Clinical evaluation of an innovative implant-prosthesis connection without screw or cement: a case study

Jean-Baptiste Verdino, DDS/DEAPrivate practice Hyeres (France) - docjbv@cabinetverdino.fr CLINICAL

INNOVATIONS

Screw retained prosthesis are today a reference in terms of fi xation of prosthesis. In this perspective, a re-volutionary connection has been de-veloped by Anthogyr, which requires either screw manipulation nor cement sealing. This new connection can be used both with bone level and tissue level implants. The inLink connection is a unique system dedicated to screw-retained multiple restora-tions. A lock system is integrated in a CAD CAM Simeda prosthe-sis. This system allows the adjustment of extreme implant diffe-rences with no intermediate abutment, and the free orientation of the angulated access between 0° and 25°.

To evaluate , through a prospective clinical follow-up, the survi-val rate and success rate of the dental implants and the stability of the prosthesis, fi xed by the new inLink (Anthogyr) connection, one year after prosthetic rehabilitation.

10 patients were selected for an indication of plural restoration, some were immediately loaded, others not. 46 Axiom Bone Le-vel or Axiom Tissue Level implants (Anthogyr) were placed. 3 to 4 months after, the 12 CAD CAM prosthesis were placed, and fi xed with the innovative connection. Success factors such as the absence of implant mobility, pain, infection, and the amount of crestal bone loss around the implants were determined in this case series, as well as the stability of the prosthesis and patient satisfaction, one year after prosthetic rehabilitation.

Implants 46 implants were placed in 10 patients

Indications 13 plural prosthesis were made.5 prosthesis were immediately loaded

Full-arch Prosthesis Mandible 2Maxillar 3

Partial Prosthesis Mandible 4Maxillar 4

Patients 1 patient dropped out for thickness reasons.

Mobility, Pain and infection One case of gingival irritation with bleeding during the cleaning procedure was observed, and solved after gingivoplasty. No implant failed.

Bone loss evaluationThe bone level measures have been performed by an inde-pendent assessor, using the Kinovea software. The mesure scale was calibrated on the implant lengh. A 1mm bone loss was observed on 2 implants over the 1-year follow-up period.

Stability of the prosthesisNo screw fracture was observed.One case of unscrewing on a partial bridge happened due to an interposition of soft tissue.

Patient satisfactionAll the patients were satisfi ed of their treatment.

A 64-year-old female, with no dental history, edentulous for over 10 years, is not wearing her full denture. The oppo-site arch is restored with a conventional fi xed prosthesis.

1) Presence of bone in the premaxillary bone [Bedrossian zones 1 and 2 ]- indication for All-on-4 type of restoration with angu-lated implants along the anterior sinus wall, 2) Placement of the Axiom TL (Tissue Level) implant, distal angulated, 3) Imme-diate screw-retained prosthesis, 4) CAD concept image of the Simeda maxillary frame. In the posterior sector, the screw chan-nels in yellow and the implant axes in blue show the angulation of the screw channels, 5) Simeda titanium frame and integrated fi tting locks, 6) Bottom surface view, note the gum-titanium contact and the “gaps” to facilitate the use of brushes for better hygiene , 7) Panoramic X-ray with the fi nal bridge, 8) Final smile

Panoramic x-rays of 3 patients of the study showing the loa-ding stage (left) and the follow-up 1 year after loading (right)The bone stability around the implants can be noted.

One year after loading, 100% of the implants placed survived and 12 on 13 posthesis were stable. This new implant system gives huge improvement on the way we treat patients.Within the limits of this case study it can be concluded that the Axiom implants showed an excellent bone crest stability, and the new inLink connection is reliable and defi nes a new standard in plural restorations.

With the kind participation of Jean-Michel Moal and Gilles Giordanengo, Dental technicians

The new connection Clinical case

1 year post-loading radiographic control

Conclusion

Objectives

Methods

Results

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