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Bone-Level Versus Tissue-Level Titanium Dental Implants: A Comparative Cross-Sectional Study.

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Bone-level (BL) and tissue-level (TL) implants show similar long-term survival and peri-implant disease rates. However, smaller diameter (3.3mm) TL implants demonstrated reduced peri-implantitis risk, while plaque and smoking increased it.

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Area of Science:

  • Dental Implantology
  • Periodontology
  • Biomaterials Science

Background:

  • Dental implants are widely used for tooth replacement.
  • Peri-implant diseases, such as mucositis and peri-implantitis, can compromise implant longevity.
  • Understanding factors influencing implant outcomes is crucial for clinical success.

Purpose of the Study:

  • To compare long-term survival and peri-implant disease prevalence between bone-level (BL) and tissue-level (TL) titanium implants.
  • To evaluate the impact of implant diameter and other risk indicators on implant therapy outcomes.

Main Methods:

  • A longitudinal study included adult patients with non-molar implant-supported prostheses.
  • Clinical and radiographic outcomes were analyzed, alongside patient, anatomical, surgical, and prosthetic factors.
  • Mean follow-up duration was 11.2 years.

Main Results:

  • Implant survival rates were high for both BL (99.4%) and TL (98.2%) implants.
  • Peri-implant health, mucositis, and peri-implantitis prevalence were comparable between BL and TL implants.
  • Smaller diameter (3.3mm) implants showed lower peri-implantitis rates (7.2%) compared to larger ones (4.1mm, 13.3%).
  • Notably, 3.3mm TL implants had significantly lower peri-implantitis rates (4.8%) than BL implants (9.6%).
  • Higher plaque scores increased mucositis and peri-implantitis risk; smoking was a strong peri-implantitis indicator.
  • Greater mucosal thickness was associated with decreased odds of mucositis and peri-implantitis.

Conclusions:

  • BL and TL implants demonstrate comparable long-term survival and peri-implant disease rates in non-molar sites.
  • Tissue-level implants with a 3.3mm diameter may offer a reduced risk of peri-implantitis.
  • Plaque accumulation and smoking are significant risk factors for peri-implant diseases.
  • Increased mucosal thickness appears to be a protective factor against peri-implant conditions.