Aim of work: Purpose of this work is to underline advantages of multi-modal implant approach, the goodness of whose choice is confirmed by the analysis of the data gathered during 25 years of implant practice, with gate controls at 5, 8 and 10 years. Suggestions useful to lead clinical practice are derived.
Materials and Methods: During 25 years (1989-2014) data concerning 7000 endosseous implants have been collected. Different implant shapes have been utilized, letting anatomical morphology lead the choice. An apparatus useful to rigidly join together implants with a titanium bar has been used to allow immediate load in cases of bony atrophy (intraoral welding machine). A proper database has been compiled.
Results: Overall success rates about any implant type here considered have been comprised between 95,5 an 99 % at five years gate control and between 87,7 and 96,6 % at 10 years gate control, widely overcoming the minimum requested by the most used success criteria [1,2]. Suitable implant shape, bicorticalism, immediate solidarization in atrophy cases, respect of healing biologic times, occlusal balance, periodic controls, are key factors for success.
Conclusions: Such a study, allows 1) getting some answers to frequently asked questions about treatment planning; 2) to conceive a schema to choose the correct implant shape in different clinical cases; 3) to help to reduce failure risks.
Different shapes of endosseous implant result useful to treat different anatomical morphologies. Choice about immediate or delayed loading follows anatomical and functional indications. Utilizing implant shapes which properly fit to wide or narrow bony ridges, success rates are similar. Different implant types can support the same fixed bridge. Connecting implants together by means of a welded bar results particularly useful in atrophy cases. Bicorticalism and respect of principles of static and dynamic occlusion are key factors for success. Passing of time leads to increase implant failures, demonstrating that 1-2 years gate control are not sufficient.
Keywords: Multi-modal implant dentistry, Statistical data over 7000 implants, Intra-oral welding, immediate load