Implantes imediatos em area estetica

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Immediate and Early Function of Brånemark System® Implants Placed in the Esthetic Zone: A 1-Year Prospective Clinical Multicenter Study
Paulo Maló, DDS;* Bertil Friberg, DDS, MDS, PhD;† Giovanni Polizzi, MD, DDS;‡ Federico Gualini, DDS;§ Torbjörn Vighagen, DDS;|| Bo Rangert, PhD Mech Eng||

ABSTRACT Background: Immediate/early implant function means great benefits for patients and therapistsbecause treatment time and cost can be substantially reduced. This concept has become an accepted alternative for complete arch fixed restorations in the mandible, and clinical documentation is emerging for other indications. Purpose: The purpose of this prospective clinical multicenter study was to evaluate the outcome of implants placed in incisor, canine, and premolar regions in maxillas ormandibles. Implants were loaded with provisional crowns and bridges on the same day or within a few days and were followed up for 1 year during function. Materials and Methods: Four centers treated 76 patients each in need of an implant-retained prosthesis in the anterior and premolar regions in the maxilla or mandible. A total of 116 titanium implants with machined surfaces (Brånemark System®, NobelBiocare AB, Gothenburg, Sweden) were placed: 74 in maxillas and 42 in mandibles. Eighty-seven prostheses were made, of which 63 were single crowns and 24 were bridges (supported by 53 splinted implants). Twenty-two implants in 14 patients were placed in fresh extraction sites. The goal with the preparation and insertion technique was to achieve good primary implant stability and a minimum implantinsertion torque of 30 Ncm before the implant was completely seated. The occlusion was adjusted to eliminate direct contact with the provisional prostheses. After 6 months, the patients received their permanent prostheses. Sixty-seven patients were followed for 1 year. Results: Five implants were lost in five patients, three in the maxilla and two in the mandible. Four of the lost implants weresingle-tooth replacements and one was splinted. The cumulative survival rate (CSR) was 95.7% for all implants after 1 year and 93.7% and 98.1% for single-tooth and splinted implants, respectively. There were no implant losses in the extraction sites. Conclusions: The CSR of 96% at 1 year indicates that immediate function of Brånemark System implants placed in incisor to premolar regions in both jawsis a viable concept. More failures occurred with single-tooth replacements (6.3%) than with splinted implants (1.9%).
KEY WORDS: immediate loading, Brånemark System® implants, esthetic zone, early loading, single tooth, short-

span bridges

he use of osseointegrated dental implants has made it possible to rehabilitate edentulous jaws to near-normal levels of esthetics and function. Thepredictability of


*Private practice, Department of Surgery and Prosthodontics, CM— Clínica Malo, Lisbon, Portugal; †The Brånemark Clinic Public Dental Health Service and Faculty of Odontology, Gothenburg, Sweden; ‡Brånemark Study Center Srl., Verona, Italy; §private practice, Bergamo, Italy; ||Nobel Biocare AB, Gothenburg, Sweden Reprint requests: Paulo Maló, DDS, Edifio Green Park, Avenidades Combatantes 43 – 43A, 1600 Lisboa, Portugal; e-mail: ©2003 BC Decker Inc

dental implants ad modum Brånemark has been shown to be high when following a two-stage surgical procedure with a submerged healing period of 3 months in the mandible and of 6 months in the maxilla.1–3 During recent years it has been demonstrated that it is possible to achieve comparableresults also with a one-stage surgical procedure when the implant is allowed to heal while the mucosa is penetrated with an abutment.4–7 Providing the patient with an immediate solution may further shorten the treatment time and increase patient comfort. The viability of this modality has been demonstrated in several clinical studies.8–16


Clinical Implant Dentistry and Related Research,...
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