Biologic Width Around Different Implant-Abutment Interface Configurations. A Radiographic Evaluation of the Effect of Horizontal Offset and Concave Abutment Profile in the Canine Mandible

Purpose: The purpose of this experimental study was to analyze radiographically in a dog model how different implant-abutment interface configurations influence alveolar crestal bone changes. Materials and Methods: Six different experimental implant-abutment connections were evaluated in six mixed-breed dogs. The following parameters were tested: absence of microgap, microgap proximal to bone crest, and microgap distant from bone crest. In addition, two different cervical abutment profiles, one straight and one featuring a supracrestal concavity, were evaluated. Implants were based on a cylindrical full-body screw design and made from coldworked grade IV commercially pure titanium. The diameter (at thread tips) measured 4.1 mm, whereas the inner diameter was 3.5 mm. Standardized periapical digital radiographs were obtained for comparative analysis at baseline and at 3, 4, 5, 6, 7, 8, and 9 months after implant placement. Radiographs were randomized and calibrated for linear measurements. For statistical analysis, mixed-model repeated-measures analysis of variance was used. Results: All implants integrated successfully and remained stable during the entire period of the study. Radiographically, when comparing groups with straight profiles, crestal bone remodeling in group C (one-piece design) was significantly less than in group A (matching diameters) and B (nonmatching diameters). In fact, implant group C showed the least crestal bone remodeling of all groups. When comparing groups with a concave profile but different microgap configurations, all three designs demonstrated bone loss with no significant differences among the three groups. Conclusion: A nonsubmerged one-piece implant design demonstrated the least amount of bone remodeling of all groups. Implant-abutment connections with a concave profile established crestal bone levels immediately apical to the concavity regardless of the microgap variable. Keywords: alveolar bone loss/etiology, dental implants, horizontal offset, platform switching, supracrestal concavity