ABSTRACT
Objective:
The objective of this research was to compare the longstanding stability of single-piece implant systems to typical two-piece systems by analyzing patient records retrospectively.
Methods:
A retrospective examination of patient records from January 2010 to December 2020 was undertaken at the Department of Oral Implantology, University Hospital. The research included dental rehabilitation patients who got single- or two-piece implant systems. Patient demographics, implant features, surgical procedures, and follow-up results were extracted. Implant success rates, stability defined by resonance frequency analysis (RFA) utilizing Osstell ISQ®, and peri-implant bone loss evaluated by standardized periapical radiographs at baseline and follow-up visits were the main outcomes.
Results:
The research involved 320 patients (160 per cohort). The average patient age was 52.7 years, with 55% men. The mandibular region received 65% of implants, and the maxillary region the rest. Single-piece cohort A had 94.6% implant success, and two-piece cohort B 96.2%. Implant success rates were similar between cohorts (P = 0.412). The mean ISQ scores were 72.4 ± 4.8 in cohort A and 74.8 ± 5.1 in cohort B (P = 0.086). Peri-implant bone loss was 1.8 ± 0.7 mm in cohort A and 1.4 ± 0.6 mm in cohort B (P = 0.031).
Conclusion:
Single-piece implant systems provide a stable and successful alternative to classic two-piece systems. However, patient selection, surgical technique, and monitoring are essential to reduce peri-implant problems and improve clinical results. To improve implant dentistry patient care and evidence-based clinical practice, single-piece and two-piece implant systems’ design, biomechanical features, and longstanding performance should be studied.
KEYWORDS: Implant success, longstanding stability, peri-implant bone loss, single-piece implant, two-piece implant
INTRODUCTION
In recent decades, there have been tremendous improvements in dental implantology, with several implant designs and methods developed to improve patient satisfaction and clinical outcomes.[1] Although extensively utilized, traditional two-piece implant systems that comprise distinct implant and abutment components necessitate numerous surgical procedures and longer patient chair times.[2] Single-piece implant systems, however, combine the implant and abutment into a single element, providing a simplified and effective method of implant placement.[3]
Clinicians have come to favor the single-piece implant method because of its potential for fewer surgical problems, faster treatment times, and easier restoration processes.[4] In single-piece systems, removing the microgap between the abutment and implant may also lower the incidence of peri-implantitis and bacterial colonization.[5] Though single-piece implant systems have advantages over standard two-piece systems, there are questions about the stability and success rates of single-piece systems in the long run.[6]
Through a retrospective review of patient data, this research seeks to assess the longstanding durability of single-piece implant systems in comparison to conventional two-piece systems. Evaluation of the peri-implant bone loss, implant stability, and success rates of single- and two-piece implant systems are the goals, along with the provision of evidence-based recommendations for clinical practice.
MATERIALS AND METHODS
At the current research’s tertiary care facility, a retrospective review of patient records from January 2010 to December 2020 was carried out. Patients undergoing dental rehabilitation who received single- or two-piece implant systems were included in the research.
Patients who met the minimum follow-up requirement of five years and were at least 18 years old might be included. Individuals with smoking habits, poor dental hygiene, or systemic disorders were not accepted.
Electronic health records provide information on follow-up results, surgical procedures, implant features, and patient demographics. Implant success rates, implant stability as determined by resonance frequency analysis (RFA) with Osstell ISQ®, and peri-implant bone loss as determined by standardized periapical radiographs at baseline and follow-up were the main outcomes investigated.
RESULTS
Patients’ average age was 52.3 years in cohort A (single piece) with a standard deviation of 6.2 and 53.1 years in cohort B (two-piece) with a standard deviation of 5.8. At P = 0.214, the age difference between the two cohorts was not statistically significant. Gender: There were 88 male and 72 female patients in cohorts A, and 84 male and 76 female patients in cohort B. There was no discernible difference in the gender distribution between the two cohorts (P = 0.528). Implant Location: In both cohorts, the mandibular area accounted for the majority of implants (66% in cohort A and 64% in cohort B). There was no statistically significant difference in the distribution of implants between the two cohorts in the mandibular and maxillary regions (P = 0.742); Table 1.
Table 1.
Demographic and Implant Characteristics
| Parameter | Cohort A (Single-Piece) | Cohort B (Two-Piece) | P |
|---|---|---|---|
| Age (years) | 52.3±6.2 | 53.1±5.8 | 0.214 |
| Gender (Male/Female) | 88/72 | 84/76 | 0.528 |
| Implant Location (%) | |||
| Mandibular | 66 | 64 | 0.742 |
| Maxillary | 34 | 36 |
Implant Success Rate: In cohort A (single piece), the overall implant success rate was 94.6%, and in cohort B (two-piece), it was 96.2%. The implant success rates in the two cohorts did not differ statistically significantly (P = 0.412). Implant Stability: In cohort A, the mean ISQ values were 72.4 ± 4.8, while in cohort B, they were 74.8 ± 5.1. Despite having somewhat more implant stability, cohort B did not show a statistically significant difference (P = 0.086). Peri-implant Bone Loss: In cohorts A and B, the mean peri-implant bone loss was 1.8 ± 0.7 mm and 1.4 ± 0.6 mm, respectively. Cohort A had a statistically significant (P = 0.031) increase in peri-implant bone loss in comparison to cohort B; Table 2.
Table 2.
Comparison of Implant Success Rates, Implant Stability, and Peri-implant Bone Loss
| Parameter | Cohort A (Single-Piece) | Cohort B (Two-Piece) | P |
|---|---|---|---|
| Implant Success Rate (%) | 94.6 | 96.2 | 0.412 |
| Mean ISQ Value | 72.4±4.8 | 74.8±5.1 | 0.086 |
| Peri-implant Bone Loss (mm) | 1.8±0.7 | 1.4±0.6 | 0.031 |
DISCUSSION
Single- and two-piece implant devices had equal success rates, supporting previous research.[1,2,3] Single-piece and two-piece systems had 94.6% and 96.2% implant success rates. The two cohorts were not significantly different (P = 0.412). These data suggest that both implant systems are clinically successful for dental rehabilitation and give consistent, longstanding results.
The mean ISQ values for single-piece implants were 72.4 ± 4.8, while for two-piece implants, they were 74.8 ± 5.1. These numbers indicate implant stability. cohort B had slightly higher implant stability but no statistically significant difference (P = 0.086). These findings support previous research[1,4] that showed single- and two-piece implants stable. Both cohorts showed effective osseointegration and excellent implant stability, indicating that both implant techniques can achieve bone biomechanical stability.
This research found that single-implant cohorts had slightly more peri-implant bone loss than two-implant cohorts. cohort A had an average peri-implant bone loss of 1.8 ± 0.7 mm, while cohort B had 1.4 ± 0.6 mm. This difference was significant (P = 0.031). Other research found that single-piece implants without an abutment or microgap accelerated bone loss.[3,4,5,6] More research is needed to identify how design elements and surgical techniques affect peri-implant bone response to optimize single-piece implant systems.
Single-piece implant systems are easier to place and have similar longstanding stability and success rates to two-piece systems. As shown by the single-piece implant cohort ‘s slightly greater peri-implant bone loss, careful patient selection and monitoring are essential to reducing issues. Clinicians should evaluate anatomical site, bone quality, and cosmetics when choosing single-piece or two-piece implant systems. They should then adjust the therapy regimen for optimal clinical results.[7,8,9,10]
The research’s retrospective design and short follow-up may limit its applicability. To evaluate single- and two-piece implant systems’ clinical effectiveness, complications, and patient satisfaction, longer follow-ups and prospective trials are needed. Biomechanical investigations of single-piece and two-piece implant systems under functional loading circumstances are needed to understand the mechanisms of peri-implant bone response and longstanding implant durability.
CONCLUSION
In conclusion, with similar longstanding stability and success rates, one-piece implant systems present a competitive option to conventional two-piece systems. However, to reduce peri-implant problems and maximize clinical outcomes, cautious patient selection, surgical technique, and monitoring are essential. To support evidence-based clinical practice and enhance patient care in implant dentistry, more research is necessary to examine the design features, biomechanical qualities, and longstanding performance of single-piece and two-piece implant systems.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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