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Volume 24 , Issue 4
July/August 2009

Pages 712719

The Influence of Soft Tissue Thickness on Crestal Bone Changes Around Implants: A 1-Year Prospective Controlled Clinical Trial

Tomas Linkevicius, DDS, Dip Pros, PhD/Peteris Apse, Prof, DDS, Dip Pros, MSc, Dr Habil Med/Simonas Grybauskas, DDS, MOS, MD, RCSEd, PhD/Algirdas Puisys, DDS

PMID: 19885413

Purpose: The aim of this clinical trial was to evaluate the influence of gingival tissue thickness on crestal bone loss around dental implants after a 1-year follow-up. Materials and Methods: Forty-six implants (23 test and 23 control) were placed in 19 patients. The test implants were placed about 2 mm supracrestally, whereas the control implants were positioned at the bone level. Before implant placement, the tissue thickness at implant sites was measured with a periodontal probe. After healing, metal-ceramic cement-retained prostheses were constructed. According to tissue thickness, the test implants were divided into A (thin) and B (thick) groups. Intraoral radiographs were performed and crestal bone changes were measured at implant placement and after 1 year. Results: Mean bone loss around the test implants in group A (thin mucosa) was 1.61 0.24 mm (SE; range, 0.9 to 3.3 mm) on the mesial and 1.28 0.167 mm (range, 0.8 to 2.1 mm) on the distal. Mean bone loss in test group B (thick mucosa) implants was 0.26 0.08 mm (range, 0.2 to 0.9 mm) on the mesial aspect and 0.09 0.05 mm (range, 0.2 to 0.6 mm) on the distal aspect. Mean bone loss around control implants was 1.8 0.164 mm (range, 0.6 to 4.0 mm) and 1.87 0.166 mm (range, 0.0 to 4.1 mm) on the mesial and distal aspects, respectively. Analysis of variance revealed a significant difference in terms of bone loss between test A (thin) and B (thick) groups on both the mesial and the distal. Conclusion: Initial gingival tissue thickness at the crest may be considered as a significant influence on marginal bone stability around implants. If the tissue thickness is 2.0 mm or less, crestal bone loss up to 1.45 mm may occur, despite a supracrestal position of the implant-abutment interface. Int J Oral Maxillofac Implants 2009;24:712719

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