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International Journal of Periodontics & Restorative Dentistry
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Int J Periodontics Restorative Dent 40 (2020), No. 1     3. Jan. 2020
Int J Periodontics Restorative Dent 40 (2020), No. 1  (03.01.2020)

Page 9-17, doi:10.11607/prd.3642, PubMed:31815968


Clinical Considerations on Strategies That Avoid Multiple Connections and Disconnections of Implant Abutments
Canullo, Luigi / Tallarico, Marco / Gracis, Stefano / Vela, Xavier / Rodriguez, Xavier / Covani, Ugo
Typically, healing or temporary abutments are connected and disconnected several times between implant placement and definitive restoration delivery, and soft tissue disruption occurs each time the abutment is disconnected and reconnected. This histologic event is supposed to cause bone resorption around the implant after second-stage surgery. To minimize this clinical scenario, immediately placing and never removing a definitive abutment the day of implant insertion (one-stage protocol) or at second-stage surgery in cases of submerged implants (two-stage protocol) was suggested. This paper details the prosthetic protocol and presents strategies and rationales for placing a definitive abutment the day of implant insertion or at second-stage surgery with cement- and screw-retained restorations. This protocol seems to be an efficient strategy to preserve peri-implant hard and soft tissues. However, positive outcomes in peri-implant bone and soft level changes should be viewed with caution, as their clinical significance is still uncertain.