Clinical Considerations on Strategies That Avoid Multiple Connections and Disconnections of Implant Abutments

Canullo, Luigi; Tallarico, Marco; Gracis, Stefano; Vela, Xavier; Rodríguez, Xavier; Covani, Ugo

doi:10.11607/prd.3642

Cited by 13 publications

(7 citation statements)

References 4 publications

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“…Among such heterogeneity, the type of implant/implant–abutment connection, the macro design, and the location of the implant in the arch and the surgical placement protocol of the implant seems to have a greater influence on the initial bone remodeling [ 78 ]. Other etiological factors associated with peri-implant bone loss should also be contemplated in the design of the studies, namely, the stability of the connection, the abutment decontamination and asepsis, the associated load protocol [ 79 ], variations in operator experience, bone loss assessment methods, bone quality and initial thickness of gingival tissue, and the use of bone substitute materials, as they may influence the treatment outcome [ 73 ].…”

Section: Discussionmentioning

confidence: 99%

One-Abutment One-Time Effect on Peri-Implant Marginal Bone: A Prospective, Controlled, Randomized, Double-Blind Study

et al. 2021

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Objective: To evaluate the peri-implant hard tissue change at 6 and 12 months after implant placement between definitive abutment placed at the same time of implant surgery, never removing it, and healing abutment disconnected and reconnected three times until the placement of the final rehabilitation. Material and methods: Each partial edentulous patient could receive between 1 and 4 platform-switched implants in the posterior regions. If the implants had primary stability—implant stability quotient (ISQ) equal to or greater than 50, they were randomized to the test group with the abutment inserted at the same time of implant placement (DA) or to the control group, receiving a healing abutment (PA). At 6 and 12 months after surgery, data related with vertical bone level changes (primary outcome) and other clinical parameters (implant mobility, bleeding on probing, probing depth, plaque index) were assessed. Results: 53 implants were included in the trial and completed 12 months follow-up (overall survival rate: 100%). All implants achieved primary stability, with an average ISQ value of 80.9 on the day of surgery. From surgery to 6 months, the mean bone loss was 0.14 ± 0.18 mm for the DA group and 0.23 ± 0.29 mm for the PA group, without statistical significance difference. Between 6 and 12 months, the mean bone loss was 0.14 ± 0.21 mm for the DA group and 0.21 ± 0.27 mm for the PA group, also without statistical significance between the two groups. There were no statistically significant differences (p = 0.330) in total bone loss after 12 months between the control and the study groups. Conclusions: The one abutment one time protocol has at least an equivalent effect on the peri-implant bone level changes when compared with the use of healing abutments that are disconnected and reconnected at least three times.

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Section: Discussionmentioning

confidence: 99%

One-Abutment One-Time Effect on Peri-Implant Marginal Bone: A Prospective, Controlled, Randomized, Double-Blind Study

et al. 2021

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“…However, in this study the healing abutments were removed within a limited number of times (3 times) in order to limit the damage of soft tissues. In addition, recent studies have shown that clinically this can have an extremely limited effect and other factors may have a greater influence [42,43]. Moreover, during the healing period the test HAs used in this study have not been removed.…”

Section: Discussionmentioning

confidence: 99%

Immunohistochemical Results of Soft Tissues around a New Implant Healing-Abutment Surface: A Human Study

Ghinassi

D’Addazio

Baldassarre

et al. 2020

JCM

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Although, the high success rate of implant rehabilitation treatment, the biological complications such as bone loss and peri-implantitis are still present. The creation of a coronal biological seal between the implant and the oral tissues seems to be a crucial point on preserving dental implants. The objective of this study was to immunohistochemically analyze the behavior of peri-implant soft tissues around a new implant healing-abutment surface on humans. A total of 30 soft tissue biopsies were collected after a healing period of 30 (±7) days, to analyze the expression of inflammatory (cluster of differentiation 63 (CD63), human neutrophil peptides 1–3 (HPN1–3)) and junctional (E-cadherin, occludin, and β-catenin) markers, on soft tissues around laser treated and machined alternated healing abutments. The evaluation demonstrated the whole area of the soft tissues adherent to the laser treated surface with a regular morphology. While several stress hallmarks in correspondence of machined surfaces were shown such as: (a) An irregular, disrupted, and discontinued basal membrane with an increased inflammation evident both the epithelial and connective tissues; (b) the absence or defective proper keratinization process of the external layer, and (c) damages in the cell to cell interaction. In conclusion, the laser treated surface is preferable to maintain the integrity and functionality of the gingiva epithelium.

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“…Thus, the attractive capacity of this surface, combined with the mucosal reduced inflammatory state, encouraged the use of this surface in direct contact with soft tissues. The cellular adhesion obtained discourages the repeated screwing and unscrewing of the components which could damage the implant–abutment interface [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

Gingival Response to Dental Implant: Comparison Study on the Effects of New Nanopored Laser-Treated vs. Traditional Healing Abutments

Ghinassi

Baldassarre

D’Addazio

et al. 2020

IJMS

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The health of peri-implant soft tissues is important for the long-term success rate of dental implants and the surface topography is pivotal in influencing it. Thus, the aim of this study was to evaluate, in human patients, the inflammatory mucosal microenvironment in the tissue surrounding a new, nanoscale, laser-treated healing abutment characterized by engineered nanopores versus a standard machined-surface. Analyses of anti- and pro-inflammatory markers, cytokeratins, desmosomal proteins and scanning electron microscopy were performed in 30 soft-tissue biopsies retrieved during second-stage surgery. The results demonstrate that the soft tissue surrounding the laser-treated surface was characterized by a lower grade of inflammation than the one facing the machined-surface, which, in turn, showed a disrupted epithelium and altered desmosomes. Moreover, higher adhesion of the epithelial cells on the laser-treated surface was detected compared to the machined one. In conclusion, the laser-treated surface topography seems to play an important role not only in cell adhesion, but also on the inflammatory makers’ expression of the soft tissue microenvironment. Thus, from a clinical point of view, the use of this kind of topography may be of crucial importance not only on healing abutments but also on prosthetic ones.

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Clinical Considerations on Strategies That Avoid Multiple Connections and Disconnections of Implant Abutments

Cited by 13 publications

References 4 publications

One-Abutment One-Time Effect on Peri-Implant Marginal Bone: A Prospective, Controlled, Randomized, Double-Blind Study

One-Abutment One-Time Effect on Peri-Implant Marginal Bone: A Prospective, Controlled, Randomized, Double-Blind Study

Immunohistochemical Results of Soft Tissues around a New Implant Healing-Abutment Surface: A Human Study

Gingival Response to Dental Implant: Comparison Study on the Effects of New Nanopored Laser-Treated vs. Traditional Healing Abutments

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