Comparison of clinical and radiographic status around immediately loaded versus conventional loaded implants placed in patients with type 2 diabetes: 12‐ and 24‐month follow‐up results

There are no studies that have compared the clinical and radiographic status around immediately loaded (IL) and conventional loaded (CL) implants placed in patients with type 2 diabetes mellitus (T2DM). The aim was to compare the clinical and radiographic status around IL and CL implants placed in T2DM patients. One hundred and eight diabetic patients [55 with IL implants (Group 1) and 53 with CL implants (Group 2)] were included in this cross‐sectional study. All implants were placed in healed sites in the maxillary and mandibular premolar and molar regions and supported single restorations. All patients underwent full mouth mechanical debridement biannually. Haemoglobin A1c (HbA1c) levels, clinical [bleeding on probing (BOP) and probing depth (PD) ≥ 4 mm] and radiographic [crestal bone loss (CBL)] peri‐implant parameters were measured for both groups at 12‐ and 24‐month follow‐up. Group comparisons were performed using the Mann–Whitney U‐test (P < 0·05). The mean age and duration of T2DM in groups 1 and 2 were 50·6 ± 2·2 and 51·8 ± 1·7 years, and 9·2 ± 2·4 and 8·5 ± 0·4 years, respectively. At 12‐ and 24‐month follow‐up, the mean HbA1c levels in groups 1 and 2 were 5·4% (4·8–5·5%) and 5·1% (4·7–5·4%) and 5·1% (4·7–5·2%) and 4·9% (4·5–5·2%), respectively. At 12‐ and 24‐month follow‐up, there was no statistically significant difference in peri‐implant BOP, PD and CBL in both groups. It was concluded that clinical and radiographic status is comparable around IL and CL implants placed in patients with T2DM. The contribution of careful case selection, oral hygiene maintenance and glycaemic control is emphasised.     

Radiographic evaluation of marginal bone maintenance around tissue level implant and bone level implant: a randomised controlled trial. A 1‐year follow‐up

The etiologic factors associated with crestal bone loss have not been comprehensively clarified. Several theories exist as to the reason for the observed changes in crestal bone height following implant restoration. In the 1990s, the wide‐diameter implants were commercially introduced. Initially, the implants were restored with standard‐diameter abutments because of lack of matching prosthetic components. Long‐term radiographic follow‐up of these ‘platform‐switched’ restored wide‐diameter dental implants has demonstrated a smaller‐than‐expected vertical change in the crestal bone height around these implants that is typically observed around implants restored conventionally with prosthetic components of matching diameters. The aim of this randomised controlled study was to assess radiographically marginal bone level alterations in implants restored according to the platform‐switching concept compared with traditionally restored implants. Fifty‐four subjects to participate in this randomised controlled study were selected. Two groups were assigned at random: control group (56 implants were restored with standard matching‐diameter abutments) and test group (58 implants were restored with medialised abutments). X‐ray explorations were taken for peri‐implant bone level at the minute the last cementing of the prosthesis and at 1‐year follow‐up. NHI Image was used to digitally process and manipulate the radiographic images and perform the measurements. Mean of bone loss with platform‐switching implants was ?0·01 mm, and the mean of bone loss with standard platform implant was 0·42 mm. Outcomes of this study indicated that the platform‐switching design could preserve the crestal bone levels to 1‐year follow‐up. There was a statistically significant difference in marginal bone loss.     

Comparison of peri‐implant clinical and radiographic status around short (6 mm in length) dental implants placed in cigarette‐smokers and never‐smokers: Six‐year follow‐up results

Background

It is hypothesized that peri‐implant clinical and radiographic inflammatory parameters (probing depth [PD], bleeding on probing [BOP] and plaque index [PI]; and radiographic (crestal bone loss [CBL]) are worse among cigarette‐smokers (CS) compared with never‐smokers (NS) with short implants.

Purpose

The present 6‐year follow‐up retrospective study compared the peri‐implant clinical and radiographic parameters in CS and NS with short dental implants (6 mm in length).

Materials and methods

Fifty‐six male individuals were included. These individuals divided into 2 groups as follows: (a) Group‐1: 29 self‐reported systemically healthy CS with 48 short‐implants; and (b) Group‐2: 27 self‐reported systemically healthy NS with 43 short implants. Peri‐implant PD, PI, BOP, and CBL were measured. Group comparisons were done using the Kruskal‐Wallis test and sample size was estimated. Level of significance was set at P values < .05.

Results

In groups 1 and 2, the follow‐up durations were 6.2 ± 0.1 years and 6.1 ± 0.3 years, respectively. A cigarette smoking history of 8.9 ± 3.6 pack years was reported by individuals in Group‐1. At follow‐up, scores of peri‐implant PD, BOP, PI, and mesial and distal CBL were comparable around short implants in both groups.

Conclusion

Under strict oral hygiene maintenance protocols, short dental implants can remain functionally stable in CS in a manner similar to NS.     

Bone density at interradicular sites: implications for orthodontic mini‐implant placement

Authors – Chun YS, Lim WH Objectives – Implant stability is primarily related to local bone density; Few studies have evaluated interradicular bone density related to mini‐implant placement for orthodontic anchorage. Therefore, this study evaluated bone density differences between interradicular sites. Setting and Sample Population – Computed tomographic (CT) images were obtained from 14 males and 14 females (mean age 27 years, range 23–35 years). Bone density in Hounsfield units (HU) was measured at 13 interradicular sites and four bone levels. Results – Bone densities in most areas were higher than 850 HU. Statistically significant differences in bone density were detected at different levels and sites. Bone densities in both maxilla and mandible significantly increased from the alveolar crest toward basal bone in posterior areas, while the opposite was observed in anterior areas. There were statistically significant differences in bone densities between the maxilla and mandible in posterior areas. Bone densities progressively increased from anterior to posterior areas in the mandible. Conclusion – The results suggest that mini‐implants for orthodontic anchorage may be effective when placed in most areas with equivalent bone density up to 6 mm apical to the alveolar crest. Site selection should be adjusted according to bone density assessment.