Clinical and Biological Effects of Horizontal and Vertical Preparations (BOPT) in Fixed Prostheses.

Abstract

Introduction: Oral preparation in fixed partial prostheses plays an important role in periodontal health and in the development of aesthetic and functional outcomes. Although horizontal preparation methods (chamfer/shoulder) are typically used in posterior regions for tooth preparation, more severe alterations in oral health may occur at the subgingival (equigingival) or gingival level, such as inflammation and gingival recession. Additionally, the Biologically Oriented Preparation Technique (BOPT) proposed by Loi and Di Felice introduces a vertical preparation method without a defined finishing line, allowing progressive tissue adaptation through provisional restoration. The aim of this study was to compare the clinical and biological effects of horizontal and BOPT vertical preparation methods in fixed prostheses regarding clinical outcomes. Methodology: This study is based on scientific literature published between 2022 and 2025, obtaining 81 results. After applying inclusion and exclusion criteria, 15 scientific articles that met the study parameters were selected. Results: This showed that BOPT provides greater gingival margin stability, thickening of the gingival phenotype, and improved long-term aesthetic response compared with horizontal preparation techniques, particularly in aesthetic areas. The clinical success rate exceeds 96% in long-term follow-up studies, with low rates of recession, inflammation, and clinical attachment loss. Discussion: Despite the advantages provided by BOPT, it remains a delicate technique that depends on previous learning experience, gingival phenotype, and a correct preparation and rehabilitation protocol. BOPT is a safe, viable, and biologically stable treatment for prosthetic rehabilitation, positioning itself as a conservative technique with predictable long-term aesthetic and periodontal outcomes.