Influence of repeated implant‐abutment manipulation on the prevalence of peri‐implant diseases in complete arch restorations. A retrospective analysis

Purpose To evaluate the effects of repeated abutment manipulation on the prevalence of peri‐implant diseases. Materials and Methods A total of 27 edentulous patients ( n = 108 implants) immediately restored with double‐crown retained implant‐supported prostheses were identified for this retrospective study. The test included the one‐abutment, one‐time care concept ( n = 18 patients, n = 72 implants, OAOT) and the control abutment replacement ( n = 9 patients, n = 36 implants, AR). A mixed effects model regression was conducted for the variable diagnosis (healthy, peri‐implant mucositis, and peri‐implantitis) with predictors abutment replacement (presence/absence), number of abutment replacement, category of keratinized mucosa (KM) (2 < KM ≥2 mm), and radiographic bone loss (BL). Results After 3–15 years (mean 10.2 ± 2.8 years), the prevalence of peri‐implant mucositis and peri‐implantitis in patients in the AR group was 11.1% and 88.9%, corresponding to 22.2% and 55.6% at the implant level, respectively. In OAOT group, none of the implants showed peri‐implant mucositis, whereas the prevalence for peri‐implantitis at patient and implant level amounted to 5.6% and 5.6%, respectively. The increased number of abutment replacements was significantly associated with the increased probability to diagnose peri‐implant mucositis and peri‐implantitis (OR: 6.13; 95% CI [2.61, 14.39]) ( p < 0.001), whereas the presence of keratinized mucosa was not founded as a significant cofounder. The estimated mean BL in AR group was 1.38 mm larger than in OAOT group ( p = 0.0190). Conclusions The OAOT concept was associated with a lower prevalence of peri‐implant diseases.