Bone Loss Evaluation by Cone Beam Computed Tomography Postdental Implant Placement: An Original Research.

Introduction: The success of the prosthetic rehabilitation is a factor of the periodontal reactions. Hence, in the current study, we aim to assess bone loss in the osseointegrated implants posttreatment by the cone beam computed tomography (CBCT) imaging. Materials and
Methods: We conducted a prospective clinical observational study among 50 subjects who received mandibular dental implants for the replacement of the single lost anterior tooth. The follow-up was done at 1 week, 2 weeks, and after 6 weeks. The bone loss around the implant was noted by imaging with CBCT. The values were compared and analyzed statistically.
Results: We observed a significant variation among the genders and the age groups. The mean bone loss around the implants was statistically significant for the different time intervals (P = 0.001).
Conclusion: Significant bone loss was noted in the first few weeks after implantation. Care should be focused in the initial posttreatment phase to eliminate the factors aggravating the periodontitis. Copyright:

INTRODUCTION

In the recent times, the prosthetic replacement of the teeth has been revolutionized by the dental implants. The dental implants are made of titanium material that is biologically inert and long-lasting. Many systems of the implants are available commercially.[123] The implant can be loaded immediately postextraction or can be place in the edentulous are after healing of the alveolar bone. The success rate of these implants is multifactorial. It depends on the dental implant, the patient, and the efficiency of the clinician. Among the factors that are patient dependent, the periodontal status is important. The bone around the implant is prone to resorption. The resorption of the peri-implant bone will affect the final outcome in the implantation. Previous studies have concluded that the bone remodeling is initiated soon after the placement of the implant.[456] Hence, in the current study, we aim to assess bone loss in the osseointegrated implants posttreatment by the cone beam computed tomography (CBCT) imaging.

MATERIALS AND METHODS

We conducted a prospective clinical observational study at the department of prosthodontics. The institutional ethics clearance was obtained for the study and the patient consent was taken. We conducted the study among 50 subjects. Both the genders were included above the age of 18 years. Only the subjects who had no other systemic health conditions or were on medication were included in the study. The implants were placed for the replacement of the mandibular anterior teeth according to the guidelines. Only single tooth replacements were considered for the study. “CBCT” imaging of the alveolar bone around the implant was taken. The subjects were recalled at 1, 2, 6 weeks and the CBCT images were taken for the evaluation of the peri-implant bone level. The observations were calculated by two independent reviewers for the interpretation. The means were compared for the statistical significance keeping P < 0.05 as statistically significant.

RESULTS

We observed that among the 50 subjects there was no statistical difference between the sexes with 27 men and 23 women. However, among the subjects, a significant difference was noted for the age (P = 0.001) with the mean age of 32 ± 5.6 years. The mean bone loss after 1 week, 2, and 6 weeks of the implant placement were 0.075 ± 1.432, 1.542 ± 0.953, and 1.049 ± 0.42 respectively [Table 1].

Table 1

Comparison of the demographics and the bone loss

Variable	Bone Loss	P
Men	27	0.540
Women	23
Age	32±5.6	0.001
Time interval (weeks)
1	0.075±1.432	0.001
2	1.542±0.953
6	1.049±0.426

DISCUSSION

The implant dentistry is ever-evolving with all the new materials and the implant systems. The bone loss around the implant might lead to the implant failure.[678] CBCT evaluation of the alveolar bone loss during the first few weeks of the implantation is done in very few studies. Hence, in our study, we have evaluated the bone loss in the first 6 weeks of the osseointegrated implant placement. We observed that the mean bone loss after 1 week, 2 weeks, and 6 weeks of the implant placement was 0.075 ± 1.432, 1.542 ± 0.953, and 1.049 ± 0.42, respectively. Our observation was in accordance with the study of Piao et al.,[6] and Lee et al.[7] They compared the marginal bone loss at the end of 3 years after the functional loading. The bone loss of 1 mm was seen in the 1st year of the implant placement in the previous studies. The bone loss is aggravated after the functional loading. The peri-implant conditions influence the osseointegration of the implant. The bone loss of over 2 mm in the 12 months of the implantation indicates implant failure. Care should be taken for the periodontal health in the 1st year of the implantation. Routine plaque control methods and the nutritional support have to be ensured for the success of the implant. The CBCT imaging was done in our study since this allowed for the accurate estimation of the bone levels. In the study of Ritter et al.,[8] they have concluded the superiority of CBCT than the regular intraoral radiograph images.

The limitation of our study was that a significant variation in the age groups was observed. This might have led to a variation of the bone loss among the subjects with older age exhibiting more bone loss.

CONCLUSION

We conclude significant bone loss in the first 6 weeks of the dental implantations. We suggest further studies to be done considering age and long time follow ups.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.