The influence of crown-to-implant ratio in single crowns on clinical outcomes: A systematic review and meta-analysis

Pellizzer, Eduardo Piza; Gomes, Jéssica Marcela de Luna; Lemos, Cleidiel Aparecido Araújo; Minatel, L; Limírio, João Pedro Justino de Oliveira; Moraes, Sandra Lúcia Dantas de

doi:10.1016/j.prosdent.2020.06.010

Cited by 17 publications

(13 citation statements)

References 25 publications

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“…The significance of CIR remains a matter of ongoing controversial discussion. While it seems reasonable that high leverage forces in case of great crown length might have a detrimental effect on a relatively small bony anchorage surface of a short implant, most clinical studies seem not to support a negative effect of enhanced CIR and implant survival (Ravida et al 2019; Pellizzer et al 2021). Likewise, MBL seems not to be significantly affected even if CIR is exceeding or below a cutoff value of 1.5 (Pandey et al 2022).…”

Section: Discussionmentioning

confidence: 99%

“…Although data generally allow for an optimistic valuation (Rossi et al 2018), several publications raise some matter of concern regarding marginal bone loss and implant failure (Storelli et al 2018). In this regard, the potential effect of the crown-to-implant length remains an ongoing specific aspect of debate (da Rocha Ferreira et al 2021; Pellizzer et al 2021). With modern treatment philosophies aiming for minimally invasive treatment, the replacement especially of single, hopeless teeth by 1 implant each has clinically become a standard situation.…”

Section: Introductionmentioning

confidence: 99%

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Ten-Year Performance of Posterior 6-mm Implants with Single-Tooth Restorations: A Randomized Controlled Trial

et al. 2023

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The aim of the study was to compare the clinical and radiographic outcomes of short dental implants (6-mm test group, TG) to longer implants (10-mm control group, CG) with single crown restorations after 10 y of loading. Patients requiring single-tooth replacement in the posterior jaws were randomly assigned to TG or CG. Implants were loaded with screw-retained single crowns after a healing period of 10 wk. Follow-up appointments were scheduled yearly and comprised patient-adapted oral hygiene reinstructions and polishing of all teeth and implants. After 10 y, clinical and radiographical parameters were assessed again. Out of initially 94 patients (47 in TG and CG, each), 70 (36 TG and 34 CG) could be reassessed. Survival rates accounted for 85.7% (TG) and 97.1% (CG), without significant intergroup difference ( P = 0.072). All but 1 lost implant had been located in the lower jaw. These implants were not lost due to peri-implantitis but due to a late loss of osseointegration without signs of inflammation and with actually stable marginal bone levels (MBLs) over the investigation period. In general, MBLs were stable with medians (interquartile ranges) of 0.13 (0.78) mm and 0.08 (1.2) mm, for TG and CG, without significant intergroup differences. Crown-to-implant ratio showed a highly significant intergroup difference of 1.06 ± 0.18 mm and 0.73 ± 0.17 mm ( P < 0.001). Few technical complications (i.e., screw loosening or chipping) were registered during the investigation period. In conclusion, given stringent professional maintenance, short dental implants with single-crown restorations show a slightly worse but statistically not different survival rate after 10 y, especially in the lower jaw, but can still be considered a valuable alternative, especially when vertical bone dimensions are limited (German Clinical Trials Registry: DRKS00006290).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ten-Year Performance of Posterior 6-mm Implants with Single-Tooth Restorations: A Randomized Controlled Trial

et al. 2023

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“…However, this design efficiently transfers occlusal loading forces to the crestal module of the implant, and may present as a risk factor for implant fracture when combined with the thin walls of reduced diameter implants made from commercially pure titanium 47,48 . Crown to Implant ratio has been reviewed and was found to have no effect on the survival of the implant 49,50 . However loss of crestal bone around an implant has been shown to change the force distribution of the implant 47 .…”

Section: Implant Designmentioning

confidence: 99%

“…47,48 Crown to Implant ratio has been reviewed and was found to have no effect on the survival of the implant. 49,50 However loss of crestal bone around an implant has been shown to change the force distribution of the implant. 47 This change also shows increase of the levering effect to the implant which may increase the risk of implant fracture.…”

Section: Implant Fracturementioning

confidence: 99%

Implant prosthodontic design as a predisposing or precipitating factor for peri‐implant disease: A review

Hamilton

Putra

Nakapaksin

et al. 2023

Clin Implant Dent Rel Res

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Over the past decade, emerging evidence indicates a strong relationship between prosthetic design and peri‐implant tissue health. The objective of this narrative review was to evaluate the evidence for the corresponding implant prosthodontic design factors on the risk to peri‐implant tissue health. One of the most important factors to achieve an acceptable implant restorative design is the ideal implant position. Malpositioned implants often result in a restorative emergence profile at the implant‐abutment junction that can restrict the access for patients to perform adequate oral hygiene. Inadequate cleansability and poor oral hygiene has been reported as a precipitating factors to induce the peri‐implant mucositis and peri‐implantitis and are influenced by restorative contours. The implant–abutment connection, restorative material selection and restoration design are also reported in the literature as having the potential to influence peri‐implant sort tissue health.

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“…8,9 The most frequent mechanic complications in implant-supported prostheses include prosthetic screw loosening, abutment loss, and ceramic fracture or chipping, while the main biologic problems are peri-implant mucositis, peri-implantitis, and peri-implant soft and hard tissues deficiencies. 2,4,[10][11][12] Possible risk factors have been assessed for mechanic complications, biologic problems or both. For example, crown-to-implant (C/I) ratio has been related to peri-implant bone loss and prosthetic complications in short implants.…”

Section: Introductionmentioning

confidence: 99%

Long‐term clinical performance of short 6‐mm implants supporting single crowns in the posterior region: A 10‐year cohort study

Bregagnol,

Coltro,

Villarinho

et al. 2023

Clin Implant Dent Rel Res

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IntroductionLong‐term clinical success of non‐splinted, posterior, and short implants still is unclear. This prospective cohort study reports the 10‐year follow‐up of 6‐mm implants supporting single crowns in the posterior region, and patient‐reported outcomes.MethodsBaseline sample comprised 20 patients treated with 46 screw‐retained crowns supported by 6‐mm implants with moderately rough implant surface. Participants were recalled for a 10‐year clinical follow‐up to assess survival rates, biologic and mechanic conditions, quality of life (OHIP‐14), and treatment satisfaction. Data were collected with clinical‐radiographic exams and analyzed using descriptive and inferential statistics.ResultsFourteen patients with 35 implant‐crown units were examined after 127.6 ± 11.8 months. For the entire cohort period, 7/46 implants were lost (survival estimate: 77.7% at 133 months), and mechanic complications occurred in 14/46 units (survival estimate: 66.4% at 116 months). In the Cox models, “maximum occlusal force” had a significant effect for implant loss (p = 0.038) and for prosthetic screw loosening (p = 0.038); “arch” and “bruxism” were not significant. Peri‐implant bone loss was 0.4 ± 0.6 mm at 10 years. For peri‐implant bone level, “crown‐to‐implant ratio” (p < 0.001) and “time” (p = 0.001) were significant. Bone levels differed from baseline to 12, 48, and 120 months. Satisfaction VAS was 94.0 ± 7.9 mm and OHIP‐14 was 2.3 ± 2.2.ConclusionSingle screw‐retained crowns supported by 6‐mm implants have an acceptable long‐term clinical performance, with stable peri‐implant bone levels after 10 years of function.

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The influence of crown-to-implant ratio in single crowns on clinical outcomes: A systematic review and meta-analysis

Cited by 17 publications

References 25 publications

Ten-Year Performance of Posterior 6-mm Implants with Single-Tooth Restorations: A Randomized Controlled Trial

Ten-Year Performance of Posterior 6-mm Implants with Single-Tooth Restorations: A Randomized Controlled Trial

Implant prosthodontic design as a predisposing or precipitating factor for peri‐implant disease: A review

Long‐term clinical performance of short 6‐mm implants supporting single crowns in the posterior region: A 10‐year cohort study

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