Page 119 - Peri-implant health: the effect of implant design and surgical procedure on bone and soft tissue stability
P. 119

                                IMPROVEMENT OF QUALITY OF LIFE WITH IMPLANT-SUPPORTED MANDIBULAR OVERDENTURES AND THE EFFECT OF IMPLANT TYPE AND SURGICAL PROCEDURE ON BONE AND SOFT TISSUE STABILITY
part of the implant. Although crestal bone remodeling is a given fact after implant placement, related to the surgical trauma from periosteal elevation, as well as the drilling procedure, it is from a preventive point of view important to have the bone covering the implant as much as possible. Initial crestal bone loss, resulting in the absence of bone contact, can predict a future bone loss in patients prior to the disease. Galindo-Moreno and co-workers concluded that 96% of implants with a marginal bone loss above 2 mm at 18 months had lost 0.44 mm or more at six months post loading.43 A critical long-term study where implants were placed in the partially edentulous mandible, indicated that bone loss in patients with thin (<2 mm) and a thick mucosa (>2 mm) was identical, when the implants were installed subcrestally to anticipate on the biologic width re-establishment.44
Another subject of debate is the predictive value of biologic parameters around dental implants. Bleeding on probing, suppuration, plaque formation and probing pocket depth are the most widely used clinical parameters to describe health and/or disease around dental implants. These biologic parameters are most of the times included in the definition of peri-implantitis. However, a largely critical review showed the absence of a correlation between bone loss and the biologic parameters mean probing pocket depth and mean bleeding on probing. The authors also reported inconsistency and incompleteness in reporting on these parameters in the literature, which could affect decision-making in clinical practice.45
Hence, the aim of this paper is to describe, by means of two prospective clinical split-mouth cohort studies, the effect of implant surface roughness and surgical implant depth positioning on crestal bone remodeling, peri-implant health, and patient-centered outcomes. The mandibular overdenture supported by two dental implants is used as a split-mouth model to scrutinize these aims.
■ EXPERIMENTALSECTION
Patient Population and Surgical/Prosthetic Procedures
This paper includes two prospective split-mouth studies. Both studies included edentulous patients in need of a two-implant supported overdenture in the lower jaw. The same inclusion and exclusion were used for both studies. Inclusion criteria
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