Crestal bone loss and implant failure of prefabricated versus customized abutments: a 10-year retrospective radiological study

Objectives: There is no information today about the impact of abutment type on the crestal bone stability. This retrospective study was aimed to evaluate the crestal bone levels (CBL) and failures of implants with prefabricated and customized abutments after the long term. Materials and methods: The mesial and distal CBL around dental implants with prefabricated and custom abutments were recorded. Measures were completed at 5- and 10-year endpoints. Results: Sixty-three patients with 249 implants were included. One hundred twenty-seven implants (51%) were restored with prefabricated and 122 implants (49%) with customized abutments. All the patients received fixed restorations. The results showed that the CBL was higher in patients with custom abutments than the CBL of patients with prefabricated abutments. The mean bone loss around implants with prefabricated abutments was 0.29 mm mesial/0.45 mm distal after 10 years. Meanwhile, the mean bone loss at implants with custom abutments was 1.19 mm mesial/1.27 mm distal (p < 0.05) after 10 years. None of the implants with prefabricated abutments failed up to 10-year follow-up, whereas 4.1% of implants with customized abutments failed. Conclusion: Implants with prefabricated abutments present less crestal bone loss compared to customized abutments. Clinical relevance. The selection of abutment type is associated with the crestal bone stability or marginal bone loss.