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Prosthetic design and choice of components for maintenance of optimal peri-implant health: a comprehensive review

British Dental Journal volume 236, pages 765–771 (2024)Cite this article

Abstract

Current research has identified features of the prosthetic design with potential to significantly impact the long-term health of peri-implant tissues, while the choice of prosthetic components is also shown to be critical in an effort to reduce long-term complications of implant therapy. Overcontouring of the prosthesis emergence profile has been associated with marginal bone loss, recession and peri-implantitis, while the mucosal emergence angle is shown to have a strong association with peri-implant tissue inflammation. Further elements of interest include convexity/concavity of the restoration, the prosthetic connection and the different geometric configurations of junctions, as well as the peri-implant tissue dimensions. With regards to implant components, the choice between original and third-party-manufactured components might come with implications, as differences in material and microgeometry might impact precision of fit and overall performance, potentially leading to complications. Scrutiny of the specifications and manufacturing is essential when third-party-manufactured components are considered.

The aim of this narrative review was to summarise the current evidence with regards to the restorative features of the implant prosthesis and also the selection of prosthetic components which can have implications for the long-term success of the implant therapy. Furthermore, the review aimed at interpretating current scientific evidence into meaningful strategies and recommendations to implement in clinical practice of implant dentistry.

Key points

  • Certain design elements of the contour of implant prostheses have been associated with mucositis, peri-implantitis, early marginal bone loss and recession.

  • Avoiding convex and overcontoured prostheses near the bone level, as well as at the mucosal margin, can help decrease the risk for long-term complications and inflammation.

  • The decision to use non-original components involves a trade-off between cost savings and increased risks associated with performance and longevity. The use of original components is recommended for optimal long-term success in dental implant treatments. While non-original components may offer cost reductions, their use raises concerns about compatibility issues, improper fit, and compromised stability, potentially leading to mechanical complications and a higher risk of adverse outcomes compared to original components.

  • The selection between original and non-original dental implant components can involve visible macroscopic differences, such as length and engagement, as well as critical microscopic variations, impacting fit and precision, even when not visually apparent.

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Authors and Affiliations

  1. Department of Prosthodontics, Faculty of Odontology, Malmö University, Sweden

    Martin Janda

  2. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Thailand; Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden

    Nikos Mattheos

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Martin Janda: conceptualisation, writing - review and editing and project administration. Nikos Mattheos: writing - review and editing.

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Correspondence to Martin Janda.

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Janda, M., Mattheos, N. Prosthetic design and choice of components for maintenance of optimal peri-implant health: a comprehensive review. Br Dent J 236, 765–771 (2024). https://doi.org/10.1038/s41415-024-7357-0

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