scholarly journals Assessment of Marginal Bone Loss around Platform-Matched and Platform-Switched Implants - A Prospective Study

2016 ◽  
Vol 27 (6) ◽  
pp. 712-716 ◽  
Author(s):  
Newton Sesma ◽  
Carlos Garaicoa-Pazmino ◽  
Piero R. Zanardi ◽  
Eliseo P. Chun ◽  
Dalva Cruz Laganá

Abstract The aim of the present study was to perform a software-assisted radiographic assessment of the effect of platform-switching on marginal bone loss (MBL) around dental implants. Forty patients requiring a dental implant in non-grafted partially edentulous mandibles were enrolled and categorized into implants receiving a platform-matched abutment (control group) or implants with a platform-switched abutment (test group). Standardized digital periapical radiographs were taken at the time of implant placement (T0), at implant loading (T1) and 1-year after functional loading (T2). Software-assisted radiographic assessment of the MBL horizontal, vertical and area changes was performed and compared between time intervals (T1-T0, T2-T1 and T2-T0). Mean radiographic horizontal MBL (hMBL) and vertical MBL (vMBL) from implant placement to 1-year after implant loading (T2-T0) were significantly increased around platform-matched when compared to platform-switched abutments (1.04 mm vs 0.84 mm, p<0.05) and (0.99 mm vs 0.82 mm, p<0.05), respectively. Additionally, bone loss area (BLa) was greater (0.77 mm2 vs 0.63 mm2; p<0.05) for platform-matched compared to platform-switched abutments. Platform-switching has a positive impact upon the amount of bone modeling after loading implants with internal hexagon connection.

2020 ◽  
Vol 08 (01) ◽  
pp. 17-21
Author(s):  
Udey Singh Wirring ◽  
Tarun Kalra ◽  
Manjit Kumar ◽  
Ajay Bansal ◽  
Aquib Javaid

Abstract Introduction Marginal bone level is the criterion for implant success. Patient expectations for more natural looking implant restorations created the need to restore implants with more esthetically pleasing materials like Zirconia rather than conventional porcelain-fused to-metal (PFM) crowns. The aim of this study was to evaluate marginal bone loss around dental implants clinically and radiographically when restored with Zirconia and PFM prosthesis. Materials and Methods Two groups (control and test) were formed with 14 patients each. In the control group, the subjects were rehabilitated with PFM crowns and in the test group, the subjects were rehabilitated with Zirconia crowns. Rehabilitation was done after the healing period of 3 months. Radiographic evaluation was done at regular (baseline, 3rd, 6th, and 12th month) intervals. Results The results were statistically analyzed. Keeping in mind the limitations of the study, it was revealed that the difference in the crestal bone resorption in both the groups was not significant.


Materials ◽  
2018 ◽  
Vol 11 (1) ◽  
pp. 119 ◽  
Author(s):  
Jose Calvo Guirado ◽  
Aldo Lucero-Sánchez ◽  
Ana Boquete Castro ◽  
Marcus Abboud ◽  
Sergio Gehrke ◽  
...  

The aim of this study was to evaluate the soft tissue thickness and marginal bone loss around dental implants with sloped micro-threaded shoulder (30° angle) in comparing with conventional design, inserted 30° degrees angulated in post extraction sockets and immediate loaded with temporary prosthesis simulating the all-on-four protocol. Materials and Methods: Six fox hound dogs received forty-eight post extraction dental implants with the different diameter and length (Medentika, Germany), but with different neck configurations. Two group of implants were inserted 1mm subcrestal. Control group has a micro-threaded neck and the Test group has a sloped microthreaded neck. Immediate loading was applied using a constructed metallic structure. After three months, soft and hard tissue levels were assessed by histomorphometric analysis. Results: The mean soft tissue thickness (STT) was 2.5 ± 0.2 mm for the Control group and 3.3 ± 0.3 mm for Test group (p = 0.036), meanwhile the mean marginal bone loss (MBL) was 1.53 ± 0.34 mm for Control group and, 1.62 ± 0.22 mm for Test group (p > 0.05). Conclusions: Within the limitations of this experimental model in dogs, the findings showed that dental implants with microthreaded and microthreaded sloped necks installed in immediate post extraction sites with immediate load, presented a comparable perimplant tissue behavior.


2021 ◽  
Vol 11 (1) ◽  
pp. 74
Author(s):  
Nasreen Hamudi ◽  
Eitan Barnea ◽  
Evgeny Weinberg ◽  
Amir Laviv ◽  
Eitan Mijiritsky ◽  
...  

Objectives: Repeated abutment disconnection/reconnection may compromise the mucosal barrier and result in crestal bone level changes. The clinical significance of this phenomenon is not yet clear, as most studies on this topic are short-term. Therefore, the aim of the present study was to evaluate the influence of abutment disconnections and reconnections on peri-implant marginal bone loss over a medium-term follow-up period. Material and methods: Twenty-one patients (6 men and 15 women) with a mean age 66.23 ± 9.35 year at the time of implant placement were included. All patients who received two adjacent nonsubmerged implants were randomly assigned into one of the two groups: definitive multiunit abutments (DEFs) connected to the implant that were not removed (test group) or healing abutments (HEAs) placed at surgery, which were disconnected and reconnected 3–5 times during the prosthetic phase (control group). Peri-implant marginal bone levels (MBL) were measured through periapical X-rays images acquired immediately after the surgery (baseline), at 4–7 months immediately after prosthetic delivery, and at 1-year and 3-year follow-up visits. Results: No implant was lost or presented bone loss of more than 1.9 mm during the 3-year follow-up; thus, the survival and success rate was 100%. Peri-implant mucositis was noticed in 38.1% DEFs and 41.9% of HEAs at the 3-year follow-up assessment. At the end of 3 years, the MBL was −0.35 ± 0.69 mm for participants in the DEFs group and −0.57 ± 0.80 mm for the HEAs group, with significant statistical difference between groups. Conclusions: Immediate connection of the multiunit abutments reduced bone loss in comparison with 3–5 disconnections noted in the healing abutments 3 years after prosthetic delivery. However, the difference between the groups was minimal; thus, the clinical relevance of those results is doubtful.


Materials ◽  
2021 ◽  
Vol 14 (15) ◽  
pp. 4179
Author(s):  
Filipe Moreira ◽  
Salomão Rocha ◽  
Francisco Caramelo ◽  
João P. Tondela

Objective: To evaluate the peri-implant hard tissue change at 6 and 12 months after implant placement between definitive abutment placed at the same time of implant surgery, never removing it, and healing abutment disconnected and reconnected three times until the placement of the final rehabilitation. Material and methods: Each partial edentulous patient could receive between 1 and 4 platform-switched implants in the posterior regions. If the implants had primary stability—implant stability quotient (ISQ) equal to or greater than 50, they were randomized to the test group with the abutment inserted at the same time of implant placement (DA) or to the control group, receiving a healing abutment (PA). At 6 and 12 months after surgery, data related with vertical bone level changes (primary outcome) and other clinical parameters (implant mobility, bleeding on probing, probing depth, plaque index) were assessed. Results: 53 implants were included in the trial and completed 12 months follow-up (overall survival rate: 100%). All implants achieved primary stability, with an average ISQ value of 80.9 on the day of surgery. From surgery to 6 months, the mean bone loss was 0.14 ± 0.18 mm for the DA group and 0.23 ± 0.29 mm for the PA group, without statistical significance difference. Between 6 and 12 months, the mean bone loss was 0.14 ± 0.21 mm for the DA group and 0.21 ± 0.27 mm for the PA group, also without statistical significance between the two groups. There were no statistically significant differences (p = 0.330) in total bone loss after 12 months between the control and the study groups. Conclusions: The one abutment one time protocol has at least an equivalent effect on the peri-implant bone level changes when compared with the use of healing abutments that are disconnected and reconnected at least three times.


2016 ◽  
Vol 17 (1) ◽  
pp. 7-15 ◽  
Author(s):  
Ronald Younes ◽  
Antoine Berberi ◽  
Nabih Nader ◽  
Maissa Aboulhosn ◽  
Cordahi Manal

ABSTRACT Background The periimplant bone level has been used as one of the criteria to assess the success of dental implants. It has been documented that the bone supporting two-piece implants undergoes resorption first following the second-stage surgery and later on further to abutment connection and delivery of the final prosthesis. Objective The aim of this multicentric randomized clinical trial was to evaluate the crestal bone resorption around internal connection dental implants using a new surgical protocol that aims to respect the biological distance, relying on the benefit of a friction fit connection abutment (test group) compared with implants receiving conventional healing abutments at secondstage surgery (control group). Materials and methods A total of partially edentulous patients were consecutively treated at two private clinics, with two adjacent two-stage implants. Three months after the first surgery, one of the implants was randomly allocated to the control group and was uncovered using a healing abutment, while the other implant received a standard final abutment and was seated and tightened to 30 Ncm. At each step of the prosthetic try-in, the abutment in the test group was removed and then retightened to 30 Ncm. Horizontal bone changes were assessed using periapical radiographs immediately after implant placement and at 3 (second-stage surgery), 6, 9 and 12 months follow-up examinations. Results At 12 months follow-up, no implant failure was reported in both groups. In the control group, the mean periimplant bone resorption was 0.249 ± 0.362 at M3, 0.773 ± 0.413 at M6, 0.904 ± 0.36 at M9 and 1.047 ± 0.395 at M12. The test group revealed a statistically significant lower marginal bone loss of 20.88% at M3 (0.197 ± 0.262), 22.25% at M6 (0.601 ± 0.386), 24.23% at M9 (0.685 ± 0.341) and 19.2% at M9 (0.846 ± 0.454). The results revealed that bone loss increased over time, with the greatest change in bone loss occurring between 3 and 6 months. Alveolar bone loss was significantly greater in the control condition than the test condition. Conclusion The results of this prospective study demonstrated the benefit of placing a prosthetic component with a stable connection at second-stage surgery, in terms of reduced marginal bone remodeling when compared with conventional procedure. Clinical significance. The use of a stable connection in a healing component during try-in stages prior to final restoration placement leads to less periimplant marginal bone loss. How to cite this article Nader N, Aboulhosn M, Berberi A, Manal C, Younes R. Marginal Bone Remodeling around healing Abutment vs Final Abutment Placement at Second Stage Surgery: A 12-month Randomized Clinical Trial. J Contemp Dent Pract 2016;17(1):7-15.


Materials ◽  
2019 ◽  
Vol 12 (10) ◽  
pp. 1710 ◽  
Author(s):  
Marco Tallarico ◽  
Francesco Mattia Ceruso ◽  
Leonardo Muzzi ◽  
Silvio Mario Meloni ◽  
Yong-Jin Kim ◽  
...  

Background: The aim of the present prospective case series study was to evaluate the implant and prosthetic survival rates, complications and marginal bone loss using ultra-fine titanium mesh membrane with simultaneous implant placement, to provide space maintenance mandatory for guided bone reconstruction of alveolar bone defects. Materials and Methods: patients were recruited and treated at a private clinic in Rome, Italy, between March 2016 and October 2017. Self-tapping tapered implants were placed through a computer-guided template-assisted approach. Autogenous bone was placed alone over the exposed implant surface, then mixed with inorganic bovine bone material. Finally, the membrane was connected and shaped in order to securely enclose the graft area, and the healing cap was connected and screwed onto the height connector. Outcome measures were: implant and prosthetic failure, biological and mechanical complications, marginal and volumetric bone level changes, esthetic evaluation performed according to the pink aesthetic score (PES). Results: in total, seven patients (five women, two men) with a mean age of 52.7 ± 20.3 years (range: 27–71) received 10 self-tapping tapered implants and simultaneous guided bone regeneration with ultra-fine titanium mesh membranes. No implants and no prostheses failed during the entire follow-up period. One slightly membrane exposure was observed one month after implant placement in one patient. The mean marginal bone loss (MBL) at implant loading was 0.13 ± 0.09 mm (95% CI 0.08–0.19). At the 18-month follow-up examination, the mean MBL was 0.28 ± 0.33 mm (95% CI 0.07–0.50) The difference was not statistically significant (0.15 ± 0.31; 95% CI 0.05–0.35; P = 0.1888). The mean horizontal alveolar ridge width was 3.72 ± 1.08 mm (95% CI 3.22–4.22 mm). At the II-stage surgery, the mean bone width was 8.79 ± 0.98 mm (95% CI 8.51–9.07 mm). The mean bone gain was 5.06 ± 1.13 mm (95% CI 4.68–5.44 mm; P = 0.000). The mean volume of the grafted bone calculated using the superimposition technique was 0.99 ± 0.38 CC (95% CI 0.75–1.23 CC). The mean PES at implant loading was 8.2 ± 0.8 mm (95% CI 7.7–8.7). At the 18-month follow-up examination, the mean PES was 12.0 ± 0.7 mm (95% CI 11.5–12.5) The difference was statistically significant (3.8 ± 0.4; 95% CI 3.5–4.1; P = 0.0000); Conclusion: with the limitation of the present prospective study, the guided bone reconstruction using an ultra-fine titanium mesh membrane with simultaneous implant placement seems to provide good and stable results in implant/prosthesis success. Further research with a longer follow-up and a higher sample size are needed to confirm the results from this preliminary report.


2021 ◽  
Author(s):  
Boroka Klara Csifo-Nagy ◽  
Eleonora Solyom ◽  
Vera Lili Bognar ◽  
Annamaria Nevelits ◽  
Ferenc Dori

Abstract Background: The aim of the study was to clinically evaluate the healing of intrabony defects after treatment with a new generation of platelet-rich fibrin (A-PRF+) respect to enamel matrix derivatives (EMD). Methods: Thirty (30) intrabony defects of 18 patients (9 males, 9 females) were randomly treated with A-PRF+ (test, n=15) or EMD (control, n=15). The following clinical parameters were recorded at baseline and 6 months after surgery: pocket depth (PD), gingival recession (GR) and clinical attachment level (CAL). After debridement the intrabony defects were filled with A-PRF+ in the test group, respectively with EMD in the control group, and fixed with sutures to ensure wound closure and stability.Results: Both treatment methods resulted in statistically significant PD reductions, respectively CAL gains six months post-operatively. No statistically significant differences were found between the two groups as the mean CAL gain was 2.33±1.58 mm in the A-PRF+ group, respectively 2.60±1.18 mm in the EMD group (p < 0.001).Conclusion: Within the limits of this study the new-generation platelet-rich fibrin seems to be as clinically effective as EMD in the surgical treatment of intrabony defects. Treatment with A-PRF+ or EMD resulted in reliable clinical outcomes. The use of A-PRF+ as a human autologous product can give a positive impact on periodontal healing.Clinical Relevance: A-PRF+ may be suitable for the treatment of intrabony periodontal defects. Trial registration number (TRN): NCT04404374 (ClinicalTrials.gov ID)Date of registration: 19.05.2020., retrospectively registered


2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Claudio Stacchi ◽  
Teresa Lombardi ◽  
Domenico Baldi ◽  
Calogero Bugea ◽  
Antonio Rapani ◽  
...  

Aim. To compare implant survival rate and marginal bone loss (MBL) of immediately loaded single implants inserted by using ultrasonic implant site preparation (UISP) (test) and conventional rotary instrumentation (control). Methods. Two single implants were inserted for each patient: after randomization, test site was prepared by using an ultrasonic device (Piezosurgery Touch, Mectron, Italy) and control site was prepared by using the drills of the selected implant system (Premium AZT, Sweden & Martina, Italy), until reaching a final diameter of 3 mm in both groups. Identical implants (3.8x11.5 mm) were inserted in all sites at crestal level. Impressions were taken and screwed resin single crowns with platform-switched provisional abutments were delivered with 48 hours. Periapical radiographs were taken at provisional crown insertion (T0), 6 months (T1) and one year (T2) after prosthetic loading to measure MBL. All data were tested for normality and subsequently analyzed by paired samples t-test and forward multiple linear regression. Results. Forty-eight patients were treated in six centers with the insertion of ninety-six implants (48 test; 48 control). Four implants in four patients failed within the first six months of healing (two in test group; two in control group; no difference between groups). Forty patients (age 60.1±10.7 years; 22 female, 18 male) were included in the final analysis. Mean MBL after six months of loading was 1.39±1.03 mm in the test group and 1.42±1.16 mm in the control group (p>0.05) and after one year was 1.92±1.14 mm and 2.14±1.55 mm in test and control, respectively (p>0.05). Conclusions. No differences in survival rate and MBL were demonstrated between UISP and conventional site preparation with rotary instruments in immediately loaded dental implants: UISP, with its characteristics of enhanced surgical control and safety in proximity of delicate structures, may be used as a reliable alternative to the traditional drilling systems.


Author(s):  
José Vicente Ríos-Santos ◽  
Gregorio Tello-González ◽  
Pedro Lázaro-Calvo ◽  
Francisco Javier Gil Mur ◽  
Blanca Ríos-Carrasco ◽  
...  

Aim: (PRIMARY) Assess the changes in bone level (6 and 12 months after implant placement) between the test (definitive abutment (DEF)) and control (healing abutment (HEA)) groups. (SECONDARY) Assess the changes in bone level (6 and 12 months after implant placement) between the 1 mm high abutment group and 2 mm abutment group. Evaluate changes in implant stability recorded with analysis of the resonance frequency (RFA) Osstell system, at 6 and 12 months after implant placement, between the control group (HEA) and test (DEF). For the DEF group, the abutment was placed at the time of the surgery and was never removed. For the HEA group, the abutment was removed three times during the manufacture of the crowns. The abutments used were 1 mm high (Subgroup A) and 2 mm high (Subgroup B). Materials and methods: A total of 147 patients were selected between 54.82 ± 11.92 years old. After implant placement, patients were randomly distributed in the DEF and HEA group. After the implant placement, a periapical radiograph was taken to assess the peri-implant bone level; the same procedure was carried out 6 and 12 months post-placement. To compare the qualitative variables between the groups (HEA/DEF), the Chi-square test was used; for quantitative (MANOVA). Results: After a year, the accumulated bone loss was 0.48 ± 0.71 mm for the HEA group and 0.36 ± 0.79 mm for the DEF group, without statistical significance. Differences were only found due to timing (time) between 0 and 6 months (=0.001) and 0 and 12 months (0.001), with no differences attributable to the study groups (DEF and HEA). The accumulated bone loss (1 year) was 0.45 ± 0.78 mm for the 1 mm abutment group and 0.41 ± 0.70 mm for the 2 mm abutment group (p = 0.02). No differences were observed in implant stability between groups. Conclusions: The “One Abutment—One Time” concept does not reduce peri-implant bone loss compared to the connection–disconnection technique. The height of the abutment does influence bone loss: the higher the abutment, the lower the bone loss.


2019 ◽  
Vol 8 (8) ◽  
pp. 1168 ◽  
Author(s):  
Teresa Lombardi ◽  
Federico Berton ◽  
Stefano Salgarello ◽  
Erika Barbalonga ◽  
Antonio Rapani ◽  
...  

Early marginal bone loss (MBL) is a non-infective remodeling process of variable entity occurring within the first year after implant placement. It has a multifactorial etiology, being influenced by both surgical and prosthetic factors. Their impact remains a matter of debate, and controversial information is available, particularly regarding implants placed subcrestally. The present multicenter prospective clinical study aimed to correlate marginal bone loss around platform-switched implants with conical connection inserted subcrestally to general and local factors. Fifty-five patients were enrolled according to strict inclusion/exclusion criteria by four clinical centers. Single or multiple implants (AnyRidge, MegaGen, South Korea) were inserted in the posterior mandible with a one-stage protocol. Impressions were taken after two months of healing (T1), screwed metal-ceramic restorations were delivered three months after implant insertion (T2), and patients were recalled after six months (T3) and twelve months (T4) of prosthetic loading. Periapical radiographs were acquired at each time point. Bone levels were measured at each time point on both mesial and distal aspects of implants. Linear mixed models were fitted to the data to identify predictors associated with MBL. Fifty patients (25 male, 25 female; mean age 58.0 ± 12.8) with a total of 83 implants were included in the final analysis. The mean subcrestal position of the implant shoulder at baseline was 1.24 ± 0.57 mm, while at T4, it was 0.46 ± 0.59 mm under the bone level. Early marginal bone remodeling was significantly influenced by implant insertion depth and factors related to biological width establishment (vertical mucosal thickness, healing, and prosthetic abutment height). Deep implant insertion, thin peri-implant mucosa, and short abutments were associated with greater marginal bone loss up to six months after prosthetic loading. Peri-implant bone levels tended to stabilize after this time, and no further marginal bone resorption was recorded at twelve months after implant loading.


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