Initial Implant Position Determines the Magnitude of Crestal Bone Remodeling
- Autores: Gary A. Hartman, David L. Cochran
- Localización: Journal of periodontology, ISSN 0022-3492, Vol. 75, Nº. 4, 2004, págs. 572-577
- Idioma: inglés
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Resumen
Background: The ability to predict the amount of bone remodeling around implants is important for a stable and predictable esthetic result. The purpose of this study was to investigate the amount of radiographic bone remodeling that occurs over time using a one-piece implant system.
Methods: Twenty-seven patients receiving implants in the maxilla and 15 receiving implants in the mandible were included in the study. All implants were placed with a non-submerged surgical technique with varying locations of the rough-smooth border with respect to the alveolar crest. Clinical exams and radiographs were taken on the day of implant placement, at 6 months, and annually up to 5 years. Linear measurements from digitized radiographs were made from the implant shoulder to the first boneto- implant contact at all time points.
Results: A significant amount of bone remodeling compared to baseline occurred for all implants at the 6-month follow-up visit (1.10 mm), with the remaining time points showing virtually no change (0.1 mm). A relationship was found between the amount of bone remodeling and the location of the rough-smooth border with respect to the alveolar crest. Those implants with the rough-smooth border surgically placed below the crest had, on average, a greater amount of remodeling at 6 months (average 1.72 mm) than implants with the rough-smooth border placed at or near the crest (average 0.68 mm). In both situations, this remodeling: 1) occurred early (within 6 months), 2) reached a similar level, and 3) remained virtually unchanged up through 60 months (0.05 mm).
Conclusions: A physiologic dimension appears to exist between the bone and the implant-crown interface around onepiece implants that is established early and maintained over time. These results are significant because they demonstrate in patients that the magnitude of initial bone remodeling around these onepiece dental implants is dependent on the positioning of the rough-smooth border of the implant in an apico-coronal dimension. Furthermore, the dimension, from the crown-implant interface to the first bone-to-implant contact, is consistent with the formation of a biologic width similar to that found around the natural dentition. J Periodontol 2004;75:572-577.
