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Subcrestal placement of dental implants with an internal conical connection of 0.5 mm versus 1.5 mm: Three-year after loading results of a multicentre within-person randomised controlled trial

Journal article
Authors S. Salina
F. Gualini
F. Rigotti
C. Mazzarini
D. Longhin
M. Grigoletto
J. Buti
L. Sbricoli
Marco Esposito
Published in European Journal of Oral Implantology
Volume 12
Issue 2
Pages 155-167
ISSN 1756-2406
Publication year 2019
Published at Institute of Clinical Sciences, Department of Biomaterials
Pages 155-167
Language en
Keywords aesthetics, bone level, dental implant, subcrestal placement, soft, Dentistry, Oral Surgery & Medicine
Subject categories Dentistry


Purpose: To evaluate whether there are some clinical benefits by placing single dental implants either 0.5 mm or 1.5 mm subcrestally in healed bone crests. Materials and methods: Sixty partially edentulous patients requiring two single implant-supported crowns had both sites randomly allocated either to 0.5-mm or 1.5-mm subcrestal implant placement according to a split-mouth design at six centres and submerged in aesthetic areas or non-submerged in non-aesthetic areas for 3 months. Provisional acrylic crowns were delivered and were replaced after 2 months by definitive metal-ceramic crowns. Patients were followed to 3 years after loading. Outcome measures were: crown and implant failures, complications, aesthetics assessed using the pink aesthetic score (PES), peri-implant marginal bone level changes and patient preference, recorded by blinded assessors. Results: One patient dropped out. One patient lost both implants for infection at impression taking. Seven complications affected seven patients of the 0.5-mm group and four complications affected four patients of the 1.5-mm subcrestal group. Three patients had complications at both implants. There were no statistically significant differences for complications between group (OR = 4; 95% CI: 0.45 to 35.79; P (McNemar test) = 0.375). At delivery of definitive crowns, 2 months after loading, the mean PES was 11.22 +/- 1.91 and 11.12 +/- 1.59 for the 0.5-and 1.5-mm groups, respectively. At 1 year after loading, the mean PES was 12.09 +/- 1.66 and 12.10 +/- 1.52 for the 0.5-and 1.5-mm groups, respectively. At 3 years after loading, the mean PES was 11.99 +/- 1.94 and 12.19 +/- 1.78 for the 0.5- and 1.5-mm groups, respectively. There were no statistically significant differences between the two groups at 2 months (P = 0.626), at 1 year (P = 0.920) or at 3 years (P = 0.296). One year after loading, patients of the 0.5-mm group lost on average 0.21 +/- 0.51 mm and those of the 1.5-mm group 0.11 +/- 0.36 mm, the difference being not statistically significant (difference = 0.10 mm; 95% CI: -0.01 to 0.20; P = 0.078). Three years after loading, patients of the 0.5-mm group lost on average 0.34 +/- 0.87 mm and those of the 1.5-mm group 0.19 +/- 0.54 mm, the difference being statistically significant (difference = 0.15 mm; 95% CI: 0.00 to 0.30; P = 0.046). Patients did not prefer any depth of the implant placement over the other. There were no differences in outcomes between centres. Conclusions: No appreciable clinical differences were noticed when placing implants 0.5 mm or 1.5 mm subcrestally; therefore clinicians can do as they prefer.

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