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. 2025 Apr;20(2):1158-1167.
doi: 10.1016/j.jds.2025.01.020. Epub 2025 Feb 1.

Marginal bone level of dental implants using computer-aided design/computer-aided manufacturing customized abutment and prefabricated abutment-A five-year follow-up

Kuang-Chi Chao  1 , Eisner Salamanca  1 , Jerry Chin-Yi Lin  1   2 , Thu Ya Linn  1 , Ting-Yi Renn  1 , Ying-Sui Sun  3 , I-Hsin Lin  1   4 , Wei-Jen Chang  1   4
Affiliations

Marginal bone level of dental implants using computer-aided design/computer-aided manufacturing customized abutment and prefabricated abutment-A five-year follow-up

Kuang-Chi Chao et al. J Dent Sci. 2025 Apr.

Abstract

Background/purpose: Computer-aided design/computer-aided manufacturing (CAD/CAM) allows for the customization of implant abutments as an alternative to prefabricated options. The purpose of this study was to compare the marginal bone levels of dental implants using CAD/CAM customized abutments (CA) versus prefabricated abutments (PA) over a five-year follow-up period.

Materials and methods: Implants were divided into two groups based on abutment type: CA and PA. Marginal bone level (MBL), changes in MBL and bone-to-implant contact ratio (BIC), were assessed from baseline to 5 years post-prosthetics loading. Additionally, the study analyzed based on dental arches, opposing structure types, and the distance from implant platform to the cementoenamel junction of adjacent teeth (CEJ-PL).

Results: Overall, MBL increased significantly for all implants from baseline to 5 years. The CA group in the mandible showed significantly higher MBL compared to the PA group (0.98 ± 0.71 mm vs. 0.54 ± 0.55 mm). Implants opposed by fixed restorations (FRs) experienced significantly more MBL compared to those opposed by natural teeth (NT) after 5 years. Implants placed at a depth greater than 3 mm (CEJ-PL > 3 mm) exhibited significantly greater changes in MBL on the distal side after 5 years compared to those placed at a shallower depth (CEJ-PL ≤ 3 mm).

Conclusion: The MBL and changes in MBL showed similar trend between the CA and PA groups in the five-year follow-up. The CA group exhibited significantly more bone remodeling after one year, particularly for implants opposing FRs and those with a CEJ-PL distance exceeding 3 mm.

Keywords: CAD/CAM; Customized abutment; Five-year follow-up; Marginal bone level; Prefabricated abutment.

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Conflict of interest statement

The authors have no conflicts of interest relevant to this article.

Figures

Figure 1
Figure 1
(A) Timepoint of acquiring radiographs. 1Y: 1-year after loading, 3Y: 3-year after loading, 5Y: 5-year after loading. (B) Measurement parameters of radiographs. CEJ: cemento-enamel junction, PL: platform of implant, CEJ-PL: distance between the implant platform and the CEJ of adjacent teeth, a: marginal bone level on mesial side of implant, b: marginal bone level on distal side of implant.
Figure 2
Figure 2
MBL of CA and PA group (A) in maxilla and (B) in mandible. Changes in MBL of CA and PA group (C) in maxilla and (D) in mandible. MBL: marginal bone level, CA: customized abutment, PA: prefabricated abutment, 1y: 1-year after loading, 3y: 3-year after loading, 5y: 5-year after loading. (∗P < 0.05).
Figure 3
Figure 3
Comparison of implants with NT or FRs as opposing structures. (A) MBL, and (B) Changes in MBL of NT group and the FRs group. (C) MBL, and (D) Changes in MBL of CA group and the PA group in opposing NT. (E) MBL, and (F) Changes in MBL of CA group and the PA group in opposing FRs. MBL: marginal bone level, NT: natural teeth, FRs: fixed restorations, CA: customized abutment, PA: prefabricated abutment, 1y: 1-year after loading, 3y: 3-year after loading, 5y: 5-year after loading. (∗P < 0.05).
Figure 4
Figure 4
Comparison of CEJ-PL groups: >3 mm vs. ≤3 mm (A) distal MBL and (B) changes in MBL. MBL: marginal bone level, CEJ-PL: distance between the implant platform and the CEJ of adjacent teeth, 1y: 1-year after loading, 3y: 3-year after loading, 5y: 5-year after loading. (∗P < 0.05).
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