Factores biomecánicos en el pronóstico de los implantes dentales: un estudio clínico

Abstract

[EN]Purpose: This study aims to assess the impact of occlusal loadings on peri-implant bone loss by measuring the cantilever of each implant and evaluating the occlusal pattern using PRESCALE®. Methods: A retrospective study was conducted to examine the relationship between occlusal overload and peri-implant bone loss in a sample of 41 patients with a total of 135 implants. Various predictive factors for marginal bone loss, including sociodemographic, clinical, behavioral, implant-related, prosthetic, and biomechanical factors, were analyzed. This study also assessed the influence of occlusal overload based on tissue-related and subject-dependent variables among patient groups with no marginal bone loss, unilateral bone loss, and bilateral bone loss. The masticatory function was evaluated using the PRESCALE® system, which quantifies the occlusal area and load along the dental arch. Results: The implants were categorized into three groups according to whether they had unilateral bone loss (n = 30), bilateral bone loss (n = 26), or no bone loss (n = 19). All three groups had similar follow-up periods, with a marginal bone loss of 1063.2 ± 1257.5 after 47.6 ± 21.0 months of follow-up. Results of occlusal distribution and pressure range are presented using the PRESCALE® analysis software (Fujifilm). The magnitudes of mesial and distal cantilevers were 1650.9 ± 1530.4 and 1407.0 ± 1672.3 microns, respectively. It was found that the mesial cantilever was statistically significantly greater (p < 0.05) for the bilateral bone loss group. Additionally, marginal bone loss was significantly proportional to occlusal loading in the left anterior sector (r = 0.47; p < 0.01) and to follow-up time (r = 0.29; p < 0.01), though it was also proportional to implant diameter and length (r = 0.27 and r = 0.20, respectively). The mean occlusal load in the anterior sector ranged from 77.7 ± 165.6 to 204.6 ± 260.2 Nw in the posterior sector. Conclusions: Sociodemographic and behavioral factors were not significantly associated with marginal bone loss. From the biomechanical point of view, the presence of a wider cantilever and excess occlusal loading appears to be associated with increased bone loss.