Impact of Second Stage Surgery on Bone Remodeling Around New Hybrid Titanium Implants: A Prospective Clinical Study in Humans

Objective: The present prospective study aimed to more precisely identify the time points of bone changes around hybrid titanium implants up to 30 months of follow-up. Materials and methods: Twelve hybrid T3 implants (Biomet 3i) were placed in 9 healthy patients with the 2-stage surgical approach. Standardized digital Rx were taken at implant insertion (T0); healing-abutment connection after 3.1 ± 0.2 weeks (TX); loading stage after 7.5 ± 0.6 weeks (T1); after 12 months (T2); and after 30 months (T3) of functional loading. The marginal bone loss was digitally measured. Results: The mean marginal bone loss was 0.76 ± 0.37 mm after 30 months. More than 60% (0.42 ± 0.29 mm) of the bone loss took place at healing-abutment connection (TX-T1). No statistically significant bone loss was found between T1-T2 and T2-T3, after 12 and 30 months, respectively. Approximately 40% of bone loss (0.34 mm) was noted between T1 and T3 (P < 0.05), which corresponds to the loading period. Conclusions: The implant-oral environment connection represents a critical step point in crestal bone loss. The amount of marginal bone loss, measured after 30 months of loading (T1-T3), was much less than that reported in the literature, showing that correct loading has a minor impact on the periimplant bone remodeling as compared to surgical implant reopening.