Early outcome of an implant system with a resorbable adhesive calcium–phosphate coating—a prospective clinical study in partially dentate patients

Abstract

This study aims to investigate the early outcome of a dental implant with bioactive calcium-phosphate (CaP) coating in the first year of usage in different clinical indications in partially edentulous patients, after early and delayed prosthetic loading. Therefore, in a prospective follow-up study, the cumulative survival and success rate of a conical, self-drilling and self-tapping implant system after 6 months and 1 year post-insertion was evaluated. A total of 311 CaP-coated implants were placed in 124 patients. Seventy-two implants in clinical high-quality bone situation were loaded after 2 weeks post-insertion with the definite restoration; the rest after 6 months. The indication for implant placement was treatment of partial dentate mandible and maxilla. One hundred sixty-three implants were placed in the posterior mandible, 117 in the posterior maxilla. In the frontal maxilla, 25 implants and in the frontal mandible, eight implants were used. In 126 cases (36%), bone augmentation procedures (guided bone regeneration and sinus lift) were performed concomitant with implant placement. The difference between primary and secondary stability (implant stability quotient (ISQ), Periotest, insertion torque), peri-implant clinical parameter as well as survival and success criteria were evaluated. In total, ISQ mean values after 6 months were higher than after implant placement. Periotest values increased in the period of the first 6 months and remained constant afterwards. After 6 months of insertion, the mean bone loss was 0.051 mm. After 12 months, a bone gain with a mean of +0.016 mm was observed; implants in the posterior maxilla showed significant less bone resorption than implants in the posterior mandible (p < 0.0001). In the most of the implants (74%), clinical normal gingival tissue could be observed. In 24%, a mild inflammation was analysed. In 35 implants, a provocation of peri-implant bleeding was possible. In the early loading group, no implant failure was seen. Altogether, one implant in D4 bone has been lost. The cumulative survival rate summed up to 99.7%. In general, implant success assessment analysis according to Albrektsson and Buser displayed success in 99.7% of the implants. With respect to the patient selection including 124 implants with minor and major augmentations as well as early loading prosthetic function, the 1-year clinical use of the studied implant system with CaP coating showed good results, comparable to that of conventional implants without a specific coating. After 1 year, neither special disadvantages nor benefits of CaP-coated implants could be evaluated. Long-term results are further needed.

Vertical Osteoconductive Characteristics of Titanium Implants with Calcium‐Phosphate‐Coated Surfaces – A Pilot Study in Rabbits

“…Therefore, further studies needed to examine this effect. Although no negative affection, even after early implant loading, was seen in a clinical study 37 …”

“…Consequently, this biological apatite layer improves the bone healing process around the implant and accelerates the biological fixation of titanium implants to bone tissue 40 . This may explain better or at least equivalent clinical long‐term success rates for CaP coatings compared to uncoated titanium implants 37,41 …”

“…According to the manufacturer's data, the resorbable CaP coating has a low coating thickness of 20–30 µm, a micro‐crystalline structure with a large active surface, and microporosity with high capillarity effect on blood. A clinical study indicated a promising 1‐year survival and success rates for this system, although not better than for conventional implants 17 . The implant material consists of a 5‐grade titanium alloy with a sandblasted and etched microstructure, internal hexagon, spiral, conical, self‐drilling, self‐tapping, double‐thread system, with deep and especially sharp threads decreasing toward the implant shoulder, enabling implant self‐retention and aiming for high primary stability.…”

A biphasic calcium phosphate coating for potential drug delivery affects early osseointegration of titanium implants

“…A rabbit animal model demonstrated that CaP‐coated implants had even higher vertical osteoconductive properties than conventional sandblasted and acid‐etched implants . In a clinical short‐term trial, neither advantages nor disadvantages of CaP‐coated implants could be seen .…”

Clinical and Radiological Long‐Term Outcome of a Tapered Implant System with Special Emphasis on the Influence of Augmentation Procedures

“…Longitudinal studies of dental implants showed high implant survival rates of 89% to 97% over periods of 4 to 10 years . Implant survival and success have been reported in various publications to be influenced by factors such as implant surface, primary stability, and implant design . An appropriately high primary implant stability following placement seems to be a key to clinical success .…”