Prosthetic factors influencing the prevalence of peri‐implant diseases and marginal bone loss in static computer‐assisted implant sites: A cross‐sectional study

Abstract Background Current evidence indicates a possible link between the design of the implant‐abutment‐prosthesis complex and the development of peri‐implant diseases. This cross‐sectional study aimed to investigate the association between implant and prosthetic factors and the prevalence of peri‐implant diseases and peri‐implant marginal bone loss in patients treated with static computer‐assisted implant surgery (sCAIS). Methods This cross‐sectional study included 115 patients with 417 dental implants, all placed using a standardized sCAIS protocol and with more than 1 year of loading. Each implant was clinically and radiographically assessed, with diagnoses made based on established criteria. Bivariate and multivariable analyses were performed to identify implant and prosthetic parameters, such as implant connection, loading protocol, crown‐to‐implant ratio (CIR), implant surface, prosthesis type, prosthetic emergence angle (EA), prosthetic emergence profile (EP), cantilever length, mucosal height of the abutment (HA), interproximal contact level, inter‐implant distance, implant and abutment angulation, and presence of open contacts, as risk indicators associated with peri‐implant diseases, bleeding on probing (BOP) scores, and changes in the peri‐implant marginal bone level (MBL). Results Of the total implants, 156 were diagnosed as healthy, 241 exhibited mucositis, and 20 showed peri‐implantitis, corresponding to 37.4%, 57.8%, and 4.8% of the implants, respectively. An odds ratio (OR) of 2.16 (95% confidence interval CI: 1.003‐4.63) for peri‐implantitis was observed in implants supporting removable prostheses, with the fixed prosthesis group serving as the reference category. Marginal bone loss was significantly associated with higher interproximal contact levels, greater prosthetic EA, shorter abutment mucosal height, longer cantilever length, and anodized implant surface treatment, as determined by bivariate and multivariable analyses. Conclusions In the present cross‐sectional study, implants supporting overdentures were associated with a higher prevalence of peri‐implantitis. Furthermore, several implant‐abutment‐prosthesis complex factors were significantly linked to marginal bone loss around dental implants, including interproximal contact level, prosthetic EA, abutment mucosal height, cantilever length, and implant surface treatment. Clinicians are recommended to meticulously select prosthesis types/designs tailored to each peri‐implant site, apply digital technology for precise implant planning, and regularly monitor patients to detect and manage peri‐implant diseases in early stages. Plain language summary This clinical study looked at how the design of dental implants and their related components (like crowns and abutments) might influence the development of gum problems around implants and bone loss. It involved 115 patients with a total of 417 dental implants that had been placed using a precise, digitally guided technique and had been in place for over a year. The study found that many implants had issues like mucositis (gum inflammation) or peri‐implantitis (a more serious gum infection involving bone loss). Implants supporting removable prostheses (like overdentures) had a higher chance of developing peri‐implantitis compared to those with fixed prostheses (like crowns or bridges). Certain implant features, like how the prosthesis connects to the implant, the shape and height of the abutment, and the length of the cantilever (part of the prosthesis extending beyond the implant) were linked to bone loss around the implant. The conclusion of the study is that the design of the implant and its components plays an important role in preventing or contributing to peri‐implant diseases and bone issues. This study suggests that dentists should carefully choose the right implant and prosthesis design for each patient, use digital tools for precise planning, and monitor patients regularly to resolve peri‐implant problems early.