The restoration of single-implants using computer-assisted design/computer-assisted manufacturing abutments appears to help maintaining a regular papillary filling although the variations of the implant positioning or the restoration/teeth relation.

Aim The aim of this study was to compare the influence of the abutment height and insertion timing on early marginal bone loss (MBL) in posterior mandibular partial implant‐supported restorations. Material and methods The study was planned as a prospective, randomized, controlled parallel group including subjects in need of at least two implants for the restoration of an edentulous posterior mandibular area. The patients were allocated into Groups A (implants immediately connected to 2‐mm height abutments), B (immediately connected 1‐mm height abutments), and C (2‐mm abutments were inserted in a second‐stage surgery). Each subject was placed in a 1‐year follow‐up program, including examination assessment of various soft tissue and bone‐level parameters. Results A total of thirty‐three patients, including sixty‐eight implants, were enrolled in this study. One implant was lost on group C after the first month of healing. A mean MBL change of 0.719 ± 0.361, 0.651 ± 0.379, and 0.754 ± 0.672 mm was computed for groups A, B, and C, respectively, with no significant differences found. The early MBL at T1 was an independent predictor variable for the marginal bone alterations that were assessed at T3 (p < 0.001). Conclusion The first‐month MBL variation is a predictor factor of the bone alterations that might occur after 1 year of treatment. The early connection of final prosthetic abutments with distinct heights does not seem to reduce the 1‐year MBL rate when compared with traditional treatment protocols.

Background After a single tooth extraction, remodelling processes are initiated and morphological changes occur in the alveolar bone. It has been suggested that implant placement in a fresh extraction socket may partly reduce the alveolar ridge contraction and that several factors like the thickness of the buccal bone wall and the size of the gap between the implant and the facial bone wall may play a role on peri‐implant tissues dimensional alterations. Methods Twenty‐six patients treated with single‐tooth maxillary implants were included in this study. A CBCT exam allowed to access the initial buccal bone thickness (BT). Digital impressions were taken prior to extractions (T0), 1 month (T1), 4 months (T2), and 12 months (T3) after implant insertion and superimposed with a computer software allowing to quantitatively analyse the three‐dimensional changes occurred in the adjacent tissues. Variables related to thickness and volume were computed. Results Participants with BT ≤ 1 mm exhibited a significantly increased buccal peri‐implant tissue thickness change than patients with BT > 1 mm (P = 0.049). At T3 patients representing BT ≤ 1 mm exhibited a total volume change of −8.53% ± 5.47% compared with patients presenting BT > 1 mm, −4.37% ± 2.08%. No statistical significance was found on the distance between implant shoulder and the buccal bone plate (BID) effect. Conclusion After the first year of treatment peri‐implant tissues showed continuous changes resulting in a higher thickness and volume reduction at thin buccal bone plates.

Aim To compare the influence of the abutment height and its insertion timing on the marginal bone change (MBC) variation of implants placed at posterior mandibular partial edentulous areas in a medium follow‐up period. Material and methods This randomized clinical trial (RCT) comprised a sample of patients with posterior mandibular edentulous areas, treated with at least two implants and distributed into three groups: implants connected to a 2 mm height abutment during the surgical stage (Group A); implants connected to a 1 mm height abutment during the surgical stage (Group B); and implants connected to a 2 mm height abutment after 2 months (Group C). Clinical and radiographic measurements were performed during a 36‐month period (T4). The MBC was set as the main variable in study. Statistical significance was set at 0.05. Results A total of 29 subjects and 59 implants were enrolled in this study. A mean MBC of 0.35 ± 0.46 mm, 0.60 ± 0.81 mm, and 0.71 ± 0.90 mm was computed for groups A, B and C, respectively, at T4. Significant differences were found between groups A and C in terms of MBC variation after 3 years of treatment (p = .048). Multiple linear regression analysis showed a significant influence of the first‐year MBC and the abutment insertion timing has independent predictor variables for the MBC assessed at T4. Conclusion The installation of 2‐mm prosthetic abutments, at the time of implant placement, in areas with limited keratinized mucosa presents as a favorable treatment option in terms of periimplant marginal bone maintenance.

ObjectivesTo assess the treatment outcomes of the dental implants placed in the grafted sockets.Material and MethodsA search protocol was developed to evaluate the treatment outcomes of dental implants placed in the grafted sockets in terms of implant survival rates (primary outcome), marginal-bone-level (MBL) changes, clinical parameters (i.e., bleeding on probing, probing depth), occurrence of peri-implant diseases, and aesthetic outcomes (secondary outcomes). Randomized controlled clinical trials (RCTs), controlled clinical trials, and prospective studies with at least 12 months of follow-up and a minimum of 10 patients having at least one dental implant inserted into the grafted socket were conducted. MEDLINE (PubMed) was searched for relevant articles published until 1st April 2019. A meta-analysis was performed using the random-effects model on the selected qualifying articles.ResultsThe present analysis included 7 RCTs. The survival rate of the implants inserted into the grafted sockets ranged from 95 to 100% after 1 to 4 years of follow-up. MBL loss was found to be significantly greater for the implants placed in the non-grafted healed sites than for those placed in the previously grafted sockets (weighted mean difference = -1.961 mm, P < 0.0001). In terms of MBL changes, no difference was detected between immediately inserted implants versus implants placed in previously grafted sockets. None of the included studies reported on the clinical parameters or occurrence of peri-implant diseasesConclusionsImplants inserted into the previously grafted sockets showed high survival rates and lower marginal-bone-level loss than the implants inserted into the non-grafted sites.