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Peri-implant Outcome of Immediately Loaded Implants with a Full-Arch Implant Fixed Denture: A 5-Year Prospective Case Series

Filip Martens, DDS1 Stefan Vandeweghe, DDS, PhD2 Hilde Browaeys, MD, DDS, MSc3 Hugo De Bruyn, DDS, MSc, PhD4 This prospective study evaluated clinical results of immediately loaded Biomet 3i implants with different surface topographies. Thirty-three periodontally compromised patients received 163 implants (130 in the maxilla and 33 in the mandible; 132 NanoTite and 31 Osseotite). After a mean loading period of 57 months, the survival rate was 96.3%. Mean crestal bone loss was 1.6 mm. No difference in bone loss was detected between the two surfaces. Only 6% of the implants had peri-implantitis based on total bone loss above 2 mm from the day of surgery in conjunction with probing depths of > 4 mm. (Int J Periodontics Restorative Dent 2014;34:189–197. doi: 10.11607/prd.1938)

Faculty Member, Department of Periodontology and Oral Implantology, Dental School, Faculty of Medicine and Health Sciences, University of Ghent, De Pintelaan, Ghent, Belgium. 2Faculty Member, Department of Periodontology and Oral Implantology, Dental School, Faculty of Medicine and Health Sciences, University of Ghent, De Pintelaan, Ghent, Belgium and Department of Prosthodontics, Faculty of Odontology, Malmö University; Carl Gustavsvag, Malmö, Sweden. 3Maxillofacial Surgeon, Department of Periodontology and Oral Implantology, Dental School, Faculty of Medicine and Health Sciences, University of Ghent, De Pintelaan, Ghent, Belgium and Department of Maxillofacial Surgery, Academic Hospital Sint-Dimpna, Geel, Belgium. 4Professor and Chairman, Department of Periodontology and Oral Implantology, Dental School, Faculty of Medicine and Health Sciences, University of Ghent, De Pintelaan, Ghent, Belgium and Department of Prosthodontics, Faculty of Odontology, Malmö University; Carl Gustavsvag, Malmö, Sweden. 1

Correspondence to: Prof Hugo De Bruyn, Department of Periodontology and Oral Implantology, University Hospital Ghent-P8, De Pintelaan 185, B-9000 Ghent, Belgium; fax: +3293323551; email: [email protected]. ©2014 by Quintessence Publishing Co Inc.

Early and immediate loading in fully edentulous arches results in outcomes similar to those for classical one- or two-stage delayed protocols.1 Several prospective studies report survival rates ranging from 91.3% to 100% for immediate loading in the mandible. Survival rates in the maxilla range from 88.5% to 100%; poorer reported outcomes may be due to poor bone quality.2–5 By and large, these protocol modifications have significantly reduced treatment time, improving patient satisfaction.6 With regard to surface topography, an improved survival rate has been reported for moderately rough surfaced implants compared with machined surfaces, especially in challenging conditions such as poor bone quality.7,8 Furthermore, the introduction of nanotechnology to implant surfaces has enhanced the implant osteoconductivity.9 Clinical studies, although limited in number and follow-up time, indicate that nanosurfaced implants may be more successful, especially when immediately loaded. Theoretically, the bioactive topographic feature, which enhances the initial osseointegration cascade, should enhance

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190

* = Lost during follow-up † = failure

33 patients (P)

163 implants (I)

Maxilla P = 25 I = 130

Mandible P=8 I = 33

Baseline

8* 6†

2* 26 mo

P=8

I = 33

1* 57 mo

P=7

5* I = 28

27 NanoTite

1 Osseotite

P = 23

I = 116 6* 3†

1* P = 22

I = 107

77 NanoTite

30 Osseotite

Fig 1    Flowchart of the study design.

bone-to-implant contact and thus implant success.10,11 The aim of the current prospective study was to evaluate results for immediately loaded full-arch provisional partial dentures placed on dual acid-etched titanium implants with NanoTite and Osseotite surfaces (Biomet 3i). Clinical outcome in terms of implant survival, crestal bone remodeling, and peri-implant health were assessed for up to 6 years in periodontally compromised patients.

Method and materials Patient selection

The study population consisted of 33 patients consecutively treated

based on clinical and radiographic inspection, which included panoramic radiograms and/or threedimensional radiographic evaluation using computed tomography (CT) or cone beam CT. Included patients had to have enough bone to insert at least four implants with a minimum diameter of 4 mm and minimum length of 10 mm. All implants placed were Biomet 3i implants with an Osseotite or NanoTite surface. In some patients, Osseotite and NanoTite implants were placed alternately to allow comparison of both surfaces within the same patient. A schematic overview of the study design is displayed in Fig 1.

Treatment protocol and follow-up

with immediately loaded implants to rehabilitate the maxilla and/or mandible. Patients with a history of radiation therapy, use of medication for cancer prevention, or irregular compliance with dental care or maintenance were excluded, but smokers were included. All patients were classified as periodontally compromised based on tooth loss at a young age and/or ongoing periodontal disease in remaining teeth. All patients were enrolled in a periodontal treatment protocol prior to implant surgery, including nonsurgical or surgical periodontal infection control, with selective extractions of hopeless teeth at least 2 months prior to implant placement. Oral hygiene instructions were given at each visit. Surgical planning was

Implants were placed by two experienced surgeons (HDB, HB) after crestal incisions were made and full-thickness flaps were raised. The drilling protocol was adapted to the bone quality to enhance initial implant stability. All implants were placed subcrestally or crestally, taking into consideration the biologic width in relation to soft tissue thickness. Impressions and bite registrations were taken in conjunction with the implant placement, in accordance with a previously described treatment protocol.12,13 All implants were loaded by a trained prosthodontist (SVDW) with a 10to 12-unit screw-retained metalreinforced acrylic resin provisional partial denture manufactured by the dental technician within 72 hours of surgery. Minor occlusal

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191

a

b

c

d

e

f

g

h

i

j

Fig 2    Case presentation of an immediate loading treatment in the maxilla. (a and b) Extensive tooth loss and caries, (c) the surgical guide made by the dental technician shows the tooth positions and contains space for bite-registration material, (d) healing abutments immediately after impression making, (e) impression analogs are connected to the impression coping by the surgeon and sent to the lab to create a working cast, (f) bite registration was performed with the guide plate, (g and h) provisional partial denture made by the dental technician, (i and j) radiographs 6 months after placement of the provisional construction.

adjustments were made to achieve spreading of the occlusal load and establish bilaterally protected articulation with group function (Fig 2).

Patients were enrolled in a recall program to ensure good oral hygiene and to evaluate the provisional restoration. After 6 months,

the referring clinician provided a definitive restoration. Digital periapical radiographs were taken after implant insertion

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192

a

b

c

Fig 3    Apical radiographs at (a) 6 months, (b) 2 years, and (c) 5 years after immediate loading. Red arrows indicate the bone level.

Results

Table 1

Implant length in relation to arch Implant survival

Implant length (mm) Arch

10.0

11.0

11.5

13.0

15.0

Total

Mandible

0

1

6

20

6

33

Maxilla

5

0

9

60

56

130

Total

5

1

15

80

62

163

(baseline) and during two followup visits to visualize the crestal marginal bone-to-implant contact (Fig 3). These radiographs were analyzed by the same clinician (FM). Twenty randomly selected radiographs were measured twice by two clinicians to analyze intra- and interexaminer reliability. Plaque and bleeding on probing were evaluated at four places around each implant using the Mombelli index.14 The presence of plaque was tested by running the side of the probe around the implant surface at the peri-implant sulcus. Bleeding was evaluated by gently sliding a periodontal probe through the sulcus. A mean pocket depth was calculated per implant.

Statistical analysis

Pairwise analysis of crestal bone changes and clinical parameters was performed with the Wilcoxon rank sum test. Correlations between clinical and radiographic measurements were calculated using the Spearman rank correlation coefficient. The intra- and interexaminer reproducibly of the radiographic analysis was calculated by means of the Spearman correlation coefficient and Wilcoxon signedrank test. All tests were performed using SPSS (version 19.0; SPSS, IBM) and were evaluated at a .05 significance level.

In total, 33 patients (16 women and 17 men) receiving 163 implants were evaluated. The mean age was 66 years (range, 39 to 89 years; SD, 12.8 years). Twenty-five patients received 130 implants in the maxilla, and 8 received 33 implants in the mandible. One patient received implants in both arches (Table 1 and Fig 4). All implants were long (10 to 15 mm) and were 4 mm in diameter. Only one implant was 3.25 mm wide and 5 were 5 mm wide. During provisionalization, 6 implants were lost in 4 patients, bringing the 1-year survival rate to 157 of 163 (96.3%). At the first investigation interval of 26 months (range, 7 to 48 months; SD, 13.6 months), no further failures had occurred, although 2 patients with 8 implants were lost from recall. At the second follow-up, after a mean period of 57 months (range, 34 to 77 months; SD, 12.4 months), 1 patient had lost 3 implants, and 2 patients with a total of 11 implants were lost from follow-up. Hence, a total of 9 of 163 implants had failed (5.5%). The dropout rate was 4 of 33 patients (12%), of which 3 were unaccounted for and 1 deceased. All failures

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193

30 6

Total (n)

Total (n)

20

10

4

2

0

18

16

14

12 22 24 Implant position

26

28

0

45

43

41 31 Implant position

33

35

4.0

4.0

3.0

3.0

Bone loss (mm)

Crestal bone loss (mm)

Fig 4    Locations of 163 implants in 33 patients, according to FDI tooth position.

2.0

2.0

1.0

1.0

0

0 26-mo follow-up

57-mo follow-up

Fig 5    Crestal bone loss at the two recall intervals. Red arrows indicate the median.

occurred in the maxilla, bringing the failure rate there to 6.9%. Implant survival in the mandible was 100%.

Peri-implant bone and health

After a mean follow-up period of 57 months, mean total crestal bone loss calculated from the day of surgery was 1.6 mm (n = 135; SD, 0.77 mm; range, 0 to 3.35 mm) and

NanoTite

Osseotite

Fig 6    Crestal bone loss with two different implant topographies.

1.40 mm (range, 0.39 to 2.29 mm; SD: 0.46 mm) with the implant and the patient as the statistical unit, respectively (Figs 5 and 6). There was no statistically significant difference (P = .23) in mean bone loss after 26 months (1.5 mm; SD, 0.69 mm; range, 0 to 3.2 mm) (Figs 7). Mean crestal bone loss for the Osseotite implants was 1.7 mm (n = 31; SD, 0.80 mm; range, 0.30 to 3.15 mm) and for the NanoTite implants,

1.5 mm (n = 104; SD, 0.76 mm; range, 0.00 to 3.35 mm). This difference was not statistically significant (P = .632). In the maxilla, the mean crestal bone loss was 1.5 mm; in the mandible, 1.6 mm. This difference was not significant (P = .708). There was no significant difference (P = .59) in bone loss between implants placed in bone of poor quality (1.5 mm) and those placed in bone of good quality (1.4 mm).

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194

100

Cumulative percent

80

60

40

20 Time interval 26-mo follow-up 57-mo follow-up 0 3.20

3.05

2.85

2.60

2.55

2.30

2.15

2.05

1.93

1.85

1.80

1.70

1.63

1.53

1.43

1.35

1.23

1.13

1.05

0.83

0.73

0.38

0

Marginal bone loss Fig 7    Cumulative percentage of implants and their corresponding bone loss as measured during the follow-up examinations. As indicated, 50% of patients had > 1.53 mm of bone loss after 57 months.

Table 2 Score   0 1 2 3 0 1 2 3

Plaque and bleeding scores Variable Bleeding No bleeding Isolated bleeding spot visible Blood forms a confluent red line on the margin Heavy or profuse bleeding Plaque/calculus Not detected Plaque only recognized by running a probe Plaque can be seen by the naked eye Abundance of soft matter

n (%) 43 (29.4) 41 (28.0) 57 (39.0) 5 (3.4) 30 (20.5) 72 (49.3) 42 (28.7) 2 (1.3)

The bone loss around 22 Osseotite (1.56 mm) and NanoTite (1.40 mm) implants was pairwise compared within 11 patients who had both implants in equal number, and the difference was not statistically significant (P = .68) (Fig 7). The Spearman correlation coefficient for bone-level assessment showed a high intra- and interexaminer reliability (κ = 0.87 and 0.91, respectively). The differences in mean bone level did not exceed 0.3 mm (corresponding to half a thread), and the Wilcoxon rank sum test could not detect a significant difference (P = .214). The mean overall and interproximal probing depth was 3.4 mm (SD, 0.70 mm; range, 1.5 to 6.0 mm) and 3.6 mm (range, 2.0 to 6.0 mm; SD, 0.76 mm), respectively. Only 5.4% of the implants had a mean interproximal probing depth of more than 5 mm. Excessive bleeding was present around 5 implants, with spontaneous bleeding evident around 2 (Table 2). There was no correlation between interproximal probing pocket depth (PPD) and marginal bone level (P = .63), according to the Spearman correlation test. The relation between radiographic bone loss and PPD is shown in Table 3. In total, 94.6% of the implants had a mean interproximal probing depth ≤ 5 mm, and 80.7% had mean marginal bone loss up to the second thread. Deeper (> 5 mm) as well as shallower (< 4 mm) pockets were present in all bone loss groups, suggestive of the low correlation coefficient between these parameters. Despite this stable bone

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195

Table 3

Cross table of individual implants presented according to the marginal bone loss and the mean interproximal PPD* Mean marginal bone level after 5 y (%) Within the 1st thread (≤ 1.5 mm)

Between the 1st and 2nd thread (1.51–2.1 mm)

Between the 2nd and 3rd thread (2.11–2.7 mm)

Surpassing the third thread (> 2.7 mm)

Total (%)

Mean interproximal PPD (mm) ≤ 3.0

25

17

7

1

50 (38.4)

3.1–4.0

30

16

7

2

55 (42.3)

4.1–5.0

7

5

5

1

18 (13.8)

> 5.0

1

4

1

1

7 (5.4)

Total

63 (48.5)

42 (32.3)

20 (15.4)

5 (3.8)

129 (100)

PPD = probing pocket depth. *Implants in green represent a low disease risk. Implants in yellow (19.2%) can be considered at risk for disease and should be monitored more closely. Implants in red (3.8%) showed bone loss past the third thread at the 57-month interval. These may be at risk for peri-implantitis. Due to probing difficulties or some unreadable radiographs, not all pockets could be related to a corresponding bone loss value. In total, 130 implants were evaluated.

condition, bleeding was present around 80% of the implants.

Discussion The aim of the present prospective study was to evaluate survival, crestal bone level changes, and peri-implant health of NanoTite and Osseotite dental implants used for complete rehabilitation of the maxilla and/or mandible using an immediate loading protocol. Immediate loading is supported by numerous reports with satisfactory outcomes,2,12,13,15 and the present study shows a high clinical cumulative survival rate of 94.4% after a mean of 5 years. Implant survival was 100% in the mandible, in line with other pub-

lished prospective clinical studies.4,16 Cumulative survival in the maxilla was 93.7% after 57 months. This outcome is consistent with recent literature.17 It should be noted that the included patients had a history of periodontal disease and tooth loss at a young age, and such a history has been associated with a threefold higher implant failure rate.18,19 Other studies have reported comparable survival rates of immediately loaded maxillary Biomet 3i implants.20,21 Immediately loaded dual acid-etched Biomet 3i implants placed in 26 patients (8 to 10 implants each) experienced no failures after 12 to 74 months of follow-up.16 The lower number of implants per patient in the present study (4 to 6 implants) may have resulted in a more unevenly

distributed occlusal load and higher micromotion on each individual implant, another potential contributing factor to increased failure risk. Clinical studies of less than 5 implants per arch have been clearly associated with higher failure rates compared with clinical studies with 5 to 8 implants per arch.17 In this study, the bone volume in 11 nonsmoking patients only allowed for placement of 4 implants per arch. Four of 44 implants (9.1%) failed in this group, including 3 after more than 2 years of loading. Five of 74 implants (6.7%) failed in patients who received 6 implants per arch. This clinical difference points to the importance of sufficient occlusal load spreading, especially in immediately loaded maxillary restorations.

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196 The surface of Biomet 3i implants has a roughness (Sa value, 0.5 µm) that has been shown to be relatively smooth compared with competing implants.22 This may be helpful in maintaining peri-implant health especially in periodontally involved patients. Use of this surface up to the abutment level has been demonstrated not to increase the risk of peri-implantitis.23 The present study confirms this; crestal bone levels did not change after the initial biologic width and remodeling were established. No changes in peri-implant health were observed between the first and second follow-up visits. Although some studies have proven that nanotechnology improves osteoconductivity, this advantage only comes into consideration during initial bone healing in compromised cases. Hence, the lack of a difference in crestal bone loss between full Osseotite or full NanoTite surfaced implants appears logical and is in agreement with earlier studies.20,24 Bone loss of less than 1.5 mm during the first year after loading and 0.2 mm annually thereafter has been defined as a criteria for implant success.25 In this study, this would allow for a total crestal bone loss of 1.94 to 2.60 mm, as the range for follow-up was 34 to 77 months. Observed crestal bone loss was below these threshold values for 75% of the evaluated implants. This bone loss was based on baseline measurements recorded on the day of surgery. However, recent clinical studies have revealed that initial bone remodeling takes

from 3 to 6 months after singlestage implant placement. Hence, a waiting period between abutment placement and loading, as is often the case in delayed loading studies, excludes a large portion of the total crestal bone loss. A comparison of immediate loading with early/immediate loading is therefore scientifically biased.26,27 A few studies have reported bone loss of 0.8 to 0.9 mm with Biomet 3i implants,20,21,24,28 less than the 1.6 mm found in the present study. An explanation may be found in the limited follow-up time of some of those studies. No correlation was found between probing depth and bone loss, pointing to the low predictive value of probing to detect ongoing disease. A total of 48.5% and 80.7% of implants showed bone loss not exceeding the first or second implant thread, respectively (Table 3). Only 19% of implants had bone loss of more than 2.1 mm. When bone loss of more than 2.1 mm and pocket depths of more than 5 mm are considered together (the diagnostic criteria for peri-implantitis),29 only 1.5% of the implants fall into this category.

Conclusion This study makes it clear that concerns about high peri-implantitis prevalences are unfounded. This confirms other reports and clearly indicates that a combination of bone loss and probing depth must be considered. Use of the NanoTite or Osseotite surface, rough to the

top, does not appear to be prone to peri-implant disease.

Acknowledgments The authors reported no conflicts of interest related to this study.

References  1. Esposito M, Grusovin MG, Maghaireh H, Worthington HV. Interventions for replacing missing teeth: Different times for loading dental implants. Cochrane Database System Rev 2013;3:CD003878.  2. Collaert B, Wijnen L, De Bruyn H. A 2-year prospective study on immediate loading with fluoride-modified implants in the edentulous mandible. Clin Oral Implants Res 2011;22:1111–1116.  3. Froberg KK, Lindh C, Ericsson I. Immediate loading of Branemark system implants: A comparison between TiUnite and turned implants placed in the anterior mandible. Clin Implant Dent Relat Res 2006;8:187–197.  4. Testori T, Del Fabbro M, Galli F, Francetti L, Taschieri S, Weinstein R. Immediate occlusal loading the same day or the after implant placement: Comparison of 2 different time frames in total edentulous lower jaws. J Oral Implantol 2004;30:307–313.   5. Testori T, Meltzer A, Del Fabbro M, et al. Immediate occlusal loading of Osseotite implants in the lower edentulous jaw. A multicenter prospective study. Clin Oral Implants Res 2004;15:278–284.  6. Dierens M, Collaert B, Deschepper E, Browaeys H, Klinge B, De Bruyn H. Patient-centered outcome of immediately loaded implants in the rehabilitation of fully edentulous jaws. Clin Oral Implants Res 2009;20:1070–1077.   7. Buser D, Weber HP, Bragger U, Balsiger C. Tissue integration of one-stage ITI implants: 3-year results of a longitudinal study with hollow-cylinder and hollowscrew implants. Int J Oral Maxillofac Implants 1991;6:405–412.   8. Weng D, Jacobson Z, Tarnow D, et al. A prospective multicenter clinical trial of 3i machined-surface implants: Results after 6 years of follow-up. Int J Oral Maxillofac Implants 2003;18:417–423.

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197

 9. Valverde GB, Jimbo R, Teixeira HS, Bonfante EA, Janal MN, Coelho PG. Evaluation of surface roughness as a function of multiple blasting processing variables. Clin Oral Implants Res 2013;24: 238–242. 10. Ostman PO, Hupalo M, del Castillo R, et al. Immediate provisionalization of NanoTite implants in support of singletooth and unilateral restorations: Oneyear interim report of a prospective, multicenter study. Clin Implant Dent Relat Res 2010;12(suppl 1):e47–e55. 11. Wennerberg A, Albrektsson T. On implant surfaces: A review of current knowledge and opinions. Int J Oral Maxillofac Implants 2010;25:63–74. 12. De Bruyn H, Van de Velde T, Collaert B. Immediate functional loading of TiOblast dental implants in full-arch edentulous mandibles: A 3-year prospective study. Clin Oral Implants Res 2008;19:717–723. 13. Van de Velde T, Collaert B, De Bruyn H. Immediate loading in the completely edentulous mandible: Technical procedure and clinical results up to 3 years of functional loading. Clin Oral Implants Res 2007;18:295–303. 14. Mombelli A, Lang NP. The diagnosis and treatment of peri-implantitis. Periodontol 2000 1998;17:63–76. 15. Collaert B, De Bruyn H. Immediate functional loading of TiOblast dental implants in full-arch edentulous maxillae: A 3-year prospective study. Clin Oral Implants Res 2008;19:1254–1260. 16. Ibanez JC, Tahhan MJ, Zamar JA, et al. Immediate occlusal loading of double acid-etched surface titanium implants in 41 consecutive full-arch cases in the mandible and maxilla: 6- to 74-month results. J Periodontol 2005;76:1972–1981.

17. De Bruyn H, Raes S, Ostman P, Cosyn J. Immediate loading in partially and completely edentulous jaws: A review of the literature with clinical guidelines. Periodontol 2000 (in press). 18. Karoussis IK, Muller S, Salvi GE, HeitzMayfield LJ, Bragger U, Lang NP. Association between periodontal and peri-implant conditions: A 10-year prospective study. Clin Oral Implants Res 2004;15:1–7. 19. Schou S, Holmstrup P, Worthington HV, Esposito M. Outcome of implant therapy in patients with previous tooth loss due to periodontitis. Clin Oral Implants Res 2006;17(suppl 2):104–123. 20. Tealdo T, Bevilacqua M, Pera F, et al. Immediate function with fixed implantsupported maxillary dentures: A 12month pilot study. J Prosthet Dent 2008; 99:351–360. 21. Testori T, Del Fabbro M, Capelli M, Zuffetti F, Francetti L, Weinstein RL. Immediate occlusal loading and tilted implants for the rehabilitation of the atrophic edentulous maxilla: 1-year interim results of a multicenter prospective study. Clin Oral Implants Res 2008;19: 227–232. 22. Liu R, Lei T, Dusevich V, et al. Surface characteristics and cell adhesion: A comparative study of four commercial dental implants [epub ahead of print]. J Prosthodont 2013 May 31. 23. Zetterqvist L, Feldman S, Rotter B, et al. A prospective, multicenter, randomized-controlled 5-year study of hybrid and fully etched implants for the incidence of peri-implantitis. J Periodontol 2010;81:493–501.

24. Hinze M, Thalmair T, Bolz W, Wachtel H. Immediate loading of fixed provisional prostheses using four implants for the rehabilitation of the edentulous arch: A prospective clinical study. Int J Oral Maxillofac Implants 2010;25:1011–1018. 25. Albrektsson T, Isidor F. Consensus report of session-IV. In: Lang N, Karring T (eds). Proceedings of the 1st European Workshop on Periodontology. Berlin: Quintessence, 1994:365–369. 26. Van de Velde T, Collaert B, Sennerby L, De Bruyn H. Effect of implant design on preservation of marginal bone in the mandible. Clin Implant Dent Relat Res 2010; 12:134–141. 27. Vandeweghe S, Cosyn J, Thevissen E, Teerlinck J, De Bruyn H. The influence of implant design on bone remodeling around surface-modified southern implants. Clin Implant Dent Relat Res 2012; 14:655–662. 28. Testori T, Szmukler-Moncler S, Francetti L, et al. Immediate loading of Osseotite implants: A case report and histologic analysis after 4 months of occlusal loading. Int J Periodontics Restorative Dent 2001;21:451–459. 29. Albrektsson T, Buser D, Chen ST, et al. Statements from the Estepona consensus meeting on peri-implantitis, February 2-4, 2012. Clin Implant Dent Relat Res 2012;14:781–782.

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Peri-implant outcome of immediately loaded implants with a full-arch implant fixed denture: a 5-year prospective case series.

This prospective study evaluated clinical results of immediately loaded Biomet 3i implants with different surface topographies. Thirty-three periodont...
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