Effect of Soft Tissue Thickness on Crestal Bone Levels and Implant Stability With Platform-Switched Abutments: A Prospective Study.

INTRODUCTION

Soft tissue thickness may play a role in the success of dental implants by influencing factors such as bone health and implant stability. This study aimed to evaluate the effect of mucosal thickness on crestal bone levels and implant stability in patients with platform-switched abutments. The objectives were to measure bleeding on probing (BOP), implant stability, and changes in crestal bone levels in thin and thick mucosal environments over six months post-prosthetic loading.

MATERIALS AND METHODS

This prospective study included 20 partially edentulous patients divided into two groups: Group 1 (thin mucosa, <1 mm) and Group 2 (thick mucosa, 1-2 mm). Mucosal thickness was measured using a Mani K-file no. 20 (Mani, Utsunomiya, Japan). Two-piece titanium implants (3.7 mm diameter, 10 mm length, Alpha Bio, Petah Tikva, Israel) were placed using a surgical stent and sequential drilling with a physiodispenser (W&H, Bürmoos, Austria). Implant stability was assessed by resonance frequency analysis using an Osstell device (Osstell AB, Göteborg, Sweden). Crestal bone levels were measured using intraoral periapical radiographs with an X-ray grid. Platform-switched (PS) abutments were placed at three months, followed by screw-retained metal ceramic crowns. Clinical parameters (BOP, mucosal thickness, implant stability, and crestal bone levels) were evaluated at baseline, three months during the second surgery, and six months post-prosthetic loading. Data were analyzed using parametric and nonparametric tests with significance set at p < 0.05.

RESULTS

The thick mucosa group exhibited significantly less crestal bone loss and higher implant stability at six months than the thin mucosa group (p < 0.05). BOP was absent in both groups of patients. Mucosal thickness remained stable, with significant differences between groups at all time points (p = 0.001). Implant stability improved over time in both groups (p = 0.001).

CONCLUSION

PS abutments promoted favorable peri-implant outcomes, with thicker mucosa associated with reduced crestal bone loss and enhanced stability, highlighting the role of mucosal thickness in optimizing implant success.