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Basic and Clinical Research

Success Rate of Immediate Nonfunctional Loaded Single-Tooth Implants: Immediate Versus Delayed Implantation

Ribeiro, Fernando Salimon MSc, PhD*; Pontes, Ana Emília Farias MSc, PhD; Marcantonio, Elcio MSc, PhD; Piattelli, Adriano MSc, PhD§; Neto, Rodolfo Jorge Boeck MSc, PhD; Marcantonio, Elcio Jr MSc, PhD

Author Information
doi: 10.1097/ID.0b013e318166cb84
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Abstract

Dental implants are widely used as a therapeutic alternative in the rehabilitation of partial or total edentulous patients. For many years, a surgical protocol was used, in which dental implants were maintained submerged during the osseointegration period. This period ranged from 3 to 6 months, and was advocated to reduce the risk of implant failure caused by movements at the bone-implant interface.1 However, this traditional protocol implies a long period of treatment. Thus, changes in clinical procedures were proposed, such as the insertion of implants into fresh extraction sites (immediate placement), and the installation of the prosthesis immediately after implantation.

Dental implants can be successfully submitted to immediate loading procedures because of improvements of surgical techniques such as gentle surgical placement, avoidance of thermal injury during drilling procedure, and achievement of primary stability; changes in micro- and macrostructure of the implant; and to a better management of masticatory forces, for instance by splinting the prostheses, avoiding the use of cantilevers, or even removing centric and eccentric occlusal contacts.2,3

Immediate loading protocol has advantages, because a provisional prosthesis is placed after implant insertion and a second surgical procedure is not required. Additionally, the use of this protocol under immediate placement condition may contribute to the maintenance of adjacent papillae and the height of peri-implant soft tissues.4 According to Barone et al,5 immediate loading results in higher bone density around implants, when compared with delayed loading. Piattelli et al6 placed implants in the posterior maxilla and mandible in monkeys, and observed a significantly greater bone-to-implant contact in the immediately loaded group in comparison with the unloaded group. Lorenzoni et al3 observed a reduced crestal bone loss around immediately loaded implants compared with the traditional two-stage implants. Degidi and Piattelli,7 after an evaluation of 93 immediately loaded implants, reported a cumulative success rate of 93.5% after 7 years.

On the other hand, high overall success rates (from 94.4% to 100%) have been reported with the use of single-tooth implants inserted under delayed implantation procedures.8–13 Recently, the study by Parel and Schow14 resulted in a rate of 97.8%, after evaluating 35 patients after a follow-up of 2.5 to 32 months. Forty-five single-tooth one-piece implants were used in the study, from which five were inserted under immediate placement conditions. Cooper et al15 evaluated 52 patients in a 12-month study, in which one-stage implants were loaded 3 weeks after implant insertion, resulting in a success rate of 96.2%.

Current literature still lacks comparative studies evaluating single-tooth implants submitted to immediate loading, investigating its predictability under different placement conditions. Therefore, the aim of the present study was to compare the success rates of immediate nonfunctional loaded single-tooth implants placed in substitution to maxillary incisors, canines, and premolars submitted to immediate or delayed implantation procedures.

Materials and Methods

All patients, from December 2001 to December 2003 who were submitted to single-tooth implant-supported prostheses in maxillae under immediate nonfunctional loading conditions, in two specific centers, were included in the present study. A total of 64 patients (27 men and 37 women; mean age 45.4 ± 12.6 years, range 23–71) and 82 implants were evaluated (Conexão Sistema de Prótese Ltda, São Paulo, SP, Brazil). Seventy-one root-form Conect (sandblasted with titanium oxide, internal hexagon; Conexão Sistema de Prótese Ltda) and 11 root-form Conic (sandblasted with titanium oxide, external hexagon; Conexão Sistema de Prótese Ltda) implants were used in the present study.

Forty-two implants were placed in private practice office (by a professor of Implantology with more than 20 years of clinical experience), and 40 were placed in the State University of São Paulo (by students from the specialization course in Implantology). Forty-six implants were inserted under immediate placement condition, whereas 36 were inserted under delayed placement condition.

During the experimental period, none of the implants was placed in substitution to a molar; thus, the sample was composed only by incisors, canines, and premolars. Immediate nonfunctional loading protocol was adopted if a minimum torque level of 40 N·cm was registered during implantation. All patients included were in good health, out of the growth phase, with no chronic systemic disease, no major psychological disorders, no cardiopathy, nonalcoholic or no medicine dependency, and had not been submitted to radiation therapy. As potential site for immediate implant placement, teeth indicated for removal had to present at least 3 mm of bone beyond the root apex and 5 mm width of available bone, and absence of periodontal disease, osseous defect, or periapical inflammatory involvement. Indications for tooth extraction and immediate implant placement included fractured root caused by trauma, residual roots, or nonrestorable crowns. Oral examination focused on the “smile line,” intra-arch relationship, vestibulolingual width, and maxillomandibular relationship. Panoramic and periapical radiographs were evaluated for mesiodistal width (interradicular distance), and residual bone beyond the apex.

This experiment was conducted in full accordance with ethical principles, including the World Medical Association Declaration of Helsinki (version VI, 2002), was approved by Institutional Experimentation Committee from the State University of São Paulo, and implant treatment alternatives were explained to the patient who signed an informed consent.

Surgical Procedure

Before the surgical procedure, all patients were submitted to a health questionnaire, and laboratory examinations were performed: blood count test, coagulation test, and glycemia level. Immediately before the surgery, patients were given a 0.12% chlorhexidine solution, for 1 minute.

Protocol for immediate placement group was as follows: after local anesthesia (with 2% mepivacaine HCl with adrenaline 1:100,000), an intrasulcular incision was performed and the tooth was carefully removed having care to maintain the integrity of the alveolar bone; the implant bed was then prepared by using a progressive sequence of spiral drills under generous saline cooling, and the implant was placed. The protocol for delayed placement group consisted of local anesthesia, followed by flap elevation, and implant bed preparation and implant insertion performed as previously described.

Abutments similar to CeraOne (Conexão Sistema de Prótese Ltda) or preparation posts were used, and acrylic provisional crowns were placed immediately after implant insertion. Special care was taken to prevent any centric or eccentric occlusal contact.

Antibiotics and anti-inflammatory medications were prescribed to the patients: clindamycin 300 mg (Dalacin C, Pharmacia Brasil Ltda, São Paulo, SP, Brazil) three times a day, for 7 days; and celecoxib 200 mg (Celebra, Pfizer, São Paulo, SP, Brazil) one time a day for 3 days. All patients had been recalled every 6 months for maintenance.

Evaluation Criteria

For collecting data for this study, all patients were recalled once. Mobility was tested; probing depth was assessed at facial, distofacial, distolingual, lingual, mesiofacial, and mesiolingual surfaces; and periapical radiograph of the implant site was taken. Data were evaluated according to the success rate criteria previously described by Albrektsson and Zarb.16 “Success” includes implants that meet all of the success criteria evaluated in clinical and radiographic examinations (absence of mobility, pain, and peri-implantar radiolucency; and marginal bone loss lower than 1.5 mm during the first year after abutment connection followed by 0.2 mm per year). “Survival” includes implants that are still in function, but do not fulfill all success criteria. “Unaccounted for” includes all implants from patients who were not available at a specific recall appointment. “Failure” includes all removed implants irrespective of the cause of their failure or removal (implants with mobility are considered failed).

With the aim of comparing success and failure values from both implants placed under immediate or delayed placement conditions, a chi-square test was performed (Analyse- it 1.71, Analyse-it Software Ltd., Leeds, LS, England) to calculate P value with one degree of liberty, considering a 5% significance level. The null hypothesis was based on the absence of difference between the modalities of treatment.

Results

All patients came to the recall in June 2005, and healing periods ranged from 18.0 to 39.7 months (mean 27.1 ± 6.1 months) after implant installation. Data concerning implant length and distribution are presented in Table 1.

Table 1
Table 1:
Distribution of Dental Implants According to Length and Location

Surgical procedures were well tolerated by all patients, and prosthetic failures were not observed. However, four patients sought help reporting mobility or pain in the implant sites at the first, fifth, and 12th month after prosthesis installation (mean 5.2 ± 5.6 months). These three implants were retrieved and replaced by new ones. Radiographic image of the implant retrieved in the 12th month after nonfunctional loading showed a significant bone loss (half-length of the implant). More details concerning failed implants are presented in Table 2.

Table 2
Table 2:
Details From the Dental Implants That Failed During the Present Study

Among all 82 implants evaluated during the present study, none was inserted in the survival group or was unaccounted, 3 had failed, and 79 fulfilled the success rate criteria (96.3%).

Considering specifically the protocol of implantation, implants inserted under immediate placement condition achieved a success rate of 93.5%, which was not statistically different from the rate of 100.0% observed for implants inserted under delayed placement condition (P = 0.33, Qui-square test). Success rates of the dental implants are presented in Table 3.

Table 3
Table 3:
Distribution and Rates of Success of Dental Implants, Considering Implantation Protocol, and Center in Which the Surgeries Were Performed

Discussion

In the present study, a high success rate was observed for single-tooth dental implants submitted to immediate nonfunctional loading (96.3%). This value is similar to the values of delayed loaded implants, which present success rates ranging from 94.4% to 100%.8,9,11–13

Implants inserted under delayed placement and immediate nonfunctional loading conditions presented a success rate of 100%. This percentage accords well with the data reported in the literature; using immediate loading procedures, Ericsson et al17 observed a success rate of 85.7%, whereas Glauser et al,18 Chaushu et al,4 Andersen et al,19 Proussaefs et al,20 Barone et al,5 Calandriello et al,21 and Lorenzoni et al3 observed success rates of 100%.

Calandriello et al21 used immediately loaded implants combined with provisional prosthesis designed in light centric occlusion, differently from the present study, in which provisional prosthesis were prevented from any centric and eccentric contacts. These centric and eccentric contacts were previously avoided by Ericsson et al,17 Andersen et al,19 and Lorenzoni et al3; in the last study, occlusal splints were provided.

In the present study, the success rate of single-tooth dental implants submitted to immediate nonfunctional loading and under immediate placement conditions (93.5%) was lower than that (100%) described by Hui et al,22 and higher than that reported by Chaushu et al4 (82.4%).

The success rates of implants placed in dental school by students from the specialization course in Implantology (97.5%) and private practice (95.2%) were not significantly different. Therefore, the success rate seems to be more influenced by patient selection and surgical and prosthetic guidelines, than by surgeon experience.

Concerning the implants lost during this study, two were removed (in substitution to teeth 8 and 10) up to the fifth months after prosthesis installation, and one was removed (in substitution to teeth 9) 12 months after prosthesis installation. In the study by Ericsson et al,17 of 24 implants, two were removed 3 and 5 months after immediate nonfunctional loading. Chaushu et al4 used immediate placement and immediate loading, and observed that of the 28 implants 3 were lost during the first month after surgery. Lazzara et al23 reported that of the 429 dental implants inserted and subsequently loaded (2.1 ± 0.7 months after placement), six implants were removed even before loading and one implant was lost 1 month after surgery.

The high success rates observed in the present study were probably related to the strict case selection, to the avoidance of occlusal overloading, to the frequent use of long and wide implants (15 × 4.3 mm, 15 × 5mm, and 13 × 4.3 mm represented 67.1% of the total), and to the minimum torque level of 40 N, which provided an adequate initial stability. The minimum torque value was higher than the 32 N suggested by Nikellis et al24 and Wang et al,25 and is in accordance to the 40 N suggested by Garber et al.26

Assad et al27 and Pontes et al28 observed, respectively, that functional and nonfunctional immediately loaded implants resulted in better stability of soft tissue margin in comparison with delayed loaded sites. Complementarily, in the present study, in which all groups were submitted to nonfunctional immediate loading, the position of the soft tissues apparently was better maintained for fresh extraction than healed ridge group. This fact may be explained by the bone stimulation caused by mechanical loading.29 However, additional studies are required not only to evaluate the stability of the marginal peri-implantar tissues, but also to evaluate the success rate of a larger sample of osseointegrated dental implants for longer periods.

Conclusion

In the present sample, no differences statistically significant were detected for immediate nonfunctional single-tooth loaded implants under immediate placement conditions in comparison with those inserted under delayed placement condition; and both protocols had high success rate in maxillary incisors, canines, and premolars areas. Immediate placement of implants seems to be a reliable treatment modality, providing a reduced treatment period between tooth extraction and placement of the definitive prosthesis.

Disclosure

The authors claim to have no financial interest, directly or indirectly, in any entity that is commercially related to the products mentioned in this article.

Acknowledgments

The authors thank Dr. Vagner Samy Lemo, for his assistance with the patients, and CAPES (Government Agency for the Development of Higher Education) for financial support.

References

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12.Vigolo P, Givani A, Majzoub Z, et al. Clinical evaluation of small-diameter implants in single-tooth and multiple-implant restorations: A 7-year retrospective study. Int J Oral Maxillofac Implant. 2004;19:703-709.
13.Doring K, Eisenmann E, Stiller M. Functional and esthetic considerations for single-tooth Ankylos implant-crowns: 8 years of clinical performance. J Oral Implantol. 2004;30:198-209.
14.Parel SM, Schow SR. Early clinical experience with a new one-piece implant system in single tooth sites. J Oral Maxillofac Surg. 2005;63(suppl 1):2-10.
15.Cooper L, Felton DA, Kugelberg CF, et al. A multicenter 12-month evaluation of single-tooth implants restored 3 weeks after 1-stage surgery. Int J Oral Maxillofac Implant. 2001;16:182-192.
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17.Ericsson I, Nilson H, Lindh T, et al. Immediate functional loading of Brånemark single tooth implants. An 18 months’ clinical pilot follow-up study. Clin Oral Implant Res. 2000;11:26-33.
18.Glauser R, Lundgren AK, Gottlow J, et al. Immediate occlusal loading of Branemark TiUnite implants placed predominantly in soft bone: 1-year results of a prospective clinical study. Clin Implant Dent Relat Res. 2003;5(suppl 1):47-56.
19.Andersen E, Haanæs HR, Knutsen BM. Immediate loading of single-tooth ITI implants in the anterior maxilla: A prospective 5-year pilot study. Clin Oral Implant Res. 2002;13:281-287.
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21.Calandriello R, Tomatis M, Vallone R, et al. Immediate occlusal loading of single lower molars using Branemark System Wide-Platform TiUnite implants: An interim report of a prospective open-ended clinical multicenter study. Clin Implant Dent Relat Res. 2003;5(suppl 1):74-80.
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23.Lazzara RJ, Porter SS, Testori T, et al. A prospective multicenter study evaluating loading of osseotite implants two months after placement: One-year results. J Esthetic Dent. 1998;10:280-289.
24.Nikellis I, Levi A, Nicolopoulos C. Immediate loading of 190 endosseous dental implants: A prospective observational study of 40 patient treatments with up to 2-year data. Int J Oral Maxillofac Implants. 2004;19:116-123.
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Abstract Translations

GERMAN / DEUTSCH

AUTOR(EN): Fernando Salimon Ribeiro, MSc, PhD, Ana Emília Farias Pontes, MSc, PhD, Elcio Marcantonio, MSc, PhD, Adriano Piattelli, MSc, PhD, Rodolfo Jorge Boeck Neto, MSc, PhD, Elcio Marcantonio Junior, MSc, PhD. Schriftverkehr: Elcio Marcantonio Jr., MSc, PhD, Departamento de Periodontia, Faculdade de Odontologia de Araraquara, UNESP Rua Humaitá, 1680. Araraquara, SP, Brasilien. CEP:14801-903. eMail:elciojr@foar.unesp.br. Tel.: + 55 (16) 3301-6369. Fax: + 55 (16) 3301-6314.

Erfolgsquote bei unmittelbarer nicht funktionaler Belastung von Einzelzahnimplantaten. Unmittelbare Implantierung im Vergleich zu verzögerter Implantatsetzung

ZUSAMMENFASSUNG:Zielsetzung: Die vorliegende Studie zielte darauf ab, die Erfolgsquote von Einzelzahnimplantaten bei unmittelbarer nicht funktionaler Belastung und Einpflanzung in die frischen Extraktionshöhlen (sofortige Platzierungsbedingungen) bzw. in den geheilten Kamm (verzögerte Platzierungsbedingungen) zu ermitteln und zu bewerten. Materialien & Methoden: 82 Zahnimplantate wurden im Oberkiefer von 64 aufeinander folgenden Patienten eingepflanzt. Der Patientenstamm wurde dabei aus Privatpraxen sowie aus einem Intensivfortbildungskurs für Implantologie gewonnen. 46 dieser Implantate wurden unter sofortigen Platzierungsbedingungen eingesetzt, während bei den anderen 36 eine Einpflanzung unter verzögerten Platzierungsbedingungen vorgenommen wurde. Die zur Beurteilung der Erfolgsquote angewendeten Kriterien sind die zuvor von Albrektsson und Zarb (1993) beschriebenen. Die Nachsorge bewegte sich in einem Zeitraum von 18,0 bis 39,7 Monaten. Ergebnisse: 79 der Implantate erfüllten die für die Erfolgsquote festgesetzten Kriterien (96,3%). Außerdem waren die Unterschiede bezüglich der Implantierungsbedingungen nicht maßgeblich (p = 0,33, Chi-Quadrat-Test): unter den versagenden Implantaten stammten drei aus der sofortigen Platzierungsgruppe mit einer Gesamterfolgsquote von 93,5%) und keines aus der verzögerten Platzierungsgruppe, bei der die Erfolgsquote damit bei 100,0% lag. Schlussfolgerung: Im aktuellen Beispiel wurden für die unmittelbar nicht funktional belasteten Einzelzahnimplantate unter sofortigen Platzierungsbedingungen keine statistisch maßgeblichen Unterschiede im Vergleich zu den unter verzögerten Platzierungsbedingungen eingebrachten festgestellt. Beide Protokolle wiesen hohe Erfolgsquoten im Bereich der Schneide- sowie Eckzähne und Prämolaren auf.

SCHLÜSSELWÖRTER: Zahnimplantate; unmittelbare Belastung; sofortige Implantierung; Erfolgsquote; Knochengewebsintegration

SPANISH / ESPAÑOL

AUTOR(ES): Fernando Salimon Ribeiro, MSc, PhD, Ana Emília Farias Pontes, MSc, PhD, Elcio Marcantonio, MSc, PhD, Adriano Piattelli, MSc, PhD, Rodolfo Jorge Boeck Neto, MSc, PhD, Elcio Marcantonio Junior, MSc, PhD. Correspondencia a:Elcio Marcantonio Jr., MSc, PhD, Departamento de Periodontia, Faculdade de Odontologia de Araraquara, UNESP Rua Humaitá, 1680. Araraquara, SP, Brazil. CEP: 14801-903. Correo electrónico:elciojr@foar.unesp.br. Teléfono: + 55 (16) 3301-6369. Fax: + 55 (16) 3301-6314.

Tasa de éxito de los implantes de un solo diente con carga inmediata, no funcional. Implante inmediato versus retrasado

ABSTRACTO:Propósito: El objetivo de este estudio fue evaluar la tasa de éxito de los implantes de un solo diente con carga inmediata, no funcional usados en cavidades de extracción reciente (colocación inmediata) y una cresta curada (colocación retrasada). Materiales y Métodos: Ochenta y dos implantes fueron colocados en el maxilar de 64 pacientes consecutivos de un consultorio privado y de un curso de especialización en Implantología. Cuarenta y seis implantes se colocaron inmediatamente y 36 se colocaron en forma retrasada. EL criterio usado para evaluar la tasa de éxito fue el previamente descrito por Albrektsson y Zarb (1993), y el período de seguimiento varió desde 18,0 a 39,7 meses. Resultados: Setenta y nueve implantes cumplieron con el criterio de éxito (96,3%). Además, las diferencias con respecto a la condición del implante no fueron significativas (p = 0,33, prueba de Qui-cuadrado): tres de los implantes fallados fueron del grupo de colocación inmediata (tasa de éxito del 93,5%), y ninguno del grupo de colocación retrasada (tasa de éxito del 100,0%). Conclusión: En esta muestra, no se detectaron diferencias estadísticamente significativas para la carga inmediata, no funcional del implante de un solo diente comparado con los que se colocaron retrasadamente; y ambos protocolos tuvieron una alta tasa de éxito en los incisivos maxilares, caninos y premolares.

PALABRAS CLAVES: implantes dentales; carga inmediata; implante inmediato; tasa de éxito; oseointegración

PORTUGUESE / PORTUGUÊS

AUTOR(ES): Fernando Salimon Ribeiro, Mestre em Ciência, PhD, Ana Emília Farias Pontes, Mestre em Ciência, PhD, Elcio Marcantonio, Mestre em Ciência, PhD, Adriano Piattelli, Mestre em Ciência, PhD, Rodolfo Jorge Boeck Neto, Mestre em Ciência, PhD, Elcio Marcantonio Junior, Mestre em Ciência, PhD. Correspondência para:Elcio Marcantonio Jr., MSc, PhD, Departamento de Periodontia, Faculdade de Odontologia de Araraquara, UNESP Rua Humaitá, 1680. Araraquara, SP, Brasil. CEP: 14801-903. e-Mail:elciojr@foar.unesp.br. Telefone: + 55 (16) 3301-6369. Fax: + 55 (16) 3301-6314.

Taxa de sucesso de implantes de dente único carregados não-funcionais imediatos

RESUMO:Objetivo: O objetivo deste estudo era avaliar a taxa de sucesso de implantes de dente único carregados não-funcionais imediatos, usados em locais de extração frescos (condição de colocação imediata) ou rebordo curado (condição de colocação retardada). Materiais & Métodos: Oitenta e dois implantes dentários foram colocados na maxila de 64 pacientes consecutivos de consultórios particulares e de um curso de especialização em Implantologia. Quarenta e seis implantes foram inseridos sob condição de colocação imediata e 36 foram inseridos sob condição de colocação retardada. Os critérios usados para avaliar a taxa de sucesso foram aqueles previamente descritos por Albrektsson e Zarb (1993), e o período de acompanhamento foi de 18.0 a 39.7 meses. Resultados: Setenta e nove implantes preencheram os critérios da taxa de sucesso (96.3%). Além disso, as diferenças relativas à condição de implantação não foram significativas (p = 0.33, teste Qui-quadrado): três dos implantes falhos foram do grupo de colocação imediata (taxa de sucesso de 93.5%), e nenhum foi do grupo de colocação retardada (taxa de sucesso de 100.0%). Conclusão: Na presente amostra, nenhuma diferença estatisticamente significativa foi detectada para implantes de dente único carregados não-funcionais imediatos sob condição de colocação imediata em comparação com aqueles inseridos sob condição de colocação retardada; e ambos os protocolos tiveram alta taxa de sucesso em incisivos maxilares, caninos e áreas pré-molares.

PALAVRAS-CHAVE: implantes dentários; carga imediata; implantação imediata; taxa de sucesso; osseointegração

RUSSIAN / SYMBOL

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АВТОРЫ: Fernando Salimon Ribeiro, магистр eстeствeнныx наук, доктор философии, Ana Emília Farias Pontes, магистр eстeствeнныx наук, доктор философии, Elcio Marcantonio, магистр eстeствeнныx наук, доктор философии, Adriano Piattelli, магистр eстeствeнныx наук, доктор философии, Rodolfo Jorge Boeck Neto, магистр eстeствeнныx наук, доктор философии, Elcio Marcantonio Junior, магистр eстeствeнныx наук, доктор философии. Адрeс для коррeспондeнции: Elcio Marcantonio Jr., MSc, PhD, Departamento de Periodontia, Faculdade de Odontologia de Araraquara, UNESP Rua Humaitб, 1680. Araraquara, SP, Brazil. CEP:14801-903. Адрeс элeктронной почты:elciojr@foar.unesp.br. Тeлeфон: + 55 (16) 3301-6369. Факс: + 55 (16) 3301-6314.

Показатeль количeства успeшныx попыток нeфункциональной установки имплантатов на мeсто отдeльныx зубов с нeмeдлeнной нагрузкой. Нeмeдлeнная имплантация по сравнeнию с отсрочeнной имплантациeй

РEЗЮМE:Цeль. Цeль данного исслeдования - оцeнить показатeль количeства успeшныx попыток нeфункциональной установки имплантатов на мeсто только что удалeнныx отдeльныx максиллярныx зубов с нeмeдлeнной нагрузкой (нeмeдлeнная установка) или в заживший альвeолярный грeбeнь (отсрочeнная установка). Матeриалы и мeтоды. Шeстидeсяти чeтырeм нeотобранным пациeнтам частной клиники и пациeнтам, участвующим в спeциализированном курсe Имплантология, было установлeно 82 имплантата в вeрxнeй чeлюсти. 46 имплантатов были установлeны нeмeдлeнно и 36 имплантатов – с отсрочкой. Критeрий, который использовался для оцeнки показатeля количeства успeшныx попыток, был описан Альбрeкцсоном (Albrektsson) и Зарбом (Zarb) в 1993 году, пeриод наблюдeния составил от 18 до 39,7 мeсяцeв. Рeзультаты. Сeмьдeсят дeвять имплантатов соотвeтствовали критeрию по показатeлю количeства успeшныx попыток (96,3%). Болee того, разница в показатeлe мeжду отсрочeнной и нeмeдлeнной имплантациeй была нeзначитeльной (р=0,33 кви-квадратный тeст): 3 из нeприжившиxся имплантатов были из группы нeмeдлeнной имплантации (показатeль количeства успeшныx попыток – 93,5%), в группe отсрочeнной имплантации всe имплантаты прижились (показатeль количeства успeшныx попыток – 100%). Вывод. В данном исслeдовании нe было выявлeно статистичeски значимой разницы для имплантатов на мeсто отдeльныx зубов с нeфункциональной нагрузкой при нeмeдлeнной имплантации по сравнeнию с отсрочeнной; по данным обоиx протоколов были достигнуты высокиe показатeли для максиллярныx рeзцов, клыков и прeмолярныx зубов.

КЛЮХEВЫE СЛОВА: зубныe имплантаты, нeмeдлeнная нагрузка, нeмeдлeнная имплантация, показатeль количeства успeшныx попыток, оссeоинтeграция

TURKISH / TÜRKÇE

YAZARLAR: Prof. Fernando Salimon Ribeiro, MSc, Prof. Ana Emília Farias Pontes, MSc, Prof. Elcio Marcantonio, MSc, Prof. Adriano Piattelli, MSc, Prof. Rodolfo Jorge Boeck Neto, MSc, Prof. Elcio Marcantonio Junior, MSc. Yazýþma için:Elcio Marcantonio Jr., MSc, PhD, Departamento de Periodontia, Faculdade de Odontologia de Araraquara, UNESP Rua Humaitá, 1680. Araraquara, SP, Brezilya. CEP:14801–903. E-posta:elciojr@foar.unesp.br. Telefon: + 55 (16) 3301-6369. Faks: + 55 (16) 3301-6314.

Ýþlevsel olmayan hemen yükleme yapýlmýþ tek diþ implantlarýnda baþarý oraný. Hemen yüklemeye karþýn geciktirilmiþ implantasyon.

ÖZET:Amaç: Bu çalışmanın amacı, taze diş çekim yerlerinde işlevsel olmayan maksiler tek diş hemen yükleme implantlarının (hemen/immediat yerleştirmenin), iyileşmiş kret üzerinde implant (geciktirilmiş yerleştirme) ile karşılaştırılmasını de˘gerlendirmekti. Gereç ve Yöntem: Özel muayenehaneden ve İmplantoloji uzmanlaşma dersinden toplanan ardışık 64 hastada maksilada seksen iki adet dental implant yerleştirildi. Kırk altı implant hemen yerleştirme yöntemiyle ve 36 implant da geciktirilmiş implantasyon ile yerleştirildi. Başarı oranını de˘gerlendirmekte kullanılan kriterler bundan önce Albrektsson ve Zarb (1993) tarafından tanımlanmış ölçütler olup, hasta takip periyodu 18.0 ila 39.7 ay arasında de˘gişmiştir. Bulgular: Yetmiş dokuz implant, başarı oranı kriterlerine uygun bulundu (%96.3). Ayrıca, implantasyon durumuyla ilgili farklılıklar önemli bulunmadı (p=0.33, Ki kare testi). Başarısız kabul edilen implantların üçü hemen (immediat) implantasyon grubuna aitti (%93.5 başarı oranı). Geciktirilmiş yerleştirme grubunda başarısızlık görülmedi (%100.0 başarı oranı). Sonuç: Bu örnekte, hemen yükleme ile implante edilen işlevsel olmayan tek diş implantları ile geciktirilmiş yerleştirme yöntemi ile yerleştirilen implantlar arasında istatistiksel olarak önemli bir fark yoktu, ve her iki protokolde de maksiler kesici ön dişler (insizör), kaninler ve premolar alanları için yüksek başarı oranı görüldü.

ANAHTAR KELÝMELER: dental implantlar; hemen (immediat) yükleme; hemen (immediat) implantasyon; başarı oranı; osseointegrasyon

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Keywords:

dental implants; immediate loading; immediate implantation; success rate; osseointegration

© 2008 Lippincott Williams & Wilkins, Inc.