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Journal of Peking University (Health Sciences) ›› 2021, Vol. 53 ›› Issue (5): 970-976. doi: 10.19723/j.issn.1671-167X.2021.05.027

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Clinical observation of the curative effect after 5-year follow-up of single tooth implant-supported restorations in the posterior region

LIANG Feng,WU Min-jie(),ZOU Li-dong   

  1. Second Clinical Division, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100101, China
  • Received:2019-09-18 Online:2021-10-18 Published:2021-10-11
  • Contact: Min-jie WU E-mail:dentwu@sohu.com

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Abstract:

Objective: To analyze the clinical curative effect after 5-year follow-up of single tooth implant-supported restorations in the posterior region. Methods: In the study, patients with single tooth implant-supported restorations in the posterior region after loading 5-year in the Second Clinical Division of Peking University School and Hospital of Stomatology from October 2005 to May 2010 was enrolled. The implant survival rate, prosthetic conditions (including the structural integrity or loosening of the prosthesis, the retention of the materials used to fill access holes of screw-retained implant crowns, loosening or fractures of the implant abutment or screw) and marginal bone lever level around implants were determined by clinical and radiographic examination. Results: The study was composed of 215 patients, the mean age was 48.6 years (range: 27 to 71), and 321 soft tissue implants were inserted. There were 9 implants loose and lost during the visit, the cumulative success rate was 97.2%. In the 312 remaining implants, 120 implants were placed in the upper jaws (38.5%) and 192 in the lower jaws (61.5%). Three different diameters as 3.3 mm (5 implants), 4.1 mm (115 implants) and 4.8 mm (192 implants) and three different lengths as 8 mm (21 implants), 10 mm (206 implants) and 12 mm (85 implants) were used, respectively. 277 (88.8%) cement-retained and 35 (11.2%) screw-retained implant-supported single crowns were made. The marginal bone loss (MBL) around dental implants after loading 5 years in the mesial and distal sides were (0.73±0.25) mm and (0.78±0.26) mm, respectively. There was no significant difference among MBL and bone quality, implant type, angle of abutment, prosthodontic type, crown-to-implant ratio, gender, and age of the patients (P>0.05). The major mechanical complications after restoration involved loosening (8.6%) and fracture (2.9%) of the crown retainer screw, loss of resin covering the screw (11.4%), and the most frequent mechanical complications were loss of crown retention (14.1%) and fracture of porcelain (13.8%). The incidence of loss of crown retention was correlated with insufficient clinical crown height or using angle abutment (P<0.05). Conclusion: After loading 5 years, the bone level around the soft-tissue-implant placed in posterior region was stable. To minimize the frequency of mechanical complications after restoration, protocols must be established from diagnosis to the completion of treatment and follow up of implant-supported prostheses, especially in terms of adequate technical steps and careful radiographic evaluation of the components.

Key words: Dental implant, Dental prosthesis, Implant-supported, Bone resorption

CLC Number: 

  • R783.6

Figure 1

The bone height around the implant and the height of the prosthesis I, length of implant; C, height of prosthesis; H, the vertical height of the proximal bone plane from the cervical margin plane of the implant."

Table 1

Analysis of 5-year survival of 332 implants placed in the posterior region"

Follow-up period/years Lost follow-up implants Failed implants Premier implants Final implants Survival rate/% Cumulative survival rate/%
0- 0 0 332 332.0 100.0 100.0
1- 2 1 332 329.5 99.7 99.7
2- 3 2 329 325.0 99.4 99.1
3- 3 3 324 319.5 99.1 98.1
4- 3 3 318* 313.5 99.0 97.2

Table 2

Diameter and length of the implants"

Items Diameter Total
3.3 mm 4.1 mm 4.8 mm
Length
8 mm 0 7 14 21
10 mm 4 63 139 206
12 mm 1 45 39 85
Total 5 115 192 312

Table 3

Tooth position of the implants"

Items Tooth position Total
First premolar Second premolar First molar Second molar
Upper jaw 16 28 66 10 120
Lower jaw 7 24 130 31 192
Total 23 52 196 41 312

Table 4

The relations between various factors and the bone losses in the mesial and distal side of the implants"

Items Implants, n Bone losses in the mesial side/mm, x ?±s Bone losses in the distal side/mm, x ?±s
Jaw
Upper jaw 120 0.71±0.26 0.80±0.27
Lower jaw 192 0.74±0.25 0.77±0.26
P 0.23 0.45
Diameter of implants
3.3 mm 5 0.57±0.18 0.69±0.09
4.1 mm 115 0.69±0.23 0.74±0.25
4.8 mm 192 0.76±0.26 0.81±0.27
P 0.06 0.08
Length
8 mm 21 0.72±0.24 0.86±0.28
10 mm 206 0.75±0.25 0.79±0.26
12 mm 85 0.70±0.24 0.75±0.26
P 0.32 0.18
Diameter of the neck
3.5 mm 3 0.63±0.18 0.61±0.10
4.8 mm 181 0.72±0.25 0.79±0.26
6.5 mm 128 0.75±0.25 0.78±0.27
P 0.50 0.51
Type of abutment
Straight 208 0.72±0.25 0.80±0.26
Angle 69 0.74±0.24 0.76±0.27
P 0.91 0.35
Retention modes
Adhesive retainer 277 0.73±0.24 0.79±0.26
Screw retainer 35 0.76±0.29 0.72±0.29
P 0.16 0.42
Bone quality
Type Ⅱ 80 0.72±0.27 0.76±0.25
Type Ⅱ-Ⅲ 52 0.75±0.25 0.81±0.28
Type Ⅲ 134 0.73±0.25 0.79±0.28
Type Ⅲ-Ⅳ 22 0.63±0.22 0.74±0.25
Type Ⅳ 24 0.82±0.22 0.82±0.20
P 0.13 0.73
Crown-to-implant ratio
<1 ∶1 181 0.73±0.25 0.76±0.28
1 ∶1-1.5 ∶1 111 0.73±0.26 0.81±0.24
>1.5 ∶1 20 0.79±0.22 0.81±0.23
P 0.67 0.22
Gender
Male 152 0.74±0.81 0.78±0.43
Female 160 0.72±0.24 0.74±0.37
P 0.26 0.39
Age/years
<45 102 0.73±0.52 0.77±0.76
45-59 134 0.74±0.38 0.79±0.53
60-74 76 0.75±0.87 0.80±0.68
P 0.59 0.64

Table 5

The relations between various factors and porcelain fracture"

Items Porcelain fracture Intact crown Total Rate of porcelain fracture P
Jaw 0.70
Upper jaw 17 103 120 14.2%
Lower jaw 26 166 192 13.5%
Retention modes 0.26
Adhesive retainer 36 241 277 13.0%
Screw retainer 7 28 35 20.0%
Diameter of implants 0.75
3.3 mm 0 5 5 0
4.1 mm 17 98 115 14.8%
4.8 mm 26 166 192 13.5%
Diameter of the neck 0.54
3.5 mm 0 3 3 0
4.8 mm 27 154 181 14.9%
6.5 mm 16 112 128 12.5%
Crown height 0.94
< 5 mm 12 62 74 16.2%
5-10 mm 17 132 149 11.4%
> 10 mm 14 75 89 15.7%
Gender 0.09
Male 26 126 152 17.1%
Female 17 143 160 10.1%
Age/years 0.26
< 45 15 87 102 14.7%
45-59 22 112 134 16.4%
60-74 6 70 76 7.9%

Table 6

The relations between various factors and prosthesis detach"

Items Prosthesis detach Stable prosthesis Total Rate of prosthesis detach P
Jaw 0.83
Upper jaw 16 87 103 15.5%
Lower jaw 23 151 174 13.2%
Type of abutment 0.01
Straight 22 186 208 10.6%
Angle 17 52 69 24.6%
Diameter of implants 0.51
3.3 mm 0 5 5 0
4.1 mm 15 87 102 14.7%
4.8 mm 24 146 170 14.1%
Diameter of the neck 0.59
3.5 mm 0 3 3 0
4.8 mm 23 162 181 14.2%
6.5 mm 16 112 128 14.3%
Crown height <0.001
< 5 mm 20 50 70 28.6%
5-10 mm 15 105 120 12.5%
> 10 mm 4 83 87 4.6%
Gender 0.33
Male 21 114 135 15.6%
Female 18 124 142 12.7%
Age/years 0.69
< 45 14 78 92 15.2%
45-59 18 102 120 15.0%
60-74 7 58 65 10.8%
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