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Spectrum of Indications for Palatal Implants in Treatment Concepts Involving Immediate and Conventional Loading

Indikationsspektrum von Gaumenimplantaten bei früh- und spätbelasteten Behandlungskonzepten

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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Aim:

To analyze the spectrum of indications for second-generation palatal implants in relation to two different loading concepts in a prospective, multicenter, randomized controlled trial (RCT).

Patients and Methods:

Forty-one patients were recruited to the study from 2006 to 2009. All implants (Orthosystem®, Straumann, Basel, Switzerland; dimensions: 4.1 mm × 4.2 mm) were inserted in the median or paramedian region of the anterior palate, and each patient was randomized to one of two loading groups (immediate loading within the first week after insertion versus conventional loading after a 12-week healing phase). In this interim evaluation, we report preliminary results obtained six months after functional loading.

Results:

All palatal implants were primarily stable at the time of insertion. One implant loss (12 weeks after surgical insertion) was documented in the cohort subjected to conventional loading, and one patient dropped out of the immediate-loading group. At the time of this investigation, 39 palatal implants are experiencing functional loads. Using both loading concepts, we had various orthodontic objectives, such as intrusion of anterior and/or posterior teeth, and the mesialization and distalization of posterior teeth. Both loading groups presented nearly identical indications, and the distribution of direct vs. indirect anchorage forms was also very similar during the active treatment.

Conclusion:

Comparison of the two treatment concepts revealed no clinical differences in implant stability. Patients undergoing immediate-loading therapy were subject to no limitations regarding indications at 6 months after functional loading compared with the patients who experienced conventional loading.

Zusammenfassung

Ziel:

Im Rahmen einer prospektiven multizentrischen RCT-Studie (Randomized Controlled Trial) wird das Indikationsspektrum von Gaumenimplantaten der zweiten Generation bei zwei verschiedenen Belastungskonzepten analysiert.

Patienten und Methodik:

Im Zeitraum von 2006 bis 2009 wurden insgesamt 41 Patienten in die Untersuchung eingeschlossen. Alle Implantate (Orthosystem®; Straumann, Basel, Schweiz; Dimension: 4,1 mm × 4,2 mm) wurden im medianen bzw. paramedianen Bereich des anterioren Gaumens inseriert und über eine Randomisierung auf zwei Belastungsgruppen (Frühbelastung innerhalb der ersten Woche nach Insertion vs. Spätbelastung nach einer Einheilphase von 12 Wochen) verteilt. In dieser Zwischenauswertung berichten wir über erste Ergebnisse 6 Monate nach funktioneller Belastung.

Ergebnisse:

Alle Gaumenimplantate waren bei der Insertion primär stabil. In der Gruppe der Spätbelastung gab es einen Implantatverlust (12. Woche nach chirurgischer Insertion) und einen Drop-out in der Gruppe der Sofortbelastung. 39 Gaumenimplantate befanden sich zum Zeitpunkt dieser Untersuchung unter funktioneller Belastung. In beiden Belastungskonzepten wurden verschiedene kieferorthopädische Behandlungsaufgaben (z.B. Intrusion von Front- und/oder Seitenzähnen, Mesialisieren und Distalisieren von Seitenzähnen) gelöst. In den Belastungsgruppen war die Verteilung der Indikationen sowie von direkten und indirekten Verankerungsformen in der aktiven Behandlungszeit annähernd gleich.

Schlussfolgerung:

Der Vergleich beider Belastungskonzepte ergab klinisch keine Unterschiede bezüglich der Implantatstabilität. Das frühzeitige Belastungskonzept zeigte gegenüber der Spätbelastung keine Indikationseinschränkungen 6 Monate nach funktioneller Belastung.

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Authors and Affiliations

  1. Department of Orthodontics, University Medical Center of Johannes Gutenberg University, Mainz, Germany

    Britta A. Jung* & Heiner Wehrbein

  2. Department of Orthodontics, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany

    Winfried Harzer & Gabriele Lüdicke

  3. Department of Orthodontics, Ernst-Moritz Arndt University, Greifswald, Germany

    Tomasz Gedrange

  4. Department of Oral and Maxillofacial Plastic Surgery, Ruhr University, Bochum, Germany

    Martin Kunkel*

  5. Department of Oral and Maxillofacial Surgery, University Medical Center of Johannes Gutenberg University, Mainz, Germany

    Maximilian Moergel

  6. Department of Orthodontics, RWTH University Aachen, Aachen, Germany

    Peter Diedrich

  7. Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Poliklinik für Kieferorthopädie, Augustusplatz 2, 55131, Mainz, Germany

    Britta A. Jung*

Authors
  1. Britta A. Jung*
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  2. Winfried Harzer
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  3. Tomasz Gedrange
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  4. Martin Kunkel*
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  5. Maximilian Moergel
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  6. Peter Diedrich
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  7. Gabriele Lüdicke
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  8. Heiner Wehrbein
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Correspondence to Britta A. Jung*.

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*These authors contributed equally to this work.

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Jung*, B.A., Harzer, W., Gedrange, T. et al. Spectrum of Indications for Palatal Implants in Treatment Concepts Involving Immediate and Conventional Loading. J Orofac Orthop 71, 273–280 (2010). https://doi.org/10.1007/s00056-010-1007-7

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  • DOI: https://doi.org/10.1007/s00056-010-1007-7

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