Original study - ZZI 02/2015

Immediate implantation in retrospect – a study regarding success and failure of implantations

R. Schindjalova1

Introduction: The success of a dental implantation can be ranked by the criteria of the consensus conference of the International Congress of Oral Implantologists, agreed in 2007. The four-point scale rates an implantation using seve-ral criteria such as pain and mobility.

Material and Methods: The criteria were also used to determine the success rate of the following retrospective study, in which 30 patients were treated with an fast & fixed restoration. Lower and upper jaws were treated, and the implants (SKY fast & fixed, bredent medical, Senden, Germany) were inserted axially and angulated.

Results: 98 % of the implantations were successful with regard to the criteria of the consensus conference 2007. Problems occurred only in 3 cases (4 implants in total), which were eliminated by reimplantation. Success rate after reimplantation is 100 %.

Conclusion: fast& fixed restorations proved an effective method of implantation. Especially the combination of angulated and axial implants provides the opportunity of a safe and probably successful implantation.

Keywords: immediate implantation; ICOI consensus conference; fast & fixed restorations; modified operation protocol

Cite as: Schindjalova R: Sofortimplantation in der Retrospektive – Eine Studie zu Erfolg und Misserfolg von Implantationen. Z Zahnärztl Implantol 2015;31:132–139

DOI 10.3238/ZZI.2015.0132–0139

Introduction

Successful implantation is the aim of every implantological procedure. But what constitutes success? Does retention of the implant in the patient’s jaw suffice as an index of success?

The question of success has preoccupied implantologists for decades, at least as long as implants have been inserted with scientific relevance and scientific interest. Retention of the implant in the patient’s jaw is still highly important in measuring success but it is equally clear that successful implantation de-pends not only on whether but also in what condition the implant is retained [1, 7].

There is no consensus in the literature regarding the para-meters and indices for assessing success, and these sometimes differ greatly. However, parameters that crop up again and again and have therefore been adopted by members of the International Congress of Oral Implantologists (ICOI for short) include: pain, mobility, bone atrophy, probing depth and peri-implantitis. These parameters also form the basis for the „ICOI Pisa Implant Quality of Health Scale“, which was drawn up at the consensus conference in Pisa in 2007 and which partially takes up ideas of earlier reviews [1, 7].

Both the health scale and the parameters can be consulted not only for single implant insertions but also for more complex implant constructions and for immediate implantation.

In recent years, immediate implantation has developed into a promising and effective treatment alternative to conventional implantation. High success and survival rates ensure that it is popular with dentists and patients. Immediate implantation and insertion of axial implants in particular have become established as a readily predictable method [3–6].

However, immediate implantation protocols certainly work with combined implant distribution. The fast & fixed method (bredent, Senden, Germany) for example combines angulated and axial implants in both the maxilla and the mandible. Four implants usually suffice in the mandible, 2 angled and 2 axial, and at least 6 in the maxilla – 4 axial and 2 angulated [2].

Angulated implants are usually placed in regions where there is less bone substance [4]. By using them additional augmentation can be avoided in many cases. More axial than angulated implants are generally placed.

In this study, the standardized operation protocol for use of the bredent SKY fast & fixed implant system was modified so that 4 of the 6 implants placed in the maxilla were angulated.

Of the 208 placed implants 98 % met the criteria of the consensus conference and were assessed as successful after a year.

It was apparent that marginal bone loss increases if only 2 axial implants are placed in the mandible instead of 4. The same picture is seen in the maxilla, while a reduction of the angulated implants from 4 to 2 did not show any significant differences in the amount of bone loss.

Material and Method

The ICOI Health Scale is also the basis of this study and an indicator of the success of the modified operation protocol.

Data were collected from the treatment of 30 patients, all of whom had fast & fixed restorations in the maxilla and/or mandible. The study design was retrospective with the patients followed up until their 12-month review.

The author modified the standardized operation protocol as recommended for the bredent SKY fast & fixed implant system. Six SKY fast & fixed implants (bredent, Senden, Germany) were inserted, both with 4 angulated and 2 axial and with 4 axial and 2 angulated implants. NewTom 3G (QR, Verona, Italy) volume tomography scans were used as the basis for diagnosis and implant planning with coDiagnostix software (Dental Wings, Chemnitz, Germany), which served to determine the optimal positioning and number of implants.

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