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      Volumetric variation of peri-implant soft tissues in convergent collar implants and crowns using the biologically oriented preparation technique (BOPT)

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          Abstract

          Background

          To evaluate the changes in the peri-implant soft tissues of convergent collar implants with biologically oriented preparation technique (BOPT) crowns, 10 months after loading.

          Material and Methods

          A pilot study was carried out from January 2016 to October 2017 involving 14 patients with one or two implants in the posterior mandibular sector. A total of 32 convergent collar implants were placed using a non-submerged protocol. Three months later the provisional cemented crowns were fitted using the BOPT approach with the finish line 1-1.5 mm below the gingival margin, simulating coronal emergence of a natural tooth. The soft tissue changes were measured with an intraoral scanner at two different timepoints: a) on the day of provisionalization, before prosthetic loading; and b) 10 months later without the provisional prosthesis. The STL files were superimposed and the soft tissue changes were recorded using a color scale with measurement of the volumetric changes in mm3.

          Results

          A mean increase in peri-implant mucosal volume of 64.7 mm3 was observed in 29 implants. The zones with the greatest increase in soft tissue volume were the papillae of implants with adjacent teeth and the peri-implant buccal margin. Three implants showed a mean decrease in soft tissue volume of -25.1 mm3.

          Conclusions

          The fitting and design of crowns using the biologically oriented preparation technique (BOPT) over convergent collar implants affords a significant increase in peri-implant soft tissue volume both at the level of the papillae and in the buccal margin.

          Key words:Dental implants, one-piece dental implants, convergent collar implants, soft tissue volume, peri-implant mucosa, BOPT, vertical preparation, shoulderless abutments, emergence profile, intraoral scanner, profilometric analysis.

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          Most cited references 28

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          Tissue integration of non-submerged implants. 1-year results of a prospective study with 100 ITI hollow-cylinder and hollow-screw implants.

          It has been postulated that the wound healing in a closed submerged location is one of the prerequisites for osseointegration of dental implants. The purpose of the present study was to evaluate the tissue integration of intentionally non-submerged titanium implants inserted by a one-stage surgical procedure. 100 ITI implants were consecutively placed in 70 partially edentulous patients. After a healing period free of masticatory loading for at least 3 months, the implants were examined. The clinical status showed for all implants neither detectable mobility nor signs of a peri-implant infection. Therefore, prosthetic abutments were inserted, and the patients were restored with fixed partial dentures. All patients were regularly recalled at 3-month intervals, and no patient dropped out of the study. Thus, all 100 implants were re-evaluated 12 months following implantation. Plaque- and sulcus bleeding indices, probing depth, clinical attachment level, width of keratinized mucosa, and periotest scores were assessed. In addition, standardized radiographs were analyzed for the presence of peri-implant radiolucencies and for the location of alveolar bone levels around the implants. Based on predefined criteria, the implants were classified as successful or failing. 98 implants were considered successful, and 1 implant failing. The remaining implant exhibited a peri-implant infection requiring local and systemic antimicrobial treatment. The results of this short-term study indicate that intentionally non-submerged ITI implants yield a high predictability for successful tissue integration.
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            Platform switching and marginal bone-level alterations: the results of a randomized-controlled trial.

            This randomized-controlled trial aimed to evaluate marginal bone level alterations at implants restored according to the platform-switching concept, using different implant/abutment mismatching. Eighty implants were divided according to the platform diameter in four groups: 3.8 mm (control), 4.3 mm (test group(1)), 4.8 mm (test group(2)) and 5.5 mm (test group(3)), and randomly placed in the posterior maxilla of 31 patients. After 3 months, implants were connected to a 3.8-mm-diameter abutment and final restorations were performed. Radiographic bone height was measured by two independent examiners at the time of implant placement (baseline), and after 9, 15, 21 and 33 months. After 21 months, all 80 implants were clinically osseointegrated in the 31 patients treated. A total of 69 implants were available for analysis, as 11 implants had to be excluded from the study due to early unintentional cover screw exposure. Radiographic evaluation showed a mean bone loss of 0.99 mm (SD = 0.42 mm) for test group(1), 0.82 mm (SD = 0.36 mm) for test group(2) and 0.56 mm (SD = 0.31 mm) for test group(3). These values were statistically significantly lower (P<0.005) compared with control (1.49 mm, SD = 0.54 mm). After 33 months, five patients were lost to follow-up. Evaluation of the remaining 60 implants showed no difference compared with 21 months data except for test group(2) (0.87 mm) and test group(3) (0.64 mm). There was an inverse correlation between the extent of mismatching and the amount of bone loss. This study suggested that marginal bone level alterations could be related to the extent of implant/abutment mismatching. Marginal bone levels were better maintained at implants restored according to the platform-switching concept.
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              • Record: found
              • Abstract: not found
              • Article: not found

              The effect of material characteristics, of surface topography and of implant components and connections on soft tissue integration: a literature review.

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                Author and article information

                Journal
                Med Oral Patol Oral Cir Bucal
                Med Oral Patol Oral Cir Bucal
                Medicina Oral S.L.
                Medicina Oral, Patología Oral y Cirugía Bucal
                Medicina Oral S.L.
                1698-4447
                1698-6946
                September 2019
                18 August 2019
                : 24
                : 5
                : e643-e651
                Affiliations
                [1 ]MD, DDS, MS, PhD. Collaborating Professor of the Master of Oral Surgery and Implantology. Valencia University Medical and Dental School. Valencia, Spain
                [2 ]DDS, MS, PhD. Assistant Professor of Dental Materials. Valencia University Medical and Dental School. Valencia, Spain
                [3 ]DDS, MS, PhD. Collaborating Professor and Doctor of Oral Surgery. Valencia University Medical and Dental School. Valencia, Spain. Investigator of the Patología y Terapéutica Odontológica y Maxilofacial group of the Instituto de Investigación Biomédica de Bellvitge (IDIBELL). Barcelona, Spain
                [4 ]DDS, MS, PhD. Collaborating Professor and Doctor of Oral Surgery. Valencia University Medical and Dental School. Valencia, Spain
                [5 ]DDS. Resident of the Master of Oral Surgery and Implantology. Valencia University Medical and Dental School. Valencia, Spain
                [6 ]DDS, MS, PhD. Assistant Professor of Oral Surgery. Valencia University Medical and Dental School. Valencia, Spain. Investigator of the Patología y Terapéutica Odontológica y Maxilofacial group of the Instituto de Investigación Biomédica de Bellvitge (IDIBELL). Barcelona, Spain
                Author notes
                Departamento de Estomatología Universitat de València C/ Gascó Oliag 1, 46010 – Valencia (Spain) , E-mail: david.penarrocha@ 123456uv.es

                Conflict of interest statement:The authors declare that they have no conflicts of interest. The implants and abutments were supplied by Sweden-Martina for conduction of the study.

                Article
                22946
                10.4317/medoral.22946
                6764706
                31422410
                Copyright: © 2019 Medicina Oral S.L.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Categories
                Research
                Oral Surgery

                Surgery

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