Tissue reactions to abutment shift: an experimental study in dogs.
BACKGROUND
Standard protocols for the clinical use of dental implants often include the placement of healing abutments prior to standard or custom-made abutments. The tissue response to a single shift from a healing abutment to a permanent abutment has not been studied.


OBJECTIVE
The aim of the present experiment was to study tissue reactions that may occur following the removal of a healing abutment and the placement of a permanent abutment.


METHODS
In six beagle dogs, all mandibular premolars were extracted. Three months later three fixtures of the Astra Tech Implants Dental System (Astra Tech AB, Mölndal, Sweden) were installed in each edentulous premolar region. An additional 3 months later, the first abutment connection was performed. In two sites on each side of the mandible, healing abutments were placed; in the remaining site, a Uni-abutment (Astra Tech AB) was used. The two healing abutments were removed 2 weeks later, and one Uni-abutment and one prepable abutment were placed. A plaque-control period was initiated, and 6 months later block biopsies were obtained. The biopsies were prepared for histometric and morphometric examination. Radiographs were obtained at fixture placement, 2 weeks after the first abutment connection, and 6 months later.


RESULTS
The length of the barrier epithelium, the height of the connective tissue attachment, and the level of the marginal bone did not differ between the three abutment groups. The major part of the radiographic bone loss during the experiment took place prior to or immediately after abutment connection; only small bone level alterations occurred during the subsequent 6-month period.


CONCLUSIONS
The shift from a healing abutment to a permanent abutment resulted in the establishment of a transmucosal attachment, the dimension and quality of which did not differ from those of the mucosal barrier formed to a permanent abutment placed during a second-stage surgery.
Abrahamsson
Ingemar
I
Department of Periodontology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden. ingemar.abrahamsson@odontologi.gu.se
Berglundh
Tord
T
Sekino
Satoshi
S
Lindhe
Jan
J
D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000473:pathology; D000704:Analysis of Variance; D000818:Animals; D002508:Cephalometry; D003238:Connective Tissue / Q000473:pathology; D000044:Dental Abutments; D015921:Dental Implants; D003773:Dental Plaque / Q000517:prevention & control; D017267:Dental Prosthesis Design; D004285:Dogs; D004846:Epithelial Attachment / Q000473:pathology; D007576:Jaw, Edentulous, Partially / Q000534:rehabilitation / Q000601:surgery; D008334:Mandible / Q000000981:diagnostic imaging / Q000601:surgery; D009061:Mouth Mucosa / Q000473:pathology; D010519:Periodontium / Q000473:pathology*; D011859:Radiography; D013499:Surface Properties; D013997:Time Factors; D014945:Wound Healing / Q000502:physiology
D015921:Dental Implants