Одредување на стабилноста на имплантите и влијанието на ризичните фактори врз успешноста на терапијата

Abstract

The number of patients treated with dental implants is increasing and continues to grow everyday, so dentists must accept the challenges that these complex restorations carry with them. Proper monitoring and maintenance of the implants in the patient's mouth is essential to ensure the longevity of the dental implant and its suprastructure through a combination of adequate control examinations, proper occupational care, evaluation and effective oral hygiene by the patient himself. Primary stability of implant placement is a mechanical phenomenon that is associated with local quality and quantity of the alveolar bone, the type of implant, and the technique of placing the implant. Secondary implant stability is an increasing in stability that can be attributed to the formation of the alveolar bone and remodeling the interface of the implant and tissue and of course the formation of the surrounding bone. During the study, endosseal dental implants were used in all subjects. Two types of implants, MIS Seven implants with internal hexagonal shape and Straumann Standard plus and Bone level implants from the ITI Academy with internal octagonal form were used. The main goal of the study was to determine the primary and secondary stability of the dental implants and to analyze the impact of risk factors on the success of implant therapy. This clinical study was performed in a private health dental clinic PZU "Vita-Dent" in Tetovo. It included patients over 18 years of age. The implants are surgically implanted by only one specialist oral surgeon, while the stability of the implants is determined using a modern diagnostic instrument, which analyzes the resonant frequency. The stability of the implants was measured with the aid of the instrument, called Osttell IDX (Osttell AB, Gothenburg, Sweden). Implant Stability Quotient (ISQ) is the measurement unit of this diagnostic tool, the measurement units range from 1 to 100. The statistical processing will be performed in statistical program Statistica 7.1 for Windows. The data will be displayed both with tables and graphicons. On the basis of the obtained and analyzed data, the average ISQ of our subjects concerning the primary stability in patients with MIS Seven implants varies in the range of 61.66 ± 7.43 units, in contrast to the secondary that varies in the interval 68.94 ± 9.91. The average values for ISQ values in subjects with Straumann implants for primary stability vary in the range 62.14 ± 4.46 units, while for secondary stability they vary in the interval 75.86 ± 12.87 units. What is to be noted is that the examined relationship between the ISQ values of the primary and secondary stability of MIS Seven implants showed a very strong positive correlation. However, in both types of implants, the rising ISQ values for primary stability were accompanied by an increasing in the ISQ values for secondary implant stability. What was discovered during our research is that the greatest impact on the primary stability of MIS Seven Dental Implants has smoking (Beta = -0.53), then hypertension (Beta = -0.53), diabetes (Beta = -0, 32), periodontal diseases (Beta = -0,26), age of patients (Beta = 0,21) and the poorest influence of sex (i.e. male sex) (Beta = 0,05). The greatest influence on the secondary stability of MIS Seven dental implants has smoking (Beta = -0.44), followed by hypertension (Beta = -0.39), age of patients (Beta = 0.29), diabetes (Beta = -0, 24), periodontal disease (Beta = -0.15) and the poorest is the gender impact (male = Beta = -0.003). Based on the presented data, it can be concluded that smoking and hypertension have the greatest influence on the primary and secondary stability of MIS Seven implants. Based on the data presented and processed from this study, it can easily be seen that the secondary stability in the two types of implants is significantly higher than the primary stability in both types (p <0,01 for p = 0.00). Also on the basis of the research it was found that the primary stability of Straumann dental implants is insignificantly greater than the primary stability of MIS dental implants, in contrast to the secondary stability of Straumann dental implants that is significantly greater than the secondary stability of MIS dental implants. The greatest influence on the primary stability of Straumann dental implants is the age of patients (Beta = -0.27), then diabetes (Beta = -0.25), sex (men) (Beta = 0.25), periodontal diseases (Beta = 0.20), smoking (Beta = -0.14), HTA (Beta = 0.11) and the worst impact of osteoporosis (Beta = -0.07). The greatest influence on the secondary stability of dental implants has diabetes (Beta = -0.32), HTA (Beta = -0.31), sex (men) (Beta = 0.22), age of patients (Beta = -0, 19), periodontal diseases (Beta = -0, 18), osteoporosis (Beta = -0, 15) and the smallest influence of smoking (Beta = -0, 04). In contrast to the previously presented data, in Straumann dental implants we have a different influence on the risk factors in terms of their effect on primary and secondary stability than in MIS Seven implants. From the research it can be concluded that the secondary stability of the two types of implants is significantly greater than the primary stability and that the primary stability is greater in both types of implants placed in the lower jaw than in the implants placed in the upper jaw. While measuring the primary stability, most of the MIS Seven implants have low stability, while in measuring secondary stability most of the implants have medium stability. When we were measuring the primary stability, most of the Straumann implants have medium stability; while we made the measurements of secondary stability, the dominant part of the placed implants has high stability. Most of the subjects have risk factors that may affect the reduction of primary and secondary implant stability. The most important risk factors that affect primary and secondary implant stability and on the duration of implants are tobacco consumption, systemic factors such as diabetes and hypertension and the local adverse impact of various forms of periodontal diseases.