BACKGROUND: Bone augmentation procedures can be associated with significant patient morbidity, can be more expensive and may requires longer times (up to 1 year) before patients are rehabilitated with implant-supported prostheses. Moreover complications, especially for vertical augmentation techniques, are common. AIM/HYPOTHESIS: The aim of this retrospective study was to evaluate whether short (4 mm) dental implants could be a suitable alternative in the failure of reconstructive surgery in the atrophic posterior mandible. MATERIAL AND METHODS: Patients experienced failure in the reconstructive surgery of the atrophic posterior mandible were enrolled. The type of reconstructive surgery, surgical complications, data related to the timing of failure and ways of resolution were collected. For their rehabilitation, super short (4 mm) implants (Twin-Kone"Universal System, Global D, France) with a mean diameter of 4.09 mm were placed. After 4 months, provisional reinforced acrylic prostheses were delivered. Provisional prostheses were replaced, after 4 months, by definitive screw-retained metal-resin restoration. Outcome measures were prostheses and implant failures, any complications, peri-implant marginal bone level changes and patient satisfaction. Patients were followed up to an average of 2.37 years after loading. RESULTS: 24 patients (5 Males and 19 Females; mean age: 60.5 year old) were enrolled in this study. They were treated with inlay technique, onlay technique, alveolar distraction osteogenesis and Guided Bone Regeneration (GBR). Complications were dehiscence/graft exposition, necrosis, periimplantitis, paresthesia, non integrated graft and graft infection; they occurred on average 6.5 weeks after surgery. Significantly more complications occurred in the GBR group than the onlay and the distraction group (Kruskal Wallis test; P = 0.001). 58 super short (4 mm) implants were placed in the posterior mandible after the resolution of the complications. Up to a mean period of 2.37 years after loading, only two patients experienced short implant and/or prosthesis failures. The resolution way of reconstructive complications did not influence the number of short implant complications. There were no statistically significant differences between marginal bone level changes at implant placement and at 1, 2, 3 years follow-up. The marginal bone level at 3 years follow-up was 0.62 mm. All patients were fully satisfied with the implant treatment. CONCLUSIONS AND CLINICAL IMPLICATIONS: This study suggests that super short (4 mm) dental implants could be a suitable, faster, cheaper and easier rehabilitation option in the failure of the reconstructive surgery of the atrophic posterior mandible. These results need to be confirmed by trials with follow-ups of at least 5 years.
4 mm short implants in the treatment of reconstructive surgery failures of the atrophic posterior mandible: a retrospective study.
BARAUSSE, CARLO;FELICE, PIETRO
2016
Abstract
BACKGROUND: Bone augmentation procedures can be associated with significant patient morbidity, can be more expensive and may requires longer times (up to 1 year) before patients are rehabilitated with implant-supported prostheses. Moreover complications, especially for vertical augmentation techniques, are common. AIM/HYPOTHESIS: The aim of this retrospective study was to evaluate whether short (4 mm) dental implants could be a suitable alternative in the failure of reconstructive surgery in the atrophic posterior mandible. MATERIAL AND METHODS: Patients experienced failure in the reconstructive surgery of the atrophic posterior mandible were enrolled. The type of reconstructive surgery, surgical complications, data related to the timing of failure and ways of resolution were collected. For their rehabilitation, super short (4 mm) implants (Twin-Kone"Universal System, Global D, France) with a mean diameter of 4.09 mm were placed. After 4 months, provisional reinforced acrylic prostheses were delivered. Provisional prostheses were replaced, after 4 months, by definitive screw-retained metal-resin restoration. Outcome measures were prostheses and implant failures, any complications, peri-implant marginal bone level changes and patient satisfaction. Patients were followed up to an average of 2.37 years after loading. RESULTS: 24 patients (5 Males and 19 Females; mean age: 60.5 year old) were enrolled in this study. They were treated with inlay technique, onlay technique, alveolar distraction osteogenesis and Guided Bone Regeneration (GBR). Complications were dehiscence/graft exposition, necrosis, periimplantitis, paresthesia, non integrated graft and graft infection; they occurred on average 6.5 weeks after surgery. Significantly more complications occurred in the GBR group than the onlay and the distraction group (Kruskal Wallis test; P = 0.001). 58 super short (4 mm) implants were placed in the posterior mandible after the resolution of the complications. Up to a mean period of 2.37 years after loading, only two patients experienced short implant and/or prosthesis failures. The resolution way of reconstructive complications did not influence the number of short implant complications. There were no statistically significant differences between marginal bone level changes at implant placement and at 1, 2, 3 years follow-up. The marginal bone level at 3 years follow-up was 0.62 mm. All patients were fully satisfied with the implant treatment. CONCLUSIONS AND CLINICAL IMPLICATIONS: This study suggests that super short (4 mm) dental implants could be a suitable, faster, cheaper and easier rehabilitation option in the failure of the reconstructive surgery of the atrophic posterior mandible. These results need to be confirmed by trials with follow-ups of at least 5 years.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
