Bone Level Tapered Implants in the Maxillary Esthetic Zone: A 1-Year Prospective Case Series in Healed Sites.

PURPOSE: Bone level tapered implants have an advantage in terms of stability and less need for additional bone augmentation procedures in healed sites, which might be advantageous for the esthetic zone. The aim of this study was to assess the clinical, radiographic, and esthetic performance of bone level tapered implants placed in healed sites in the maxillary esthetic region during a 1-year evaluation period. MATERIALS AND METHODS: Thirty participants (15 male, 15 female) with a single-tooth diastema that had healed without an alveolar ridge preservation procedure received a bone level tapered implant. Buccal bone augmentation procedures were performed at implant placement if the labial bone wall thickness was < 2 mm. A provisional crown was connected after a healing phase of 3 months. A definitive crown was placed 3 months after the provisional restoration. Implant stability, peri-implant soft and hard tissue health, esthetics, and patient-reported outcomes were recorded. RESULTS: All the placed implants demonstrated good stability. A labial bone augmentation technique was needed in 23 of the 30 cases. The median implant stability quotient value was 73 (68;76) at implant placement and had increased to 79 (76;81) when the definitive restoration was inserted (P < .005). All patients were present at the 1-year evaluation, and none had lost an implant. The mean loss of marginal bone was 0.07 ± 0.10 mm. The midbuccal mucosa-level recession was 0.14 ± 0.40 mm. There was an overall gain in papilla height: +0.05 ± 0.60 mm mesially and +0.06 ± 0.53 mm distally. Median values of the pink esthetic score and white esthetic score were 6 (4;7 interquartile range) and 8 (7;8.3 interquartile range), respectively. The participants' mean overall satisfaction was 90.1 ± 6.5 on a visual analog scale. No complications occurred. CONCLUSION: It can be concluded from a 1-year followup that treatment with the bone level tapered implant system resulted in good implant stability, healthy peri-implant soft and hard tissues, satisfying esthetics, and good patient-reported outcomes.

The effect of implant-abutment connections on peri-implant bone levels around single implants in the aesthetic zone: A systematic review and a meta-analysis.

OBJECTIVE: To systematically review literature about the effect of different implant-abutment interface designs on peri-implant bone level changes, implant loss and mid-buccal mucosa changes around single implants in the anterior maxilla. Reviewing three connection configurations: Platform switched conical (PS-conical); Platform switched parallel (PS-parallel); Platform matched parallel (PM-parallel). METHODS: A detailed search was carried out in Pubmed, EMBASE, Cochrane, Scopus, Open Gray and African journals Online (until December 1, 2020) and was restricted to clinical prospective studies of at least 1 year and with at least 10 human participants. A meta regression analysis was carried out primarily on the pooled peri-implant bone level changes followed by implant loss and mid-buccal mucosa level change. Risk of bias was assessed with RoB 2.0 and ROBINS-I. The manuscript complied with the PRISMA guidelines and was registered in the PROSPERO database (ID: 225092). RESULTS: A total of 5513 hits gave 44 eligible articles for the analyses. Bone level change did not differ significantly between the two platform switched connections; their bone loss scores were significantly lower than PM-connection. The PS-conical connections have significantly lower implant losses than the PM connection. Mid-buccal mucosa level change was comparable between the three connection configurations. Moderate to high risk of bias was detected in the included studies. CONCLUSIONS: The performance of PS-conical and PS-parallel connection configurations both favored bone loss scores compared to the PM-parallel connection configuration. All three demonstrated mid-buccal mucosa changes that were small and did not differ significantly amongst the groups.

Alveolar ridge preservation in defect sockets in the maxillary aesthetic zone followed by single-tooth bone level tapered implants with immediate provisionalization: a 1-year prospective case series.

BACKGROUND: Clinical studies of single-tooth replacement in compromised bone using bone level tapered implants in the aesthetic zone are scarce. AIM: To assess clinically, radiographically and aesthetically over 1 year the performance of a bone level tapered implant in the maxillary aesthetic zone in sites after alveolar ridge preservation. MATERIAL AND METHODS: Thirty patients (16 male, 14 female) with a failing tooth and large bone defect after removal received alveolar ridge preservation. After 3 months, implants were placed with immediate provisionalization. Definitive restorations were placed after 3 months. The treatment was evaluated 1 year following the definitive restoration. RESULTS: All the patients attended the 1-year follow-up. One implant was lost (96.7% implant survival rate). The mean implant stability quotient value was 68.9 ± 8.74 at implant placement. The mean marginal bone level change was minor (- 0.07 ± 0.12 mm). The mean mid-buccal mucosa changed with + 0.01 ± 0.45 mm. The median Pink Esthetic Score and White Esthetic Score after 1 year were 6 [4; 7] and 8 [7; 9], respectively. The patients' mean overall satisfaction (0-100 VAS scale) was 86.6 ± 10.3. CONCLUSION: Bone level tapered implants with immediate provisionalization perform well after alveolar ridge preservation in the maxillary aesthetic zone, according to implant stability, clinical, radiographic, aesthetic and patient-centred outcomes. TRIAL REGISTRATION: NTR, NL8755 . Registered on 1 January 2016.

Immediate Placement and Restoration of a New Tapered Implant System in the Aesthetic Region: A Report of Three Cases.

OBJECTIVE: To assess the clinical, radiographic, aesthetic, and patient-centred outcomes of a new implant system applied for an immediate implant placement and restoration approach in single tooth replacement of anterior maxillary teeth. Material and Method. Three cases were treated with a bone level tapered implant. All patients were treated with the same strategy involving flapless extraction and implant placement with simultaneous augmentation. Implants were provisionally restored with a screw-retained restoration at the day of surgery. Definitive restoration was fabricated after 3 months. Follow-up was one year after definitive restoration. RESULTS: At the 1-year follow-up, the implants were stable and no complications had occurred. Peri-implant bone levels had increased with a mean value of 0.24 ± 0.30 mm between definitive restoration placement and 1 year of follow-up. Clinical outcome scores showed healthy soft tissues. Mean Pink and White Esthetic scores were rated 7.0 and 7.3, respectively. Mean patient satisfaction had improved from 55.7 (pretreatment) to 90.0 (1-year follow-up) on a 0-100 VAS scale. CONCLUSION: Immediate implant placement and restoration with the new tapered bone level implant system are accompanied by good initial clinical and radiographic results as well as high patient satisfaction.

Performance of bone-level implants with conical connections in the anterior maxilla: A 5-year prospective cohort study.

OBJECTIVES: To assess clinical, radiographic and aesthetic outcomes, and satisfaction of patients treated with single implant restorations in the maxillary aesthetic region 5 years after final restoration. MATERIAL AND METHODS: Sixty patients (29 male/31 female, mean age 37 years) with a missing anterior tooth in the maxilla (39 central incisors/10 lateral incisors/5 cuspids/6 first premolars) received a bone-level implant with conical connection. In 29 patients, a bone augmentation procedure was necessary before implant placement (autogenous bone grafts mixed with spongiosa granules). All implants (12 with 3.3 mm diameter/ 48 with 4.1 mm diameter) were loaded after 3 months of submerged healing. The restoration consisted of an individually designed full-zirconia abutment veneered with porcelain. Follow-up with clinical and radiographic assessment was conducted until 60 months after the final restoration. Aesthetic outcome of the restoration was determined with the Pink Esthetic Score-White Esthetic Score (PES-WES). Patient satisfaction was assessed with a VAS scale and satisfaction questionnaire. RESULTS: Fifty patients completed the 5-year follow-up. Implant survival was 100%, restoration survival 98%. Mean bone-level change was -0.13 ± 0.66 mm with a median (IQR) pocket probing depth of 2.75 [2.25; 3.25]. The mean PES and WES scores were 6.6 ± 1.7 and 7.8 ± 1.5, respectively. Patient satisfaction was high (92.1 ± 7.8 on 100 mm VAS scale). There were no differences between patients with or without a bone augmentation procedure. CONCLUSION: Bone-level implants with a conical connection are a reliable treatment option in single-tooth replacements in the maxillary aesthetic zone.

Single implants in the aesthetic region preceded by local ridge augmentation; a 10-year randomized controlled trial.

OBJECTIVES: The aim of this randomized controlled trial was to assess the 10-year effects of three different augmentation techniques (augmentation with chin bone, augmentation with chin bone plus a membrane and augmentation with a bone substitute plus a membrane) for implant-supported restorations in the maxillary aesthetic region regarding clinical and radiographic parameters, and patient-centred outcomes. MATERIALS AND METHODS: Ninety-three patients requesting single tooth replacement and presenting with a horizontal bone deficiency were included. After augmentation, 93 implants were placed. Clinical variables, standardized radiographs and photographs and patient questionnaires were analysed to assess the impact of the various augmentation techniques 1 month (T1 ), 12 months (T12 ) and 120 months (T120 ) after final crown placement. RESULTS: 10-years implant survival was 95.7% and did not differ between the groups neither were significant differences observed in the other treatment outcomes assessed. Peri-implant bone loss was low, viz. 0.48 ± 1.19 mm (mesial) and 0.30 ± 1.24 mm (distal) at T120 . Loss of midbuccal marginal gingival level at T120 was 0.32 ± 0.83 mm. Mean overall satisfaction at T120 was 8.6 with 98.6% of the patients satisfied. CONCLUSIONS: Clinical, radiographic, aesthetic and patient centred outcomes were very favourable after 10 years and did not differ between the groups with different bone augmentation techniques.