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Journal of Oral Science & Rehabilitation No. 4, 2016

Journal of Oral Science & Rehabilitation 72 Volume 2 | Issue 4/2016 E f f e c t s o f i n s e r t i o n t o r q u e o n h a r d a n d s o f t t i s s u e a f t e r t w o y e a r s However, a recent systematic review analyzing bone resorption, implant failure and bone- implant contact found no significant differenc- es between implants inserted with a high or low IT.22 The same review stated that there is poor evidence regarding the correlation be- tween excessive bone compression and bone resorption, but there is still no clear statement about the minimum IT necessaryto obtain clin- ical success, even when considering immediate loading.22 As the soft-tissue appearance significantly influences the esthetics of implants, its treat- ment is of great importance, although more research on the behavior of soft tissue around dental implants is required. In our findings, significant differences were observed in soft-tissue changes too. In the high- IT group, the FSTL significantly decreased after oneyearandremainedquitestableatthetwo-ye- ar follow-up. In the regular-IT group, the FSTL remained stableforthe oneyear, andthen it see- med to gain soft tissue, the difference between the two groups becoming more evident, both in the maxilla and in the mandible. If we consider the BBT, recession of the FSTL seemed to be si- gnificantly influenced by a BBT < 1 mm. Differences were evident within both of the ex- perimentalgroups.Infact,theΔFSTLinthehigh- IT group at 24 months was -1.15 ± 0.36 mm for Group A and -0.67 ± 0.66 mm for Group B. The ΔFSTL in the regular-IT group at 24 months was -0.21 ± 0.42 mm in Group A and -0.09 ± 0.42 mm in Group B. These results are in line with that of other studies, which found 0–1 mm gingival recessi- on at the buccal side of implants placed in post-extractive sites and restored after three weeks.23 The same studies did not observe sig- nificant recession in sites with a thick gingival biotype; therefore, the FSTL seemed to be in- fluenced not only by the bone but also by the tissue thickness.23 The implants inserted in the present study were not immediately restored. A key point of this study is the observation period: Two years is a relatively short follow-up inwhich to observe the behavior not onlyduring the osseointegration period but also after the prosthesis delivery. Also, surgical sites were strictly selected, excluding the possible influ- ence of bone augmentation; thus, only IT and BBT were studied. IT and bone resorption were measured via software, allowing precise and reliable comparisons. Conclusion The present randomized clinical trial analyzed the effect ofITon MBLand FSTLaftertwoyears. The effect of BBT on MBL after the implant osteotomy was investigated too. Implants in- sertedwith an IT> 50 N cm showed significant- ly more bone resorption; this was evident after one year, but became even more marked at the two-yearfollow-up.The FSTLshowed more ev- ident recession in the high-IT group after two years, especially in implants with a BBT < 1 mm after osteotomy. The findings of this study suggest that in- serting implants with a high IT could be detri- mental to soft- and hard-tissue outcome, even though the implant success rate was similarfor the high-ITand regular-ITgroups. Furthermore, the clinician should pay great attention during the preparation of the implant site, as a BBT > 1 mm could positively affect the long- term behavior of soft tissue. Although the ran- domization process lent reliabilityto the results, thefindings ofthis studyshould be corroborated with a longer follow-up and a greater number of patients. Competing interests The authorsdeclarethattheyhave nocompeting interests.

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