Effect of one‐time placement of the definitive abutment versus multiple healing abutment disconnections and reconnections during the prosthetic phase on radiographic and clinical outcomes: A 12‐month randomized clinical trial

doi:10.1111/cid.13361

AutoresJavier Calatrava, Ignacio Sanz‐Sánchez, Ana Molina, Juan Bollaín, Conchita Martín, Mariano Sanz

Por qué importa

Este ensayo clínico aleatorizado compara dos protocolos durante la fase protésica en implantología. Por un lado, la colocación del pilar definitivo en una sola intervención (protocolo test) y, por otro, la manipulación repetida del pilar de cicatrización con desconexiones y reconexiones hasta tres veces antes de la carga funcional (protocolo control). El estudio evaluó el nivel de remodelación ósea marginal, parámetros clínicos de salud periodontal y la experiencia del paciente a los 6 y 12 meses post-carga. Los resultados revelan que la manipulación múltiple del pilar de cicatrización se asocia con una pérdida ósea significativamente mayor en comparación con la colocación única del pilar definitivo. Estos hallazgos son relevantes para optimizar la toma de decisiones clínicas y minimizar complicaciones periimplantarias.

Abstract original

OBJECTIVE: The aim of this investigation was to evaluate the effect on clinical and radiological outcomes of the one-abutment, one-time protocol (test) versus placing the definitive abutment on the day of functional loading after having disconnected and connected three times the healing abutment during the prosthetic phase (control). MATERIALS AND METHODS: Forty patients with 80 implants were randomly allocated to either the test or the control group. Changes in the radiographic marginal bone levels (MBLs), clinical outcomes, prosthetic-related outcomes, and patient-reported outcomes measures (PROMs) were assessed and compared 6 and 12 months after functional loading. RESULTS: Thirty-seven patients with 74 implants were followed at 12 months. A statistically significant bone remodeling was observed in both groups following implant placement. MBLs were significantly greater in the control group at the 6- (-0.13 mm vs. -0.61 mm) and 12-month visits (-0.01 mm vs. -0.53 mm). Bone loss was significantly greater in the control group from surgery to 6 and 12 months and from loading to 6 and 12 months. The abutment height was significantly greater in the test group, however, there were no significant differences in the restorative angle. Similarly, there were no statistically significant differences between groups for the measured clinical variables (probing depth, plaque, and bleeding index) and PROMs. CONCLUSIONS: Disconnecting and reconnecting the healing abutment was associated with significantly higher bone loss after 12 months, as compared to the placement of the definitive abutment at implant installation.

Leer texto completo ↗DOI · 10.1111/cid.13361

Autor Doctor&Cols

Javier Calatrava Serrano de Haro
Cirugía Oral e Implantología

Cómo citar

Calatrava J, Sanz‐Sánchez I, Molina A, Bollaín J, Martín C, Sanz M. Effect of one‐time placement of the definitive abutment versus multiple healing abutment disconnections and reconnections during the prosthetic phase on radiographic and clinical outcomes: A 12‐month randomized clinical trial. Clinical Implant Dentistry and Related Research. 2024. doi:10.1111/cid.13361