Comparing OsseoSpeed™ 4.0 S
6 mm with 11 mm implant length
P71
Homayoun Zadeh1, Richard Palmer2, Jan Wennström3, Felix Guljé4, Stephen Chen5, Clark Stanford6 , Jan Lindhe3
1University
of Southern California, USA; 2King’s College London, United Kingdom; 3The Sahlgrenska Academy, Sweden
de Mondhoek, The Netherlands; 5Balwyn Periodontic Center, Australia; 6University of Iowa, USA
4Praktijk
ABSTRACT
This randomized controlled study was initiated to evaluate the clinical performance of OsseoSpeed™ 4.0 S implants of
6 mm length compared to 11 mm, when replacing two or three missing teeth in the posterior region. The implants were
loaded 6 to 7 weeks after implant placement. This poster reports marginal bone level alterations 6 months after implant
installation for 39 patients (89 implants). Marginal bone level alterations 6 months after implant installation was -0.36 for
the 6 mm implant and -0.36 mm for the 11 mm implant. There was no statistically significant difference between the two
groups. This clinical study has been sponsored by Astra Tech AB, Mölndal, Sweden.
Figure 1. Pre-surgery, position 46 and 47
BACKGROUND AND AIM
There is a clinical need for using shorter implants in the posterior regions of both maxilla and mandible with limited
vertical bone height. This study was designed to compare the preservation of marginal bone when using Astra Tech
OsseoSpeed™ 4.0 S of 6 mm and 11 mm length, respectively. After randomization the implants were placed in the
posterior maxilla or mandible, utilizing an early loading protocol.
Figure 2. OsseoSpeed™ 4.0 S 6mm with
UniAbutment and ProHeal cap
MATERIALS AND METHODS
This randomized, controlled, international multi-center study is ongoing and was designed with specific inclusion and
exclusion criteria. Patients in need of replacing two or three missing teeth in the posterior maxilla or mandible, and with a
minimum of 11 mm vertical bone height, were eligible to the study. The patients were randomized to either short
implants (6 mm) or standard length implants (11 mm). All implants used in the study were 4.0 mm diameter
OsseoSpeed™. A one-stage surgical protocol was utilized for all implants with primary stability. UniAbutments with
ProHeal caps were used during the 6 to 7 weeks healing period. After healing screw-retained bridges were placed on
standard UniAbutments. All implants and study components were supplied by Astra Tech AB, Mölndal, Sweden.
Main inclusion criteria were edentulism in the study area for at least 4 months and presence of natural tooth root mesial to
the study area. Main exclusion criteria were smoking >10 cigarettes daily and a health status that would not allow implant
placement. Primary variable in the study is to compare marginal bone level alterations 5 years after implant placement.
Figure 3. Healing 7 days after surgery
Thus far, 61 patients with 137 implants have been treated at six different study centers (United Kingdom, Sweden, The
Netherlands, Australia and USA), and of these 39 patients with 89 implants have been followed for 6 months. Twentythree of the patients, with 54 implants, have been followed for 12 months.
RESULTS
Implant length
Time
Marginal bone levels six months after implant installation is
-0.36 and -0.36 mm for 6 and 11 mm, respectively.
6 mm
11 mm
Installation
45
44
Total
89*
12 months
32
22
54
*Only including patients having reached at least 6 months follow up
Of the 137 implants followed, complications are limited to
three lost implants (two 6 mm implants and one 11 mm
implant), equal to 97.8% total survival rate.
Graph 1. Marginal bone levels
4.0 S 6 mm
6OsseoSpeed™
mm
OsseoSpeed™
11
mm 4.0 S 11 mm
0,5
mm
One 6 mm implant did not achieve stability during installation
and was replaced with a longer implant.
Figure 4. Follow-up 12 months after surgery
Table 2. Distribution of implants
The study population represents a wide variety of patients
with respect to age (mean 53 years, ranging from 26 to 68
years), gender (51% male and 49% female) and smoking history
(8% smokers, 25% previous smokers, 67% non smokers).
Figure 5. X-ray of implant placement
0
Table 1. Bone quality and quantity of implant positions
Bone quantity
Bone quality
A
B
C
-0,5
D
E
Total
Loading
0
1
2
19
3
15
4
7
Total
41
9 (1)
23
4
2
3 (2)
35
6
32
2
42
3
2
15
5
2
89
Number of implants (lost implants within parenthesis)
-1,0
-2
-1
0
1
2
3
4
5
6
7
8
9
10
11
12
Figure 6. X-ray of temporary restoration 6 weeks
after surgery
Months from loading
At 12 months follow-up 54 implants have been radiographically examined
CONCLUSIONS
Early results from this randomized, controlled clinical study indicate that treatment with OsseoSpeed™ 4.0 S preserves
the marginal bone which is in agreement with data previously reported for OsseoSpeed™ implants1-5. This study also
indicates that treatment with short implants had no negative effects on maintaining marginal bone levels compared to
standard length implants.
Figure 7. X-ray follow-up 12 months after surgery
Both treatments were safe and predictable and this is in line with a previous review article by Renouard and Nisand6
showing that survival rates for short implants were similar to that of standard length implants.
CASE IMAGES, COURTESY OF DR. FELIX GULJÉ
REFERENCES
1. Donati et.al., Clin Oral Implants Res 2008;19:740-48
2) Steveling et.al., J Clin Periodontol 2009;36(Suppl 9):197
3) Stanford et.al., Appl Osseointegration Res 2008;7:49-57
4) Schliephake et.al., Appl Osseointegration Res 2006;5:56-58
5) Roediger et.al., J Dent Res 2009;84(Spec Iss A):3385
6. Renouard and Nisand, Clin Oral Implants Res 2006;17 Suppl 2:35-51