Ultra-Wide Diameter Implants Have Predictable Outcomes With Little Bone Loss

Phillip Bonner, DDS

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Although wide diameter implants are well documented, little is known about ultra‐wide diameter implants (>6 mm). A study evaluated the clinical outcome of ultra‐wide diameter implants placed in molar extraction sockets.

Ultra‐wide diameter implants (7 to 9 mm) were placed immediately after molar extraction in a 1‐stage protocol, without raising a flap or using any bone grafts. After 4 months, each implant was loaded with a single screw‐retained crown.

Bone loss was evaluated using peri‐apical radiographs, plaque and bleeding were recorded, and crown and papilla dimensions were measured and compared with the contra‐lateral tooth. 

Fifty‐one patients (36 male and 15 female), with a mean age of 61 years, were treated with 26 implants in the maxilla and 25 implants in the mandible. Most had a thick (#19) or medium (#31) biotype.

After a mean follow‐up period of 23 months, the mean bone level was located 1.16 mm apical of the implant‐abutment junction (SD 0.42, range 0.00 to 2.45) while the actual bone remodeling associated with socket healing resulted in a mean coronal movement of the bone level of 0.15 mm. 

The mean insertion torque was 116 Ncm (SD 53, range 10 to 250). There were no differences in papilla height (P = .55), crown length (P = .32), zenith (P = .84), or bucco‐palatal dimensions (P = .38). There was a significant difference in the mesio‐distal dimension (P = .01). 

Mean probing depth was 2.59 mm at the implant and 2.23 mm at the contra‐lateral tooth (P = .001). There was significantly more plaque at the tooth compared to the implant (P = .01), but there was no significant difference in terms of bleeding on probing (P = .08). Patient satisfaction was high with 72.5% of the patients experiencing no problems at all. 

The study concluded that ultra‐wide diameter implants have a predictable outcome, demonstrating very little bone loss. Papilla and crown dimensions were comparable to the contra‐lateral natural tooth. (Source: Clinical Implant Dentistry and Related Research, Sept. 25, 2018)

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