Camacho-Alonso Fabio, Bernabeu-Mira Juan Carlos, Sánchez Joaquín, Buendía Antonio Julián, Mercado-Díaz Ana María, Pérez-Sayáns Mario, Pérez-Jardón Alba, Martín José Manuel Somoza, Montero Javier, Gomez-Polo Cristina, Quispe-López Norberto, Peñarrocha-Oltra David
Department of Oral Surgery, University of Murcia, Murcia, Spain.
Oral Surgery and Implant Dentistry, Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain.
J Periodontol. 2025 May;96(5):418-428. doi: 10.1002/JPER.24-0250. Epub 2024 Aug 26.
This study aimed to analyze the influence of concave and cylindrical abutments on peri-implant soft tissue. Dimensions, collagen fiber orientation, and immunohistochemical data were assessed.
A multicenter, split-mouth, double-blind randomized clinical trial was conducted. Two groups were analyzed: cylindrical abutments and concave abutments. After a 12-week healing period, peri-implant soft tissue samples were collected, processed, and evaluated for dimensions, collagen fiber orientation, and immunohistochemical data. Inflammatory infiltration and vascularization were assessed, and the abutment surfaces were analyzed using scanning electron microscopy. The statistical analysis was performed using the SPSS version 20.0 statistical package.
A total of 74 samples in 37 patients were evaluated. Histological evaluation of peri-implant soft tissue dimensions revealed significant differences between concave and cylindrical abutments. Concave abutments exhibited greater total height (concave: 3.57 ± 0.28 - cylindrical: 2.95 ± 0.27) and barrier epithelium extension (concave: 2.46 ± 0.17 - cylindrical: 1.89 ± 0.21) (p < 0.05), while the supracrestal connective tissue extension (concave: 1.11 ± 0.17 - cylindrical: 1.03 ± 0.16) was slightly greater (p > 0.05). Collagen fiber orientation favored concave abutments (23.76 ± 5.86), with significantly more transverse/perpendicular fibers than for cylindrical abutments (15.68 ± 4.57). The immunohistochemical analysis evidenced greater inflammatory and vascular intensity in the lower portion for both abutments, though concave abutments showed lower overall intensity (concave: 1.05 ± 0.78 - cylindrical: 1.97 ± 0.68) (p < 0.05). The abutment surface analysis demonstrated a higher percentage of tissue remnants on concave abutments (42.47 ± 1.32; 45.12 ± 3.03) (p < 0.05).
Within the limitations of this study, concave abutments presented significantly greater peri-implant tissue height, linked to an extended barrier epithelium, versus cylindrical abutments in thick tissue phenotype. This enhanced soft tissue sealing, favoring a greater percentage of transversely oriented collagen fibers. The concave design reduced chronic inflammatory exudation with T and B cells, thus minimizing the risk of chronic inflammation.
This study looked at how 2 different shapes of dental implant abutments (the parts that connect the implant to the crown), specifically concave and cylindrical, affect the soft tissue around the implants. We wanted to see how these shapes influenced the tissue's size, structure, and health. We conducted a clinical trial with 37 patients, comparing the 2 types of abutments in the same mouth over 12 weeks. Our findings showed that the concave abutments led to a taller and more extensive layer of protective tissue around the implant compared to the cylindrical ones. This protective tissue had more favorable collagen fiber orientation, which is important for the strength and health of the tissue. Additionally, the concave abutments resulted in less inflammation and better tissue integration. In conclusion, concave abutments may provide better support and health for the soft tissue around dental implants, reducing the risk of chronic inflammation and potentially leading to better long-term outcomes for patients with dental implants.
本研究旨在分析凹形和圆柱形基台对种植体周围软组织的影响。评估了尺寸、胶原纤维方向和免疫组化数据。
进行了一项多中心、分口、双盲随机临床试验。分析了两组：圆柱形基台和凹形基台。在12周的愈合期后，收集种植体周围软组织样本，进行处理，并评估其尺寸、胶原纤维方向和免疫组化数据。评估炎症浸润和血管形成情况，并使用扫描电子显微镜分析基台表面。使用SPSS 20.0统计软件包进行统计分析。
共评估了37例患者的74个样本。种植体周围软组织尺寸的组织学评估显示，凹形和圆柱形基台之间存在显著差异。凹形基台的总高度（凹形：3.57±0.28 - 圆柱形：2.95±0.27）和屏障上皮延伸（凹形：2.46±0.17 - 圆柱形：1.89±0.21）更大（p<0.05），而龈上结缔组织延伸（凹形：1.11±0.17 - 圆柱形：1.03±0.16）略大（p>0.05）。胶原纤维方向有利于凹形基台（23.76±5.86），横向/垂直纤维明显多于圆柱形基台（15.68±4.57）。免疫组化分析表明，两种基台下部的炎症和血管强度均较高，但凹形基台的总体强度较低（凹形：1.05±0.78 - 圆柱形：1.97±0.68）（p<0.05）。基台表面分析显示，凹形基台上组织残留的百分比更高（42.47±1.32；45.12±3.03）（p<0.05）。
在本研究的局限性内，与厚组织表型中的圆柱形基台相比，凹形基台的种植体周围组织高度明显更高，与屏障上皮的延伸有关。这种增强的软组织封闭有利于更高比例的横向排列胶原纤维。凹形设计减少了T细胞和B细胞引起的慢性炎症渗出，从而将慢性炎症风险降至最低。
本研究观察了两种不同形状的牙种植体基台（连接种植体与牙冠的部分），即凹形和圆柱形，如何影响种植体周围的软组织。我们想了解这些形状如何影响组织的大小、结构和健康状况。我们对37例患者进行了一项临床试验，在12周内比较同一口腔内的两种基台类型。我们的研究结果表明，与圆柱形基台相比，凹形基台导致种植体周围的保护组织层更高、更广泛。这种保护组织具有更有利的胶原纤维方向，这对组织的强度和健康很重要。此外，凹形基台导致炎症更少，组织整合更好。总之，凹形基台可能为牙种植体周围的软组织提供更好的支持和健康状况，降低慢性炎症风险，并可能为牙种植体患者带来更好的长期效果。
