and 1 other(s)
Background Implant-supported rehabilitation of the edentulous posterior jaws can be a challenging situation due to a relevant atrophy of the residual bone. An alternative approach to bone regenerative procedures is the use of short implants (intrabony implant length greater than or equal to 6 mm). It represents a less-invasive treatment with growing evidence of acceptable long-term survival rates. Aim To evaluate the survival and the marginal bone loss of 5 mm and 6 mm short implants supporting conventionally and immediately non functionally loaded fixed rehabilitations. Data are presented at 1 and 2-year follow-up from the prosthetic loading. Materials and Methods 36 patients were consecutively included. Inclusion criteria were the absence of one or more maxillary or mandibular molar and premolar associated to alveolar bone atrophy (height between 6 mm and 8 mm, width at least 8 mm). Fifty-six 5mm and 6mm short implants were positioned (of these, 17 implants immediately non functionally loaded in 13 patients). Implants were positioned subcrestally and were treated with 4.1 mm immediate platform switching applied to the cover screw if submerged, healing screw or prosthetic abutment when not submerged or immediately loaded. Implant survival and marginal bone loss (MBL) were measured at 1 and 2-year follow-up from the prosthetic loading. Anatomical crown to implant (C/I) ratio was measured as well. The correlations between MBL and the use of low profile abutments, C/I ratio and single/multiple units restorations were assessed using mixed statistical models. Resultats The analysis included 11 males and 25 females (median age 62 years, IQR 54-68). Loading was immediate in 17 implants (30%). Low profile abutment was used in 18 implants (32%). Mean C/I ratio was 2.5 (SD 0.6). Implant-based survival was 96% at 1 year (immediate loading 94%; conventional loading 97%) and 88% at 2 years (immediate loading 94%; conventional loading 85%). 4 of these implant failures occurred in 1 patient between the first and the second year after conventional loading. Mean MBL was 0.17 mm (SD 0.30) at 1 year and 0.22 (SD (0.33) at 2 years. MBL at 1 year was not associated with immediate loading (mean difference 0.06 mm, 95%CI -0.25 to 0.13; p=0.54) vs traditional loading. MBL at 2 year was not associated with immediate loading (mean difference 0.06 mm, 95%CI -0.28 to 0.16; p=0.61) vs traditional loading. Low profile was not associated with MBL at 1 year (p=0.42) or at 2 years (p=0.72). C/I ratio was not associated with MBL at 1 year (p=0.42) or at 2 years (p=0.69). Conclusions and Clinical Implications Within the limitations of this case series, short implants showed acceptable survival rate and MBL. Comparable results were observed between immediate and conventional loading. Further evaluations with a longer follow up are required.
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