Alveolar Bone Loss Clinical Trial
Official title:
The Comparison of Narrow and Regular Platform Dental Implants Placed Posterior Regions
The study was designed as a retrospective, parallel, two years longitudinal pilot trial. Twenty-eight patients (mean age: 48.34 ± 6.06) aged between 35 and 60 years and 66 TiUnite surfaces (Nobel Biocare Parallel Conical Connection), bone level dental implant were included in the study. The implants were divided into two different groups according to the NPIs and regular platform implants(RPIs). The mean implant lengths, plaque index(PI), gingival index(GI), periodontal pocket depth(PD), gingival recession(GR), keratinized gingival width(KGW) and bleeding on probing(BOP) values were recorded. The Student's t-test used for between-group comparison.
Fifty-one participants and 123 dental implants were evaluated; twenty-three participants and
49 dental implants were excluded because of the different commercial brand dental implant
(AstraTech, Straumann Roxolid, Bilimplant) and declining to participate. Seventy-four TiUnite
dental implants were included in the study, but 8 TiUnite surface implants placed in the
anterior region were excluded. Consequently, 15 male and 13 female patients and 66 dental
implants were included in the study. This randomized retrospective clinical trial was
designed according to the Consolidated Standards of Reporting Trials (CONSORT) Statement
guidelines. A CONSORT Flow Chart of this study was shown in Figure 118.
The assignment was performed according to the dental implant diameters to include cases in
the NPI and RPI which are the test and control groups. All dental implants involved are the
Nobel Biocare Parallel CC brand (Nobel Biocare, Gothenburg, Sweden) with a TiUnite surface,
and it defined a regular diameter of 4.3 mm and narrow diameter of 3.75 mm. Dental implants
divided into two groups according to implant diameter, the NPI group comprised 3.75 mm
diameter (NP, Ø= 3.75 mm) implants, and the RPI group comprised 4.3 mm diameter (RP, Ø=
4.3mm) implants (implant lengths: 10 mm-13 mm).
Clinical Measurements The clinical measurements were recorded at follow-up sessions using a
periodontal probe that was calibrated in 1 mm increments. The clinical measurements were as
follows: 1) plaque index (PI); 2) gingival index (GI); 3) probing depth (PD), the distance
between the gingival margin and the bottom of a pocket; 4) clinical attachment level (CAL);
the distance from the neck of the implant and the bottom of the pocket; 5) bleeding on
probing (BOP); 6) keratinized gingival width (KGW), the height of peri-implant keratinized
mucosa; 7) gingival recession (GR), the distance between the neck of the implant and the
gingival margin. The same researcher performed all clinical measurements. A calibration
protocol was applied to the reliability of measurements. PI, GI, PD, CAL, GR, KGW meaurements
on five patients and ten peri-implant values were assessed. Calibration was accepted when
measurements were 90% similar20. All clinical measurements were recorded for four sites
(mesiobuccal, distobuccal, mid-buccal, mesiopalatal, midpalatal, and distopalatal) per
peri-implant region. PD and PI measurements are reliable in peri-implantitis diagnosis21.
Prosthetic complications of patients were also evaluated clinically. Veneer ceramic chipping,
abutment screw loosening or fracture, implant fracture, loss of retention were recorded.
Radiographic Measurements The studies have reported that periapical radiographs taken with
the parallel technique are reliable in determining the MBL changes at different follow-ups.
Digital periapical radiographs of the posterior region were obtained using a parallel method
at follow-up sessions. MBL measurements were provided on periapical radiographs by a software
program (Mediadent Software, The Dental Imaging Company, London, England). Ten radiographic
MBL measurements around peri-implant were performed twice with an interval of 3 weeks, and
researcher calibration was accepted when measurements were similar as %90. MBL was measured
separately from the mesial and distal parts and also which the average of the two
measurements. The reference points for the assessments are the implant shoulder and the most
apical end-point of the bone-implant contact point. The vertical length between these two
points is defined as MBL.
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