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Biological Oriented Immediate Loading: A New Mathematical Implant Vertical Insertion Protocol, Five-Year Follow-Up

Fabrizio Bambini1, Giulia Orilisi1, Alessandro Quaranta2

  • 1Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, Via Tronto 10, 60126 Ancona, Italy.

Materials (Basel, Switzerland)
|January 20, 2021
PubMed
Summary

A new mathematical rule for implant placement, based on soft tissue thickness, successfully prevented bone loss and bacterial invasion in 127 dental implants. This Biological Oriented Immediate Loading (B.O.I.L.) protocol achieved 100% survival after five years.

Keywords:
dental implantsimmediate dental implant loadingmarginal bone lossoral bacteriasoft tissue

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Area of Science:

  • Dental Implantology
  • Biomaterials Science
  • Surgical Protocols

Background:

  • Minimizing marginal bone loss around dental implants is crucial to prevent bacterial colonization and implant failure.
  • Current challenges include achieving optimal tissue adaptation to abutment/implant surfaces and preventing peri-implant bone resorption.

Purpose of the Study:

  • To validate a novel mathematical rule correlating soft tissue thickness with implant positioning relative to the bone crest.
  • To assess the efficacy of this rule within the Biological Oriented Immediate Loading (B.O.I.L.) protocol in preventing peri-implant bone loss and bacterial invasion.

Main Methods:

  • A cohort of 127 implants was placed using the B.O.I.L. protocol and the mathematical rule Y = X - 3 (Y=implant position from bone crest, X=soft tissue thickness).
  • Implants were placed in fresh extraction sockets and immediately loaded. Bone levels were radiographically assessed at multiple time points up to 5 years.
  • Statistical analysis included One-way ANOVA and Tukey's multiple comparison test (p < 0.05).

Main Results:

  • The study achieved a 100% implant survival rate after 5 years.
  • The mean marginal bone loss around implants was minimal (0.0704 mm ± 0.169 mm).
  • The B.O.I.L. protocol with the mathematical rule demonstrated a robust soft tissue seal, preventing bacterial infiltration and promoting healing.

Conclusions:

  • The validated mathematical rule enables precise vertical implant placement, effectively mitigating bone resorption and bacterial challenges.
  • The B.O.I.L. protocol, incorporating this rule and Multi Unit Abutments (MUA), ensures implant success and preserves the biological seal.
  • This approach offers a safe and successful method for immediate implant loading, maintaining long-term peri-implant bone health.