Effects of modified abutment characteristics on peri-implant soft tissue health: A systematic review and meta-analysis

Abstract

Objectives

The purpose of this systematic review was to evaluate the impact of the abutment characteristics on peri-implant tissue health and to identify the most suitable material and surface characteristics.

Methods

A protocol was developed aimed to answer the following focused question: "Which is the effect of the modification of the abutment design in regard to the maintenance of the peri-implant soft tissue health?" Further subanalysis aimed to investigate the impact of the abutment material, macroscopic design, surface topography and surface manipulation. Randomised controlled trials (RCTs) with a follow-up of at least 6 months after implant loading were considered as inclusion criteria. Meta-analyses were performed whenever possible.

Results

Nineteen final publications from thirteen investigations were included. The results from the meta-analysis indicated that zirconia abutments (Zi) experienced less increase in BOP values over time [n = 3; WMD = −26.96; 95% CI (−45.00; −8.92); p = .003] and less plaque accumulation [n = 1; MD = −20.00; 95% CI (−41.47; 1.47); p = .068] when compared with titanium abutments (Ti). Bone loss was influenced by the method of abutment decontamination [n = 1; MD = −0.44; 95% CI (−0.65; −0.23); p < .001]. The rest of the studied outcomes did not show statistically significant differences.

Conclusions

The macroscopic design, the surface topography and the manipulation of the implant abutment did not have a significant influence on peri-implant inflammation. In contrast, the abutment material demonstrated increased BOP values over time for Ti when compared to Zi abutments.

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