{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:15:27Z","timestamp":1787015727207,"version":"build-2736575974"},"reference-count":16,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100014654","name":"Dentsply Sirona","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014654","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Periodontal Research"],"published-print":{"date-parts":[[2026,2]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aims<\/jats:title>\n To evaluate the influence of at least three abutment disconnections in conventionally loaded implants against placement of a definitive abutment in immediately non\u2010occlusal loaded implants on hard and soft tissue changes. A secondary aim was to evaluate whether the presence of less than 2\u2009mm of keratinised mucosa is associated with increased peri\u2010implant marginal bone loss and soft tissue recessions.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Sixty patients requiring one single crown or one fixed partial prosthesis supported by a maximum of three implants were randomised, after implants were placed with a torque superior to 35\u2009Ncm, according to a parallel group design to receive definitive abutments which were loaded immediately (definitive abutment group) or transmucosal abutments which were delayed loaded after 3\u2009months and were removed at least three times (repeated disconnection group). Patients were treated in three centres, and each patient contributed to the study with only one prosthesis followed for 12\u2009years after initial loading. Outcome measures were: prosthesis failures, implant failures, complications, pink esthetic score (PES), buccal recessions, patient satisfaction, peri\u2010implant marginal bone level changes, and height of the keratinised mucosa.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Thirty patients were randomly allocated to each group according to a parallel group design. Six patients dropped out or died from the definitive abutment group and seven from the repeated disconnection group. At 12\u2009years post\u2010loading, no patient in the definitive abutment group had implant failures versus three patients who lost five implants in the repeated disconnection group (difference\u2009=\u200913.04%; 95% CI: \u22126.7 to 26.8 to;\n p<\/jats:italic>\n \u2009=\u20090.109; Fisher's exact test). No patient in the definitive abutment group had a prosthesis failure versus four patients of the repeated disconnection group. The difference was statistically significant (difference\u2009=\u200917.39%; 95% CI: 1.9 to 32.9;\n p<\/jats:italic>\n \u2009=\u20090.049; Fisher's exact test). Four patients from the definitive abutment group versus seven patients from the repeated disconnection group were affected by complications (difference\u2009=\u200913.77%; 95% CI: \u221237.8 to 10.2;\n p<\/jats:italic>\n \u2009=\u20090.318; Fisher's exact test), the difference not being statistically significant. PES scores did not show any statistically significant differences between the two groups: 10.84\u2009\u00b1\u20091.95 for the definitive abutment group and 10.31\u2009\u00b1\u20092.57 for the repeated abutment changes group (difference\u2009=\u2009\u22120.53; 95% CI: \u22121.14 to 2.20;\n p<\/jats:italic>\n \u2009=\u20090.505). Buccal recessions amounted to 0.30\u2009\u00b1\u20090.98\u2009mm for the definitive abutment group and 0.15\u2009\u00b1\u20090.54\u2009mm for the repeated abutment changes group with no statistically significant differences between the two groups (difference\u2009=\u2009\u22120.14; 95% CI: \u22120.69 to 0.41;\n p<\/jats:italic>\n \u2009=\u20090.592). All patients were declared to be very satisfied with the function and aesthetics of the prostheses and would undergo the same procedure again. Mean peri\u2010implant marginal bone loss was 0.25\u2009\u00b1\u20090.49\u2009mm for the definitive abutment group and 0.70\u2009\u00b1\u20091.04\u2009mm for the repeated abutment changes group (difference\u2009=\u20090.45; 95% CI: \u22120.16 to 1.05;\n p<\/jats:italic>\n \u2009=\u20090.135), the difference not being statistically significant. Height of keratinised mucosa was 2.56\u2009\u00b1\u20091.75 for the definitive abutment group and 2.77\u2009\u00b1\u20092.07 for the repeated abutment changes group (difference\u2009=\u20090.21\u2009mm; 95% CI: \u22121.06 to 1.49;\n p<\/jats:italic>\n \u2009=\u20090.746). There was no significantly increased marginal bone loss (difference\u2009=\u20090.20; 95% CI: \u22120.06 to 0.33;\n p<\/jats:italic>\n \u2009=\u20090.268) or buccal recessions (difference\u2009=\u20090.10; 95% CI: \u22120.05 to 0.33;\n p<\/jats:italic>\n \u2009=\u20090.203) at implants having less than 2\u2009mm of keratinised mucosa at loading.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n More prosthesis failures were observed at 12\u2009years after loading when comparing implants that underwent at least three repeated abutment disconnections to implants subjected to no disconnection. Immediate non\u2010occlusal loading is a viable alternative to conventional loading. No increased bone loss or buccal recessions were noticed at implants with less than 2\u2009mm of keratinised mucosa compared to those having more than 2\u2009mm of keratinised mucosa.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jre.13418","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T07:04:24Z","timestamp":1748934264000},"page":"165-179","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Influence of Repeated Abutment Changes on Peri\u2010Implant Tissue Stability and Keratinised Tissue on Peri\u2010Implant Health: 12\u2010Year Post\u2010Loading Results From a Multicentre Randomised Controlled Trial"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4698-8598","authenticated-orcid":false,"given":"Eriberto","family":"Bressan","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Specialties University of Padua Padua Italy"},{"name":"Private Practice Chions Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4078-384X","authenticated-orcid":false,"given":"Maria Gabriella","family":"Grusovin","sequence":"additional","affiliation":[{"name":"Private Practice Gorizia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6562-8874","authenticated-orcid":false,"given":"Riccardo Federico","family":"Visconti","sequence":"additional","affiliation":[{"name":"Dental School IRCCS San Raffaele Scientific Institute and Vita\u2010Salute San Raffaele University Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9104-2916","authenticated-orcid":false,"given":"Giuseppe","family":"Luongo","sequence":"additional","affiliation":[{"name":"Federico II University Naples Italy"},{"name":"Private Practice Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8624-0878","authenticated-orcid":false,"given":"Pasquale","family":"Piombino","sequence":"additional","affiliation":[{"name":"Maxillofacial Department Federico II University of Naples Napoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1653-7288","authenticated-orcid":false,"given":"Katia","family":"Greco","sequence":"additional","affiliation":[{"name":"Dental School IRCCS San Raffaele Scientific Institute and Vita\u2010Salute San Raffaele University Milan Italy"},{"name":"Private Practice Maglie Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9945-0666","authenticated-orcid":false,"given":"Jacopo","family":"Buti","sequence":"additional","affiliation":[{"name":"Unit of Periodontology UCL Eastman Dental Institute London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2222-5764","authenticated-orcid":false,"given":"Luca","family":"Sbricoli","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Specialties University of Padua Padua Italy"},{"name":"Private Practice Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2952-9933","authenticated-orcid":false,"given":"Marco","family":"Esposito","sequence":"additional","affiliation":[{"name":"Dental School IRCCS San Raffaele Scientific Institute and Vita\u2010Salute San Raffaele University Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,3]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Osseointegrated Implants in the Treatment of the Edentulous Jaw. 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One\u2010Year Post\u2010Loading Results From a Multicentre Randomised Controlled Trial","volume":"10","author":"Esposito M.","year":"2017","journal-title":"European Journal of Oral Implantology"},{"key":"e_1_2_11_14_1","first-page":"373","article-title":"The Influence of Repeated Abutment Changes on Peri\u2010Implant Tissue Stability: 3\u2010Year Post\u2010Loading Results From a Multicentre Randomised Controlled Trial","volume":"10","author":"Bressan E.","year":"2017","journal-title":"European Journal of Oral Implantology"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.36130\/CTD.02.2020.03"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0501.2005.01193.x"},{"key":"e_1_2_11_17_1","first-page":"13","article-title":"On the Role of Keratinised Mucosa at Dental Implants: A 5\u2010Year Prospective Single\u2010Cohort Study","volume":"12","author":"Todisco M.","year":"2019","journal-title":"International Journal of Oral Implantology"}],"container-title":["Journal of Periodontal Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jre.13418","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jre.13418","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jre.13418","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T07:00:14Z","timestamp":1773385214000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jre.13418"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,3]]},"references-count":16,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1111\/jre.13418"],"URL":"https:\/\/doi.org\/10.1111\/jre.13418","archive":["Portico"],"relation":{},"ISSN":["0022-3484","1600-0765"],"issn-type":[{"value":"0022-3484","type":"print"},{"value":"1600-0765","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,3]]},"assertion":[{"value":"2025-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}