Comparison of the bone change around teeth and implants between tooth-implant and implant-implant connection

Abstract

Cilj istraživanja: Cilj ovog istraživanja je ispitati kakva se promjena u visini kosti događa oko zuba i implantata nakon protetske opskrbe gdje su nosači konstrukcije zub i implantat nasuprot situaciji gdje su nosači protetske konstrukcije implantat i implantat. Zatim, ispitati je li u slučaju gdje su zub i implantat nosači protetske konstrukcije promjena u visini kosti lokalizirana dominantno na zubima ili implantatima. Osim navedenog, daljnji cilj je bio i ispitati utjecaj različitih faktora kao što je broj zuba uključenih u rad, endodontski tretman istih, broj implantata, vrsta implantološkog rada, čeljust u kojoj se rad nalazi, stanje nasuprotne čeljusti, spol, dob, vrijeme nošenja rada, kao i ispitati je li početno stanje kosti imalo utjecaj na sami iznos promjene koštane visine. Materijali i metode: Istraživanje je provedeno u Salona Dental Poliklinici, gdje su korištene radiološke panoramske snimke od ukupno 50 ispitanika, od čega su 25 činile snimke nositelja rada zub-implantat, dok su ostalih 25 snimki bili nositelji rada implantat-implantat. Mjernim alatima rtg-programa poliklinike su izmjerene razine kosti oko zuba/implantata snimljenih neposredno nakon postave implantata te u razdoblju od pola godine do sedam godina nakon postave samog rada, čime je dobivena razlika među njima (ovisno o tome jeli bila negativna ili pozitivna ili je uopće nije bilo) predstavljala koštanu resorpciju, odnosno dobitak ili pak stanje bez promjene. Kao referentne točke korišteni su vrat implantata i caklinsko-cementno spojište zuba. Prilikom izrade statističke analize korišteni su :tablice frekvencije, osnovni statistički parametri, Mann-Whitney U test, Kruskal-Wallis Anova, Wilcoxon test, regresijska analiza, a rezultati su prikazani tablično i u formi Pareto dijagrama t-vrijednosti. Sudjelovanje je bilo dobrovoljno, anonimno i bez naknade, a svi sudionici su informirani o cilju samog istraživanja, uz pisani pristanak. Rezultati: Obradom podataka možemo zaključiti da je u istraživanju sudjelovala raznolika struktura ispitanika, počevši od godina, vremena nošenja, početnog stanja, broja zuba, broja implantata, vrste implantološkog rada itd. Rezultati istraživanja govore u prilog tome da kod ugradnje implantata dominiraju resorptivne promjene, neovisno o vrsti veze. Nije dokazana statistički značajna razlika u iznosu koštane resorpcije između protetskih konstrukcija nošenih zubom i implantatom naspram protetskih konstrukcija nošenih samo implantatima. Od svih faktora čije je utjecaj ispitan na iznos promjene visine kosti, jedino se broj implantat pokazao kao varijabla sa značajnim doprinosom na promjenu visine kosti kod veze implantat-implantat. Zaključak: Kod ugradnje implantata, neovisno o vrsti veze, dolazi do raznovrsnih promjena, među kojima dominiraju resorptivne promjene, a iste su kod veze zub-implantat dominantno lokalizirane na mjestu implantata. Nije dokazana statistički značajna razlika u samom iznosu koštane resorpcije oko zuba i implantata kod veze zub-implantat. Statistički značajna razlika u iznosu same resorpcije između veze zub-implantat i implantat-implantat također nije dokazana. Značajan utjecaj različitih faktora na iznos koštane promjene, kao što je spol, dob pacijenta, vrijeme nošenja rada, broj zuba uključenih u rad, endodontski tretman istih,vrsta implantološkog rada, čeljust u kojoj se rad nalazi, stanje u suprotnoj čeljusti, početno stanje kosti, također nije dokazan. Jedino se broj implantat pokazao kao varijabla sa značajnim doprinosom na promjenu visine kosti kod veze implantat-implantat Budući da je istraživanje provedeno na skupini od 50 ispitanika, za koje raspodjela podataka nije ravnomjerna, za bilo kakve druge zaključke, potrebna su daljnja istraživanja na većem uzorku.Objectives: The objective of this study was to determine what type of bone change occurs after implant is being placed, as to examinate whether the bone loss is being localized predominantly on the teeth or implants. Furthermore, we wanted to examinate whether there is a difference in bone change between the tooth-implant and implant-implant connection and check if it is statistically significant. The influence of various factors such as: sex, age of the patient, time of work, number of teeth involved in work, endodontic treatment, number of implants, type of implant work, jaw where the work is being located, condition of the opposite jaw, as well as the initial bone condition on the amount of bone change, was also observed. Materials and methods: The research was conducted at the Salona Dental Polyclinic, with total of 50 respondents that participated in the research and were divided into two groups based on the type of the connection, whether it was a tooth-implant or implant-implant connection. Thanks to the special X-ray program of the polyclinic, we were able to measure the levels of bone around the teeth/implants taken immediately after the implant placement and in the period from six months to seven years after the placement. The difference between these two levels (depending on whether it was negative, positive or did not exist at all) represented the bone resorption, the bone formation or a state without change. During the statistical analysis, frequency tables, basic statistical parameters, Mann-Whitney U test, Kruskal-Wallis Anova, Wilcoxon test, regression analysis were used, and the results were presented in tabular form and in the form of a Pareto diagram of t-values. Participation was voluntary, anonymous and free of charge, and all participants were informed about the purpose of the research itself, including the written consent. Results: By processing the data, we were able to see that the study involved a diverse structure of respondents, including an age, wearing time, initial condition, number of teeth, number of implants, type of implant work, etc. The results of the study suggest that bone resorption occurs mainly after implant replacement, regardless of the type of connection. In the case of a tooth-implant connection these kinds of changes predominantly occur at the site of the implant. The difference in the amount of resorption between the tooth-implant and implant-implant connection did not prove to be significant. Of all the factors whose influence was examined on the amount of the bone change, only the number of implants proved to be a variable with a significant contribution to the change in bone height in the case of the implant-implant connection. Conclusions: When implant is being placed, different kind of changes occur, among which, resorptive changes definitely predominate. These types of changes and are predominantly localized at the placement of the implant, when talking about the tooth-implant connection, but no statistically significant difference has been proven in the amount of bone resorption around the tooth and implant. A statistically significant difference in the amount of the bone resorption between the tooth-implant and the implant connection, has not been proven as well. Significant influence of various factors on the amount of bone change, such as sex, age of the patient, time of wearing, number of teeth involved, endodontic treatment, number of implants, type of implant work, jaw where the work is being located, condition of the opposite jaw, as well as the initial bone condition, has not been proven. Only the number of implants was shown to be a variable with a significant contribution to the change in bone height in the implant-implant connection. Considering that the research was conducted on a group of 50 respondents, for whom the distribution of data was not equally distributed, for any other conclusion, further research, as well as larger sample is needed