The Causes of Early Implant Bone Loss: Myth or Science?

Abstract

The success of dental implants is highly dependent on integration between the implant and intraoral hard/soft tissue. Initial breakdown of the implant-tissue interface generally begins at the crestal region in successfully osseointegrated endosteal implants, regardless of surgical approaches (submerged or nonsubmerged). Early crestal bone loss is often observed after the first year of function, followed by minimal bone loss (< or =0.2 mm) annually thereafter. Six plausible etiologic factors are hypothesized, including surgical trauma, occlusal overload, peri-implantitis, microgap, biologic width, and implant crest module. It is the purpose of this article to review and discuss each factor Based upon currently available literature, the reformation of biologic width around dental implants, microgap if placed at or below the bone crest, occlusal overload, and implant crest module may be the most likely causes of early implant bone loss. Furthermore, it is important to note that other contributing factors, such as surgical trauma and penimplantitis, may also play a role in the process of early implant bone loss. Future randomized, well-controlled clinical trials comparing the effect of each plausible factor are needed to clarify the causes of early implant bone loss.

Preload loss and bacterial penetration on different implant-abutment connection systems

“…The presence of microorganisms in the periimplant tissues may lead to a chronic inflammatory response causing implant failure. Periimplantitis can lead to implant loss in later stages (6,8,9) and a correlation between biofilm accumulation and progressive periimplant bone loss has been reported in experimental and clinical studies (6,7,10).…”

“…The success of dental implants is first dependent on osseointegration phenomenon and late, the bone support maintenance (2,6,7). The presence of a microgap at the implantabutment interface allows microorganisms to penetrate and colonize the inner part of the implant.…”

Influence of microthreads and platform switching on stress distribution in bone using angled abutments

“…As a result of the significant technological advancement in the field of osseointegrated implants, some of the parameters, such as implant design, materials, and surgical techniques, have allowed greater predictability of success for restorations, achieving an esthetic clinical solution in situations that were considered complex in the past [1].appliance connection [5]. Late bone loss arises due to the implant/prosthesis wear or function [4,[6][7][8].…”

“…While late marginal bone loss has been associated with peri-implantitis and occlusal overload [4], early marginal bone loss has been associated with the implant's design (macro and microdesign) and the process of the biologic seal establishment and stabilization. This process can be exacerbated by the microgap, the implant crest module, reformation of biologic width, and surgical trauma [4,5].…”

Peri-Implant Bone Loss of External Hexagon and Morse Taper in Patients Wearing Immediately Loaded Overdentures

“…Literature has also discussed about bone loss etiologies after loading of implants. The most frequent causes are surgical trauma, microgaps, peri-implantitis and immediate loading (21)(22)(23). The results of this study are probably related to the presence of microgaps between the External Hexagon implant and abutment, in contrast to the intimate matching observed between the Morse Taper components (9,10).…”