The Vertical Soft Tissue Thickness and Subcrestal Implant Placement as Factors for Peri-implant Crestal bone Stability

Darko Veljanovski; Aneta Atanasovska-Stojanovska; Aleksandra Pivkova-Veljanovska; Eitan Mijiritsky; Curd Bollen

doi:10.3889/oamjms.2021.6605

Authors

Darko Veljanovski Optimum Dental Clinic, Skopje, Macedonia https://orcid.org/0000-0002-9004-0764
Aneta Atanasovska-Stojanovska Department of Oral Pathology and Periodontology, Faculty of Dentistry, Universty “Ss.Cyril and Methodius”, Skopje, Macedonia
Aleksandra Pivkova-Veljanovska University Clinic for Hematology, Medical Faculty, University “Ss.Cyril and Methodius”, Skopje, Macedonia
Eitan Mijiritsky Department of Prosthodontics, School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel https://orcid.org/0000-0002-1661-7529
Curd Bollen Department of Implant Dentistry, College of Medicine and Dentistry, Ulster University, Birmingham, UK

DOI:

https://doi.org/10.3889/oamjms.2021.6605

Keywords:

Vertical soft tissue thickness, Subcrestal implant placement, Bone loss

Abstract

Aim

The aim of this prospective study was to determine the influence of vertical soft tissue thickness on bone level changes in platform-switched implants placed eqicrestally or subcrestally and restored with screw-retained or cement-retained restorations.

Methods

Platform-switched bone-level implants were placed in a single stage manner in the posterior mandibular region. Implant sites were divided into thick (control) and thin (test) vertical soft tissue groups. The implants in the control group were placed equicrestally. The implant sites from the control group were randomly allocated to receive equicrestally or subcrestally placed implants. Bone remodeling/loss was radiographically measured at baseline, three months postoperatively and six months after delivery of final prosthetic restoration.

Results

The mean crestal bone loss values three months postoperatively and six months post prosthetic restoration were higher in sites with thin versus sites with thick gingiva. In implant sites with thin gingiva, subcrestally placed implants presented less bone loss than eqicrestally placed implants.

Conclusion

Platform switched implants are prone to more bone loss when they are placed in sites with thin soft tissue, regardless of the type of final restoration (screw-retained or cement-retained). Subcrestal placement of platform-switched implants can prevent crestal bone loss in sites with vertical soft tissue thickness < 3 mm.

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