Evaluation of factors influencing the marginal bone stability around implants in the treatment of partial edentulism

Background: The original protocol or Branemark to achieve predictable osseointegration for oral implants has substantially been modified. One may question whether results are influenced by those modifications, especially for the longterm prognosis. Purpose: The goal of the present study was to investigate the impact of those parameters that deviate from the original protocol as defined by P-I Branemark. Materials and Methods: In this study, 246 patients with 263 fixed partial prostheses supported by 668 Branemark implants were followed from 1 to 15 years (mean:6.3 yr). Radiographs were taken at the time of abutment connection, at 3 to 6 months, at 12 months, and then every 3 years. The bone level was rated mesially and distally from the implants on a total of 2588 radiographs. Results: A positive relation between abutment length and marginal bone level was found (p >.0001). The maxilla (p =.03), porcelain (p =.007), long abutments (p =.008), and regular-sized diameter implants (p =.001) all exhibited more bone loss in the first 6 months. After 6 months, only long implants showed more bone loss (p =.03). Conclusions: Overall, the marginal bone level remained stable around Branemark implants, never surpassing 2.2 mm, even after 15 years. Although longer implants lost more bone over time, this has to be interpreted with respect to higher resorption rates in less resorbed jaws.