Biological effect of the abutment material on the stability of peri‐implant marginal bone levels: A systematic review and meta‐analysis

Sanz‐Sánchez, Ignacio; Sanz‐Martín, Ignacio; Albornoz, A. Carrillo de; Figuero, Elena; Sanz, Mariano

doi:10.1111/clr.13293

Cited by 56 publications

(69 citation statements)

References 93 publications

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“…Although the data from Zirconia‐based implants are scarce (Cionca, Hashim, & Mombelli, ; Pieralli, Kohal, Jung, Vach, & Spies, ; Roehling, Schlegel, Woelfler, & Gahlert, ), the “green” tendencies among populations from European Countries provide reasonable expectations for higher demands on non‐metal solutions. Similarly, although data on oral biofilm adherence to different implant surfaces are scarce, it is expected that ceramics may provide more cleansable surfaces (Sanz‐Martin, Sanz‐Sanchez, Carrillo de Albornoz, Figuero, & Sanz, ; Sanz‐Sanchez, Sanz‐Martin, Carrillo de Albornoz, Figuero, & Sanz, ). In this regard, there was also a moderate consensus towards a tendency to smoother and bioactive implant surfaces.…”

Section: Discussionmentioning

confidence: 99%

European Association for Osseointegration Delphi study on the trends in Implant Dentistry in Europe for the year 2030

Sanz

Noguerol

Sanz‐Sánchez

et al. 2019

Clinical Oral Implants Res

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Objectives To assess the potential trends for the year 2030 in dental implant dentistry in Europe using the Delphi methodology. Material and methods A steering committee and a management team of experts in implant dentistry were created and validated a questionnaire including 60 questions, divided in eight topics. The survey was conducted in two rounds using an anonymous questionnaire, which provided the participants in the second round with the results of the first. Each question had three possible answers, and the results were expressed as percentages. Results A total of 138 experts were invited to participate in the survey. From all the invited experts, 52 answered in both the first and second rounds. Three different consensus categories were established based on the percentage of agreement: no consensus (<65%); moderate consensus (65%–85%); and high consensus (≥86%). Within the topic categories, a consensus was reached (mainly moderate consensus) for the majority of questions discussed among experts during a face to face consensus meeting. However, consensus was not reached for a small number of questions/topics. Conclusions About 82% of the questions reached consensus. The consensus points towards a lower number of implants to replace chewing units, with implants surfaces made of bioactive materials with reduced micro‐roughness using mainly customized abutments with polished surfaces and an internal implant–abutment connection (85%). CBCT‐3D technologies will be the main tool for pre‐surgical implant placement diagnosis together with direct digital restorative workflows. There will be an increase in the incidence of peri‐implantitis, although there will be more efficient interventions its treatment and prevention.

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Section: Discussionmentioning

confidence: 99%

European Association for Osseointegration Delphi study on the trends in Implant Dentistry in Europe for the year 2030

Sanz

Noguerol

Sanz‐Sánchez

et al. 2019

Clinical Oral Implants Res

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“…Several factors related to the abutments may have affected the amount of MBL. The height of the abutments may influence the bone level in the early and late periods of healing while the abutment material has been shown to have a low influence on marginal bone level . An external implant‐abutment connection presented higher MBL compared to an internal connection that was mostly related to the platform switching concept .…”

Section: Discussionmentioning

confidence: 99%

Biological and mechanical complications of angulated abutments connected to fixed dental prostheses: A systematic review with meta‐analysis

Omori

Lang

Botticelli³

et al. 2019

J of Oral Rehabilitation

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Objectives To evaluate the biological and mechanical complications of angulated abutments on full‐arch and partial jaw rehabilitations with a follow‐up for at least 1 year. Methods Electronic search was carried out in MEDLINE, EMBASE and Web of Science. Studies published between January 2000 and January 2019 were included. The quality of the included studies was assessed. The data extraction was focused on implant loss, marginal bone loss and mechanical complications, and meta‐analyses were performed for marginal bone loss, mechanical complications and implant failure. Results Nine studies, three prospective and six retrospective cohort studies were included. They reported on 797 patients that received 4127 implants. The total number of abutments was 4079 of which 1673 were angulated, and 2406 were straight. All abutments were prefabricated. Angulated abutments were associated with increased implant failure rates (two studies; RR = 7.30; 95% CI = 2.79‐19.08) and an effect that was both statistically significant (P < .001) and clinically relevant. Three studies reported differentiated data for mechanical and technical complications at 1 year of follow‐up, being mostly related to the retention screw while screw fracture. Angulated abutments were associated with a statistically significant increase in MBL 1 year after insertion compared to straight abutments (three studies; MD = 0.08 mm; 95% CI = 0.01‐0.14 mm; P = .02), which might be, however, clinically negligible. Conclusions The prosthetic complications such as screw loosening and abutment loosening were frequent. After 1 year of follow‐up, implants supporting angulated abutments yielded significantly more marginal bone loss than those supporting straight abutments.

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“…This therapeutic modality requires the installation of a dental implant followed by the placement of a prosthetic abutment to allow the setting of the prosthetic crown. Clinical outcomes of treatments with osseointegrated implants have been demonstrated clear benefits for patients regarding masticatory efficiency and quality of life . Despite the mentioned high success rate of osseointegrated implants, bone loss has been observed around implants over the time .…”

Section: Introductionmentioning

confidence: 99%

“…When selecting materials for abutments, biological compatibility is a prerequisite to ensure long‐term stability together with optimal mechanical and physical properties. For this reason, a considerable number of researches have proposed different composition and designs of abutments to prevent marginal bone loss . Considering metallic materials such as titanium (Ti), which is bioinert and non‐bioactive, a simplified procedure for biofunctionalization of its surface could improve bone repair .…”

Section: Introductionmentioning

confidence: 99%

Titanium coated with poly(lactic‐co‐glycolic) acid incorporating simvastatin: Biofunctionalization of dental prosthetic abutments

Littuma

Sordi

Curtarelli

et al. 2019

J of Periodontal Research

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Objective To propose a biofunctionalized prosthetic abutment by analyzing physico‐chemical and morphological properties, simvastatin (SIM) release, and biocompatibility of titanium (Ti) disks coated with poly(lactic‐co‐glycolic) acid (PLGA) incorporating SIM. Methods Titanium disks (8 × 3 mm) were distributed into four groups: Ti: pure Ti; Ti + PLGA: Ti coated with PLGA; Ti + PLGA + SIM6%: Ti + PLGA with 6% SIM; and Ti + PLGA + SIM0.6%: Ti + PLGA incorporating 0.6% SIM. PLGA was prepared through chloroform evaporation technique. After complete dissolution of PLGA, SIM was diluted in the solution. Ti + PLGA, Ti + PLGA + SIM6%, and Ti + PLGA + SIM0.6% were dip coated with PLGA and PLGA + SIM, respectively. Samples were sterilized by ethylene oxide. For SIM release assay, disks were submerged in PBS, pH 7.4, 37°C, 30 rpm up to 600 hours. At different time intervals, SIM was quantified by spectrophotometry (238 nm). For characterization of the biomaterial components, it was performed Fourier‐transform infrared spectroscopy, differential scanning calorimetry, scanning electron microscopy (SEM), optical profilometry, and atomic force microscopy. Biocompatibility analyses were performed by MTS colorimetric assay on murine fibroblasts L929, human gingival fibroblasts (HGFs), and stem cells from human exfoliated deciduous teeth (SHEDs). Absorbance was measured at 490 nm, and percentages of viable cells were calculated in relation to positive control (Ti). SEM images were obtained to verify cell adhesion and morphology. One‐way ANOVA followed by Tukey's post hoc test was applied (P < 0.05) for statistical analyses. Results SIM release was slow and continuous, reaching about 21% of the incorporated SIM after 600 hours. Topographical analyses revealed success in coating Ti disks with PLGA incorporating SIM. Regarding biocompatibility test, Ti + PLGA + SIM0.6% showed the highest percentage of L929 viability at days 3 and 7. There was no significant difference for Ti, Ti + PLGA, and Ti + PLGA + SIM0.6% groups on cell viability of both SHEDs and HGFs at days 3 and 7. SEM corroborates that SHEDs and HGFs were able to adhere and proliferate on Ti, Ti + PLGA, and Ti + PLGA + SIM0.6% surfaces. Conclusion A slow and controlled release of SIM was achieved, attributed to a diffusional mass transfer mechanism. Moreover, a homogenous coating topography was obtained. Additionally, 0.6% SIM incorporated into PLGA coating improved fibroblasts L929 viability compared to titanium or PLGA. Also, 0.6% SIM incorporated into PLGA promoted cell viability of about 100% for HGFs and approximately 150% for human mesenchymal stem cells. Therefore, this study allows to consider the use of PLGA‐coated titanium incorporating SIM as a biofunctionalized abutment for dental implants.

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Biological effect of the abutment material on the stability of peri‐implant marginal bone levels: A systematic review and meta‐analysis

Abstract: This systematic review has shown that the abutment material had minimal impact on marginal bone levels when compared to the standard titanium.

Cited by 56 publications

References 93 publications

European Association for Osseointegration Delphi study on the trends in Implant Dentistry in Europe for the year 2030

European Association for Osseointegration Delphi study on the trends in Implant Dentistry in Europe for the year 2030

Biological and mechanical complications of angulated abutments connected to fixed dental prostheses: A systematic review with meta‐analysis

Titanium coated with poly(lactic‐co‐glycolic) acid incorporating simvastatin: Biofunctionalization of dental prosthetic abutments

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