THE EFFECT OF ABUTMENT RECONNECTION AND DISCONNECTION ON PERI-IMPLANT MARGINAL BONE: A SYSTEMATIC REVIEW AND META-ANALYSIS

Resnick Auditorium

Objective. The aim of the present systematic review and meta-analysis was to evaluate the effect of abutment disconnection and reconnection on peri-implant marginal bone. Background. It has been reported that multiple abutment disconnections and reconnections following implant placement may compromise the peri-implant mucosal seal and may lead to increased marginal bone loss. Methods. This review was conducted according to the PRISMA guidelines for systematic reviews. An electronic search was conducted in databases including Ovid Medline, Elsevier EMBASE, and EBSCO CINAHL from January 1937 up to Oct 2015 to find clinical studies to evaluate the effect of abutment reconnection and disconnection on peri-implant marginal bone. Two reviewers independently screened titles and abstracts for potential inclusion. Meta-analyses were conducted for the primary outcome: peri-implant marginal bone level change. The mean differences of peri-implant marginal bone loss between implants received final abutments at the time of implant placement and implants submitted to multiple abutment reconnections and disconnections were estimated as the effect-size measures. Results. A total of 392 titles and abstracts were identified after de-duplicating the electronic search. 383 articles were excluded as irrelevant to the PICO question. Scrutiny of the full-text articles from the remaining 9 articles led to the exclusion of 2 studies after application of the pre-specified exclusion criteria. In total, 7 clinical studies were included in this review. All studies reported changes in periimplant marginal bone level as an outcome. Meta- analysis of seven studies showed an increased in mean (95% confidence interval) marginal bone loss of 0.19 (0.06- 0.32) mm. Conclusion. Multiple abutment reconnections and disconnections are associated with statistically significant increased marginal bone loss, when compared to final abutment placement at the time of implant surgery (one abutment one time). Grants. N/A