Four Year Biologic Widths of Immediately Loaded Implants in Humans

Objectives: Objectives: Characteristics and dynamics of biologic width of implants is very important for biological form and function. Information is usually from histological investigations in animals, and confirmatory evidence from humans is lacking because of difficulty obtaining histological materials. However, clinical and radiographic parameters around implants correspond to the individual histological components of the biologic width. Our earlier studies ( Polson 2010,2014) reported initial formations of biologic widths, and this present study reports 4 year comparisons.

Methods: Methods: In this randomized trial, Study population comprised 14 adults with edentulous mandibles each of whom had 5 intraforaminal mandibular implants, and these 70 implants had been immediately loaded. Control population comprised 8 adults with 40 implants and conventional loading. Clinical parameters comprising Plaque Index, Bleeding Index, Mucosal Margin Location, Pocket Depth, and Attachment Level were measured by a standardized, calibrated examiner every six months. Standardized periapical radiographs had been taken of the implants using customized stents at loading, 6 mo, 1, 2, 3, and 4 years, and crestal alveolar bone level was measured by a trained examiner. These clinical and radiographic data were combined and correlated to calculate biologic width of these implants, and comparisons across time were made using paired-statistical analyses.
Results: Results: In the Control Group Biologic Width at 6 mo, and Years 1, 2, 3, and 4 was 3.20 (0.19) [Mean (SE), mm], 3.22 (0.17), 3.30 (0.21), 3.24 (0.16), and 3.34 (0.20). In the Study Group, Biologic Widths were 3.22 (0.15) [Mean (SE), mm], 3.17 (0.13), 2.87 (0.11), 2.74 (0.10) and 3.10 (0.12) with no statistically significant differences within or between the groups. Inflammation indices were negligible indicating remodeling in a physiologic environment. Crestal alveolar bone levels had initially remodeled in relation to immediate loading.
Conclusions: Conclusions: Biologic Width of these immediately loaded implants in humans seemed constant over time and were comparable with conventional loading. Supported by ITI, Penn Periodontal Fund, and Alpha Omega.