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Excessive occlusal load on chemically modified and moderately rough titanium implants restored with cantilever reconstructions. An experimental study in dogs

Clin Oral Implants Res. 2019 Nov30(11):1142-1154

Lima LA, Bosshardt DD, Chambrone L, Araújo MG, Lang NP

Study objectives

The aim of this study in dogs was to evaluate the outcomes of excessively loaded implants. Mandibular premolars were extracted in 5 dogs. After 3 months, each dog received 6 implants (SLA®: n=3; SLActive®: n=3) at Day 0 . Four weeks after surgery, both types of implants were restored with either one single crown with stable occlusal contacts (SC), one crown and a cantilever unit with excessive occlusal contacts (OL), ora non-loaded implant (NL). The following treatment modalities were evaluated: (1) SC SLA®; (2) OL SLA®; (3) NL SLA®; (4) SC SLActive®; (5) OL SLActive®; and (6) NL SLActive®. Bleeding-onprobing (BoP), relative attachment level (AL), mucosal marginal position (GM) were assessed. Resonance frequency analysis (RFA) was assessed weekly. Standardized X-rays were taken at Day 0, and at 4 and 24 weeks.

Results

Similar findings were observed for SLA® and SLActive® implants regarding modified plaque index (PlI), modified bleeding index (GI), GM, AL, and bone level (BL). No significant differences were detected between implant loading and the 24-weekfollow-upor between treatment modalities for all clinical parameters (p>0.05). Six months after loading, RFA values were significantly greater than at implant placement; no significant differences between treatment modalities were found. Linear radiographic measurements yielded similar results between SLA® and SLActive® implants. OL SLA® implants yielded a statistically significant gain on peri-implant bone density over all other groups (p=0.012). Technical complications: Loosened occlusal screws occurred in 13.3% (SC: 3.3%; OL: 10%), while abutment fractures totalized 23.3% (SC: 6.6%; OL: 16.6%).

Conclusions

Excessive occlusal load applied to implants (SLA® or SLActive®) restored with cantilevers did not cause loss of osseointegration or significant changes in their clinical, radiographic, or histologic outcomes. Early excessive occlusal load on SLA® implants promoted a gain in peri-implant bone density. Excessively loaded implants showed more technical complications.

Adapted from Lima LA et al., Clin Oral Implants Res. 2019 Nov 30(11):1142-1154, for more info about this publication click HERE

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