Discussion : Study of implants (4)|palmerah.implantgigi.com

Discussion : Study of implants (4)

author: David French, H Michelle Grandin, Ronen Ofec | publisher: drg. Andreas Tjandra, Sp. Perio, FISID

However, the one‐stage tapered effect (TE) design was found to have increased initial MBL at base line (stage 2) (Figure 2C). For the TE design, the increased early MBL may be related to bone compression and a learning curve associated with placement of tapered implants. Two stage platform switch implants typically have bone loss of about 0.5 mm. For the bone level platform shift design, the initial MBL of about 0.2 mm was better than expected for a platform shift design (Figure 2C). Of note is that, despite the initial increase in MBL for the bone level design, the subsequent rate of change is comparable to the RN and WN polished collar designs.

Of the surgically related risk indicators, immediate implant loading and presence of a bone defect with bone grafting were found to have an effect on MBL. Immediate loading, within 48 hours, is found to have a significant effect on early MBL, in this case 0.08 mm (Figure 3A). This small increase in radiographic MBL may be explained by load concentrated at the crestal bone caused by micro‐mobility of early loaded non‐integrated implants. This may re‐mineralize as the implant becomes integrated and the micro‐mobility is reduced. Indeed, crestal bone seems to re‐establish over time as seen in Figure 3A, the slopes eventually intersect, which indicates that the early MBL is recovered and that the rate of MBL is not related to immediate loading. This is in keeping with other studies that found bone loss was not related to immediate loading despite having an effect on implant survival.

Bone grafting of an osseous defect at the time of implant placement was also found to be a significant risk indicator for bone loss, as evidenced by the similarity of initial bone loss together with a significant interaction over time (different slopes) shown in Figure 3B with more MBL in grafted sites when compared with native bone.

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