A Study of the Crestal Bone Loss Around Bone Level Versus Tissue Level Implants in Non-compliant Patients With Healthy or Reduced Periodontium After 5-8 Years in Function

A Comparative Observational Study of the Crestal Bone Loss Around Bone Level Versus Tissue Level Implants in Non-compliant Patients With Healthy or Reduced Periodontium After 5-8 Years in Function"


Lead Sponsor: Saint-Joseph University

Source Saint-Joseph University
Brief Summary

The goal is to evaluate, after 5 to 8 years, the marginal bone loss around tissue-level implants and bone-level implants in patients who have not followed the maintenance program. Medical records of patients who have been implanted for at least 5 to 8 years and who have been lost during this period are collected from three private clinics in Beirut,Lebanon and the Saint Joseph University Health Center in Beirut,Lebanon. On an individual sheet, the patient as well as the implants data will be noted. Patients will be called for reevaluation after 5-8 years. After signing the informed consent, the measurements by a PCP-15 probe of the plaque index (FMPS) and the bleeding index (FMBS) as well as the height of the keratinized tissue are indicated on the sheet. If the smoking status has changed, this will be mentioned too. The marginal bone loss will be measured on the X-rays taken immediately after the implant placement, after 1 year of loading and then at the reevaluation session.

Detailed Description

On the individual sheet for each patient, the data concerning the name, age, sex, general condition, smoking status, periodontal status , the number of follow-up sessions and the plaque index as well as bleeding on probing (if noted in the file before placing the implants) will be recorded. Then, the data concerning the implant such as the site (maxilla or mandibular), the type of implant, the length, the diameter, the surface, sealed or screwed, presence of a cantilever, hiatus or over-contour, a one or two surgical time, the date of placement and the number of years of operation will also be noted on the form. Patients will be called for reassessment appointments after 5-8 years. After signing the informed consent, the measurements by a PCP-15 periodontal probe of the plaque index (FMPS), bleeding on probing (FMBS) as well as the height and thickness of the keratinized mucosa are indicated on the sheet. The smoking status will also be updated and indicated. Implants will be classified into one of these groups: 1. Patients with tissue implants (TL). 2. Patients with bone level implants with internal connection (BL, Internal hex). 3. Patients with bone level implants with external connection (BL, External hex). X-rays taken after insertion, after 1 year of loading and after 5-8 years will be collected and analyzed on the DBSWIN software. Mesial and distal bone loss after implant placement and after 5 to 8 years will be measured on retro-alveolar radiographs with calibration and recorded on the patient file. The total bone loss will then be calculated. The radiographic measurement technique is as follows. The platform of the mesial and distal implant (MIS: Mesial Implant Shoulder and DIS: Distal Implant Shoulder) will be defined and a line (A) connecting the two is drawn. Another line (B) tangential to the apex of the implant and parallel to A is also drawn. The bisecting line at A and B is therefore produced and measured to assess the distorted implant length (DIL: Distorted Implant Length). Bone level (BL) measurements will be recorded from the implant platform (MIS-DIS) to the most coronary bone-to-implant contact (BIC) on the mesial and distal sides of each implant. The length of the implant will be used as an actual measurement to calibrate the other measurements.

Overall Status Recruiting
Start Date 2021-06-01
Completion Date 2022-07-29
Primary Completion Date 2022-05-29
Study Type Observational
Primary Outcome
Measure Time Frame
Marginal bone loss 5 to 8 years
Level of oral hygiene 5 to 8 years
Secondary Outcome
Measure Time Frame
Smoking status 5 to 8 years
Periodontal status 5 to 8 years
success and survival of the implant 5 to 8 years
Years in function 5 to 8 years
Height and thickness of the peri-implant keratinized mucosa 5 to 8 years
Overhang or hiatus or cantilever 5 to 8 years
Full mouth plaque score 1 year
Full mouth bleeding score 1 year
Enrollment 130

Intervention Type: Radiation

Intervention Name: Periapical radiographs

Description: Periapical radiographs on reevaluation


Sampling Method:

Non-Probability Sample


Inclusion Criteria: - Patients who have undergone the initial phase followed by implant placement in the posterior region. - Implants placed for more than 5 years. - The implant systems selected are: - Tissue Level Implants: Straumann (Straumann Dental Implants System, Switzerland), - Bone Level implants: Branemark, 3i Biomet (external and internal connection), Nobel replace and Astra. - Patients who did not comply with the maintenance program and who missed more than 30% of appointments. Exclusion Criteria: - Systemic diseases (uncontrolled diabetes, drugs which may affect bone metabolism). - Totally edentulous. - Severe periodontitis not stabilized - Inappropriate, unavailable or distorted x-rays. - Augmented sites. - Implants placed at a supra or infraosseous level. - Implants placed immediately after extraction.



Minimum Age:

18 Years

Maximum Age:


Healthy Volunteers:

Accepts Healthy Volunteers

Overall Contact

Last Name: Layal Bou Semaan, DDS

Phone: +96178898880

Email: [email protected]

Facility: Status: Contact: Saint Joseph University of Beirut Layal Bou Semaan, DDS +96178898880 [email protected]
Location Countries


Verification Date


Responsible Party

Type: Principal Investigator

Investigator Affiliation: Saint-Joseph University

Investigator Full Name: Layal Bou Semaan

Investigator Title: Resident

Has Expanded Access No
Condition Browse
Patient Data Yes
Study Design Info

Observational Model: Other

Time Perspective: Retrospective

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