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The influence of initial soft tissue thickness on peri-implant bone remodeling

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Abstract
Aim : To elucidate the influence of initial soft tissue thickness on peri-implant bone remodeling. The research hypothesis was that implants installed in patients or at sites with thin mucosal tissues would show increased peri-implant bone loss. Material and Methods : 79 edentulous patients were consecutively treated with two non-splinted implants supporting an overdenture in the mandible. During recall-visits, peri-implant health was determined by means of probing pocket depth and the modified plaque/bleeding index. Digital peri-apical radiographs were taken from individual implants. Bone level changes were measured from a reference point (lower border of the smooth implant collar) to the marginal bone-to-implant contact level. The linear mixed-effect model analysis was adopted to analyze the influence of clinical parameters and transmucosal abutment height on peri-implant bone loss. Results : 67 patients attended the 1-year and 66 the 2-year recall-visit. Mean bone level changes were 0.89 mm (SD 0.62) and 0.90 mm (SD 0.66), plaque scores 0.82 (SD 0.94) and 0.87 (SD 0.92), bleeding scores 0.46 (SD 0.68) and 0.56 (SD 0.72) and PPD 1.65 mm (SD 0.60) and 1.78 mm (SD 0.59) after 1 year and 2 years respectively. The linear mixed-effect model revealed increasing bone level changes with decreasing abutment heights. Peri-implant bone level changes were significantly higher for implants with abutments of <2 mm (1.17 mm, p < .01; 1.23 mm, p < .01), 2 mm (0.86 mm, p < .01; 1.03 mm, p < .01) or 3 mm (0.38 mm, p = .046; 0.41 mm, p = .044) compared to >= 4 mm-abutments (bone level changes set to zero as reference value) both after 1 year and 2 years and bone level changes were significantly influenced by probing pocket depth (p < .01, p < .01), but not by plaque (p = .31, p = .09) and bleeding scores (p = .30, p = .40). Conclusion : The present study suggests that implants with lower abutments, reflecting the initial gingival thickness, lose more peri-implant bone, possibly by a re-establishment of the biological width.
Keywords
biologic width, peri-implant bone loss, dental implant, soft tissue, overdenture, SINGLE-TOOTH REPLACEMENTS, TIOBLAST DENTAL IMPLANTS, TITANIUM IMPLANTS, GINGIVA, DIMENSIONS, STABILITY, JUNCTION, ABSENCE, PAPILLA, TEETH

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MLA
Vervaeke, Stijn, et al. “The Influence of Initial Soft Tissue Thickness on Peri-Implant Bone Remodeling.” CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, vol. 16, no. 2, 2014, pp. 238–47, doi:10.1111/j.1708-8208.2012.00474.x.
APA
Vervaeke, S., Dierens, M., Besseler, J., & De Bruyn, H. (2014). The influence of initial soft tissue thickness on peri-implant bone remodeling. CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, 16(2), 238–247. https://doi.org/10.1111/j.1708-8208.2012.00474.x
Chicago author-date
Vervaeke, Stijn, Melissa Dierens, Jos Besseler, and Hugo De Bruyn. 2014. “The Influence of Initial Soft Tissue Thickness on Peri-Implant Bone Remodeling.” CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH 16 (2): 238–47. https://doi.org/10.1111/j.1708-8208.2012.00474.x.
Chicago author-date (all authors)
Vervaeke, Stijn, Melissa Dierens, Jos Besseler, and Hugo De Bruyn. 2014. “The Influence of Initial Soft Tissue Thickness on Peri-Implant Bone Remodeling.” CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH 16 (2): 238–247. doi:10.1111/j.1708-8208.2012.00474.x.
Vancouver
1.
Vervaeke S, Dierens M, Besseler J, De Bruyn H. The influence of initial soft tissue thickness on peri-implant bone remodeling. CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH. 2014;16(2):238–47.
IEEE
[1]
S. Vervaeke, M. Dierens, J. Besseler, and H. De Bruyn, “The influence of initial soft tissue thickness on peri-implant bone remodeling,” CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, vol. 16, no. 2, pp. 238–247, 2014.
@article{2970545,
  abstract     = {{Aim : To elucidate the influence of initial soft tissue thickness on peri-implant bone remodeling. The research hypothesis was that implants installed in patients or at sites with thin mucosal tissues would show increased peri-implant bone loss. 
Material and Methods : 79 edentulous patients were consecutively treated with two non-splinted implants supporting an overdenture in the mandible. During recall-visits, peri-implant health was determined by means of probing pocket depth and the modified plaque/bleeding index. Digital peri-apical radiographs were taken from individual implants. Bone level changes were measured from a reference point (lower border of the smooth implant collar) to the marginal bone-to-implant contact level. The linear mixed-effect model analysis was adopted to analyze the influence of clinical parameters and transmucosal abutment height on peri-implant bone loss. 
Results : 67 patients attended the 1-year and 66 the 2-year recall-visit. Mean bone level changes were 0.89 mm (SD 0.62) and 0.90 mm (SD 0.66), plaque scores 0.82 (SD 0.94) and 0.87 (SD 0.92), bleeding scores 0.46 (SD 0.68) and 0.56 (SD 0.72) and PPD 1.65 mm (SD 0.60) and 1.78 mm (SD 0.59) after 1 year and 2 years respectively. The linear mixed-effect model revealed increasing bone level changes with decreasing abutment heights. Peri-implant bone level changes were significantly higher for implants with abutments of <2 mm (1.17 mm, p < .01; 1.23 mm, p < .01), 2 mm (0.86 mm, p < .01; 1.03 mm, p < .01) or 3 mm (0.38 mm, p = .046; 0.41 mm, p = .044) compared to >= 4 mm-abutments (bone level changes set to zero as reference value) both after 1 year and 2 years and bone level changes were significantly influenced by probing pocket depth (p < .01, p < .01), but not by plaque (p = .31, p = .09) and bleeding scores (p = .30, p = .40). 
Conclusion : The present study suggests that implants with lower abutments, reflecting the initial gingival thickness, lose more peri-implant bone, possibly by a re-establishment of the biological width.}},
  author       = {{Vervaeke, Stijn and Dierens, Melissa and Besseler, Jos and De Bruyn, Hugo}},
  issn         = {{1523-0899}},
  journal      = {{CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH}},
  keywords     = {{biologic width,peri-implant bone loss,dental implant,soft tissue,overdenture,SINGLE-TOOTH REPLACEMENTS,TIOBLAST DENTAL IMPLANTS,TITANIUM IMPLANTS,GINGIVA,DIMENSIONS,STABILITY,JUNCTION,ABSENCE,PAPILLA,TEETH}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{238--247}},
  title        = {{The influence of initial soft tissue thickness on peri-implant bone remodeling}},
  url          = {{http://doi.org/10.1111/j.1708-8208.2012.00474.x}},
  volume       = {{16}},
  year         = {{2014}},
}

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