Dual‐Hybrid Treatment Approach for Peri‐Implant Hard and Soft Tissue Stability

OBJECTIVE: Long-term stability of peri-implant hard and soft tissues is a primary goal of implant treatment. Studies have shown that peri-implant tissue stability is influenced by factors such as the implant characteristics, implant-abutment interface, abutment type/length, and prosthetic design. To enhance tissue stability while offering clinical versatility, this case report utilizes a dual-hybrid approach. This combines (1) a hybrid implant surface design, combining a micro-rough and machined surface, and (2) a hybrid connection where one implant connection allows for two different implant-abutment interfaces (matching platform/non-matching with platform switching). CLINICAL CONSIDERATIONS: A patient presented with two posterior teeth deemed "hopeless" due to periodontal and endodontic pathologies. Following extractions, immediate implant placements were performed. Tissue-level implants were placed subcrestally and restored with non-matching abutments. The 3-year follow-up examination showed stable marginal bone levels maintained at the implant shoulder. CONCLUSIONS: This dual-hybrid approach represents an alternative strategy for supporting peri-implant tissue stability. It underscores the importance of versatile implant-abutment connections that preserve tissues while allowing future restorative modifications without compromising the implant. This method retains the option to transition to a matching abutment if clinically indicated in the future, for example if any pathologies lead to changes in the peri-implant tissue levels. CLINICAL SIGNIFICANCE: The presented dual-hybrid approach represents a treatment strategy designed to support peri-implant tissue stability while maintaining the flexibility to transition to a matching abutment when clinically indicated. Given the prevalence of peri-implantitis reported in the literature, treatment concepts that not only aim to reduce the risk of disease onset but also facilitate effective reintervention without compromising the implant are of critical importance.