Factors influencing the preservation of the periimplant marginal bone

Implant Dent. 2007 Jun;16(2):165-75. doi: 10.1097/ID.0b013e318065aa81.

Abstract

Esthetic outcomes cannot be attributed to a single parameter. Rather, as this article shows, they are the result of a number of important factors, especially in the esthetic zone. An understanding of the meaning of biologic width, of the integration of the platform-switching concept into implant treatment facilitates the preservation of a stable marginal bone level around the implant neck. This stable bone then serves to support the soft tissue, determining the long-term esthetic and functional treatment outcomes stability. The following points should be noted: (1) A prefabricated post that can be used both as a temporary post and as the definitive abutment helps to avoid a frequent replacement of secondary components, provided that the 3-dimensional position of the implant is correct. It prevents a repeated destruction of the connective-tissue attachment on the biologic width, which would carry with it the risk of bone resorption. (2) A special implant and abutment design (a ledge and integration of the biologic width/tapered shape of the post) facilitates nonsurgical lengthening and thickening of the periimplant soft tissue. This leads to the establishment of a wider and more resistant zone of connective tissue. (3) A microrough and nanorough titanium surface extending to the implant shoulder in conjunction with the platform-switching concept provides osseous integration along the entire length of the implant. A fine thread optimally distributes the masticatory forces in the region of the implant neck, avoiding further bone loss in this region.

MeSH terms

  • Alveolar Bone Loss / prevention & control*
  • Alveolar Process / diagnostic imaging
  • Alveolar Process / physiopathology*
  • Bite Force
  • Connective Tissue / pathology
  • Dental Abutments
  • Dental Implantation, Endosseous / methods*
  • Dental Implants*
  • Dental Materials / chemistry
  • Dental Prosthesis Design*
  • Esthetics, Dental
  • Gingiva / pathology
  • Humans
  • Osseointegration / physiology
  • Radiography
  • Stress, Mechanical
  • Surface Properties
  • Titanium / chemistry
  • Treatment Outcome

Substances

  • Dental Implants
  • Dental Materials
  • Titanium