Volumetric variation of peri-implant soft tissues in convergent collar implants and crowns using the biologically oriented preparation technique (BOPT)

G Cabanes-Gumbau, A Pascual-Moscardó, D Peñarrocha-Oltra, B García-Mira, J Aizcorbe-Vicente, M-A Peñarrocha-Diago, G Cabanes-Gumbau, A Pascual-Moscardó, D Peñarrocha-Oltra, B García-Mira, J Aizcorbe-Vicente, M-A Peñarrocha-Diago

Abstract

Background: To evaluate the changes in the peri-implant soft tissues of convergent collar implants with biologically oriented preparation technique (BOPT) crowns, 10 months after loading.

Material and methods: A pilot study was carried out from January 2016 to October 2017 involving 14 patients with one or two implants in the posterior mandibular sector. A total of 32 convergent collar implants were placed using a non-submerged protocol. Three months later the provisional cemented crowns were fitted using the BOPT approach with the finish line 1-1.5 mm below the gingival margin, simulating coronal emergence of a natural tooth. The soft tissue changes were measured with an intraoral scanner at two different timepoints: a) on the day of provisionalization, before prosthetic loading; and b) 10 months later without the provisional prosthesis. The STL files were superimposed and the soft tissue changes were recorded using a color scale with measurement of the volumetric changes in mm3.

Results: A mean increase in peri-implant mucosal volume of 64.7 mm3 was observed in 29 implants. The zones with the greatest increase in soft tissue volume were the papillae of implants with adjacent teeth and the peri-implant buccal margin. Three implants showed a mean decrease in soft tissue volume of -25.1 mm3.

Conclusions: The fitting and design of crowns using the biologically oriented preparation technique (BOPT) over convergent collar implants affords a significant increase in peri-implant soft tissue volume both at the level of the papillae and in the buccal margin.

Conflict of interest statement

Conflict of interest statement:The authors declare that they have no conflicts of interest. The implants and abutments were supplied by Sweden-Martina for conduction of the study.

Figures

Figure 1
Figure 1
1.a: Schematic representation of the implant with a machined-surface convergent collar (Prama®, Sweden & Martina, Padua, Italy) used in the study. 1.b: Representative clinical case; peri-implant mucosa prior to loading. 1.c: Cementation of definitive crowns. 1.d: Intraoral aspect of peri-implant tissues 1 month after loading. 1.e: 1-month radiographic control.
Figure 2
Figure 2
2.a: Intraoral scan of the gingival profile 10 months after crown placement. 2,b: Superimposition of images at T0 and T1 for quantitative volumetric evaluation (in mm3, using the Oracheck application) of the variations in gingival profile. 2.c: Superimposition of images at T0 and T1 for qualitative volumetric evaluation (based on a color scale using the Oracheck application) of the variations in gingival profile (blue = loss of volume, green = no change, red = increase in volume). 2.d: The values reflected in figures 4 and 5 are obtained from the average of this 8 measurement points.
Figure 3
Figure 3
3.a: In implant-supported bridges, the inclusion of the pontic area in quantification of gingival variations yields negative volume values. 3.b: Only including distal peri-implant area (without the pontic) the volumetric quantitative variation between T0 and T1 was positive. 3.c: Only including mesial peri-implant area (without the pontic) the volumetric quantitative variation between T0 and T1 was positive. 3.d: Illustrative scans at T0 and T1 for qualitative volumetric evaluation of implant-supported bridges, in which, soft tissue volume loss is usually seen in the pontic area.
Figure 4
Figure 4
The gain at mesial level is significantly greater than at distal level.
Figure 5
Figure 5
In the buccal zone the gain at marginal level is significantly more manifest.

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