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Bone Response and Soft Tissue Changes Around Implants With/Without Abutments Supporting Fixed Partial Dentures:
Catharina Göthberg1,2, Ulrika André1, Kerstin Gröndahl3
1Department of Prosthetic Dentistry, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
Clinical Implant Dentistry and Related Research
|March 25, 2015
Summary
Machined abutments may improve marginal bone stability in dental implants, with no significant bone loss observed between 1 and 3 years, regardless of immediate loading. This study investigated tissue response and implant loading effects.
Area of Science:
- Dental Implantology
- Biomaterials Science
- Periodontology
Background:
- Divergent clinical opinions exist regarding the use of rough surface abutments in dental implantology.
- The specific effects of abutment exclusion on peri-implant tissues remain largely unstudied.
Purpose of the Study:
- To assess and compare the tissue response to oxidized (AOX) or machined (AM) abutments versus direct implant-level (IL) placement.
- To evaluate the effects of immediate implant loading on peri-implant outcomes.
- To analyze marginal bone loss (MBL) and soft tissue parameters over a 3-year period.
Main Methods:
- A 3-year parallel-group randomized clinical trial involving 50 partially edentulous subjects receiving three dental implants.
- Implants were restored with AOX abutments, AM abutments, or directly at the implant level (IL).
- Immediate loading (test) versus delayed loading (control) protocols were employed, with postoperative examinations up to 3 years.
Main Results:
- Implant survival rate was 95.7% after 3 years. Marginal bone loss (MBL) was comparable between immediate and delayed loading groups.
- After 3 years, MBL was significantly lower with machined abutments (AM) compared to direct implant-level placement (IL).
- Soft tissue parameters like mucosal bleeding and probing depths were recorded, with soft tissue recession noted primarily during the first year.
Conclusions:
- No significant additional marginal bone loss occurred between years 1 and 3, irrespective of the loading protocol.
- Machined abutments demonstrated a potential benefit for long-term marginal bone stability compared to direct implant placement.
- Factors such as smoking, periodontal disease, bleeding on probing, and initial implant stability influenced marginal bone loss.
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