Exploring the Importance of Corticalization Occurring in Alveolar Bone Surrounding a Dental Implant

Abstract

Several measures describing the transformation of trabecular bone to cortical bone on the basis of analysis of intraoral radiographs are known (including bone index or corticalization index, CI). At the same time, it has been noted that after functional loading of dental implants such transformations occur in the bone directly adjacent to the fixture. Intuitively, it seems that this is a process conducive to the long-term maintenance of dental implants and certainly necessary when immediate loading is applied. The authors examined the relationship of implant design features to marginal bone loss (MBL) and the intensity of corticalization over a 10-year period of functional loading. This study is a general description of the phenomenon of peri-implant bone corticalization and an attempt to interpret this phenomenon to achieve success of implant treatment in the long term. Corticalization significantly increased over the first 5-year functional loading (CI from 200 ± 146 initially to 282 ± 182, p < 0.001) and maintained a high level (CI = 261 ± 168) in the 10-year study relative to the reference bone (149 ± 178). MBL significantly increased throughout the follow-up period—5 years: 0.83 ± 1.26 mm (p < 0.001), 10 years: 1.48 ± 2.01 mm (p < 0.001). MBL and radiographic bone structure (CI) were evaluated in relation to intraosseous implant design features and prosthetic work performed. In the scope of the study, it can be concluded that the phenomenon of peri-implant jawbone corticalization seems an unfavorable condition for the future fate of bone-anchored implants, but it requires further research to fully explain the significance of this phenomenon.

New Radiological Corticalization Index as an Indicator of Implant Success Rate Depending on Prosthetic Restoration—5 Years of Follow-Up

“…The corticalization phenomenon, or corticalization index, is still not well explored in science. The literature reveals only a few studies that describe this phenomenon in dental/implant surgery [8][9][10]16]. Considering the presented research, this phenomenon may reflect various changes in the alveolar bone, both positive and negative, depending on multiple factors.…”

Is Corticalization in Radiographs Related to a Higher Risk of Bone Loss around Dental Implants in Smoking Patients? A 5-Year Observation of Radiograph Bone-Texture Changes

“…The effect of this correlation may result in marginal bone loss. After five years of observation, the research showed that the higher the MBL, the greater the probability of implant loss in the smoking patients’ group, which is indirectly correlated with the occurrence of the corticalization phenomenon [ 24 , 25 , 27 ].…”

“…Taking into account the types of implants, it can be stated that not only the design of the dental implant affects the corticalization phenomenon. There is a relationship between bone condition, prosthetic restoration and also the surgeon’s experience and preferences [ 24 , 55 , 56 ].…”

“…Spine densitometry is one of the methods used to check and control the metabolism of human bone [ 22 , 23 ]. Previous studies observed a warning relation between marginal bone loss and the transformation of the bone surrounding dental implants toward corticalization [ 24 , 25 ]. The coexistence of these two phenomena may have an adverse effect on the long-term success of dental implant treatment.…”

An Experimental Anodized and Low-Pressure Oxygen Plasma-Treated Titanium Dental Implant Surface—Preliminary Report

“…Since the fractal architecture concept is particularly interesting in surface and materials science, it also can be adapted to assess the surface of titanium dental implants. Texture analysis is used in dentistry or medicine to analyze images of computed tomography or X-ray [ 10 , 11 , 12 , 13 ]…”