Objective: To evaluate the influence of the crown-to-implant ratio (C/I) ratio and different implant prosthetic treatment modalities on crestal bone loss around dental implants placed in the posterior region.

Material and methods: A total of 192 ITI dental implants were consecutively placed in premolars and molars of 83 partially edentulous patients. All implants were restored by means of ceramic-to-metal fused fixed partial dentures or a single crown. Patients were followed as part of a prospective longitudinal study focusing on implant success. Surgical, radiographic and clinical variables were collected at the 1-year recall after implant placement and at the most recent clinical evaluation. Radiographic parameters were evaluated on periapical radiographs taken with a standardized long-cone paralleling technique. Implant restorations were divided into three groups according to their respective clinical C/I ratios: (a) 0–0.99, (b) 1–1.99 and (c) ≥2.

Results: The mean clinical C/I ratio was 1.77±0.56 mm. A total of 51 implants (26.5%) showed a clinical C/I ratio equal to or greater than 2. In this group, three implants failed, giving a cumulative survival rate of 94.1%. Crestal bone loss was −0.34±0.27 mm in group a, −0.03±0.15 mm in group b and −0.02±0.26 mm in group c. Differences among groups were statistically significant (P=0.009). Mode of retention, splinting or presence of cantilever extensions did not have an effect on crestal bone loss around ITI dental implants.

Conclusions: Implant restorations with C/I ratios between 2 and 3 may be successfully used in the posterior areas of the jaw.

A 10-year prospective study of ITI dental implants placed in the posterior region. II: Influence of the crown-to-implant ratio and different prosthetic treatment modalities on crestal bone loss

Statement of Problem. To circumvent the difficulty of achieving a passive framework fit, some authors have suggested that multiple adjacent implants be restored individually. This protocol requires that each unit be able to withstand mastication forces. Non-splinted restorations have numerous interproximal contacts that require adjustments prior to placement, with an unknown outcome relative to load transfer. Purpose. This in vitro simulation study examined the effect of splinting and interproximal contact tightness on passivity of fit and the load transfer characteristics of implant restorations. Material and Methods. A photoelastic model of a human partially edentulous left mandible with 3 screw-type implants (3.75 × 10 mm) was fabricated. For non-splinted restorations, individual crowns were fabricated on 3 custom-milled titanium abutments. After the units were cemented, 5 levels of interproximal contact tightness were evaluated: open, ideal (8 μm shim stock drags without tearing), light (ideal +10 μm), medium (ideal + 50 μm), and heavy (ideal + 90 μm). For splinted restorations, five 3-unit fixed partial dentures were fabricated, internally adjusted with silicone disclosing material, and cemented to the model. Changes in stress distribution under simulated non-loaded and loaded conditions (6.8 kg) were analyzed with a polariscope. Results. In the simulated alveolar structures, non-splinted restorations with heavier interproximal contacts were associated with increased tensile stresses between implants; occlusal loads tended to concentrate around the specific loaded implant. Splinted restorations shared the occlusal loads and distributed the stresses more evenly between the implants when force was applied. The load-sharing effect was most evident on the center implant but also was seen on the terminal abutments of the splinted restorations. Conclusion. The results of this in vitro study suggest that excessive contact tightness between individual crowns can lead to a non-passive situation. In this experiment, splinted restorations exhibited better load sharing than non-splinted restorations. (J Prosthet Dent 2002;87:528-35.)

Effect of splinting and interproximal contact tightness on load transfer by implant restorations.

PURPOSE: The purpose of this study was to measure marginal bone loss from the implant-abutment microgap to the bone crest between multiple freestanding implants functionally loaded for up to 7.5 years in the posterior jaws. MATERIALS AND METHODS: Patients consecutively treated for the replacement of missing posterior teeth were included in the study. Using the implant-abutment interface, which was placed level with the crestal bone as a reference point, standardized follow-up radiographs were obtained to evaluate marginal bone loss. Results were subject to statistical analysis using the Wilcoxon rank sum test and the Wilcoxon signed rank test at the 95% confidence level. Additionally, soft tissue and prosthetic complications were recorded. RESULTS: One hundred seventy-three implants in 54 patients were evaluated. Implants were in function for a mean of 37 months (range, 21 to 91 months). One implant failed, for a survival rate of 99.4%. Overall mean marginal bone loss was 0.65 mm (range, 0.0 to 4.8 mm). For the 80 maxillary and 93 mandibular implants, mean marginal bone loss was 0.56 mm and 0.70 mm, respectively. The frequency of bone loss > or = 1.0 mm was 25.0% in the maxilla and 36.0% in the mandible; 23.1% of maxillary implants and 16.7% of mandibular implants demonstrated no bone loss. No significant differences were observed between men and women or between smokers and nonsmokers. The difference between mesial and distal bone levels was statistically significant (P < .001), with respective means of 0.53 mm and 0.76 mm. Recorded prosthetic complications included cementation failure (17.7%), porcelain fracture (7.2%), and abutment screw loosening (2.2%). CONCLUSIONS: Multiple single-tooth implants placed in the posterior jaws perform extremely well. Furthermore, it is possible to retain bone close to the implant-abutment microgap with certain implant designs.

Multiple single-tooth implant restorations in the posterior jaws: maintenance of marginal bone levels with reference to the implant-abutment microgap.

Purpose The success of single-tooth implant restorations has resulted in an increased use of nonsplinted implants to replace adjacent missing teeth; however, this may result in excessive force transmission to the implant and bone, causing bone loss. The purpose of this prospective study was to compare the marginal bone level change of adjacent splinted implants and of nonsplinted implants functionally loaded with cemented restorations up to 5 years in maxillae. Material and methods Between 2002 and 2004, all patients who received three consecutive adjacent implants in a private office and a university implant dentistry department were included in this study. All implants were placed in posterior maxillae. Maxillary left implants were restored with splinted cemented restorations, and maxillary right implants were restored with nonsplinted cemented restorations. Marginal bone resorption was measured with intraoral radiographs annually for 5 years. The data were analyzed statistically with the Mann-Whitney U test and the two-sample Kolmogorov-Smirnov test to identify differences between splinted and nonsplinted implant restorations. Results One hundred thirty-two implants were placed in 44 patients. Two subjects (6 implants in total) did not complete the study. Three implants failed at stage-two surgery. Of the remaining 123 implants, 63 were restored with splinted cemented restorations and 60 were restored with nonsplinted cemented restorations. The mean marginal bone level changes at the 5-year recall were -0.7 ± 0.2 mm for splinted restorations and -0.8 ± 0.2 mm) for nonsplinted restorations. Conclusions Peri-implant marginal bone loss around nonsplinted implants in the present study was statistically equivalent to that observed in splinted implants. Multiple nonsplinted implants can be successfully included in many clinical situations in an effort to optimize esthetics and circumvent the problem of nonpassively fitting frameworks.

Clinical evaluation of marginal bone level change of multiple adjacent implants restored with splinted and nonsplinted restorations: a 5-year prospective study.

Purpose: The management of occlusal forces on implant restorations may influence their long-term prosthetic success. The purpose of this randomized controlled trial was to compare marginal bone level changes around adjacent splinted and nonsplinted implants, functionally loaded with cemented restorations, up to 10 years in maxillae. Materials and Methods: During 2002 and 2003, all patients who received three adjacent implants in a private office and a university setting were included in this study. All implants featured an external-hexagon design and were placed in the posterior maxilla. Implants in the left maxilla were randomly selected to be restored with splinted cemented restorations; maxillary right implants were restored with nonsplinted cemented restorations. Marginal bone resorption was measured with intraoral radiographs yearly over a period of at least 10 years after placement of abutments and restorations. The amount of bone loss in each group was analyzed with the two-sample Wilcoxon rank-sum (Mann-Whitney) test because variable bone loss was normally distributed at the fifth year only. Results: One hundred thirty-two implants were placed in 44 patients. Three implants failed at stage-two surgery. Five years after initial loading, two patients moved away and were lost to follow-up (6 implants in total); three additional patients did not complete the study (9 implants in total). Of the remaining 114 implants, 60 left implants were restored with splinted cemented restorations and 54 right implants were restored with nonsplinted cemented restorations. At 10 years, the splinted group showed a mean of 1.2 mm (interquartile range: 0.2 mm) of bone loss; the nonsplinted group showed 1.3 mm (interquartile range: 0.2 mm). Conclusion: A significant difference in bone loss was seen between the two groups. However, the difference of 0.1 mm was not considered clinically meaningful.

Clinical evaluation of marginal bone level change around multiple adjacent implants restored with splinted and nonsplinted restorations: a 10-year randomized controlled trial.

The restoration of patients with dental implants presents many challenges. Some of the common concerns and problems are difficulty in achieving a passive-fitting cast framework and loosening of prosthesis-retraining screws or abutment screws when using external hex prosthesis connection systems. The ITI system uses a unique connection of the abutment to the prosthesis-anchoring component. Because of this unique connection, many problems encountered with external hex designs have been greatly reduced or eliminated by the ability to more easily restore individual teeth with individual implants. This article will present the rationale for restoration of a patient with implants using individual implant-supported restorations.

An alternative to splinting multiple implants: use of the ITI system.

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Gary S. Solnit

Author Tools

Chat about Author

Papers

An alternative to splinting multiple implants: use of the ITI system.