Yerleştirme Sonrası İyileşme Başlığı ile Kapatılan İmplantlarda İlk Yılda Marjinal Kemik Kaybı Daha Az mı Görülür?

Yıl 2021, Cilt: 8 Sayı: 3, 652 - 657, 31.12.2021

Esra Beyler Nur Altıparmak Sıdıka Soydan

https://doi.org/10.15311/selcukdentj.749344

Öz

Amaç: İmplant tipinden bağımsız olarak iyileşme periyodu ve fonksiyondaki ilk yılda görülen erken dönem implant çevresi krestal kemik kaybı genellikle ilerleyen yıllarda oluşan kemik kaybından daha fazladır. Günümüze kadar, marjinal kemik kaybını etkileyen birçok faktör tanımlanmıştır. Bunlar; cerrahi travma, flapsiz ya da flap kaldırılan prosedürler, mikrogap, krestal implant modülü olarak sıralanmaktadır. Bu çalışmanın amacı; yerleştirme sonrası kapama vidası ile primer kapatılan implantlar ile iyileşme başlığı ile kapatılan implantların ilk yılda görülen implant çevresi kemik kaybına etkisini karşılaştırmaktır. Gereç ve Yöntemler: Bu prospektif çalışmaya 30 hasta dahil edilmiştir. Kemik seviyesi, “platform switch” özellikli, aynı marka, konik, posterior tek diş implantlar yerleştirilmiş hastalar iki gruba ayrılmıştır. Birinci grup, implant yerleştirilmesini takiben iyileşme başlığı takılan implantlardan oluşurken ikinci grupta implantlar kapama vidası ile primer olarak kapatılmıştır. Cerrahi öncesi, hemen sonrası ve 1 yıllık takip sonrası alınan panoramik radyograflar kemik kaybı değerlendirilmesinde kullanılmıştır. İmplant çevresi kemik kaybı miktarları, dijital olarak bilgisayar yazılımı aracılığıyla ölçülmüştür. Bulgular: Çalışmaya, iyileşme başlığı grubunda 14 adet ve kapama vidası grubunda 16 adet, toplamda 30 implant dahil edilmiştir. Perioperatif ve postoperatif dönemde herhangi bir komplikasyon görülmemiştir. Çalışma sonunda hiçbir implant başarısızlığı görülmemiştir. Birinci yıl sonrası iyileşme başlığı grubunda ortalama 0,7014 mm (0.2477 mm standart sapma) marjinal kemik kaybı görülürken, kapama vidası yerleştirilen ikinci grup implantlarda ortalama 1,3156 mm (0.0943 mm standart sapma) kemik kaybı ölçülmüştür. İki grup arasındaki 0,6142 mm’lik fark istatistiksel olarak anlamlı bulunmuştur. Sonuç: Yerleştirme sonrası kapama vidası yerine iyileşme başlığı yerleştirmek, krestal kemik üzerinde periost basıncını önleyerek özellikle ilk yılda görülen marjinal kemik kaybını önleyebilir.

Anahtar Kelimeler

Alveoler kemik kaybı, , Diş implantı, , tek diş, , Diş Kaybı

Destekleyen Kurum

Başkent Üniversitesi

Proje Numarası

D-KA19/27

Do implants closed with healing cap show less marginal bone loss after first year?

Öz

Background: Early peri-implant crestal bone loss during the healing period and the first year on function, is often greater than the bone loss occurring in the following years. Several factors affecting marginal bone loss have been described; such as surgical trauma, flapped or flapless procedures, occlusal overload, microgap and implant crest module. The aim of this study; was to compare the amount of first year peri-implant bone loss in implants closed with cover screw or healing cap. Material and Methods: Patients with same brand, posterior single tooth implants included in this prospective study and divided into two groups. In group I, after implant placement healing cap was placed while in group II, cover screw was placed before primary closure. Panoramic radiographs, taken before and after the implant surgery and after 1 year follow up, were used in bone loss evaluations. Peri-implant bone loss measurements were performed digitally in computer assisted software programme. Results: Thirty implants included in the study with fourteen implants in group I and sixteen implants in group II. There were no perioperative or postoperative complications and no implant failure in all patients. After the first year, mean marginal bone loss was 0.7014 mm (0.2477 mm standard deviation) in group I and 1.3156 mm (0.0943 mm standard deviation) in group II. This 0.6142 mm difference was found statistically significant. Conclusion: Placing healing cap instead of cover screws may prevent periosteal tissue pressure on the crestal bone and reduce the amount of marginal peri-implant bone in the first year.

Anahtar Kelimeler

Alveolar Bone Loss, Dental Implant, , Single-Tooth, , Tooth Loss

Proje Numarası

D-KA19/27

Kaynakça

• 1. Oh TJ, Yoon J, Misch CE, Wang HL. The causes of early implant bone loss: myth or science? Journal of periodontology. 2002;73(3):322-33.
• 2. Alshehri ADMA. The maintenance of crestal bone around dental implants. Implants. 2011;2:20-4.
• 3. Adell R, Lekholm U, Rockler B, Brånemark P-I. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. International journal of oral surgery. 1981;10(6):387-416.
• 4. Adell R, Lekholm U, Rockler B, Brånemark P, Lindhe J, Eriksson B, et al. Marginal tissue reactions at osseointegrated titanium fixtures:(I). A 3-year longitudinal prospective study. International journal of oral and maxillofacial surgery. 1986;15(1):39-52.
• 5. Cox J, Zarb G. The longitudinal clinical efficacy of osseointegrated dental implants: a 3-year report. International Journal of Oral & Maxillofacial Implants. 1987;2(2).
• 6. Jemt T, Lekholm U, Gröndahl K. 3-year followup study of early single implant restorations ad modum Brånemark. The International journal of periodontics & restorative dentistry. 1990;10(5):340-9.
• 7. Albrektsson T, Zarb G, Worthington P, Eriksson A. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int j oral maxillofac implants. 1986;1(1):11-25.
• 8. Smith DE, Zarb GA. Criteria for success of osseointegrated endosseous implants. The Journal of prosthetic dentistry. 1989;62(5):567-72.
• 9. Cassetta M. Immediate loading of implants inserted in edentulous arches using multiple mucosa-supported stereolithographic surgical templates: a 10-year prospective cohort study. International journal of oral and maxillofacial surgery. 2016;45(4):526-34.
• 10. Esposito M, Hirsch JM, Lekholm U, Thomsen P. Biological factors contributing to failures of osseointegrated oral implants,(I). Success criteria and epidemiology. European journal of oral sciences. 1998;106(1):527-51.
• 11. Serino G, Sato H, Holmes P, Turri A. Intra‐surgical vs. radiographic bone level assessments in measuring peri‐implant bone loss. Clinical oral implants research. 2017;28(11):1396-400.
• 12. Hollender L, Rockler B. Radiographic evaluation of osseointegrated implants of the jaws. Dentomaxillofacial Radiology. 1980;9(2):91-5.
• 13. SEWERIN IP. Errors in radiographic assessment of marginal bone height around osseointegrated implants. European Journal of Oral Sciences. 1990;98(5):428-33.
• 14. Cassetta M, Di Giorgio R, Barbato E. Are intraoral radiographs reliable in determining peri-implant marginal bone level changes? The correlation between open surgical measurements and peri-apical radiographs. International journal of oral and maxillofacial surgery. 2018;47(10):1358-64.
• 15. Zechner W, Watzak G, Gahleitner A, Busenlechner D, Tepper G, Watzek G. Rotational panoramic versus intraoral rectangular radiographs for evaluation of peri-implant bone loss in the anterior atrophic mandible. International Journal of Oral & Maxillofacial Implants. 2003;18(6).
• 16. Gutmacher Z, Machtei EE, Hirsh I, Zigdon-Giladi H, Horwitz J. A comparative study on the use of digital panoramic and periapical radiographs to assess proximal bone height around dental implants. Quintessence International. 2016;47(5).
• 17. Vazquez L, Nizamaldin Y, Combescure C, Nedir R, Bischof M, Dohan Ehrenfest D, et al. Accuracy of vertical height measurements on direct digital panoramic radiographs using posterior mandibular implants and metal balls as reference objects. Dentomaxillofacial Radiology. 2013;42(2):20110429.
• 18. Weber HP, Crohin CC, Fiorellini JP. A 5‐year prospective clinical and radiographic study of non‐submerged dental implants. Clinical Oral Implants Research. 2000;11(2):144-53.
• 19. Cochran DL, Jackson JM, Jones AA, Jones JD, Kaiser DA, Taylor TD, et al. A 5‐year prospective multicenter clinical trial of non‐submerged dental implants with a titanium plasma‐sprayed surface in 200 patients. Journal of periodontology. 2011;82(7):990-9.
• 20. Ferrigno N, Laureti M, Fanali S, Grippaudo G. A long‐term follow‐up study of non‐submerged ITI implants in the treatment of totally edentulous jaws: Part 1: Ten‐year life table analysis of a prospective multicenter study with 1286 implants. Clinical Oral Implants Research. 2002;13(3):260-73.
• 21. Mericske‐Stern R, Grütter L, Rösch R, Mericske E. Clinical evaluation and prosthetic complications of single tooth replacements by non‐submerged implants. Clinical Oral Implants Research. 2001;12(4):309-18.
• 22. Romeo E, Lops D, Margutti E, Ghisolfi M, Chiapasco M, Vogel G. Long-term survival and success of oral implants in the treatment of full and partial arches: a 7-year prospective study with the ITI dental implant system. International Journal of Oral & Maxillofacial Implants. 2004;19(2).
• 23. Sánchez‐Siles M, Muñoz‐Cámara D, Salazar‐Sánchez N, Camacho‐Alonso F, Calvo‐Guirado JL. Crestal bone loss around submerged and non‐submerged implants during the osseointegration phase with different healing abutment designs: a randomized prospective clinical study. Clinical oral implants research. 2018;29(7):808-12.
• 24. Naveau A, Shinmyouzu K, Moore C, Avivi-Arber L, Jokerst J, Koka S. Etiology and measurement of peri-implant crestal bone loss (CBL). Journal of clinical medicine. 2019;8(2):166.
• 25. Wilderman MN, Pennel BM, King K, Barron JM. Histogenesis of repair following osseous surgery. Journal of periodontology. 1970;41(10):551-65.
• 26. Misch CE, Dietsh-Misch F, Hoar J, Beck G, Hazen R, Misch CM. A bone quality–based implant system: first year of prosthetic loading. Journal of Oral Implantology. 1999;25(3):185-97.
• 27. Hagiwara Y. Does platform switching really prevent crestal bone loss around implants? Japanese Dental Science Review. 2010;46(2):122-31.
• 28. Molina A, Sanz‐Sánchez I, Martín C, Blanco J, Sanz M. The effect of one‐time abutment placement on interproximal bone levels and peri‐implant soft tissues: a prospective randomized clinical trial. Clinical oral implants research. 2017;28(4):443-52.
• 29. Praça L, Teixeira RC, Rego RO. Influence of Abutment Disconnection on Peri‐implant Marginal Bone Loss: a randomized clinical trial. Clinical Oral Implants Research. 2020.