Marginal Bone Loss and Treatment Complications with Mandibular Overdentures Retained by Two Immediate or Conventionally Loaded Implants—A Randomized Clinical Trial
Abstract
:1. Introduction
2. Materials and Methods
2.1. Surgical Protocol
2.2. Evaluation of Complications
2.3. Data Analysis
3. Results
3.1. Sample Description
3.2. Distribution and Characteristics of the Placed Implants
4. Discussion
4.1. Bone Loss Assessment
4.2. Implant Stability
4.3. Implant Failure
4.4. Complications
4.5. Limitations and Continuity
5. Conclusions
- There were no differences in marginal bone loss observed at one year in immediately loaded (0.40 ± 0.39 mm) versus conventionally loaded (0.44 ± 0.36 mm) implants placed for the retention of mandibular overdentures.
- There were no differences in primary and secondary stability of immediately loaded versus conventional implants; however, in the conventional loading group, stability increased significantly between the time of implant placement at both 6 and 12 months post-placement.
- The main predictive factor for implant failure as well as marginal bone loss is bone quality (β = 13.61; 95% CI: 1.3–25.8).
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Implant Size | All Patients (n = 20 Patients with 40 Implants) | Immediate Loading Group (n = 10 Patients with 20 Implants) | Conventional Loading Group (n = 10 Patients with 20 Implants) | |||
---|---|---|---|---|---|---|
Diameter | N | % | N | % | N | % |
3.3 mm | 7 | 17.5 | 3 | 15.0 | 4 | 20.0 |
3.75 mm | 23 | 57.5 | 13 | 65.0 | 10 | 50.0 |
4.2 mm | 10 | 25.0 | 4 | 20.0 | 6 | 30.0 |
Length | N | % | N | % | N | % |
10 mm | 14 | 35.0 | 5 | 25.0 | 9 | 45.0 |
11.5 mm | 22 | 55.0 | 13 | 65.0 | 9 | 45.0 |
13 mm | 4 | 10.0 | 2 | 10.0 | 2 | 10.0 |
Baseline | All Patients (n = 20 Patients with 40 Implants) | Immediate Loading Group (n = 10 Patients with 20 Implants) | Conventional Loading Group (n = 10 Patients with 20 Implants) | |||
---|---|---|---|---|---|---|
Implant insertion torque at different sites | Mean | SD | Mean | SD | Mean | SD |
#33 | 62.9 | 14.4 | 64.5 | 13.8 | 61.2 | 15.5 |
#43 | 64.0 | 13.0 | 65.9 | 11.9 | 62.0 | 14.4 |
Average | 63.5 | 13.1 | 65.2 | 12.1 | 61.7 | 14.4 |
Implant stability by ISQ | Mean | SD | Mean | SD | Mean | SD |
#33 | 69.1 a | 7.3 | 69.2 a | 6.7 | 69.0 a | 8.1 |
#43 | 71.7 a | 8.6 | 72.3 a | 10.3 | 71.0 a | 6.9 |
Average | 70.4 a | 5.9 | 70.8 a | 6.8 | 70.0 a | 5.3 |
Averaged Crestal position (aggregating mesial and distal sides of both implants) | N | % | N | % | N | % |
Subcrestal | 6 a | 30.0 | 2 a | 20.0 | 4 a | 40.0 |
Crestal | 7 a | 35.0 | 4 a | 40.0 a | 3 a | 30.0 |
Supracrestal | 7 a | 35.0 | 4 a | 40.0 | 3 a | 30.0 |
At 2 months of follow-up | ||||||
Implant stability by ISQ | Mean | SD | Mean | SD | Mean | SD |
#33 | 67.0 a | 10.3 | 66.9 a | 12.5 | 67.1 a | 8.3 |
#43 | 72.8 a | 4.8 | 72.7 a | 6.2 | 72.9 a | 3.3 |
Average | 69.9 a | 5.8 | 69.8 a | 7.2 | 70.0 a | 4.3 |
Percentage of healthy gingival sites | 57.5 a | 46.7 | 65.0 a | 47.4 | 50.0 a | 47.1 |
At 6 months of follow-up | ||||||
Implant stability by ISQ | Mean | SD | Mean | SD | Mean | SD |
#33 | 71.9 a | 4.3 | 73.0 a | 5.2 | 70.9 a | 3.0 |
#43 | 72.9 a | 4.5 | 72.8 a | 5.8 | 72.9 a | 3.1 |
Average | 72.8 b | 4.1 | 73.3 a | 5.2 | 72.3 b | 2.8 |
Percentage of healthy gingival sites | 55.0 a | 45.6 | 60.0 a | 46.0 | 50.0 a | 47.1 |
At 12 months of follow-up | ||||||
Implant stability by ISQ | Mean | SD | Mean | SD | Mean | SD |
#33 | 72.9 b | 6.0 | 71.4 a | 7.4 | 74.6 b | 3.9 |
#43 | 73.7 b | 5.0 | 73.5 a | 5.2 | 73.8 a | 5.0 |
Average | 73.5 b | 4.8 | 72.8 a | 5.7 | 74.2 b | 3.9 |
Percentage of healthy gingival sites | 87.5 b | 22.2 | 100.0 b | 0.0 | 75.0 a | 26.4 |
Averaged Crestal position (aggregating mesial and distal sides of both implants) | N | % | N | % | N | % |
Subcrestal | 3 b | 15.0 | 2 a | 20.0 | 1 b | 10.0 |
Crestal | 4 b | 20.0 | 2 a | 20.0 | 2 b | 20.0 |
Supracrestal | 13 b | 65.0 | 6 a | 60.0 | 7 b | 70.0 |
All Patients (n = 20 Patients with 40 Implants) | Immediate Loading Group (n = 10 Patients with 20 Implants) | Conventional Loading Group (n = 10 Patients with 20 Implants) | ||||
---|---|---|---|---|---|---|
Baseline Implant shoulder position (mm) | Mean | SD | Mean | SD | Mean | SD |
#33 | −0.08 | 0.63 | 0.00 | 0.61 | −0.17 | 0.67 |
#43 | −0.06 | 0.46 | −0.05 | 0.28 | −0.08 | 0.60 |
All implants | −0.08 | 0.51 | −0.03 | 0.40 | −0.13 | 0.62 |
Final Implant shoulder position (mm) | Mean | SD | Mean | SD | Mean | SD |
#33 | 0.45 | 0.85 | 0.47 | 0.87 | 0.44 | 0.88 |
#43 | 0.21 | 0.59 | 0.29 | 0.42 | 0.14 | 0.74 |
All implants | 0.34 | 0.68 | 0.38 | 0.60 | 0.30 | 0.68 |
Marginal Bone Loss (mm) | Mean | SD | Mean | SD | Mean | SD |
#33 | 0.54 | 0.50 | 0.47 | 0.53 | 0.61 | 0.50 |
#43 | 0.28 | 0.30 | 0.34 | 0.33 | 0.22 | 0.26 |
All implants | 0.4 | 0.37 | 0.40 | 0.39 | 0.44 | 0.36 |
CI 95% | CI 95% | CI 95% | ||||
lower limit | upper limit | lower limit | upper limit | lower limit | upper limit | |
Averaged Marginal Bone loss (mm) | 0.25 | 0.59 | 0.12 | 0.68 | 0.19 | 0.69 |
Mean | SD | Mean | SD | Mean | SD | |
Months of follow-up | 13.4 | 2.1 | 13.2 | 2.1 | 13.5 | 2.1 |
Short-Term Complications | All Patients (n = 20) | Immediate Loading Group (n = 10) | Conventional Loading Group (n = 10) | |||
---|---|---|---|---|---|---|
Prevalence | N | % | N | % | N | % |
Biological A | 10 | 50.0 | 4 | 40.0 | 6 | 60.0 |
Mechanical B | 5 | 25.0 | 3 | 30.0 | 2 | 2.0 |
None | 5 | 25.0 | 3 | 30.0 | 2 | 2.0 |
Number of complications | Mean | SD | Mean | SD | Mean | SD |
Average complications | 1.0 | 0.9 | 1.1 | 1.1 | 0.8 | 0.6 |
Biological complications | 0.8 | 0.8 | 0.8 | 1.0 | 0.8 | 0.6 |
Mechanical complications | 0.4 | 0.5 | 0.5 | 0.5 | 0.3 | 0.5 |
Prevalence of complications | ||||||
Type of complications | N | % | N | % | N | % |
Uneventful treatment | 7 | 35.0 | 4 | 40.0 | 3 | 30.0 |
Prosthetic complications | 13 | 65.0 | 6 | 60.0 | 7 | 70.0 |
Minor C | 8 | 40.0 | 5 | 50.0 | 3 | 30.0 |
Major D | 6 | 30.0 | 4 | 40.0 | 2 | 20.0 |
Biological complications | 12 | 60.0 | 5 | 50.0 | 7 | 70.0 |
Implant Failure | 4 | 20.0 | 2 | 20.0 | 2 | 20.0 |
Mean | SD | Mean | SD | Mean | SD | |
Failure Ratio(%) E | 11.2 | 25.9 | 8.3 | 18.0 | 14.0 | 32.7 |
Event Rate Per 100 Yrs F | Mean | CI-95% | Mean | CI-95% | Mean | CI-95% |
Total | 5.4 | 3.4–7.3 | 5.6 | 2.3–9.0 | 5.1 | 2.4–7.9 |
Prosthetic | 1.9 | 0.8–3.0 | 2.2 | 0.5–4.0 | 1.5 | −0.2–3.2 |
Biological | 3.5 | 1.9–5.2 | 3.4 | 0.5–6.3 | 3.6 | 1.4–5.9 |
Implant failure | 1.1 | −0.1–2.3 | 0.8 | −0.5–2.1 | 1.4 | −0.9–3.7 |
Dependent Predictors | β | Error | T | p-Value | Lower CI 95% | Upper CI 95% |
---|---|---|---|---|---|---|
Implant Failure a | ||||||
Bone Quality | 13.61 | 12.7 | 2.4 | 0.03 | 1.3 | 25.8 |
Prosthetic Complications b | ||||||
Averaged insertion torque | 0.13 | 0.05 | 2.4 | 0.03 | 0.01 | 0.24 |
Biological Complications c | ||||||
Minor prosthetic complications | 1.11 | 0.4 | 2.4 | 0.04 | 0.1 | 2.0 |
Marginal Bone Loss d | ||||||
Bone Quality | −0.59 | 0.21 | −2.8 | 0.01 | −0.15 | −1.02 |
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Pardal-Peláez, B.; Dib, A.; Guadilla, Y.; Flores-Fraile, J.; Quispe-López, N.; Montero, J. Marginal Bone Loss and Treatment Complications with Mandibular Overdentures Retained by Two Immediate or Conventionally Loaded Implants—A Randomized Clinical Trial. Prosthesis 2023, 5, 295-309. https://doi.org/10.3390/prosthesis5010022
Pardal-Peláez B, Dib A, Guadilla Y, Flores-Fraile J, Quispe-López N, Montero J. Marginal Bone Loss and Treatment Complications with Mandibular Overdentures Retained by Two Immediate or Conventionally Loaded Implants—A Randomized Clinical Trial. Prosthesis. 2023; 5(1):295-309. https://doi.org/10.3390/prosthesis5010022
Chicago/Turabian StylePardal-Peláez, Beatriz, Abraham Dib, Yasmina Guadilla, Javier Flores-Fraile, Norberto Quispe-López, and Javier Montero. 2023. "Marginal Bone Loss and Treatment Complications with Mandibular Overdentures Retained by Two Immediate or Conventionally Loaded Implants—A Randomized Clinical Trial" Prosthesis 5, no. 1: 295-309. https://doi.org/10.3390/prosthesis5010022