Factors Influencing Marginal Bone Loss in Dental Treatment Planning and Prosthetic Phases
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Introduction: This review aims to explore the prosthetic factors that affect marginal bone loss (MBL) in dental implants and to provide evidence-based insights to improve clinical outcomes and ensure long-term implant success. Materials and Methods: A total of 236 articles were initially retrieved through database searches using keywords such as “implant design,” “platform switching,” “emergence profile,” and “marginal bone loss,” and 38 were selected based on relevance, methodological rigor, and level of evidence, with preference given to systematic reviews, meta-analyses, and recent studies. The selected studies were narratively summarized based on the following topics. Results: Internal connection implants showed significantly lower MBL than external connection types. The emergence profile, particularly the emergence angle, was identified as a critical factor for peri-implant bone stability, with over-contoured designs being associated with increased MBL. Residual cement at subgingival margins posed a significant risk of peri-implant inflammation and bone loss. Fixture length and diameter had limited direct effects, but deeper implant placement was associated with greater initial MBL while reducing thread exposure over time. The crown-toimplant ratio and cantilever design were associated with biomechanical stress and bone loss. Conclusion: Splinting improved load distribution and implant survival rates, but also increased hygienic challenges and the risk of peri-implantitis.
Abstract
Introduction: This review aims to explore the prosthetic factors that affect marginal bone loss (MBL) in dental implants and to provide evidence-based insights to improve clinical outcomes and ensure long-term implant success. Materials and Methods: A total of 236 articles were initially retrieved through database searches using keywords such as “implant design,” “platform switching,” “emergence profile,” and “marginal bone loss,” and 38 were selected based on relevance, methodological rigor, and level of evidence, with preference given to systematic reviews, meta-analyses, and recent studies. The selected studies were narratively summarized based on the following topics. Results: Internal connection implants showed significantly lower MBL than external connection types. The emergence profile, particularly the emergence angle, was identified as a critical factor for peri-implant bone stability, with over-contoured designs being associated with increased MBL. Residual cement at subgingival margins posed a significant risk of peri-implant inflammation and bone loss. Fixture length and diameter had limited direct effects, but deeper implant placement was associated with greater initial MBL while reducing thread exposure over time. The crown-toimplant ratio and cantilever design were associated with biomechanical stress and bone loss. Conclusion: Splinting improved load distribution and implant survival rates, but also increased hygienic challenges and the risk of peri-implantitis.