An unique utilization of sloped profile implants by adaption to proximal heteromorphic bone levels

Background

Despite the fact that nowadays many restorative options exist, there are still cases where limitations can be seen due to anatomical restrictions and esthetic standards for implant treatment. It has been proved that after tooth loss, bone resorption is more likely to occur in the buccal bone than in the lingual palatal bone, leaving as a result, an sloped alveolar ridge. Profile EV Implants from ASTRATECH present a slope adapted to particular bone defects, with a 360° bone preservation concept.

Aim/Hypothesis

To introduce an unique and innovative use of PROFILE implants in which the sloped surface of the implant is not only adapted to bucally sloped alveolar ridges, but also to mesially and distally sloped ridges, where proximal bone levels are heteromorphic and irregular after tooth loss extraction.

Material and Methods

According to each clinical case and resorption patterns, five PROFILE implants (n = 5) were placed in post-extraction alveolar bone ridges with the sloped surface of the implant towards either the mesial or distal side of the osteotomy. No post-extraction ridge preservation was performed in any of the cases. Performance of PROFILE implants was evaluated by measuring surrounding bone levels at the loading time (LT) and after one year of follow-up (1Y) for both proximal sides. Among the five implants, three (n = 3) of the implants were positioned with the slope towards the mesial side and two (n = 2) of the implants were positioned with the slope towards the distal side. Dental radiographs were analyzed with ImageJ after setting the appropriate scale knowing the distance between the threads of the body of the implant. Peri-implant bone behavior was analyzed for the sloped sides and for the non-sloped sides.

Results

Differences between peri-implant bone levels at the LT and at 1Y were calculated. For the sloped sides the average bone loss was 0.124 mm (SD = 0.18) whereas for the non-sloped sides the average bone loss was 1.26 mm (SD = 0.77). Despite the fact that both results did not show a significant unstability, by these results it can be said that peri-implant bone levels were slightly more stable for the sloped side than for the non-sloped side. In this case, depending on wether there was an implant or natural teeth remaining or not, the morphology of the osteotomy was defined in order to place the sloped surface towards the proximal side with the lowest pre-placement bone level. By placing PROFILE implants in these particular anatomies, the use of this type of implants represented a good alternative to unnecessary bone grafts and invasive graft surgeries.

Conclusion and Clinical Implications

In this study we were able to prove that there was not a significant difference between sloped sides and non-sloped sides of PROFILE implants in terms of peri-implant stability. Bone loss was slightly higher for non-sloped sides than for sloped sides, which encourages dental practitioners to use this innovative techniques where the slope is either mesially or distally located by preserving the bone with a 360°concept.