Effects of immediate and delayed loading on peri-implant trabecular structures: a cone beam CT evaluation

Clin Implant Dent Relat Res. 2014 Dec;16(6):873-83. doi: 10.1111/cid.12063. Epub 2013 Apr 2.

Abstract

Purpose: To develop a method for characterizing trabecular bone microarchitecture using cone beam computed tomography (CBCT) and to evaluate trabecular bone changes after rehabilitation using immediate versus delayed implant protocols.

Materials and methods: Six mongrel dogs randomly received 27 titanium implants in the maxillary incisor or mandibular premolar areas, following one of four protocols: (1) normal extraction socket healing; (2) immediate implant placement and immediate loading; (3) delayed implant placement and delayed loading; (4) delayed implant placement and immediate loading. The animals were euthanized at 8 weeks, and block biopsies were scanned using high resolution CBCT. Standard bone structural variables were assessed in coronal, middle, and apical levels.

Results: Coronal and middle regions had more compact, more platelike, and thicker trabeculae. Protocols (2), (3), and (4) had significantly higher values (p < 0.001) than protocol (1) for bone surface density, bone surface volume ratio, and connectivity density, while significantly lower values (p < 0.001) were found for trabecular separation and fractal dimension. However, protocols (2), (3), and (4) did not show significantly different bone remodeling.

Conclusions: Compared with normal extraction healing, the implant protocols have an improved bone structural integration. Results do not suggest a different bone remodeling pattern when a delayed versus an immediate implant protocol is used.

Keywords: animal experiments; cone beam CT; dental implants; immediate loading; trabecular bone.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Bicuspid / surgery
  • Biopsy / methods
  • Bone Density / physiology
  • Bone Remodeling / physiology
  • Cone-Beam Computed Tomography / methods*
  • Dental Arch / diagnostic imaging
  • Dental Arch / surgery
  • Dental Implantation, Endosseous / methods*
  • Dogs
  • Fractals
  • Imaging, Three-Dimensional / methods
  • Immediate Dental Implant Loading / methods*
  • Incisor / surgery
  • Male
  • Mandible / diagnostic imaging
  • Mandible / surgery
  • Maxilla / diagnostic imaging
  • Maxilla / surgery
  • Random Allocation
  • Tooth Extraction / methods
  • Tooth Socket / diagnostic imaging*
  • Tooth Socket / surgery
  • Wound Healing / physiology