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Abstract
Purpose
The periimplant soft tissue is remodeled by the initial marginal bone resorption affecting the prognosis and esthetic result of treatment. Thus various designs on implant neck design are studied to preserve periimplant bone. The purpose of this study is to review on the causes of initial marginal bone resorption, the configuration of periimplant soft tissue, and the implant crestal module favorable in preserving periimplant tissue.
Materials and methods
The studies on the causes of initial marginal bone resorption and the implant crestal modules are researched and reviewed using Pubmed database. The implant crestal modules including one piece and two-piece implant, internal and external hex abutment, taper and butt joint connection, scalloped design abutment, and platform switching concept are reviewed.
Results
A number of clinical and experimental studies preferred one piece implant to two-piece in preserving initial periimplant tissue. For two piece implants, internal hex abutment and taper joint connection appear more favorable than external hex abutment and butt joint connection relatively. Controversial issues still exist on scalloped design requiring more studies on it. Although the rationale is not certain, the concept of platform switching seems favorable in preserving initial periimplant tissue based on clinical and experimental studies.
Conclusion
Each implant crestal module contains its own advantages and disadvantages with various controversial issues. In the aspect of preservation of initial periimplant tissue, however, one-piece implant seems beneficial. In cases when two-piece implant is more appropriate due to prosthodontic concerns or any other problems, the application of platform switching concept, internal connection abutment, and taper joint connection may be favorable for the preservation of periimplant tissues. (J Korean Acad Prosthodont 2011;49:346-53)
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Fig. 2.
Sealing around the soft tissue is excellent and adequate thickness could be maintained at the fixture-abutment interface in platform switching concept.
Table 1.
Advantages and disadvantages of external hex abutment and internal hex abutment
Table 2.
Clinical outcome of platform switching concept
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