restorations also had a survival of 100% over this time frame. This report presents these implants and restorations over a 1‐ to 5‐year period, with an average follow‐up period of 2.6 years. Results: The bone loss from implant insertion to final prosthesis delivery averaged 0.7 mm. The first‐year bone loss after final prosthesis delivery averaged 0.07 mm. A slight increase in bone height was observed after the first year, but generally no increase was observed over the remaining evaluation period. Conclusions: In the current report, no implant failure occurred, and crestal bone loss values were similar to or less than values reported with the conditional two‐stage approach. This may be related to the number and position of implants, implant design, and/or the surface condition of the implant loading.</div>
</front>
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