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Immediate Loading of Single Implants in the Anterior Maxilla: A 1-Year Prospective Clinical Study on 34 Patients

Identifieur interne : 002E15 ( Pmc/Curation ); précédent : 002E14; suivant : 002E16

Immediate Loading of Single Implants in the Anterior Maxilla: A 1-Year Prospective Clinical Study on 34 Patients

Auteurs : Miguel Stanley [Portugal] ; Filipa Calheiros Braga [Portugal] ; Beatriz Mota Jordao [Portugal]

Source :

RBID : PMC:5458381

Abstract

Purpose

To present the outcomes of immediately loaded single implants placed in the anterior maxilla.

Methods

Over a 2-year period, all patients referred to a private clinic were considered for enrolment in this study. Inclusion criteria were single-tooth placement in postextraction sockets or healed sites of the anterior maxilla. All implants were immediately loaded and followed for a period of 1 year after the placement of definitive crowns. The outcome measures were implant stability, survival, and success.

Results

34 patients were selected and 43 tapered implants with a knife-edge thread design and a nanostructured, calcium-incorporated surface (Anyridge®, Megagen, Gyeongsang, Korea) were installed. Two implants were not sufficiently stable at placement (ISQ < 60) and were considered failed for immediate loading; 41 implants had an ISQ ≥ 60 at placement and were immediately loaded. One year after the placement of definitive crowns, no implant failures were reported, for a survival rate of 100%. No biological complications were found, but 2 implants had their prosthetic abutments loosened: the implant success rate was 95.2%.

Conclusions

In the present study on the immediate loading of single implants in the anterior maxilla, positive outcomes were reported, with high survival (100%) and success (95.2%) rates (the present study has been registered in the ISRCTN registry, a publicly available trial register recognized by WHO and ICMJE, with number ISRCTN12935478).


Url:
DOI: 10.1155/2017/8346496
PubMed: 28611844
PubMed Central: 5458381

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PMC:5458381

Le document en format XML

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<title> Methods</title>
<p> Over a 2-year period, all patients referred to a private clinic were considered for enrolment in this study. Inclusion criteria were single-tooth placement in postextraction sockets or healed sites of the anterior maxilla. All implants were immediately loaded and followed for a period of 1 year after the placement of definitive crowns. The outcome measures were implant stability, survival, and success.</p>
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<p> 34 patients were selected and 43 tapered implants with a knife-edge thread design and a nanostructured, calcium-incorporated surface (Anyridge®, Megagen, Gyeongsang, Korea) were installed. Two implants were not sufficiently stable at placement (ISQ < 60) and were considered failed for immediate loading; 41 implants had an ISQ ≥ 60 at placement and were immediately loaded. One year after the placement of definitive crowns, no implant failures were reported, for a survival rate of 100%. No biological complications were found, but 2 implants had their prosthetic abutments loosened: the implant success rate was 95.2%.</p>
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<p> In the present study on the immediate loading of single implants in the anterior maxilla, positive outcomes were reported, with high survival (100%) and success (95.2%) rates
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</listBibl>
</div1>
</back>
</TEI>
<pmc article-type="research-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Int J Dent</journal-id>
<journal-id journal-id-type="iso-abbrev">Int J Dent</journal-id>
<journal-id journal-id-type="publisher-id">IJD</journal-id>
<journal-title-group>
<journal-title>International Journal of Dentistry</journal-title>
</journal-title-group>
<issn pub-type="ppub">1687-8728</issn>
<issn pub-type="epub">1687-8736</issn>
<publisher>
<publisher-name>Hindawi</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">28611844</article-id>
<article-id pub-id-type="pmc">5458381</article-id>
<article-id pub-id-type="doi">10.1155/2017/8346496</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Clinical Study</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Immediate Loading of Single Implants in the Anterior Maxilla: A 1-Year Prospective Clinical Study on 34 Patients</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Stanley</surname>
<given-names>Miguel</given-names>
</name>
<xref ref-type="aff" rid="I1"></xref>
</contrib>
<contrib contrib-type="author">
<contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0001-7251-5458</contrib-id>
<name>
<surname>Braga</surname>
<given-names>Filipa Calheiros</given-names>
</name>
<xref ref-type="aff" rid="I1"></xref>
<xref ref-type="corresp" rid="cor1">
<sup>*</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Jordao</surname>
<given-names>Beatriz Mota</given-names>
</name>
<xref ref-type="aff" rid="I1"></xref>
</contrib>
</contrib-group>
<aff id="I1">White Clinic, Rua Dr. António Loureiro Borges, Edifício 5, 1 Andar 131, 1495 Algés, Portugal</aff>
<author-notes>
<corresp id="cor1">*Filipa Calheiros Braga:
<email>filipabraga@whiteclinic.pt</email>
</corresp>
<fn fn-type="other">
<p>Academic Editor: Eitan Mijiritsky</p>
</fn>
</author-notes>
<pub-date pub-type="ppub">
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>22</day>
<month>5</month>
<year>2017</year>
</pub-date>
<volume>2017</volume>
<elocation-id>8346496</elocation-id>
<history>
<date date-type="received">
<day>2</day>
<month>3</month>
<year>2017</year>
</date>
<date date-type="accepted">
<day>13</day>
<month>3</month>
<year>2017</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright © 2017 Miguel Stanley et al.</copyright-statement>
<copyright-year>2017</copyright-year>
<license xlink:href="https://creativecommons.org/licenses/by/4.0/">
<license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract>
<sec>
<title>Purpose</title>
<p> To present the outcomes of immediately loaded single implants placed in the anterior maxilla.</p>
</sec>
<sec>
<title> Methods</title>
<p> Over a 2-year period, all patients referred to a private clinic were considered for enrolment in this study. Inclusion criteria were single-tooth placement in postextraction sockets or healed sites of the anterior maxilla. All implants were immediately loaded and followed for a period of 1 year after the placement of definitive crowns. The outcome measures were implant stability, survival, and success.</p>
</sec>
<sec>
<title> Results</title>
<p> 34 patients were selected and 43 tapered implants with a knife-edge thread design and a nanostructured, calcium-incorporated surface (Anyridge®, Megagen, Gyeongsang, Korea) were installed. Two implants were not sufficiently stable at placement (ISQ < 60) and were considered failed for immediate loading; 41 implants had an ISQ ≥ 60 at placement and were immediately loaded. One year after the placement of definitive crowns, no implant failures were reported, for a survival rate of 100%. No biological complications were found, but 2 implants had their prosthetic abutments loosened: the implant success rate was 95.2%.</p>
</sec>
<sec>
<title> Conclusions</title>
<p> In the present study on the immediate loading of single implants in the anterior maxilla, positive outcomes were reported, with high survival (100%) and success (95.2%) rates
<italic> (the present study has been registered in the ISRCTN registry, a publicly available trial register recognized by WHO and ICMJE, with number </italic>
<ext-link ext-link-type="uri" xlink:href="https://www.isrctn.com/ISRCTN12935478?q=&filters=&sort=&offset=2&totalResults=15726&page=1&pageSize=10&searchType=basic-search">ISRCTN12935478</ext-link>
).</p>
</sec>
</abstract>
</article-meta>
</front>
<floats-group>
<fig id="fig1" orientation="portrait" position="float">
<label>Figure 1</label>
<caption>
<p>Preoperative situation. The patient complains because the left central incisor, which was restored with a single crown several years before, appears extruded and presents a high mobility (a). The periapical radiograph shows a severe resorption (b): the tooth is nonrestorable and needs to be extracted.</p>
</caption>
<graphic xlink:href="IJD2017-8346496.001"></graphic>
</fig>
<fig id="fig2" orientation="portrait" position="float">
<label>Figure 2</label>
<caption>
<p>Cone beam computed tomography (CBCT). The cone beam computed tomography (CBCT) examination confirms the presence of the tooth resorption. A careful 3D analysis of the height and width of the alveolar ridge is performed, in order to better plan the implant placement.</p>
</caption>
<graphic xlink:href="IJD2017-8346496.002"></graphic>
</fig>
<fig id="fig3" orientation="portrait" position="float">
<label>Figure 3</label>
<caption>
<p>Surgery. The nonrestorable tooth is extracted (a) and the socket is carefully debrided (b), in order to remove all infected tissue; then, the implant site is prepared with sequential drills, exceeding the alveolar apex 3-4 mm (c) and before to place the implant, a connective tissue graft is harvested from the palate, in order to thicken the soft tissues in the delicate buccal area (d).</p>
</caption>
<graphic xlink:href="IJD2017-8346496.003"></graphic>
</fig>
<fig id="fig4" orientation="portrait" position="float">
<label>Figure 4</label>
<caption>
<p>Surgery. The connective tissue graft is secured in position, within the envelope flap (a); then the implant (Anyridge, Megagen) is inserted slightly subcrestal and in palatal position (b); the autogenous bone chips collected during the preparation of the implant site are then placed in the alveolus (c), in order to fill the gaps between the socket and the implant (d).</p>
</caption>
<graphic xlink:href="IJD2017-8346496.004"></graphic>
</fig>
<fig id="fig5" orientation="portrait" position="float">
<label>Figure 5</label>
<caption>
<p>Immediate provisionalization. A provisional abutment is screwed on the implant (a) and the individual emergence profile is obtained with composite resin (b) in order the correct pressure that is exerted on the soft tissues (c); in this case, the immediate temporary restoration is then splinted to the adjacent teeth, for a short period after the surgery, in order to reduce the effects of prosthetic loading on the immediately inserted implant (d).</p>
</caption>
<graphic xlink:href="IJD2017-8346496.005"></graphic>
</fig>
<fig id="fig6" orientation="portrait" position="float">
<label>Figure 6</label>
<caption>
<p>The provisional restoration after 2 months. The soft tissues outline has been modeled by the temporary and the level and curvature of the facial mucosa look better, even if oral hygiene should be improved. (a) Clinical view; (b) radiographic control.</p>
</caption>
<graphic xlink:href="IJD2017-8346496.006"></graphic>
</fig>
<fig id="fig7" orientation="portrait" position="float">
<label>Figure 7</label>
<caption>
<p>The definitive ceramic restoration in position. (a) The definitive ceramic crown is delivered to the patient, along with the other planned definitive, tooth-supported restorations. (b) The aesthetic result 4 months after implant placement.</p>
</caption>
<graphic xlink:href="IJD2017-8346496.007"></graphic>
</fig>
<fig id="fig8" orientation="portrait" position="float">
<label>Figure 8</label>
<caption>
<p>The definitive ceramic crown 1 year after the delivery. (a) An aesthetically pleasing result has been maintained clinically, and the patient is fully satisfied; (b) the radiographic control confirms the stability of the hard tissues around the implant.</p>
</caption>
<graphic xlink:href="IJD2017-8346496.008"></graphic>
</fig>
<table-wrap id="tab1" orientation="portrait" position="float">
<label>Table 1</label>
<caption>
<p>Patient demographics.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" rowspan="1" colspan="1"></th>
<th align="center" rowspan="1" colspan="1">Number of patients (%)</th>
<th align="center" rowspan="1" colspan="1">
<italic>p</italic>
<sup>
<italic></italic>
</sup>
</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Gender</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Males</td>
<td align="center" rowspan="1" colspan="1">13 (38.2%)</td>
<td rowspan="2" align="center" colspan="1">0.170</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Females</td>
<td align="center" rowspan="1" colspan="1">21 (61.8%)</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Age at surgery</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">20–34 years</td>
<td align="center" rowspan="1" colspan="1">3 (8.8%)</td>
<td rowspan="4" align="center" colspan="1"><0.0001</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">35–49 years</td>
<td align="center" rowspan="1" colspan="1">21 (61.8%)</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">50–64 years</td>
<td align="center" rowspan="1" colspan="1">7 (20.6%)</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">≥65 years</td>
<td align="center" rowspan="1" colspan="1">3 (8.8%)</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Smoke</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">6 (17.6%)</td>
<td rowspan="2" align="center" colspan="1">0.0002</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">28 (82.4%)</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>History of periodontal disease</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">20 (58.8%)</td>
<td rowspan="2" align="center" colspan="1">0.303</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">14 (41.2%)</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Parafunctions</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">12 (35.3%)</td>
<td rowspan="2" align="center" colspan="1">0.086</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">22 (64.7%)</td>
</tr>
<tr>
<td colspan="3" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Total</td>
<td align="center" rowspan="1" colspan="1">34</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>
<italic>p</italic>
<sup>
<italic></italic>
</sup>
= Chi-square test.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="tab2" orientation="portrait" position="float">
<label>Table 2</label>
<caption>
<p>Distribution of the implants.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" rowspan="1" colspan="1"></th>
<th align="center" rowspan="1" colspan="1">Number of implants (%)</th>
<th align="center" rowspan="1" colspan="1">
<italic>p</italic>
<sup>
<italic></italic>
</sup>
</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Surgical protocol</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Postex. sockets</td>
<td align="center" rowspan="1" colspan="1">14 (32.6%)</td>
<td rowspan="2" align="center" colspan="1">0.022</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Healed sites</td>
<td align="center" rowspan="1" colspan="1">29 (67.4%)</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Position</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Incisors</td>
<td align="center" rowspan="1" colspan="1">11 (25.6%)</td>
<td rowspan="3" align="center" colspan="1"><0.0001</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Cuspids</td>
<td align="center" rowspan="1" colspan="1">4 (9.3%)</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Premolars</td>
<td align="center" rowspan="1" colspan="1">28 (65.1%)</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Length</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">10.0 mm</td>
<td align="center" rowspan="1" colspan="1">3 (7.0%)</td>
<td rowspan="4" align="center" colspan="1">0.010</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">11.5 mm</td>
<td align="center" rowspan="1" colspan="1">9 (20.9%)</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">13.0 mm</td>
<td align="center" rowspan="1" colspan="1">13 (30.2%)</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">15.0 mm</td>
<td align="center" rowspan="1" colspan="1">18 (41.9%)</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Diameter</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">3.5 mm</td>
<td align="center" rowspan="1" colspan="1">15 (34.9%)</td>
<td rowspan="4" align="center" colspan="1">0.026</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">4.0 mm</td>
<td align="center" rowspan="1" colspan="1">16 (37.2%)</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">4.5 mm</td>
<td align="center" rowspan="1" colspan="1">8 (18.6%)</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">5.0 mm</td>
<td align="center" rowspan="1" colspan="1">4 (9.3%)</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Bone regeneration</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">37 (86.0%)</td>
<td rowspan="2" align="center" colspan="1"><0.0001</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">6 (14.0%)</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Connective tissue graft</italic>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">10 (23.3%)</td>
<td rowspan="2" align="center" colspan="1">0.0005</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">33 (76.7%)</td>
</tr>
<tr>
<td colspan="3" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Total</td>
<td align="center" rowspan="1" colspan="1">43</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>
<italic>p</italic>
<sup>
<italic></italic>
</sup>
= Chi-square test.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
</record>

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