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Bone and soft tissue outcomes, risk factors, and complications of implant-supported prostheses: 5-Years RCT with different abutment types and loading protocols

Journal article
Authors Catharina Göthberg
K. Grondahl
Omar Omar
Peter Thomsen
Christer Slotte
Published in Clinical Implant Dentistry and Related Research
Volume 20
Issue 3
Pages 313-321
ISSN 1523-0899
Publication year 2018
Published at Institute of Clinical Sciences, Department of Biomaterials
Pages 313-321
Language en
Links https://doi.org/10.1111/cid.12587
Keywords clinical outcomes, complications, dental abutment, dental implant, marginal bone loss, risk factors, peri-implantitis, dental implants, fixed prostheses, follow-up, survival, diseases, prevalence, frequency, metaanalysis, rates, Dentistry, Oral Surgery & Medicine
Subject categories Biomaterials Science

Abstract

BackgroundData on risk factors and complications after long-term implant treatment is limited. The aims were to evaluate the role of various fixation modes and to analyze complications and risks that affect long-term use of implant-supported partial fixed dental prostheses. Materials and MethodsFifty partially edentulous subjects received three Branemark TiUnite implants. Superstructures were attached directly at implant level (IL) or via abutments: machined surface (AM) and an oxidized surface (AOX, TiUnite). Implants were immediately loaded (test) or unloaded for 3 months (control). Examinations occurred over a 5-year period. ResultsForty-four subjects were re-examined after 5 years. Cumulative survival rates in test and control groups were 93.9% and 97.0%, respectively. Marginal bone loss (MBL; Mean [SEM]) was significantly lower at superstructures connected to AM (1.61 [0.25] mm) than at sites with no abutment IL (2.14 [0.17] mm). Peri-implantitis occurred in 9.1% of subjects and in 4.0% of implants. Multiple linear regression indicated that increased probing pocket depth (PPD), periodontal disease experience, deteriorating health, and light smoking (10 cigarettes/day) predict greater MBL, whereas increased buccal soft tissue thickness and higher ISQ predict lower MBL. ConclusionsThe results show that MBL was influenced by the connection type. A machined abutment, instead of connecting the superstructure directly at the implant level, was beneficial. The following factors influenced MBL: PPD, periodontal disease experience, deteriorating health, light smoking, buccal soft tissue thickness, and ISQ. The results on peri-implantitis underscore the need for long-term maintenance care. Further, the abutment material surface properties constitute additional target for strategies to minimize MBL.

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