Posterior atrophic jaws rehabilitated

[av_one_full first min_height=“ vertical_alignment=“ space=“ custom_margin=“ margin=’0px‘ padding=’0px‘ border=“ border_color=“ radius=’0px‘ background_color=“ src=“ background_position=’top left‘ background_repeat=’no-repeat‘ animation=“]
[av_textblock size=“ font_color=“ color=“]
Title: Posterior atrophic jaws rehabilitated with prostheses supported by 5×5 mm implants with a novel nanostructured calcium-incorporated titanium surface or by longer implants in augmented bone. Preliminary results from a randomised controlled trial.

Journal: Eur J Oral Implantol 2012;5(2):149-161

Authors: Pietro Felice, Roberto Pistilli, Maurizio Piattelli, Elisa Soardi, Valeria Corvino, Marco Esposito


Purpose: To evaluate whether 5×5 mm dental implants with a novel nanostructured calcium-incorporated titanium surface could be an alternative to at least 10×5 mm long implants placed in bone augmented with bone substitutes in posterior atrophic jaws.

Materials and Methods: Forty patients with atrophic posterior (premolar and molar areas) mandibles having 5-7 mm bone height above the mandibular canal and 40 patients with atrophic maxillas having 4 to 6 mm below the maxillary sinus, were randomised according to a parallel group design to receive one to three 5×5 mm implants or one to three at least 10×5 mm long implants in augmented bone at 2 centres. Mandibles were vertically augmented with interpositional bovine bone blocks and resorbable barriers and implants were placed after 4 months. Maxillary sinuses were augmented with particulated porcine bone via a lateral window covered with resorbable barriers and implants were placed simultaneously. All implants were submerged and loaded after 4 months with provisional prostheses. Four months later, definitive screw-retained of provisionally cement metal-ceramic or zirconia prostheses were delivered. Outcome measures were: prosthesis and implant failures as well as any complication.

Results: Patients were followed to 4 months post-loading with the exception of one patient subjected mandibular augmentation who had a multiple complications at and after grafting and subsequent graft failure who did not want to go ahead with the treatment. This case was considered a complete failure. There were no statistically significant differences in prostheses and implant failures. In mandibles, apart the complete graft failure, one 10×5 mm implant, failed at placement of the provisional prosthesis. In maxillas one 5×5 mm implant failed with its provisional crown 3 months after loading. All complications occurred before loading. Significantly more intra- and post-operative complications occurred at both mandibular and maxillary grafted sites: 16 augmented patients were affected by complications versus 8 patients treated with short implants in the mandible and 5 sinus lifted patients versus none treated with maxillary short implants.

Conclusions: Short-term data (4 months after loading) indicate that 5×5 mm implants with achieved similar results than longer implants placed in augmented bone. Short implants might be a preferable choice to bone augmentation especially in posterior mandibles since the treatment is faster, cheaper and associated with less morbidity, however 5-10 years post-loading data are necessary before making reliable recommendations.

Key words: inlay graft, bone substitutes, short dental implants, sinus lift, vertical augmentation


MegaGen Newsletter

MegaGen Newsletter

Abonnieren Sie unseren Newsletter und bleiben Sie immer auf dem neuesten Stand.

Vielen Dank, dass Sie den Newsletter von MegaGen abonniert haben.