Computational protocol: Influence of occlusal loading on peri-implant clinical parameters. A pilot study

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Protocol publication

[…] -Patient selection and study design (Fig. ) Figure 1 This clinical study took place at the Oral Surgery Unit at Valencia University between October 2010 and October 2011. Fifteen patients were selected, who had been rehabilitated with ceramo-metallic complete fixed prostheses, supported by 8 Phibo TSA® implants with Avanblast surface in the upper maxillary and 6 in the mandible (Phibo Dental Solutions, Impladent, Senmenat, Barcelona, Spain) (Fig. ). shows all inclusion and exclusion criteria. The study fulfilled Declaration of Helsinki principles for medical research involving humans. All patients gave their informed consent to take part and the study was approved by the University of Valencia ethics committee (ref no. H1335344280712). Figure 2 Four patients did not fulfill the inclusion criteria: one for failing to attend scheduled appointment, 2 for poor oral hygiene and one for using mouthwashes. This left a final total of 11 patients, 4 women and 7 men, with a mean age of 58.4 years. All patients received rigorous oral hygiene with Teflon curettes and rotary instrument brushing and patients were given instructions for improving and maintaining oral hygiene at home. Patients then underwent occlusal analysis with the T-scan®III system (Tesco, South Boston, USA) in order to establish two study groups per patient: (Fig. ) Figure 3 Study Group: Maxillary implant closest to the point of highest occlusal loading.Control Group: Maxillary implant with least loading, furthest from the study implant.A month later (week 8), the first set of data was collected, registering peri-implant clinical parameters (probing depth, bleeding on probing, gingival retraction, keratinized mucosa width and crevicular fluid volume). Occlusal adjustment was performed to distribute occlusal loading evenly over the whole arch, verifying the distribution with the T-Scan®III (Fig. ), following the method described by Kerstein (). This verification was repeated two (week 16) and twelve (week 52) months after occlusal adjustment, when peri-implant parameters were again evaluated. Figure 4 -Data collection and follow-up.Patient data were registered following a previously established protocol; in a sequence of scheduled visits to the clinic, patients were attended by a specially trained dentist, who registered the following clinical parameters:▪ Probe depth: This was measured using a Click-Probe® plastic periodontal probe with force delivery system (Click-Probe®, Kerr, Bioggio, Switzerland). Periodontal pocket depth was measure at the selected implants, registering depth at three vestibular and lingual points and calculating the mean value.▪ Bleeding on probing: was graded using the scale established by Mombelli et al. (): grade 0= no bleeding; grade 1= isolated point bleeding; grade 2= line of blood at gumline; grade 3= profuse bleeding.▪ Gingival retraction: was determined as the presence or absence of retraction and when present was measured at the midfacial mucosa level in relation to the edge of the prosthetic crown ().▪ Keratinized mucosa width: was measured in millimeters from the mucogingival line to the peri-implant groove ().▪ Crevicular fluid volume: crevicular fluid was collected from the implants selected for study by inserting sterile paper strips (Periopaper Strip® Proflow Incorporated. New York, NY, USA). The technique consisted of: a) air-drying the mouth; b) isolating the area with cotton wool rolls; c) gentle drying of the implant area where the paper strip was to be placed; d) crevicular fluid sample collection, inserting the Periopaper® in the groove between the implant and the gum for 30 seconds; e) placing samples between Periotron® 8000 sensors (Proflow Incorporated. New York. USA) to evaluate the quantity of crevicular fluid collected in Periotron Units (PU). The Periotron® had been calibrated previously following the manufacturer’s instructions.-Statistical Analysis Statistical analysis used SPSS for windows statistical software (version 15.0. SPSS Inc., Chicago, IL, USA). Spearman and Pear-son correlation coefficients were applied to the data. Statistical significance was established as p<0.05. […]

Pipeline specifications

Software tools SPSS, PEAR
Application Miscellaneous
Organisms Homo sapiens