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. 2020 Oct 16;9(10):3320.
doi: 10.3390/jcm9103320.

The Long-Term Effect of Adapting the Vertical Position of Implants on Peri-Implant Health: A 5-Year Intra-Subject Comparison in the Edentulous Mandible Including Oral Health-Related Quality of Life

Ron Doornewaard  1   2 , Hugo de Bruyn  1   2 , Carine Matthys  1 , Ewald Bronkhorst  2 , Stefan Vandeweghe  3 , Stijn Vervaeke  1
Affiliations

The Long-Term Effect of Adapting the Vertical Position of Implants on Peri-Implant Health: A 5-Year Intra-Subject Comparison in the Edentulous Mandible Including Oral Health-Related Quality of Life

Ron Doornewaard et al. J Clin Med. .

Abstract

Despite high success rates of dental implants, surface exposure may occur as a consequence of biologic width establishment associated with surgery. This prospective split-mouth study evaluated the effect of early implant surface exposure caused by initial bone remodeling on long-term peri-implant bone stability and peri-implant health. Additionally, Oral Health-Related Quality of Life (OHRQoL) was assessed by means of the Oral Health Impact Profile-14 (OHIP-14). Twenty-six patients received two non-splinted implants supporting an overdenture in the mandible by means of locators. One implant was installed equicrestally (control) and the second one was installed subcrestally, taking at least 3 mm soft tissue thickness into account (test). During initial bone remodeling (up to 6 months postoperatively), equicrestal placement yielded 0.68 mm additional surface exposure compared to subcrestal placement (p < 0.001). Afterwards, bone level and peri-implant health were comparable in both treatment conditions and stable up to 5 years. The implant overdenture improved OHRQoL (p < 0.01) and remained unchanged thereafter (p = 0.51). In conclusion, adapting the vertical position of the implant concerning the soft tissue thickness prevents early implant surface exposure caused by initial bone remodeling, but in a well-maintained population, this has no impact on long-term prognosis. The treatment of edentulousness with an implant mandibular overdenture improves OHRQoL.

Keywords: bone loss; dental implant; implant survival; oral health-related quality of life; overdenture; patient-reported outcome measures; peri-implantitis; soft tissue; split-mouth design.

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Conflict of interest statement

On behalf of the Ghent University, De Bruyn declares an educational and research collaboration agreement with Dentsply Implants at time of study initiation. The other authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Boxplots representing bone level at subsequent time points for the equicrestally (Group 1) and subcrestally placed implants (Group 2). * Outliers (≥3× IQR above third quartile), ° suspected outliers (between 1.5 and 3× Inter Quartile Range above third quartile).
Figure 2
Figure 2
Boxplots representing bone level change between 6 and 60 months for the equicrestally (Group 1) and subcrestally placed implants (group 2). ° Suspected outliers (between 1.5× IQR and 3× IQR above third quartile), a negative number is indicative for bone gain.
Figure 3
Figure 3
X-ray representing one and the same patients with the bone level directly after placement (A) and after 6 (B), 12 (C), 24 (D), 36 (E), 48 (F), and 60 (G) months for the equicrestally (Group 1) and subcrestally placed implants (Group 2).
See this image and copyright information in PMC

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