Clinical and radiographic changes at tissue level implants with either a machined or a modified transmucosal neck surface: A 3‐year multicentre randomized controlled proof‐of‐concept study

Abstract

Background Surface modification may yield enhanced soft tissue adhesion to transmucosal titanium implant necks. Aim To evaluate and compare changes in soft tissues around implants with a modified hydrophilic sandblasted and acid‐etched neck (mSLA; test) to those with a machined neck (M; control). Materials and methods Implants with a diameter of 4.1 mm and a neck height of 1.8 mm were randomly inserted in healed sites with pristine bone of the posterior maxilla or mandible. The modified Sulcus Bleeding Index (mSBI) (primary outcome) was assessed at baseline (BL) and 6, 12 and 36 months. Secondary outcomes included the assessment of pocket probing depth (PPD), mucosal recession (REC) and clinical attachment level (CAL). Standardized radiographs were taken at time of implant placement, at BL and after 12 and 36 months. Results Of the 43 randomized subjects, 38 (19 test and 19 controls) completed the 36‐month follow‐up. Implant survival rates amounted to 95.5% (test) and 100% (control) (p > .05). At 36 months, 77.6% of test implants and 78.9% of control implants were without any bleeding sites (mSBI = 0; p > .05). The 36‐month success rate was 86.4% in the test and 85.7% in the control group, respectively (p > .05). At 36 months, the mean radiographic bone level change from BL was 0.33 ± 0.69 mm at test implants and 0.12 ± 0.3 mm at control implants (p > .05). Conclusion Tissue level implants with a hydrophilic mSLA transmucosal neck failed to yield clinical and radiographic benefits compared with implants with a machined neck up to 3 years.

Influence of Periodontitis, Implant, and Prosthesis Characteristics on the Peri-Implant Status: A Cross-Sectional Study

“…However, the purpose of this work was first to compare the implant and periodontal status and their associations during implant follow-up. e one-year function was chosen as the minimal follow-up duration requirement for patient inclusion because it allowed a sufficient time for soft peri-implant tissue and bone initial adaptation to the oral environment and for their stabilization to occur [16,56]. Furthermore, this time was frequently chosen in comparable studies [20,21,24,32,43].…”

Physiopathology of peri‐implant diseases

“…Evidence for the influence of implant surface topography (i.e., micro and macro design) on the incidence of peri‐implant diseases in humans is still limited 48–51 …”

“…Based on the hypothesis that surface modification may yield enhanced soft tissue adhesion to transmucosal titanium implant necks, thereby reducing the incidence of peri‐implant diseases, a randomized controlled trial evaluated and compared clinical and radiographic changes at tissue level implants with either a machined or a modified transmucosal neck surface 51 . The outcomes of that study indicated that tissue level implants with a hydrophilic sand‐blasted and acid‐etched transmucosal neck failed to yield clinical and radiographic benefits compared with implants with a machined neck up to 3 years 51 …”

“…47 Evidence for the influence of implant surface topography (i.e., micro and macro design) on the incidence of peri-implant diseases in humans is still limited. [48][49][50][51] Findings of an experimental study in humans and a systematic review indicated that peri-implant mucositis does not seem to be associated with implant or abutment systems with a specific design or surface roughness. 49,52 Moreover, outcomes of a clinical study including three different implant systems failed to detect differences in the incidence of peri-implantitis as an effect of implant surface and design over a period of 13 years.…”

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

“…Implant surface modifications may facilitate enhanced soft-tissue adhesion resulting in clinical and radiographic benefits once implants are exposed to the contaminated environment of the oral cavity. To study this proposed transmucosal benefit, Salvi et al 268 Multiple implant surface modifications have been proposed for the treatment of peri-implantitis, yet none has been identified as most effective. Lasserre et al 269 studied the efficacy of implantoplasty and glycine air polishing for the surgical management of periimplantitis.…”