The use of tapered dental implants in severe jaw atrophies

Objective: To evaluate the use of tapered implants in combination with piezosurgical split-crest technique in severe atrophy of jaws. Methods: We selected 10 patients (age 45−58) presenting grade 4 to 5 class by Cawood and Howell of jaws. Those underwent piezosurgical split-crest technique and simultaneous tapered implants surgery. Pre-operative x-ray evaluation included standard x-panoramic and CT Dental-scan. Standard chemoprophylaxis was administered to each patient. The piezosurgical split-crest procedure was combined with alloplastic bone substitutes and double-layer membrane to improve the thickness of alveolar bone and simultaneous implant surgery. Every patient received from 3 to 6 with tapered screws which diameter was 3.75 mm and length 10−11.5 at 3 months from the first procedure. Results: Patients were monitored clinically and marginal bone changes were calculated utilizing periapical radiographs taken at placement and at subsequent appointments utilizing a standardized paralleling device and a 1-mm measurement grid for marginal bone remodeling at baseline and after 3 months within loading. Cumulative implant survival was 98.4% (n = 65). Mean marginal bone resorption (SD) was 1.19 (1.01) mm for the early loading group after 1 year. The use of tapered implants seem to reduce peak stress in both cortical and trabecular bone. Discussion: the use of tapered implants was revealed ideal in patients presenting atrophy of jaws. The taped designs show an ability to dissipate the interfacial stresses of bone, therefore improving the stability and the osteointegration if used in association to split crest made with piezosurgical device.