Publication: Hemen yüklenmiş 4 imlantla destekli tam ark sabit protetik restarasyonların klinik ve radyografik olarak incelenmesi
Abstract
Amaç: Bu çalışmanın amacı ‘All-on-four’ tekniği ile tamamen dişsiz maksilla ve mandibulalara yerleştirilen ve sabit akrilik geçici protezler ile hemen fonksiyona sokulan implantların, 8 haftalık iyileşme döneminde ve sonrasındaki stabilizasyon değişimlerinin rezonans frekans analiziyle belirlenmesi ve 1 yıllık klinik takibin marjinal kemik seviyesi ve klinik parametreler yönünden değerlendirilmesidir. Gereç ve Yöntem: Bu çalışmaya tamamen dişsiz 13 hasta katıldı. Hastalara toplamda 88 adet dental implant (ICX Templant ®, Medentis Medical GmbH, Dernau, Almanya) uygulandı. Bu implantlar yerleştirildikleri gün sabit akrilik geçici protezler ile hemen yüklendi. İmplantların stabiliteleri yerleştirildikten sonra 8. haftaya kadar her hafta, 6. ay ve 12. ayda ölçüldü. Operasyon günü, 6. ayda ve 12. ayda periapikal röntgenleri alınarak marjinal kemik seviyeleri belirlendi. 6. ayda ve 12. ayda klinik takiplerle plak ve gingival indeksi değişimleri değerlendirildi. Bulgular: İyileşme döneminde 2 hastada 2 implant kaybedildi. 1 yıllık başarı oranı %97,73’dir. İyileşme döneminde stabilite değerlerinde 5.haftaya kadar bir değişim gözlenmezken, 6.haftadan itibaren istatistiksel olarak anlamlı derecede artış gözlendi (p˂0,05). İmplant açısı, implant çapı, implant uzunluğu, kemik genişliği ve cinsiyet stabilite değerlerini etkilemezken, mandibuladaki stabilite değerleri maksilladan anlamlı derecede yüksek bulundu (p˂0,05). Birinci yılın sonunda ortalama marjinal kemik seviyesi 0,66±0,55 mm olarak ölçüldü. İmplantın yerleştirildiği çene marjinal kemik seviyesini etkilemezken, cinsiyet, implant açısı, implant çapı, kemik genişliğinin marjinal kemik seviyesi üzerindeki etkisi istatistiksel olarak anlamlı bulundu (p˂0,05). 1 yıllık klinik takip sonucunda plak ve gingival indeksi değerlerinde istatistiksel olarak anlamlı bir artış gözlendi (p˂0,05). Sonuç: ‘All-on-four’ tekniği rezorbe tamamen dişsiz çeneleri olan hastalarda konvansiyonel implant yerleşim prosedürlerine benzer sonuçlar gösterdiği için, başarılı bir tedavi alternatifi olarak kullanılabilir. Anahtar Sözcükler: ‘All-on-four’ tekniği, atrofik çeneler, rezonans frekans analizi, marjinal kemik seviyesi
Purpose: The aim of this study was to determine the stability changes of the implants, placed with ‘All-on-four’ technique in edentulous jaws and functioned immediately with fixed acrylic provisional prosthesis, in 8-week healing and post-healing period with resonance frequency analysis and evaluate marginal bone level and clinical parameters of them in one-year. Materials and Methods: Edentulous thirteen patients were included in this study. Patients received a sum of 88 dental implants (ICX Templant ®, Medentis Medical GmbH, Dernau, Germany). These implants were immediately loaded with fixed acrylic provisional prosthesis in the day they were placed. The stability of implants was measured in every week until the eighth week and after six and twelve months by using resonance frequency analysis (RFA). Marginal bone level was determined by using the periapical radiographies at the day of insertion, after six and twelve months. Plaque and bleeding scores of the implants were also measured after six and twelve months. Results: 2 implants in two patients were lost during the healing period. One-year success rate was 97,73%. No changes were observed in the stability values during the healing period until the fifth week, but after the sixth week, a statistically significant increase was observed (p˂0,05). While angle, diameter and length of implants and gender did not affect stability values, the jaw type did (p˂0,05). After one-year the mean marginal bone level was 0.66 ± 0.55 mm. Marginal bone level was affected by angle, diameter and length of implants and gender, except the jaw type (p˂0,05). One-year clinical follow-up showed a statistically significant increase in plaque and bleeding index values (p˂0,05 ). Conclusion: In implant-supported fixed prosthetic treatment, the use of the combination of ‘All-on-four’ technique and immediate loading, according to these encouraging results, can be a predictable, useful and successful treatment alternative for the patients with edentulous atrophic jaws. Key Words: ‘All-on-four’ technique, atrophic jaws, resonance frequency analysis, marginal bone level
Purpose: The aim of this study was to determine the stability changes of the implants, placed with ‘All-on-four’ technique in edentulous jaws and functioned immediately with fixed acrylic provisional prosthesis, in 8-week healing and post-healing period with resonance frequency analysis and evaluate marginal bone level and clinical parameters of them in one-year. Materials and Methods: Edentulous thirteen patients were included in this study. Patients received a sum of 88 dental implants (ICX Templant ®, Medentis Medical GmbH, Dernau, Germany). These implants were immediately loaded with fixed acrylic provisional prosthesis in the day they were placed. The stability of implants was measured in every week until the eighth week and after six and twelve months by using resonance frequency analysis (RFA). Marginal bone level was determined by using the periapical radiographies at the day of insertion, after six and twelve months. Plaque and bleeding scores of the implants were also measured after six and twelve months. Results: 2 implants in two patients were lost during the healing period. One-year success rate was 97,73%. No changes were observed in the stability values during the healing period until the fifth week, but after the sixth week, a statistically significant increase was observed (p˂0,05). While angle, diameter and length of implants and gender did not affect stability values, the jaw type did (p˂0,05). After one-year the mean marginal bone level was 0.66 ± 0.55 mm. Marginal bone level was affected by angle, diameter and length of implants and gender, except the jaw type (p˂0,05). One-year clinical follow-up showed a statistically significant increase in plaque and bleeding index values (p˂0,05 ). Conclusion: In implant-supported fixed prosthetic treatment, the use of the combination of ‘All-on-four’ technique and immediate loading, according to these encouraging results, can be a predictable, useful and successful treatment alternative for the patients with edentulous atrophic jaws. Key Words: ‘All-on-four’ technique, atrophic jaws, resonance frequency analysis, marginal bone level