Effects of repeated abutment changes on implant success and bone resorption: Systematic review and meta-analysis

The present systematic review and meta-analysis evaluates the effect of a special treatment procedure that avoids the repeated change of implant abutments (one-abutment one-time concept, study group) on implant survival and peri-implant bone level stability compared to the standard procedure (control group).

The National Center for Biotechnology Information database (PubMed) was searched systematically using preselected search terms. Randomised clinical control trials were extracted that were conducted no more than 10 years previously at the time (2012 to 2022), comparing two treatment approaches (study group vs control group) in single-tooth implant replacement over a minimum observation period of 12 months. A meta-analysis was then performed to compare the implant survival rate and marginal bone loss between the study and control groups.

Ten studies met the inclusion criteria and were included in the subsequent meta-analysis, in which a total of 753 implants were placed in 573 patients. On average, 55.8 patients were included per study and 75.3 implants were placed. The cumulative survival rate of the implants was 99.34%. When comparing the subgroups, the survival rate in the study group was 99.43%, whereas in the control group with multiple changes it was 99.25%. The difference was only marginally statistically significant and there was slightly less bone resorption in the study group compared to the control group (P = 0.0518).

The one-abutment one-time concept leads to less bone resorption on implants; however, due to the marginal statistical significance and the low influence on implant survival, further studies involving a larger number of patients need to be carried out to evaluate the clinical relevance.