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International Arab Journal of Dentistry

Abstract

Abstract

Background of the study: The study focuses on the success and durability of dental implants, which depends heavily on the bone surrounding them. Changes in this bone affect how the implant looks and functions. The researchers aimed to use CBCT, a modern three-dimensional imaging tool, to accurately measure changes in the thickness of the bone plate on the cheek side (vestibular bone plate) around implants placed in the lower jaw (mandible). Specifically, they looked at bone changes five months after placing implants that were immediately loaded (meaning they were used for chewing right away) in 15 patients who had missing molars or premolars. Research objectives and hypotheses: The main objective was to evaluate the effectiveness of CBCT imaging in determining changes in the bone thickness on the cheek side following immediate loading of dental implants over a 05-month period. The study implicitly aimed to see if bone loss (absorption) occurs, if patient factors like sex or age affect this loss, and how bone thickness changes at specific measurement points around the implant. Methodology: The study involved 15 patients (8 men, 7 women’s) who received 30 dental implants (two per patient: one on the right/ and one on the left side of the posterior mandible). All implants were of the same size (5.5 x 4.0 x 13.5 mm) and were immediately loaded. This research was approved by the Research Ethics Board of the Mustapha Stambouli University of Mascara, Faculty of Science and Technology, under reference number: FST 4091713 / 2024. 1. Imaging: A preliminary CBCT scan was taken before implant placement (Image 01), and a second scan was taken 05 months after placement (Image 02). 2.Image Processing: The images were processed using Whitefox software. This involved filtering the image to reduce artifacts caused by the metal implant, removing the implant structure itself (using a threshold of 5,000 HU), and then removing the softer cancellous bone (using a threshold of 960 HU) to isolate only the dense cortical bone. 3.Measurements: Three specific points on the vestibular bone plate thickness were measured using a ruler tool on the processed images: Point A (1 mm apically from the implant-abutment junction), Point B (middle of the implant radially), and Point C (1 mm coronally from the implant apex). Measurements were taken three times for each site and averaged. 4.Data Analysis: Statistical analysis was performed using SPSS software. A paired samples t-test was used to compare bone thickness measurements before and after implantation. Independent samples t-tests were used to compare bone loss between sexes and between implants in premolar versus molar regions. The Pearson test was used to check for correlations between bone loss and patient age. Statistical significance was set at a probability value (p) less than 0.05. Results and findings: 1.Implant Success: The implant success rate was 100% over the five-month period. 2.Overall Bone Loss: There was a statistically significant overall mean bone loss (absorption) of (0.60 ± 0.35) mm five months after implantation. 3.Thickness Changes at Specific Sites: Statistically significant decreases in vestibular bone plate thickness were found at all three measured sites: • Point A (1 mm apically from the junction): - 0.29 mm change. • Point B (middle of the implant): - 0.17 mm change. • Point C (1 mm coronally from the apex): - 0.08 mm change. 4.Influence of Patient Factors: Patient sex and patient age showed no statistically significant difference in the amount of bone loss. Implant location (premolar vs. molar region) also did not significantly affect bone loss. 5.Correlation: A strong positive correlation (r = 0.804) was found between the marginal bone loss and the change in thickness of the buccal cortical bone plate at Point A (1 mm from the implant-abutment junction in the apical direction). Conclusions: Despite the limitations of this study, we can conclude that immediate-loading implants are a reliable option for orthodontics in the posterior mandible. The rate of peri-implant bone absorption in the cortical plate thickness region does not influence implant failure. Although this study showed acceptable results, their effectiveness remains closely linked to the degree of implant fixation. Further studies are needed to confirm these results.

Keywords : Bone Absorption , CBCT , Immediate Loading , Implants ,Vestibular Bone Plate Thickness.

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