Abutment Disconnection/Reconnection Affects Peri-implant Marginal Bone Levels: A Meta-Analysis

Biological width establishment around dental implants is influenced by abutment height irrespective of vertical mucosal thickness: A cluster randomized controlled trial

“…Limited but noticeable marginal bone loss occurred in the first period ( T 1 – T 0 ) before loading, as recently described elsewhere (Borges, Leitao, Pereira, Carvalho, & Galindo‐Moreno, ). MBL was similar in the 4 groups (A1, A3, B1, B3) during this period and is probably due to the remodeling process caused by surgical trauma related to implant insertion and uncovering, and to the two healing abutment disconnections performed for prosthetic reasons (impression taking and subsequent try‐in of the crown) (Koutouzis, Gholami, Reynolds, Lundgren, & Kotsakis, ; Tatarakis et al, ).…”

The influence of abutment macro‐design on clinical and radiographic peri‐implant tissue changes for guided, placed, and restored implants: A 1‐year randomized controlled trial

“…In the present study we avoided any abutment disconnections after the surgical phase of the treatment, in order to maximize periimplant bone stability. Recent systematic reviews have addressed that topic (Koutouzis et al(2017); Atieh et al(2017), pointing out a modest positive effect of non-removal of the final abutment on periimplant bone levels. To our knowledge this is the first clinical study utilizing custom CAD-CAM abutments as opposed to prefabricated standard abutments for this application.…”

“…Multiple abutment disconnections and reconnections from the time of implant placement to the final restoration has been identified as a factor that may affect peri-implant bone remodeling at the early stages of implant therapy (Atieh, Tawse-Smith, Alsabeeha, Ma, & Duncan, 2017;Koutouzis, Gholami, Reynolds, Lundgren, & Kotsakis, 2017). The concept that avoidance of abutment disconnections and reconnections can be beneficial for marginal bone stability stems from the fact that multiple disruptions of the peri-implant mucosa adhesion can lead to marginal bone loss (Abrahamsson, Berglundh, & Lindhe, 1997).…”

Bone loss around oral and orthopedic implants: An immunologically based condition

“…79 Evaluated sites presented a higher number of titanium particles compared to healthy implants. [84][85][86] Although this limited crestal bone resorption does not seem to be clinically relevant, this established fact should at least raise the doubt that regular periimplant tissue probing assessments might repeatedly disrupt the soft tissue barrier with consequent serious iatrogenic effects on the stability of the peri-implant tissues in the long term. 81 There is strong evidence in the literature that the mechanical disruption of the mucosal barrier around an implant should be considered as a connective tissue wound resulting in epithelial proliferation to cover the wound, and in bone resorption to allow a connective tissue barrier of proper dimension to reform to re-establish a "biological width."…”

“…Repeated abutment dis/reconnections, with consequent disruption of the peri-implant soft tissue barrier, have been shown to cause crestal bone resorption around dental implants in animal studies 82,83 and in short-term and long-term clinical investigations as confirmed in several meta-analysis reports. [84][85][86] Although this limited crestal bone resorption does not seem to be clinically relevant, this established fact should at least raise the doubt that regular periimplant tissue probing assessments might repeatedly disrupt the soft tissue barrier with consequent serious iatrogenic effects on the stability of the peri-implant tissues in the long term.…”