Clinical Performance and Radiographic Evaluation of Immediate Restoration of Single Tooth Edentulous Sites with Basal Osseointegrated Implants: A Prospective Study Sunil Sheroff

The standard procedure for placing basal implants includes one surgery followed by immediately loading, thus reducing time, cost and stress to the patient. With the emphasis on horizontal rather than vertical placement, pre-implantological bone augmentation was never required for anchorage. Primary stability is never a problem with basal osseointegrated implants because of the implant design and bicortical nature of anchorage. This offers several advantages like - no hospitalization required, no time period with loss of esthetics and a missing tooth, low degree of invasiveness, no second surgery, no bone transplants, no bone distractions, simple repair in difficult areas, manageable system (few components), simple lab technique. However, stock keeping requirements are greater than in basal implantology. It will always be necessary to keep a few more implants handy to avoid extensive planning including three dimensional exploration of bone conditions. Also, the technique poses substantial challenges for instructors and users alike, as far as the surgical and prosthetic treatment stages and substantial knowledge requirements in the field of biomechanics and bone physiology are concerned. Although we had two implants failures, one due to unicortical anchorage and the other due to occlusal overload during the osseointegration period, it does not effect the final outcome of this study as these were mainly due to operator errors. Basal implants have always shown to perform well in immediate load conditions, when splinted with other implants or natural teeth. But when they are subjected to a loading protocol which is gradual and not immediate, it does not seem to affect the osseointegraton, in single tooth edentulous sites. Immediate restoration in such cases would not significantly increase the load over the implant during this period. Mild contacts during mastication though unavoidable, acts like a stimulation for bone remodeling to take place. We have observed a good success rate in this study, during a observation period of maximum 17 months from our earliest cases. Although, a larger sample size is required to generalize this data. All cases reached and maintained the treatment aim of immediate restoration and early occlusal loading. This indicates that, placement of basal osseointegrated implants in single edentulous sites is a predictable and reliable procedure and is a good option to be considered in compromised situations to avoid additional procedures like bone grafting and sinus lifts