J Adv Prosthodont.  2019 Jun;11(3):147-154. 10.4047/jap.2019.11.3.147.

Influence of implant-abutment connection structure on peri-implant bone level in a second molar: A 1-year randomized controlled trial

• Kim JC
• Lee J
• Kim S
• Koo KT
• Kim HY
• Yeo IS

• KMID: 2450990
• DOI: http://doi.org/10.4047/jap.2019.11.3.147

Abstract

PURPOSE
This study aimed to evaluate the effect of two different implant-abutment connection structures with identical implant design on peri-implant bone level.
MATERIALS AND METHODS
This clinical study was a patient-blind randomized controlled trial following the CONSORT 2010 checklists. This trial was conducted in 24 patients recruited between March 2013 and July 2015. Implants with internal friction connection were compared to those with external hex connection. One implant for each patient was installed, replacing the second molar. Implant-supported crowns were delivered at four months after implant insertion. Standardized periapical radiographs were taken at prosthesis delivery (baseline), and one year after delivery. On the radiographs, distance from implant shoulder to first bone-to-implant contact (DIB) and peri-implant area were measured, which were the primary and secondary outcome, respectively.
RESULTS
Eleven external and eleven internal implants were analyzed. Mean changes of DIB from baseline to 1-year postloading were 0.59 (0.95) mm for the external and 0.01 (0.68) mm for the internal connection. Although no significant differences were found between the two groups, medium effect size was found in DIB between the connections (Cohen's d = 0.67).
CONCLUSION
Considering the effect size in DIB, this study suggested the possibility of the internal friction connection structure for more effective preservation of marginal bone.

Keyword

Randomized controlled trial; Dental implant-abutment design; Alveolar bone loss

MeSH Terms

Alveolar Bone Loss
Checklist
Clinical Study
Crowns
Dental Implant-Abutment Design
Friction
Humans
Molar*
Prostheses and Implants
Shoulder

Figure

• 

  Fig. 1 Flow chart of the study. Twelve subjects were allocated to the control and test groups each. Two patients did not receive allocated interventions. One participant in the control group changed decision and one in the test group did not return to the treatment program. In total, 11 subjects in the control group and 11 in the test group received treatment and were analyzed.

• 

  Fig. 2 Two implants with different implant-abutment connection structures were used in this study. The control group was an external connection structure (A), and the test group was an internal connection structure (B). Two implants have an identical design such as thread geometry, implant body profile, and surface topography (middle) with the exception of implant-abutment connection structure. The implant thread pitch is 0.8 mm, the thread depth is 0.3 – 0.45 mm, and the inclination angle of thread flank is 35°. Implant surface was blasted by resorbable blast media, and its arithmetic mean height (Ra) was 1.50 – 2.00 µm.

• 

  Fig. 3 Schematic of parameters performed in the radiographic analysis. Distance from implant shoulder to first bone-to-implant contact (DIB, blue lines) (A) and peri-implant area (PA, blue areas) (B) of the test group (internal connection structure) were calculated. In the control group, DIB (C, red lines) and PA (D, red areas) were also measured. The black dotted line represents an imaginary line parallel to vertical and horizontal axis of the implants. Digital processing of a radiographic image was performed using ImageJ 1.60 Image Tool software.

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