Novel design single implants successful 1 year after fresh extraction
MedWire News: Use of a novel single implant, with a 12°-angled prosthodontic platform, is successful in fresh extraction sockets in the maxilla 1 year following placement, research published in the Clinical Oral Implants Research journal suggests.
Use of dental implants is often complicated by the need to augment bone and tissue lost following resorption and remodeling following tooth extraction. However, immediate placement of implants in the extraction socket has been shown to limit this problem.
This study, carried out by Alan Payne and Simon Brown (University of Otago, Dunedin, New Zealand) evaluated the effectiveness of the immediate placement and restoration of an implant with a novel 12°-angled prosthodontic platform, in fresh extraction sockets of the maxilla.
Twenty-seven participants requiring 28 single-tooth extractions were prospectively selected from the Single Implant Research Project at the University of Otago. The mean age of the group was 47.1 years (range: 21-71 years) and it included 18 women and nine men.
Reasons for tooth extraction included caries (n=5), endodontic failure (n=3), failure of the post/core crown complex (n=4), fracture of the tooth root (n=2), and insufficient tooth structure to support a coronal restoration (n=13)
The implants used had a novel 12°-angled prosthodontic platform allowing use of standard gold cylinder abutments. The implants were made from titanium with roughened surfaces (1.43 µm), and with thread pitches at 0.6° and 0.6 mm apart.
Implant success was determined at placement, baseline (8 weeks post-operation), and at 1 year. Marginal bone levels were measured using standardized intraoral radiographs.
Of 28 implants placed, only two were excluded, due to low insertion torques. From surgery to baseline, a net gain of marginal bone of 0.78 mm was observed, which was further increased by 0.2 mm from baseline to 1 year, giving an overall marginal bone gain of 0.98 mm. Implant stability also increased during this period.
All 26 implants were considered to be successful as they exhibited less than 1 mm bone loss 1 year post placement. The two implants excluded because of implant instability at placement were classified as successful at the 1-year recall.
The majority of implants were also successful from a prosthodontic and esthetic perspective.
In their conclusions, Payne and Brown state that: "Tapered, roughened-surface implants with a novel 12°-angled prosthodontic platform can be immediately placed in anterior maxillary fresh extraction sockets, and immediately restored with provisional crowns and subsequent definitive crowns at 8 weeks for 1 year".
However, recognizing the general short-term reporting of outcomes for single implant crown studies, they also note that, "in order to determine the overall success and the level of maintenance required for this protocol, long-term follow-ups must be implemented".
By Iain Bartlett