s-CAIS surgery; digital workflow; one-abutment one-time; custom-made abutment; bone remodelling; distance between the implant shoulder and first bone-to-implant contact (DBI); pink aesthetic score (PES)
Abstract :
[en] Aim: The aim of this case series was to evaluate the 4-year outcomes of implants placed in the aesthetic area using static computer-assisted implant surgery (s-CAIS) and restored with a one-abutment one-time (OAOT) protocol using custom-made zirconia abutments and cemented provisional crowns manufactured prior to surgery.
Material and methods: Ten consecutive implants were placed in the aesthetic area. Based on a digital implant and prosthodontic planning, surgical guides were ordered and used for the preparation of definitive custom-made zirconia abutments and polymethylmethacrylate provisional crowns. Implants were placed using the s-CAIS guide, and prosthetic components were placed immediately. Implant outcomes were evaluated at the time of surgery, after 4 months and after 4 years.
Results: All implants were successfully placed with s-CAIS and restored with final abutments and provisional crowns. No major prosthetic adverse events were observed. After 4 years, the implant survival rate was 100%, minor peri-implant bleeding on probing was reported, and very stable peri-implant bone levels were observed. The pink aesthetic score showed that the prosthetic components were well integrated, and the peri-implant soft tissues were stable.
Conclusions: Within the limits of this case series, these results suggest that emerging digital workflows allow the manufacture of final custom-made abutments and provisional crowns prior to surgery. This individualised OAOT procedure may reduce cement-related complications and improve aesthetic outcomes by optimising soft tissue healing with prosthetic components. However, such protocols have evolved towards full digital workflows, and comparative clinical trials are needed.
Research center :
d‐BRU - Dental Biomaterials Research Unit - ULiège [BE]
Disciplines :
Dentistry & oral medicine
Author, co-author :
VINCENT, Kim ; Centre Hospitalier Universitaire de Liège - CHU > Département de dentisterie > Service parodontologie, chir. bucco-dentaire et implantaire
LI MANNI, Lou; Centre Hospitalier Universitaire de Liège - CHU > Département de dentisterie > Parodontologie et chirurgie bucco-dentaire
Mainjot, Amélie ; Université de Liège - ULiège > Département des sciences dentaires > Biomatériaux dentaires
LECLOUX, Geoffrey ; Centre Hospitalier Universitaire de Liège - CHU > Département de dentisterie > Service parodontologie, chir. bucco-dentaire et implantaire
LAMBERT, France ; Centre Hospitalier Universitaire de Liège - CHU > Département de dentisterie > Service parodontologie, chir. bucco-dentaire et implantaire
Language :
English
Title :
An individualized approach for a one-abutment one-time protocol
using fully guided implant surgery: a 4-year follow-up case series
1. Wang Y, Zhang Y, Miron RJ. Health, maintenance, and recovery of soft tissues around implants. Clin Implant Dent Relat Res 2016;18:618–634.
2. Berglundh T, Lindhe J, Ericsson I, Marinello CP, Liljenberg B, Thomsen P. The soft tissue barrier at implants and teeth. Clin Oral Implants Res 1991;2:81–90.
3. Hermann JS, Buser D, Schenk RK, Higginbottom FL, Cochran DL. Biologic width around titanium implants. A physiologically formed and stable dimension over time. Clin Oral Implants Res 2000;11:1–11.
4. Cochran D, Simpson J, Weber HP, Buser D. Attachment and growth of periodontal cells on smooth and rough titanium. Int J Oral Maxillofac Implants 1994;9:289–297.
5. Rompen E. The impact of the type and configuration of abutments and their (repeated) removal on the attachment level and marginal bone. Eur J Oral Implantol 2012;5(suppl):S83–S90.
6. Abrahamsson I, Berglundh T, Lindhe J. The mucosal barrier following abutment dis/reconnection. An experimental study in dogs. J Clin Periodontol 1997;24:568–572.
7. Abrahamsson I, Berglundh T, Sekino S, Lindhe J. Tissue reactions to abutment shift: an experimental study in dogs. Clin Implant Dent Relat Res 2003;5:82–88.
8. Luongo R, Traini T, Guidone PC, Bianco G, Cocchetto R, Celletti R. Hard and soft tissue responses to the platform-switching technique. Int J Periodontics Restorative Dent 2008;28:551–557.
9. Becker K, Mihatovic I, Golubovic V, Schwarz F. Impact of abutment material and dis-/re-connection on soft and hard tissue changes at implants with platform-switching. J Clin Periodontol 2012;39:774–780.
10. Alves CC, Muñoz F, Cantalapiedra A, Ramos I, Neves M, Blanco J. Marginal bone and soft tissue behavior following platform switching abutment connection/disconnection – a dog model study. Clin Oral Implants Res 2015;26:983–991.
11. Rodríguez X, Vela X, Méndez V, Segalà M, Calvo-Guirado JL, Tarnow DP. The effect of abutment dis/reconnections on peri-implant bone resorption: a radiologic study of platform-switched and non-platform-switched implants placed in animals. Clin Oral Implants Res 2013;24:305–311.
12. Canullo L, Bignozzi I, Cocchetto R, Cristalli MP, Iannello G. Immediate positioning of a definitive abutment versus repeated abutment replacements in post-extractive implants: 3-year follow-up of a randomised multicentre clinical trial. Eur J Oral Implantol 2010;3:285–296.
13. Degidi M, Nardi D, Piattelli A. One abutment at one time: non-removal of an immediate abutment and its effect on bone healing around sub-crestal tapered implants. Clin Oral Implants Res 2011;22:1303–1307.
14. Koutouzis T, Koutouzis G, Gadella H, Neiva R. The effect of healing abutment reconnection and disconnection on soft and hard peri-implant tissues: a short-term randomized controlled clinical trial. Int J Oral Maxillofac Implants 2013;28:807–814.
15. Molina A, Sanz-Sánchez I, Martín C, Blanco J, Sanz M. The effect of one-time abutment placement on interproximal bone levels and peri-implant soft tissues: a prospective randomized clinical trial. Clin Oral Implants Res 2017;28:443–452.
16. Santos JS, Santos TS, Martins-Filho PRS, von Krockow N, Weigl P, Pablo H. One abutment at one time concept for platform-switched morse implants: systematic review and meta-analysis. Braz Dent J 2018;29:7–13.
17. Grandi T, Garuti G, Guazzi P, Tarabini L, Forabosco A. Survival and success rates of immediately and early loaded implants: 12-month results from a multicentric randomized clinical study. J Oral Implantol 2012;38:239–249.
18. Tallarico M, Caneva M, Meloni SM, Xhanari E, Omori Y, Canullo L. Survival and success rates of different shoulder designs: a systematic review of the literature. Int J Dent 2018;2018:6812875.
19. Wang QQ, Dai R, Cao CY, Fang H, Han M, Li QL. One-time versus repeated abutment connection for platform-switched implant: a systematic review and meta-analysis. PLoS One 2017;12:e0186385.
20. Piñeyro A, Tucker LM. One abutment-one time: the negative effect of uncontrolled abutment margin depths and excess cement – a case report. Compend Contin Educ Dent 2013;34:680–684.
21. Vindasiute E, Puisys A, Maslova N, Linkeviciene L, Peciuliene V, Linkevicius T. Clinical factors influencing removal of the cement excess in implant-supported restorations. Clin Implant Dent Relat Res 2015;17:771–778.
22. Linkevicius T, Vindasiute E, Puisys A, Linkeviciene L, Maslova N, Puriene A. The influence of the cementation margin position on the amount of undetected cement. A prospective clinical study. Clin Oral Implants Res 2013;24:71–76.
23. Linkevicius T, Vindasiute E, Puisys A, Peciuliene V. The influence of margin location on the amount of undetected cement excess after delivery of cement-retained implant restorations. Clin Oral Implants Res 2011;22:1379–1384.
24. D’haese J, Ackhurst J, Wismeijer D, De Bruyn H, Tahmaseb A. Current state of the art of computer-guided implant surgery. Periodontol 2000 2017;73:121–133.
25. Ersoy AE, Turkyilmaz I, Ozan O, McGlumphy EA. Reliability of implant placement with stereolithographic surgical guides generated rrom computed tomography: clinical data from 94 implants. J Periodontol 2008;79:1339–1345.
26. Testori T, Weinstein T, Scutellà F, Wang HL, Zucchelli G. Implant placement in the esthetic area: criteria for positioning single and multiple implants. Periodontol 2000 2018;77:176–196.
27. Löe H. The Gingival Index, the Plaque Index and the Retention Index systems. J Periodontol 1967;38:610–616.
28. Enkling N, Moazzin R, Geers G, Kokoschka S, Abou-Ayash S, Schimmel M. Clinical outcomes and bone-level alterations around one-piece mini dental implants retaining mandibular overdentures: 5-year follow-up of a prospective cohort study. Clin Oral Implants Res 2020;31:549–556.
29. Fürhauser R, Florescu D, Benesch T, Haas R, Mailath G, Watzek G. Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score. Clin Oral Implants Res 2005;16:639–644.
30. Schneider D, Marquardt P, Zwahlen M, Jung RE. A systematic review on the accuracy and the clinical outcome of computer-guided template-based implant dentistry. Clin Oral Implants Res 2009; 20(suppl 4):73–86.
31. Tahmaseb A, Wu V, Wismeijer D, Coucke W, Evans C. The accuracy of static computer-aided implant surgery: a systematic review and meta-analysis. Clin Oral Implants Res 2018;29(suppl 16):416–435.
32. Zhou W, Liu Z, Song L, Kuo CI, Shafer DM. Clinical factors affecting the accuracy of guided implant surgery – a systematic review and meta-analysis. J Evid Based Dent Pract 2018;18:28–40.
33. Van Assche N, Vercruyssen M, Coucke W, Teughels W, Jacobs R, Quirynen M. Accuracy of computer-aided implant placement. Clin Oral Implants Res 2012;23(suppl 6):112–123.
34. Vercruyssen M, Hultin M, Van Assche N, Svensson K, Naert I, Quirynen M. Guided surgery: accuracy and efficacy. Periodontol 2000 2014;66: 228–246.
35. Arisan V, Karabuda ZC, Ozdemir T. Accuracy of two stereo-lithographic guide systems for computer-aided implant placement: a computed tomography-based clinical comparative study. J Periodontol 2010;81:43–51.
36. Sicilia A, Botticelli D. Computer-guided implant therapy and soft and hard-tissue aspects. The Third EAO Consensus Conference 2012. Clin Oral Implants Res 2012;23(suppl 6):157–161.
37. Buser D, Halbritter S, Hart C, et al. Early implant placement with simultaneous guided bone regeneration following single-tooth extraction in the esthetic zone: 12-month results of a prospective study with 20 consecutive patients. J Periodontol 2009;80:152–162.
38. Atieh MA, Tawse-Smith A, Alsabeeha NHM, Ma S, Duncan WJ. The one abutment-one time protocol: a systematic review and meta-analysis. J Periodontol 2017;88:1173–1185.
39. Canullo L, Omori Y, Amari Y, Iannello G, Pesce P. Five-year cohort prospective study on single implants in the esthetic area restored using one-abutment/one-time prosthetic approach. Clin Implant Dent Relat Res 2018;20:668–673.
40. Cosyn J, Eghbali A, Hanselaer L, et al. Four modalities of single implant treatment in the anterior maxilla: a clinical, radiographic, and aesthetic evaluation. Clin Implant Dent Relat Res 2013;15:517–530.
41. Esposito M, Grusovin MG, Polyzos IP, Felice P, Worthington HV. Interventions for replacing missing teeth: dental implants in fresh extraction sockets (immediate, immediate-delayed and delayed implants). Cochrane Database Syst Rev 2010;9:CD005968.
42. Lambert F, Mainjot A. One-tooth one-time (1T1T): a straightforward approach to replace missing teeth in the posterior region. J Oral Implantol 2017;43:371–377.
