title: Factors influencing the preservation of the periimplant marginal bone.
abstract: Esthetic outcomes cannot be attributed to a single parameter. Rather, as this article shows, they are the result of a number of important factors, especially in the esthetic zone. An understanding of the meaning of biologic width, of the integration of the platform-switching concept into implant treatment facilitates the preservation of a stable marginal bone level around the implant neck. This stable bone then serves to support the soft tissue, determining the long-term esthetic and functional treatment outcomes stability. The following points should be noted: (1) A prefabricated post that can be used both as a temporary post and as the definitive abutment helps to avoid a frequent replacement of secondary components, provided that the 3-dimensional position of the implant is correct. It prevents a repeated destruction of the connective-tissue attachment on the biologic width, which would carry with it the risk of bone resorption. (2) A special implant and abutment design (a ledge and integration of the biologic width/tapered shape of the post) facilitates nonsurgical lengthening and thickening of the periimplant soft tissue. This leads to the establishment of a wider and more resistant zone of connective tissue. (3) A microrough and nanorough titanium surface extending to the implant shoulder in conjunction with the platform-switching concept provides osseous integration along the entire length of the implant. A fine thread optimally distributes the masticatory forces in the region of the implant neck, avoiding further bone loss in this region.
authors.affiliation: Bruchsaler Strasse 8, 76703 Kraichtal, Germany. frederic.herrmann@gmx.de
authors.forename: Frederic
authors.initials: F
authors.lastname: Hermann
authors.forename: Henriette
authors.initials: H
authors.lastname: Lerner
authors.forename: Ady
authors.initials: A
authors.lastname: Palti
mesh_terms: D016301:Alveolar Bone Loss / Q000517:prevention & control*; D000539:Alveolar Process / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001732:Bite Force; D003238:Connective Tissue / Q000473:pathology; D000044:Dental Abutments; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D003764:Dental Materials / Q000737:chemistry; D017267:Dental Prosthesis Design; D004955:Esthetics, Dental; D005881:Gingiva / Q000473:pathology; D006801:Humans; D016348:Osseointegration / Q000502:physiology; D011859:Radiography; D013314:Stress, Mechanical; D013499:Surface Properties; D014025:Titanium / Q000737:chemistry; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants; D003764:Dental Materials; D014025:Titanium