Nur ALTIPARMAK, Sıdıka Sinem AKDENİZ, Esra BEYLER

Yerleştirme Sonrası İyileşme Başlığı ile Kapatılan İmplantlarda İlkYılda Marjinal Kemik Kaybı Daha Az mı Görülür?

Amaç: İmplant tipinden bağımsız olarak iyileşme periyodu vefonksiyondaki ilk yılda görülen erken dönem implant çevresi krestalkemik kaybı genellikle ilerleyen yıllarda oluşan kemik kaybından dahafazladır. Günümüze kadar, marjinal kemik kaybını etkileyen birçokfaktör tanımlanmıştır. Bunlar; cerrahi travma, flapsiz ya da flap kaldırılanprosedürler, mikrogap, krestal implant modülü olarak sıralanmaktadır.Bu çalışmanın amacı; yerleştirme sonrası kapama vidası ile primerkapatılan implantlar ile iyileşme başlığı ile kapatılan implantların ilk yıldagörülen implant çevresi kemik kaybına etkisini karşılaştırmaktır. Gereç ve Yöntemler: Bu prospektif çalışmaya 30 hasta dahil edilmiştir.Kemik seviyesi, “platform switch” özellikli, aynı marka, konik, posteriortek diş implantlar yerleştirilmiş hastalar iki gruba ayrılmıştır. Birinci grup,implant yerleştirilmesini takiben iyileşme başlığı takılan implantlardanoluşurken ikinci grupta implantlar kapama vidası ile primer olarakkapatılmıştır. Cerrahi öncesi, hemen sonrası ve 1 yıllık takip sonrasıalınan panoramik radyograflar kemik kaybı değerlendirilmesindekullanılmıştır. İmplant çevresi kemik kaybı miktarları, dijital olarakbilgisayar yazılımı aracılığıyla ölçülmüştür. Bulgular: Çalışmaya, iyileşme başlığı grubunda 14 adet ve kapamavidası grubunda 16 adet, toplamda 30 implant dahil edilmiştir.Perioperatif ve postoperatif dönemde herhangi bir komplikasyongörülmemiştir. Çalışma sonunda hiçbir implant başarısızlığıgörülmemiştir. Birinci yıl sonrası iyileşme başlığı grubunda ortalama0,7014 mm (0.2477 mm standart sapma) marjinal kemik kaybıgörülürken, kapama vidası yerleştirilen ikinci grup implantlardaortalama 1,3156 mm (0.0943 mm standart sapma) kemik kaybıölçülmüştür. İki grup arasındaki 0,6142 mm’lik fark istatistiksel olarakanlamlı bulunmuştur. Sonuç: Yerleştirme sonrası kapama vidası yerine iyileşme başlığıyerleştirmek, krestal kemik üzerinde periost basıncını önleyereközellikle ilk yılda görülen marjinal kemik kaybını önleyebilir.

Do Implants Closed with Healing Cap Show LessMarginal Bone Loss After First Year?

Background: Early peri-implant crestal bone loss during thehealing period and the first year on function, is often greaterthan the bone loss occurring in the following years. Severalfactors affecting marginal bone loss have been described;such as surgical trauma, flapped or flapless procedures,occlusal overload, microgap and implant crest module. Theaim of this study; was to compare the amount of first yearperi-implant bone loss in implants closed with cover screwor healing cap. Methods: Patients with same brand, posterior single toothimplants included in this prospective study and divided intotwo groups. In group I, after implant placement healing capwas placed while in group II, cover screw was placed beforeprimary closure. Panoramic radiographs, taken before andafter the implant surgery and after 1 year follow up, wereused in bone loss evaluations. Peri-implant bone lossmeasurements were performed digitally in computerassisted software programme. Results: Thirty implants included in the study with fourteenimplants in group I and sixteen implants in group II. Therewere no perioperative or postoperative complications andno implant failure in all patients. After the first year, meanmarginal bone loss was 0.7014 mm (0.2477 mm standarddeviation) in group I and 1.3156 mm (0.0943 mm standarddeviation) in group II. This 0.6142 mm difference was foundstatistically significant. Conclusion: Placing healing cap instead of cover screwsmay prevent periosteal tissue pressure on the crestal boneand reduce the amount of marginal peri-implant bone in thefirst year.

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