The effect of triangular cross‐section neck design on crestal bone stability in the anterior mandible: A randomized, controlled, split‐mouth clinical trial

Abstract

Objectives: This randomized controlled trial aimed to compare crestal bone loss (CBL) and buccal bone thickness (BBT) around triangular cross-section neck (TN) to round neck (RN) implants retaining mandibular overdentures one year after loading, using cone beam computed tomography (CBCT).Material and Methods: Twenty edentulous patients receiving 40 implants with similar diameters were randomly assigned to the RN and TN groups. Clinical buccal bone thickness (CBBT) around the implants was measured with a caliper at baseline. A resonance frequency analyzer was used to measure the implant stability quotient (ISQ) at the baseline and two months after insertion. Pocket probing depths (PPD), plaque index (PI), and gingival index (GI) were also recorded at postoperative months 2, 6, and 12. CBCT was used to evaluate proximal CBL and BBT at three levels (0, −2, and −4 mm) one year after loading.Results: No implant loss was observed during the follow-up period. No significant differences in CBBT, ISQ values, and scores for PPD, PI, and GI between the two groups were observed at any time (p > .05). BBT was also comparable one year after loading (p > .05). The mean ± SD proximal CBL one year after loading was 0.58 ± 0.36 mm for TN and 0.91 ± 0.59 mm for RN (p < .01). Conclusions:This study found better crestal bone preservation in the implants with the novel neck design than conventional neck design in the anterior mandible after a follow-up of one year. However, it may not be clinically noticeable.

Clinical and radiographic assessment of circular versus triangular cross‐section neck implants in the posterior maxilla: Five‐year follow‐up of a randomized controlled trial

“…According to some authors, triangular neck implant designs (Tri) allow the creation of gap between the osteotomy site and the implant surface, leading to a subsequent bone apposition (Nevins et al, 2020). Among the few clinical studies investigating the outcomes of Tri after 1 year, one retrospective study demonstrated a significant improvement of the Pink Esthetic Score (PES) as well as excellent hard and soft tissue preservation (D'Avenia et al, 2019) and a randomized controlled trial (RCT) observed better crestal bone level of implant placed in the anterior mandible with the Cir when compared to the conventional implant designs (Tokuc & Kan, 2021). On the other hand, the 1-year report of the present RCT did not find any difference between the control and the test group in terms of peri-implant bone changes, PES and patient satisfaction (Li Manni et al, 2020).…”

The effect of triangular cross‐section neck design on crestal bone stability in the anterior mandible: A retrospective study with a 5‐year follow‐up

“…All patients signed an informed consent form about the possible risks and benefits of the study. The initial 1‐year trial was carried out at Kocaeli University Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, between October 2016 and July 2018 (Tokuc & Kan, 2021). The present retrospective study was carried out at İstanbul Okan University Faculty of Dentistry, Department of Oral and Maxillofacial Surgery.…”

“…This TN design provides a greater compression‐free area to the alveolar crest during implant insertion, to minimize CBL. In addition, a TN design would also enhance buccal bone thickness (BBT) by preserving more space between the flat part of the triangle and the buccal bone cortex (Li Manni et al, 2020; Tokuc & Kan, 2021; Wiskott & Belser, 1999). In a recent publication, we compared the 1‐year outcomes of implants with either a TN design or a RN design using cone‐beam computed tomography (CBCT) in a study using split‐mouth design.…”

“…In this study, the implants with the novel TN design showed better crestal bone preservation compared to conventional neck design. However, medium‐term and long‐term evidence from clinical trials reporting the effect of a TN design is lacking (Tokuc & Kan, 2021). Unfortunately, the data derived from only a very few short‐term comparative clinical trials undertaken to date do not provide a robust answer on benefits of the TN design over the RN implants in terms of the preservation of crestal bone.…”

Bone Damage during Dental Implant Insertion: A Pilot Study Combining Strain Gauge and Histologic Analysis

“…Following the creation of a round osteotomy, the insertion of a triangular implant with a flat surface oriented buccally would relieve the buccal bone plate. However, two clinical studies did not identify major differences with circular cross-section neck implants [13] apart from somewhat reduced crestal bone loss [14].…”