Influence of placement depth and abutment connection pattern on bone remodeling around 1‐stage implants: a prospective randomized controlled clinical trial

Palaska, Iro; Tsaousoglou, Phoebus; Vouros, Ioannis; Konstantinidis, Antonis; Menexes, George

doi:10.1111/clr.12527

Cited by 47 publications

(71 citation statements)

References 83 publications

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“…Although subcrestal implants had slightly less CB loss when compared to equicrestal implants, no statistically significant difference was noted. This is in agreement with previous studies that demonstrated no statistically significant difference between the two placement depths tested (Al Amri et al, ; Koh et al, ; Koutouzis et al, ; Palaska et al, ). Although the placement of subcrestal implants was suggested to minimize bone resorption (Barros, Novaes, Muglia, Iezzi, & Piattelli, ; Fetner et al, ; Novaes et al, ; Pontes et al, ; Saleh et al, ; Vervaeke et al, ; Weng, Nagata, Leite, de Melo, & Bosco, ), a study conducted by Pellicer and coworkers found greater bone loss for subcrestal implants (Pellicer‐Chover et al, ).…”

Section: Discussionsupporting

confidence: 93%

Effect of different implant placement depths on crestal bone levels and soft tissue behavior: A 5‐year randomized clinical trial

Siqueira

Fontão²,

Sartori³

et al. 2020

Clinical Oral Implants Res

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Objectives This randomized clinical trial analyzed the long‐term (5‐year) crestal bone changes and soft tissue dimensions surrounding implants with an internal tapered connection placed in the anterior mandibular region at different depths (equi‐ and subcrestal). Materials and methods Eleven edentulous patients were randomly divided in a split‐mouth design: 28 equicrestal implants (G1) and 27 subcrestal (1–3 mm) implants (G2). Five implants were placed per patient. All implants were immediately loaded. Standardized intraoral radiographs were used to evaluate crestal bone (CB) changes. Patients were assessed immediately, 4, 8, and 60 months after implant placement. The correlation between vertical mucosal thickness (VMT) and soft tissue recession was analyzed. Sub‐group analysis was also performed to evaluate the correlation between VMT and CB loss. Rank‐based ANOVA was used for comparison between groups (α = .05). Results Fifty‐five implants (G1 = 28 and G2 = 27) were assessed. Implant and prosthetic survival rate were 100%. Subcrestal positioning resulted in less CB loss (−0.80 mm) when compared to equicrestal position (−0.99 mm), although the difference was not statistically significant (p > .05). Significant CB loss was found within the G1 and G2 groups at two different measurement times (T4 and T60) (p < .05). Implant placement depths and VMT had no effect on soft tissue recession (p > .05). Conclusions There was no statistically significant difference in CB changes between subcrestal and equicrestal implant positioning; however, subcrestal position resulted in higher bone levels. Neither mucosal recession nor vertical mucosa thickness was influenced by different implant placement depths.

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Section: Discussionsupporting

confidence: 93%

Effect of different implant placement depths on crestal bone levels and soft tissue behavior: A 5‐year randomized clinical trial

Siqueira

Fontão²,

Sartori³

et al. 2020

Clinical Oral Implants Res

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“…Placement of the IAI more subcrestally has been suggested to support the re‐establishment of favorable marginal tissue architecture and to minimize crestal bone resorption around the implants . On the contrary, some reports indicated that subcrestal implants showed no superiority against equicrestal implants with regard to the preservation of peri‐implant crestal bone levels . The findings of the present clinical trial are in line with the study conducted by Amri et al in which no statistically significant differences were found between crestal and subcrestal implants for the mean MBL changes at 6, 18, and 36 months.…”

Section: Discussionsupporting

confidence: 89%

Platform‐switched implants vs platform‐matched implants placed in different implant‐abutment interface positions: A prospective randomized clinical and microbiological study

Uraz

İşler

Cula

et al. 2019

Clin Implant Dent Rel Res

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Background Placement of the implant‐abutment interface (IAI) away from the bone crest has been suggested to have positive impacts on maintenance of peri‐implant tissues. Purpose To assess the effects of platform‐switched and platform‐matched implants, taking into consideration the IAI at different positions relative to the bone crest, on clinical, radiographic, and microbiological outcomes during 12 months following functional loading. Materials and Methods The present prospective randomized study was performed upon 70 patients. Group I (n = 23) implants presenting a platform‐switched implant‐abutment connection design was inserted 1 mm subcrestally. Group II (n = 22) implants with similar properties were inserted crestally. Group III (n = 25) implants presenting a platform‐matched approach with an internal hexagon connection design was inserted crestally. The periodontal parameters were assessed at baseline, and 3, 6, and 12 months postloading. Radiographic marginal bone level (MBL) changes were analyzed at the 12‐month follow‐up. The amount of DNA copies of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Provetalla intermedia and total bacterial mean load in peri‐implant sulcus fluid (PISF) were assessed at the same periods. Results There were no significant differences among the groups with respect to the periodontal parameters for all time periods. At 12‐month follow‐up, the MBL changes were 0.16 ± 0.29 mm and 0.17 ± 0.23 mm for group I, 0.15 ± 0.25 mm and 0.17 ± 0.26 mm for group II, 0.17 ± 0.26 mm and for group III in mesial and distal sites, respectively. The mean total bacterial load was found significantly higher for group III compared to the other groups in the three interval times (P < .05). Conclusion Implants restored with platform‐switching and platform‐matching performed equally regarding clinical and radiographic outcomes. Platform‐matched implants inserted at the crestal level presented higher the mean bacterial total load in PISF.

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“…In cases with thin mucosa, is advisable to place the implant slightly deeper (subcrestally), in such a way the mucosa can hide the long abutment, avoiding aesthetic complications, and at the same time allowing the establishment of the biologic width. This concept was investigated by several authors (Aimetti et al, ; Koutouzis et al, ; Palaska, Tsaousoglou, Vouros, Konstantinidis, & Menexes, ; de Siqueira et al, ), and different results were obtained. While some authors observed better bone preservation placing bone‐level implants in a subcrestal position (Aimetti et al, ; Koutouzis et al, ), Palaska et al () concluded that the connection pattern between fixture and abutment, rather than vertical implant placement in relation to crestal bone level, seems to have more relevance.…”

Section: Discussionmentioning

confidence: 99%

Influence of abutment height and implant depth position on interproximal peri‐implant bone in sites with thin mucosa: A 1‐year randomized clinical trial

Pico

Martín-Lancharro

Caneiro

et al. 2019

Clinical Oral Implants Res

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Objectives The aim of this RCT was to assess radiographically the effect of abutment height and depth of placement of platform‐switched implants on interproximal peri‐implant bone loss (IPBL) in patients with thin peri‐implant mucosa. Material and Methods Thirty‐three patients received one prosthesis supported by two implants replacing at least two adjacent missing teeth (66 implants). Patients were randomly allocated and implant insertion depth adapted to abutment height groups (3 mm height group the implants were placed 2 mm subcrestally; 1 mm height group, equicrestally). Clinical and radiological measurements were performed at 3, 6 and 12 months after surgery. Interproximal bone‐level changes were compared between treatment groups using repeated measures mixed ANOVA. The association between IPBL and categorical variables was also analyzed. Results The mean IPBL in 1 mm abutment group was 0.76 ± 0.79 mm at 3 months, 0.92 ± 0.88 mm at 6 months, and 0.95 ± 0.88 mm at 12 months, while in the 3 mm abutment group was 0.06 ± 0.21, 0.07 ± 0.22 mm, and 0.12 ± 0.33 mm, respectively. Significant differences between both groups were observed at every time point. When the influence of patient characteristics and clinical variables was analyzed, no statistically significant differences were also observed. Conclusions The use of long abutments, in combination with subcrestal implant position in sites with thin mucosa, led to lower IPBL in comparison with the use of short abutments.

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Influence of placement depth and abutment connection pattern on bone remodeling around 1‐stage implants: a prospective randomized controlled clinical trial

Abstract: The connection between fixture/abutment rather than vertical implant placement in relation to alveolar bone level seems to affect peri-implant marginal bone resorption.

Cited by 47 publications

References 83 publications

Effect of different implant placement depths on crestal bone levels and soft tissue behavior: A 5‐year randomized clinical trial

Effect of different implant placement depths on crestal bone levels and soft tissue behavior: A 5‐year randomized clinical trial

Platform‐switched implants vs platform‐matched implants placed in different implant‐abutment interface positions: A prospective randomized clinical and microbiological study

Influence of abutment height and implant depth position on interproximal peri‐implant bone in sites with thin mucosa: A 1‐year randomized clinical trial

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