 Astra Tech
BioManagement Complex
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 Prosthetic solutions
The Astra Tech Implant System™ has been documented when used to support a wide range of prosthetic solutions. Good clinical and mechanical results have been obtained for single tooth, fixed partial and complete prostheses as well as for removable overdentures. Please read more about it in this section.
 Clinical and radiographic outcomes of implants immediately placed in fresh extraction sockets
Purpose: The objective of this study was to evaluate the 2-year clinical and radiographical outcome of implants; supporting a mandibular overdenture and placed in fresh extraction sockets or in healed ridges.
Materials and Methods: Ten consecutive patients visiting the Faculty of Dentistry, University of Istanbul, were included in the study. All patients had been treatment planned to receive a maxillary complete denture and an implant supported mandibular over-denture on the day of extraction of failing mandibular teeth. Exclusion criteria were general contraindications for implant surgery, previously grafted bone or implant failure, poor plaque control and clinical attachment loss of 4 mm or more on the buccal aspect of the tooth to be extracted.
Each patient received 4 OsseoSpeed™ implants (position 34-44); 2 immediately placed in extraction sockets and 2 placed in healed ridges, using an open flap surgery and local anaesthesia. The gap between the implant and socket wall was augmented by locally harvested bone. Sutures were removed after 1 week. The permanent overdenture was attached by locators after 4 months of healing. Recalls were performed at 3,6,12 and 24 months post loading and osseointegration was considered successful if the criteria according to Buser et al. 1990 were met, i.e. no peri-implant infection, pain, foreign body sensation, dysaesthesia, radiolucency around the implant or implant mobility. Modified plaque index, modified bleeding index and probing pocket depth were recorded at 4 sites of each implant. Mobility of the prosthesis, width of the keratinized mucosa and any adverse event reported by the patient were also recorded. Radiographic evaluation of the marginal bone was done at the 1- and 2-year visits, and were compared to baseline (prosthetic loading). Intra-oral radiographs were taken using the long-cone parallel technique and marginal bone levels assessed at mesial and distal sites.
Descriptive statistics were calculated, and the chi-square test was used to detect statistically significant differences between the two groups (i.e. p < 0.05).
Results: Implant survival and success rate were both 100%, and no discomfort or pain were recorded during the course of the study. Clinical parameters were similar in the two groups and did not change over time. Bleeding and plaque indexes equals to 0 in slightly more than 80% of the sites, and less than 15% of the sites scored 1. Bone level changes were on average 0.58 mm (SD±0.42) and 0.72 mm (SD±0.45) after 1 year in function for healed versus extraction sites. Additional remodelling occurred to the same extent in the two groups during the second year in function, (mean 0.59 mm and 0.64 mm for healed and extraction sites). Hence, changes in the marginal bone were slightly higher in the extraction group. One screw loosening and 2 fractured resin teeth were reported.
Discussion and conclusion: Out of 40 implants placed none were lost or failed. There were no differences between implants placed in extraction sockets and healed ridges as measured by clinical parameters. Marginal bone level changes met the success criteria defined for implant treatment proposed by the 1st European Workshop on periodontology (1994). No major prosthetic complications occurred. The successful results presented here can be explained by a careful preoperative evaluation and the grafting method.
In conclusion, provided a careful patient selections is done, immediate placement is a safe, reliable and less time-consuming treatment alternative for patients in need of tooth extraction before implant treatment. |
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