Continuous craniofacial growth in adult patients treated with dental implantsin the anterior maxilla

Background: In the Literature, there are several studies demonstrating that infraposition happens also in adult patients. Purpose: To conduct a retrospective evaluation of infraocclusion of implant-retained crowns in the anterior maxilla of adult patients and of the patient awareness and perception of the problem. Material and Methods: From January to June 2017, all adult patients who in the last 5 to 20 years had received in the same clinic implant restorations in the upper anterior maxilla were recalled to assess the presence of crown infraocclusion. Ninety-four patients were recalled. Twenty-six males, 34 females, with 76 implants were included in the study. According to the age, patients were divided into group I (<30 years: 12 males, 14 female) and group II (>30 years: 14 males, 20 females). Digital photographs, taken at the time of final prosthesis delivery (T0) and at time of the study examination (T1) were compared by three blinded previously calibrated examiners. Cast models of the dental arches were taken at T1 and served as a reference for infraocclusion measurements. According to the Literature, cases were included in three categories: infraocclusion <0.5 mm, infraocclusion 0.5-1.0 mm, and infraocclusion >1 mm. An awareness and perception score (APS) was prepared to classify patients in: “unaware patients” (0), “aware but disinterested patients” (1), “aware patients requiring explications” (2), and “aware patients requiring treatment” (3). Results: Infraocclusion was present in 73.3% of all cases, 65.4% among males, 79.4% among females. Infraocclusion was less than 1 mm in 88.2% of males and in 85.1% of females. No significant differences were found for sex (P = .223). No significant differences were found for age: group I: 47.7%, group II: 52.2%, (P = .481). The overall APS was: “unaware patients” = 38.6%, “aware but disinterested patients” = 27.3%, “aware patients requiring explications” = 15.9%, “aware patients requiring treatment” = 18.2%.