Surgical Management of Deficient Implant Sites and Its Influence on Subsequent Prosthetic Rehabilitation

Abstract

Aim:
To compare ridge augmentation, implant stability, peri-implant tissue health, prosthetic outcomes, implant survival, and patient satisfaction between conventional site management and surgical augmentation in patients with deficient implant sites.
Materials and Methods:
A total of 60 patients with deficient implant sites were included and equally allocated to Group I (conventional site management, n = 30) and Group II (surgical augmentation, n = 30). Baseline ridge dimensions, horizontal and vertical ridge gain, insertion torque, implant stability quotient (ISQ), healing and loading intervals, prosthetic complications, peri-implant clinical parameters, marginal bone loss, patient satisfaction, implant survival, and prosthetic success were evaluated. Intergroup comparisons were performed using appropriate statistical tests, with p < 0.05 considered statistically significant.
Results:
Baseline ridge width and height were comparable between the groups. At implant placement, Group II demonstrated greater ridge width (6.72 ± 0.61 vs. 5.01 ± 0.58 mm), horizontal ridge gain (2.63 ± 0.55 vs. 0.89 ± 0.42 mm), and vertical ridge gain (2.18 ± 0.63 vs. 0.91 ± 0.48 mm), with all differences statistically significant (p < 0.001). Insertion torque and ISQ values were also higher in Group II at placement and at 3 months. Group II showed lower marginal bone loss at 6 and 12 months and more favourable peri-implant clinical parameters at 6 months. Patient satisfaction at 12 months was significantly higher in Group II for overall satisfaction, chewing comfort, and esthetics. Prosthetic complications were less frequent in Group II, although the difference was not statistically significant. Implant survival (96.7% vs. 93.3%) and prosthetic success (93.3% vs. 86.7%) were numerically higher in Group II but did not differ significantly between groups.
Conclusion:
Surgical augmentation provided greater ridge enhancement, improved early implant stability, favourable peri-implant tissue outcomes, reduced marginal bone loss, and higher patient satisfaction compared with conventional site management. However, implant survival and prosthetic success were comparable between the groups at 12 months.