Abstract：
OBJECTIVE: Marginal bone loss (MBL) occurs in the periapical cervical bone after dental implant placement and abutment connection. MBL may not result in peri-implantitis; however, it is always accompanied by MBL. Recent studies have demonstrated that early MBL is a predictor of peri-implantitis. In this narrative review, we aimed to provide an evidence base for recommended treatment strategies for clinicians to prevent MBL.
METHODS: We reviewed the recent literature and performed a narrative synthesis of the evidence, focusing on available systematic reviews and meta-analyses of implant marginal bone resorption.
RESULTS: The available evidence indicates that certain biological, material, and technical factors can influence MBL and consequently dictate the risk of developing peri-implant disease in later years. The order of the impact of the strength of each factor is unknown. Current recommendations to prevent MBL include controlling patients\' smoking and hemoglobin A1c levels to sufficiently low levels before surgery and throughout their lifetime. Regarding the material, a platform-switching, conical-connecting implant system, and an abutment with a height of at least 2 mm should be selected. Placement should be performed using techniques that ensure sufficient soft tissue (keratinized gingival width > 2 mm, supracrestal tissue height > 3 mm), and non-undersized preparations in the cortical bone should be made with connected concave abutments during primary or secondary surgery. Patients should receive supportive peri-implant therapy during maintenance.
CONCLUSIONS: MBL development is multifactorial and can be reduced by considering the biological, material, and technical factors.
METHODS: We reviewed the recent literature and performed a narrative synthesis of the evidence, focusing on available systematic reviews and meta-analyses of implant marginal bone resorption.
RESULTS: The available evidence indicates that certain biological, material, and technical factors can influence MBL and consequently dictate the risk of developing peri-implant disease in later years. The order of the impact of the strength of each factor is unknown. Current recommendations to prevent MBL include controlling patients\' smoking and hemoglobin A1c levels to sufficiently low levels before surgery and throughout their lifetime. Regarding the material, a platform-switching, conical-connecting implant system, and an abutment with a height of at least 2 mm should be selected. Placement should be performed using techniques that ensure sufficient soft tissue (keratinized gingival width > 2 mm, supracrestal tissue height > 3 mm), and non-undersized preparations in the cortical bone should be made with connected concave abutments during primary or secondary surgery. Patients should receive supportive peri-implant therapy during maintenance.
CONCLUSIONS: MBL development is multifactorial and can be reduced by considering the biological, material, and technical factors.
摘要：
目的：牙种植体放置和基台连接后，颈根尖周骨发生边缘骨丢失（MBL）。MBL可能不会导致种植体周围炎；然而，它总是伴随着MBL。最近的研究表明，早期MBL是种植体周围炎的预测因子。在这篇叙述性评论中，我们旨在为临床医生预防MBL的推荐治疗策略提供证据基础.
方法：我们回顾了最近的文献，并对证据进行了叙述性综合，专注于种植体边缘骨吸收的系统评价和荟萃分析。
结果：现有证据表明，某些生物，材料,和技术因素会影响MBL，因此决定了以后几年发生种植体周围疾病的风险。每个因素的强度的影响顺序是未知的。目前预防MBL的建议包括在手术前和整个生命周期内将患者的吸烟和血红蛋白A1c水平控制在足够低的水平。关于材料,一个平台切换，锥形连接植入系统，应选择高度至少为2mm的基台。应使用确保足够软组织的技术进行放置（角化牙龈宽度>2mm，肌上组织高度>3毫米)，在初次或二次手术中，皮质骨中的非尺寸过小的制剂应与连接的凹形基台一起制成。患者在维持期间应接受支持性种植体周围治疗。
结论：MBL的发展是多因素的，可以通过考虑生物，材料,和技术因素。
方法：我们回顾了最近的文献，并对证据进行了叙述性综合，专注于种植体边缘骨吸收的系统评价和荟萃分析。
结果：现有证据表明，某些生物，材料,和技术因素会影响MBL，因此决定了以后几年发生种植体周围疾病的风险。每个因素的强度的影响顺序是未知的。目前预防MBL的建议包括在手术前和整个生命周期内将患者的吸烟和血红蛋白A1c水平控制在足够低的水平。关于材料,一个平台切换，锥形连接植入系统，应选择高度至少为2mm的基台。应使用确保足够软组织的技术进行放置（角化牙龈宽度>2mm，肌上组织高度>3毫米)，在初次或二次手术中，皮质骨中的非尺寸过小的制剂应与连接的凹形基台一起制成。患者在维持期间应接受支持性种植体周围治疗。
结论：MBL的发展是多因素的，可以通过考虑生物，材料,和技术因素。
