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 »  Home  »  Dental Implant 3  »  The Adaptation of Implant-Supported Superstructures to the Alveolar Crest: A Follow-Up of 49 Cases
The Adaptation of Implant-Supported Superstructures to the Alveolar Crest: A Follow-Up of 49 Cases
Results.

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The follow-up time for the patients varied from two to five years. All patients have been examined annually with standardized intraoral radiographs. In 15 patients, the superstructures were removed annually to allow thorough inspection of the underlying mucosa (Fig. 3). Marginal bone loss was found mainly in the maxillary cases. In the mandibular cases, only one fixture was lost. In the maxillary cases, six fixtures were lost. This translates to a success rate of 98.9% for the individual fixtures in the lower jaw, 96.3% for the upper jaw, and 97.3% for individual implants. The radiologic examination was made by two independent observers and showed results similar to superstructures with a standardized design of a couple of millimeters above the alveolar crest. When measuring the marginal bone height in the periodic identical radiographs, it was found that there was almost no marginal bone reduction in the mandible. In the maxilla, the reduction during the first postoperative year was 0.49 mm and then gradually increased to 0.72 mm the second year, 0.81 mm the third year, and 1.1 mm the fifth year (Figs. 5, 6, and 7 and Table 1). The bone volume and the quality of bone were assessed according to Lekholm and Zarb20 and varied between 1 and 4 in bone volume and 3 and 4 in bone quality. The patient’s satisfaction with the prosthetic constructions and designs was extremely good. For some of the patients, the oral hygiene procedures, including the use dental floss and special techniques to get around the abutments, were difficult or not worth the effort. The marginal conditions, even after a period of six years, appeared healthy with no observable periodontal signs of inflammation as judged by the oral hygienist. These judgments were based on color change, gingival texture, and bleeding on probing.

Fig. 5. Periodic identical intraoral radiographs in the upper jaw one year (A) and five years (B) after the fixture installation and the bridge adaptation.

Periodic identical intraoral radiographs in the upper jaw one year

Fig. 6. Periodic identical intraoral radiographs of implants in the lower jaw after the bridge connection (A) and four years later (B).

Periodic identical intraoral radiographs of implants in the lower jaw after the bridge connection

Fig. 7. Periodic identical radiographs in the upper jaw of a patient with thin alveolar crest showing initial remodeling and marginal bone loss (A). The situation becomes stable when comparing radiographs four years later (B).

Periodic identical radiographs in the upper jaw of a patient with thin alveolar crest showing initial remodeling and marginal bone loss

Table 1. Marginal Bone Loss.

Marginal Bone Loss