Comparison of Narrow and Regular Implants
Condition: Dental Implant Failed; Alveolar Bone Loss; Complication,Postoperative
MeSH terms: Alveolar Bone Loss; Postoperative Complications
Study type: Observational [Patient Registry]

Summary: 
      The study was designed as a retrospective, parallel, two years longitudinal pilot trial.
      Twenty-eight patients (mean age: 48.34 ± 6.06) aged between 35 and 60 years and 66 TiUnite
      surfaces (Nobel Biocare Parallel Conical Connection), bone level dental implant were included
      in the study. The implants were divided into two different groups according to the NPIs and
      regular platform implants(RPIs). The mean implant lengths, plaque index(PI), gingival
      index(GI), periodontal pocket depth(PD), gingival recession(GR), keratinized gingival
      width(KGW) and bleeding on probing(BOP) values were recorded. The Student's t-test used for
      between-group comparison.
    

Detailed description: 
      Fifty-one participants and 123 dental implants were evaluated; twenty-three participants and
      49 dental implants were excluded because of the different commercial brand dental implant
      (AstraTech, Straumann Roxolid, Bilimplant) and declining to participate. Seventy-four TiUnite
      dental implants were included in the study, but 8 TiUnite surface implants placed in the
      anterior region were excluded. Consequently, 15 male and 13 female patients and 66 dental
      implants were included in the study. This randomized retrospective clinical trial was
      designed according to the Consolidated Standards of Reporting Trials (CONSORT) Statement
      guidelines. A CONSORT Flow Chart of this study was shown in Figure 118.

      The assignment was performed according to the dental implant diameters to include cases in
      the NPI and RPI which are the test and control groups. All dental implants involved are the
      Nobel Biocare Parallel CC brand (Nobel Biocare, Gothenburg, Sweden) with a TiUnite surface,
      and it defined a regular diameter of 4.3 mm and narrow diameter of 3.75 mm. Dental implants
      divided into two groups according to implant diameter, the NPI group comprised 3.75 mm
      diameter (NP, Ø= 3.75 mm) implants, and the RPI group comprised 4.3 mm diameter (RP, Ø=
      4.3mm) implants (implant lengths: 10 mm-13 mm).

      Clinical Measurements The clinical measurements were recorded at follow-up sessions using a
      periodontal probe that was calibrated in 1 mm increments. The clinical measurements were as
      follows: 1) plaque index (PI); 2) gingival index (GI); 3) probing depth (PD), the distance
      between the gingival margin and the bottom of a pocket; 4) clinical attachment level (CAL);
      the distance from the neck of the implant and the bottom of the pocket; 5) bleeding on
      probing (BOP); 6) keratinized gingival width (KGW), the height of peri-implant keratinized
      mucosa; 7) gingival recession (GR), the distance between the neck of the implant and the
      gingival margin. The same researcher performed all clinical measurements. A calibration
      protocol was applied to the reliability of measurements. PI, GI, PD, CAL, GR, KGW meaurements
      on five patients and ten peri-implant values were assessed. Calibration was accepted when
      measurements were 90% similar20. All clinical measurements were recorded for four sites
      (mesiobuccal, distobuccal, mid-buccal, mesiopalatal, midpalatal, and distopalatal) per
      peri-implant region. PD and PI measurements are reliable in peri-implantitis diagnosis21.

      Prosthetic complications of patients were also evaluated clinically. Veneer ceramic chipping,
      abutment screw loosening or fracture, implant fracture, loss of retention were recorded.

      Radiographic Measurements The studies have reported that periapical radiographs taken with
      the parallel technique are reliable in determining the MBL changes at different follow-ups.
      Digital periapical radiographs of the posterior region were obtained using a parallel method
      at follow-up sessions. MBL measurements were provided on periapical radiographs by a software
      program (Mediadent Software, The Dental Imaging Company, London, England). Ten radiographic
      MBL measurements around peri-implant were performed twice with an interval of 3 weeks, and
      researcher calibration was accepted when measurements were similar as %90. MBL was measured
      separately from the mesial and distal parts and also which the average of the two
      measurements. The reference points for the assessments are the implant shoulder and the most
      apical end-point of the bone-implant contact point. The vertical length between these two
      points is defined as MBL.
    

Intervention name(s): periapical radiograph
Intervention type(s): Diagnostic Test
Intervention description(s): alveolar bone loss measurement on standardized parallel periapical radiograph
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        All dental implants involved are the Nobel Biocare Parallel CC brand (Nobel Biocare,
        Gothenburg, Sweden) with a TiUnite surface, and it defined a regular diameter of 4.3 mm and
        narrow diameter of 3.75 mm. Dental implants divided into two groups according to implant
        diameter, the NPI group comprised 3.75 mm diameter (NP, Ø= 3.75 mm) implants, and the RPI
        group comprised 4.3 mm diameter (RP, Ø= 4.3mm) implants (implant lengths: 10 mm-13 mm).
      
Keywords: Dental implants Alveolar bone loss