A radiographic comparison of progressive and conventional loading on crestal bone loss and density in single dental implants: a randomized controlled trial study

Rahab Ghoveizi, Marzieh Alikhasi, Mohammad-Reza Siadat, Hakimeh Siadat, Majid Sorouri, Rahab Ghoveizi, Marzieh Alikhasi, Mohammad-Reza Siadat, Hakimeh Siadat, Majid Sorouri

Abstract

Objective: Crestal bone loss is a biological complication in implant dentistry. The aim of this study was to compare the effect of progressive and conventional loading on crestal bone height and bone density around single osseointegrated implants in the posterior maxilla by a longitudinal radiographic assessment technique.

Materials and methods: Twenty micro thread implants were placed in 10 patients (two implants per patient). One of the two implants in each patient was assigned to progressive and the other to conventional loading groups. Eight weeks after surgery, conventional implants were restored with a metal ceramic crown and the progressive group underwent a progressive loading protocol. The progressive loading group took different temporary acrylic crowns at 2, 4 and 6 months. After eight months, acrylic crowns were replaced with a metal ceramic crown. Computer radiography of both progressive and conventional implants was taken at 2, 4, 6, and 12 months. Image analysis was performed to measure the height of crestal bone loss and bone density.

Results: The mean values of crestal bone loss at month 12 were 0.11 (0.19) mm for progressively and 0.36 (0.36) mm for conventionally loaded implants, with a statistically significant difference (P < 0.05) using Wilcoxon sign rank. Progressively loaded group showed a trend for higher bone density gain compared to the conventionally loaded group, but when tested with repeated measure ANOVA, the differences were not statistically significant (P > 0.05).

Conclusion: The progressive group showed less crestal bone loss in single osseointegrated implant than the conventional group. Bone density around progressively loaded implants showed increase in crestal, middle and apical areas.

Keywords: Dental Implant Loading; Dental Prosthesis; Implant-Supported.

Figures

Fig 1
Fig 1
Progressive loaded implant sequence, a: two months after surgery, the first temporary crown was placed in 2mm infraocclusion, b: four months after surgery, the second temporary crown was placed in 40μ occlusal contact, c: six months after surgery, the last temporary crown was placed into full occlusion (12μ occlusal contact), d: eight months after surgery, the last temporary crown was replaced by a cemented metal ceramic crown with the same occlusal contact.
Fig 2
Fig 2
To measure crestal bone loss, implant shoulder on the mesial (a) and distal (c), the first contact of the alveolar crestal bone to the implant on the mesial (b) and distal (d) the apex of the implant (e) and the middle of the implant shoulder (f) were marked
Fig 3
Fig 3
To measure the change on bone density around the implant, nine 1mm2 regions-of-insert (ROI) were considered. Immediately apical to the bone-implant contact on the mesial and distal area of the implant (A,H), in the middle of micro-thread on the mesial and distal area of the implant (B,G), on the contact of micro-thread to the macro-thread on the mesial and distal area of the implant (C,F), the apical area of the implant at the mesial and distal of the implant (D, E), the last ROI was placed on the body of the implant in the distal shoulder (Ref)

References

    1. Astrand P, Engquist B, Dahlgren S, Gröndahl K, Engquist E, Feldmann H. Astra Tech and Brånemark system implants: a 5-year prospective study of marginal bone reactions. Clin Oral Implants Res. 2004 Aug;15(4):413–20.
    1. Adell R, Lekholm U, Rockler B, Branemark PI. A 15-year study of osseointegrated implants in the treatment of edentulous jaw. Int J Oral Surg. 1981 Dec;10(6):387–416.
    1. Albrektsson T, Zarb G, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants. A review and prognosis criteria for success. Int J Oral Maxillofac Implants. 1986 Summer;1(1):11–25.
    1. Buser D, Weber HP, Bragger U, Balsiger C. Tissue integration of one stage ITI implants:3-year results of a longitudinal study with Hollow-Cylinder and Hollow-Screw implants. Int J Oral Maxillofac Implants. 1991 Winter;6(4):405–12.
    1. Albrektsson T, Buser D, Sennerby L.On crestal/marginal bone loss around dental implants Int J Periodontics Restorative Dent 2013January–Feb339–11.
    1. Jovanovic SA, Kenney EB, Carranza FA, Jr, Donath K. The regenerative potential of plaque-induced periimplant bone defects treated by a submerged membrane technique: an experimental study. Int J Oral Maxillofac Implants. 1993;8(1):13–8.
    1. Misch CE. Progressive bone loading. In: Misch CE, editor. Contemporary implant dentistry. St Louis: Mosby; 1999.
    1. Clelland NL, Ismail YH, Zaki HS, Pipko D. Three dimentional finite element stress analysis in and around the screw-vent implant. Int J Oral Maxillofac Implants. 1991 Winter;6(4):391–8.
    1. Holmes DC, Grigsby WR, Goel VK, Keller JC. Comparison of stress transmission in the IMZ implant system withpolyoxymethylene and titanium intramobile element: a finite element stress analysis. Int J Oral Maxillofac Implants. 1992 Winter;7(4):450–8.
    1. Rasouli Ghahroudi A, Talaeepour A, Mesgarzadeh A, Rokn A, Khorsand A, Mesgarzadeh N, et al. Radiographic vertical bone loss evaluation around dental implants following one year of functional loading. J Dent (Tehran) 2010 Spring;7(2):89–97.
    1. Al-Juboori MJ, AbRahaman S, Bin Ismail IH, Tawfiq OF. Causes of abutment screw loosening and crestal bone resorption. Year loading: a case report. Dent Implantol Update. 2012 Sep;23:69–72.
    1. Ricci G, Aimetti M, Stablum W, Guasti A.Crestal bone resorption 5 years after implant loading: clinical and radiologic results with a 2-stage implant system Int J Oral Maxillofac Implants 2004July–Aug19597–602.
    1. Rokn A, Rasouli Ghahroudi AR, Hemati S, Soolari A. Comparison of peri-implant bone loss and survival of maxillary intrasinus and extrasinus implants after 2 years. J Dent (Tehran) 2011 Summer;8(3):130–7.
    1. Lee DW, Choi YS, Park KH, Kim CS, Moon IS. Effect of microthread on the maintenance of marginal bone level: a 3-year prospective study. Clin Oral Implants Res. 2007 Aug;18(4):465–70. Epub 2007 Apr 18.
    1. Manz MC. Radiographic assessment of peri-impalnt bone loss. J Oral Maxillofac Surg. 1997 Dec;55(12 Suppl 15):62–71.
    1. Uribe R, Peñarrocha M, Balaguer J, Fulgueiras N. Immediate loading in oral implants. Present situation. Med Oral Patol Oral Cir Bucal. 2005 Jul 1;10(Suppl 2):E143–53.
    1. Misch CE. Progressive bone loading. In: Misch CE, editor. Dental implant prosthetics. St Louis: Mosby; 2005. pp. 511–30.
    1. Cattaneo PM, Dalstra M, Melsen B.Analysis of stress and strain around orthodontically loaded implants: an animal study Int J Oral Maxillofac Implants 2007March–Apr22213–25.
    1. Misch CE. Density of bone: effect on treatment plans, surgical approach, healing and progressive bone loading. Int J Oral Implantol. 1990;6(2):23–31.
    1. Misch CE. Consideration of biomechanical stress in treatment with dental implants. Dent Today. 2006 May;25:80, 82, 84–5.
    1. Appleton RS, Nummikoski PV, Pigno MA, Cronin RJ, Chung KH. A radiographic assessment of progressive loading on bone around single osseointegrated implants in the posterior maxilla. Clin Oral Implants Res. 2005 Apr;16(2):161–7.
    1. Siadat H, Panjnoosh M, Alikhasi M, Alihoseini M, Bassir H, Rokn AR. Does implant staging choice affect crestal bone loss? J Oral Maxillofac Surg. 2012 Feb;70(2):307–13.
    1. Peck DJ, Windham JP, Emery LL, Soltanian-Zadeh H, Hearshen DO, Mikkelsen T. Cerebral tumor volume calculations using planimetric and eigenimage analysis. Med Phys. 1996 Dec;23(12):2035–42.
    1. Lu M, Mitsias PD, Ewing JR, Soltanian-Zadeh H, Bagher-Ebadian H, Zhao Q, et al. Predicting final infarct size using acute and subacutemultiparametric MRI measurements in patients with ischemic stroke. J Magn Reson Imag. 2005 May;21(5):495–502.
    1. Ding G, Jiang Q, Li L, Zhang L, Zhang ZG, Soltanian-Zadeh H, et al. Characterization of cerebral tissue by MRI map ISODATA in embolic stroke in rat. Brain Res. 2006 Apr 21;1084(1):202–9.
    1. Soltanian-Zadeh H, Bagher-Ebadian H, Ewing JR, Mitsias PD, Kapke A, Lu M, et al. Multiparametric iterative self-organizing data analysis of ischemic lesions using pre- or post-Gd T1 MRI. Cerebrovasc Dis. 2007;23(2–3):91–102.

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