Comparison of external and internal implant-abutment connections for implant supported prostheses. A systematic review and meta-analysis

Lemos, Caa; Verri, Fellippo Ramos; Bonfante, Estevam A.; Júnior, Joel Ferreira Santiago; Pellizzer, Eduardo Piza

doi:10.1016/j.jdent.2017.12.001

Cited by 76 publications

(72 citation statements)

References 57 publications

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“…The hybrid surface has the advantage of being moderately rough along the implant body, which promotes osseointegration 24 and minimally rough around the implant neck, which is suggested to be less susceptible to develop peri-implantitis on the long term, especially in high-risk patients. 17 [26][27][28] In the present study, one patient showed extensive crestal bone loss beyond the normal bone remodeling, at both the MSC (1.75 mm) and DCC implant (3.93 mm), 3 months post-implant placement. In the present study, no difference in initial crestal bone loss was found between the MSC and the DCC implant after a follow-up of at least 1 year.…”

Section: Discussionmentioning

confidence: 45%

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A randomized controlled clinical trial assessing initial crestal bone remodeling of implants with a different surface roughness

Glibert

Matthys

Maat

et al. 2018

Clin Implant Dent Rel Res

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Section: Discussionmentioning

confidence: 45%

“…This outcome confirms a previous paper by Spinato and colleagues. 17 [26][27][28] In the present study, one patient showed extensive crestal bone loss beyond the normal bone remodeling, at both the MSC (1.75 mm) and DCC implant (3.93 mm), 3 months post-implant placement. Bone…”

Section: Discussionmentioning

confidence: 45%

A randomized controlled clinical trial assessing initial crestal bone remodeling of implants with a different surface roughness

Glibert

Matthys

Maat

et al. 2018

Clin Implant Dent Rel Res

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“…11,12 However, the findings of the present systematic review should be analysed with caution due to the small number of randomized clinical trials included, which can be considered a limitation. In addition, other factors such as number/position, 14 connection type, 42 length/diameter of the implant, 43,44 loading protocol 45 and follow-up period 1 are considered as influencing factors; unfortunately, sub-analyses could not be performed to verify the influence of these variables in association with the attachment system. Further randomized clinical trials are needed to evaluate these factors in patients with a longer follow-up period.…”

Section: Discussionmentioning

confidence: 99%

Splinted and unsplinted overdenture attachment systems: A systematic review and meta‐analysis

Leão

Moraes

Vasconcelos

et al. 2018

J of Oral Rehabilitation

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Splinted and unsplinted overdenture attachment systems have unique advantages and disadvantages. The aim of the present systematic review was to determine the influence of splinted and unsplinted overdenture attachment systems on the marginal bone loss, prosthetic complications and implant survival rate. PubMed/MEDLINE, Scopus and Cochrane databases were searched for articles published up to October 2017, using the following search terms: "overdenture AND attachment OR overdenture AND bar OR overdenture splinted." The PICO question "Do splinted overdenture attachment systems promote better clinical results in comparison to unsplinted systems?" was evaluated. Eligible studies included randomized controlled clinical trials, prospective studies with at least 10 participants and a minimum follow-up of 6 months, and studies published in English that compared splinted and unsplinted attachment systems within the same study. The 95% confidence interval (CI) was considered for all outcomes analysed. After completion of the different steps in the article selection process, nine articles were included in the qualitative and quantitative analyses. A total of 984 implants were placed in 380 patients (mean age: 62.8 years). The meta-analysis demonstrated no statistically significant differences between splinted and unsplinted attachment systems with regard to marginal bone loss (P = .39; MD: -0.11; 95% CI: -0.37 to 0.14), complications (P = .31; RR: 1.26; CI: 0.80-1.99) and implant survival rate (P = .14; RR: 0.37% CI: 0.10-1.36). In addition, splinted and unsplinted overdenture attachment systems achieved similar results with regard to marginal bone loss, prosthetic complications and implant survival rate.

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“…4 Thus, marginal bone stability is considered one of the most important issues in implant dentistry. [11][12][13][14] Additionally, occlusal overload is considered to be associated with periimplant bone resorption. 9,10 The associations between various factors such as systemic diseases, implant position, prosthetic design, implant connection types, and marginal bone resorption are also being examined.…”

mentioning

confidence: 99%

Risk indicators for marginal bone resorption around implants in function for at least 4 years: A retrospective longitudinal study

Mameno

Wada

Otsuki

et al. 2019

Journal of Periodontology

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Background Marginal bone stability is considered one of the most important issues in implant dentistry. It is essential to understand how various factors influence bone resorption around implants. The purpose of this retrospective longitudinal study was to identify potential risk indicators associated with marginal bone resorption around implants in function for at least 4 years. Methods Several systemic‐related, intraoral‐related, implant‐related factors were collected. Marginal bone level change (MBLC) was determined by comparing intraoral radiographs taken at baseline (1 year after prosthesis delivery), and at follow‐up (over 3 years from baseline). A hierarchical regression analysis using liner mixed‐effects models was performed to examine correlations between MBLC and various factors. Results Overall, 514 patients with 1535 implants were analyzed. The mean age of the participants was 62.9 years. Mean annual MBLC was 0.048 mm, and mean functional time was 5.96 years. The result showed that the following explanatory variables had significant effects on MBLC: functional time, plaque control record > 20%, Eichner index C1‐3, maxilla, cement‐retained superstructure, and keratinized mucosa width < 2 mm. We did not find statistically significant associations between bone resorption and some variables known as risk factors, such as diabetes, smoking, and history of periodontitis. Conclusions Within the limits of this study, longer functional time, poor oral hygiene, loss of occlusal support, location in the maxilla, cement‐retained superstructure, and less keratinized mucosa should be considered as risk indicators for bone resorption around implants.

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Comparison of external and internal implant-abutment connections for implant supported prostheses. A systematic review and meta-analysis

Abstract: Internal connection implants should be preferred over external connection implants, especially when different risk factors that may contribute to increased marginal bone loss are present.

Cited by 76 publications

References 57 publications

A randomized controlled clinical trial assessing initial crestal bone remodeling of implants with a different surface roughness

A randomized controlled clinical trial assessing initial crestal bone remodeling of implants with a different surface roughness

Splinted and unsplinted overdenture attachment systems: A systematic review and meta‐analysis

Risk indicators for marginal bone resorption around implants in function for at least 4 years: A retrospective longitudinal study

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