Avaliação da perda óssea marginal com o uso de pilar personalizado definitivo em titânio após implante e função imediatos na zona estética : um estudo de coorte prospectivo de até 8 anos de acompanhamento

Abstract

Objectives: The purpose of this 3-year cohort prospective study was to assess the implant survival rate, marginal bone loss (MBL) and clinical complications using a minimally invasive technique for immediate implant placement and restoration and the one abutment-one time (OAOT) protocol in the aesthetic zone. Material and methods: Fifty-two subjects (38 females, 14 males) with a mean age of 58 years received a single-tooth implant definitive prosthesis between both maxillary canines seven months after immediate implant placement and restoration, followed by a reconstructive bone graft with DBBM particles. Each patient received a temporary crown with a customized definitive abutment placed on the same day of surgery that was not removed throughout the subsequent restorative procedures. Patients were clinically screened for mechanical and biological complications during the follow-ups and periapical radiographs were used forMBL measurements at 6 months, 12 months and at a final follow-up assessment that ranged from 12 to 100 months (mean = 36.34 months). Data were analyzed with Student’s t test and analysis of variance (ANOVA) at the significance level of  = 0.05. Results: Two implants and one definitive crown were lost for a cumulative implant survival rate of 96.2% and definitive crown survival rate of 98%. The mean MBL at the mesial and distal aspects were 0.19 ± 0.35 mm and 0.25 ± 0.47 mm, respectively, after a 3-year follow up. There were no statistically significant differences between the 6-month and 12-month MBL at both mesial and distal aspects compared to the final follow-up (p = 0.832 and p = 0.958, respectively). Only 8% of the implants showed MBL > 1mm and 65.6% of implants with no marginal bone loss presented bone/prosthetic abutment contact radiographically.The most frequent complication was temporary crown loosening with 30 occurrences. Conclusions: This study describes a predictable one-stage surgical procedure that offers immediate aesthetics and reduced morbidity combined to highly stable bone remodeling results in the anterior zone.