Implant-prosthetic rehabilitation of patients with severe horizontal bone deficit on mini-implants with two-piece design—retrospective analysis after a mean follow-up of 5 years

Abstract

Background As a consequence of tooth loss due to trauma or extraction, a reduced alveolar crest volume limits the deployment of standard implants in certain patient cases. For this reason, minimal-invasive treatment with mini-dental implants (MDI) might be an option to allow implant treatment even in cases with severe horizontal bone loss without augmentation measures. The aim of this retrospective cohort study was to investigate clinical and radiological implant, as well as patient-related parameters after treatment with MDI. Results Clinical and radiological records of 19 female (82.6%) and 4 male patients (17.4%) (N = 23), who received 52 mini-dental implants with a two-piece design in a single surgical center between November 2011 and October 2018, were retrospectively analyzed. Implants were submitted to conventional loading on different types of screwed superstructures. Crestal bone loss was measured on standardized periapical radiographs. Patient-related outcome parameters (PROMs) were recorded during follow-up period. Mean clinical and radiological follow-up was 69.6 months (5.8 years) and 51.6 months (4.3 years), respectively. Three implants were lost in two patients, leading to an implant survival rate of 94.2%. Mean radiological crestal bone loss was 1.6 mm. Both amount of peri-implant recession and crestal bone loss were significantly correlated (r = 0.65; p < 0.001). Likewise, a significant correlation was observed between deeper probing depths and increased peri-implant bone loss (r = 0.41; p = 0.012). Alveolar ridges with a reduced alveolar crest width were significantly correlated with higher peri-implant bone loss as well (r = − 0.33; p = 0.011). No prosthetic complications were reported during follow-up. Extent of midfacial recession and papilla height loss had a significant negative impact on most of the PROMs. Conclusions Treatment with MDI seems to be a successful alternative treatment option, especially for elderly patients with reduced crest width at implant sites. Due to the good clinical results and high survival and success rates, this treatment option was associated with high patient satisfaction. Despite the promising results, particular consideration should be given to appropriate treatment planning in these patients due to the strong correlation between peri-implant soft-tissue parameters, crestal bone loss, and reduced alveolar crest width.

Outcomes of Immediately & Conventionally Loaded Dental Implants

“…[20][21][22] Previous publications have shown that primary stability has a pivotal role in success of "IL protocol"; diminished initial stability being a key factor in early implant failure. In contrast, another publication revealed a high final success rate of implants loaded immediately subjected to low insertion torques i-e < 25 N-cm [23][24][25][26][27][28][29][30] Hence, ideal value of insertion torque dictating successful osseointegration still needs to be set by conducting further investigations.…”

Impact of Implant Diameter on Success and Survival of Dental Implants: An Observational Cohort Study

“…This means that bone resorption after tooth loss is often greater in width than in height [10]. To insert standard diameter implants (SDIs), however, a minimum bone width of 6 mm is required [11,12]. Bone augmentation can be performed to improve insufficient available bone; however, the procedure is cost-and time-intensive and can lead to complications such as infection, wound dehiscence, damage to surrounding tissue, or gingival recession [13][14][15].…”

Evaluation of the clinical safety and performance of a narrow diameter (2.9 mm) bone-level implant: a 1-year prospective single-arm multicenter study

“…Increased prosthetic flexibility may also be possible under certain clinical situations [ 12 ]. Furthermore, studies have reported the successful use of 2.7–3.25 mm NDIs and mini-diameter implants as a minimally invasive alternative for patients with insufficient bone ridge thickness in the posterior mandible and a reduced alveolar crest volume [ 14 , 15 ]. Another meta-analysis study described high patient satisfaction for mini-diameter implants as compared to SDIs when used for implant-supported overdentures [ 16 ].…”