Laser microgrooved vs. machined healing abutment disconnection/reconnection: a comparative clinical, radiographical and biochemical study with split-mouth design

Abstract

Background: Repeated removal and replacement of healing abutments result in frequent injuries to the soft tissues.

Purpose: The purpose of this study was to evaluate the effect of disconnection/reconnection of laser microgrooved vs. machined healing and prosthetic abutments on clinical periodontal parameters, marginal bone levels, and proinflammatory cytokine levels around dental implants.

Material and methods: Twenty-four patients each received 2 implants with one-stage protocol in a split-mouth design on the same jaw. In each patient, one healing and prosthetic abutments with a laser microgrooved surface (LMS group) and one healing and prosthetic abutments with machined surface (MS group) were used. Four months following implant placement (T0), the healing abutments were disconnnected and reconnected three times to carry out the impression procedures and metal framework try-in. Four weeks later (T1), definitive prosthetic abutments were installated with screw-retained crowns. Modified plaque index (mPI), modified gingival index (mGI) bleeding on probing (BOP), and probing depth (PD) were recorded at T0 and T1. At the same time points, samples for immunological analyses were taken from the sulcus around each implant. Peri-implant crevicular fluid (PICF) samples were analyzed for interleukin-1beta (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor (TNF)-α levels using the ELISA kit.

Results: At T0 and T1, mPI and mGI showed no statistical difference between the two groups, while higher PD and BoP values were noted for the MS group (P < 0.05). The mean PICF volume and mean concentrations of IL-1β, IL-6, and (TNF)-α in the LMS group were statistically less than those in the MS group (P < 0.05). In addition, comparison of IL-6 and IL-1β mean concentrations at T0 and T1 in the MS group showed a statistically significant increase (p < 0.05) over time, which was not noted for the LMS.

Conclusion: Disconnection/reconnection of healing and prosthetic abutments with a laser-microgrooved surface resulted in less inflammatory molecular response compared with conventional machined ones.

Trial registration: ClinicalTrials.gov NCT04415801 , registered 03/06/2020.

Keywords: Abutments; Cytokines; Inflammation; Peri-implant crevicular fluid.

Fig. 1

Overview of the study outline and follow-up visits

Fig. 2

Mean mPI and mGI values recorded around LMS and MS abutments during the study period

Fig. 3

Mean BoP and PD values recorded around LMS and MS abutments during the study period

Fig 4

Mean values of PICF (μl) detected in the LMS and MS groups

Fig. 5

Mean levels of interleukin 1β (pg/mL) detected in the LMS and MS groups

Fig. 6

Comparison of the level of interleukin IL-6 (pg/mL) detected in the LMS and MS groups

Fig. 7

Comparison of the level of tumor necrosis factor (TNF)-α (pg/mL) detected in LMS and MS