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Marginal Bone Loss Around Bone-Level Fully Guided Implants With Direct Implant Connection Versus Intermediate
Jordi Gargallo-Albiol1,2, María José Zilleruelo-Pozo1, Anna Treserra-Parra1
1Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, Barcelona, Spain.
Clinical Oral Implants Research
|June 2, 2026
Summary
Using an intermediate abutment for posterior implant-supported restorations significantly reduced marginal bone loss (MBL) compared to direct implant connections. This finding highlights the benefit of intermediate abutments in preserving peri-implant bone health.
Area of Science:
- Dentistry
- Oral Implantology
- Prosthodontics
Background:
- Partial edentulism necessitates implant-supported restorations.
- Bone-level tapered implants are utilized for posterior restorations.
- The use of intermediate abutments is being investigated for peri-implant health.
Purpose of the Study:
- To evaluate the impact of intermediate prosthetic abutments on peri-implant marginal bone loss (MBL).
- To compare MBL in posterior implant-supported fixed restorations with and without intermediate abutments.
Main Methods:
- A randomized clinical trial involving 30 patients (60 implants) with partial edentulism.
- Implants were bone-level tapered, placed via a guided approach, and restored with full zirconia.
- Patients were divided into a Control group (direct connection) and a Test group (intermediate abutment).
- Marginal bone loss was measured via periapical radiography over 24 months.
Main Results:
- The Test group (intermediate abutment) exhibited significantly lower MBL (0.83 ± 0.25 mm) than the Control group (1.17 ± 0.35 mm; p=0.001).
- No significant difference in MBL was found between intermediate abutment height subgroups (1 mm vs. 2.5 mm).
- A trend towards more favorable outcomes was observed with the higher intermediate abutment.
Conclusions:
- Intermediate abutments significantly reduce marginal bone loss in posterior implant-supported fixed restorations compared to direct implant connections.
- The use of intermediate abutments is a beneficial strategy for preserving peri-implant bone.
- Further research may explore optimal intermediate abutment heights.