Stability of mandibular implants with Morse taper and external hexagon connections placed under immediate loading: a longitudinal clinical study.

The aim of this study was to compare the longitudinal stability of implants with Morse taper and external hexagon connections placed in the anterior mandible and subjected to immediate functional loading. Nine patients each received 4 mandibular implants placed between the mental foramina. In each patient, 2 implants on the left side of the arch had Morse taper prosthetic connections, and 2 implants on the right side had external hexagon prosthetic connections. Mandibular overdentures and opposing removable complete dentures were placed within 72 hours after implant surgery. Clinical evaluation of the implants via magnetic transduction resonance frequency analysis was performed immediately following surgery and 3 months, 6 months, and 2 years following surgery to obtain the implant stability quotient (ISQ). The data obtained were parametric according to the Kolmogorov-Smirnov normality test. The lowest ISQ of any implant was approximately 67, representing reliable osseointegration. The only statistically significant difference between the 2 types of prosthetic connection was found in the initial period (immediately following surgery), when the external hexagon connection in the distal position presented greater stability than did the Morse taper connection in the same position on the opposite side (P < 0.05; Student t test). In intragroup comparisons, no statistically significant differences were found regarding the positions of the implants in the mandible. When the different follow-up periods were evaluated, there were statistically significant differences only in the external hexagon group, with significant reductions in stability of both mesial and distal implants at 6 months compared to other time periods (P < 0.05; Tukey test). Within the limitations of the study, it can be concluded that both Morse taper and external hexagon prosthetic connections provide good stability in an immediate functional loading protocol.

Immediate loading over lower prosthesis in edentulous mandibles: comparison between two types of prosthetic connection / Carga imediata sobre protocolos inferiores: comparação entre dois tipos de conexões protéticas

ABSTRACT Objective: This study evaluated two implant-abutment connection systems under immediate loading of lower prosthesis in edentulous mandibles. Methods: Seventy-two implants placed in 18 patients were analyzed. The parameters evaluated included probing depth, stability of implants and perimplant bone loss, which were measured immediately when installing the prosthesis and after 3 and 6 months. All data underwent statistical analysis (T-Test and ANOVA, 5% significance level). Results: Implants with Morse cone connections showed smaller, statistically significant probing depth values for all periods (0.68/1.19/1.31), when compared to the external hexagon connections (1.08/1.52/1.64). A statistically significant difference was observed between baseline, 3 months (p<0.01 for Morse cone; p<0.001 for external hexagon) and 6 months (p<0.001 for both connections). When periods were considered there was a statistically significant difference in Implant Stability Quotient ISQ values between baseline and 6 months for both prosthetic connections. Conclusion: Immediate loading of the lower prosthesis is a viable option for the treatment of edentulous mandibles and that the external hexagon or Morse cone connections do not interfere with the success of the implants in a short-term evaluation.

RESUMO Objetivo: Avaliar dois sistemas de conexões protéticas sobre carga imediata em próteses tipo protocolo em mandíbulas edêntulas. Métodos: Setenta e dois implantes instalados em 18 pacientes foram analisados. Os parâmetros avaliados incluíram: profundidade de sondagem, estabilidade dos implantes e perda óssea periimplantar, os quais foram mensurados imediatamente após a instalação das próteses e depois de 3 e 6 meses pós-operatórios. Todos os dados foram submetidos à análise estatística (Teste T e ANOVA, ao nível de 5% de significância). Resultados: Implantes com conexão cone Morse mostraram profundidade de sondagem estatisticamente menor em todos os períodos (0,68/1,19/1,31), quando comparado com a conexão hexágono externo (1,08/1,52/1,64). Diferença estatisticamente significante foi observada entre o pré-operatório imediato, 3 meses (p<0,01 para cone Morse; p<0,001 para hexágono externo) e 6 meses (p<0,001 para ambas as conexões). Quando os períodos foram considerados houve uma diferença estatisticamente significante no quociente de estabilidade do implante (ISQ) entre o pré-operatório imediata e de 6 meses para ambas as conexões protéticas. Conclusão: A carga imediata sobre protocolos inferiores é uma opção viável para o tratamento de mandíbulas edêntulas e a conexão hexágono externo ou cone Morse não interferiram no sucesso dos implantes em um período curto de avaliação.

Frequência de ressonância e sondagem peri-implantar em implantes curtos sob carga imediata com prótese total fixa em cantiléver na arcada mandibular: acompanhamento de um ano / Frequency resonance analysis and peri-implant probing values on short, immediate-loaded dental implants with cantilevered fixed prosthesis in the mandibular arch: one year follow-up results

A proposta desse trabalho foi relatar um caso de atrofia mandibular tratada, com sucesso, por meio da instalação de quatro implantes curtos entre os forâmenes mentuais para reabilitação com prótese implantossuportada tipo protocolo híbrido submetido à carga imediata. Atualmente, a paciente encontra-se em pós-operatório de 13 meses apresentando valor médio de profundidade de sondagem peri-implantar de 1,87 mm e de 78,56 ISQ da frequência de ressonância

This paper presents a case report with the use of short dental implants and immediate prosthesis placement. After 13 months of follow-up, peri-implant probing values are near 1.87 mm and ISQ values around 78.56