My first Magazine | Page 115

PROSTHETIC RECONSTRUCTIONS AND REFERRING IMPLANT SURVIVAL IN A POSTGRADUATE PROGRAM : A RETROSPECTIVE STUDY

NRG , 10 / 4.3 24 No No No Yes Bar-IOD 38

Complication : at 1.5 year recall mild periimplantitis , at 3 years additional circumferential 0.5mm bone loss , mild mucosal inflammation , no pus , no pain / Etiology : Overload and periimplantitis / Therapy : explantation .

NRG , 13 / 3.5 24 Yes No No No Bar-IOD 46

Complication : Periimplantitis ( 8 mm crestal bone loss distal and mesial , pus ), occasional pain ; Etiology : Periimplantitis , local risk factor ? / Therapy : : explantation and bar shortened , relining of IOD .

GBA : Guided Bone Augmentation , i . e . simultaneous buccal augmentation with Bio-Oss / particulated autogenous bone and Bio-Gide membrane ( Geistlich , Wolhusen , Switzerland ) SFE : Sinus Floor Elevation NRG : NobelReplace Tapered Groovy Implant ( Nobel Biocare , Gothenburg , Sweden ) ISR : Implant supported reconstruction SC : Single crown FDP : short-span fixed dental prosthesis IB : Full-arch FDP ( Implant bridge ) RDP : Removable dental prosthesis IOD : Implant-Overdenture

4 . Discussion The aim of this retrospective study was to analyze frequency distribution of implant-supported prosthetic reconstructions and referred implant survival of implants placed from graduate students in a university training program . A broad variety of fixed and removable ISRs for partially and completely edentulous patients was identified . Although these data represent learning curves for graduate students working under supervision , implant survival was successful in a short-term range . The overall implant CSR of 98.6 % after 8 years is comparable to other studies where implants where placed by novice operators that were supervised by experts during implant placement . In a recent study 22 the survival rate of 49 implants and referring SC that were placed and fabricated by undergraduate students was 94 % after 10 years of loading . The authors concluded that it is acceptable to include implant therapy in the clinical undergraduate dental curriculum , provided the focus remains on straightforward cases with substantial supervision by trained dentists and oral and maxillofacial surgeons . This teaching situation is comparable to the setting in the present study . However , the 5-year cumulative survival rate of the implants was considerably higher with 98.6 %. A learning curve has to be considered but cannot be specified for the single students . Maxillary implants were slightly less successful , as it is often reported from clinical studies . Some specific treatment outcomes are also represented by various clinical studies performed during the same time period , based on the same study material 23-29 . Since the present data were collected within a prosthodontic department the number of edentulous jaws that were included in the data collection is relatively high . This is in contrast to a study performed in a department for oral surgery where the most frequent reconstruction performed was an implant supported SC 30 . This difference is also represented by the average number of implants per patient of 1.5 vs . 2.9 in the present study . Another study investigated the 12-months clinical outcome of immediate implants placed by novice operators showing that the success rate was high and predictable provided there were routine school procedures and supervision from experienced surgeons 31 . The clinical studies available in the literature reporting on success rate of implants placed by graduate students include only a small number of implants . At the Prosthodontic Department of the University of Washington a number of 273 implants was observed during at least 5 years and showed a comparable survival rate of 96.3 % 32 . At the University of Kentucky College of Dentistry a total of 415 patients with 963 implants were interviewed . The implant survival rate was 97 %, and 88 % of the implants were considered successful as determined by patient-centred criteria 33 . These results suggest that work standardization ( in the form of specific treatment protocols ) and the use of a formal , incremental learning system can result in positive patient outcomes . Clinical outcomes should be monitored in academic dental settings as part of the clinical process improvement , and these outcomes can provide a means of assessing the effectiveness of the training program . So far little information was provided in the literature on the treatment outcomes of implant-