Immediate functional loading: Results for the concept of the strategic implant^®

Abstract

Background: Immediate functional loading of one-piece dental implants has become an accepted treatment modality for fixed restorations in fully edentulous mandibles and maxillae. Nevertheless, studies regarding immediate loading procedures in extraction sites in both the jaws, as well as in segment reconstructions and single-tooth replacements, are limited. Purpose: The purpose of this study was to evaluate the presently used protocol for immediate functional loading (within maximum 3 days) of one-piece implants which are placed according to the following methods as published by the IF. Materials and Methods: This prospective cohort study included totally 87 consecutively treated patients who receive 1169 immediately loaded one-piece Strategic Implant ® , supporting fixed complete-arch maxillary or mandibular metal-ceramic bridges or segment reconstructions in both the jaws. All implants were placed by one treatment provider, who delivered also the prosthetics and controlled all cases himself over the years. Data were extracted by an experienced dentist from the patient records and from panoramic X-rays. A number of patients were interviewed at the end of the observation period. Although a total of 5100 implants were placed and observed for 12 – 57 months totally (with 105 implants out of these, having failed), this article reports the detailed results only for 1169 implants which have been followed for at least 48 months. Results: Immediate functional loading of using multiple, cortically anchored basal screw implants as a support for fixed full-arch and segment prosthesis in the upper and lower jaw demonstrated a high cumulative implant survival rate after an observation period of up to 57 months. Neither hypertension nor diabetes and neither smoking nor bending of the implant's neck had an influence on the success of the implants observed in this study. Within the limits of this study (5100 Strategic Implants were observed over a period of up to 57 months), “peri-implantitis” was not observed at all. Conclusion: The treatment concept developed for the technology of the Strategic Implant® is safe and effective and it avoids bone augmentations and “peri-implantitis”.

The influence of immediately loaded basal implant treatment on patient satisfaction

“…The strongest anchorage obtained with basal implants offers stable occlusal units leading to good chewing function. 12,13,16,18,21 Most of the patients in our study reported a significant improvement in their satisfaction with mastication from average to excellent after basal implant treatment, a finding that matches the findings of S. Ihde and A. Ihde 12,18 and Scortecci 15 and is in accordance with other studies on endo-osseous implant treatment showing improved mastication with implant-supported prostheses. 55−59 Since speech is usually affected by edentulism, improving patients' speech is one of the main purposes of replacing missing teeth.…”

“…Basal implants have been prescribed as an alternative treatment for these patients with a high success rate, less severe complications, and lower cost and number of surgeries. [12][13][14]20,21 There is an increased need for clinical research to evaluate patient satisfaction and quality of life in relation to this treatment modality as a major parameter indicating implant success.…”

“…On the other hand, several techniques have been advanced in order to optimise the aesthetic and functional outcomes of the prosthetic rehabilitation of patients with severe alveolar ridge resorption including the bone graft procedure, 12,13,18,20 use of short implants, 16 use of 'All-on-4 concept', 13 and utilisation of remote basal bone areas for anchorage such as the cortical bone of the nasal floor and maxillary sinus, pterygoid plate of the sphenoid bone, zygomatic bone, inferior cortex of the mandible, and buccal and lingual cortex of the mandible for basal implants. 12,13,18,20 The main reasons given by our patients for changing from a fixed conventional prosthesis were caries and fracture of the abutment, which is similar to numerous previous studies. 24,52−54 Goodacre et al 52 noted that the most common complications associated with conventional fixed partial dentures were caries, need for endodontic treatment, loss of retention, aesthetics, periodontal disease, tooth fracture, and prosthesis/porcelain fracture.…”

“…12−14,16,20−22 The BCS → implant is a special type of basal implant, consisting of one piece that is inserted through a crestal approach, just like the other endoosseous implants, and then anchored deeply inside the basal bone through its horizontal plates. [12][13][14]19 Lazarov 13 revealed in a prospective cohort study that the use of Strategic Implant → prosthesis (BECES/BCS, KOS, KOS Plus, and BOI) is a safe and efficient procedure with a high success rate and without peri-implantitis. He followed up 1019 BECES/BCS cases for more than 48 and up to 57 months and reported a cumulative survival rate of 97.5%.…”

The Influence of Immediately Loaded Basal Implant Treatment on Patient Satisfaction

“…Many implant systems have been developed and distributed in the dental market, one of which is the basal implant [12][13][14][15][16][17][18][19][20][21][22]. In this system, the implant is anchored to the basal/cortical bone [12][13][14][15][16][17][18][19][20][21][22] which is useful in cases of severe alveolar ridge resorption, when bone grafting is prohibited due to the patient's general medical condition and when a more conservative treatment with lower cost is needed [12-14, 16, 20-22]. e BCS ® implant is a special type of basal implant, consisting of one piece that is inserted through a crestal approach, just like the other endo-osseous implants and then anchored deeply inside the basal bone through its horizontal plates [12][13][14]19].…”