One-Abutment One-Time Effect on Peri-Implant Marginal Bone: A Prospective, Controlled, Randomized, Double-Blind Study

Area of Science:

• Dental Implantology
• Periodontology
• Prosthodontics

Background:

• The management of abutments during dental implant procedures can influence peri-implant bone levels.
• The 'one abutment one time' (OAOT) protocol is a technique aiming to minimize surgical interventions and potential contamination.
• Alternative protocols involve using healing abutments that are removed and replaced multiple times before final restoration.

Purpose of the Study:

• To compare peri-implant hard tissue changes at 6 and 12 months between the OAOT protocol and a protocol involving multiple disconnections/reconnections of healing abutments.
• To evaluate the effect of different abutment management strategies on vertical bone level changes around platform-switched implants.

Main Methods:

• A randomized controlled trial involving patients receiving 1-4 platform-switched implants in posterior regions.
• Implants with primary stability (ISQ ≥ 50) were randomized to either the test group (definitive abutment at surgery - DA) or the control group (healing abutment - PA).
• Vertical bone level changes and other clinical parameters were assessed at 6 and 12 months post-surgery.

Main Results:

• 53 implants completed 12-month follow-up with a 100% survival rate.
• No statistically significant differences in mean bone loss were observed between the DA and PA groups at 6 months (0.14 vs 0.23 mm) or between 6 and 12 months (0.14 vs 0.21 mm).
• Total bone loss after 12 months showed no statistically significant difference between the two groups (p = 0.330).

Conclusions:

• The 'one abutment one time' protocol demonstrates equivalent outcomes in terms of peri-implant bone level changes compared to using healing abutments that are repeatedly disconnected and reconnected.
• This finding supports the clinical efficacy and predictability of the OAOT protocol in maintaining peri-implant bone health.