engleski

Immediate implant loading in augmented sites: Mission (Im)possible?

Sažetak/Abstract: INTRODUCTION: High success rates, progress in therapy and technical innovations provided cause for accelerated implant protocols. For some patients implant treatment would not be an option without bone augmentation but they often insist on immediate restoration. AIM: Assessment of possibilities and success rates of implant placement and immediate restoration in augmented sites. MATERIALS AND METHODS: 14 patients with maxillary single tooth replacement in sites augmented due to one-wall horizontal bone defects. In six patients horizontal augmentation (bovine bone particulate and resorbable membrane) was done 4-6 months prior to implant placement, while in eight patients the site was grafted at time of placement. All patients received immediate provisional crown without occlusal contacts after the ISQ measurement (Ostell Mentor, Sweden) showed value over 65. The ISQ value measurement was repeated at time of definitive restoration, which was no less than 6 months after implant placement. Control group consisted of 18 patients restored by maxillary single tooth implants following the same protocol but without augmentation procedures. RESULTS: No significant differences were determined between the group of patients undergone augmentation at time of implant and crown placement and the control group (p=0.68). The group with augmented sites prior to implant placement demonstrated somewhat lower ISQ values at both measurements compared to controls, but with no significant difference (p=0.057). One implant was lost after 1.5 months due to poor hygiene. CONCLUSIONS: The study suggests that limited horizontal bone augmentation with bovine bone particulate can offer predictable results even in cases of immediate provisional restoration. However, the study is based on limited patient number. Therefore, definitive conclusions cannot be drawn concerning survival and success rates of immediately loaded implants compared with conventionally loaded implants in augmented sites. More high-level evidence-based studies are needed to demonstrate the relative merits of immediate loading in such cases.

immediately loaded implants; horizontal bone augmentation

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