The Vertical Soft Tissue Thickness and Subcrestal Implant Placement as Factors for Peri-implant Crestal bone Stability

Aim The aim of this prospective study was to determine the influence of vertical soft tissue thickness on bone level changes in platform-switched implants placed eqicrestally or subcrestally and restored with screw-retained or cement-retained restorations. Methods Platform-switched bone-level implants were placed in a single stage manner in the posterior mandibular region. Implant sites were divided into thick (control) and thin (test) vertical soft tissue groups. The implants in the control group were placed equicrestally. The implant sites from the control group were randomly allocated to receive equicrestally or subcrestally placed implants. Bone remodeling/loss was radiographically measured at baseline, three months postoperatively and six months after delivery of final prosthetic restoration. Results The mean crestal bone loss values three months postoperatively and six months post prosthetic restoration were higher in sites with thin versus sites with thick gingiva. In implant sites with thin gingiva, subcrestally placed implants presented less bone loss than eqicrestally placed implants. Conclusion Platform switched implants are prone to more bone loss when they are placed in sites with thin soft tissue, regardless of the type of final restoration (screw-retained or cement-retained). Subcrestal placement of platform-switched implants can prevent crestal bone loss in sites with vertical soft tissue thickness < 3 mm.

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The effect of soft tissue thickness on crestal bone loss of early loaded implants

Clinical Oral Implants Research ◽

10.1111/clr.122_13644 ◽

2020 ◽

Vol 31 (S20) ◽

pp. 180-180

Author(s):

Alper Saglanmak ◽

Alper Gultekin ◽

Caglar Cinar ◽

Cuneyt Karabuda ◽

Serge Szmukler‐Moncle

Keyword(s):

Soft Tissue ◽

Bone Loss ◽

Tissue Thickness ◽

Soft Tissue Thickness ◽

Crestal Bone Loss

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What is the effect of soft tissue thickness on crestal bone loss around dental implants? A systematic review

Clinical Oral Implants Research ◽

10.1111/clr.12916 ◽

2016 ◽

Vol 28 (9) ◽

pp. 1046-1053 ◽

Cited By ~ 29

Author(s):

Aliye Akcalı ◽

Anna Trullenque-Eriksson ◽

Chuanming Sun ◽

Aviva Petrie ◽

Luigi Nibali ◽

...

Keyword(s):

Systematic Review ◽

Soft Tissue ◽

Bone Loss ◽

Dental Implants ◽

Tissue Thickness ◽

Soft Tissue Thickness ◽

Crestal Bone Loss

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Peri-Implant Behavior of Sloped Shoulder Dental Implants Used for All-On-Four Protocols: An Histomorphometric Analysis in Dogs

Materials ◽

10.3390/ma11010119 ◽

2018 ◽

Vol 11 (1) ◽

pp. 119 ◽

Cited By ~ 1

Author(s):

Jose Calvo Guirado ◽

Aldo Lucero-Sánchez ◽

Ana Boquete Castro ◽

Marcus Abboud ◽

Sergio Gehrke ◽

...

Keyword(s):

Soft Tissue ◽

Bone Loss ◽

Dental Implants ◽

Test Group ◽

Control Group ◽

Histomorphometric Analysis ◽

Tissue Thickness ◽

Marginal Bone Loss ◽

Soft Tissue Thickness ◽

The Mean

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.

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The effect of soft tissue augmentation on the clinical and radiographical outcomes following immediate implant placement and provisionalization: a systematic review and meta-analysis

International Journal of Implant Dentistry ◽

10.1186/s40729-021-00365-4 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Paolo De Angelis ◽

Paolo Francesco Manicone ◽

Edoardo Rella ◽

Margherita Giorgia Liguori ◽

Silvio De Angelis ◽

...

Keyword(s):

Systematic Review ◽

Soft Tissue ◽

Bone Loss ◽

Intervention Group ◽

Tissue Thickness ◽

Marginal Bone Loss ◽

Facial Soft Tissue ◽

Implant Placement ◽

Soft Tissue Thickness ◽

Immediate Implant

Abstract Background Nowadays, due to the esthetic and social demands of patients, conventional staged protocols seem to be increasingly replaced by faster, one-step protocols. The purpose of the present systematic review is to assess the peri-implant soft tissue changes after immediate implant placement and provisionalization (IIPP) comparing patients treated with or without a sub-epithelial connective tissue graft (SCTG) when replacing a single tooth in the esthetic region. Methods The present systematic review was written following the PRISMA checklist. Immediate implants placed with a connective tissue graft and without one were compared. The researched primary outcomes were the mid-buccal mucosa level (MBML) facial soft tissue thickness (FSTT) and marginal bone loss (MBL). The weighted mean differences (WMD) were estimated for all three outcomes. Results The change in the mid-buccal mucosa level in the intervention group was significantly higher (WMD 0.54; 95% CI 0.33–0.75), with no indication of heterogeneity (I2 = 16%). The facial soft tissue thickness increased significantly in the intervention group (WMD 0.79; 95% CI 0.37–1.22). The marginal bone loss was significantly higher in the control group (WMD 0.13; 95% CI 0.07–0.18), with no indication of heterogeneity (I2 = 0%). Conclusions The results of the meta-analyses showed a statistically significant reduced change of the marginal bone loss and vestibular recession, as well as higher soft tissue thickness, when a graft was used. The included studies had a short observation time; therefore, studies with longer follow-ups are needed to confirm these findings.

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One Abutment One Time: A Multicenter, Prospective, Controlled, Randomized Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17249453 ◽

2020 ◽

Vol 17 (24) ◽

pp. 9453

Author(s):

José Vicente Ríos-Santos ◽

Gregorio Tello-González ◽

Pedro Lázaro-Calvo ◽

Francisco Javier Gil Mur ◽

Blanca Ríos-Carrasco ◽

...

Keyword(s):

Bone Loss ◽

Statistical Significance ◽

Randomized Study ◽

Study Groups ◽

Control Group ◽

Implant Stability ◽

Chi Square ◽

Implant Placement ◽

Qualitative Variables ◽

Bone Level

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.

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In-Office Guided Implant Placement for Prosthetically Driven Implant Surgery

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0036-1584891 ◽

2017 ◽

Vol 10 (3) ◽

pp. 246-254 ◽

Cited By ~ 2

Author(s):

Daryoush Karami ◽

Hamid Reza Alborzinia ◽

Reza Amid ◽

Mahdi Kadkhodazadeh ◽

Navid Yousefi ◽

...

Keyword(s):

Soft Tissue ◽

Direct Observation ◽

Three Dimensional ◽

Hard Tissue ◽

Tissue Thickness ◽

Computed Tomographic ◽

Implant Placement ◽

Soft Tissue Thickness ◽

Ct Data ◽

The Cost

Application of surgical stents for implant placement via guided flapless surgery is increasing. However, high cost, need for some professional machines, and not taking into account the soft-tissue parameters have limited their application. We sought to design and introduce a technique named in-office guided implant placement (iGIP) to decrease the cost by using available devices in office and enhance the applicability of surgical stents. A customized surgical stent was fabricated based on prosthetic, soft- and hard-tissue parameters by taking into account the amount of available bone (using the computed tomographic [CT] data), soft-tissue thickness and contour (using a composite-covered radiographic stent), and position of the final crown (by diagnostic cast wax up and marking the final crown position with composite). The efficacy of iGIP, in terms of the accuracy of the three-dimensional position of the implant placed in the study cast and in patient's mouth, was confirmed by direct observation and postoperative CT. The iGIP can enhance implant placement in the prosthetically desired position in various types of edentulism. Using this technique minimizes the risk of unwanted consequences, as the soft-tissue thickness and contour are taken into account when fabricating a surgical stent.

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Accuracy of high-resolution ultrasound (US) for gingival soft tissue thickness mesurement in edentulous patients prior to implant placement

Dentomaxillofacial Radiology ◽

10.1259/dmfr.20200309 ◽

2020 ◽

pp. 20200309

Author(s):

Gül Sönmez ◽

Kıvanç Kamburoğlu ◽

Ayşe Gülşahı

Keyword(s):

High Resolution ◽

Soft Tissue ◽

Alveolar Process ◽

Tissue Thickness ◽

Gingival Thickness ◽

Implant Placement ◽

Soft Tissue Thickness ◽

Significant Difference ◽

Edentulous Patients ◽

Clinical Measurements

Objectives: To evaluate and compare the accuracy of high-resolution ultrasound (US) with two different cone beam CT (CBCT) units and clinical assessment for measuring gingival soft tissue thickness in edentulous patients prior to implant placement. Methods and materials: The study consisted of 40 maxillary implant sites of 40 healthy patients (20 females, 20 males; mean age, 47.88 years). We prospectively evaluated labial/buccal gingival thickness in 40 implant regions (16 anterior and 24 posterior) by using limited field of view (FOV) CBCT images and US images in comparison to gold standard transgingival probing measurements. One-way analysis of variance (ANOVA) was used to compare mean measurements obtained from CBCT (Morita and Planmeca), US, and transgingival probing. Interclass correlation coefficient (ICC) estimates were calculated based on means with two-way mixed and absolute-agreement model. Bland Altman plot was used to describe agreement between clinical vs US and CBCT measurements by constructing limits of agreement. Statistical significance was set at p < 0.05. Results: There was no significant difference between methods used according to mean gingival thickness measurements obtained from the top (p = 0.519) and bottom (p = 0.346) of the alveolar process. US and CBCT measurements highly correlated with clinical measurements for both top and bottom alveolar process gingival thickness (p < 0.001). Distribution of differences between clinical measurements and both CBCT measurements showed statistically significant differences according to 0 (p < 0.05). Distribution of differences between clinical measurements and US measurements did not show statistically significant difference (p > 0.05). Conclusion: High-resolution US provided accurate information for the measurement of gingival soft tissue thickness in edentulous patients prior to implant placement.

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