Abstract
BackgroundTo assess the influence of the crestal or subcrestal placement of implants upon peri-implant bone loss over 12 months of follow-up.Material and MethodsTwenty-six patients with a single hopeless tooth were recruited in the Oral Surgery Unit (Valencia University, Valencia, Spain). The patients were randomized into two treatment groups: group A (implants placed at crestal level) or group B (implants placed at subcrestal level). Control visits were conducted by a trained clinician at the time of implant placement and 12 months after loading. A previously established standard protocol was used to compile general data on all patients (sex and age, implant length and diameter, and brushing frequency). Implant success rate, peri-implant bone loss and the treatment of the exposed implant surface were studied. The level of statistical significance was defined as 5% (α=0.05).ResultsTwenty-three patients (8 males and 15 females, mean age 49.8±11.6 years, range 28-75 years) were included in the final data analyses, while three were excluded. All the included subjects were nonsmokers with a brushing frequency of up to twice a day in 85.7% of the cases. The 23 implants comprised 10 crestal implants and 13 subcrestal implants. After implant placement, the mean bone position with respect to the implant platform in group A was 0.0 mm versus 2.16±0.88 mm in group B. After 12 months of follow-up, the mean bone positions were -0.06±1.11 mm and 0.95±1.50 mm, respectively - this representing a bone loss of 0.06±1.11 mm in the case of the crestal implants and of 1.22±1.06 mm in the case of the subcrestal implants (p=0.014). Four crestal implants and 5 subcrestal implants presented peri-implant bone levels below the platform, leaving a mean exposed treated surface of 1.13 mm and 0.57 mm, respectively. The implant osseointegration success rate at 12 months was 100% in both groups.ConclusionsWithin the limitations of this study, bone loss was found to be greater in the case of the subcrestal implants, though from the clinical perspective these implants presented bone levels above the implant platform after 12 months of follow-up. Key words:Immediate implants, tooth extraction, dental implants, single-tooth, crestal bone, placement level.
Highlights
The connecting line between implant and abutment, the so-called microgap, has been intensely investigated during the last 10 years
Subcrestal implant placement has recently been associated to increased marginal bone loss [14], and Hammerle et al had already concluded that such an approach was not to be recommended [9]
The purpose of this study was to evaluate and compare the marginal bone loss and success of crestal and subcrestal implants rehabilitated with single crowns
Summary
The connecting line between implant and abutment, the so-called microgap, has been intensely investigated during the last 10 years. Subcrestal implant placement has recently been associated to increased marginal bone loss [14], and Hammerle et al had already concluded that such an approach was not to be recommended [9]. Such increased loss may be caused by bacterial colonization of the microgap present in the fixtureabutment junction [15]. The aim of this study was to assess the influence of the crestal or subcrestal placement of implants upon periimplant bone loss over 12 months of follow-up. To assess the influence of the crestal or subcrestal placement of implants upon peri-implant bone loss over 12 months of follow-up. Four crestal implants and 5 subcrestal implants presented peri-implant bone levels below the platform, leaving a mean exposed treated e103
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