Is there an effect of crown‐to‐implant ratio on implant treatment outcomes? A systematic review

Meijer, Henny J. A.; Boven, Carina; Delli, Konstantina; Raghoebar, Gerry M.

doi:10.1111/clr.13338

Cited by 50 publications

(52 citation statements)

References 29 publications

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“…While the present study showed that crown‐to‐implant ratio had an impact on radiopacity, a recently published analysis tested for a possible effect of crown‐to‐implant ratio on the marginal bone level but did not prove any clinical impact (Guljé, Raghoebar, Erkens, & Meijer, ). Within a range of 0.86–2.14 (thereby covering the ratios for both test and control implants of the present analysis), the crown‐to‐implant ratio seems not to have an effect on biological or technical complications (Meijer, Boven, Delli, & Raghoebar, ). Any clinical relevance of the difference in GSV after 5 years of loading therefore appears to be questionable.…”

Section: Discussionmentioning

confidence: 85%

Changes of radiopacity around implants of different lengths: Five‐year follow‐up data of a randomized clinical trial

Sluka

Naenni

Jung

et al. 2020

Clinical Oral Implants Res

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Objective To follow‐up the radiographic changes in peri‐implant bone of short (6 mm, test group) and long (10 mm, control group) single‐unit implants five years after loading. Materials and methods Forty‐three implants of the test and 44 implants of the control group could be reassessed from 96 originally included implants. Standardized areas of interest (AOI) were defined in the peri‐implant bone at pre‐defined locations at mid‐length on both sides of the implants, and at the apex. An arbitrary mean grey scale value (GSV) was calculated for the AOI after brightness calibration of the radiographs. Changes for GSV were calculated and tested for possible inter‐ and intra‐group differences using the Mann–Whitney and Wilcoxon tests. Results The calculated intra‐group differences between baseline and 5 years in the test group accounted for 2.4 ± 19.6 (i.e. slight brightening) and −6.2 ± 20.2 for the control group (i.e. slight shading), which resulted in a statistically significant difference in GSV change (p < .05). Crown‐to‐implant ratio was the only parameter showing an effect on GSV change (p = .001). Conclusions Assessing conventional radiographs, longer implants showed a slightly stronger change of radiopacity of the peri‐implant bone (slight loss of density) than short ones (slightly enhanced density) after five years of loading.

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Section: Discussionmentioning

confidence: 85%

Changes of radiopacity around implants of different lengths: Five‐year follow‐up data of a randomized clinical trial

Sluka

Naenni

Jung

et al. 2020

Clinical Oral Implants Res

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“…It should also be mentioned that in vitro studies have shown that splinted implants provide better distribution of high occlusal forces despite the unfavorable crown-to-implant ratio [52]. A systematic review by Meijer et al showed that with splinted implant-supported restorations, the connection between crown and implant may behave differently, perhaps transmitting forces onto peri-implant bone of a different magnitude from non-splinted restorations [53]. In the present study, crestal bone stability was measured by radiographic examination at the time of implant placement, and 2, 6, 12, and 24 months after.…”

Section: Discussionmentioning

confidence: 99%

Prospective, Clinical Pilot Study with Eleven 4-Mm Extra-Short Implants Splinted to Longer Implants for Posterior Maxilla Rehabilitation

Torassa

Naldini

Calvo-Guirado

et al. 2020

JCM

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In many clinical situations, rehabilitation with implants in the posterior maxillary region is complicated by limited bone availability. In this context, the use of 4 mm long implants (known as extra-short implants) may be used thanks to the concept of osseointegration enhancement. It has been demonstrated that short implants offer an alternative to the regeneration procedures involved in placing longer implants in areas where bone height is compromised. This prospective pilot study tested a treatment protocol in which 11 extra-short (4 mm) implants were splinted to 11 mesially placed longer (8 mm) implants in the posterior maxillary regions of partially edentulous patients, without using supplementary bone regeneration procedures. Eleven patients were included in this single cohort study. The clinical performance of the extra-short implants was assessed during a two-year follow-up period, obtaining a 100% survival rate and mean bone loss of 0.3 mm. Implant stability measured by resonance frequency analysis (RFA) at the time of placement was 54.9 ± 4.9, increasing to 77.0 ± 2.6 at 24 months. The study demonstrated the gradual consolidation of osseointegration in bone of less-than-ideal quality in the posterior maxillary region. The results obtained show that a partially edentulous maxilla with reduced bone height may be rehabilitated by using an extra-short implant splinted to a mesial implant of 8mm length or longer. Despite the small sample size, this pilot study observed that extra-short implants achieved adequate bone stability and clinical performance after a 24-month follow-up.

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“…The meta-analysis on nonsplinted implant-supported singletooth restorations with increased crown-to-implant ratio after a mean observation time ranging from 12 to 74 months including eight studies demonstrated high survival rates of the implants and small mean marginal bone loss (Meijer, Boven & Raghoebar, 2018). Scarce evidence could be retrieved on whether different increased crown-to-implant ratios have an influence on the former outcomes.…”

Section: Major Findings From the Reviewmentioning

confidence: 99%

Biomechanical aspects: Summary and consensus statements of group 4. The 5^th EAO Consensus Conference 2018

Hämmerle

Cordaro

Alccayhuaman

et al. 2018

Clinical Oral Implants Res

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Objectives:The aim of the present publication was to report on the EAO Workshop group-4 discussions and consensus statements on the five reviews previously prepared. These reviews provided the scientific evidence on the effect of crown-to-implant ratio, on reconstructions with cantilevers in fully and partially edentulous patients, on biological and technical complications of tilted in comparison with straight implants, and on the effects of osseointegrated implants functioning in a residual dentition. Material and Methods:The group discussed, evaluated, corrected where deemed appropriate, and made recommendations to the authors regarding the following five reviews submitted: (a) Is there an effect of crown-to-implant ratio on implant treatment outcomes?; (b) Implant-supported cantilevered fixed dental rehabilitations in fully edentulous patients; (c) and in partially edentulous patients; (d) Biological and technical complications of tilted implants in comparison with straight implants supporting fixed dental prostheses; (e) What are the adverse effects of osseointegrated implants functioning among natural teeth of a residual dentition? Based on the five manuscripts and the discussion among the group as well as the plenum members, the major findings were summarized, consensus statements were formulated, clinical recommendations were proposed, and areas of future research were identified.Results: Crown-to-implant ratios ranging from 0.9 to 2.2 did not influence the occurrence of biological or technical complications also in single-tooth restorations.Reconstructions with cantilevers for the rehabilitation of fully and partially edentulous jaws showed high implant and reconstruction survival rates. In contrast, the rate of complications-in particular associated with veneering material-was high during the observation period of 5-10 years. The data reported were primarily derived from studies with high risk of bias. The data for single-implant reconstructions were small. There was no evidence that distally tilted implants were associated with higher failure rates and increased amounts of marginal bone loss. The data supporting these findings, This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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Is there an effect of crown‐to‐implant ratio on implant treatment outcomes? A systematic review

Cited by 50 publications

References 29 publications

Changes of radiopacity around implants of different lengths: Five‐year follow‐up data of a randomized clinical trial

Changes of radiopacity around implants of different lengths: Five‐year follow‐up data of a randomized clinical trial

Prospective, Clinical Pilot Study with Eleven 4-Mm Extra-Short Implants Splinted to Longer Implants for Posterior Maxilla Rehabilitation

Biomechanical aspects: Summary and consensus statements of group 4. The 5^th EAO Consensus Conference 2018

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Is there an effect of crown‐to‐implant ratio on implant treatment outcomes? A systematic review

Cited by 50 publications

References 29 publications

Changes of radiopacity around implants of different lengths: Five‐year follow‐up data of a randomized clinical trial

Changes of radiopacity around implants of different lengths: Five‐year follow‐up data of a randomized clinical trial

Prospective, Clinical Pilot Study with Eleven 4-Mm Extra-Short Implants Splinted to Longer Implants for Posterior Maxilla Rehabilitation

Biomechanical aspects: Summary and consensus statements of group 4. The 5th EAO Consensus Conference 2018

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Biomechanical aspects: Summary and consensus statements of group 4. The 5^th EAO Consensus Conference 2018