And what were the key results?
We achieved a 100% survival rate for both implant and abutment with a mean marginal bone loss of just 0.46 mm after 1 year. Though some mechanical complications occurred with provisional prosthesis screw fractures, there was an absence of biological complications and a good and stable soft tissue response. In a nutshell, these are good results.
Though it’s a pilot study with one-year follow-up, is this 100% survival rate a very promising figure?
Through our experiences with All-on-4® Immediate Function, we have learned over the years that if a stable maintenance protocol is kept up, the majority of implant failures normally occur in the first year or two of follow-up. We also know that the osseointegration period is an important milestone for immediate function implants and, once it is passed, the probability of implant failure is low. In my opinion, to register a 100% survival during the first year of follow-up is very promising. From a researcher’s point of view, the one-year survival rate is an important indicator of potential long-term success. Yes, it’s still a pilot study with 16 patients and it’s still quite early, but as we’ve discovered with All-on-4®, a one-year outcome like this gives you a positive start.
Regarding the marginal bone loss results: What can a clinician learn from this? Is there any indication for potential long-term outcomes?
Often the amount of marginal bone loss is a predictor of long-term outcome success. When you place an implant, the implant failure likelihood tends to decrease over time but at the same time, the probability for pockets of marginal bone loss increase. This is the difference between early and late implant failure. For this study, we recorded an average of 0.46 mm of marginal bone loss after 1 year—0.57 mm in the maxilla, and 0.19 mm in the mandible. From our perspective, these results are a very pleasant surprise. It was less than we are used to observing from the All-on-4® concept and though we can’t directly compare this with data from older studies, in this case we are looking in-house and so it’s a very promising result.
What made you first adopt the Xeal and TiUltra surfaces?
First of all, we have previous experience using anodized surfaces — we started using Nobel Biocare’s TiUnite implant surface a long time ago, and have up to 18 years’ follow-up data that prove they are a reliable long-term option.
We are always trying to improve the treatment quality for our patients, who constantly pose rehabilitation challenges. These improvements can usually either be achieved through updated protocols or the use of new innovations. For these new Xeal and TiUltra surfaces, we scrutinized the research beforehand. We were particularly interested in the Mucointegration™ concept; from our view, it fills a gap in implant dentistry in relation to the peri-implant complex.