engleski

Complications in accelerated single implant placement and loading - biological reintegration

Background: Clinical complications during accelerated implant protocols are not uncommon and vary from reduction in implant stability to complete loss of osseointegration and that of implant. Clinical cases demonstrate that implant stability reduction does not necessarily lead to implant loss. Excess loading has been cited as a reason for the failure of dental implants or bone loss post- osseointegration. In early loaded implants osseointegration is not complete but implant stability can be satisfactory for restoration. Despite of adequate implant stability, after early loading significant stability dip can occure, but if recognized early enough it does not necessarily affect the final treatment outcome. Aim: The goal of the present documentations is to demonstrate the clinical manifestations of early loaded implant complications as well as possibilities of osseous and soft tissue reintegration. Material and methods: Four cases of early loaded single tooth implants placed in maxilla are presented where implants were loaded 6 weeks after placement. Implant mobility 3-6 weeks after crown placement was the only sign of pathology, no plaque or periimplant tissue inflamation was present. In all four cases the crowns were replaced by temporaries with no occlusal contacts and patients followed strickt maintentance instructions and regular 2-week check-ups. After 6 months the temporaries were removed, ISQ measurement performed and values over ISQ 75 were determined so definitive crowns were made again. Another 6 months after definitive crowns placement new ISQ measurement confirmed stability increase of 15-22%. Soft tissue stability was evaluated clinically and by using standardized photographs. Results: Osseous and soft tissue reintegration was achieved after removal of functional occlusal loading from implants demonstrating mobility. No inflamation was determined in periimplant tissue and no plaque accumulation was present during the healing period. Conclusions and clinical implications: The four cases documentations and presentation demonstrated significant stability dip after early functional loading, but without the bacterial induced peri-implant tissue inflamation. With absence of functional occlusal loading the biological implant reintegration occured in four cases specific for the absence of plaque related inflamation. It seemes that early loading in some cases can be considered overloading and treated as such. The explanation of the process cannot be done in clinical trials but rather through case reporting of clinical complications.

complications; accelerated implant protocols; loading

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