Crestal Bone Loss Minimized When Following the Crestal Preparation Protocol: A Histomorphometric Study in Dogs

Abstract

Initial breakdown of the implant-tissue interface generally begins at the crestal region in successfully osseointegrated implants. The purpose of this study was to evaluate the effect on crestal bone loss (CBL) around implants specially developed for immediate loading with a unique crestal drill. After 8 weeks postextraction, 6 young male mongrel dogs received 48 implants (XiVE) in the region corresponding to the 4 mandibular premolars. The implant sites were prepared according to the manufacturer's protocol with conventional standard drills. Before implant placement, the crestal drill was used in the experimental group but not in the control group. After a healing period of 12 weeks, the dogs were sedated and euthanized. Through linear measurements, from the top of the implant to the first bone-implant contact, the amount of CBL was determined. The histomorphometric results of CBL (mean +/- SEM) were 0.88 +/- 0.13 mm (range 0.0-3.0 mm) in the experimental group and 1.69 +/- 0.17 mm (range 0.0-4.2 mm) in the control group. The difference was statistically significant (P < .05) when the implants were used as the experimental units. The statistical analysis also revealed significance when the dogs were used as the experimental units (P < .05). When the median was used for analyses, the CBL was 0.44 mm for the experimental group and 1.91 mm for the control group. Crestal bone loss was minimized when the crestal preparation protocol was carefully followed by using the osseocondensating XiVE implant system.

Histological, histomorphometrical, and radiological evaluation of an experimental implant design with a high insertion torque

“…In the surgical protocol of the control implant, the diameter of the last drill was 3.2 mm and a decorticaliser of 3.5 mm was used to prepare the upper 2 mm of the cortex to the same diameter of the implant (3.5 mm). This crestal preparation aims to avoid excessive osseocompression, which can lead to lesser bone‐to‐implant contact and a lower bone density in the bone‐to‐implant contact area (Novaes et al 2005; De Oliveira et al 2007). It is still not completely clear whether it is beneficial to have an osteotomy diameter that is smaller than the implant and what consequences the resultant higher mechanical stress has (Ottoni et al 2005).…”

Evaluation of Crestal Bone Loss Around Implants Placed at Equicrestal and Subcrestal Levels Before Loading: A Prospective Clinical Study

“…This peri implant crestal bone level and peri implant bone remodelling depends upon location of Implant Abutment Junction (IAJ) in relation to bone crest and the amount of soft tissue coverage [3]. Numerous studies [4][5][6] have been done describing methods to prevent crestal bone loss. The amount of bone loss expected from implant during first year must be less than 2 mm, apical to IAJ.…”

Microscopical and chemical surface characterization of the gingival portion and connection of an internal hexagon abutment before and after different technical stages of preparation

“…Implant insertion at the crestal level or slightly sub‐crestal was demonstrated to be appropriate for two‐stage implants (Novaes et al. ; Veis et al. ; Degidi et al.…”

“…In fact, focusing on the interaction between hard/soft tissues and bacteria, Literature has suggested that crestal bone remodeling could be the result of localized inflammation within the soft tissue located close to the implant-abutment connection due either to the soft tissue's re-establishing the biologic width or to the presence of a septic reservoir at the implant-abutment interface (Berglundh & Lindhe 1996;Abrahamsson et al 1998Abrahamsson et al , 2002Brä gger et al 1998;Broggini et al 2006). Implant insertion at the crestal level or slightly sub-crestal was demonstrated to be appropriate for two-stage implants (Novaes et al 2005;Veis et al 2010;Degidi et al 2011). At the same time, the importance of microbiological and micro-mechanic damages on the peri-implant connective tissue was put under the spot in histological and clinical Date: Accepted 6 April 2012…”