Objectives: This paper aims to observe peri-implant time-related vertical bone level and soft tissue changes with immediate, non-detached glass-ceramic (lithium-disilicate) individualized abutments and dis-/reconnections.
Materials and methods: Sixteen split-mouth patients received provisionalized immediate definitive individualized abutments (test T) versus dis-/reconnected individualized abutments (control C). In group T, digital impressions were made by using titanium bases (Conelog, Camlog), and individualized abutments (E.maxCAD) and temporary crowns (TelioCAD) were designed and milled (CerecMCXL). Lithium-disilicate abutments were crystallized and luted (Multilink Hybrid Abutment) to titanium bases. Non-occluding temporary crowns were connected to abutments. After 16 weeks, definitive digital restorations were delivered. In group C, 8 weeks were allowed after healing cap mounting for conventional impressions. Lithium-disilicate individualized abutments were produced, try-ins were performed by dis-/reconnections. Crowns were luted. Cone beam computed tomography (CBCT) images were obtained at restoration delivery, 12 months and 24 months. Pink esthetic scoring was made, plaque-gingival index measurements were done and statistical analyses (Shapiro-Wilk, Mann-Whitney U, Wilcoxon's, Spearman's rank, α = 0.05) were completed.
Results: No implant failures occurred. At 12 months, T (-0.1 ± 0.14 mm) exhibited significantly reduced vertical bone loss only on the labial side than C (-0.24 ± 0.13 mm) (p < 0.05). In T, all sides except distal presented reduced vertical bone loss at 24 months (p < 0.05). Vertical bone loss for all measurement sides in both C (-0.12 ± 0.09 mm; -0.18 ± 0.11 mm) and T (-0.17 ± 0.11; -0.26 ± 0.10 mm) was higher for 24 months than 12 months, respectively (p < 0.05).
Conclusions: Reduced vertical bone loss was observed around implants with immediate definitive individualized abutments than abutments with repeated dis-/reconnections.
Clinical relevance: Non-detached immediate definitive lithium-disilicate individualized abutments and provisionalization through digital technology resulted in successful clinical outcomes and can be routinely applied.
Keywords: Glass-ceramic; Immediate implant; Individualized abutment.