Dr Sowmya Salian post Graduate Student

Department of Periodontics & Oral Implantology

S.D.M Dental College Dharwad

Dr Srinath ThakurPrincipal & Head of Department

Dr Sudhindra.S.Kulkarni Professor

• The use of dental implants for dental restorations has revolutionized patient care and is increasing by the day.

• The concept of osseointegration has changed the very way in which we replace missing teeth…

• Its been proven beyond doubt that dental implant retained restorations enhance masticatory efficacy, quality of speech,stability of the existing prosthesis, provide outstanding esthetics along with reduced resorption of the alveolar ridge.

• As on date dental implants are possibly the best possible mode to replace missing teeth.

• The success of dental implants and its longevity is influenced by various factors..

• The dental implant success criteria have been proposed and revised over a period of time..

Schnitman 1979, Cranin 1982, McKinney RV 1984, Albrektsson 1986,1998, Smith & Zarb 1989

• “Implant success criteria” – by Albreksson et al.. has

been the “Gold Standard” while measuring the implant

success ..given way back in 1986.

• However with the change in implant design, surface

characteristics and technique of placement of dental

implants.. has necessitated newer definition for implant

success..

• 1993 .. James established.. Implant quality of health

scale.. Further .. Misch in 1993,1998.

• The International Congress Of Oral Implantologist

[ICOI] consensus conference on implant success

criteria contains a list of parameters to be checked

to call the implant as a success or a failure..

Misch et al 2008

• Patients visiting Department of Oral Implantology and

Periodontics, S.D.M. College of Dental Sciences and

Hospital, Dharwad.

SOURCE OF DATA

• This prospective, longitudinal Cohort study involved a

total of 30 sites in 20 subjects[11 male, 8 females] who

received implants from 1st January 2008 to 30th June 2009

…were evaluated.

• Informed written consent obtained …

PATIENT SELECTION CRITERIA:

• Patients undergoing implant therapy to replace

either single or multiple unit bridge and full mouth

restorations.

• All patients should have received and had

restored the implants with a minimum of 6 months

period.

• 1] Patients with any systemic conditions that may

influence the survival and success rates of the

dental implants.

• 2] Patients not agreeable to the terms of the study.

• 3] Patients with implants without restorations

All the implant sites were clinically evaluated :

• At the time of implant placement

• At the time of cementation

• At 6 months post cementation..

Implant characteristics

Diameter Length Bone quality around implant

Torque at implant placement

Grafting procedures

Clinical evaluation

1] Modified Plaque Index ; Mombelli et al 1987.

2] The distance between the implant shoulder and the

mucosal margin [DIM] in mm

3] Pocket Probing Depth [PPD] in mm

4] Probing attachment level [PAL] in mm which was

calculated by subtracting PPD from DIM.

5] Bleeding on probing [BOP].

6] Exudation

7] Pain

8] Mobility

Radiographs were obtained using a long cone

Technique and taken

• At the time of implant placement.

• At time of cementation

• At 6 months post cementation

To visualize the distance between the implant

shoulder and the crest of the alveolar bone.

IMPLANT SHOULDER

THREAD PITCH

Misch et al 2008

The statistical analysis was done using

• Student’s paired t-test.

• Wilcoxon matched pairs test.

• Karl Pearson’s correlation coefficient.

In the present study we found that :

• Around 35% of the implants sites had bleeding on

probing at the end of 6 months post cementation

• 78% of the sites had D2 bone quality and

• 20% of the implants had D3 bone quality at the

time of implant placement.

• 70% of implants .. mean diameter of 3.5 -4.3mm

mean length of about 10 -14mm.

• The implants had 35-40 Ncm2 of torque at the

time of placement.

• The mean probing depth was about 1-1.5mm

however it was around 2.5 mm at the end of

6 month post cementation.

Interval Mean p-value S

At implant placement 0.40 ± 0.89 0.00 S

At cementation 1.63 ± 0.42

At implant placement 0.40 ± 0.89 0.00 S

6 months post cementation

1.58 ± 0.44

At cementation 1.63 ± 0.42 0.73 NS

6 months post cementation

1.58 ± 0.44

NS= Non -Significant (p > 0.05), S= Significant (p < 0.05)

Table 1: Comparison of vertical bone levels (MESIAL) at the implant site at different time intervals

Interval Mean p-value S

At implant placement

0.40 ± 0.89

0.00 SAt cementation 1.73 ± 0.47

At implant placement

0.40 ± 0.89

0.00 S6 months post cementation

1.56 ± 0.34

At cementation 1.72 ± 0.47

0.13 NS6 months post cementation

1.56 ± 0.34

NS= Non -Significant (p > 0.05), S= Significant (p < 0.05)

Table 2: Comparison of vertical bone levels (DISTAL) at the implant site at different time intervals

Table 3: Comparison of mPI and GI at cementation and 6 months by wilcoxon matched pairs test

Table 4: Correlation Between Various Parameters And Marginal Bone Level

2

Table 4 [continued]: Correlation Between Various Parameters And Marginal Bone Level

Present study was carried out to evaluate the factors influencing the survival and success rate of dental implants… we found that

• We had 100% survival with optimum health of success as per the criteria laid down by … Misch et al 2008..

• Also found no correlation between implant diameter and crestal bone loss..• Increase in implant diameter … 3.5 fold reduction in crestal strain.. Petrie C.S et al 2002

• In our study it was found that there was no significant bone loss seen between final cementation and 6 month post cementation .. Misch et al 1999, Miyata et al 2000.

• Wilderman et al 1999.. Mean horizontal bone loss after osseous surgery … 0.8mm.

• We also could not find any significant correlation between the amount of torque and bone loss around implants.

•

• This may be : - All the surgeries done in D3 bone quality was done by modified drilling protocol. . Schnitmann et al 1979, Albreksson et al 1985 • Bone quality dental implant design minimizes overall implant failure and crestal bone loss.. Misch C1999

• Bone density .. Influences primary implant stability.. Important factor for implant success Turkyilmaz et al 2008

• Thus to conclude it can be said that all 30

implants in our study were very successful

and survived with a 100% survival rate and

were functioning in optimum health as per the

success criteria guidelines set by the ICOI

Pisa Consensus conference 2008

• Further long term prospective studies are required to

be done for more consistent long term data and results.

THANK YOU