Adapting the vertical position of implants with a conical connection in relation to soft tissue thickness prevents early implant surface exposure: A 2‐year prospective intra‐subject comparison

• Published in: Journal of clinical periodontology Vol. 45; no. 5; pp. 605 - 612
• Main Authors: Vervaeke, Stijn, Matthys, Carine, Nassar, Rima, Christiaens, Veronique, Cosyn, Jan, De Bruyn, Hugo
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.05.2018
• Subjects: Adaptation, Physiological; Adult; Aged; Aged, 80 and over; Alveolar Process - diagnostic imaging; Alveolar Process - surgery; Bone implants; bone level; Bone remodeling; Bone Remodeling - physiology; dental implant; Dental Implantation, Endosseous - methods; Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure - statistics & numerical data; Female; Gingiva - diagnostic imaging; Gingiva - surgery; Humans; implant surface; Male; Mandible; Middle Aged; prevention; Prospective Studies; Radiography; soft tissue; Transplants & implants; Ultrasonography - methods; Ultrasound; soft tissue; bone level; implant surface; prevention; dental implant
• ISSN: 0303-6979; 1600-051X; 1600-051X
• DOI: 10.1111/jcpe.12871

Aim To evaluate the effect of soft tissue thickness on bone remodelling and to investigate whether implant surface exposure can be avoided by adapting the vertical implant position in relation to the soft tissue thickness. Materials and Methods Twenty‐five patients received two non‐splinted implants supporting an overdenture in the mandible. Soft tissue thickness was measured using bone sounding and ultrasonically. One implant was installed equicrestally (control), and the vertical position of the second implant was adapted to the site‐specific soft tissue thickness (test). Crestal bone levels were determined on digital peri‐apical radiographs and compared with baseline (implant placement). Results Twenty‐five patients were consecutively treated. No implants failed during the follow‐up. A significant correlation was observed between soft tissue thickness and bone level alterations after 6 months (ultrasound ICC = 0.610; bone sounding ICC = 0.641) with inferior bone levels for equicrestal implants when thin tissues are present. Subcrestal implants showed significantly better bone levels after 6‐month (n = 24, 0.04 mm versus 0.72 mm; p < .001), 1‐year (n = 24, 0.03 mm versus 0.77 mm; p < .001) and 2‐year follow‐up (n = 24, 0.04 mm versus 0.73 mm; p < .001). Conclusion Initial bone remodelling was affected by soft tissue thickness. Anticipating biologic width re‐establishment by adapting the vertical position of the implant seemed highly successful to avoid implant surface exposure.