Dental News - Interview: Non-passive fit in immediate loading

Dental Tribune International

Fri. 1. March 2019

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Dr Nicolas Agustin Rubio, a dentist both in private practice and involved in higher education, began his dual training in implantology and prosthodontics at the University of Buenos Aires in Argentina, where he received his specialisation in prosthodontics. Later, Rubio spent a year in Mexico City in Mexico completing a residency in implantology. There, together with Dr Alejandro Treviño Santos, he began investigating different immediate loading protocols in edentulous patients. In this interview, Rubio shares his insight on some of his recent work, in which he evaluated the influence of non-passively fitting prostheses on implant osseointegration and possible implant displacement during the healing period.

Dr Rubio, could you summarise in a few sentences what your findings were?
First of all, we were able to confirm that interim fixed prostheses obtained from complete dentures by a chairside pick-up technique resulted in a clear misfit, which was obviously associated with the use of a considerable amount of acrylic resin, as is often the case in these procedures. Although the prostheses were successfully attached to the implants, tension was applied to achieve the fit. After eight weeks and without any clinical intervention, this strain was released. During our final tests, we could confirm that, in all cases, implant position had changed while prosthetic structure was conserved.

For what reasons did you conduct this study, and how do you think it is relevant for the future treatment of edentulous patients?
During our immediate loading protocols, we noticed that tension was present when installing our interim prostheses. After the healing period was complete, we observed that one or even all of the components (acrylic resin, abutments, implants, screws) had adapted to achieve a passive fit and release said tension. Understanding that implant position can be guided by abutments in the interim prostheses can save us valuable time in fabricating the final prosthesis from these abutments rather than the implant position to obtain a passive fit—very important in final restorations and apparently not so necessary during immediate loading.

What do you intend working on next?
I would like to continue with this line of work and try to develop new digital protocols in which virtual planning would serve as a starting point for final prosthetic manufacturing. No analogue or digital impressions should be needed if we have the abutment position registered, as implants can displace to fit the desired prosthetic planning. Moreover, I’m studying the influence of different pontic designs on prosthetic maintenance and patient comfort to improve long-term results.

Thank you very much for the interview.

Editorial note: The study, titled “Influence of nonpassive fit in immediate loading: A pilot study”, was published in the 3/2018 issue of the Journal of Oral Science and Rehabilitation.

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