Definitive Abutments Placed at Implant Insertion and Never Removed: Is It an Effective Approach? A Systematic Review and Meta-Analysis of Randomized Controlled Trials

J Oral Maxillofac Surg. 2018 Feb;76(2):316-324. doi: 10.1016/j.joms.2017.08.025. Epub 2017 Aug 24.

Abstract

Purpose: To assess whether repeated abutment disconnections and reconnections have any impact on peri-implant bone resorption and soft tissue healing.

Materials and methods: Electronic and manual searches were conducted for English-language articles published up to March 2017 that identified a relation between repeated disconnections of implant abutments (PA group) and prosthetic or implant failures, complications, marginal bone loss (MBL), soft tissue healing, and esthetic evaluation (pink esthetic score [PES]) after at least 1 year of function compared with implants receiving a final abutment at the time of implant placement (DA group).

Results: Fourteen articles (535 patients with 994 implants) were selected for qualitative analysis. Six of these were included in the meta-analysis. Five prostheses failed in the PA group and 1 failed in the DA group (P = .1047). Seven biologic complications occurred in the PA group and 6 occurred in the DA group (P = .8121). MBL was significantly less in the DA group (difference, 0.279 mm; P = .000). Greater buccal recession occurred in the PA group (difference, 0.198 mm; P = .0004). The PES evaluation showed no differences between groups (P = .289).

Conclusions: Repeated abutment disconnections and reconnections considerably increased MBL and buccal recession. Further studies are needed to confirm these results.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Bone Resorption
  • Dental Abutments*
  • Dental Implant-Abutment Design
  • Dental Implants*
  • Dental Restoration Failure*
  • Humans
  • Wound Healing

Substances

  • Dental Implants