I risultati di questo studio, hanno suggerito che gli impianti inseriti con un torque di inserimento elevato (superiore ai 50 Ncm) in creste ossee guarite hanno mostrato maggiore rimodellamento osseo peri-implantare e recessione dei tessuti molli vestibolari rispetto a impianti inseriti con un torque di inserimento regolare (inferiore a 50 Ncm).
Inoltre, i siti con una pareti ossee vestibolari spesse (superiori a 1 mm) - dopo la preparazione osteotomica implantare - sembravano essere meno inclini alla recessione vestibolare dei tessuti molli, alla valutazione a 12 mesi, rispetto ai siti con pareti ossee vestibolare sottili, (inferiori a 1 mm).
La considerazione che l'osso corticale è sostanzialmente più rappresentato nella mandibola potrebbe spiegare perché gli effetti clinici peggiori di elevati valori di torque di inserimento sono stati più pronunciati nella mandibola.
Va posta una grande attenzione clinica all'importanza della larghezza residua della cresta ossea alveolare, della quantità di osso corticale, della macro-geometria implantare e dei rischi potenziali di elevati torque di inserimento per gli impianti posizionati dove la componente corticale è ben rappresentata.
5 – NOTE
**
CT, Intralock International, Boca-Raton, FL, USA
°°
Blossom CT, Intralock International, Boca-Raton, FL, USA
^^
ElcoMed, W&H, Procter & Gamble GmbH manufactures, Austria
¢¢
Tohinichi, BTGE 10CN, Tohnichi Torque, Northbrook, Il, USA
++
ITAB transfer/abutment, Intralock International, Boca-Raton, FL, USA
¶¶
Flexitime, Heraeus/Kulzer, Hanu, Germany
††
UTHSCSA Image Tool, Version 3.00, University of Texas Health Science, San Antonio, TX
§§
Database Toolbox, MatLab 7.0.1, The MathWorks, Natick, MA
‡‡
6 – RIFERIMENTI
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7 – RINGRAZIAMENTI
Per la stesura di questa tesi desidero ringraziare i miei Relatori, Prof. Ugo Covani e Prof. Antonio Barone per la loro importantissima presenza e disponibilità, qualità che ogni laureando spera di trovare in un relatore e che io ho avuto la fortuna di trovare in loro.
Ringraziamenti speciali vanno a Mamma e Papà, due eroi ai quali sarò sempre grato per aver interpretato il loro ruolo di genitori con impegno, passione e intelligenza.
A mio fratello Pasquale dico grazie per il suo modo di essere che è stato una fonte di stimolo a migliorare me stesso.
Ringrazio gli Amici, Marco soprattutto, per essere stati sempre al mio fianco, nel bene e nel male, in questi ultimi cinque straordinari anni.
Ringrazio infine tutti coloro che ho incontrato durante il percorso che hanno contribuito a fare di me la persona che sono oggi.