Background:
The success of a dental implants therapy depends not only on restored function but also on harmonious integration of the restoration into the patient’s overall appearance, especially the peri-implant soft tissue. The implant therapy in patients with atrophied ridges is very challenging because it may require hard and soft tissue grafting prior or simultaneous to the implant placement. Recently published systematic reviews about implants placed in laterally augmented sites have documented high implant survival and success rates. A biologic width of approximately 3-4 mm of soft tissue always seems to be established after insertion of an implant and when a definitive crown is connected, the crown could induce the peri-implant soft tissue into the scalloped morphology of a natural tooth. To further consolidate the clinical efficacy and esthetic success of this reconstructive procedure, it is necessary to evaluate the stability of hard and soft tissues after a medium-term follow-up period.
Aim/Hypothesis:
The aim of the present study was to evaluate at 3-years after prosthetic loading, the hard and soft tissue stability of implants placed with intraoral block bone grafts in horizontal defects; and compare between simultaneous or delayed implant placement. The following variables were assessed: implant survival and success rate, peri-implant soft tissue conditions, radiographic peri-implant marginal bone loss, patient satisfaction and quality of life following implant therapy.
Material and Methods:
A cross-sectional clinical study was made of patients involving localized lateral alveolar ridge augmentation with autogenous block bone grafts performed before or at the implant placement between 2005 and 2010 in the Oral Surgery Unit of the University of Valencia. The patient sample came from a patient series previously studied (Peñarrocha et al. 2013). Patients with a minimum follow-up of three years after loading were included. Surgical procedures were performed by the same oral surgeon. This research followed the Declaration of Helsinki for human research. The study design was approved by the University of Valencia ethical board (Ref: H1390229683751). All grafts were obtained using the Piezon Master Surgery System® (EMS Electromedical Systems). TSA® implants (Phibo Dental Solutions) were installed. All data collection was made by a single trained clinician, different from the surgeon or the prosthodontist. At the 3-year follow-up visit the following parameters were evaluated: implant survival, implant success (Albrektsson et al), implant success from an esthetic viewpoint, peri-implant marginal bone loss (intraoral radiographs at prosthetic loading and at the 3-year control visit; bone loss was the difference between the baseline and the 3-year control radiograph), peri-implant soft-tissue conditions (plaque and bleeding index, probing depth, buccal gingival retraction), assessment of patient satisfaction and quality of life.
Results:
Thirty-four patients with 53 implants (23 delayed and 30 simultaneously) were included. None implant failed after 1-year post-loading. The implant success rate was 86.8% (76.6% for simultaneous and 100% for delayed implants) according to the Albrektsson criteria. According to esthetic issues, the implant success was 79.2% (73.3% for simultaneous and 86.9% for delayed implants). There were not significant differences in plaque index and the modified bleeding index between simultaneous or delayed implant placements. Proportion of implants with buccal gingival recession was higher in simultaneous implants group (26.6% vs 13%); although the difference was not statistically significant. The average marginal bone loss 3-year after loading was significantly higher for simultaneously (0.71±0.77 mm) than delayed inserted implants (0.21±0.11 mm). General patient satisfaction averaged 9.05 ± 0.82 and good quality of life was reported by all patients.
Conclusions and clinical implications:
Clinical and radiographic data after 3 years of prosthetic loading showed healthy peri-implant soft tissues and stable crestal bone loss, with a high implant survival and success rates, a high patient satisfaction and a good quality of life, with no differences according the timing of the implants.
Background:
The success of a dental implants therapy depends not only on restored function but also on harmonious integration of the restoration into the patient’s overall appearance, especially the peri-implant soft tissue. The implant therapy in patients with atrophied ridges is very challenging because it may require hard and soft tissue grafting prior or simultaneous to the implant placement. Recently published systematic reviews about implants placed in laterally augmented sites have documented high implant survival and success rates. A biologic width of approximately 3-4 mm of soft tissue always seems to be established after insertion of an implant and when a definitive crown is connected, the crown could induce the peri-implant soft tissue into the scalloped morphology of a natural tooth. To further consolidate the clinical efficacy and esthetic success of this reconstructive procedure, it is necessary to evaluate the stability of hard and soft tissues after a medium-term follow-up period.
Aim/Hypothesis:
The aim of the present study was to evaluate at 3-years after prosthetic loading, the hard and soft tissue stability of implants placed with intraoral block bone grafts in horizontal defects; and compare between simultaneous or delayed implant placement. The following variables were assessed: implant survival and success rate, peri-implant soft tissue conditions, radiographic peri-implant marginal bone loss, patient satisfaction and quality of life following implant therapy.
Material and Methods:
A cross-sectional clinical study was made of patients involving localized lateral alveolar ridge augmentation with autogenous block bone grafts performed before or at the implant placement between 2005 and 2010 in the Oral Surgery Unit of the University of Valencia. The patient sample came from a patient series previously studied (Peñarrocha et al. 2013). Patients with a minimum follow-up of three years after loading were included. Surgical procedures were performed by the same oral surgeon. This research followed the Declaration of Helsinki for human research. The study design was approved by the University of Valencia ethical board (Ref: H1390229683751). All grafts were obtained using the Piezon Master Surgery System® (EMS Electromedical Systems). TSA® implants (Phibo Dental Solutions) were installed. All data collection was made by a single trained clinician, different from the surgeon or the prosthodontist. At the 3-year follow-up visit the following parameters were evaluated: implant survival, implant success (Albrektsson et al), implant success from an esthetic viewpoint, peri-implant marginal bone loss (intraoral radiographs at prosthetic loading and at the 3-year control visit; bone loss was the difference between the baseline and the 3-year control radiograph), peri-implant soft-tissue conditions (plaque and bleeding index, probing depth, buccal gingival retraction), assessment of patient satisfaction and quality of life.
Results:
Thirty-four patients with 53 implants (23 delayed and 30 simultaneously) were included. None implant failed after 1-year post-loading. The implant success rate was 86.8% (76.6% for simultaneous and 100% for delayed implants) according to the Albrektsson criteria. According to esthetic issues, the implant success was 79.2% (73.3% for simultaneous and 86.9% for delayed implants). There were not significant differences in plaque index and the modified bleeding index between simultaneous or delayed implant placements. Proportion of implants with buccal gingival recession was higher in simultaneous implants group (26.6% vs 13%); although the difference was not statistically significant. The average marginal bone loss 3-year after loading was significantly higher for simultaneously (0.71±0.77 mm) than delayed inserted implants (0.21±0.11 mm). General patient satisfaction averaged 9.05 ± 0.82 and good quality of life was reported by all patients.
Conclusions and clinical implications:
Clinical and radiographic data after 3 years of prosthetic loading showed healthy peri-implant soft tissues and stable crestal bone loss, with a high implant survival and success rates, a high patient satisfaction and a good quality of life, with no differences according the timing of the implants.