Soft tissue development around abutments with a circular macro-groove in healed sites of partially edentulous posterior maxillae and mandibles: a clinical pilot study.
ABSTRACT The aim of this study was to evaluate soft tissue development at concave circular macro-grooved titanium abutments in healed sites.
In a split-mouth pilot study 10 patients received two implants each at healed posterior sites in contralateral maxillary or mandibular jaw quadrants. Either circular macro-grooved concave study abutments or conventional convex control abutments were immediately provisionalized and received permanent crowns 3 months postimplantation. Marginal bone level, papilla index, modified plaque and bleeding index were recorded. The esthetic outcome was evaluated with standardized perpendicular pictures according to the Pink Esthetic Score (PES). Statistical analysis included the description of all variables by mean value, standard deviation and range. PES values were compared using the Wilcoxon signed rank test for paired data.
Cumulative survival rate for all 20 implants was 100%. At the 1-year follow-up, there was no statistical significant difference of marginal bone levels between sites restored with the study (-0.11 ± 0.77 mm) vs. the control (-0.34 ± 0.53 mm) abutments (P>0.05). Esthetic evaluation (PES) revealed statistically significant differences in scores between the study group [study abutment group] (7.2 ± 2.82, 8 ± 1.89) and the control group [control abutment group] (9.5 ± 1.58, 10.5 ± 1.72) at the time of prosthetic delivery and the 1-year follow-up. Whereas PES scores for mesial papilla at control sites at the 1-year follow-up demonstrated statistically significant higher values, both soft tissue level and soft tissue contour at control sites revealed statistically significantly higher PES values (P<0.05) at time of prosthetic delivery and at 1-year follow-up when compared with study sites.
Concave macro-grooved abutments in healed posterior maxillary and mandibular sites did not exhibit a superior soft tissue development compared with standard convex abutments.
- SourceAvailable from: Hua Hong (Ben) Chien[Show abstract] [Hide abstract]
ABSTRACT: Abstract The purpose of this study was to assess the effects of a modified implant abutment design on peri-implant soft and hard tissues in dogs. Three months after extraction of mandibular premolar teeth, 3 dental implants were placed in each side of the jaw, using a one-stage approach. Implants on one side of the mandible received standard abutments (controls; C), while contralateral side implants received modified, patented, grooved abutments (test, T). Two months after implant placement, animals were euthanized and specimens prepared for histological and histomorphometric assessment. The linear distance (in µm) from implant shoulder (IS) to the following landmarks was measured: gingival margin (GM; distance IS-GM), most apical position of junctional epithelium (JE; distance IS-JE), and bone crest (BC; distance IS-BC). Bone-to-implant contact (BIC; %) was also measured. Histological assessment revealed that all implants were osseointegrated and that inter-implant gingival fibers between T abutments appeared to be more numerous and organized, compared to C abutments. IS-GM and IS-JE in T implants were greater than corresponding distances in C implants (p=0.024 and p=0.015, respectively), while crestal bone loss (IS-BC) was greater for C implants than T implants (p=0.037). There were no differences between C and T implants in BIC (p=0.69), which averaged close to 50%. These results suggest that the modified groove design incorporated in standard abutments confers both soft and hard tissue benefits.Journal of Oral Implantology 01/2013; · 0.98 Impact Factor
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ABSTRACT: The aim of the current review was to systematically appraise the esthetic outcome of soft tissue around single implant crowns following type 1 and type 3 implants placement in published dental literature. A PubMed, Embase, and the Cochrane Central Register of Controlled Trials search up to March 2013 was conducted for articles published in the dental literature and limited to human trials with no language restricted. Furthermore, the reference lists of related articles were systematically screened, and additional manual searches were also performed. The primary outcome was pink esthetics score (PES). The electronic search in the database of PubMed, Embase, and the Cohrane Central Register of Controlled Trials resulted in the identification of 463 titles. These titles were initially screened by the two independent reviewers for possible inclusion. Screening the abstracts and titles led to 28 articles for future full-text consideration. From these articles, 18 studies were excluded. Manual search identified one article. After quality assessment, eight studies were included in this review. This review showed that no significant difference of PES index could be found between type 1 and type 3 implant placement. According to the current evidence, short-term esthetic outcomes of peri-implant soft tissue did not show significant difference following type 1 and type 3 implants placement with well-selected patients. However, caution should be taken for clinicians to extrapolate this result to all types of patients, as more randomized clinical trials are needed for long-term soft-tissue esthetic outcome in patients with high esthetic risk following type 1 implant placement. PES frequency, peri-implant condition and other risk factors for peri-implantitis are recommended to be reported for future studies.Clinical Oral Implants Research 01/2014; · 3.43 Impact Factor
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ABSTRACT: Objective The aim of this prospective study was to assess the esthetic outcome and alterations of peri-implant soft tissue using tissue-level implants. Furthermore, the influencing factors, including grafting and gingival biotype, of esthetic outcome of peri-implant soft tissue were also evaluated.Materials and methodsOf 38 patients with single missing anterior tooth in maxilla were treated with a Straumann ® Standard Plus SLA implant. Bone augmentation was performed in 24 patients. Follow-up was conducted at 12 and 24 months after definitive crowns placement. Esthetic outcome using the pink esthetic score/white esthetic score (PES/WES) and clinical parameters were evaluated.ResultsThe mean PES/WES value at baseline, 1-year, and 2-year examination was 13.79, 14.87, and 14.96. Significant improvement was found between baseline and 1-year examination (P < 0.01). And the improvement between 1-year and 2-year examination was not significant (P = 0.40). The mean PES changing value in patients with thick biotype was significantly higher than those with thin biotype at 2-year after definitive crowns placement (P = 0.03). Graft procedure had an unfavorable effect on mean PES value both at baseline and at follow-up (P < 0.01). No implants were lost at 2-year examination. Three patients experienced peri-implant infection. No significant difference was found with the passage of time in modified plaque index (mPI), probing pocket depth (PPD), and modified bleeding index (mBI).Conclusion According to the present prospective clinical study, it can be concluded that it is feasible to use tissue-level implant to support single crowns in esthetic area. Favorable short-term esthetic outcome and stability of soft tissue around single implant crowns can be expected in patients with or without graft. However, graft procedures might have an unfavorable effect on the esthetic outcome. Gingival biotype can be considered as prognostic factor for esthetic outcome. RCTs with long-term follow-up are needed to provide evidence for the long-term stability of peri-implant soft tissue using tissue-level implant systems.Clinical Oral Implants Research 04/2014; · 3.43 Impact Factor