Surgical and Radiographic Parameters to Guide Timing of Implant Loading in the Posterior Mandible
Abstract
Purpose: Implant placement elicits a cascade of dynamic and unique osteogenic events that differ amongst patients. These differences in the host response have opened the door to early implant loading and has left many clinicians wondering how loading time affects osseointegration. Hence, the main focus of this prospective cohort study was to determine if the incidence of osseointegration for early loaded implants (at 2 months) in the posterior mandible was equivalent to that of implants loaded conventionally (3 months). Secondarily, this study aimed to determine if osseointegration could be predicted based on clinical parameters such as percent bone volume (% BV), insertion torque (IT), and implant stability quotient (ISQ). Materials and Methods: 21 partially edentulous subjects requiring 22 implants in the posterior mandible were examined. Prior to implant placement, a 2x4 mm bone sample was removed for micro-computed tomography and histologic analyses. Clinical and radiographic parameters including % BV, IT, and ISQ were measured at placement (T0), 2 months (T1), 3 months (T2), and 6 months (T3) post-operatively. At T1, a reverse torque of 20 N cm was applied to the implants and osseointegration was confirmed. Data were statistically analyzed with bivariate regressions, repeated measures analysis of variance, and Tukey post hoc tests. Results: At T1, 95% of implants achieved early osseointegration, with osseointegration maintained through T3. The % BV in the bone-tissue core samples ranged from 29% to 82%, and there was a strong, linear relationship between ISQ and % BV (R2 = 0.8). Analyses revealed the difference in measurements between T0 and T1 was the only time point at which the % BV difference was statistically significant (p < 0.0001). 82% of patients exhibited the greatest amount of healing in the first recall (at T1) after implant placement. Patients with an initial ISQ score greater than 80 tend to have the least amount of ISQ improvement over time.
Document Details
- Document Type
- Technical Report
- Publication Date
- Aug 18, 2020
- Accession Number
- AD1183217
Entities
People
- Concepcion B. Arguello
- Demetri Villarreal
- Petrina Gerogianni
- Rachael L. Voigt
- Wen Lien
Organizations
- Uniformed Services University of the Health Sciences
- University of Texas Health Science Center at San Antonio