ABSTRACT
Focused Clinical Question: The integration of connective tissue (CT) to a laser-ablated abutment with a microgrooved surface at the apical millimeter (LL) has been documented in both animal and human studies. How should the healing be influenced to optimize the CT integration on abutment surfaces? Summary: When smooth machined titanium (ST) abutments were placed, epithelial attachment was found on abutments, but no CT integration was noted. On LL abutments, a zone of epithelial attachment and CT integration was noted. When an ST abutment was switched for an LL abutment, the soft tissue was inconsistent; however, when an LL abutment was placed after the removal of a prior LL abutment, CT integration was observed. Conclusions: Consistent CT integration was observed on LL abutment surfaces after implant placement. Switching LL abutments with new LL abutments consistently led to CT integration. This was not consistent when an ST abutment was switched for an LL abutment. Plaque and gingival indices were comparable between teeth and abutments. Probing depth (PD) was lower around teeth. There was no difference in PD between abutments. CT integration on LL abutments was optimized by initial healing occurring on an LL abutment or by creation of a CT wound before insertion of the abutment.
ABSTRACT
Recent observations suggest that less bone loss may result from placing a more medialized abutment on an implant (platform switching). The objective of this study was to measure the radiographic crestal bone loss and biologic width around conventional and platform-switched implants. Implants were randomly assigned into conventional or switched categories within the same prosthesis. Twenty-five implants were placed and observed in the mandibles of 10 patients for 2 years. A regression analysis demonstrated a significant difference between groups (P < or = .0001). These findings suggest that less crestal bone loss occurs around a platform-switched dental implant versus a conventional implant.
