Long-term clinical performance of short 6-mm implants supporting single crowns in the posterior region: A 10-year cohort study.

INTRODUCTION: Long-term clinical success of non-splinted, posterior, and short implants still is unclear. This prospective cohort study reports the 10-year follow-up of 6-mm implants supporting single crowns in the posterior region, and patient-reported outcomes. METHODS: Baseline sample comprised 20 patients treated with 46 screw-retained crowns supported by 6-mm implants with moderately rough implant surface. Participants were recalled for a 10-year clinical follow-up to assess survival rates, biologic and mechanic conditions, quality of life (OHIP-14), and treatment satisfaction. Data were collected with clinical-radiographic exams and analyzed using descriptive and inferential statistics. RESULTS: Fourteen patients with 35 implant-crown units were examined after 127.6 ± 11.8 months. For the entire cohort period, 7/46 implants were lost (survival estimate: 77.7% at 133 months), and mechanic complications occurred in 14/46 units (survival estimate: 66.4% at 116 months). In the Cox models, "maximum occlusal force" had a significant effect for implant loss (p = 0.038) and for prosthetic screw loosening (p = 0.038); "arch" and "bruxism" were not significant. Peri-implant bone loss was 0.4 ± 0.6 mm at 10 years. For peri-implant bone level, "crown-to-implant ratio" (p < 0.001) and "time" (p = 0.001) were significant. Bone levels differed from baseline to 12, 48, and 120 months. Satisfaction VAS was 94.0 ± 7.9 mm and OHIP-14 was 2.3 ± 2.2. CONCLUSION: Single screw-retained crowns supported by 6-mm implants have an acceptable long-term clinical performance, with stable peri-implant bone levels after 10 years of function.

Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants.

BACKGROUND: This study assessed the relationship between insertion torque and bone quality evaluated during surgery and in preoperative computed tomographic (CT) images analyzed either visually or by rescaled mean gray values (MGVs). The study also tested the correlation between the clinical and radiographic measures of bone quality. METHODS: The consecutive sample was composed of 45 short implants (4.1 × 6 mm) placed in the posterior region of 20 patients. Intra-surgical tactile bone quality, based on the classification of bone types by Lekholm and Zarb, and insertion torque were recorded during the implant placement. Visual bone quality and normalized MGV were assessed in standardized axial, coronal, and sagittal sections of preoperative CT images. Data were analyzed by ANOVA and Spearman correlation (alpha = 0.05). RESULTS: Insertion torque was associated with all assessment methods of bone quality (tactile, CT visual, MGV). A moderate correlation was found among all methods of bone quality, except for CT visual assessment and tactile evaluation. MGVs varied as a function of arch, dental region, insertion torque, and bone types. CONCLUSIONS: The results suggest that bone quality measures affect primary stability as recorded by insertion torque, and the assessment methods are consistently related.

Risk factors for single crowns supported by short (6-mm) implants in the posterior region: A prospective clinical and radiographic study.

BACKGROUND: The use of short implants is still not a consensus for challenging clinical situations, such as unfavorable crown-to-implant (C/I) ratio. PURPOSE: This prospective study evaluated the rates of prosthetic complications and implant failure, the mean marginal bone loss of 6-mm dental implants with single crowns in posterior regions and the potential risk factors. MATERIALS AND METHODS: Forty-six dental implants, 6-mm long and 4.1-mm wide, were placed in the posterior region in 20 patients. Patients were clinically and radiographically examined after the restoration with single crowns and on a yearly basis. Potential risk factors (arch, bruxism, maximum bite force, anatomical and clinical C/I ratios, and occlusal table area) were analyzed according to the following outcomes: implant survival, bone loss, and prosthetic complications. RESULTS: The mean follow-up time was 45 ± 9 (16-57) months. There was no early loss of implants. After prosthetic loading, 4 implants were lost (2 in the mandible and 2 in the maxilla; 91.3% survival), and there were 13 prosthetic complications (28.3%), yielding a 65.2% success rate. The frailty term showed a 95% greater chance of loss in the mandible than the maxilla. Mean peri-implant bone loss was of 0.2 ± 0.4 mm, 0.1 ± 0.2 mm, 0.1 ± 0.3 mm, and 0.2 ± 0.4 mm in the first, second, third, and fourth years, respectively, with a mean cumulative loss of 0.3 ± 0.5 mm at 48 months. In the multilevel model, the effects of the clinical C/I ratio and time were significant for bone loss (P < .001). It was estimated that a mean bone loss of 0.1 mm is associated with both a one-unit increase in time (12 months) and a 0.1 increase in the clinical C/I ratio. The other potential risk factors showed no significant relationship with the outcomes. CONCLUSIONS: The 6-mm implants supporting single crowns performed well, but the mandible shows a higher risk of failure. The time and clinical C/I ratio are predictors for bone loss.

Influence of calcinable cylinders cast in cobalt-chromium alloy on the passivity of implant-supported frameworks / Influência de cilindros calcináveis fundidos em cobalto-cromo na passividade de próteses implanto-suportadas

Purpose: This study aimed to determine the effect of using calcinable cylinders on the passivity of a framework that simulates a three-unit fixed partial prosthesis on two implants. Methods: Two 3.75 x 10 mm external hex implants were used, with their abutments set on a steel base forming the master model. Ten cobalt-chromium alloy frameworks were manufactured by the induction casting technique. Two groups were established: Group 1 used premachined cylinders to cast five frameworks; Group 2 used plastic calcinable cylinders to cast five frameworks. Passivity evaluation was accomplished by using strain gauges placed in the cervical and occlusal regions of the framework pontics. The measurement was performed during screwing of the second prosthetic screw with a torque of 10 Ncm. Data were analyzed by Student's t test (α = 0.05). Results: The mean (standard deviation) values were 39.16 (24.74) mV/V for Group 1 and 43.76 (21.13) mV/V for Group 2. There was no statistically significant difference between groups (P = 0.815). Conclusion: The results suggest that the use of calcinable cylinders had a similar degree of passivity compared to the use of premachined prosthetic cylinders.

Objetivo: Este trabalho avaliou a influência da utilização de cilindros calcináveis no grau de passividade de infra-estruturas que simulam uma prótese parcial fixa de três elementos sobre dois implantes. Metodologia: Foram utilizados dois implantes de hexágono externo de 3,75 mm×10 mm, com seus respectivos pilares intermediários, fixados numa base de aço, formando o modelomestre. A partir disto, foram fabricadas dez infra-estruturas em liga de cobalto-cromo através da técnica de fundição por indução. Foram criados dois grupos: Grupo 1 utilizando cilindros pré-usinados para a fabricação de cinco infra-estruturas; Grupo 2 cinco infra-estruturas fundidas com cilindros de plástico calcináveis. Para avaliação da passividade foram utilizados extensômetros colados na região oclusal e cervical do pôntico das infra-estruturas. A medição foi realizada no momento do aperto do segundo parafuso protético com torque de 10Ncm. Os dados foram analisados pelo teste t de Student (α=0,05). Resultados: As médias (desvio-padrão) dos grupos foram de 39,16 (24,74) mV/V no Grupo 1 e 43,76 (21,13) mV/V no Grupo 2. Não houve diferença estatisticamente significante entre os grupos (P=0,815). Conclusão: Considerando-se as limitações deste trabalho, sugere-se que o uso de cilindros calcináveis obtém o mesmo grau de passividade que o uso de cilindros pré-usinados.

Marginal fit of implant-supported fixed prosthesis frameworks with prefabricated and calcinable cylinders / Adaptação marginal de infra-estruturas de prótese fixa implanto-suportada com cilindros pré-usinados e calcináveis

Purpose: The aim of this study was to evaluate the vertical marginal misfit of the metal framework of an implant-supported prosthesis. Methods: Ten frameworks were made of cobalt-chromium alloy (Co-Cr), simulating a three-element fixed prosthesis on two implants. Five frameworks were constructed using prefabricated cylinders, and the other five were constructed using calcinable cylinders. All frameworks were cast by the induction technique and laser-welded. Marginal misfit was measured by means of scanning electron microscopy with the frameworks subjected to the single-screw test. Twenty-five measurements of marginal fit were recorded per abutment and averaged for statistical analysis (ANOVA, alpha=0.05). Results: There was no statistically significant difference in marginal fit between the groups tested. The only difference found was when comparing the abutments with and without screw. Conclusion: It was concluded that there is no difference in marginal fit between frameworks cast in Co-Cr with calcinable and prefabricated cylinders using induction casting, laser-welding, and single-screw test.

Objetivo: O objetivo deste trabalho foi avaliar o desajuste marginal vertical de infra-estruturas metálicas de prótese fixa sobre implantes. Metodologia: Foram confeccionadas 10 infra-estruturas em liga de cobalto-cromo (Co-Cr), simulando uma prótese fixa de três elementos sobre dois implantes, com o auxílio de uma matriz metálica. Cinco infra-estruturas foram confeccionadas com cilindros pré-usinados. Outras cinco foram confeccionadas com cilindros calcináveis. Todas as infra-estruturas foram fundidas pela técnica de indução e soldadas a laser. As leituras do desajuste marginal foram realizadas através de microscopia eletrônica de varredura, utilizando a técnica do parafuso único, totalizando 25 medições em cada cilindro. As médias de desajuste marginal de cada cilindro foram utilizadas para a análise estatística (ANOVA, alfa=0,05). Resultados: Não houve diferença estatística no grau de desajuste marginal entre os grupos testados. Apenas houve diferença quando comparados os cilindros com e sem parafuso. Conclusão: Foi concluído que não há diferença de adaptação marginal entre as infra-estruturas fundidas em Co-Cr com cilindros calcináveis e pré-usinados, utilizando fundição por indução, soldagem a laser e teste do parafuso único.