The One Abutment–One Time Protocol: A Systematic Review and Meta‐Analysis

Objectives The aim was to evaluate the peri‐implant tissue levels over a 1‐year period for implants connected to either convex or concave final abutments at the time of implant placement. Materials and Methods In this randomized, double masked, controlled clinical study, twenty‐eight patients with one missing maxillary premolar were allocated to receive one single implant with abutment of either convex (CX Group) or concave (CV Group) emergence shape. A block randomization sequence was used to allocate treatments. Opaque sealed randomization envelopes were used for allocation concealment. All implants received final abutments and interim crowns at implant placement and permanent crowns following 3 months. Clinical and radiographic data were collected at the time of implant placement (IP), final prosthesis delivery (PR), and 12 months following implant placement (FU‐1). Results One patient from the CX Group (n = 13) dropped out from the study and for one patient from CV Group (n = 13), the implant failed to integrate. The mean change in peri‐implant buccal mucosa position (MP) from IP to FU‐1 was −0.76 ± 0.72 mm for CX Group and −0.69 ± 0.89 mm for CV Group (p = 0.8). The amount of bone remodeling above the implant platform from IP to FU‐1 was −0.66 ± 0.46 mm for the CX Group and −0.24 ± 0.25 mm for the CV Group (p = 0.007). Buccal bone thickness was significantly correlated with the amount of buccal MP change from IP to FU‐1 (r = 0.4, p = 0.038). Conclusion The study failed to support the hypothesis that abutment macro‐design has an effect on peri‐implant mucosa margin position changes over time.

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The influence of abutment macro‐design on clinical and radiographic peri‐implant tissue changes for guided, placed, and restored implants: A 1‐year randomized controlled trial

Koutouzis

Adeinat

Ali

2019

“…Recent reviews on the effect of definitive abutments connection at time of implant placement provide improved results in terms of MBL changes when comparing the consecutive reconnection of provisional abutments (Atieh, Tawse‐Smith, Alsabeeha, Ma, & Duncan, ; Koutouzis, Gholami, Reynolds, Lundgren, & Kotsakis, ). The theory that abutment handling in early phases may lead to the apical reorganization of the biologic width components, disrupting the established mucosal seal, was reported by Becker, Mihatovic, Golubovic, and Schwarz ().…”

Section: Discussionmentioning

confidence: 99%

Influence of the abutment height and connection timing in early peri‐implant marginal bone changes: A prospective randomized clinical trial

Borges

Leitão

Pereira

et al. 2018

Aim The aim of this study was to compare the influence of the abutment height and insertion timing on early marginal bone loss (MBL) in posterior mandibular partial implant‐supported restorations. Material and methods The study was planned as a prospective, randomized, controlled parallel group including subjects in need of at least two implants for the restoration of an edentulous posterior mandibular area. The patients were allocated into Groups A (implants immediately connected to 2‐mm height abutments), B (immediately connected 1‐mm height abutments), and C (2‐mm abutments were inserted in a second‐stage surgery). Each subject was placed in a 1‐year follow‐up program, including examination assessment of various soft tissue and bone‐level parameters. Results A total of thirty‐three patients, including sixty‐eight implants, were enrolled in this study. One implant was lost on group C after the first month of healing. A mean MBL change of 0.719 ± 0.361, 0.651 ± 0.379, and 0.754 ± 0.672 mm was computed for groups A, B, and C, respectively, with no significant differences found. The early MBL at T1 was an independent predictor variable for the marginal bone alterations that were assessed at T3 (p < 0.001). Conclusion The first‐month MBL variation is a predictor factor of the bone alterations that might occur after 1 year of treatment. The early connection of final prosthetic abutments with distinct heights does not seem to reduce the 1‐year MBL rate when compared with traditional treatment protocols.

“…The "one abutment-one time" protocol (use of one definitive abutment at the time of implant placement) was introduced to overcome potential sequalae of repeated changes of a cover screw or provisional abutments (Canullo, Bignozzi, Cocchetto, Cristalli, & Iannello, 2010;Degidi, Nardi, & Piattelli, 2011). However, a systematic review on this topic concluded that despite the potential benefits of this approach on marginal bone level changes, its clinical significance remains uncertain (Atieh, Tawse-Smith, Alsabeeha, Ma, & Duncan, 2017).…”

Section: Introductionmentioning

confidence: 99%

Effect of different implant placement depths on crestal bone levels and soft tissue behavior: A 5‐year randomized clinical trial

Siqueira

Fontão²,

Sartori³

et al. 2020

Objectives This randomized clinical trial analyzed the long‐term (5‐year) crestal bone changes and soft tissue dimensions surrounding implants with an internal tapered connection placed in the anterior mandibular region at different depths (equi‐ and subcrestal). Materials and methods Eleven edentulous patients were randomly divided in a split‐mouth design: 28 equicrestal implants (G1) and 27 subcrestal (1–3 mm) implants (G2). Five implants were placed per patient. All implants were immediately loaded. Standardized intraoral radiographs were used to evaluate crestal bone (CB) changes. Patients were assessed immediately, 4, 8, and 60 months after implant placement. The correlation between vertical mucosal thickness (VMT) and soft tissue recession was analyzed. Sub‐group analysis was also performed to evaluate the correlation between VMT and CB loss. Rank‐based ANOVA was used for comparison between groups (α = .05). Results Fifty‐five implants (G1 = 28 and G2 = 27) were assessed. Implant and prosthetic survival rate were 100%. Subcrestal positioning resulted in less CB loss (−0.80 mm) when compared to equicrestal position (−0.99 mm), although the difference was not statistically significant (p > .05). Significant CB loss was found within the G1 and G2 groups at two different measurement times (T4 and T60) (p < .05). Implant placement depths and VMT had no effect on soft tissue recession (p > .05). Conclusions There was no statistically significant difference in CB changes between subcrestal and equicrestal implant positioning; however, subcrestal position resulted in higher bone levels. Neither mucosal recession nor vertical mucosa thickness was influenced by different implant placement depths.