Impact of Marginal Misfit in Implant-Supported Fixed Dental Prostheses on Peri-Implant Bone Levels - A Retrospective Quantitative Analysis

Q: Which factors were identified as independent risk factors for increased peri-implant bone level changes?

Smoking and a history of periodontitis were independent risk factors for increased radiographic distance (DIB values).

Sep 29, 2026

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Evaluate how the marginal fit of implant-supported prostheses influences peri-implant bone levels and establish a clinically relevant threshold for radiographic vertical misfit gap in the presence of such gaps. Use standardized intraoral periapical radiographs taken 10 years after loading to measure distance between the implant shoulder and crestal bone. Classify gaps by vertical dimensions and apply a multivariable linear mixed-effect model to control confounders. Analyze 301 patients and 505 implants to quantify effects and risk factors.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

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Abstract

Objectives

Methods

Results

Conclusions

Introduction

Clinical Oral Implants Research ORIGINAL ARTICLE OPEN ACCESS Impact of Marginal Misfit in Implant-Supported Fixed Dental Prostheses on Peri-Implant Bone Levels: A Retrospective Quantitative Analysis Emilio Couso-Queiruga1 | Christoph A. Ramseier2 | Vivianne Chappuis2 | Simone F. M. Janner M1 | Daniel Buser1 | Urs Brägger3 | Giovanni E. Salvi2 1Department of Oral Surgery and Stomatology, University of Bern School of Dental Medicine, Bern, Switzerland | 2Department of Periodontology, University of Bern School of Dental Medicine, Bern, Switzerland | 3Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, Bern, Switzerland Correspondence: Emilio Couso-Queiruga ([emilio.couso@unibe.ch](emilio.couso@unibe.ch)) Received: 5 May 2025 | Revised: 8 September 2025 | Accepted: 22 September 2025 Funding: This study was supported by the Departments of Periodontology, Oral Surgery and Stomatology, and Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern. A research grant from the ITI Foundation (ITI Grant No. 637-2009) also provided financial support. Keywords: bone resorption | dental digital radiography | dental implants | implant shoulder bone distance | implant-supported prostheses | outcome assessment ABSTRACT Objectives: To evaluate the impact of the marginal fit of implant-supported prostheses (ISP) on peri-implant bone levels. Additionally, the study aimed to determine a clinically relevant threshold for the radiographic vertical misfit gap at the ISP, when present, and to identify potential risk factors associated with changes in bone levels. Methods: This study involved subjects who received ISPs for tooth replacement therapy. Standardized intraoral periapical radiographs were taken 10 years after loading to assess the radiographic distance between the implant shoulder and the most coronal point of crestal bone (DIB). ISP marginal gaps were categorized as no gap or gap, with vertical dimensions categorized as 0 mm,> 0- < 0.1 mm, and ≥0.1 mm. A multivariable linear mixed-effect model was applied to control for potential confounders. Results: A total of 301 patients and 505 implants with a 10.6 ± 0.7years follow-up were analyzed. ISPs without gaps exhibited statistically significantly lower DIB values (3.22 ± 0.8mm) than those with gaps (3.43 ± 0.6 mm; p = 0.001) . Gaps ≥0.1 mm were associated with statistically significantly higher DIB values (3.45 ± 0.7 mm; p = 0.001) compared with gaps between > 0 and < 0.1 mm (3.36 ± 0.5 mm; p = 0.001), or no gaps (3.22 ± 0.7 mm; p = 0.001). Each increment of 0.1 mm in the vertical crestal gap corresponded to a significant increase in DIB values (0.08 mm; p = 0.03). Finally, smoking and a history of periodontitis were independent risk factors for increased DIB. Conclusions: Marginal misfit of ISP affects peri-implant bone stability, with gaps ≥0.1 mm linked to higher DIB. Smoking and periodontitis are independent risk factors for increased DIB. 1 | Introduction Implant-supported prostheses (ISP) are highly effective in replacing missing teeth, restoring oral function, health, esthetics, and comfort, ultimately improving patients' quality of life (Braun et al. 2025; Buser et al. 2012; Duong et al. 2022; Howe et al. 2019; Raabe et al. 2024). However, the high prevalence of peri-implant diseases and the unpredictability of resolving the condition This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2025 The Author(s). Clinical Oral Implants Research published by John Wiley & Sons Ltd. Clinical Oral Implants Research, 2026; 37:69–78 69 [https://doi.org/10.1111/clr.70053](https://doi.org/10.1111/clr.70053) through non-surgical or surgical therapies remain critical challenges (Apaza-Bedoya et al. 2024; Couso-Queiruga et al. 2024; Diaz et al.

FAQs

What was the main objective of this study?

To evaluate the impact of the marginal fit of implant-supported prostheses on peri-implant bone levels, and to determine a clinically relevant threshold for radiographic vertical misfit gap when present.

How were peri-implant bone levels and misfit gaps assessed?

Standardized intraoral periapical radiographs were taken 10 years after loading to measure the radiographic distance between the implant shoulder and the most coronal point of crestal bone, and gaps were categorized by vertical dimensions.

Which factors were identified as independent risk factors for increased peri-implant bone level changes?

Smoking and a history of periodontitis were independent risk factors for increased radiographic distance (DIB values).

Sep 29, 2026

Uploaded by Cipher