Impact of implant-abutment connection, positioning of the machined collar/microgap, and platform switching on crestal bone level changes. Camlog Foundation Consensus Report

Abstract

Objectives: The aim of this consensus meeting was to assess the impact of implant-abutment connection, positioning of the machined collar/microgap, and platform switching on crestal bone level changes.

Materials and methods: Two comprehensive systematic reviews were prepared in advance of the meeting. Consensus statements, practical recommendations, and implications for future research were based on within group as well as plenary scrutinization and discussions of these systematic reviews.

Results: Placing the smooth part of the implant below the alveolar crest may lead to bone loss. Despite a more pronounced bone remodeling, the subcrestal positioning of the microgap may help to retain the bony coverage of the rough surface. Crestal bone remodeling has been observed for either internal and external, or conical and butt-joint connections. There was a trend favoring the platform switching concept to prevent or minimize peri-implant marginal bone loss.

Conclusions: Future research should consider an uniform and comparable study design, either excluding or exactly documenting possible confounding factors.

Keywords: crestal bone level; titanium implants.

Figure 1

Members of working group. (a) Insertion depth/Implant–abutment connection. Chairperson: Gil Alcoforado. Secretaries: Katja Nelson, Alex Schär. Rapporteur: Frank Schwarz. Participants: Luis Aracil, Thomas Barth, Alfonso Baruffaldi, Jürgen Becker, Stephan Beuer, Claudio Cacaci, Wong Chanchai, Luca Cordaro, Laszlo Csato, Ben Derksen, Rolf Ewers, Manuel Gómez, Hans-Jürgen Hartmann, Helfried Hulla, Peter Hunt, Gerhard Iglhaut, Attila Kámán, Martin Keweloh, Alfons Kiener, Axel Kirsch, Henning Lehmann Bastian, Carlo Maiorana, Piotr Majewski, Ralf Masur, Timothy Patrick McVaney, Andreas Meschenmoser, Werner Millesi, Eric Normand, Toshiyuki Oshima, Frank Palm, Torsten E. Reichert, Lutz Ricken, Robert Sader, José Vincente Sanz, Georg Christoph Scheiderbauer, Alexander Schramm, Vojtech Slezacek, Ralf Smeets, Andres Stricker, Hendrik Terheyden, Wilfried Wagner, Fumihiko Watanabe, Daniel Wismeijer, Manfred Wolf. (b) Platform switching. Chairperson: Thomas Taylor. Secretary: Florian Beuer. Rapporteur: Frank Peter Strietzel. Participants: Karl-Ludwig Ackermann, Rodrigo Andrés Garcia, Isaac Angel, Mario Beretta, Sven Marcus Beschnidt, Sergio de Paoli, Kerem Dedeoglu, Antoine Diss, Fernando Guerra, Christian Hammächer, Arndt Happe, Frederic Hermann, Detlef Hildebrand, András Huszák, Matthias Kern, Gerald Krennmair, Yasemin Kulak Ozkan, Jan Märkle, Marc Mongeot, Gerhard Neuendorff, Selim Pamuk, Françoise Peters, Mariano Sanz Alonso, Paul Sipos, Michael Stimmelmayr, Maciej Stupka, Peter Thoolen, Carsten Urbild, Pieter van Elsas, Stefan Wolfart.