Chapter 2 44 3.3. Implant characteristics In total seventy fixtures were implanted (not including the sleeper fixtures) of these 49 (56%) we 3 mm and 21 (30%) 4 mm (30%) in size. Implant size is selected based on surgical findings and all 3 mm implant were chosen due to thin bone or exposed dura. At the second stage these implants were fitted with abutments: lengths of 6 mm (23%), 9 mm (54%), 12 mm (8.6%) and 14 mm (2.9%) were used in this cohort. Of the 70 implants originally loaded with an abutment, there were seven fixture failures (10%) including one child with isolated microtia who had two failures (first at 6 months post stage one surgery and a second at 9 months). All occurring following implantation with the 3 mm fixture. One other fixture failure was secondary to trauma at 7 months post-surgery. A sleeper fixture was quickly loaded in replacement. 3.4. Soft tissue outcomes Peri-abutment skin related complications were reported to affect eight implants (11.4%). Four peri-abutment skin problems were treated with replacement of a longer abutment with subsequent resolution of the skin issues. Two peri-abutment skin reactions required antibiotic treatment and one peri-abutment skin overgrowth required revision surgery of skin reduction (1.4%). Two (2.9%) of the total loaded abutments became loose and required tightening with the appropriate torque and equipment in outpatient clinic which resolved the issue. Finally, one abutment was lost without any associated fixture failure and a new abutment was placed [Table 4]. Table 4: Comparison between the two surgical groups Overall % Surgeon 1 ‘U Shape’ % Surgeon 2 ‘Linear’ % Recorded Complications Peri-abutment skin complication 8 11 4 10 4 13 Abutment exchange 4 6 2 5 2 7 Fixture failure 7 10 3 8 4 13 Loose abutment 2 3 0 0 2 7 Skin reduction 1 1 1 3 0 0
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