Assessment of Peri-Implant Soft Tissues Conditions around Short and Ultra-Short Implant-Supported Single Crowns: A 3-Year Retrospective Study on Periodontally Healthy Patients and Patients with a History of Periodontal Disease

Abstract

The aim of this retrospective study was to evaluate implant survival, marginal bone loss and peri-implant complications in 326 short and ultra-short implants. Implants were placed in the maxillary and mandibular posterior regions of 140 patients with (PP) and without (NPP) a history of periodontal disease. Clinical and radiographic examinations were performed at 3-year recall appointments. The 8.0, 6.0 and 5.0 mm-length implants placed in PP and NPP were respectively 43.75% and 38.46%, 35.10% and 34.19%, 21.15% and 27.35%; 325 implants (one early failure) were rehabilitated with single crowns in 139 patients. Overall implant survival after 3 years of follow-up was 97.55%, 98.08% and 96.61% for PP and NPP (p = 0.46). Crestal bone level variations were not statistically different among PP and NPP; 15.41% of implants presented signs of mucositis, 14.71% and 16.67% in PP and NPP (p = 0.64). Setting the threshold for bone loss at 2 mm after 36 months, peri-implantitis prevalence was 2.2%, 1.96% and 2.63% in PP and NPP (p = 0.7). Overall implant success was 82.39%, 83.33% and 80.7% for PP and NPP (p = 0.55). Short-term outcomes suggest that short and ultra-short locking-taper implants can successfully be restored with single crowns in the posterior jaws both in PP and NPP.

Survival rates of ultra‐short (<6 mm) compared with short locking‐taper implants supporting single crowns in posterior areas: A 5‐year retrospective study

“…The promising 5‐year outcomes reported in this study for implant survival and bone levels stability—even in presence of unfavorable high CIR, may be explained also by a series of human retrieval published studies of implants with the same macrodesign, consistently showing that from initial woven bone formation at the healing chambers, further bone morphologic evolution occurs toward a Haversian‐like configuration that over time increases significantly in mechanical properties 63–65 . The presence of a screwless, locking‐taper implant‐abutment connection confers greater mechanical stability to the implant/crown assembly, previously shown to provide an impervious seal to microbial penetration or infiltration, 66 an absence of micromovements, or micro gaps at the IAI, which lead to minimal bone resorption 22,31–33 . In this way, adjacent bone is hardly loaded at levels that could exceed the minimum effective strain necessary for bone modeling and remodeling.…”

“…F-BIC was defined as the first most coronal bone-to-implant relationship visible at the first line of contact, on both mesial and distal sides; if F-BIC matches with IAI, the measurement was 0; if it is located apically, the measurement was a positive value. 22,[31][32][33] As described in the literature, implants were divided into two groups on…”

“…34 Recall appointments were established to manage prosthetic complications as needed, and a maintenance program was designed to provide patients a professional oral hygiene session every 4 months. Clinical and radiographic examinations 22,[31][32][33] were performed during the follow-up 5 years from loading time, one time per year at regular intervals.…”

“…Implant survival was considered as the implant's state of being in function at the 5-year follow-up evaluation, for example, symptom-free, without mobility, radiolucency, or bone loss so severe as to warrant implant removal. 33,[36][37][38] A descriptive analysis was conducted between loading time and the 5-year follow-up time, according to covariates. This included assessment of crestal bone level (CBL; average bone level around implants at mesial and distal sides, expressed in mm), first bone-to-implant contact (F-BIC; in mm) [39][40][41] with their variations ΔCBL (average bone loss) and ΔF-BIC (average apical shift of the "first bone-to-implant contact point" position) (see Appendix).…”

Peri-implantitis: A Classification Update

“…22 Peri-implantitis shows signs of inflammation, bleeding on probing and/or suppuration, increased probing depths and/or recession of the mucosal margin and radiographic bone loss compared to previous examinations. 23 Diagnosis of peri-implantitis: 24 • Evidence of visual inflammatory changes in the peri-implant soft tissues combined with bleeding on probing and/or suppuration.…”