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. 2026 Jan;37(1):69-78.
doi: 10.1111/clr.70053. Epub 2025 Oct 4.

Impact of Marginal Misfit in Implant-Supported Fixed Dental Prostheses on Peri-Implant Bone Levels: A Retrospective Quantitative Analysis

Emilio Couso-Queiruga  1 , Christoph A Ramseier  2 , Vivianne Chappuis  2 , Simone F M Janner M  1 , Daniel Buser  1 , Urs Brägger  3 , Giovanni E Salvi  2
Affiliations

Impact of Marginal Misfit in Implant-Supported Fixed Dental Prostheses on Peri-Implant Bone Levels: A Retrospective Quantitative Analysis

Emilio Couso-Queiruga et al. Clin Oral Implants Res. 2026 Jan.

Abstract

Objectives: To evaluate the impact of the marginal fit of implant-supported prostheses (ISP) on peri-implant bone levels. Additionally, the study aimed to determine a clinically relevant threshold for the radiographic vertical misfit gap at the ISP, when present, and to identify potential risk factors associated with changes in bone levels.

Methods: This study involved subjects who received ISPs for tooth replacement therapy. Standardized intraoral periapical radiographs were taken 10 years after loading to assess the radiographic distance between the implant shoulder and the most coronal point of crestal bone (DIB). ISP marginal gaps were categorized as no gap or gap, with vertical dimensions categorized as 0 mm, > 0- < 0.1 mm, and ≥ 0.1 mm. A multivariable linear mixed-effect model was applied to control for potential confounders.

Results: A total of 301 patients and 505 implants with a 10.6 ± 0.7 years follow-up were analyzed. ISPs without gaps exhibited statistically significantly lower DIB values (3.22 ± 0.8 mm) than those with gaps (3.43 ± 0.6 mm; p = 0.001). Gaps ≥ 0.1 mm were associated with statistically significantly higher DIB values (3.45 ± 0.7 mm; p = 0.001) compared with gaps between > 0 and < 0.1 mm (3.36 ± 0.5 mm; p = 0.001), or no gaps (3.22 ± 0.7 mm; p = 0.001). Each increment of 0.1 mm in the vertical crestal gap corresponded to a significant increase in DIB values (0.08 mm; p = 0.03). Finally, smoking and a history of periodontitis were independent risk factors for increased DIB.

Conclusions: Marginal misfit of ISP affects peri-implant bone stability, with gaps ≥ 0.1 mm linked to higher DIB. Smoking and periodontitis are independent risk factors for increased DIB.

Keywords: bone resorption; dental digital radiography; dental implants; implant shoulder bone distance; implant‐supported prostheses; outcome assessment.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
A clinical case illustrating a radiographic misfit of the implant‐supported prosthesis and peri‐implant marginal mucosal dehiscence, exposing the implant surface.
FIGURE 2
FIGURE 2
Data representation of implant distribution and causes of tooth loss. (A) Bar chart showing the number of implants placed across various locations. (B) Pie chart displaying the etiological causes for tooth loss in the study group.
FIGURE 3
FIGURE 3
Graphical analysis of gap distribution in relation to the number and locations of dental implants.
See this image and copyright information in PMC

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