Biological Width around One- and Two-piece Implants: A Systematic Review

Abstract

The concept of biological width (BW) around dental implants is crucial for the long-term success of implant placement. This systematic review aimed to investigate the differences in BW around one- and two-piece dental implants and to assess the impact of implant design on peri-implant soft tissues. To compare biological width around one-piece and two-piece implant in a population undergone implant treatment. A comprehensive search of MEDLINE (via PubMed), EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, Web of Science, CINAHL, PsycINFO, and Google Scholar was conducted to identify studies that compared the BW around one- and two-piece dental implants. Eligibility criteria included published peer-reviewed studies that provided quantitative measurements of BW and related soft-tissue dimensions. Data extraction and synthesis were performed, and the findings were compared for consistency and relevance to the research question. The review included four studies that met the inclusion criteria. Two studies suggested that two-piece implants might lead to an adaptive change in BW and marginal bone levels over time. One study indicated that one-piece implants could maintain a BW and gingival margin position similar to that of natural teeth, while another found no significant long-term differences in soft-tissue volumetric stability between the one- and two-piece systems. The evidence pointed toward the microgap and implant design as influential factors in determining peri-implant soft-tissue dimensions. We found that implant design, particularly the presence of a microgap, plays a significant role in the establishment and maintenance of BW around dental implants. Two-piece implants may induce a greater adaptation in BW, whereas one-piece implants may better mimic the natural soft-tissue architecture. Long-term volumetric stability of the soft tissues appeared to be comparable between the two systems. These findings can inform clinical decision-making regarding the choice of implant systems for optimal soft-tissue health and integration.