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The effect of One-Abutment at One-Time Protocol on peri-implant soft tissue health and marginal bone loss around dental Implants; A systematic review
Purpose: Aim of the study is to compare one abutment one time protocol which uses an immediate hybrid abutment and the traditional technique which uses a titanium stock abutment to find out which provides more stable peri-implant soft and hard tissue around implants. Material and Method: An electronic search of the literature was performed between December 2015 and September 2021 to identify all articles related to our research questions. The search was conducted using PubMed. Multiple keywords, including one abutment one time, immediate, anterior, marginal bone loss, reconnection, disconnection abutment were used. This was followed by a manual search, and references were used to identify relevant articles. Another additional electronic searches were performed using different keywords including zirconia milled abutments, ceramic milled abutments, hybrid abutments, provisional abutment, custom abutments. Results: As well as the design of implant, the number of re-disconnection showed an influence on the marginal bone loss. On platform switch implants a greater number of disconnection may generate more peri-implant bone resorption. One or two times disconnection didn't have a significant influence but more than two times of disconnection induced marginal bone loss. On non-platform switch implants single disconnection of abutments may cause the similar amount of marginal bone loss to that produced by 4 times of disconnection. For longer observation periods the loss was generally higher. Re-disconnection number also is reported to be an important factor for especially PS abutments. There are limited studies available for comparing use of hybrid abutments for one abutment one time technique and titanium stock abutments for traditional workflow. Conclusion: The marginal bone loss reported in one abutment one-time technique is statistically significantly reduced in platform switch implants which may not have a clinical impact. Avoiding recurrent disturbance of mucosal seal leads to more stable soft tissues around the implants which may provide a reduced marginal bone resorption.