CLINICAL ASPECTS AMT, vol. 20, no. 2, 2015, p. 123 RADIOLOGICAL EVALUATION OF DENTAL IMPLANT TREATMENT SUCCESS RATE CONSUELA GHIUȚĂ 1 , AUGUSTIN MIHAI 2 , CORINA MARILENA CRISTACHE 3 , GABRIELA TĂNASE 4 , DANA CRISTINA BODNAR 5 , MIHAI DAVID 6 , TRAIAN BODNAR 7 , ANCA TEMELCEA 8 1,2,3,4,5,6,7,8 “Carol Davila” University of Medicine and Pharmacy Bucharest Keywords: dental implant, success, panoramic radiograph, bone loss. Abstract: Measurement of marginal bone is one of the most reliable criteria for establishing dental implant treatment success rate. If an implant is still in function but is not tested with respect of success criteria is considered as surviving. The aim of the present retrospective study was to evaluate long term treatment success with mandibular two-implant overdenture in fully edentulous patients by measuring the marginal bone loss on radiographs. Methods: Panoramic radiographs of 47 patients, three for each (after surgery, one week after implants loading and at 5-year follow-up) were analysed. Marginal bone loss was measured according to baseline, set at one week after implants loading. Results: 94 implants measured a marginal bone loss between 0.30 and 1.71 mm with a mean value of 0.73 (±0.19) mm, below the limit of 1.80 mm proposed according to different success criteria. Conclusions: All implants retrospectivelly evaluated are considered successful, despite of the type of retention system used for mandibular overdenture. 3 Corresponding author: Corina Marilena Cristache, B-dul. Eroii Sanitari, Nr. 8, Cod 050474, Bucureşti, România, E-mail: trili_poli@yahoo.com, Phone: +40723 472632 Article received on 20.01.2015 and accepted for publication on 09.02.2015 ACTA MEDICA TRANSILVANICA June 2015;20(2):123-125 INTRODUCTION To be considered successful, a restored dental implant should fulfil several criteria related to functionality (especially chewing), tissue physiology (osseointegration), absence of pain and patient satisfaction.(1) Albrektsson et al.(2), after performing an extensive literature review including all major implant systems used in the 98s, proposed some criteria to evaluate the success of treatment with dental implants. Those criteria, revised by a great number of researchers (3,4), are currently accepted and include: lack of mobility, peri-implant radiolucency, pain, infection and less than 0.2 mm peri-implant bone resorption per year except the first year after prosthetic loading. In the first year of functioning, maximum allowed bone resorption is 1.0 mm (5) to 1.5 mm.(4) An implant can be called a failure if osseointegration is failing, if there is clinical mobility, if normal use gives pain or if there is peri-implant radiolucency owing to infection or if it is removed, irrespective of the reason. The implants that are still in function but were not tested with respect of success criteria or neither the criteria of success or failure are met are considered as surviving. Therefore, radiological measurement of the distance from an established landmark of the implant to the alveolar bone crest represents one of the most reliable criteria in assessing dental implants treatment success, in conjunction with other clinical parameters evaluation (e.g., peri-implant probing depth, bleeding on probing, implant stabilility).(6) PURPOSE The aim of this study was to evaluate long term treatment success with mandibular two-implant overdenture in fully edentulous patients by measuring the marginal bone loss on radiographs. MATERIALS AND METHODS In the present study, the panoramic radiographs of the fully mandibular edentulous patients treated at Concordia Dent Clinic Bucharest between September 2004 and March 2012 in a project granted by the ITI Foundation for the Promotion of Oral Implantology, Switzerland (ClinicalTrials.gov Identifier: NCT01034930), were retrospectively analyzed. The initial study included 69 patients (48 women and 21 men) aged between 42 and 84 years old at the time of surgery. All patients had been wearing conventional complete dentures with fitting problems due to extensive ridge atrophy. They received two screw type standard Soft Tissue Level (STL) Straumann implants (Institute Straumann AG, Switzerland) with 4,1 mm diameter and 10 or 12 mm length in the anterior region of the mandible, between the two mental foramen, following a one stage non-submerged protocol. After a 6-week-healing period, implants were loaded and each patient was randomly assigned to one of the following overdenture retention system: Magnet (23 patients), Retentive anchor (23 patients) and Locator (23 patients).(7) Out of the 138 implants placed, four failed to osseointegrate, were replaced and all patients could be treated as previously planned with two-implant retained overdenture. At 5-year-evaluation period, patients were satisfied with the treatment carried out both functionally and aesthetically and no other implant was lost, considering 100% survival rate after loading. But to evaluate the success, a rigorous radiographic analysis and the measurements of bone loss was mandatory. Therefore, panoramic radiographs of the patients from surgery to the last follow-up were retrospectively evaluated. To be included in the present study, several requirements for the accuracy of measurements were imposed: - At least three panoramic radiographs (after surgery, one