ABSTRACT
Aim: The present split-mouth case report aims to describe the clinical and radiographic long-term outcomes of the implant rehabilitation of two mandibular premolars in which the digital workflow was used to apply different prosthetic protocols. Case description: A female 42-year-old patient with the absence of both mandibular second premolars was submitted to guided surgery for the placement of platform-switching Grand Morse connection implants. Digital workflow was used for implant and prosthetic planning, applying early loading protocol 21 days after surgery. The implant on the right side received the final abutment at the time of surgery (without loading), whereas the implant on the left side had a healing abutment placed, which was replaced by a temporary abutment and then by a final abutment. Two months after surgery, both implants had final ceramic restorations delivered. The patient was followed clinically and radiographically for 30 months, presenting excellent hard and soft tissue outcomes, with bone level changes lower than 2mm for both implants. Conclusion: The use of digital workflow and early loading, made the present implant-supported rehabilitation predictable, safe and time-efficient, resulting in total patient satisfaction. Peri-implant bone level was observed to be stable after early loading protocol for both platform-switching connection implants inserted, despite the prosthetic protocol applied.(AU)
Objetivo: O presente relato de caso de boca dividida tem como objetivo descrever os resultados clínicos e radiográficos a longo prazo da reabilitação com implante de dois pré-molares inferiores em que o fluxo de trabalho digital foi usado para aplicar os conceitos de "one abutment-one time" em uma das reabilitações e troca de componente no outro. Descrição do caso: Paciente do sexo feminino, 42 anos, com ausência de ambos os segundos pré-molares inferiores, foi submetida à cirurgia guiada para colocação de implantes de conexão Grand Morse plataforma-switching. Foi utilizado fluxo de trabalho digital para planejamento de implante e prótese, aplicando protocolo de carga antecipada 21 dias após a cirurgia. O implante do lado direito recebeu o componente protético definitivo no momento da cirurgia (sem carga), enquanto o implante do lado esquerdo recebeu um cicatrizador, que foi substituído por um pilar provisório e depois por um componente definitivo. Dois meses após a cirurgia, ambos os implantes tiveram restaurações cerâmicas finais entregues. A paciente foi acompanhada clínica e radiograficamente por 30 meses, apresentando excelentes resultados de tecidos duros emoles, com alterações do nível ósseo inferiores a 2mm para ambos os implantes. Conclusão: O fluxo de trabalho digital e carregamento precoce, tornou a presente reabilitação implantossuportada previsível, segura e eficiente em termos de tempo, resultando em total satisfação do paciente. O nível ósseo peri-implantar foi observado como estável após o protocolo de carregamento inicial para ambos os implantes de conexão plataforma-switching inseridos, independente do protocolo protético aplicado. (AU)
Subject(s)
Humans , Female , Adult , Prostheses and Implants , Dental Implants , Alveolar Bone Loss , Patient Satisfaction , Computer-Aided DesignABSTRACT
Abstract Objective This study aimed to retrospectively collect clinical data to evaluate the influence of possible risk factors on the long-term success of implant treatment with extra-narrow (2.9 mm diameter) implants in a daily dental practice setting. Methodology Data were collected from records of patients who received at least one extra-narrow implant from 2012 to 2017, regarding implant survival, prosthesis survival, patient characteristics, and implant characteristics. The association between the dependent variables "implant survival", "prosthesis survival," and "adverse events" related to patient and implant characteristics was statistically evaluated by chi-square tests. Moreover, implant and prosthesis survival were analyzed by Kaplan-Meier survival curves. Results The sample was constituted of 58 patients (37 women and 21 men) with a mean age of 54.8 years old (SD: 12.5), followed up for up to eight years. In total, 86 extra-narrow implants were placed within this sample. Four implants were lost, resulting in an implant survival rate of 95.3%. A total of 55 prostheses were inserted and only one (1.8%) was lost, resulting in a prosthesis survival rate of 98.2%. The mean implant and prosthesis survival time was, respectively, 7.1 years and 6.3 years, according to the Kaplan-Meier survival analysis. A correlation was found between smoking and implant loss, which makes implant loss eight times more likely to occur in smokers than non-smokers. A significant association was also found between prosthesis loss and previous need of prosthesis repair. However, it was not considered clinically relevant. No association was found between the occurrence of adverse events and later implant or prosthesis loss. Conclusion High implant and prosthesis survival rates were found in the long term for treatment with extra-narrow implants. Moreover, a significant correlation between smoking and implant loss was observed.
ABSTRACT
Objective: The aim of this study was to evaluate implant and prosthesis survival rates in full-arch rehabilitation supported by implants with platform-switched Morse taper connection submitted to immediate or delayed loading, after up to 5 years of follow-up. Material and Methods: Data was retrospectively collected from clinical records of patients who were treated by means of implant-supported full-arch rehabilitation. Survival rates of implants and prostheses were evaluated according to immediate or delayed loading. Results: The sample comprised 967 implants. Of those, 627 were submitted to immediate loading (IL) while 340 to delayed loading (DL). After a follow-up period of up to 5 years, the implant survival rate for IL was of 99.7% (622/627 implants) and 97.2% (333/340 implants) for DL. The overall implant survival rate was 98.8% (955/967 implants). Prosthesis survival rate was 100% (N = 178) for both groups. Significantly more implants in the DL group presented bone loss (p > 0.01), either greater or lower than 2 mm, during the follow-up period. Conclusion:Within their limits, the present results suggest that full-arch rehabilitation with platform-switched Morse taper connection implants can lead to surgical and prosthetic predictable outcomes. Moreover, immediate loading protocol seems to be a good option for the rehabilitation of fully edentulous patients, as it involves a shorter treatment time, which may lead to greater patient satisfaction. (AU)
Objetivo: O objetivo deste estudo foi avaliar as taxas de sobrevivência de implantes e próteses em reabilitações de arco completo suportadas por implantes de conexão cone Morse e platform switching submetidos à carga imediata ou tardia, após até 5 anos de acompanhamento. Material e Métodos: Os dados foram coletados retrospectivamente em prontuários clínicos de pacientes que foram tratados por meio de reabilitação de arco completo suportada por implantes. As taxas de sobrevivência de implantes e próteses foram avaliadas de acordo com a carga imediata ou tardia. Resultados: A amostra foi composta por 967 implantes. Destes, 627 foram submetidos à carga imediata (IL) e 340 à carga tardia (DL). Após um período de acompanhamento de até 5 anos, a taxa de sobrevivência de implantes para IL foi de 99,7% (622/627 implantes) e de 97,2% (333/340 implantes) para DL. A taxa de sobrevivência geral dos implantes foi de 98,8% (955/967 implantes). Taxa de sobrevivência da prótese de 100% (N = 178) foi encontrada para ambos os grupos. Significantemente mais implantes no grupo DL apresentaram perda óssea (p > 0,01), seja maior ou menor que 2 mm, durante o período de acompanhamento. Conclusão: Os presentes resultados sugerem, dentro de seus limites, que a reabilitação de arco completo com implantes de conexão cone Morse e platform switching pode obter resultados cirúrgicos e protéticos previsíveis. Além disso, o protocolo de carga imediata parece ser uma boa opção para a reabilitação de pacientes totalmente edêntulos, pois envolve um menor tempo de tratamento, o que pode levar a uma maior satisfação do paciente (AU)