COMPARATIVE STU D Y O F T W O TA P E R E D I M P L A N T S P L A C E D
WITH THE SAME GU I D E D S U R G E RY P R O TO C O L F O L L O W E D B Y
IMMED I AT E L O A D I N G I N T H E M A X I L L A
D r. Pe d r o Pe ñ a M D, D D S , O. S u r g
D r. R a m ó n Pa l o m e r o. M D, O M S
D r. R a m ó n Pa l o m e r o. J r D D S
D r. R a f a e l A r e s e s . M D D D S
PSN-EAO09PS1-346
Results
Abstract
- In the last few years Computer Guided Surgery has become one of the
most popular treatment modalities. Some implant companies have developed
their own implant guided surgery system.
- In this study we took the advantage of a single implant surgical drilling
protocol (Nobel-Guide; Nobelbiocare Sweden) to compare two different
implant systems with slight macro-design changes and a completely different
titanium surface (Ti-Unite and SBM)
- This is a multicenter clinical study with four clinics and 6 clinicians involved.
The group have selected 73 healthy patients to join the study. Selection
criteria includes non smokers with good oral health and sufficient healing
time after tooth extraction (min 3 months).
- After treatment planning, implants were placed following the same surgical
and immediate loading protocol. Panoramic X-rays were taken the day of
surgery and at intervals of 6 , 12 and 18 months respectively.
48
36%
64%
373
NB / ID
Men/Women
2%
13%
Background and Aim
87%
- In order to test the null hypothesis that two different implants cannot
have the same clinical behaviour when placed under the same surgical
and loading protocol, random placement of two different implants side by
side was done.
- A total of 73 surgeries was performed in four clinical centers with
the biggest observation period of 29 months and the lowest being
3 months.
NB % of failures
1%
Methods and Materials
- A total of 73 maxillary, partial or fully edentulous healthy patients were selected for
the study .
- In each case one or two Nobelbiocare Replace implants (control) were randomly
selected for placement in one or two locations. These implants were used to further
stabilize the Surgical Guide with a Template abutment.
- The balance of the implants placed were Replant Implant Direct (test).
- All of them were placed following the same Nobel-guide surgical protocol and
immediately loaded within 24-48h frame time. Panoramic X Rays were taken the day
of surgery, and at 6 , 12 and 18 months period.
- All the implants were tested to fulfil the success criteria given by Alberktsson
including no bone loss, no mobility, no swelling, no pain, good looking and healthy
mucosa and no X-ray images surrounding any implant device.
Texto
421
99%
ID % of failures
Total % of failures
- Of the 73 patients treated, 47 were women and
26 were men and a total of 421 implants were
placed.
- The longest observation period was 26 months
and the minimum was 3 months.
- A total of 9 implants failed from the 421 implants
placed. 6 were Replace (Nobelbiocare) and 3 were
RePlant (Implant Direct).
- The percentage failure rate is 2%, with all
patients being able to wear their planned final
prosthesis.
CONCLUSIONS
- The present experiment failed to prove that two different implants
with similar body shape (one with double-lead threads and cervical
micro threads and the other not) and two different surface
enhancements (Ti-Unite/ Soluble Blast Media), would have the
same clinical outcome
- It can be stated then that both implant systems can successfully
be used with the same Stereo-lithography (SLA) method of
surgical guide manufacture
- The percentage of failures is in agreement with previous studies,
but when separated by product families (Replace vs. RePlant)
Ti Unite (Oxidized treated) implants failed 13 times more than
Ti SBM treated implants.
- The failure differential can be attributed to the surface treatment
and how it responds in maxillary bone and/or the slight thread
design change over the length of the implant .
- More experiments need to be conducted to further study these
results.
References
1. Accuracy of template-based dental implant placement, Int J Oral Maxillofac Implants. 2009 May-Jun;24(3):447-54.
2. Accuracy of computer-aided oral implant surgery: a clinical and radiographic study, Int J Oral Maxillofac Implants 2009
Mar-Apr;24(2):234-42.
3. Computer-guided flapless surgery: immediately loaded implant-prosthetic rehabilitation.Minerva Stomatol. 2009 Mar;
58(3):115-26.
4. Misfit of implant fixed complete denture following computer-guided surgery; IJOMI 2009 Jan-Feb;24(1):124-30
Presented at the 18th Annual Scientific Meeting of the European Association of Osseointegration – 30 September-3 October 2009, Monaco, France
jueves 24 de septiembre de 2009