A total fixed reconstruction in patients with severe chronic periodontitis and requiring immediate implant placement and loading: A retrospective clinical study

Year 2023, Volume: 33 Issue: 1, 14 - 19, 31.01.2023

Mehmet Eşkan

https://doi.org/10.54614/CRDS.2022.6241

Abstract

ABSTRACT
Objective: Immediate implant placement has become an acceptable treatment alternative in a patient undergoing total edentulism and seeking fixed total restorations. It is still a controversial topic if previous periodontal status such as generalized chronic severe periodontitis has a nega- tive effect on implant survival rate. The focus of this study is, therefore, to determine whether generalized chronic severe periodontitis compromises implant survival rates in a patient seeking an implant-supported full-arch fixed rehabilitation.
Methods: Fifty-five consecutive patients with generalized chronic severe periodontitis received 272 implants. Each jaw, 23 mandibles, and 45 maxillae were treated with a fixed full-arch prosthe- sis. The majority (95%) of the restorations were supported by 4 implants, of which the posterior 2 implants were tilted. All implants were placed immediately, and a provisional functional acrylic prosthesis was delivered on the same day of surgery. Subjects were followed up to 8.8 years. The cumulative survival rate was determined using Kaplan–Meier analysis.
Results: The overall follow-up time for survival rate was up to 8.8 years. Nine implants (8 implants in maxilla and 1 implant in mandible) were lost, resulting in an overall cumulative implant survival rate of 96.3%. The axial or non-axial (tilted) placed implants resulted in a similar survival rate. Good soft tissue health was observed in almost 99% of patients. The final prosthesis survival rate was 100%.
Conclusion: The results of this retrospective study indicated that patients undergoing total edentulism due to poor prognosis of the remaining teeth were treated successfully by utilizing the immediate implant placement and loading.
Keywords: Dental implants, total edentulism, primary implant stability, chronic periodontitis, immediate loading

ÖZ
Amaç: Çekim sonrası implant yerleştirme, total dişsizliğe giden ve sabit-total restorasyonlar ara- yan hastalar için kabul edilen bir tedavi yöntemi haline gelmiştir. Genel kronik şiddetli periodon- titis (GCSP) gibi önceki periodontal durumun implant başarı oranı üzerinde olumsuz bir etkisinin olup olmadığı hala tartışmalı bir konudur. Bu nedenle bu çalışmanın amacı, implant destekli tam ark sabit rehabilitasyon arayan bir hastada GCSP'nin implant başarı oranlarını (SR'ler) etkileyip etkilemediğini belirlemektir.
Yöntemler: 55 ardışık GCSP hastası 272 implant yerleştirildi. Her bir çene, 23 alt çene ve 45 üst çene sabit-tam ark protezi ile tedavi edildi. Restorasyonların çoğunluğu (%95) arkadaki iki imp- lantın eğimli olduğu dört implantla desteklenmiştir. Tüm implantlar hemen çekim sonrasi yerleş- tirildi ve ameliyatın aynı günü geçici fonksiyonel akrilik protez teslim edildi. Tüm hastalar 8.8 yıla kadar takip edildi. Kümülatif hayatta kalma oranı Kaplan-Meier analizi kullanılarak belirlendi.
Bulgular: Implant başarı oranı için hastalar 8,8 yıla kadar takip edildi. Dokuz implant (maksillada 8 implant, mandibulada 1 implant) kaybedildi, bu da toplam kümülatif implant başarı oranının %96,3 olduğunu gösterdi. Dik ve eğimli implantlardaki implant başarı oranlari arasindaki fark istatistiksel olarak anlamlı değildi. Hastaların %99'unda sağlıklı yumuşak doku gözlendi. Daimi protez başarı oranı %100 idi.
Sonuç: Bu retrospektif çalışmanın sonuçları, umutsuz dişleri olan ve acil implant yerleştirme ve yükleme gerektiren hastaların All-on-4 konsepti kullanılarak başarılı bir şekilde tedavi edilebileceğini gösterdi.
Anahtar Kelimeler: Dental implantlar, total dişsizlik, ilk implant stabilitesi, kronik periodontitis, ani fonksiyon

Keywords

Dental implants, total edentulism, primary implant stability, chronic periodontitis

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