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Clin Oral Investig. 2018 Mar;22(2):555-570. doi: 10.1007/s00784-017-2301-1. Epub 2018 Jan 8.

Influence of subcrestal implant placement compared with equicrestal position on the peri-implant hard and soft tissues around platform-switched implants: a systematic review and meta-analysis.

Author information

1
Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, 08195, Sant Cugat del Vallès, Barcelona, Spain. cristinavallveg@uic.es.
2
Department of Oral Surgery, Universitat Internacional de Catalunya, Barcelona, Spain.
3
Department of Periodontology, Università Vita-Salute San Raffaele, Milan, Italy.
4
Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, 08195, Sant Cugat del Vallès, Barcelona, Spain.

Abstract

AIM:

The aim of this article is to systematically review the effect of subcrestal implant placement compared with equicrestal position on hard and soft tissues around dental implants with platform switch.

MATERIAL AND METHODS:

A manual and electronic search (National Library of Medicine and Cochrane Central Register of Controlled Trials) was performed for animal and human studies published up to December 2016. Primary outcome variable was marginal bone level (MBL) and secondary outcomes were crestal bone level (CBL), soft tissue dimensions (barrier epithelium, connective tissue, and peri-implant mucosa), and changes in the position of soft tissue margin. For primary and secondary outcomes, data reporting mean values and standard deviations of each study were extracted and weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated.

RESULTS:

A total of 14 publications were included (7 human studies and 7 animal investigations). The results from the meta-analyses have shown that subcrestal implants, when compared with implants placed in an equicrestal position, exhibited less MBL changes (human studies: WMD = - 0.18 mm; 95% CI = - 1.31 to 0.95; P = 0.75; animal studies: WMD = - 0.45 mm; 95% CI = - 0.66 to - 0.24; P < 0.001). Furthermore, the CBL was located at a more coronal position in subcrestal implants with respect to the implant shoulder (WMD = - 1.09 mm; 95% CI = - 1.43 to - 0.75; P < 0.001). The dimensions of the peri-implant mucosa seem to be affected by the positioning of the microgap and were greater at implants placed in a subcrestal position than those inserted equicrestally (WMD = 0.60 mm; 95% CI = 0.26 to 0.95; P < 0.001). While the length of the barrier epithelium was significantly greater in implants placed in a subcrestal position (WMD = 0.39 mm; 95% CI = 0.19 to 0.58; P < 0.001), no statistical significant differences were observed between equicrestal and subcrestal implant positioning for the connective tissue length (WMD = 0.17 mm; 95% CI = - 0.03 to 0.36; P = 0.10).

CONCLUSION:

This systematic review suggests that PS implants placed in a subcrestal position have less MBL changes when compared with implants placed equicrestally. Furthermore, the location of the microgap seems to have an influence on the dimensions of peri-implant soft tissues. Clinical relevance When compared with PS placed in an equicrestal position, subcrestal implant positioning demonstrated less peri-implant bone remodeling.

KEYWORDS:

Dental implants; Insertion depth; Marginal bone level; Platform  switch; Vertical implant position

PMID:
29313133
DOI:
10.1007/s00784-017-2301-1
[Indexed for MEDLINE]

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