Dr Sowmya Salian post Graduate Student Department of Periodontics & Oral Implantology S.D.M Dental College Dharwad Dr Srinath Thakur Principal & Head of Department Dr Sudhindra.S.Kulkarni Professor
Dr Sowmya Salian post Graduate Student
Department of Periodontics & Oral Implantology
S.D.M Dental College Dharwad
Dr Srinath ThakurPrincipal & Head of Department
Dr Sudhindra.S.Kulkarni Professor
• The use of dental implants for dental restorations has revolutionized patient care and is increasing by the day.
• The concept of osseointegration has changed the very way in which we replace missing teeth…
• Its been proven beyond doubt that dental implant retained restorations enhance masticatory efficacy, quality of speech,stability of the existing prosthesis, provide outstanding esthetics along with reduced resorption of the alveolar ridge.
• As on date dental implants are possibly the best possible mode to replace missing teeth.
• The success of dental implants and its longevity is influenced by various factors..
• The dental implant success criteria have been proposed and revised over a period of time..
Schnitman 1979, Cranin 1982, McKinney RV 1984, Albrektsson 1986,1998, Smith & Zarb 1989
• “Implant success criteria” – by Albreksson et al.. has
been the “Gold Standard” while measuring the implant
success ..given way back in 1986.
• However with the change in implant design, surface
characteristics and technique of placement of dental
implants.. has necessitated newer definition for implant
success..
• 1993 .. James established.. Implant quality of health
scale.. Further .. Misch in 1993,1998.
• The International Congress Of Oral Implantologist
[ICOI] consensus conference on implant success
criteria contains a list of parameters to be checked
to call the implant as a success or a failure..
Misch et al 2008
• Patients visiting Department of Oral Implantology and
Periodontics, S.D.M. College of Dental Sciences and
Hospital, Dharwad.
SOURCE OF DATA
• This prospective, longitudinal Cohort study involved a
total of 30 sites in 20 subjects[11 male, 8 females] who
received implants from 1st January 2008 to 30th June 2009
…were evaluated.
• Informed written consent obtained …
PATIENT SELECTION CRITERIA:
• Patients undergoing implant therapy to replace
either single or multiple unit bridge and full mouth
restorations.
• All patients should have received and had
restored the implants with a minimum of 6 months
period.
• 1] Patients with any systemic conditions that may
influence the survival and success rates of the
dental implants.
• 2] Patients not agreeable to the terms of the study.
• 3] Patients with implants without restorations
All the implant sites were clinically evaluated :
• At the time of implant placement
• At the time of cementation
• At 6 months post cementation..
Implant characteristics
Diameter Length Bone quality around implant
Torque at implant placement
Grafting procedures
Clinical evaluation
1] Modified Plaque Index ; Mombelli et al 1987.
2] The distance between the implant shoulder and the
mucosal margin [DIM] in mm
3] Pocket Probing Depth [PPD] in mm
4] Probing attachment level [PAL] in mm which was
calculated by subtracting PPD from DIM.
5] Bleeding on probing [BOP].
6] Exudation
7] Pain
8] Mobility
Radiographs were obtained using a long cone
Technique and taken
• At the time of implant placement.
• At time of cementation
• At 6 months post cementation
To visualize the distance between the implant
shoulder and the crest of the alveolar bone.
IMPLANT SHOULDER
THREAD PITCH
Misch et al 2008
The statistical analysis was done using
• Student’s paired t-test.
• Wilcoxon matched pairs test.
• Karl Pearson’s correlation coefficient.
In the present study we found that :
• Around 35% of the implants sites had bleeding on
probing at the end of 6 months post cementation
• 78% of the sites had D2 bone quality and
• 20% of the implants had D3 bone quality at the
time of implant placement.
• 70% of implants .. mean diameter of 3.5 -4.3mm
mean length of about 10 -14mm.
• The implants had 35-40 Ncm2 of torque at the
time of placement.
• The mean probing depth was about 1-1.5mm
however it was around 2.5 mm at the end of
6 month post cementation.
Interval Mean p-value S
At implant placement 0.40 ± 0.89 0.00 S
At cementation 1.63 ± 0.42
At implant placement 0.40 ± 0.89 0.00 S
6 months post cementation
1.58 ± 0.44
At cementation 1.63 ± 0.42 0.73 NS
6 months post cementation
1.58 ± 0.44
NS= Non -Significant (p > 0.05), S= Significant (p < 0.05)
Table 1: Comparison of vertical bone levels (MESIAL) at the implant site at different time intervals
Interval Mean p-value S
At implant placement
0.40 ± 0.89
0.00 SAt cementation 1.73 ± 0.47
At implant placement
0.40 ± 0.89
0.00 S6 months post cementation
1.56 ± 0.34
At cementation 1.72 ± 0.47
0.13 NS6 months post cementation
1.56 ± 0.34
NS= Non -Significant (p > 0.05), S= Significant (p < 0.05)
Table 2: Comparison of vertical bone levels (DISTAL) at the implant site at different time intervals
Table 3: Comparison of mPI and GI at cementation and 6 months by wilcoxon matched pairs test
Table 4: Correlation Between Various Parameters And Marginal Bone Level
2
Table 4 [continued]: Correlation Between Various Parameters And Marginal Bone Level
Present study was carried out to evaluate the factors influencing the survival and success rate of dental implants… we found that
• We had 100% survival with optimum health of success as per the criteria laid down by … Misch et al 2008..
• Also found no correlation between implant diameter and crestal bone loss..• Increase in implant diameter … 3.5 fold reduction in crestal strain.. Petrie C.S et al 2002
• In our study it was found that there was no significant bone loss seen between final cementation and 6 month post cementation .. Misch et al 1999, Miyata et al 2000.
• Wilderman et al 1999.. Mean horizontal bone loss after osseous surgery … 0.8mm.
• We also could not find any significant correlation between the amount of torque and bone loss around implants.
•
• This may be : - All the surgeries done in D3 bone quality was done by modified drilling protocol. . Schnitmann et al 1979, Albreksson et al 1985 • Bone quality dental implant design minimizes overall implant failure and crestal bone loss.. Misch C1999
• Bone density .. Influences primary implant stability.. Important factor for implant success Turkyilmaz et al 2008
• Thus to conclude it can be said that all 30
implants in our study were very successful
and survived with a 100% survival rate and
were functioning in optimum health as per the
success criteria guidelines set by the ICOI
Pisa Consensus conference 2008
• Further long term prospective studies are required to
be done for more consistent long term data and results.
THANK YOU