Protocols to Prevent Marginal Bone Loss in Dental Implants

Abstract

The main objective is to study the implant parameters that influence marginal bone loss around osteointegrated implants, with the aim of preventing this phenomenon from the development of the treatment plan. Methodology : An electronic research made on Pubmed and Medline, conducted to the selection of 38 articles that were discussed to analyze the influence of some parameters on marginal bone loss around implants. Discussion of results : Marginal bone loss around implants has a multifactorial etiology, but there are parameters over which the practitioner has some leeway to limit bone loss. There is no consensus about an optimal implant length but implant diameter is a more influent parameter. Some implant design features, as the microthreads, have impact on crestal bone stability. Subcrestal implant position associated with platformswitching presents some advantages, as well as the internal connection, and the long abutments. Platform-switching concept allows a better bone preservation thanks to the inward reposition of the microgap and by improving the distribution of forces. When thin, the soft tissue can be thickened with grafts to achieve the thickness needed to prevent bone loss. Conclusion : Lower bone loss is expected for implants with microthreads, wide diameter, internal connection, platform-switching, long abutments, and when the initial soft tissue thickness was of minimum 2mm. Further studies would be needed to further improve protocols of prevention of marginal bone loss around implants.