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P e r i i m p l a n t s o f t - t i s s u e a n d b o n e l e v e l s w i t h d i f f e r e n t i m p l a n t n e c k d e s i g n s Most of the studies measured bone loss from the start of prosthetic loading to the end of follow- up, except Nickenig et al., who measured loss from the time of placement of the implants.14 They compared smooth and rough implants for restoring missing mandibular molars. In their study, for smooth implants, bone loss pro- gressed from 0.5 mm in the healing period to 1.1, 1.3 and 1.4 mm in the second, third and fifth year of follow-up, respectively. In contrast, for the rough-surfaced, microthreaded implants, bone loss progressed from 0.1 mm in the healing period to 0.5, 0.6 and 0.7 mm in the second, third and fifth year of follow-up, respectively. They found a significant difference in bone level changes, suggesting that rough-surfaced, microthreaded implants more effectively mini- mized overall marginal bone loss than machined- neck implants did, particularly during the heal- ing period. Even if some studies have shown less mar- ginal bone loss around implants with a rough neck, these implants favor bacterial plaque retention when exposed to the oral environment, and this in turn would imply an increased risk of periimplant disease such as mucositis or periim- plantits.40, 41 The relatively smooth implant neck allows the least accumulation of plaque18, 19 and is designed as a transmucosal component, thus making the microgap or interface between implant and restoration easily accessible for oral hygiene.21 Taking into account the results, it is neces- sary to highlight the limitations of the present study. Sample size and the lack of randomization could limit generalization of the results. Further studies with a larger sample are needed to clar- ify the influence of implant neck design on periimplant tissue health and periimplant bone remodeling after medium- to long-term func- tional loading. Conclusion According to the results of the present study, the implant neck designs and neck surface treat- ments did not significantly influence periimplant tissue health and radiographic bone loss after 3 years of follow-up. Competing interests The authors declare that they have no compet- ing interests. References 1. Albrektsson T, Zarb G, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. → Int J Oral Maxillofac Implants. 1986 Summer;1(1):11–25. 5. Bratu EA, Tandlich M, Shapira L. A rough surface implant neck with microthreads reduces the amount of marginal bone loss: a prospective clinical study. → Clin Oral Implants Res. 2009 Aug;20(8):827–32. 9. Esposito M, Hirsch JM, Lekholm U, Thomsen P. Biological factors contributing to failures of osseointegrated oral implants. (II). Etiopathogenesis. → Eur J Oral Sci. 1998 Jun;106(3):721–64. 12. Shin YK, Han CH, Heo SJ, Kim S, Chun HJ. Radiographic evaluation of marginal bone level around implants with different neck designs after 1 year. → Int J Oral Maxillofac Implants. 2006 Sep–Oct;21(5):789–94. 2. Lee DW, Choi YS, Park KH, Kim CS, Moon IS. Effect of microthread on the maintenance of marginal bone level: a 3-year prospective study. → Clin Oral Implants Res. 2007 Aug;18(4):465–70. 3. Manz MC. Factors associated with radiographic vertical bone loss around implants placed in a clinical study. → Ann Periodontol. 2000 Dec;5(1):137–51. 4. Spray JR, Black CG, Morris HF, Ochi S. The influence of bone thickness on facial marginal bone response: stage 1 placement through stage 2 uncovering. → Ann Periodontol. 2000 Dec;5(1):119–28. 6. Hartman GA, Cochran DL. Initial implant position determines the magnitude of crestal bone remodeling. → J Periodontol. 2004 Apr;75(4):572–7. 7. Oh TJ, Yoon J, Misch CE, Wang HL. The causes of early implant bone loss: myth or science? → J Periodontol. 2002 Mar;73(3):322–33. 8. Kronström M, Svenson B, Hellman M, Persson GR. Early implant failures in patients treated with Brånemark System titanium dental implants: a retrospective study. → Int J Oral Maxillofac Implants. 2001 Mar–Apr;16(2):201–7. 10. Misch CE, Perel ML, Wang HL, Sammartino G, Galindo-Moreno P, Trisi P, Steigmann M, Rebaudi A, Palti A, Pikos MA, Schwartz- Arad D, Choukroun J, Gutierrez-Perez JL, Marenzi G, Valavanis DK. Implant success, survival, and failure: the International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference. → Implant Dent. 2008 Mar;17(1):5–15. 11. Lang NP, Jepsen S; Working Group 4. Implant surfaces and design (Working Group 4). → Clin Oral Implants Res. 2009 Sep;20 Suppl 4:228–31. 13. Nickenig HJ, Wichmann M, Schlegel KA, Nkenke E, Eitner S. Radiographic evaluation of marginal bone levels adjacent to parallel-screw cylinder machined-neck implants and rough-surfaced microthrea- ded implants using digitized panoramic radiographs. → Clin Oral Implants Res. 2009 Jun;20(6):550–4. 14. Nickenig HJ, Wichmann M, Happe A, Zöller JE, Eitner S. A 5-year prospective radiographic evaluation of marginal bone levels adjacent to parallel-screw cylinder machined-neck implants and rough- surfaced microthreaded implants using digitized panoramic radiographs. → J Craniomaxillofac Surg. 2013 Oct;41(7):564–8. 22 Volume 3 | Issue 4/2017 Journal of Oral Science & Rehabilitation