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EDI Journal – Dicembre 2016 – First report of a two-year retrospective study with a newly developed bone-level implant system Peri-implant health and peri-implant bone stability after immediate implant placement

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International Journal of Implant Dentistry • Dicembre 2016

Prima relazione di uno studio retrospettivo biennale con un impianto a livello osseo di recente sviluppo Salute perimplantare e stabilità ossea perimplantare dopo il posizionamento immediato dell’impianto

DR-Medic Stom. Henriette Lerner HL DENTCLINIC, Dr. Jonas Lorenz University Hospital Frankfurt · Department of oral, maxillofacial and plastic surgery, Professor Robert A. Sader Goethe-Universität Frankfurt am Main · Center of Stomatology and Dr. Shahram Ghanaati Goethe University of Frankfurt/Main; Universitätsmedizin der Johannes Gutenberg-Universität Mainz · Department for Oral, Craniomaxillofacial and Facial Plastic Surgery; Institute of Pathology

Gli impianti dentali sono diventati una modalità di trattamento affidabile e prevedibile per sostituire il dente o i denti mancanti e conservare la dentatura in caso di pazienti edentuli. Possono ripristinare la salute orale, la forma, la funzione, la masticazione, l’articolazione e l’estetica dell’apparato stomatognatico con un tasso di successo pluriennale superiore al 90 percento nel caso di impianti in pazienti completamente edentuli [1,2] o parzialmente edentuli [3-6]. Si è riscontrato che le variazioni nel successo dell’impianto dipendono dalla tecnica chirurgica, dal protocollo di carico, dalla localizzazione dell’impianto e dalla qualità ossea. Ad esempio, sono state rilevate percentuali di successo inferiori per impianti mascellari rispetto a quelli mandibolari [7,8]

Negli ultimi decenni, la ricerca sugli impianti dentali ha portato ad una vasta modifica dei protocolli chirurgici e protesici.
Per la superficie degli impianti dentali c’è ampio consenso in riferimento alla superiorità delle superfici rese ruvide (con rugosità a scala micrometrica o superiore).

Altri modi per aumentare la superficie dell’impianto comprendono il design filettato, la lunghezza dell’impianto e il diametro dell’impianto. Il tipo di impianto dovrebbe prevedere caratteristiche in grado di trasformare al meglio le forze di trazione e taglio durante la masticazione e minimizzare i componenti di forze indesiderate.
Un ulteriore fattore essenziale per la stabilità di lungo periodo dei tessuti ossei perimplantari e per garantire un impianto dentale esteticamente e funzionalmente adeguato è la stabilità della connessione impianto-moncone, per evitare fratture dell’impianto e l’allentamento della vite e per mantenere stabile il livello osseo perimplantare.
Con il design in due pezzi, uno spazio o micro-gap tra l’impianto e il moncone è inevitabile; ciò nonostante, talvolta si può rilevare un micro-gap inferiore se il design è con connettori conici a cono Morse e platform switching, per trasferire il micro-gap davanti all’asse impianto e ridurre il micro-movimento. Ciò può ridurre la propulsione del fluido dal solco e, di conseguenza, la perdita ossea crestale, anche con impianti inseriti sotto alla cresta alveolare (subcrestali).

Lo scopo di questo studio retrospettivo è quello di descrivere i risultati clinici e radiologici di un nuovo impianto con topografia della superficie pallinata e trattata con acido e connessione impianto-moncone con attacco conico Morse. Gli impianti sono stati inseriti in alveoli di estrazione freschi e intatti di denti mascellari e mandibolari non recuperabili, con follow-up clinico e radiologico dopo un tempo di carico medio di due anni. È stata posta particolare enfasi sul mantenimento della salute perimplantare e sulla stabilità del livello osseo perimplantare.


 

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