J Korean Acad Prosthodont.  2011 Oct;49(4):346-353. 10.4047/jkap.2011.49.4.346.

Considerations in implant crestal module to preserve peri-implant tissue

Affiliations
  • 1Department of Prodthodontics, Yonsei University College of Dentistry, Seoul, Korea. drypark@yuhs.ac

Abstract

PURPOSE
The peri-implant 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 peri-implant bone. The purpose of this study is to review on the causes of initial marginal bone resorption, the configuration of peri-implant soft tissue, and the implant crestal module favorable in preserving peri-implant 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 peri-implant 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 peri-implant 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 peri-implant 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 peri-implant tissues.

Keyword

Implant crestal module; Implant neck design; One piece implant; Internal hex abutment; Taper joint connection; Platform switching concept

MeSH Terms

Bone Resorption
Joints
Neck
Pectinidae
Prognosis
Prosthodontics

Figure

  • Fig. 1. Infiltrated connective tissue zone around the implant.

  • Fig. 2. Sealing around the soft tissue is excellent and adequate thickness could be maintained at the fixture-abutment interface in platform switching concept.


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