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

Abstract

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.

Effects of customized CAD/CAM abutments on cytokine levels in peri-implant crevicular fluid during early implant healing: a pilot study

“…No significant differences in the marginal bone levels between the two abutment groups could be identified during the observation period of the present study. Our findings are in line with a study by Moreira et al, who compared the placement of a definitive abutment after implant placement to three times disconnection and reconnection of the healing abutment; they reported a slightly inferior bone loss at 6 months of 0.14 ± 0.18 mm and 0.23 ± 0.29, respectively [ 28 ]. However, the present study focused on early implant healing, and possible differences in peri-implant bone level might be detected at a later follow-up visit.…”

The Effect Of Multi-Unit Or Implant-Level Fixed Partial Dentures On Peri-Implant Tissues 1-Year Follow-Up Of A Randomized Clinical Trial

“…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 [23].…”

Clinical efficacy of a two‐piece abutment conforming to the concept of one abutment one time in the posterior region: A clinical pilot study

“…[15][16][17][18] However, others have not discerned any meaningful differences. [19][20][21] The latest review highlighted that abutment disconnection was probably a predisposing factor to the occurrence of peri-implant diseases, and suggested to prevent it in order to reduce mechanical injury of the soft tissues. 22 Furthermore, most OAOT abutment placements require clinicians to anticipate the final soft tissue level and determine the abutment height during surgery, which adds complexity to the technical aspects.…”