Multiple Single-Tooth Implant Restorations in the Posterior Jaws: Maintenance of Marginal Bone Levels with Reference to the Implant-Abutment Microgap

Purpose: The purpose of this study was to measure marginal bone loss from the implant-abutment microgap to the bone crest between multiple freestanding implants functionally loaded for up to 7.5 years in the posterior jaws. Materials and Methods: Patients consecutively treated for the replacement of missing posterior teeth were included in the study. Using the implant-abutment interface, which was placed level with the crestal bone as a reference point, standardized follow-up radiographs were obtained to evaluate marginal bone loss. Results were subject to statistical analysis using the Wilcoxon rank sum test and the Wilcoxon signed rank test at the 95% confidence level. Additionally, soft tissue and prosthetic complications were recorded. Results: One hundred seventy-three implants in 54 patients were evaluated. Implants were in function for a mean of 37 months (range, 21 to 91 months). One implant failed, for a survival rate of 99.4%. Overall mean marginal bone loss was 0.65 mm (range, 0.0 to 4.8 mm). For the 80 maxillary and 93 mandibular implants, mean marginal bone loss was 0.56 mm and 0.70 mm, respectively. The frequency of bone loss >= 1.0 mm was 25.0% in the maxilla and 36.0% in the mandible; 23.1% of maxillary implants and 16.7% of mandibular implants demonstrated no bone loss. No significant differences were observed between men and women or between smokers and nonsmokers. The difference between mesial and distal bone levels was statistically significant (P .001), with respective means of 0.53 mm and 0.76 mm. Recorded prosthetic complications included cementation failure (17.7%), porcelain fracture (7.2%), and abutment screw loosening (2.2%). Conclusions: Multiple single-tooth implants placed in the posterior jaws perform extremely well. Furthermore, it is possible to retain bone close to the implant-abutment microgap with certain implant designs. (Case Series) Keywords: bone loading, cement fixation, finite element analysis, in vivo strain measurements, passive fit, screw retention