Early Function of Splinted Implants in Maxillas and Posterior Mandibles, Using Br�nemark System� Tiunite? Implants: An 18-Month Prospective Clinical Multicenter Study

Abstract

Background: Immediate or early loading of implants placed in maxillas and posterior mandibles has been a concern as bone density is often low in these areas, making it difficult to establish good initial implant stability. By adapting implant design and insertion protocols, however, high initial implant stability may be achieved in these regions. Further, a modified implant surface texture has been proved to help in maintaining stability during the initial healing period. Purpose:The aim of the present study was to investigate the clinical performance of oxidized titanium implants (TiUniteTM, Nobel Biocare AB, Gothenburg, Sweden) when used for early function in the maxilla and in the posterior mandible, locations where the bone density often is low. A further aim was to evaluate the marginal bone level at oxidized implants and compare it with that of machined-surface implants used in a previous study. Materials and Methods:Thirty-one patients were consecutively included in the study, and 37 edentulous areas in maxillas and posterior mandibles were treated. Bruxism and uncontrolled periodontal disease were exclusion criteria. Temporary prostheses were generally placed within 9 days but not after 16 days from implant placement. A previous study applying the same study design and clinical protocol but using machined-surface implants was used for comparisons. Results:Of the 11 1 implants installed, 1 failed, giving an overall survival rate of 99.1 Yo after 18 months. The prosthesis survival was 100%. The marginal bone resorption was 0.8 mm (standard deviation ISD], l.O), as opposed to 1.6 rnm (SD, 1.3) in the previous study with machined-surface implants, but was not statistically significantly different ( p = .lo). Conclusion:The present clinical protocol (aiming at high primary stability) and the use of oxidized titanium implants for early functional loading in the maxilla and the posterior mandible resulted in a high implant survival rate and a favorable marginal bone level during a follow-up of 18 months. The difference in marginal bone resorption between the oxidized implants in the present study and the machined implants from a previous investigation with the same study design was not statistically significant.KEY WORDS: dental implants, early function, oxidized implants, posterior regions, prospective clinical multicenter study, provisional prosthesis he original protocol for implant treatment described T by B r i n e m a r k a n d colleagues' included 3 t o 6 months of submerged healing time before prosthesis attachment. The results of this technique have been doc-'Private practice, Concorezzo, Italy; 'private practice,