One-time versus repeated abutment connection for platform-switched implant: A systematic review and meta-analysis

Abstract

ObjectiveThis review aims to compare peri-implant tissue changes in terms of clinical and radiographic aspects of implant restoration protocol using one-time abutment to repeated abutment connection in platform switched implant.MethodA structured search strategy was applied to three electronic databases, namely, Pubmed, Embase and Web of Science. Eight eligible studies, including seven randomised controlled studies and one controlled clinical study, were identified in accordance with inclusion/exclusion criteria. Outcome measures included peri-implant bone changes (mm), peri-implant soft tissue changes (mm), probing depth (mm) and postsurgical complications.ResultSix studies were pooled for meta-analysis on bone tissue, three for soft tissue, two for probing depth and four for postsurgical complications. A total of 197 implants were placed in one-time abutment group, whereas 214 implants were included in repeated abutment group. The implant systems included Global implants, Ankylos, JDEvolution (JdentalCare), Straumann Bone level and Conelog-Screwline. One-time abutment group showed significantly better outcomes than repeated abutment group, as measured in the standardised differences in mean values (fixed- and random-effect model): vertical bone change (0.41, 3.23) in 6 months, (1.51, 14.81) in 12 months and (2.47, 2.47) in 3 years and soft tissue change (0.21, 0.23). No significant difference was observed in terms of probing depth and complications.ConclusionOur meta-analysis revealed that implant restoration protocol using one-time abutment is superior to repeated abutment for platform switched implant because of less bone resorption and soft tissue shifts in former. However, future randomised clinical trials should be conducted to further confirm these findings because of the small samples and the limited quality of the original research.

Two‐piece zirconia versus titanium implants after 80 months: Clinical outcomes from a prospective randomized pilot trial

“…Connecting a final abutment without ever using a temporary one has its merits, not least by entailing fewer surgical visits and less tissue trauma. Studies have repeatedly demonstrated more favorable tissue outcomes in this way than after multiple abutment changes (Esposito et al, ; Wang et al, ).…”

Biological Responses to the Transitional Area of Dental Implants: Material- and Structure-Dependent Responses of Peri-Implant Tissue to Abutments

“…A systematic review suggested that the OAOT protocol might preserve peri-implant bone loss and soft tissue changes for two reasons [57]. First of all, the micro-gap between abutment and implant could cause to bacterial leakage and micromotion, and this might lead to the inflammation of peri-implant soft tissue and bone resorption.…”

“…First of all, the micro-gap between abutment and implant could cause to bacterial leakage and micromotion, and this might lead to the inflammation of peri-implant soft tissue and bone resorption. The OAOT protocol could provide less micro-gap because healing or temporary abutments were installed by less preloading force (<10 Ncm) than final abutments (about 30 Ncm) [57]. Second, the OAOT protocol could reduce the disruption of the soft tissue seal around the implant abutment complex to avoid repeated the dis/reconnection of abutments [57].…”

Bone loss around oral and orthopedic implants: An immunologically based condition

“…79 Evaluated sites presented a higher number of titanium particles compared to healthy implants. [84][85][86] Although this limited crestal bone resorption does not seem to be clinically relevant, this established fact should at least raise the doubt that regular periimplant tissue probing assessments might repeatedly disrupt the soft tissue barrier with consequent serious iatrogenic effects on the stability of the peri-implant tissues in the long term. 81 There is strong evidence in the literature that the mechanical disruption of the mucosal barrier around an implant should be considered as a connective tissue wound resulting in epithelial proliferation to cover the wound, and in bone resorption to allow a connective tissue barrier of proper dimension to reform to re-establish a "biological width."…”

“…Repeated abutment dis/reconnections, with consequent disruption of the peri-implant soft tissue barrier, have been shown to cause crestal bone resorption around dental implants in animal studies 82,83 and in short-term and long-term clinical investigations as confirmed in several meta-analysis reports. [84][85][86] Although this limited crestal bone resorption does not seem to be clinically relevant, this established fact should at least raise the doubt that regular periimplant tissue probing assessments might repeatedly disrupt the soft tissue barrier with consequent serious iatrogenic effects on the stability of the peri-implant tissues in the long term.…”