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Terzioglu B, Ayyildiz BG. Effect of supracrestal tissue height on marginal bone level changes at platform-switching dental implants placed crestally and subcrestally: A randomized clinical-trial. J Dent 2024; 148:105219. [PMID: 38960001 DOI: 10.1016/j.jdent.2024.105219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 06/14/2024] [Accepted: 06/28/2024] [Indexed: 07/05/2024] Open
Abstract
OBJECTIVES The presence of insufficient peri-implant supracrestal tissue height (STH) may increase marginal bone resorption. This study aims to evaluate the effect of STH on marginal bone level changes (ΔMBC) in platform-switching posterior implants placed crestally and subcrestally. METHODS A total of 80 implants were included in this study. There were two main groups in the study; STH≤2 mm (A) and STH> 2 mm (B) and four subgroups according to the implant placement level, crestally (I) and subcrestally (II): A-I, A-II, B-I, and B-II. Intraoperatively, STH and placement depths of implants were measured from mesial and distal aspects. The mesial and distal peri-implant marginal bone levels were measured on periapical radiographs at immediately (T0), 6 months (T1), 9 months (T2), and 12 months (T3) after functional loading, and the difference between the marginal bone levels was calculated as the ΔMBC. RESULTS Statistically significantly more mesial ΔMBC was detected in the A-I than in the B-I at the time of T0-T1. In the group with STH greater than 2 mm, the difference in ΔMBC between the crestally and subcrestally placements was not statistically significant. CONCLUSIONS This study was found that STH is effective at protecting the marginal bone in the early period, and in cases where the STH is insufficient, subcrestally placement may increase long-term implant success by preventing marginal bone loss from occurring beyond the implant shoulder. The clinical trial number is NCT05595746. CLINICAL SIGNIFICANCE In this study, it was demonstrated that an STH greater than 2 mm is important for marginal bone stabilization, regardless of crestal and subcrestal levels, and that subcrestally placement is beneficial in cases of insufficient STH.
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Affiliation(s)
- Busra Terzioglu
- Kutahya Health Sciences University, Tavsanli Vocational School of Health Services, Kutahya, Turkey; Kutahya Health Sciences University, Faculty of Dentistry, Department of Periodontology, Kutahya, Turkey.
| | - Berceste Guler Ayyildiz
- Kutahya Health Sciences University, Faculty of Dentistry, Department of Periodontology, Kutahya, Turkey.
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Strasding M, Marchand L, Merino E, Zarauz C, Pitta J. Material and abutment selection for CAD/CAM implant-supported fixed dental prostheses in partially edentulous patients - A narrative review. Clin Oral Implants Res 2024; 35:984-999. [PMID: 38864592 DOI: 10.1111/clr.14315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 05/15/2024] [Accepted: 05/27/2024] [Indexed: 06/13/2024]
Abstract
Restorative material selection has become increasingly challenging due to the speed of new developments in the field of dental material science. The present narrative review gives an overview of the current indications for implant abutments and restoration materials for provisional and definitive implant-supported fixed dental prostheses in partially edentulous patients. For single implant restorations, titanium base abutments for crowns are suggested as an alternative to the conventional stock- and customized abutments made out of metal or zirconia. They combine the mechanical stability of a metallic connection with the esthetic potential of ceramics. For multiple-unit restorations, conical titanium bases especially designed for bridges are recommended, to compensate for deviating implant insertion axes and angulations. Even though titanium base abutments with different geometries and heights are available, certain clinical scenarios still benefit from customized titanium abutments. Indications for the definitive material in fixed implant restorations depend on the region of tooth replacement. In the posterior (not esthetically critical) zone, ceramics such as zirconia (3-5-Ymol%) and lithium-disilicate are recommended to be used in a monolithic fashion. In the anterior sector, ceramic restorations may be buccally micro-veneered for an optimal esthetic appearance. Lithium-disilicate is only recommended for single-crowns, while zirconia (3-5-Ymol%) is also recommended for multiple-unit and cantilever restorations. Attention must be given to the specific mechanical properties of different types of zirconia, as some feature reduced mechanical strengths and are therefore not indicated for all regions and restoration span lengths. Metal-ceramics remain an option, especially for cantilever restorations.
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Affiliation(s)
- Malin Strasding
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Laurent Marchand
- Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
| | - Elizabeth Merino
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Cristina Zarauz
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - João Pitta
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
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Maceiras L, Liñares A, Nóvoa L, Batalla P, Mareque S, Pérez J, Blanco J. Marginal changes at bone-level implants supporting dental prostheses with or without intermediate standardised abutments after 36 months: Randomised controlled clinical trial. Clin Oral Implants Res 2024. [PMID: 38797975 DOI: 10.1111/clr.14297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 03/18/2024] [Accepted: 05/13/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE The objective of this study is to evaluate the changes at marginal bone level at implants restored with screw-retained prosthesis connected directly to the implants or with an intermediate abutment, after 3-year follow-up. MATERIAL AND METHODS Thirty-six partially edentulous patients received 72 implants. Each patient received 2 implants and a 2-4-unit screw-retained implant-prosthesis. The test group implants received a screw-retained prosthesis connected directly to the implant shoulder, the control group prosthesis were connected through a 3-mm standardised intermediate abutment. Clinical and radiological data were recorded at baseline and at 6-, 12-, and 36-month follow-up. RESULTS At 36 months, the mean marginal bone loss was 0.13 ± 0.18 mm for the control group and 0.20 ± 0.24 for the test group, with no significant differences between groups (p > .05). Clinical variables (Probing Pocket Depth, Bleeding on Probing and Plaque Index) at 36 months also showed no significant difference between groups. Minor complications frequency was 6.7% in the control group and 5.3% in test group. None of the groups suffered from mayor complications. Patient Reported Outcomes (PROs) showed a General Satisfaction mean score in the control group of 9.40 (SD 0.82) and 9.37 (SD 1.06) in the test group with no significant differences between groups. CONCLUSIONS Bone-level implants restored with screw-retained partial prostheses with or without intermediate abutments showed similar radiographic and clinical outcomes after 3 years.
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Affiliation(s)
- Lucía Maceiras
- Periodontology Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Antonio Liñares
- Periodontology Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
- Medical-Surgical Odontology (OMEQUI) Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Lourdes Nóvoa
- Periodontology Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Pilar Batalla
- Periodontology Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Santiago Mareque
- Periodontology Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Juan Blanco
- Periodontology Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
- Medical-Surgical Odontology (OMEQUI) Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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Tajti P, Solyom E, Váncsa S, Mátrai P, Hegyi P, Varga G, Hermann P, Borbély J, Sculean A, Mikulás K. Less marginal bone loss around bone-level implants restored with long abutments: A systematic review and meta-analysis. Periodontol 2000 2024; 94:627-638. [PMID: 37766634 DOI: 10.1111/prd.12534] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023]
Abstract
The aim of this study was to investigate the biological outcomes of bone-level implants restored with long vs. short abutments, with regard to the 'one abutment at one time' protocol. The systematic search was performed in five databases: MEDLINE (PubMed), EMBASE, Web of Science, Scopus, and CENTRAL for randomized controlled trials up to January 14, 2023. Data were collected for marginal bone loss, bleeding on probing, and probing pocket depth by two reviewers. As effect size measure, mean difference (MD), and risk ratio (RR) were used for continuous and categorical outcomes, R-statistics software was used for conducting statistical analyses. For quality and certainty assessment, Risk of Bias Tool 2, ROBINS-I, and GRADE approach were used. The search resulted in 4055 records without any duplicates. After title, abstract, and full-text analysis, eight articles were found eligible for inclusion. Bone-level and platform-switched implants presented less marginal bone loss after 6 months and 1 year as well, when long abutments were used (MD 0.63, 95% CI: [-0.16; 1.42]) and (MD 0.26, 95% CI: [-0.02; 0.53]). However, subgroup analysis revealed no difference in marginal bone loss when applying 'one abutment at one time' protocol (p = 0.973). Bleeding on probing and probing pocket depth presented similarly good results in both groups without almost any differences (RR 0.97, 95% CI: [0.76; 1.23]) and (MD -0.05, 95% CI: [-1.11; 1.01]). Longer abutments on bone-level implants seem to be a favorable choice for decreasing early marginal bone loss, irrespective of connection timing.
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Affiliation(s)
- Péter Tajti
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Eleonora Solyom
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - Szilárd Váncsa
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Mátrai
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Gábor Varga
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Oral Biology, Semmelweis University, Budapest, Hungary
| | - Péter Hermann
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Judit Borbély
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Krisztina Mikulás
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
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Paolantoni G, Tatullo M, Miniello A, Sammartino G, Marenzi G. Influence of crestal and sub-crestal implant position on development of peri-implant diseases: a 5-year retrospective analysis. Clin Oral Investig 2023; 28:16. [PMID: 38135770 DOI: 10.1007/s00784-023-05413-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVES The aim of the present study was to evaluate the influence of crestal and subcrestal implant position on development of peri-implant diseases. MATERIALS AND METHODS The study was designed as a retrospective clinical and radiographic analysis. Implant-supported fixed dental prostheses were allocated in two groups: with the shoulder (i) placed in sub-crestal level and (ii) placed at bone level. For each patient, the following clinical variables were assessed: FMPS, FMBS, PlI, BOP, and PD. After prothesis delivery, an intraoral radiograph was obtained; this exam was performed also at 5 years of observation period. RESULTS No statistically significant difference was found in terms of FMPS and FMBS at baseline and after 5 years follow-up (P < 0.05). A statistically significant difference was assessed between PD of control group and test group (P = 0.042). Patient-based analysis showed a 25.6% of peri-implant mucositis and 32.6% of peri-implantitis for implants placed with the shoulder in crestal position, while for implants inserted in sub-crestal position the percentage of peri-implant-mucositis and peri-implantitis were 19%; no statistically significant difference was found between groups after 5 years (P < 0.05). CONCLUSIONS Within the limitation of the present study, the clinical and radiographic outcomes showed that the percentage of peri-implant mucositis and peri-implantitis was not statistically significant for both groups after 5 years follow-up. CLINICAL RELEVANCE The outcomes of present study clinically demonstrated that a deep position of implant shoulder did not provide any benefits. On the contrary, it may be considered a possible risk indicator for implant diseases.
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Affiliation(s)
| | - Marco Tatullo
- Department of Traslational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Piazza Umberto I, 70121, Bari, Italy
| | - Alessandra Miniello
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Gilberto Sammartino
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Gaetano Marenzi
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy.
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