One-Abutment at One-Time in Posterior Edentulism: A Systematic Review and Meta-Analysis.

Abstract

The objective of this systematic review and meta-analysis was to investigate the clinical significance of one-abutment at one-time protocol in healed posterior edentulism. An online search was undertaken in November 2022, which included PubMed, Cochrane Library, Wiley Online Library, and Google Scholar in addition to manual searching. The Cochrane Collaboration tool was performed to assess the quality of selected articles. Marginal bone loss (MBL) was estimated by the performance of meta-analysis. Moreover, all the pooled analyses were based on random-effect models. Subgroup analysis was applied to evaluate the effects of different variables. In line with the inclusion criteria, 6 trials with 446 dental implants were identified. The meta-analysis showed a total of 0.22mm less MBL within 6 months and decreased by 0.30mm at 1-year follow-up in favor of one-abutment at one-time protocol. A significant loss MBL was found in implants placed equicrestally using one-abutment at one-time protocol [6 months: mean difference (MD): -0.22mm; 95% CI, -0.34 to 0.10mm, P =0.0004; 12 months: MD: -0.32mm; 95% CI, -0.40 to -0.24mm, P <0.00001), whereas no difference was found between 2 groups in an implant placed subscrestally (6 months: MD: 0.14mm; 95% CI, -0.03 to 0.22mm; P =0.11; 12 months: MD: -0.12mm; 95% CI, -0.32 to 0.08mm; P =0.23). Implant platform position might greatly affect the marginal bone level. Moreover, one-abutment at one-time protocol demonstrated better bone preservation in implants placed equicrestally in healed posterior edentulism. This study highlights the significant clinical application of one-abutment at one-time protocol in healed posterior edentulism.