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Predictors of inter-proximal and midfacial recession following single implant treatment in the anterior maxilla: a multivariate analysis

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Abstract
Purpose: A number of factors have been associated with soft tissue recession following single implant treatment. However, given the cross-sectional design of most of these studies and crude associations based on univariate analyses, such factors may only be considered risk indicators. The objective of the present retrospective cohort study using multivariate analyses was to identify predictors of recession. Material and methods: Patients who had been treated by two periodontists and two prosthodontists in 2006 and 2007 for a single implant in the anterior maxilla were re-examined in 2009 and their records were scrutinized. Subjects treated via flap surgery with and without ridge recontouring were considered. Outcome variables were interproximal and midfacial recession. Explanatory variables included demographic data, the surgical approach and a number of local factors that were evaluated on radiographs taken preoperatively or at permanent crown installation (baseline). Results: Data pertaining to 97/115 (60 females, 37 males; mean age 51, SD 13, range 23 - 80) patients were available for evaluation. Significant bone loss was observed between baseline and re-examination at the implant surface (0.2 – 0.3 mm, p < 0.001) and tooth surface (0.3 – 0.5 mm, p < 0.001). Surgery with ridge recontouring demonstrated 0.2 mm additional bone loss at the distal tooth surface when compared to surgery without ridge recontouring (p = 0.034). This could be explained by a disparity in possible papilla opening procedures (3 versus 1 or 2). As a result, regression analyses identified surgery with ridge recontouring as a predictor of interproximal recession (OR ≥ 3.4). Preoperative bone level at the tooth surface was another predictor of interproximal recession (OR ≥ 2.1). Recession of the distal papilla was also affected by a missing contact point (OR: 221.9), the implant to tooth distance (OR = 0.3) and the distance of the bone peak to the contact point (OR = 2.9). Midfacial recession was only associated with a buccal shoulder position (OR = 17.2). Conclusions: In order to optimize soft tissue levels around single implants, clinicians should limit papilla opening procedures and pay utmost attention to a correct implant and contact point positioning.
Keywords
BRANEMARK IMPLANTS, PATIENT SATISFACTION, CASE SERIES, IMMEDIATE, ADJACENT, AESTHETICS, RADIOGRAPHIC EVALUATION, TOOTH IMPLANTS, PRIVATE DENTAL PRACTICES, SOFT-TISSUE RESPONSE, single tooth, risk, recession, dental implant

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MLA
Cosyn, Jan, et al. “Predictors of Inter-Proximal and Midfacial Recession Following Single Implant Treatment in the Anterior Maxilla: A Multivariate Analysis.” JOURNAL OF CLINICAL PERIODONTOLOGY, vol. 39, no. 9, 2012, pp. 895–903, doi:10.1111/j.1600-051X.2012.01921.x.
APA
Cosyn, J., Moradi Sabzevar, M., & De Bruyn, H. (2012). Predictors of inter-proximal and midfacial recession following single implant treatment in the anterior maxilla: a multivariate analysis. JOURNAL OF CLINICAL PERIODONTOLOGY, 39(9), 895–903. https://doi.org/10.1111/j.1600-051X.2012.01921.x
Chicago author-date
Cosyn, Jan, Mehran Moradi Sabzevar, and Hugo De Bruyn. 2012. “Predictors of Inter-Proximal and Midfacial Recession Following Single Implant Treatment in the Anterior Maxilla: A Multivariate Analysis.” JOURNAL OF CLINICAL PERIODONTOLOGY 39 (9): 895–903. https://doi.org/10.1111/j.1600-051X.2012.01921.x.
Chicago author-date (all authors)
Cosyn, Jan, Mehran Moradi Sabzevar, and Hugo De Bruyn. 2012. “Predictors of Inter-Proximal and Midfacial Recession Following Single Implant Treatment in the Anterior Maxilla: A Multivariate Analysis.” JOURNAL OF CLINICAL PERIODONTOLOGY 39 (9): 895–903. doi:10.1111/j.1600-051X.2012.01921.x.
Vancouver
1.
Cosyn J, Moradi Sabzevar M, De Bruyn H. Predictors of inter-proximal and midfacial recession following single implant treatment in the anterior maxilla: a multivariate analysis. JOURNAL OF CLINICAL PERIODONTOLOGY. 2012;39(9):895–903.
IEEE
[1]
J. Cosyn, M. Moradi Sabzevar, and H. De Bruyn, “Predictors of inter-proximal and midfacial recession following single implant treatment in the anterior maxilla: a multivariate analysis,” JOURNAL OF CLINICAL PERIODONTOLOGY, vol. 39, no. 9, pp. 895–903, 2012.
@article{2111564,
  abstract     = {{Purpose: A number of factors have been associated with soft tissue recession following single implant treatment. However, given the cross-sectional design of most of these studies and crude associations based on univariate analyses, such factors may only be considered risk indicators. The objective of the present retrospective cohort study using multivariate analyses was to identify predictors of recession.
Material and methods: Patients who had been treated by two periodontists and two prosthodontists in 2006 and 2007 for a single implant in the anterior maxilla were re-examined in 2009 and their records were scrutinized. Subjects treated via flap surgery with and without ridge recontouring were considered. Outcome variables were interproximal and midfacial recession. Explanatory variables included demographic data, the surgical approach and a number of local factors that were evaluated on radiographs taken preoperatively or at permanent crown installation (baseline).
Results: Data pertaining to 97/115 (60 females, 37 males; mean age 51, SD 13, range 23 - 80) patients were available for evaluation. Significant bone loss was observed between baseline and re-examination at the implant surface (0.2 – 0.3 mm,  p < 0.001) and tooth surface (0.3 – 0.5 mm,  p < 0.001). Surgery with ridge recontouring demonstrated 0.2 mm additional bone loss at the distal tooth surface when compared to surgery without ridge recontouring (p = 0.034). This could be explained by a disparity in possible papilla opening procedures (3 versus 1 or 2). As a result, regression analyses identified surgery with ridge recontouring as a predictor of interproximal recession (OR ≥ 3.4). Preoperative bone level at the tooth surface was another predictor of interproximal recession (OR ≥ 2.1). Recession of the distal papilla was also affected by a missing contact point (OR: 221.9), the implant to tooth distance (OR = 0.3) and the distance of the bone peak to the contact point (OR = 2.9). Midfacial recession was only associated with a buccal shoulder position (OR = 17.2). 
Conclusions: In order to optimize soft tissue levels around single implants, clinicians should limit papilla opening procedures and pay utmost attention to a correct implant and contact point positioning.}},
  author       = {{Cosyn, Jan and Moradi Sabzevar, Mehran and De Bruyn, Hugo}},
  issn         = {{0303-6979}},
  journal      = {{JOURNAL OF CLINICAL PERIODONTOLOGY}},
  keywords     = {{BRANEMARK IMPLANTS,PATIENT SATISFACTION,CASE SERIES,IMMEDIATE,ADJACENT,AESTHETICS,RADIOGRAPHIC EVALUATION,TOOTH IMPLANTS,PRIVATE DENTAL PRACTICES,SOFT-TISSUE RESPONSE,single tooth,risk,recession,dental implant}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{895--903}},
  title        = {{Predictors of inter-proximal and midfacial recession following single implant treatment in the anterior maxilla: a multivariate analysis}},
  url          = {{http://dx.doi.org/10.1111/j.1600-051X.2012.01921.x}},
  volume       = {{39}},
  year         = {{2012}},
}

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