J Korean Assoc Oral Maxillofac Surg.  2023 Feb;49(1):13-20. 10.5125/jkaoms.2023.49.1.13.

Effectiveness of ultra-wide implants in the mandibular and maxillary posterior areas: a 5-year retrospective clinical study

• Kim SY
• Kim HG
• Yun PY
• Kim YK

• KMID: 2539700
• DOI: http://doi.org/10.5125/jkaoms.2023.49.1.13

Abstract

Objectives
Ultra-wide implants may be used as a replacement if existing implants fail. This study was conducted to evaluate the factors influencing the prognosis and failure of ultra-wide implants.
Patients and Methods
This study evaluated whether sex, age, site, diameter, length, additional surgery, implant stability (primary and secondary), and reason for ultra-wide implant placement affect the 5-year survival and success rates and marginal bone loss (MBL) of ultra-wide implants. Seventy-eight ultra-wide implants that were placed in 71 patients (39 males and 32 females) from 2008 to 2010 were studied. One-way ANOVA analysis was conducted to evaluate the statistical significance of MBL according to the patient’s sex, implant site, and diameter. Independent sample t-tests were used to determine the statistical significance of MBL analysis which was used to determine the significance of the 5-year success and survival rates related to the variables. One-way ANOVA was conducted to evaluate the statistical significance of sex, implantation site, diameter, and MBL. Independent sample t-tests were used to evaluate the correlation between implantability and MBL for implantation reasons, while additional surgery, length, and Kaplan–Meier analysis were used to evaluate 5-year survival and success rates.
Results
The mean age of patients was 54.2 years with a survival rate of 92.3% and a success rate of 83.3% over a mean 97.8-month period of observation. MBL averaged 0.2 mm after one year of prosthetic function loading and 0.54 mm at the time of final observation. Success rates correlated with primary stability (P=0.045), survival rates correlated with secondary stability (P=0.036), and MBL did not correlate with any variables.
Conclusion
Ultra-wide implants can be used to achieve secure initial fixation in the maxillary and mandibular molar regions with poor bone quality or for alternative purposes in cases of previous implant failure.

Keyword

Implant; Survival rate; Retrospective study

Figure

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  Fig. 1 Landmark of the periapical radiograph. A: marginal bone level of the mesiobuccal aspect, B: marginal bone level of the distobuccal aspect, C: marginal bone level of the mesiolingual aspect, D: marginal bone level of the distolingual aspect, E: length of the implant on the periapical radiograph.

Reference

References

1. Al-Johany SS, Al Amri MD, Alsaeed S, Alalola B. 2017; Dental implant length and diameter: a proposed classification scheme. J Prosthodont. 26:252–60. https://doi.org/10.1111/jopr.12517. DOI: 10.1111/jopr.12517. PMID: 27379723.

2. Hattingh A, De Bruyn H, Vandeweghe S. 2019; A retrospective study on ultra-wide diameter dental implants for immediate molar replacement. Clin Implant Dent Relat Res. 21:879–87. https://doi.org/10.1111/cid.12759. DOI: 10.1111/cid.12759. PMID: 30938033.

3. Lee CT, Chen YW, Starr JR, Chuang SK. 2016; Survival analysis of wide dental implant: systematic review and meta-analysis. Clin Oral Implants Res. 27:1251–64. https://doi.org/10.1111/clr.12730. DOI: 10.1111/clr.12730. PMID: 26705937.

4. Saluja B, Alam M, Ravindranath T, Mubeen A, Adya N, Bhardwaj J, et al. 2012; Effect of length and diameter on stress distribution pattern of INDIDENT dental implants by finite element analysis. J Dent Implants. 2:19–25. https://doi.org/10.4103/0974-6781.96561. DOI: 10.4103/0974-6781.96561.

5. Small PN, Tarnow DP. 2000; Gingival recession around implants: a 1-year longitudinal prospective study. Int J Oral Maxillofac Implants. 15:527–32. DOI: 10.1097/00008505-200101000-00012. PMID: 10960986.

6. Will MJ, Drago C. 2023; Survival rate of ultrawide diameter implants placed into molar postextraction sockets and in function for up to 144 months. J Prosthodont. 32:116–24. https://doi.org/10.1111/jopr.13534. DOI: 10.1111/jopr.13534. PMID: 35567405.

7. Wadhwa P, Kim SK, Kim HJ, Lim HK, Jia Q, Jiang HB, et al. 2021; A six-year prospective comparative study of wide and standard diameter implants in the maxillary and mandibular posterior area. Medicina (Kaunas). 57:1009. https://doi.org/10.3390/medicina57101009. DOI: 10.3390/medicina57101009. PMID: 34684046. PMCID: PMC8540610.

8. Ketabi M, Deporter D, Atenafu EG. 2016; A systematic review of outcomes following immediate molar implant placement based on recently published studies. Clin Implant Dent Relat Res. 18:1084–94. https://doi.org/10.1111/cid.12390. DOI: 10.1111/cid.12390. PMID: 26856388.

9. Hattingh AC, De Bruyn H, Ackermann A, Vandeweghe S. 2018; Immediate placement of ultrawide-diameter implants in molar sockets: description of a recommended technique. Int J Periodontics Restorative Dent. 38:17–23. https://doi.org/10.11607/prd.3433. DOI: 10.11607/prd.3433. PMID: 29240200.

10. Ku JK, Yi YJ, Yun PY, Kim YK. 2016; Retrospective clinical study of ultrawide implants more than 6 mm in diameter. Maxillofac Plast Reconstr Surg. 38:30. https://doi.org/10.1186/s40902-016-0075-z. DOI: 10.1186/s40902-016-0075-z. PMID: 27547748. PMCID: PMC4974300.

11. Chrcanovic BR, Kisch J, Albrektsson T, Wennerberg A. 2017; Survival of dental implants placed in sites of previously failed implants. Clin Oral Implants Res. 28:1348–53. https://doi.org/10.1111/clr.12992. DOI: 10.1111/clr.12992. PMID: 27743398.

12. Agari K, Le B. 2020; Successive reimplantation of dental implants into sites of previous failure. J Oral Maxillofac Surg. 78:375–85. https://doi.org/10.1016/j.joms.2019.10.001. DOI: 10.1016/j.joms.2019.10.001. PMID: 31705865.

13. Ting M, Palermo M, Donatelli DP, Gaughan JP, Suzuki JB, Jefferies SR. 2015; A meta-analysis on the effect of implant characteristics on the survival of the wide-diameter implant. Int J Implant Dent. 1:28. https://doi.org/10.1186/s40729-015-0030-2. DOI: 10.1186/s40729-015-0030-2. PMID: 27747650. PMCID: PMC5005654.

14. Termeie D, Klokkevold PR, Caputo AA. 2015; Effect of implant diameter and ridge dimension on stress distribution in mandibular first molar sites-a photoelastic study. J Oral Implantol. 41:e165–73. https://doi.org/10.1563/aaid-joi-d-14-00008. DOI: 10.1563/aaid-joi-D-14-00008. PMID: 25072829.

15. Bazrafshan N, Darby I. 2014; Retrospective success and survival rates of dental implants placed with simultaneous bone augmentation in partially edentulous patients. Clin Oral Implants Res. 25:768–73. https://doi.org/10.1111/clr.12185. DOI: 10.1111/clr.12185. PMID: 23647237.

16. Monje A, Ravidà A, Wang HL, Helms JA, Brunski JB. 2019; Relationship between primary/mechanical and secondary/biological implant stability. Int J Oral Maxillofac Implants. 34:s7–23. https://doi.org/10.11607/jomi.19suppl.g1. DOI: 10.11607/jomi.19suppl.g1. PMID: 31116830.

17. Cobo-Vázquez C, Reininger D, Molinero-Mourelle P, González-Serrano J, Guisado-Moya B, López-Quiles J. 2018; Effect of the lack of primary stability in the survival of dental implants. J Clin Exp Dent. 10:e14–9. https://doi.org/10.4317/jced.54441. DOI: 10.4317/jced.54441. PMID: 29670710. PMCID: PMC5899809.

18. Huwiler MA, Pjetursson BE, Bosshardt DD, Salvi GE, Lang NP. 2007; Resonance frequency analysis in relation to jawbone characteristics and during early healing of implant installation. Clin Oral Implants Res. 18:275–80. https://doi.org/10.1111/j.1600-0501.2007.01336.x. DOI: 10.1111/j.1600-0501.2007.01336.x. PMID: 17355357.

19. Rodrigo D, Aracil L, Martin C, Sanz M. 2010; Diagnosis of implant stability and its impact on implant survival: a prospective case series study. Clin Oral Implants Res. 21:255–61. https://doi.org/10.1111/j.1600-0501.2009.01820.x. DOI: 10.1111/j.1600-0501.2009.01820.x. PMID: 19958375.

20. Ivanova V, Chenchev I, Zlatev S, Mijiritsky E. 2021; Correlation between primary, secondary stability, bone density, percentage of vital bone formation and implant size. Int J Environ Res Public Health. 18:6994. https://doi.org/10.3390/ijerph18136994. DOI: 10.3390/ijerph18136994. PMID: 34208849. PMCID: PMC8297224.

21. Deger M, Surmelioglu O, Kuleci S, Izol V, Akdogan N, Onan E, et al. 2021; Risk factors associated with nocturia in patients with obstructive sleep apnea syndrome. Int J Clin Pract. 75:e13724. https://doi.org/10.1111/ijcp.13724. DOI: 10.1111/ijcp.13724. PMID: 32959453.

22. Ibañez C, Catena A, Galindo-Moreno P, Noguerol B, Magán-Fernández A, Mesa F. 2016; Relationship between long-term marginal bone loss and bone quality, implant width, and surface. Int J Oral Maxillofac Implants. 31:398–405. https://doi.org/10.11607/jomi.4245. DOI: 10.11607/jomi.4245. PMID: 27004286.

23. Park WB, Han JY, Kang KL. 2021; Long-term comparison of survival and marginal bone of implants with and without sinus augmentation in maxillary molars within the same patients: a 5.8- to 22-year retrospective study. J Clin Med. 10:1360. https://doi.org/10.3390/jcm10071360. DOI: 10.3390/jcm10071360. PMID: 33806214. PMCID: PMC8036778.

24. Zumstein T, Schütz S, Sahlin H, Sennerby L. 2019; Factors influencing marginal bone loss at a hydrophilic implant design placed with or without GBR procedures: a 5-year retrospective study. Clin Implant Dent Relat Res. 21:817–26. https://doi.org/10.1111/cid.12826. DOI: 10.1111/cid.12826. PMID: 31432605.