Aims: To assess the success rate and implant stability changes of narrow dental implants (NDIs) during the osseous healing period.
Materials and methods: This prospective observational clinical study included 21 patients with narrow alveolar ridge of restricted mesiodistal interdental span who received NDIs. The alveolar ridge width was determined by the ridge mapping technique. Implant stability was measured using Periotest® M immediately after implant insertion then after 4 weeks, 8 weeks and 12 weeks postoperatively. The outcome variables were success rate and implant stability changes during the healing period. The statistical analysis included one-way analysis of variance (ANOVA) and Tukey's multiple comparisons test, values < 0.05 were considered statistically significant.
Results: Twenty-one patients received 54 implants, the success rate was 92.6% (50/54). The mean ± SD periotest value (PTV) was significantly increased at 4 weeks (7.62 ± 6.39 PTV) compared with primary stability (1.48 ± 3.16 PTV), at 8 weeks (4.46 ± 4.45 PTV). It significantly decreased compared with that at 4 weeks and at 12 weeks (1.82 ± 3.22 PTV); it decreased significantly compared to that at 8 weeks.
Conclusion: Narrow dental implants have a high early success rate. The implant stability during the healing period drops significantly in the first 4 weeks postoperatively and then increases steadily in the following weeks to reach to a level close to that of primary stability after 12 weeks.
Clinical significance: Narrow dental implants are indicated in cases of insufficient alveolar bone width obviating the need for bone augmentation and reduced interdental space such as in cases of congenitally missing teeth or after orthodontic treatment. Knowledge of the stability changes during the osseous healing period enables the clinicians to determine the optimum time for functional loading.
Scipioni A, Bruschi GB, Calesini G, Bruschi E, De Martino C. Bone regeneration in the edentulous ridge expansion technique: Histologic and ultrastructural study of 20 clinical cases. Int J Periodontics Restorative Dent 1999;19:269-277.
Summers R.B. A new concept in maxilary Implant surgery: the osteotome technique. Compendium 1994;15:152-158.
Scipioni A, Bruschi GB, Calesini G. The edentulous ridge expansion technique: a five-year study. Int J Periodontics Restor Dent 1994;14:451-459.
Dahlin C, Johansson A. Iliac crest autogenous bone graft versus alloplastic graft and guided bone regeneration in the reconstruction of atrophic maxillae: a 5-year retrospective study on cost-effectiveness and clinical outcome. Clin Implant Dent Relat Res 2011;13: 305-310.
Hammerle CH, Jung RE, Feloutzis A. A systematic review of the survival of implants in bone sites augmented with barrier membranes (guided bone regeneration) in partially edentulous patients. J Clin Periodontol 2002;29 Suppl 3:226-31;discussion 232-233.
Braidy H, Appelbaum M. Alveolar distraction osteogenesis of the severely atrophic anterior maxilla: surgical and prosthetic challenges. J Prosthodont 2011;20:139-143.
Grunder U, Wenz B, Schupbach P. Guided bone regeneration around single-tooth implants in the esthetic zone: a case series. Int J Periodont Res 2011;31:613-620.
Esposito M, Grusovin M.G, Felice P, Karatzopoulos G, Worthington HV, Coulthard P. The efficacy of horizontal and vertical bone augmentation procedures for dental implants: a Cochrane systematic review. Eur J Oral Implantol 2009;2: 167-184.
Davarpanah M, Martinez H, Tecucianu JF, Celletti R, Lazzara R. Small-diameter implants: indications and contraindications. J Esthet Dent. 2000; 12(4):186-194.
Froum SJ, Cho SC, Cho YS, et al. Narrow-diameter implants: a restorative option for limited interdental space. Int J Periodont Rest Dent 2007;27:449-455.
Gleiznys A, Skirbutis G, Harb A, Barzdziukaite I, Grinyte I. New approach towards mini dental implants and smalldiameter implants: an option for long- term prosthesis. Stomatologi J 2012;14(2):39-45.
Sennerby L, Meredith N. Implant stability measurements using resonance frequency analysis: biological and biomechanical aspects and clinical implications. Periodontol 2000 2008;47:51-66.
Östman PO, Hellman M, Wendelhag I, Sennerby L. Resonance frequency analysis measurements of implants at placement surgery. Int J Prosthodont 2006;19:77-83.
Sennerby L, Roos J. surgical determinants of clinical success of osseointegrated oral implants. A review of literature. Int J Prosthodont 1998;11:408-420.
Wilson, D.J. Ridge mapping for determination of alveolar ridge width. Int J Oral Maxillofac Implants 1989;4:41-43.
Lekholm U, Zarb GA. Patient selection and preparation. In Tissue-integrated prostheses: osseointegration in clinical dentistry. Branemark P-1, Zarb GA, Albrektsson T. (eds.) Quintessence; 1985. p. 199-209.
Misch CE, Perel ML, Wang HL, Sammartino G, Galindo- Moreno P, Trisi P, et al. Implant success, survival, and failure: the International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference. Implant Dent 2008;17(1):5-15.
Traxler, M., Ulm, C., Solar, P. & Lill, W. Sonographic measurement versus mapping for determination of residual ridge width. J Prosthet Dent 1992;67:358-361.
Ten Bruggenkate CM, de Rijcke TB, Kraaijenhagen HA, Oosterbeek HS. Ridge mapping. Implant Dent 1994;3: 179-182.
Chen LC, Lundgren T, Hallström H, Cherel F. Comparison of different methods of assessing alveolar ridge dimensions prior to dental implant placement. J Periodontol 2008;79: 401-405.
Meredith N. Assessment of implant stability as a prognostic determinant. Int J Prosthodont 1998;11:491-501.
Oh JS, Kim SG, Lim SC, Ong JL. A comparative study of two noninvasive techniques to evaluate implant stability: Periotest and Osstell Mentor. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:513-518
Han J, Lulic M, Lang NP. Factors influencing resonance frequency analysis assessed by Osstellt mentor during implant tissue integration: II. Implant surface modifications and implant diameter. Clin Oral Implants Res 2010;21(6):605-611.
Boronat-Lopez A, Balaguer-Martinez J, Lamas-Pelayo J, Carrillo Garcia C, Penarrocha Diago M. Resonance frequency analysis of dental implant stability during the healing period. Med Oral Patol Oral Cir Bucal 2008;13(4):244-247.
Huwiler MA, Pjetursson BE, Bosshardt DD, Salvi GE, Lang NP. Resonance frequency analysis in relation to jawbone characteristics and during early healing of implant installation. Clin Oral Implants Res 2007;18:275-280.
Bischof M, Nedir R, Szmukler-Moncler S, Bernard JP, Samson J. Implant stability measurement of delayed and immediately loaded implants during healing. Clin Oral Implants Res 2004;15:529-539.
Valderrama P, Oates TW, Jones AA, Simpson J, Schoolfield JD, Cochran DL. Evaluation of two different resonance frequency devices to detect implant stability: a clinical trial. J Periodont 2007; 78(2):262-272.
Balshi SF, Allen FD, Wolfinger GJ, Balshi TJ. A resonance frequency analysis assessment of maxillary and mandibular immediately loaded implants. Int J Oral Maxillofac Implants 2005;20(4): 584-594.
Bilhan H, Cilingir A, Bural C, Bilmenoglu C, Sakar O, Geckili O. The evaluation of the reliability of periotest for implant stability measurements: an in vitro study. J Oral Implantol 2015;41(4):90-95.
Sierra-Sánchez JL, Martínez-González A, García-SalaBonmatí F, Mañes Ferrer JF, Brotons-Oliver A. Narrow-diameter implants: Are they a predictable treatment option? A literature review. Med Oral Patol Oral Cir Bucal. 2014;19(1):e74-81.
Sohrabi K, Mushantat A, Esfandiari S, Feine J. How successful are small-diameter implants? A literature review. Clin Oral Impl Res 2012;23:515-525.
El-Sheikh AM, Shihabuddin OF, Ghoraba SM. Two versus three narrow-diameter implants with locator attachments supporting mandibular overdentures: a two-year prospective study. Int J Dent. 2012;2012:285684.
Maló P, de Araújo Nobre M. Implants (3.3 mm diameter) for the rehabilitation of edentulous posterior regions: a retrospective clinical study with up to 11 years of follow-up. Clin Implant Dent Relat Res 2011;13:95-103.
Arisan V, Bölükbasi N, Ersanli S, Özdemir T. Evaluation of 316 narrow diameter implants followed for 5-10 years: a clinical and radiographic retrospective study. Clin Oral Impl Res 2010;21:296-307.
Degidi M, Nardi D, Piatelli A. Immediate restoration of smalldiameter implants in cases of partial posterior edentulism: a 4-year case series. J. Periodontol 2009;6:1006-1012.
Misch CE. Density of Bone: Effects on surgical approach and healing. In: Misch CE. editor. Contemporary Implant Dentistry. 3rd edition. St. Louis: Mosby Elsevier; 2008. p. 645-667
Alsaadi G, Quirynen M, Komarek A, Van Steenberghe D. Impact of local and systemic factors on the incidence of oral implant failures, up to abutment connection. J Clin Periodontol 2007;34(7):610-617.
Turkyilmaz I, McGlumphy EA. Influence of bone density on implant stability parameters and implant success: a retrospective clinical study. BMC Oral Health 2008;8(1):32.