Results : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [1]
The first results of this longitudinal study include data from 9 patients with an average age of 57 years (range from 44 to 80) in whom 30 implants were inserted (maxilla n = 15, mandible n = 15). All 30 implants in the 9 patients could be inserted without intraoperative problems. Based on intraoperative and radiological findings, the bone quality was assessed as follows: D1 in n = 2, D2 in n = 3, D3 in n = 2 and D4 in n = 2 cases. The employed implant dimensions were as follows: 4.1 × 5 mm (n = 2), 4.1 × 6 mm (n = 1), 4.1 × 7 mm (n = 10) and 3.75 × 7 mm (n = 17). The expansion process could successfully be performed in every case. The healing period was uneventful. Patients were rehabilitated with fixed dentures in 5 cases and with removable dentures in 4 cases. Basic clinical characteristics are summarised in detail in Table 4.
Over the 3-year follow-up period, the overall cumulative implant success rate in these patients was 28/30 (93.3%). Two implants were lost in the posterior maxilla. The two affected patients had highly atrophic posterior maxillae (Cawood et Howell IV–V) [38] and a bone quality of D3–D4 (Table 4). The male patient was a smoker and suffered from a squamous cell carcinoma of mouth floor. In both cases, the manufactured removable denture was successfully relined and no technical complications were observed to date.
The Kaplan-Meyer analysis of implant survival for both jaws is visualised in Fig. 2 (log rank test, p = 0.173): 1-year survival 96.7% and 2-year survival 93.3%. The 3-year follow-up has not yet been completed by all patients (Table 4).
Measurements of implant stability by resonance frequency analysis (RFA) displayed the following ISQ values: primary stability 69.7 ± 10.3 95% CI (65.9; 73.6) ISQ units and secondary stability 69.8 ± 10.2 95% CI (65.8; 73.5) ISQ units (Fig. 3a, b). The differences were not statistically significant (p = 0.780; paired t test). In detail, the ISQ values for primary stability displayed in the maxilla 66.9 ± 8.9 95% CI (61.9; 71.8), and in the mandible 72.5 ± 11.1 95% CI (66.4; 78.7). The differences were not statistically significant (p = 0.134; independent t test). According to the measurement of secondary implant stability, we observed comparable ISQ values in the maxilla 66.4 ± 10.0 95% CI (60.9; 71.9) and higher ISQ values in the mandible 73.0 ± 9.7 95% CI (67.6; 78.4). The differences were as well not statistically significant (p = 0.780; independent t test).
Serial posts:
- Abstract : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- Introduction : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [1]
- Introduction : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [2]
- Material and methods : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [1]
- Material and methods : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [2]
- Material and methods : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [3]
- Results : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [1]
- Results : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [2]
- Discussion : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [1]
- Discussion : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [2]
- Discussion : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [3]
- Discussion : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [4]
- Discussion : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [5]
- Conclusion : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- Abbreviations : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- References : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [1]
- References : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [2]
- References : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [3]
- References : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [4]
- References : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [5]
- References : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [6]
- References : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [7]
- Acknowledgements : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- Author information : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [1]
- Author information : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [2]
- Ethics declarations : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- Additional files : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- Rights and permissions : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- About this article : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- Table 1 Patient recruitment : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- Table 2 Surgical treatment protocol : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- Table 3 Prosthetic treatment protocol : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- Table 4 Clinical characteristics of the study cohort : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- Fig. 1. a Closed short expandable dental implant (4.1 × 7 mm). The implant-abutment connection is characterised by an internal hexagon for rotation stability, combining the advantages of conical and parallel surfaces to reduce microgaps and micromovement [68]. The microthread concept and platform switching concept are implemented in the implant shoulder to reduce periimplant bone strain [53]. b Manual fixation of the expansion tool. Take note of the distance between both yellow rings. c Completion of the expansion process using the ratchet. Take note of the contact between both yellow rings. d Opened short expandable dental implant (4.1 × 7 mm). The expanded implant provides an increased bone-to-implant interface (pyramid shape) in the apical portion [54]. e Cross-section view of the implant apex. The apical expansion process is characterised by the unfolding of four wings, which are connected by four foils. D1: diameter of the closed implant. D2: diameter of the opened implant. fTop v
- Fig. 2. Cumulative implant survival over the follow-up period. The Kaplan-Meyer diagram visualises the analysis of implant survival in the maxilla and in the mandible (log rank test, p = 0.173) over the follow-up period up to 37 months (Table 4) : Novel expandable short dental implant
- Fig. 3. a Primary implant stability. The histogram visualises the distribution of the implant stability quotients (ISQ) for both jaws measured by resonance frequency analysis (Osstell AB, Göteborg, Sweden). b Secondary implant stability. The histogram shows the distribution of the implant stability quotients (ISQ) of osseointegrated implants. According to the measurement implant stability was classified as low with ISQ values < 60, medium with ISQ values 60–70, and high with values ISQ > 70 [34] : Novel expandable short dental implant
- Fig. 4. a–h Prosthetic restauration—follow-up examination. Intraoral and perioral views of a rehabilitated female patient. (She asked explicitly only for implantological treatment in the mandible.) : Novel expandable short dental implant
- Fig. 5. a Postoperative orthopantomogram. b Follow-up orthopantomogram. c Follow-up standard periapical radiogram (implants i42 and i44). d Follow-up standard periapical radiogram (implants i32 and i34) : Novel expandable short dental implant