Background
The NobelActive™ implant (Nobel Biocare, Gothenburg, Sweden) was introduced in 2008. It was developed and designed to improve primary implant stability and to prevent marginal bone loss. That makes the implant well-suited for immediate implant placement in extraction sockets or at sites with low bone quality.
Aim/Hypothesis
The aim of this prospective clinical 2-year study is (1) to document the overall treatment outcome of NobelActive™ implants, and (2) to evaluate the impact of several variables on crestal bone loss around these implants. The variables for analysis include: insertion torque, initial gingival tissue thickness, bone quality and quantity.
Material and Methods
From March 2011 to August 2016, 306 NobelActive™ implants (3 to 5 mm in diameter, and 8,5 to 15 mm in length) were installed in 163 partially edentulous subjects; following an immediate, delayed or late protocol. The insertion torque ranged between 15 and 80 Ncm with a mean value of 36 Ncm (SD 14, n = 306). The mean gingival tissue thickness at the buccal side was 1.9 mm (SD 0.99, n = 287) and 2.7 mm at the crestal side (SD 1.27, n = 171). According to the Lekholm and Zarb classification, the median quality and quantity of bone was 3 C (n = 306). Twenty-two implants were immediately loaded with a provisional crown and all implants were restored with final restorations after 3-4 months. Clinical evaluation including assessment of bleeding on probing, gingival recession and PerioTest® values were performed at 6 months, 1 and 2 years after loading. Radiographic bone loss was measured on peri-apical radiographs at the same evaluation moments, with loading as baseline.
Results
Of the 306 implants, 7 implants did not osseointegrate, these were replaced by another implant after 4 to 5 months. Preliminary results of the 213 implants, with a minimum 1-year follow-up, revealed a mean marginal bone loss at the mesial (M) aspect of 0,16 mm (SD 0,85, n = 213) and at the distal (D) aspect of 0,21 mm (SD 0,77, n=213) at 6 months after loading. At 1-year follow-up the M bone loss was 0,05 mm (SD 0.88, n = 213) and the D bone loss was 0,15 mm (SD 0,93, n=213). The mean bone change from baseline to year 2 was at the mesial aspect a bone gain of 0,04 mm (SD 0,92, n = 125) and at the D aspect a bone loss of 0,13 mm (SD 0,87, n=125).
Conclusions and clinical implications
After an initial bone remodeling during the first months, a stable or even improving bone level around the NobelActive™ implants during the first year of functional loading was observed. Following parameters could be identified as reliable predictors for peri-implant bone loss: smoking, periodontal bone loss / age, bone quality and quantity, biotype, GBR and insertion torque values.
Background
The NobelActive™ implant (Nobel Biocare, Gothenburg, Sweden) was introduced in 2008. It was developed and designed to improve primary implant stability and to prevent marginal bone loss. That makes the implant well-suited for immediate implant placement in extraction sockets or at sites with low bone quality.
Aim/Hypothesis
The aim of this prospective clinical 2-year study is (1) to document the overall treatment outcome of NobelActive™ implants, and (2) to evaluate the impact of several variables on crestal bone loss around these implants. The variables for analysis include: insertion torque, initial gingival tissue thickness, bone quality and quantity.
Material and Methods
From March 2011 to August 2016, 306 NobelActive™ implants (3 to 5 mm in diameter, and 8,5 to 15 mm in length) were installed in 163 partially edentulous subjects; following an immediate, delayed or late protocol. The insertion torque ranged between 15 and 80 Ncm with a mean value of 36 Ncm (SD 14, n = 306). The mean gingival tissue thickness at the buccal side was 1.9 mm (SD 0.99, n = 287) and 2.7 mm at the crestal side (SD 1.27, n = 171). According to the Lekholm and Zarb classification, the median quality and quantity of bone was 3 C (n = 306). Twenty-two implants were immediately loaded with a provisional crown and all implants were restored with final restorations after 3-4 months. Clinical evaluation including assessment of bleeding on probing, gingival recession and PerioTest® values were performed at 6 months, 1 and 2 years after loading. Radiographic bone loss was measured on peri-apical radiographs at the same evaluation moments, with loading as baseline.
Results
Of the 306 implants, 7 implants did not osseointegrate, these were replaced by another implant after 4 to 5 months. Preliminary results of the 213 implants, with a minimum 1-year follow-up, revealed a mean marginal bone loss at the mesial (M) aspect of 0,16 mm (SD 0,85, n = 213) and at the distal (D) aspect of 0,21 mm (SD 0,77, n=213) at 6 months after loading. At 1-year follow-up the M bone loss was 0,05 mm (SD 0.88, n = 213) and the D bone loss was 0,15 mm (SD 0,93, n=213). The mean bone change from baseline to year 2 was at the mesial aspect a bone gain of 0,04 mm (SD 0,92, n = 125) and at the D aspect a bone loss of 0,13 mm (SD 0,87, n=125).
Conclusions and clinical implications
After an initial bone remodeling during the first months, a stable or even improving bone level around the NobelActive™ implants during the first year of functional loading was observed. Following parameters could be identified as reliable predictors for peri-implant bone loss: smoking, periodontal bone loss / age, bone quality and quantity, biotype, GBR and insertion torque values.