Marginal Bone Loss in Implants with External Connection versus Internal Conical Connection Prior to Prosthetic Loading. A Randomized Clinical Study

Abstract

Introduction: The prosthetic connection of implants has been related to the loss of marginal bone. The aim of this study was to evaluate bone loss around external connection (EC) and internal conical connection (ICC) implants prior to prosthetic loading. Material and methods: A randomized clinical trial (RCT) was carried out, with a sample size of 93 implants (31 EC and 62 ICC) placed in 27 patients. Radiological controls were performed and stability was measured by resonance frequency analysis (RFA) on the day of placement, at 1 month and at 4 months after the placement. Results: Bone loss in EC implants was not statistically different than in ICC implants between the time of placement (T0) and the subsequent month (T1): (EC = 0.18 mm and ICC = 0.17 mm). Between one month (T1) and four months (T2): (EC = 0.39 mm and ICC = 0.19 mm) this difference was highly significant (p = 0.00). Bone loss between T0 and T2 was significantly lower in the ICC (EC = 0.57 mm and ICC = 0.36 mm), (p = 0.01). The overall success rate of the implants was 97.8%. The stability of the implants increased from 70.69 (T0) to 73.91 (T1) and 75.32 (T2). Conclusions: ICC showed less bone loss up to the time of prosthesis placement. Such bone loss did not have a significant impact on bone stability. Long term RCTs are needed to demonstrate whether this bone loss, which is more pronounced at the beginning in EC, tends to stabilize and equate to ICC.

Three interfaces of the dental implant system and their clinical effects on hard and soft tissues

“…164,182,256 Normally, these products dissolve the alveolar bone to the level of the first or second implant thread along the long axis. 245,265 Following the loss of alveolar bone, the upper gingiva may be lost or attached gingiva may become free. 5,148 Gingival loss, or transformation from attached to free gingiva, facilitates the invasion of oral bacteria, resulting in periimplantitis.…”

Marginal Bone Loss in Internal Conical Connection Implants Placed at the Crestal and Subcrestal Levels before Prosthetic Loading: A Randomized Clinical Study

“…One of the challenges of current research in implantology is to reduce the minimal bone loss that occurs in the most coronal area of the implant, and that is more accentuated during the first year [ 1 ].…”