Enrico Luigi Agliardi*, Alberto Pitino, Giulia Moreo, Bianca DOrto and Davide Romeo
Volume5-Issue10
Dates: Received: 2024-10-14 | Accepted: 2024-10-25 | Published: 2024-10-27
Pages: 1403-1410
Abstract
Background: The aim of this case series was to evaluate the 5-years clinical and radiographic outcomes of immediate full-arch fixed prosthesis supported by a novel implant system characterized by a low-speed site preparation protocol.
Methods: Six medically compromised patients (3 females and 3 males) were consecutively enrolled and treated. Each patient received a fixed full-arch rehabilitations supported by two axial and two tilted implants. A total of 24 implants (N1 System, Nobel Biocare AB, Göteborg, Sweden) were placed in three mandibles and three maxillae using a low-speed drilling protocol with no irrigation. Prosthetic loading was applied within 2 hours of surgery, while then definitive restorations were placed 4 months later. Patients were scheduled for follow-up every 6 months up to 2 years and then annually. Radiographic evaluation of marginal bone level change was performed on regular intervals.
Results: Between February 2019 and July 2019, six patients received a full-arch fixed prosthesis on four implants. All implants reached a minimum insertion torque of 30 Newton for immediate loading. After 5 years of observation (range 62-67 months), no implants failed and all definitive prostheses were stable and functional, resulting in a cumulative survival rate of 100%. After 5 years, the marginal bone loss was 1.46 ± 0.16 mm for the mandible and 1.85 ± 0.18 mm for the maxilla. Two implants (one axial and 1 tilted) in 1 patient treated in the maxillary arch reported more then 2 mm of marginal bone loss after 5 years.
Conclusions: Within the limitations of this study, the successful medium-term results seem to confirm that immediate fixed full-arch rehabilitation, supported by two anterior axial and two posterior tilted implants, could be an effective and biologically beneficial treatment for complete arch edentulism. The reduced bone remodeling evidenced after 5 years of function confirm the biologically friendly concept behind this novel implant system.
FullText HTML
FullText PDF
DOI: 10.37871/jbres2029
Certificate of Publication

Copyright
© 2024 Agliardi EL, et al. Distributed under Creative Commons CC-BY 4.0
How to cite this article
Agliardi EL, Pitino A, Moreo G, DOrto B, Romeo D. Clinical Outcomes of Full Arch Immediate Fixed Prostheses Supported By a Novel Implant System with Low Speed Site Preparation A 5 Years Retrospective Case Series. J Biomed Res Environ Sci. 2024 Oct 27; 5(10): 1403-1410. doi: 10.37871/jbres2029, Article ID: JBRES2029, Available at: https://www.jelsciences.com/articles/ jbres2029.pdf
Subject area(s)
References
- Brånemark PI, Hansson BO, Adell R, Breine U, Lindström J, Hallén O, Ohman A. Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period. Scand J Plast Reconstr Surg Suppl. 1977;16:1-132. PMID: 356184.
- BRANEMARK PI. Vital microscopy of bone marrow in rabbit. Scand J Clin Lab Invest. 1959;11 Supp 38:1-82. PMID: 13658913.
- Brånemark PI, Adell R, Breine U, Hansson BO, Lindström J, Ohlsson A. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg. 1969;3(2):81-100. doi: 10.3109/02844316909036699. PMID: 4924041.
- Del Fabbro M, Pozzi A, Romeo D, de Araújo Nobre M, Agliardi E. Outcomes of Fixed Full-Arch Rehabilitations Supported by Tilted and Axially Placed Implants: A Systematic Review and Meta-Analysis. Int J Oral Maxillofac Implants. 2022 Sep-Oct;37(5):1003-1025. doi: 10.11607/jomi.9710. PMID: 36170316.
- Maló P, Rangert B, Nobre M. "All-on-Four" immediate-function concept with Brånemark System implants for completely edentulous mandibles: a retrospective clinical study. Clin Implant Dent Relat Res. 2003;5 Suppl 1:2-9. doi: 10.1111/j.1708-8208.2003.tb00010.x. PMID: 12691645.
- Maló P, Rangert B, Nobre M. All-on-4 immediate-function concept with Brånemark System implants for completely edentulous maxillae: a 1-year retrospective clinical study. Clin Implant Dent Relat Res. 2005;7 Suppl 1:S88-94. doi: 10.1111/j.1708-8208.2005.tb00080.x. PMID: 16137093.
- Agliardi EL, Pozzi A, Romeo D, Del Fabbro M. Clinical outcomes of full-arch immediate fixed prostheses supported by two axial and two tilted implants: A retrospective cohort study with 12-15 years of follow-up. Clin Oral Implants Res. 2023 Apr;34(4):351-366. doi: 10.1111/clr.14047. Epub 2023 Feb 22. PMID: 36760035.
- Albrektsson T, Brånemark PI, Hansson HA, Lindström J. Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man. Acta Orthop Scand. 1981;52(2):155-70. doi: 10.3109/17453678108991776. PMID: 7246093.
- Singhatanadgit W. Biological responses to new advanced surface modifications of endosseous medical implants. Bone and Tissue Regeneration Insights. 2009;2. doi: 10.4137/BTRI.S315.
- Coelho PG, Jimbo R. Osseointegration of metallic devices: current trends based on implant hardware design. Arch Biochem Biophys. 2014 Nov 1;561:99-108. doi: 10.1016/j.abb.2014.06.033. Epub 2014 Jul 8. PMID: 25010447.
- Pandey C, Rokaya D, Bhattarai BP. Contemporary Concepts in Osseointegration of Dental Implants: A Review. Biomed Res Int. 2022 Jun 14;2022:6170452. doi: 10.1155/2022/6170452. PMID: 35747499; PMCID: PMC9213185.
- Bahat O, Yin X, Holst S, Zabalegui I, Berroeta E, Pérez J, Wöhrle P, Sörgel N, Brunski J, Helms JA. An Osteotomy Tool That Preserves Bone Viability: Evaluation in Preclinical and Clinical Settings. J Clin Med. 2022 Apr 30;11(9):2536. doi: 10.3390/jcm11092536. PMID: 35566662; PMCID: PMC9103213.
- Vanpee D, Gillet JB, Dupuis M. Clinical trials in an emergency setting: implications from the fifth version of the Declaration of Helsinki. J Emerg Med. 2004 Jan;26(1):127-31. doi: 10.1016/j.jemermed.2003.04.007. PMID: 14751494.
- Eriksson AR, Albrektsson T. Temperature threshold levels for heat-induced bone tissue injury: a vital-microscopic study in the rabbit. J Prosthet Dent. 1983 Jul;50(1):101-7. doi: 10.1016/0022-3913(83)90174-9. PMID: 6576145.
- Eriksson AR, Albrektsson T, Albrektsson B. Heat caused by drilling cortical bone. Temperature measured in vivo in patients and animals. Acta Orthop Scand. 1984 Dec;55(6):629-31. doi: 10.3109/17453678408992410. PMID: 6524329.
- Sharawy M, Misch CE, Weller N, Tehemar S. Heat generation during implant drilling: the significance of motor speed. J Oral Maxillofac Surg. 2002 Oct;60(10):1160-9. doi: 10.1053/joms.2002.34992. PMID: 12378492.
- Kim SJ, Yoo J, Kim YS, Shin SW. Temperature change in pig rib bone during implant site preparation by low-speed drilling. J Appl Oral Sci. 2010 Sep-Oct;18(5):522-7. doi: 10.1590/s1678-77572010000500016. PMID: 21085811; PMCID: PMC4246386.
- Abouzgia MB, James DF. Measurements of shaft speed while drilling through bone. J Oral Maxillofac Surg. 1996 Mar;54(3):379. doi: 10.1016/s0278-2391(96)90786-7. PMID: 8600253.
- Aghvami M, Brunski JB, Serdar Tulu U, Chen CH, Helms JA. A Thermal and Biological Analysis of Bone Drilling. J Biomech Eng. 2018 Oct 1;140(10):1010101–8. doi: 10.1115/1.4040312. PMID: 30029243; PMCID: PMC6059311.
- Chen CH, Coyac BR, Arioka M, Leahy B, Tulu US, Aghvami M, Holst S, Hoffmann W, Quarry A, Bahat O, Salmon B, Brunski JB, Helms JA. A Novel Osteotomy Preparation Technique to Preserve Implant Site Viability and Enhance Osteogenesis. J Clin Med. 2019 Feb 1;8(2):170. doi: 10.3390/jcm8020170. PMID: 30717291; PMCID: PMC6406409.
- Chen CH, Pei X, Tulu US, Aghvami M, Chen CT, Gaudillière D, Arioka M, Maghazeh Moghim M, Bahat O, Kolinski M, Crosby TR, Felderhoff A, Brunski JB, Helms JA. A Comparative Assessment of Implant Site Viability in Humans and Rats. J Dent Res. 2018 Apr;97(4):451-459. doi: 10.1177/0022034517742631. Epub 2017 Dec 4. PMID: 29202640; PMCID: PMC5863872.
- Coyac BR, Salvi G, Leahy B, Li Z, Salmon B, Hoffmann W, Helms JA. A novel system exploits bone debris for implant osseointegration. J Periodontol. 2021 May;92(5):716-726. doi: 10.1002/JPER.20-0099. Epub 2020 Sep 10. PMID: 32829495.
- Khan SN, Cammisa FP Jr, Sandhu HS, Diwan AD, Girardi FP, Lane JM. The biology of bone grafting. J Am Acad Orthop Surg. 2005 Jan-Feb;13(1):77-86. PMID: 15712985.
- Bahat O, Yin X, Holst S, Zabalegui I, Berroeta E, Pérez J, Wöhrle P, Sörgel N, Brunski J, Helms JA. An Osteotomy Tool That Preserves Bone Viability: Evaluation in Preclinical and Clinical Settings. J Clin Med. 2022 Apr 30;11(9):2536. doi: 10.3390/jcm11092536. PMID: 35566662; PMCID: PMC9103213.
- Meljon A, Geisendorf M. Kamber S, Fuchs F. Irastorza-Landa, A. Evaluation of heat generated by a new site preparation using low-speed tools without irrigation. Clin Oral Impl Res. 2021;32:111.
- Fabbri G, Staas T, Urban I. A Retrospective Observational Study Assessing the Clinical Outcomes of a Novel Implant System with Low-Speed Site Preparation Protocol and Tri-Oval Implant Geometry. J Clin Med. 2022 Aug 18;11(16):4859. doi: 10.3390/jcm11164859. PMID: 36013098; PMCID: PMC9410172.
- Yin X, Li J, Hoffmann W, Gasser A, Brunski JB, Helms JA. Mechanical and Biological Advantages of a Tri-Oval Implant Design. J Clin Med. 2019 Mar 28;8(4):427. doi: 10.3390/jcm8040427. PMID: 30925746; PMCID: PMC6517945.