Alberto Sicilia1, Marc Quirynen2, Alain Fontolliet3, Helena Francisco4, Anton Friedman5, Tomas Linkevicius6, Rainer Lutz7, Henny J Meijer8, Eric Rompen9, Roberto Rotundo10, Frank Schwarz11, Massimo Simion12, Wim Teughels2, Ann Wennerberg13, Otto Zuhr14. 1. University of Oviedo, Oviedo, Spain. 2. Catholic University of Leuven, Leuven University Hospital, Leuven, Belgium. 3. University of Zurich, Zurich, Switzerland. 4. University of Lisbon, Lisbon, Portugal. 5. Witten-Herdecke University, Witten, Germany. 6. University of Vilnius, Vilnius, Lithuania. 7. University of Erlangen-Nuremberg, Erlangen, Germany. 8. University of Groningen, Groningen, Netherlands. 9. University of Liège, Liège, Belgium. 10. University of Florence, Florence, Italy. 11. Heinrich Heine University, Düsseldorf, Germany. 12. University of Milan, Milan, Italy. 13. University of Malmö, Malmö, Sweden. 14. Private Practice in Munich, University of Frankfurt, Frankfurt, Germany.
Abstract
INTRODUCTION: Several surgical techniques and prosthetic devices have been developed in the last decades, aiming to improve aesthetic, hygienic and functional outcomes that may affect the peri-implant tissues, such as procedures of bone and soft tissue augmentation and the use of custom-made abutments of titanium and zirconium. MATERIALS AND METHODS: Three systematic reviews, based on randomized clinical trials and prospective studies covering the above reported topics were analysed, and the detected evidence was exposed to interactive experts' discussion during the group's and general assembly's meetings of the 4th EAO Consensus Conference. The results are reported using the following abbreviations: S-T: short-term evidence, M-T: medium-term evidence; L-T: long-term evidence; LE: limited evidence. RESULTS: Soft tissue augmentation procedures may be indicated for the increase of soft tissue thickness and keratinized tissue, the reduction of interproximal peri-implant bone loss, and the coverage of shallow peri-implant soft tissue recessions (S-T, LE), L-T is lacking. Guided bone regeneration approaches (GBR) showed efficacy when used for ridge reconstruction after the complete healing of the soft tissues (S-T & L-T), and the stability of the augmented bone may play a role in the maintenance of the soft tissue position and dimensions (LE). No significant differences were observed between titanium and zirconia abutments when evaluating probing pocket depth, bleeding on probing, marginal bone levels and mucosal recessions. Zirconia abutments were associated with more biological complications but demonstrated superiority in terms of achieving natural soft tissue colour (S-T).
INTRODUCTION: Several surgical techniques and prosthetic devices have been developed in the last decades, aiming to improve aesthetic, hygienic and functional outcomes that may affect the peri-implant tissues, such as procedures of bone and soft tissue augmentation and the use of custom-made abutments of titanium and zirconium. MATERIALS AND METHODS: Three systematic reviews, based on randomized clinical trials and prospective studies covering the above reported topics were analysed, and the detected evidence was exposed to interactive experts' discussion during the group's and general assembly's meetings of the 4th EAO Consensus Conference. The results are reported using the following abbreviations: S-T: short-term evidence, M-T: medium-term evidence; L-T: long-term evidence; LE: limited evidence. RESULTS: Soft tissue augmentation procedures may be indicated for the increase of soft tissue thickness and keratinized tissue, the reduction of interproximal peri-implant bone loss, and the coverage of shallow peri-implant soft tissue recessions (S-T, LE), L-T is lacking. Guided bone regeneration approaches (GBR) showed efficacy when used for ridge reconstruction after the complete healing of the soft tissues (S-T & L-T), and the stability of the augmented bone may play a role in the maintenance of the soft tissue position and dimensions (LE). No significant differences were observed between titanium and zirconia abutments when evaluating probing pocket depth, bleeding on probing, marginal bone levels and mucosal recessions. Zirconia abutments were associated with more biological complications but demonstrated superiority in terms of achieving natural soft tissue colour (S-T).