RESUMEN
PURPOSE: Osseointegrated dental implantation is traditionally performed by a flap approach that involves soft tissue flap reflection, but this technique is associated with several drawbacks. Conversely, the flapless method requires only minimal removal of soft tissue but is not suitable for all patients. The objective of this study was to compare the flapless (FL) method of implant placement with the traditional flap (TR) method with regard to achievement of success, change in bone level, and overall safety. PATIENTS AND METHODS: In this single-center, open, retrospective, investigator-driven, nonrandomized, comparative study, patients were pre- or intraoperatively assigned to the FL or TR treatment. The primary success criteria were the absence of mobility, radiolucency, pain, and infection. RESULTS: The FL method was applied to 174 implants (46%) in 121 patients and the TR method to 203 implants (54%) in 98 patients. At visit 1, implantation was rated successful in 171/174 (98.3%) implants with the FL method and in 200/203 (98.5%) with the TR method. Success rate remained constant until visit 2. The difference between the 2 groups in the rate of success was not significant. Similarly, no significant difference was observed for mean time to last follow-up for success. CONCLUSIONS: Based on pre- or intraoperative decision-making, patients eligible for FL surgery can benefit from a less straining procedure without affecting the high success rate of dental implant surgery. The FL approach is a predictable procedure when patient selection and surgical technique are appropriate.
Asunto(s)
Implantación Dental Endoósea/métodos , Colgajos Quirúrgicos , Adulto , Anciano , Anciano de 80 o más Años , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/etiología , Densidad Ósea , Distribución de Chi-Cuadrado , Implantación Dental Endoósea/efectos adversos , Implantes Dentales , Diseño de Prótesis Dental , Retención de Prótesis Dentales , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Dolor Facial/etiología , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Selección de Paciente , Modelos de Riesgos Proporcionales , Radiografía , Estudios Retrospectivos , Seguridad , Estadísticas no Paramétricas , Infección de la Herida Quirúrgica/etiología , Resultado del Tratamiento , Adulto JovenRESUMEN
Narrow diameter implants may be at increased risk of overload due to occlusal forces; therefore, implants with higher fatigue strength may be beneficial. The aim of this observational study was to evaluate survival and success of narrow diameter (Ø 3.3 mm) TiZr alloy (Roxolid, Institut Straumann AG, Basel, Switzerland) implants for 2 years in daily dental practice. This was a prospective, non-interventional, multicenter study; no specific patient inclusion or exclusion criteria were applied. Each patient received at least one TiZr implant; the treatment plan, including implant loading and final restoration, was at the investigator's discretion. The primary outcome was implant survival and success after 1 year. Secondary outcomes included 2-year survival and success and marginal bone level change. A total of 603 implants were placed in 357 patients. Cumulative survival and success rates were 97.8% and 97.6%, respectively, after 1 year and 97.6% and 97.4%, respectively, after 2 years. Bone levels remained stable in the majority of patients, and soft tissue remained stable up to 2 years. Within the limitations of a non-interventional study design, TiZr implants showed excellent survival and success with minimal bone loss up to 2 years in daily dental practice. The results compare favorably with those of small-diameter implants in controlled clinical trials.