Les implants ostéo-intégrés comme ancrages dans le traitement des édentements partiels chez l'adulte

Chez neuf patients édentés partiels, dont la moyenne d'âge était de 47 ans (compris entre 17 et 64 ans), 23 implants ostéo-intégrés furent utilisés comme ancrage orthodontique pour réaliser les différents types suivants de mouvements orthodontiques : version, torque, rotation, ingression, egression et ceux associés aux mouvements de gression. La durée totale du traitement orthodontique varia entre 4 et 33 mois (x = 17 mois). Avant l'intervention chirurgicale, au commencement et à la fin du traitement orthodontique, et aux contrôles annuels, des examens cliniques, biométriques et radiographiques (panoramiques, téléradiographies de profil et radiographies péri-apicales) furent réalisés. Les éléments d'ancrage ostéo-intégrés furent utilisés comme point de référence pour mesurer les mouvements des dents en deux ou trois dimensions avec une machine à enregistrer les coordonnées. La variation des mouvements dentaires en 2 D évolua entre 0,2 et 6,2 mm, tandis que les mouvements dans la troisième dimension (egression et ingression) furent compris entre 0,0 et 13,5 mm. Le mouvement dans l'espace pour une dent individuelle fut en moyenne de 3,9 mm (compris entre 0,6 et 18,7 mm). Les implants ostéo-intégrés en titane utilisés comme ancrage orthodontique demeurèrent en place quand ils furent mis en charge orthodontiquement pour les différents mouvements dentaires. Après l'achèvement du traitement orthodontique, les implants servirent de piliers pour des constructions prothétiques permanentes

Evaluation of patient and implant characteristics as potential prognostic factors for oral implant failures.

PURPOSE: The purpose of this study was to evaluate patient, implant, and treatment characteristics to identify possible prognostic factors for implant failure. MATERIALS AND METHODS: Out of a database with different dental implant treatment protocols, a research database of 1 randomly selected implant per patient was created. The database consisted of 487 implants. Of these, 80 were withdrawn, 36 failed, and 371 remained successful during a 5-year follow-up period. Potential risk factors were evaluated by chi-square tests and post hoc analyses. RESULTS: Significant or strongly significant differences were found regarding implant failures as a result of jawbone quality, jaw shape, implant length, treatment protocol, and combinations of jawbone-related characteristics. Responsible clinics and number of implants supporting the restoration were factors that could not be associated with implant failure. DISCUSSION: Implant failures in this study were more often seen when negative patient-related factors were present. Approximately 65% of the patients with a combination of the 2 most negative bone-related factors (jawbone quality 4 and jaw shape D or E) experienced implant failure. However, only 3% of the patients had this combination. Implant length, the only implant-related factor evaluated, was also significantly correlated with the success rate, but implant length could also be regarded as a result of the jawbone volume available. Another negative patient-related factor was the treatment protocol; however, in most cases this was also indirectly or partly related to the status of the jawbone available for implant placement. CONCLUSION: Patient selection appears to be of importance for increasing implant success rates

Evaluation of patient and implant characteristics as potential prognostic factors for oral implant failures.

PURPOSE: The purpose of this study was to evaluate patient, implant, and treatment characteristics to identify possible prognostic factors for implant failure. MATERIALS AND METHODS: Out of a database with different dental implant treatment protocols, a research database of 1 randomly selected implant per patient was created. The database consisted of 487 implants. Of these, 80 were withdrawn, 36 failed, and 371 remained successful during a 5-year follow-up period. Potential risk factors were evaluated by chi-square tests and post hoc analyses. RESULTS: Significant or strongly significant differences were found regarding implant failures as a result of jawbone quality, jaw shape, implant length, treatment protocol, and combinations of jawbone-related characteristics. Responsible clinics and number of implants supporting the restoration were factors that could not be associated with implant failure. DISCUSSION: Implant failures in this study were more often seen when negative patient-related factors were present. Approximately 65% of the patients with a combination of the 2 most negative bone-related factors (jawbone quality 4 and jaw shape D or E) experienced implant failure. However, only 3% of the patients had this combination. Implant length, the only implant-related factor evaluated, was also significantly correlated with the success rate, but implant length could also be regarded as a result of the jawbone volume available. Another negative patient-related factor was the treatment protocol; however, in most cases this was also indirectly or partly related to the status of the jawbone available for implant placement. CONCLUSION: Patient selection appears to be of importance for increasing implant success rates