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Purpose: To analyze peri-implant bone loss around two types of tissue-level implants (convergent and divergent transmucosal morphology) placed in the same region of either the maxilla or mandible in a single surgical session. Materials and Methods: This prospective study included 21 patients who each received two implants, one with a convergent transmucosal collar (n = 21) and the other with a divergent collar (n = 21). Implants were placed in a single surgical session, by the same clinician, in the same clinical setting at the Prosthodontic and Occlusion Unit, University of Valencia (Spain). The implants (n = 42) were restored with splinted crowns screwed directly onto the prosthetic platforms. Bone loss analysis consisted of measurements taken from periapical radiographs 24 months after loading. Statistical analysis evaluated the homogeneity of the groups using Pearson's chi-square test; bone loss was compared with the Wilcoxon test. Statistical significance was set at 5% (α = .05), with a confidence interval of 95% and a power of 57%. Results: Implants with convergent transmucosal morphology presented less mean peri-implant bone loss (0.29 ± 0.34 mm) than those with divergent transmucosal morphology (0.60 ± 0.63 mm), with a statistically significant difference between the two types of implants (P = .031). Conclusion: Less peri-implant bone loss occurs around supracrestal implants with convergent transmucosal morphology than divergent transmucosal morphology [ABSTRACT FROM AUTHOR]

Statement of the problem: The gingival configuration around implant abutments is of paramount importance for preserving the underlying marginal bone, and hence for the long-term success of dental implants. Objective: The objective was to study, clinically and histologically, the effects of the change in the morphology of abutments connected to the endosseous implant, and of their surface treatment. In particular, the objective was to ascertain the effect of changing the shape of the transepithelial pillar and the treatment of its surface on the dimensions, quality and health of the components of the peri-implant biological space, such as the dimensions of the epithelial and connective tissues of the biological space, the concentration of inflammatory cells and the density of collagen fibers. Methods: A clinical trial of 10 patients with a totally edentulous maxilla, who had four implants (IPX4010_GALIMPLANT®, Sarria, Spain) inserted in the area of the first and second molars on both sides with computer-guided implant surgery, was conducted with the final purpose of assessing the quality of the peri-implant soft tissue attachment around the transepithelial abutments which were employed (aesthetic machined (RM), aesthetic anodized (RA), slim machined (SM) and slim anodized (SA)). At 8 weeks and following the collection of the samples (removal of the implant-abutment assembly with its surrounding hard and soft tissue) and their processing for subsequent histological and histomorphometric analysis in order to study the dimensions, quality and health of the peri-implant soft tissue area, the variables previously mentioned were determined according to the aims of the study. By using appropriate diameter trephine in order to obtain a useful fringe of soft tissue around the transepithelial pillars, ANOVA and chi-square tests were performed. Results: The SPSS statistical analysis ANOVA results revealed that the machined slim abutments have a better performance considering the variables analyzed with epithelial and connective attachment heights of 1.52 mm and 2.3 mm, respectively, and that connective density (density of collagen fibers) was high at 85.7% of the sample size affected by the design for the slim abutments and 92.9% of the high-density sample size affected by the surface treatment for the machined surface. Conclusions: All variables studied, despite the small sample size, showed the superiority of the slim machined abutment among the four groups. [ABSTRACT FROM AUTHOR]

Background: It is hypothesized that, for patients with hearing loss, surgically placing an implant/abutment combination whilst leaving the subcutaneous tissues intact will improve cosmetic and clinical results, increase quality of life (QoL) for the patient, and reduce medical costs. Here, incremental costs and consequences associated with soft tissue preservation surgery with a hydroxyapatite (HA)-coated abutment (test) were compared with the conventional approach, soft tissue reduction surgery with an all-titanium abutment (control). Methods: A cost-consequence analysis was performed based on data gathered over a period of 3 years in an open randomized (1:1) controlled trial (RCT) running in four European countries (The Netherlands, Spain, France, and Sweden). Subjects with conductive or mixed hearing loss or single-sided sensorineural deafness were included. Results: During the first year, in the Netherlands (NL), France (FR), and Spain (ES) a net cost saving was achieved in favor of the test intervention because of a lower cost associated with surgery time and adverse event treatments [NL €86 (CI −50.33; 219.20), FR €134 (CI −3.63; 261.30), ES €178 (CI 34.12; 97.48)]. In Sweden (SE), the HA-coated abutment was more expensive than the conventional abutment, which neutralized the cost savings and led to a negative cost (SE €-29 CI −160.27; 97.48) of the new treatment modality. After 3 years, the mean cost saving reduced to €17 (CI −191.80; 213.30) in the Netherlands, in Spain to €84.50 (CI −117.90; 289.50), and in France to €80 (CI −99.40; 248.50). The mean additional cost in Sweden increased to €-116 (CI −326.90; 68.10). The consequences in terms of the subjective audiological benefit and Health-related quality of life (HRQoL) were comparable between treatments. A trend was identified for favorable results in the test group for some consequences and statistical significance is achieved for the cosmetic outcome as assessed by the clinician. Conclusions: From this multinational cost-consequence analysis it can be discerned that health care systems can achieve a cost saving during the first year that regresses after 3 years, by implementing soft tissue preservation surgery with a HA-coated abutment in comparison to the conventional treatment. The cosmetic results are better. (sponsored by Cochlear Bone Anchored Solutions AB; Clinical and health economic evaluation with a new Baha® abutment design combined with a minimally invasive surgical technique, ClinicalTrials.gov NCT01796236). [ABSTRACT FROM AUTHOR]

It has been asserted that the average height of natural teeth in Mediterranean Latin populations is relatively short and that these teeth are of insufficient size to host standard attachments manufactured by different companies. The occlusogingival height of 159 potential abutment teeth from 50 Spanish patients was measured and compared to the sizes of intracoronal and extracoronal attachments available from one manufacturer. Twenty-one abutments (13% of the sample) were smaller than the smallest intracoronal attachment available. Eighty-seven percent of the abutments in the sample would have allowed the use of an attachment. However, only 11% of the sample would have allowed the use of a large intracoronal or medium extracoronal attachment, and none would have been able to host a large extracoronal attachment. In addition, 35% of the sample could only have accepted a small intracoronal attachment. In such cases, the capacity for retention would have to be carefully evaluated.