Assessment of short dental implants restored with single-unit nonsplinted restorations.

OBJECTIVES: To investigate the survival rate of short (≤9 mm) implants restored with single-unit, nonsplinted crowns after an average follow-up of 37 months (21-94 months). MATERIALS AND METHODS: Two hundred and twenty-one implants placed in 168 patients (74 men, 94 women, aged 34-87 years, mean = 61 years). Implant lengths were 6 (n = 16), 8 (n = 166), 8.5 (n = 2), or 9 mm (n = 34). The implant diameters ranged from 3.7 to 5.6 mm. Implants were placed in the maxillary (n = 44) and mandibular arches (n = 176). RESULTS: Survival rate was 94.1% (maxilla [88.6%] and mandible [96.0%]) and 12 early failures (first 4 months) and 1 late failure (4.5 years in the maxillary molar region) observed. Of the 12 early failures, 4 were in the maxilla (2 premolars and 2 molars) and 8 in the mandible (2 premolars and 6 molars). The early failures were 11 implants of 8 mm long and a 9-mm implant. Smoking cigarettes, diabetes mellitus, and bone augmentation procedures were not associated with implant failure significantly (P > 0.05). CONCLUSIONS: Survival rate of short implants restored with single-unit, nonsplinted restorations over an average period of 37 months was favorable and comparable with longer implants.

An analysis of the decision-making process for single implant treatment in general practice.

PURPOSE: To study the frequency of and factors associated with the decision to perform single implant treatment after tooth extraction by general practitioners in a private, fee-for-service setting. MATERIAL AND METHODS: One hundred practitioners with a general dental practice in Ghent were randomly selected. Clinicians were asked to fill in a study form for every single extraction they performed during an 8-week period. The form related to the treatment decision and a number of patient- and clinician-related factors. RESULTS: Ninety-four general dentists (52 men, 42 women; mean age 49; range 24-68) agreed to participate and extracted 1180 single teeth. After exclusion of third molars and cases where the reason for tooth loss would generally prohibit replacement, 900 cases were identified. In 24% of these patients, there was no treatment decision and in 18% replacement was deemed unnecessary. When replacement was necessary (n = 526), removable partial denture (RPD), fixed partial denture (FPD), single implant treatment and resin-bonded bridge were chosen in 54%, 24%, 21% and 1% of the patients, respectively. Multinomial logistic regression was used to evaluate the decision-making process for single implant treatment against RPD and FPD. In relation to RPD, single implant treatment was more likely in highly educated patients with few missing teeth and no bone loss at adjacent teeth. In relation to FPD, single implant treatment was more likely in patients with intact adjacent teeth and when the tooth was extracted by a female dentist. Experience in implant prosthetics was positively associated with single implant treatment in all analyses. CONCLUSIONS: Single implant treatment is not the most common procedure in daily practice to restore a single tooth gap. Patient's education, oral factors and clinician-related factors may affect the decision-making process, whereas medical factors may not.

Success rate of immediate implants placed and restored by novice operators.

AIMS: The primary aim of this study was to evaluate the 1-year crestal bone loss and success rate of an immediately placed single-stage implant placed and restored by novice operators. A secondary aim was to determine the patient's assessment of the appearance of the final restoration. METHODS: Fifty-one patients received a tooth extraction and placement of at least 1 immediate implant by a Graduate Periodontics resident. Clinical and radiographic measurements were taken at the surgical, 4-month, and 1-year follow-up visits. After at least 3 months healing, dental students restored the implants with either a crown or an overdenture. Patient satisfaction was assessed using 5 categories: excellent, very good, good, fair, or poor. RESULTS: Sixty-two immediate implants were placed. The success rate was 100% at the 12-month visit and was subclassified as grade 3 because of the mean first year bone loss of 1.3 +/- 1.0 mm. Using the 2008 classification of Misch et al, 42 implants were classified as success optimum health, 19 as survival satisfactory health, and 1 as survival compromised health. Radiographic bone loss was stratified by implant platform position relative to the alveolar crest and changed from time 0 to time 12 by -1.0 +/- 1.2 mm for the supracrestal group (n = 25, P < 0.05), -1.5 +/- 0.9 mm for the crestal group (n = 31, P < 0.05), and -1.3 +/- 1.2 mm for the subcrestal group (n = 6, P < 0.05). The supracrestal group had significantly less bone loss than either the crestal or the subcrestal group (P < 0.05). The appearance of the final restoration at 1 year was rated excellent by 82% of patients, very good by 16%, and good by 2%. CONCLUSIONS: Immediate implant placement by novice operators using routine dental school procedures was a highly predictable procedure as indicated by the 100% success rate at 12 months. Most patients rated the restoration appearance as excellent.

Dental dilemmas: Endodontics or dental implants?

UNLABELLED: This narrative review explores treatment planning options in restorative dentistry. The growth of dental implants, as an accessible and predictable treatment option, gives practitioners a useful tool for managing the missing tooth or teeth with a hopeless prognosis. Traditionally, endodontics and fixed prosthodontics have been used to restore teeth and spaces where the outlook for such treatment appears reasonable. Practitioners may, however, question the predictability and cost effectiveness of such an approach where, at times, it might appear that replacement of a compromised tooth with a dental implant could be a more predictable option. The evidence base for these treatment options is explored and discussed, and suggestions are made for future management strategies. CLINICAL RELEVANCE: A clear knowledge and understanding of the scientific literature for implants and endodontic treatment is necessary if practitioners are to make an evidence-based approach when treatment planning these modalities for their patients. This is particularly true in cases where there may appear to be a reasonable choice between the two of these.

Assessment of Peri-Implant Soft Tissues Conditions around Short and Ultra-Short Implant-Supported Single Crowns: A 3-Year Retrospective Study on Periodontally Healthy Patients and Patients with a History of Periodontal Disease.

The aim of this retrospective study was to evaluate implant survival, marginal bone loss and peri-implant complications in 326 short and ultra-short implants. Implants were placed in the maxillary and mandibular posterior regions of 140 patients with (PP) and without (NPP) a history of periodontal disease. Clinical and radiographic examinations were performed at 3-year recall appointments. The 8.0, 6.0 and 5.0 mm-length implants placed in PP and NPP were respectively 43.75% and 38.46%, 35.10% and 34.19%, 21.15% and 27.35%; 325 implants (one early failure) were rehabilitated with single crowns in 139 patients. Overall implant survival after 3 years of follow-up was 97.55%, 98.08% and 96.61% for PP and NPP (p = 0.46). Crestal bone level variations were not statistically different among PP and NPP; 15.41% of implants presented signs of mucositis, 14.71% and 16.67% in PP and NPP (p = 0.64). Setting the threshold for bone loss at 2 mm after 36 months, peri-implantitis prevalence was 2.2%, 1.96% and 2.63% in PP and NPP (p = 0.7). Overall implant success was 82.39%, 83.33% and 80.7% for PP and NPP (p = 0.55). Short-term outcomes suggest that short and ultra-short locking-taper implants can successfully be restored with single crowns in the posterior jaws both in PP and NPP.

Posterior implant single-tooth replacement and status of adjacent teeth during a 10-year period: a retrospective report.

BACKGROUND: The purpose of this case series study was to evaluate posterior single-tooth implant survival and the long-term conditions of the adjacent teeth. METHODS: A retrospective evaluation of 1,162 consecutive patients with a single missing posterior tooth treated with 1,377 external hex implants supporting 1,365 restorations surrounded by natural teeth over a 1- to 10-year period was reviewed from four private offices. Implant survival data were collected relative to stage I to stage II healing, stage II to prosthesis delivery, and prosthesis delivery to up to 10 years of follow-up. Long-term adjacent tooth conditions were assessed, including decay, endodontic therapy (root canal therapy [RCT]), and/or extraction during the follow-up period. RESULTS: Of the 1,377 implants inserted, there were 11 surgical failures from stage I to stage II healing. There was one failure from stage II healing to prosthesis delivery. There were two prosthetic-phase failures. The surgical success rate was 99.2%, whereas the overall survival rate was 98.9% at an average of 61 months of follow-up (range, 12 to 125 months). A total of 2,589 adjacent teeth were followed during the study. No natural adjacent tooth was lost during this period. Interproximal decay developed in 129 adjacent teeth (5%), and nine adjacent teeth required RCT (0.4%) as a result of decay or restoration. CONCLUSIONS: The use of single-tooth implants as replacements for posterior missing teeth is a viable long-term treatment. Adjacent natural teeth complications are minimal for as long as 10 years after implant insertion.

A retrospective analysis of patients referred for implant placement to a specialty clinic: indications, surgical procedures, and early failures.

PURPOSE: This retrospective study analyzed the pool of patients referred for treatment with dental implants over a 3-year period in a referral specialty clinic. MATERIALS AND METHODS: All patients receiving dental implants between 2002 and 2004 in the Department of Oral Surgery and Stomatology, University of Bern, were included in this retrospective study. Patients were analyzed according to age, gender, indications for implant therapy, location of implants, and type and length of implants placed. A cumulative logistic regression analysis was performed to identify and analyze potential risk factors for complications or failures. RESULTS: A total of 1,206 patients received 1,817 dental implants. The group comprised 573 men and 633 women with a mean age of 55.2 years. Almost 60% of patients were age 50 or older. The most frequent indication for implant therapy was single-tooth replacement in the maxilla (522 implants or 28.7%). A total of 726 implants (40%) were inserted in the esthetically demanding region of the anterior maxilla. For 939 implants (51.7%), additional bone-augmentation procedures were required. Of these, ridge augmentation with guided bone regeneration was performed more frequently than sinus grafting. Thirteen complications leading to early failures were recorded, resulting in an early failure rate of 0.7%. The regression analysis failed to identify statistically significant failure etiologies for the variables assessed. CONCLUSIONS: From this study it can be concluded that patients referred to a specialty clinic for implant placement were more likely to be partially edentulous and over 50 years old. Single-tooth replacement was the most frequent indication (> 50%). Similarly, additional bone augmentation was indicated in more than 50% of cases. Adhering to strict patient selection criteria and a standardized surgical protocol, an early failure rate of 0.7% was experienced in this study population.

The effect of single tooth implant restorations on the survival, morbidity, pulpal, and periapical health of adjacent teeth: A chart review.

PURPOSE: To determine whether the placement and restoration of a single tooth posterior implant affects the survival, morbidity, pulpal, and periapical health of adjacent natural teeth. MATERIALS AND METHODS: A retrospective chart review identified patients who received single posterior tooth implants between August 2004 and July 2015 at the UNC SOD and met the study inclusion criteria. Preoperative and postoperative records were reviewed; survival and changes in coronal, pulpal, and periapical status of teeth adjacent to the implant and contralateral tooth were recorded. Dichotomous survival, restoration, and retreatment outcomes were analyzed using conditional logistic regression with patient as strata and implant versus control as the predictor. Exact odds ratio estimates and the 95% confidence intervals were obtained for the relationship of implant versus control side and outcomes. RESULTS: Five hundred and fifty-five sites with follow-up time averaging 5 years ± 30.8 months were reviewed. Teeth adjacent to implants had 1.75 (95% CI: 1.17, 2.64) times the odds of restorative retreatments as compared to controls (P = .005). On the implant side, 48 adjacent teeth (4.5%) were more heavily restored at follow up, while 84 (7.9%) experienced retreatment with comparable number of surfaces restored. On the contralateral side, 54 adjacent teeth (5.0%) were more heavily restored, and 56 (5.2%) experienced comparable levels of retreatment. In addition, 17 (1.7%) implant adjacent teeth required root canal treatment, compared to 12 (1.2%) on the contralateral side; 1 implant adjacent tooth required root canal retreatment. Forty-two teeth (3.8%) adjacent to implants were lost, compared to 35 (3.2%) adjacent to natural teeth. CONCLUSIONS: The incidence for restorative retreatment was significantly higher on teeth adjacent to implant restorations as compared to the contralateral controls. There were no significant differences in the survival, morbidity, pulpal, or periapical health of teeth adjacent to single tooth implants compared to those adjacent to the contralateral natural tooth.

Do longer implants improve clinical outcome in immediate loading?

It is generally believed that longer implants (length >13 mm) have higher success rates than standard implants (length=13 mm). Few reports focus on long implants and none specifically address the clinical outcome of immediate loading (IL) of longer implants. This retrospective study was performed to compare the clinical outcomes of long and standard length implants. A total of 244 standard and 536 long implants were inserted and immediately loaded. The mean follow-up was 3 years. Only 4 of 780 implants (99.5%) were lost, and these 4 were all 13 mm long. No or reduced marginal bone loss was taken as an additional indicator of success to evaluate the effect of several factors on clinical outcome. Only 4 of the 244 13-mm-long implants were lost (98%), but this was statistically different from the survival rate of longer implants. Poor quality bone was related to increased marginal bone loss and thus a worse outcome in both groups. IL standard length implants have a high survival rate, but it is statistically worse than that of IL longer implants. Standard or longer implants are reliable devices for insertion in poor quality bone, although slightly higher bone resorption is to be expected.

A retrospective evaluation of 1,387 single-tooth implants: a 6-year follow-up.

BACKGROUND: The aim of this study was to evaluate the overall survival rate and factors that affect the clinical outcome of 1,387 consecutively placed implant-supported single restorations up to 6 years. METHODS: During 6 years (1999 to 2005), 1,387 implants were placed in 1,215 subjects (1,073 males and 142 females) who required single-tooth replacements. The average time from implant placement was 2.7 +/- 3.27 years. Implants were mostly placed in the maxillary premolar area (39.5%) followed by the anterior maxillary area (28.7%). Implant survival and location, need for bone augmentation, and implant dimensions were recorded and analyzed. RESULTS: Failed implants totaled 96, resulting in an overall survival rate of 93.1%. The vast majority of failures (94.8%) occurred during the first year following implant placement. Bone augmentation was performed in 9.7% of the implants with a 92.5% survival rate, similar to the survival rate of non-augmented areas (93.1%; P = 0.79). The average implant length was 13.3 mm, ranging from 8 to 16 mm. Longer implants (> or =11 mm) showed similar survival rates as implants <11 mm (93.2% versus 90.2%, respectively; P = 0.4). Implant width ranged between 3.25 to 5 mm (mean 3.9), with no effect on implant survival (P = 0.43). There was a significant difference in implant survival according to the anatomic zone of implant placement (P = 0.0075). The maxillary premolar area showed the highest survival rate (96.2%). CONCLUSION: Implant-supported single-tooth replacement is a predictable procedure with good survival rates up to 6 years.

Retrospective cross sectional comparison of initial nonsurgical endodontic treatment and single-tooth implants.

Initial root canal treatment and the replacement of a single tooth with implants are both viable treatment options, but various success rates have been reported for each treatment modality. This study compared 196 implant restorations and 196 matched initial nonsurgical root canal treatment (NSRCT) teeth in patients for four possible outcomes- success, survival, survival with subsequent treatment intervention and failure. Cross classifications/tabulations were analyzed using Pearson's chi(2) test for association of the two classifications (endo vs. implant and outcome). Polytomous regression with likelihood ratio tests were used in testing association with tooth location and outcome. Outcomes were as follows for implants and NSRCT outcomes, respectively: success 73.5% and 82.1%; survival with no intervention 2.6% and 8.2%; survival with intervention 17.9% and 3.6%; and failure 6.1% and 6.1%. Location of the restoration in the mouth did not affect outcome. This study suggests that restored endodontically treated teeth and single-tooth implant restorations have similar failure rates, although the implant group showed a longer average and median time to function and a higher incidence of postoperative complications requiring subsequent treatment intervention.

The Up-to-14-Year Survival and Complication Burden of 256 TiUnite Implants Supporting One-Piece Cast Abutment/Metal-Ceramic Implant-Supported Single Crowns.

PURPOSE: To assess the estimated cumulative survival (ECS) and explore the technical and biologic complications of 256 TiUnite implants (Nobel Biocare) supporting one-piece cast abutment/metal-ceramic implant-supported single crowns (ISCs) in situ for up to 14 years. MATERIALS AND METHODS: A prospective sequentially recruited cohort of 207 patients received 256 metal-ceramic ISCs on TiUnite implants between 2001 and 2014. All but 24 patients with 27 crowns were clinically evaluated between January 2014 and April 2015 in conjunction with or in addition to their tailored maintenance program. Radiographs were obtained, and any previously recorded treatments associated with the crowns were tabulated. The ECS and standard errors were calculated with the life table actuarial method and Greenwood's formula, respectively. The log rank test was applied to assess differences between anterior and posterior crowns. Complication incidence, severity, and economic burden, measured in time/cost accounting units (TAUs), were tallied and compared descriptively. Independent groups were compared with the Mann-Whitney U test and related groups with the Wilcoxon Signed Rank Test. RESULTS: The mean clinical service time of the crowns was 5.61 years (44 ≥ 10 years). The 14-year ECS was 95.95% ± 3.20% with no significant difference between anterior and posterior prostheses. Only seven implants lost marginal bone ≥ one thread from the time of crown insertion. There were 30 nonterminal complications (16 biologic, 14 mechanical). The associated economic burden was low (n = 35 TAUs). CONCLUSION: High gold-alloy one-piece cast abutment/metal-ceramic ISCs on TiUnite implants exhibited excellent longevity and few complications over 14 years.

Oral health-related quality of life and implant therapy: A prospective multicenter study of preoperative, intermediate, and posttreatment assessment.

PURPOSE: Loss of teeth is associated with a significant reduction in quality of life. The aim of this prospective multicenter study was to assess the impact of dental implants on oral health-related quality of life (OHRQoL). MATERIAL AND METHODS: Patients with various kinds of indications for dental implants ranging from single-tooth loss to edentulous jaws were included. Quality of life related to dental implants was assessed through the Oral Health Impact Profile (OHIP-G 21), which has a score from 0 to 20 in healthy patients. RESULTS: In total, 8689 patients from 17 centers from 2009 to 2014 were enrolled in the study. The sex distribution was almost even (53.3% men, 46.7% women). The most frequent indications for the insertion of dental implants were free-end gaps (30.6%) and posterior single-tooth gaps (27%). In all, 12.4% of patients had an edentulous jaw. For all indications, patients reported significant changes in mean OHIP scores after prosthetic reconstruction. The most significant improvements in the OHIP score occurred in the groups of patients with edentulous jaws (pretreatment score: 42.3) after prosthodontic reconstruction (score: 24.8) and in the patient group with an anterior single-tooth gap (pretreatment score: 36.4) after prosthodontic reconstruction (score: 24.8). CONCLUSION: The insertion of dental implants and prosthodontic rehabilitation led to an improved OHRQoL for patients with all indications for dental implants, with the most significant improvements in patients with edentulous jaws and anterior single-tooth gaps.

Effectiveness of Implant Therapy Analyzed in a Swedish Population: Prevalence of Peri-implantitis.

Peri-implantitis is an inflammatory disease affecting soft and hard tissues surrounding dental implants. As the global number of individuals that undergo restorative therapy through dental implants increases, peri-implantitis is considered as a major and growing problem in dentistry. A randomly selected sample of 588 patients who all had received implant-supported therapy 9 y earlier was clinically and radiographically examined. Prevalence of peri-implantitis was assessed and risk indicators were identified by multilevel regression analysis. Forty-five percent of all patients presented with peri-implantitis (bleeding on probing/suppuration and bone loss >0.5 mm). Moderate/severe peri-implantitis (bleeding on probing/suppuration and bone loss >2 mm) was diagnosed in 14.5%. Patients with periodontitis and with ≥4 implants, as well as implants of certain brands and prosthetic therapy delivered by general practitioners, exhibited higher odds ratios for moderate/severe peri-implantitis. Similarly, higher odds ratios were identified for implants installed in the mandible and with crown restoration margins positioned ≤1.5 mm from the crestal bone at baseline. It is suggested that peri-implantitis is a common condition and that several patient- and implant-related factors influence the risk for moderate/severe peri-implantitis (ClinicalTrials.gov NCT01825772).

Interdisciplinary index of prosthodontic/substitution orthodontic treatment need for patients with missing teeth.

The need for treatment in cases of missing teeth may result from aesthetic demands or functional impairment, although tooth loss itself does not necessarily constitute a need for prosthetic replacement. In selected cases, restorative treatment can be replaced by tooth autotransplantation or substitution orthodontic treatment. The authors have tried to make an index based not on missing particular teeth, but on the presence of spacing requiring restoration. An attempt has been made to categorize the restorative treatment need. Orthodontic treatment was considered, when it could completely eliminate the need for prosthetic treatment. The proposed classification could be used for assessing eligibility for public refund of restorative or substitution orthodontic treatment, as well as to motivate the patients to have restorations. It should be an individual approach-based decision, which treatment: orthodontic substitution tooth movement or prosthodontic is more cost-effective for the rest of the patient's life.

Survival rates and complication types for single implants provided at the Melbourne Dental School.

BACKGROUND: Single implants and implant-supported single crowns (ISSCs) have become popular treatment modalities for single tooth replacement. Studies have identified high implant survival rates, but also many complications. The aim of this five-year retrospective study was to assess the survival rates, complication types and occurrences for single implants and ISSCs at the Melbourne Dental School (MDS) in Victoria, Australia. METHODS: A search of the Royal Dental Hospital of Melbourne (RDHM) database was conducted for data on all implant treatment and reported complications during the period between 1 January 2005 and 31 December 2009. Complications were categorized into surgical, biological and restorative types. RESULTS: A total of 622 implant fixtures and 444 ISSCs were inserted into 406 patients. Seventeen implants failed during the mean follow-up time of 2.18 years, yielding a 2.7% failure rate and an estimated one- and five-year survival rate of 98.8% and 93.9%, respectively. The cumulative surgical, biological and restorative complication incidences were 11.9%, 17.6% and 14.1%, respectively. CONCLUSIONS: This study confirmed that single tooth replacement using implant therapy within a teaching environment had a high survival rate. However, complications frequently occurred. This article only provides a descriptive analysis. Correlation analysis between variables would provide greater insight into the causes of complications.

An Up-to-15-Year Comparison of the Survival and Complication Burden of Three-Unit Tooth-Supported Fixed Dental Prostheses and Implant-Supported Single Crowns.

PURPOSE: To assess and compare the outcomes and economic complication burden of three-unit tooth-supported fixed dental prostheses (TFDPs) and implant-supported single crowns (ISCs) provided to a sequential cohort in a specialist prosthodontic practice over a 15-year period. MATERIALS AND METHODS: Sequential patients requiring replacement of a single missing tooth between 1996 and 2010 with a metal-ceramic three-unit TFDP (n = 145 patients, n = 174 prostheses) or ISC (n = 174 patients, n = 220 prostheses) were included. Prostheses subjectively judged at insertion to have an unfavorable 10-year prognosis (17 TFDPs, 0 ISCs) were removed from statistical analyses. The estimated cumulative survival (ECS) was calculated with the life table actuarial method and standard errors calculated with the Greenwood formula. Differences in outcomes between all prostheses and those replacing only anterior or only posterior teeth were assessed with the log rank test. Complication incidence, severity, and economic burden, measured in time/cost accounting units (TAUs), were tallied and compared descriptively. RESULTS: The 15-year ECS did not differ for 112 TFDPs (92.75% ± 3.28%) and 81 ISCs (95.95% ± 2.92%) replacing posterior teeth. However, the 15-year ECS was significantly greater for 139 ISCs (93.33% ± 6.44%) than for 45 TFDPs (82.82% ± 6.50%) replacing anterior teeth. The economic burden of nonterminal complications for both prostheses was low (mean = 0.3 and 0.2 TAUs per prosthesis for TFDPs and ISCs, respectively). This equated to 3 TAUs/100 years in clinical service and 4 TAUs/100 years in clinical service for the TFDPs and ISCs, respectively. CONCLUSION: The survival of three-unit TFDPs and ISCs over 15 years was not statistically different when replacing posterior teeth, but ISCs survived significantly better when replacing anterior teeth. The complication rates of the TFDPs and ISCs were similar, but the economic burden for the TFDPs was greater.

Osseointegrated implant for single-tooth replacement: a retrospective multicenter study on routine use in private practice.

BACKGROUND: Implant restorations first started with total edentulism. Later, the scientific community gave its approval for restorations in partial edentulism, and only recently some studies confirmed the validity of the treatment for single-tooth replacement. PURPOSE: The purpose of the study was to evaluate implant survival and prosthesis stability of Brånemark implants (titanium screws) when used routinely for single-tooth replacement in all regions. MATERIALS AND METHODS: Two hundred and fourteen patients received 252 implants for single-tooth replacement over a period of 8 years at five private clinics in Italy. The patients were treated in accordance with the protocol for Brånemark implants, and the data gathered have been analyzed according to established evaluation methods. RESULTS: During the observation period, 10 failures were recorded and 229 restorations were carried out. After the first year of loading, the total cumulative survival rate (CSR) was 96%, which then remained stable over the study time. The most frequent complication was loosening of the abutment screws (n = 22), amounting to 35% of all of the complications. This problem was related mainly to earlier types of abutments, whereas the more recent design, CeraOne abutment, showed a low frequency of screw loosening. CONCLUSIONS: The high survival rate, which is similar to that presented for prospective multicenter studies for single-tooth restorations with Brånemark implants, led to the conclusion that the use of this treatment modality is a reliable treatment for routine use in all oral regions.