الفهرس | Only 14 pages are availabe for public view |
Abstract The use of endosseous implants to restore lost dentition has proved to be a successful treatment modality, providing the patient with a near-natural replacement. Implants have become the treatment of choice in many, if not most, situations when missing teeth require replacement. Despite the predictability of the conventional protocol involving two surgical stages established by Branemark et al the quest for decreased treatment periods between device placement and its subsequent functional loading has fostered implant engineering design modifications at different length scales. A delay in the healing process leads to a marked decrease in the total stability of the implant between weeks 2 and 4, making this “stability dip” a critical time in the osseointegration process. implants should be kept unloaded until after the dip has passed, which limits the application of immediate and early loading. The purpose of this study is to clinically evaluate dental implants stability at placement and its subsequent changes during healing when placed in healed bony sites following an over- drilling protocol compared to the conventional-drilling protocol, thus, shifting the dip, achieving secondary stability sooner by accelerating the osseointegration process and shorter treatment time. This study included 18 implants placed in 16 patients. With 9 implants in every group. Primary stability of the implant (primary outcome) was assessed the day of the surgery and then 1,2,3,4,5.6,8,12 weeks. At week 0 and week 1, a higher mean value was recorded in control group in comparison to intervention group, with a significant difference (p=0.00, p=0.04 respectively). Starting from week 2, in comparison to control group a higher mean value was recorded in the intervention group, with a statistically significant difference (p=0.04). Similarly, at week 3, week4, week6, week 8, week 12, a higher mean value was recorded in the intervention group, with a statistically significant difference (p=0.00) in comparison to control group. Crestal bone loss (measured by digital periapical x rays) was assessed the day of the surgery and then 3 and 6 months after implant placement. At baseline, there was a higher mean value in the control group, with no statistically significant difference between groups (p=0.15). At 3 months, there was a higher mean value in the control group, with no statistically significant difference between groups (p=0.20). At 6 months, there was a higher mean value in the intervention group, with statistically significant difference between group (p=0.00) |