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RESEARCH PRODUCT

Definitive Abutments Placed at Implant Insertion and Never Removed: Is It an Effective Approach? A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

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Purpose To assess whether repeated abutment disconnections and reconnections have any impact on peri-implant bone resorption and soft tissue healing. Materials and Methods Electronic and manual searches were conducted for English-language articles published up to March 2017 that identified a relation between repeated disconnections of implant abutments (PA group) and prosthetic or implant failures, complications, marginal bone loss (MBL), soft tissue healing, and esthetic evaluation (pink esthetic score [PES]) after at least 1 year of function compared with implants receiving a final abutment at the time of implant placement (DA group). Results Fourteen articles (535 patients with 994 implants) were selected for qualitative analysis. Six of these were included in the meta-analysis. Five prostheses failed in the PA group and 1 failed in the DA group (P = .1047). Seven biologic complications occurred in the PA group and 6 occurred in the DA group (P = .8121). MBL was significantly less in the DA group (difference, 0.279 mm; P = .000). Greater buccal recession occurred in the PA group (difference, 0.198 mm; P = .0004). The PES evaluation showed no differences between groups (P = .289). Conclusions Repeated abutment disconnections and reconnections considerably increased MBL and buccal recession. Further studies are needed to confirm these results.