Crestal Bone Changes in Different Implants Designs: A Prospective Clinical Trial
31 December 2019 (online)
Objective Several modifications, such as changes in the implant–abutment connection, have been suggested in studies on dental implants to better preserve the peri-implant bone level. The aim of this study was to prospectively compare crestal bone level changes between two different implant designs—tissue level (TL) and bone level (BL).
Materials and Methods The sample comprised 18 patients, on whom a total of 30 hydrophilic tissue- and bone level implants were placed (SLActive, Straumann Institut AG, Basel, Switzerland), in the posterior region of the maxilla or the mandible. Impressions were taken after 45 days of healing. Then, cemented-retained metalloceramic crowns were fabricated and installed. Marginal bone level changes were assessed by the paralleling technique of periapical radiographies, on both mesial and distal aspects of each implant, at the moment of the implant placement and after 1 year of loading. Photoshop software was used to perform linear measurements by a single and calibrated examiner.
Statistical Analysis The Mann–Whitney test at a 5% significance level was used to compare the bone changes among the implants assessed.
Results A significantly lower (p = 0.048) bone remodeling was observed on bone level implants (0.05 mm), when compared to tissue level implants (0.47 mm; p = 0.048). The average marginal bone level changes at the distal aspect did not show any statistically significant difference (p = 0.325).
Conclusions Tissue level implants presented greater bone loss in the mesial surface than bone level implants. Both designs presented stable and clinically acceptable bone crests.
- 1 Albrektsson T, Zarb G, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants 1986; 1 (01) 11-25
- 2 Lekholm U, Gunne J, Henry P. et al. Survival of the Brånemark implant in partially edentulous jaws: a 10-year prospective multicenter study. Int J Oral Maxillofac Implants 1999; 14 (05) 639-645
- 3 Brocard D, Barthet P, Baysse E. et al. A multicenter report on 1,022 consecutively placed ITI implants: a 7-year longitudinal study. Int J Oral Maxillofac Implants 2000; 15 (05) 691-700
- 4 Östman P-O, Hellman M, Sennerby L. Ten years later. Results from a prospective single-centre clinical study on 121 oxidized (TiUnite™) Brånemark implants in 46 patients. Clin Implant Dent Relat Res 2012; 14 (06) 852-860
- 5 Rabel A, Köhler SG, Schmidt-Westhausen AM. Clinical study on the primary stability of two dental implant systems with resonance frequency analysis. Clin Oral Investig 2007; 11 (03) 257-265
- 6 Albrektsson T, Zarb GA. Current interpretations of the osseointegrated response: clinical significance. Int J Prosthodont 1993; 6 (02) 95-105
- 7 Cochran DL, Nummikoski PV, Higginbottom FL, Hermann JS, Makins SR, Buser D. Evaluation of an endosseous titanium implant with a sandblasted and acid-etched surface in the canine mandible: radiographic results. Clin Oral Implants Res 1996; 7 (03) 240-252
- 8 Buser D, Nydegger T, Oxland T. et al. Interface shear strength of titanium implants with a sandblasted and acid-etched surface: a biomechanical study in the maxilla of miniature pigs. J Biomed Mater Res 1999; 45 (02) 75-83
- 9 Lin M-I, Shen Y-W, Huang H-L, Hsu J-T, Fuh L-J. A retrospective study of implant-abutment connections on crestal bone level. J Dent Res 2013; 92 (12) Suppl 202S-207S
- 10 Mangano C, Mangano F, Piattelli A, Iezzi G, Mangano A, La Colla L. Prospective clinical evaluation of 1920 Morse taper connection implants: results after 4 years of functional loading. Clin Oral Implants Res 2009; 20 (03) 254-261
- 11 Ganeles J, Zöllner A, Jackowski J, ten Bruggenkate C, Beagle J, Guerra F. Immediate and early loading of Straumann implants with a chemically modified surface (SLActive) in the posterior mandible and maxilla: 1-year results from a prospective multicenter study. Clin Oral Implants Res 2008; 19 (11) 1119-1128
- 12 Valderrama P, Bornstein MM, Jones AA, Wilson Jr. TG, Higginbottom FL, Cochran DL. Effects of implant design on marginal bone changes around early loaded, chemically modified, sandblasted Acid-etched-surfaced implants: a histologic analysis in dogs. J Periodontol 2011; 82 (07) 1025-1034
- 13 Kumar VV, Sagheb K, Kämmerer PW, Al-Nawas B, Wagner W. Retrospective clinical study of marginal bone level changes with two different screw-implant types: comparison between tissue level (TE) and bone level (BL) implant. J Maxillofac Oral Surg 2014; 13 (03) 259-266
- 14 Hartman GA, Cochran DL. Initial implant position determines the magnitude of crestal bone remodeling. J Periodontol 2004; 75 (04) 572-577
- 15 Broggini N, McManus LM, Hermann JS. et al. Persistent acute inflammation at the implant-abutment interface. J Dent Res 2003; 82 (03) 232-237
- 16 Lazzara RJ, Porter SS. Platform switching: a new concept in implant dentistry for controlling postrestorative crestal bone levels. Int J Periodontics Restorative Dent 2006; 26 (01) 9-17
- 17 Weber HP, Crohin CC, Fiorellini JP. A 5-year prospective clinical and radiographic study of non-submerged dental implants. Clin Oral Implants Res 2000; 11 (02) 144-153
- 18 Heitz-Mayfield LJ, Darby I, Heitz F, Chen S. Preservation of crestal bone by implant design. A comparative study in minipigs. Clin Oral Implants Res 2013; 24 (03) 243-249
- 19 Alomrani AN, Hermann JS, Jones AA, Buser D, Schoolfield J, Cochran DL. The effect of a machined collar on coronal hard tissue around titanium implants: a radiographic study in the canine mandible. Int J Oral Maxillofac Implants 2005; 20 (05) 677-686
- 20 Jung RE, Jones AA, Higginbottom FL. et al. The influence of non-matching implant and abutment diameters on radiographic crestal bone levels in dogs. J Periodontol 2008; 79 (02) 260-270
- 21 Hansson S, Norton M. The relation between surface roughness and interfacial shear strength for bone-anchored implants. A mathematical model. J Biomech 1999; 32 (08) 829-836
- 22 Hänggi MP, Hänggi DC, Schoolfield JD, Meyer J, Cochran DL, Hermann JS. Crestal bone changes around titanium implants. Part I: a retrospective radiographic evaluation in humans comparing two non-submerged implant designs with different machined collar lengths. J Periodontol 2005; 76 (05) 791-802
- 23 DI Girolamo M, Calcaterra R, DI Gianfilippo R, Arcuri C, Baggi L. Bone level changes around platform switching and platform matching implants: a systematic review with meta-analysis. Oral Implantol (Rome) 2016; 9 (01) 1-10
- 24 Atieh MA, Ibrahim HM, Atieh AH. Platform switching for marginal bone preservation around dental implants: a systematic review and meta-analysis. J Periodontol 2010; 81 (10) 1350-1366
- 25 King GN, Hermann JS, Schoolfield JD, Buser D, Cochran DL. Influence of the size of the microgap on crestal bone levels in non-submerged dental implants: a radiographic study in the canine mandible. J Periodontol 2002; 73 (10) 1111-1117
- 26 Astrand P, Engquist B, Dahlgren S, Gröndahl K, Engquist E, Feldmann H. Astra Tech and Brånemark system implants: a 5-year prospective study of marginal bone reactions. Clin Oral Implants Res 2004; 15 (04) 413-420