Bone Atrophy, Alveolar Clinical Trial
Official title:
Ultrasonic Preparation of the Implant Site in the All-on-Four Technique With Trans-sinus Implants
The objective of this observational study is the radiographic evaluation of marginal bone remodeling after surgical implant insertion in an immediate loading all-on-four technique with trans-sinusal titanium implants, correlating the gingival thickness and the height of the implant prosthetic stump with the proportion of the abovementioned marginal bone remodeling.
The extent of marginal bone remodeling around the neck of dental implants has been used for
many years as a criterion for defining its long-term success.
In fact, the etiology of this Marginal Bone Loss has not yet been well understood, although
many theories have been proposed to explain it.
The influence of the thickness of the mucous membrane on marginal bone loss was discussed
elsewhere which suggests a protective action for the underlying soft tissue that recreates a
kind of "biological amplitude" around the implant. Some studies have suggested that a
marginally oscillating bone loss between 1.5 and 2.0 mm provides the vertical space for
proper restoration of the biological amplitude. Some authors. published a study that
demonstrated that, in crestal systems with switching platforms, a vertical thickness of soft
tissue greater than 2 mm is effective in preventing periimplant crestal bone loss. However,
the severity of the sample examined precludes the possibility of making definitive
conclusions.
Recently other authors have shown significant marginal bone loss around implants with lower
prosthetic implants than those with higher prosthetic prostheses, without however measuring
the thickness of soft tissues and evaluating their influence. In particular, the extent of
bone loss was extremely limited when the height of the stump was equal to or greater than 2
mm. From a theoretical point of view, a prosthetic abutment of at least 2 mm high, calculated
from the apical margin of the crown to the platform of the implant, should provide adequate
space for restoring the biological amplitude.
It can therefore be hypothesized that these two factors (the vertical thickness of soft
tissues and the height of the prosthetic stump) are the expression of the same principle: the
restoration of the biological amplitude around the implant's neck. From a clinical point of
view it will be useful to determine which of the two factors is most important in preventing
and limiting periimplant bone loss.
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